PNHP

Dr. Chaoulli's private clinic waiting room death

Dr. Chaoulli's private clinic waiting room death

Waiting-room death triggers review of Quebec private clinic rules

Canadian Medicine
April 22, 2009
Quebec coroner Catherine Rudel-Tessier’s report released today on the death of Jean-Jacques Sauvageau, who died January 11, 2008, in the waiting room of a private Montreal urgent-care clinic, demands that the Collège des médecins du Québec refine its regulations on such clinics to better protect patients.
Ms Rudel-Tessier said the 2007 Collège guidelines on private clinic administration should be “more precise” on certain points and must help administrators “offer a safe environment to their patients and permit them to adequately deal with emergencies.”
The Collège’s president and CEO, Dr Yves Lamontagne, said the guidelines would be either revised or replaced, depending on the results of the Collège’s investigation of the incident. He said he expects two new measures will be incorporated into the guidelines. “One, every physician or nurse working in that type of clinic should follow a course on cardiopulmonary resuscitation. And two, all clinics should have equipment — a defibrillator.”
Ms Rudel-Tessier also recommended that the Collège investigate the doctor or doctors who attended to Mr Sauvageau.
Dr Jacques Chaoulli — the same crusading Jacques Chaoulli whose high-profile 2005 Supreme Court case against the government of Quebec forced the province to overturn some of its restrictions on private health insurance — examined Mr Sauvageau minutes after he stopped breathing and decided not to attempt resuscitation, instead leaving Mr Sauvageau’s body in his waiting room seat until an ambulance arrived. An autopsy later revealed that Mr Sauvageau died of massive bilateral pulmonary embolisms and would not have been saved by resuscitation but Ms Rudel-Tessier concluded that Dr Chaoulli could not have known that at the time and should have tried to save Mr Sauvageau.
http://canadianmedicine.blogspot.com/2009/04/waiting-room-death-triggers-review-of.html
Rapport d’enquête sur LE DÉCÈS DE M. JEAN-JACQUES SAUVAGEAU
http://qgov.newswire.ca/gouvqc/communiques/GPQF/Avril2009/22/c4034.html?slang=en

In the Canadian Supreme Court case of Chaoulli v. Quebec, Justice Deschamps wrote, “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”
This decision has resulted in intense efforts to privatize both the Canadian health insurance system and the Canadian health care delivery system. The outspoken proponents of privatization would have you believe that only the private sector is capable of saving lives that would be lost by neglect in the public sector.
Dr. Chaoulli’s patient did not die while on a waiting list for an elective orthopedic procedure. He collapsed and died in Dr. Chaoulli’s private waiting room. Dr. Chaoulli withheld cardiopulmonary resuscitation – a standard of care that surely would have been provided in any public health care facility – with questions over whether or not he had adequately trained staff and appropriate equipment to initiate such care. Dr. Chaoulli then asked his nurse to call 911 (to have the body removed), and he returned to his work. Only after the ambulance team arrived was cardiopulmonary resuscitation instituted.
The lesson of the tragic death of Jean-Jacques Sauvageau is simply that Crusader Dr. Jacques Chaoulli and the other privatizers have no credibility when they claim that the private system has a special capability of saving lives that the public system lacks.

Dr. Chaoulli's private clinic waiting room death

Waiting-room death triggers review of Quebec private clinic rules

Canadian Medicine
April 22, 2009

Quebec coroner Catherine Rudel-Tessier’s report released today on the death of Jean-Jacques Sauvageau, who died January 11, 2008, in the waiting room of a private Montreal urgent-care clinic, demands that the Collège des médecins du Québec refine its regulations on such clinics to better protect patients.

Ms Rudel-Tessier said the 2007 Collège guidelines on private clinic administration should be “more precise” on certain points and must help administrators “offer a safe environment to their patients and permit them to adequately deal with emergencies.”

The Collège’s president and CEO, Dr Yves Lamontagne, said the guidelines would be either revised or replaced, depending on the results of the Collège’s investigation of the incident. He said he expects two new measures will be incorporated into the guidelines. “One, every physician or nurse working in that type of clinic should follow a course on cardiopulmonary resuscitation. And two, all clinics should have equipment — a defibrillator.”

Ms Rudel-Tessier also recommended that the Collège investigate the doctor or doctors who attended to Mr Sauvageau.

Dr Jacques Chaoulli — the same crusading Jacques Chaoulli whose high-profile 2005 Supreme Court case against the government of Quebec forced the province to overturn some of its restrictions on private health insurance — examined Mr Sauvageau minutes after he stopped breathing and decided not to attempt resuscitation, instead leaving Mr Sauvageau’s body in his waiting room seat until an ambulance arrived. An autopsy later revealed that Mr Sauvageau died of massive bilateral pulmonary embolisms and would not have been saved by resuscitation but Ms Rudel-Tessier concluded that Dr Chaoulli could not have known that at the time and should have tried to save Mr Sauvageau.

http://canadianmedicine.blogspot.com/2009/04/waiting-room-death-triggers-review-of.html

Rapport d’enquête sur LE DÉCÈS DE M. JEAN-JACQUES SAUVAGEAU
http://qgov.newswire.ca/gouvqc/communiques/GPQF/Avril2009/22/c4034.html?slang=en

Comment:

By Don McCanne, MD

In the Canadian Supreme Court case of Chaoulli v. Quebec, Justice Deschamps wrote, “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”

This decision has resulted in intense efforts to privatize both the Canadian health insurance system and the Canadian health care delivery system. The outspoken proponents of privatization would have you believe that only the private sector is capable of saving lives that would be lost by neglect in the public sector.

Dr. Chaoulli’s patient did not die while on a waiting list for an elective orthopedic procedure. He collapsed and died in Dr. Chaoulli’s private waiting room. Dr. Chaoulli withheld cardiopulmonary resuscitation – a standard of care that surely would have been provided in any public health care facility – with questions over whether or not he had adequately trained staff and appropriate equipment to initiate such care. Dr. Chaoulli then asked his nurse to call 911 (to have the body removed), and he returned to his work. Only after the ambulance team arrived was cardiopulmonary resuscitation instituted.

The lesson of the tragic death of Jean-Jacques Sauvageau is simply that Crusader Dr. Jacques Chaoulli and the other privatizers have no credibility when they claim that the private system has a special capability of saving lives that the public system lacks.

Fight for single-payer health care

Kay Mueller
Indiana Daily Student
Apr. 28, 2009

Soon, thousands of IU students will be graduating. Those who were carried on their parents’ health insurance will now be on their own.

Many, if not most, entry-level jobs do not offer health insurance. The stereotype is that young people don’t care about universal health insurance. Recently I heard of two new graduates who were surprised to find themselves suddenly without insurance. One of them has a pre-existing condition and is unable to get any insurance at all.

President Barack Obama has promised to reform our health care system. Unfortunately, he intends to rely on the for-profit insurance companies. These insurers add so much overhead to health care that we could never afford to cover everyone as long as the system is based on them. The U.S. now spends 16 percent of its GNP on health care and leaves more than 45 million uninsured.

All other developed countries, which do not rely on for-profit insurers, and which do cover everyone, spend less than 12 percent.

Whether or not you see yourself as needing insurance right now, your tax money will be wasted on insurance company profits and bureaucracy. A better approach is a Medicare-like “single-payer” system: You choose your own doctor and hospital, but a single payer, such as the government, pays the bills.

What can you do? You can e-mail or call Obama and say you support a single-payer system, such as Medicare for all (president@whitehouse.gov, 202-456-1111). Contact your Representative and urge him to support HR-676, which provides Medicare for all. Baron Hill is the Representative for Bloomington (baronhill.house.gov, 202-225-5315). Contact Sens. Evan Bayh and Richard Lugar, and ask them to support S-703, which also provides Medicare for all (bayh.senate.gov, 202-224-5623; lugar.senate.gov, 202-224-4814).

You can also join a demonstration at 11 a.m. May 20 on Monument Circle in Indianapolis. Hoosiers for a Commonsense Health Care Plan will be demonstrating against health insurance companies immediately after the shareholders’ meeting of WellPoint (a huge national insurer with headquarters in Indianapolis).

For information, call 824-1082. If the energy put into the Obama campaign can be applied to fixing health care, anything can be accomplished.

AFL-CIO's Health-Care Survey Ignores 'Single Payer' Plan Favored by Unions

By Harry Kelber
Labor’s Voice for Change (31)
April 30, 2009

An AFL-CIO-sponsored on line health care survey of 26,419 respondents, more than half of them union members, reveals a widespread discontent with the cost, benefits and operating procedures of current health insurance plans. The survey, taken between Jan. 14 and March 3, shows that “ninety-four percent of the insured say the health care system needs fundamental change or to be rebuilt.”

Curiously, the survey makes no mention of the Single Payer (H.R. 676) health care system or Medicare as possible options that the respondents were never asked. Those questions were left out, says Amaya Smith, survey director, “for no particular reason.”

H.R. 676, introduced in Congress by Representative John Conyers (Dem.-Mich, has been gathering sensational support from unions across the country. It has already been endorsed by 512 union organizations in 49 states. That includes 39 AFL-CIO-affiliated State Federations and 125 Central Labor Councils. The Service Employees International Union and other Change to Win internationals have also endorsed it.

Surely, Single Payer is worth at least an occasional story on the AFL-CIO’s Web, but none has appeared. Instead, it has been totally ignored. The health care advantages that H.R, 676 has to offer have been given only limited coverage in the labor media, despite the strong record of union endorsements. Why? The short answer is that AFL-CIO President John Sweeney and his close associates are supporting a universal health care plan that would include profit-making insurance companies and HMOs.

Under H.R. 676, a single public payer would replace the many hundreds of private, for profit insurance companies, each with an expensive bureaucracy and a different set of rules, that is focused on making money for the company rather than the health of their customers. The billions that could be saved from the continuing increases in premiums, co-payments and deductibles could be used to cut costs or improve health care services.

For those who are unfamiliar with Single Payer, H.R. 676 would provide every resident in the United States with an expanded and greatly improved Medicare system. It would cover every person for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, as well as dental, substance abuse, mental and other health problems. No insurance company bureaucrat would come between you and your doctor.

Let’s Have an Open Dialogue on the AFL-CIO’s Web Site

Health care insurance, particularly for the tens of millions of people who don’t have any, is one of the most important issues worrying working families. It is a good sign that there is general agreement among our unions that our current health care system needs to be reformed. There is also consensus that some form of universal health care insurance is necessary, but which plan?

The Sweeney camp believes that Congress won’t pass a bill for universal coverage without a clear role for the powerful insurance companies. On the other hand, the Single Payer advocates say that the insurance companies are part of the problem, not the solution. Letting them participate in any eventual health care plan would retain the abuses and shortcomings that working families currently encounter in protecting their health.

It will be interesting to see how the health care issue is debated and voted upon at the AFL-CIO’s 2009 convention in Pittsburgh, less than five months away.. The odds are that there will be a general resolution of support for universal health care insurance, but it will stop short of making a specific recommendation..

Strange things have happened before at AFL-CIO conventions, where a vote called for at a critical time on a particular issue can decide the outcome of an election of officers… It will be worth watching how the health care issue is played out at this convention.

Subcommittee Members Spar Over Cost Control Tactics

By Jane Norman
CQ HealthBeat Associate Editor
CQ HEALTHBEAT NEWS
April 23, 2009

The lack of a middle ground among lawmakers on an approach to the health care overhaul was on full display Thursday as the Health, Employment, Labor and Pensions Subcommittee of the House Education and Labor Committee probed witnesses on how to cut U.S. health insurance costs now exceeding $2 trillion annually.

“We spend too much on our health care system relative to our national income and do not get the results we should,” said Subcommittee Chairman Robert E. Andrews, D-N.J. He said that he wanted to encourage a “dynamic interchange” at the hearing on how to curb costs that are rising for workers at three times the rate of their paychecks, and keeping many Americans from obtaining insurance at all.

Andrews and the subcommittee heard solutions offered that included a single-payer system similar to Canada’s; a system of “employee benefit cooperatives” that would allow small employers, employees and families to band together to buy access to affordable coverage; choices between private and public plans within a national insurance exchange; expansion of Medicaid; and making changes to increase affordability while continuing traditional group employer plans.

But Democrats John Tierney of Massachusetts and Dennis J. Kucinich of Ohio, both of whom back a single-payer plan, strongly objected that not enough time was being spent discussing private insurers and their role in rising costs. “The 800-pound gorilla in this room is unspoken, and it’s insurance companies,” said Tierney. “Everybody’s trying to find a way to keep insurance companies in business.” Congress should “find the gumption” to order insurers to spend a set percentage on providing care as opposed to administrative costs, he said.

Kucinich said that “our effort in Congress should be about health care, not insurance care,” and pointed out 70 members of the House have signed on to the single-payer plan. Yet he said from all he is hearing and reading about the debate over an overhaul, “I am deeply concerned Congress is going to miss a rare opportunity to adopt a single payer health plan.”

Ron Pollack, executive director of liberal-leaning Families USA, said it is “not likely” that insurance companies will vanish but more could be done to rein them in, including establishment of standardized benefits and reforms in the ways pre-existing conditions among patients are treated.

Another witness, David U. Himmelstein, a primary care doctor and associate professor of medicine at Harvard University who testified in favor of a single-payer plan like Canada’s, retorted: “The problem is actually the private insurer wants not to pay.” Himmelstein said lesser reforms, including a widely discussed public option accompanying private plans, could not realize the same kind of savings in administrative costs as a single-payer plan.

“While reforms that maintain a major role for private insurers may be politically attractive, they are economically and medically nonsensical,” he said.

On the Republican side, Rep. John Kline of Minnesota said, “we have wonderful health care in this country” and Canadians who can’t get health care they need wind up in his border state. Group employer plans cover 160 million Americans, he said. “We may be changing the paradigm, but we need to be very careful to do no harm and pull a thread on the sweater that is ERISA,” he said, referring to the Employee Retirement Income Security Act, which covers employee benefit plans.

Rep. Phil Roe, R-Tenn., said he wants to see access to health care improved, and care should be made portable and less costly. But he expressed the fear that’s heard often among Republicans that a public plan will lead private employers to drop their own coverage, and the government will become the primary player in health care. “If you like the way government has managed AIG, you’re going to love the way they manage your health care,” said Roe, a physician.

Rep. Phil Hare, an Illinois Democrat, extracted some agreement from the witnesses that most Americans like their health care.

“They’re happy generally until they get sick,” said Himmelstein.

Hare expressed interest in Himmelstein’s point of view and praised the veterans’ health care system as a model, while also observing “at times you swear the federal government can’t do anything right.” Whatever is done, “we’ve got to be bold and we better do it right,” he said.

Rep. David Wu, an Oregon Democrat, said it would be difficult to change health care “in a way that’s perceived as taking these health plans away.”

The discussion was a beginning, said Andrews, of how to provide a system with high quality and access for all. “This committee, the House, the Congress, the country are going to struggle with these questions,” he said.

Kline said, “There is obviously a great deal of disagreement and diversity here. . .we’ve got a long way to go here.”

Source: CQ HealthBeat News
Same-day coverage of the people and events shaping health care policy from Washington.
(c) 2009 Congressional Quarterly Inc. All Rights Reserved.

Mass. Model for Health Overhaul 'Not Viable,' Expert Tells Lawmakers

By Alex Wayne, CQ Staff
CQ TODAY ONLINE NEWS — HEALTH
April 23, 2009

A Massachusetts doctor and health policy expert told Congress on Thursday that he believes his state’s 2006 overhaul of its health system — legislation that may be a model for a national overhaul — “will fail.”

The physician, David Himmelstein, told the House Education and Labor panel’s health subcommittee that based on his experience working in the Cambridge Health Alliance, Harvard University’s hospital system, Massachusetts’ health overhaul won’t work in the long term because it is too expensive.

“I think it’s economically not viable and I see from my patients it’s not viable,” Himmelstein said after Rep. Dennis J. Kucinich, D-Ohio, asked him if he thought the overhaul would fail.

“I think it will fail,” said Himmelstein, who is an associate professor of medicine at Harvard and a well known advocate for a single-payer health system, in which the government would provide everyone health care.

His observations might be important as lawmakers in Washington move toward a Massachusetts-style overhaul of the nation’s health system. Many Democrats have expressed admiration for the Massachusetts system, in which a government agency called the Commonwealth Connector helps state residents obtain private health insurance if they can’t get it through their employers or government programs such as Medicare.

The overhaul has greatly boosted insurance coverage in Massachusetts; the state says that less than 3 percent of its residents lack insurance, and the U.S. Census says the state has the lowest rate of uninsurance in the country.

But the overhaul has also been more expensive than expected. Massachusetts legislators have been criticized for doing little, when the overhaul was written, to try to control health care costs.

State legislators predicted when the law was written that the new system would cost the state $400 million in fiscal 2008; it actually cost $628 million. Fiscal 2009 spending was forecasted to be $725 million; the budget for the system is $869 million this year, though the state expects to spend less.

Long-term cost problems in the state are even worse, according to the Urban Institute, which published a study on the Massachusetts overhaul in January. Massachusetts has some of the highest health costs in the nation, in part because its hospital, physician and insurance markets are all highly concentrated and lack serious competition, according to the Urban Institute. For those and other reasons, premiums for insurance offered through the Connector are often unaffordable if residents make too much money to qualify for subsidies, the Urban Institute says.

“The way we’re increasing coverage is by buying additional insurance from [private insurers] on top of already high costs,” Himmelstein said. “We’ve had no means of cost containment.”

Kucinich, a single-payer advocate himself, thinks Congress is too concerned about preserving a role for private insurers within the health care system.

“Our efforts in Congress should be about health care, not insurance care,” Kucinich said. “What we know, and what Dr. Himmelstein was talking about is, the insurance companies make money not providing health care.”

But a single-payer system is not supported by President Obama or many Democratic leaders. That is because previous efforts at health care overhauls, particularly former President Bill Clinton’s effort in 1993-94, failed after people with insurance became worried they would lose their coverage and be forced into a government-run system.

“As we go forward, we need be mindful of those 160 million people getting insurance from their employers and we not pull that string unless and until we’re ready to replace the paradigm,” warned Rep. John Kline, R-Minn.

Source: CQ Today Online News
Round-the-clock coverage of news from Capitol Hill.
(c) 2009 Congressional Quarterly Inc. All Rights Reserved.

Dr. Chaoulli’s private clinic waiting room death

Waiting-room death triggers review of Quebec private clinic rules

Canadian Medicine
April 22, 2009

Quebec coroner Catherine Rudel-Tessier’s report released today on the death of Jean-Jacques Sauvageau, who died January 11, 2008, in the waiting room of a private Montreal urgent-care clinic, demands that the Collège des médecins du Québec refine its regulations on such clinics to better protect patients.

Ms Rudel-Tessier said the 2007 Collège guidelines on private clinic administration should be “more precise” on certain points and must help administrators “offer a safe environment to their patients and permit them to adequately deal with emergencies.”

The Collège’s president and CEO, Dr Yves Lamontagne, said the guidelines would be either revised or replaced, depending on the results of the Collège’s investigation of the incident. He said he expects two new measures will be incorporated into the guidelines. “One, every physician or nurse working in that type of clinic should follow a course on cardiopulmonary resuscitation. And two, all clinics should have equipment — a defibrillator.”

Ms Rudel-Tessier also recommended that the Collège investigate the doctor or doctors who attended to Mr Sauvageau.

Dr Jacques Chaoulli — the same crusading Jacques Chaoulli whose high-profile 2005 Supreme Court case against the government of Quebec forced the province to overturn some of its restrictions on private health insurance — examined Mr Sauvageau minutes after he stopped breathing and decided not to attempt resuscitation, instead leaving Mr Sauvageau’s body in his waiting room seat until an ambulance arrived. An autopsy later revealed that Mr Sauvageau died of massive bilateral pulmonary embolisms and would not have been saved by resuscitation but Ms Rudel-Tessier concluded that Dr Chaoulli could not have known that at the time and should have tried to save Mr Sauvageau.

http://canadianmedicine.blogspot.com/2009/04/waiting-room-death-triggers-review-of.html

Rapport d’enquête sur LE DÉCÈS DE M. JEAN-JACQUES SAUVAGEAU
http://qgov.newswire.ca/gouvqc/communiques/GPQF/Avril2009/22/c4034.html?slang=en

Comment:

By Don McCanne, MD

In the Canadian Supreme Court case of Chaoulli v. Quebec, Justice Deschamps wrote, “The evidence in this case shows that delays in the public health care system are widespread, and that, in some serious cases, patients die as a result of waiting lists for public health care.”

This decision has resulted in intense efforts to privatize both the Canadian health insurance system and the Canadian health care delivery system. The outspoken proponents of privatization would have you believe that only the private sector is capable of saving lives that would be lost by neglect in the public sector.

Dr. Chaoulli’s patient did not die while on a waiting list for an elective orthopedic procedure. He collapsed and died in Dr. Chaoulli’s private waiting room. Dr. Chaoulli withheld cardiopulmonary resuscitation – a standard of care that surely would have been provided in any public health care facility – with questions over whether or not he had adequately trained staff and appropriate equipment to initiate such care. Dr. Chaoulli then asked his nurse to call 911 (to have the body removed), and he returned to his work. Only after the ambulance team arrived was cardiopulmonary resuscitation instituted.

The lesson of the tragic death of Jean-Jacques Sauvageau is simply that Crusader Dr. Jacques Chaoulli and the other privatizers have no credibility when they claim that the private system has a special capability of saving lives that the public system lacks.

AFL-CIO’s Health-Care Survey Ignores ‘Single Payer’ Plan Favored by Unions

By Harry Kelber
Labor’s Voice for Change (31)
April 30, 2009

An AFL-CIO-sponsored on line health care survey of 26,419 respondents, more than half of them union members, reveals a widespread discontent with the cost, benefits and operating procedures of current health insurance plans. The survey, taken between Jan. 14 and March 3, shows that “ninety-four percent of the insured say the health care system needs fundamental change or to be rebuilt.”

Curiously, the survey makes no mention of the Single Payer (H.R. 676) health care system or Medicare as possible options that the respondents were never asked. Those questions were left out, says Amaya Smith, survey director, “for no particular reason.”

H.R. 676, introduced in Congress by Representative John Conyers (Dem.-Mich, has been gathering sensational support from unions across the country. It has already been endorsed by 512 union organizations in 49 states. That includes 39 AFL-CIO-affiliated State Federations and 125 Central Labor Councils. The Service Employees International Union and other Change to Win internationals have also endorsed it.

Surely, Single Payer is worth at least an occasional story on the AFL-CIO’s Web, but none has appeared. Instead, it has been totally ignored. The health care advantages that H.R, 676 has to offer have been given only limited coverage in the labor media, despite the strong record of union endorsements. Why? The short answer is that AFL-CIO President John Sweeney and his close associates are supporting a universal health care plan that would include profit-making insurance companies and HMOs.

Under H.R. 676, a single public payer would replace the many hundreds of private, for profit insurance companies, each with an expensive bureaucracy and a different set of rules, that is focused on making money for the company rather than the health of their customers. The billions that could be saved from the continuing increases in premiums, co-payments and deductibles could be used to cut costs or improve health care services.

For those who are unfamiliar with Single Payer, H.R. 676 would provide every resident in the United States with an expanded and greatly improved Medicare system. It would cover every person for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, as well as dental, substance abuse, mental and other health problems. No insurance company bureaucrat would come between you and your doctor.

Let’s Have an Open Dialogue on the AFL-CIO’s Web Site

Health care insurance, particularly for the tens of millions of people who don’t have any, is one of the most important issues worrying working families. It is a good sign that there is general agreement among our unions that our current health care system needs to be reformed. There is also consensus that some form of universal health care insurance is necessary, but which plan?

The Sweeney camp believes that Congress won’t pass a bill for universal coverage without a clear role for the powerful insurance companies. On the other hand, the Single Payer advocates say that the insurance companies are part of the problem, not the solution. Letting them participate in any eventual health care plan would retain the abuses and shortcomings that working families currently encounter in protecting their health.

It will be interesting to see how the health care issue is debated and voted upon at the AFL-CIO’s 2009 convention in Pittsburgh, less than five months away.. The odds are that there will be a general resolution of support for universal health care insurance, but it will stop short of making a specific recommendation..

Strange things have happened before at AFL-CIO conventions, where a vote called for at a critical time on a particular issue can decide the outcome of an election of officers… It will be worth watching how the health care issue is played out at this convention.

Mass. Model for Health Overhaul ‘Not Viable,’ Expert Tells Lawmakers

By Alex Wayne, CQ Staff
CQ TODAY ONLINE NEWS — HEALTH
April 23, 2009

A Massachusetts doctor and health policy expert told Congress on Thursday that he believes his state’s 2006 overhaul of its health system — legislation that may be a model for a national overhaul — “will fail.”

The physician, David Himmelstein, told the House Education and Labor panel’s health subcommittee that based on his experience working in the Cambridge Health Alliance, Harvard University’s hospital system, Massachusetts’ health overhaul won’t work in the long term because it is too expensive.

“I think it’s economically not viable and I see from my patients it’s not viable,” Himmelstein said after Rep. Dennis J. Kucinich, D-Ohio, asked him if he thought the overhaul would fail.

“I think it will fail,” said Himmelstein, who is an associate professor of medicine at Harvard and a well known advocate for a single-payer health system, in which the government would provide everyone health care.

His observations might be important as lawmakers in Washington move toward a Massachusetts-style overhaul of the nation’s health system. Many Democrats have expressed admiration for the Massachusetts system, in which a government agency called the Commonwealth Connector helps state residents obtain private health insurance if they can’t get it through their employers or government programs such as Medicare.

The overhaul has greatly boosted insurance coverage in Massachusetts; the state says that less than 3 percent of its residents lack insurance, and the U.S. Census says the state has the lowest rate of uninsurance in the country.

But the overhaul has also been more expensive than expected. Massachusetts legislators have been criticized for doing little, when the overhaul was written, to try to control health care costs.

State legislators predicted when the law was written that the new system would cost the state $400 million in fiscal 2008; it actually cost $628 million. Fiscal 2009 spending was forecasted to be $725 million; the budget for the system is $869 million this year, though the state expects to spend less.

Long-term cost problems in the state are even worse, according to the Urban Institute, which published a study on the Massachusetts overhaul in January. Massachusetts has some of the highest health costs in the nation, in part because its hospital, physician and insurance markets are all highly concentrated and lack serious competition, according to the Urban Institute. For those and other reasons, premiums for insurance offered through the Connector are often unaffordable if residents make too much money to qualify for subsidies, the Urban Institute says.

“The way we’re increasing coverage is by buying additional insurance from [private insurers] on top of already high costs,” Himmelstein said. “We’ve had no means of cost containment.”

Kucinich, a single-payer advocate himself, thinks Congress is too concerned about preserving a role for private insurers within the health care system.

“Our efforts in Congress should be about health care, not insurance care,” Kucinich said. “What we know, and what Dr. Himmelstein was talking about is, the insurance companies make money not providing health care.”

But a single-payer system is not supported by President Obama or many Democratic leaders. That is because previous efforts at health care overhauls, particularly former President Bill Clinton’s effort in 1993-94, failed after people with insurance became worried they would lose their coverage and be forced into a government-run system.

“As we go forward, we need be mindful of those 160 million people getting insurance from their employers and we not pull that string unless and until we’re ready to replace the paradigm,” warned Rep. John Kline, R-Minn.

Source: CQ Today Online News
Round-the-clock coverage of news from Capitol Hill.
(c) 2009 Congressional Quarterly Inc. All Rights Reserved.

State legislators launch effort to push H.R. 676

By All Unions Committee for Single Payer Health Care — H.R. 676

A group of state legislators has initiated a nationwide effort to publish an appeal to President Obama and members of the 111th Congress to support H.R. 676, single-payer health care legislation introduced in Congress by Rep. John Conyers Jr. and presently co-sponsored by 75 other House members.

Last week, 24 state legislators from 16 states sent a copy of the appeal to all 7,500 state legislators in the United States asking them to add their names to the appeal which will be published in Roll Call, a widely read Capitol Hill publication, in late May or in June.

The legislators, in their letter, cite the growing “economic crisis” and “badly strained” state budgets as the reason why they are asking “the U.S. Congress … to heal our hemorrhaging state budgets while bringing comprehensive, quality health care to all our people by passing H.R. 676.”

Co-conveners of the campaign are state Sen. Jim Ferlo of Pittsburgh and Assemblyman Richard Gottfried of New York. State senators and representatives from Colorado, Georgia, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, New Jersey, Texas, Virginia and Wisconsin also signed the letter.

Kay Tillow, coordinator of the All Unions Committee for Single Payer Health Care — H.R. 676, welcomed the effort by the state legislators and urged everyone to contact their own state senator and representative and ask them to sign the appeal.

“State legislators are caught in a vise of escalating health care costs, driven largely by the for-profit insurance industry and declining revenues,” Tillow said. “Without a national single-payer system, state budgets will continue in crisis and health needs will not be met.”

The “Dear Colleague” letter, the appeal and other materials can be found at:

http://www.healthcare-now.org/campaigns/state-legislators/

Ed Show: Bernie Sanders on single payer

Bernie Sanders on the Need for a Single Payer Health Care System

Ed Show
April 28, 2009
(Clip courtesy of Video Cafe)
Bernie Sanders: … We can guarantee every man, woman and child health care with a single payer system.
Ed Schultz: Senator, that is what just boggles my mind. We have, right now, a political moment in this country. The president has high approval ratings; you have the people out there; town hall after town hall I hear it, they want single payer; you’re close to the super majority depending on how…
Sanders: Ed, what are you forgetting in that equation?
Schultz: Well, I’m forgetting the filibuster I guess.
Sanders: And you’re forgetting the power of the insurance companies…
Schultz: Yes. Right.
Sanders: The huge amounts of money they spend; the power of the drug companies, and if you think that every member of the Democratic caucus is prepared to stand up to those guys, you’re mistaken.
****
Sanders: But the bottom line here, Ed, is, you’re absolutely right; we have a Democratic president, a strong majority in the House, sixty votes in the Senate. If we can’t deliver on energy, on health care, on workers’ rights, then what’s the sense of it all. The answer is people have got to put pressure on Congress to have the guts to stand up to the insurance companies, the drug companies, the banks, the military-industrial complex.
Schultz: Well, who’s going to put pressure on them?
Sanders: We’re going to need a strong grassroots movement to make that happen.
Schultz: So you think the people can be heard on this.
Sanders: Absolutely. Absolutely they can.
****
Schultz: I think this is a real moment for the president. What if the president comes out tomorrow night at the press conference… I would love to hear President Obama come out and say, “Look, I don’t have all the answers, but everything is on the table.” And this idea that single payer is not politically achievable, Mr. President, respectfully, I think you’re wrong on that. I think it is politically achievable, because the people want it.
Video clip (7 minutes, 41 seconds):
http://videocafe.crooksandliars.com/heather/ed-show-bernie-sanders-need-single-payer-health

When the people lead, Congress will follow.

Ed Show: Bernie Sanders on single payer

Bernie Sanders on the Need for a Single Payer Health Care System

Ed Show
April 28, 2009

(Clip courtesy of Video Cafe)

Bernie Sanders: … We can guarantee every man, woman and child health care with a single payer system.

Ed Schultz: Senator, that is what just boggles my mind. We have, right now, a political moment in this country. The president has high approval ratings; you have the people out there; town hall after town hall I hear it, they want single payer; you’re close to the super majority depending on how…

Sanders: Ed, what are you forgetting in that equation?

Schultz: Well, I’m forgetting the filibuster I guess.

Sanders: And you’re forgetting the power of the insurance companies…

Schultz: Yes. Right.

Sanders: The huge amounts of money they spend; the power of the drug companies, and if you think that every member of the Democratic caucus is prepared to stand up to those guys, you’re mistaken.

****

Sanders: But the bottom line here, Ed, is, you’re absolutely right; we have a Democratic president, a strong majority in the House, sixty votes in the Senate. If we can’t deliver on energy, on health care, on workers’ rights, then what’s the sense of it all. The answer is people have got to put pressure on Congress to have the guts to stand up to the insurance companies, the drug companies, the banks, the military-industrial complex.

Schultz: Well, who’s going to put pressure on them?

Sanders: We’re going to need a strong grassroots movement to make that happen.

Schultz: So you think the people can be heard on this.

Sanders: Absolutely. Absolutely they can.

****

Schultz: I think this is a real moment for the president. What if the president comes out tomorrow night at the press conference… I would love to hear President Obama come out and say, “Look, I don’t have all the answers, but everything is on the table.” And this idea that single payer is not politically achievable, Mr. President, respectfully, I think you’re wrong on that. I think it is politically achievable, because the people want it.

Video clip (7 minutes, 41 seconds):
http://videocafe.crooksandliars.com/heather/ed-show-bernie-sanders-need-single-payer-health

Comment:

By Don McCanne, MD

When the people lead, Congress will follow.