Senate Finance Committee Chairman Max Baucus (D-MT), who ruled single payer “off the table” before he even started considering healthcare reform, is now trying to pressure the Congressional Budget Office (CBO) to judge the Baucus health plan financially sound.

Baucus held a Finance Committee hearing last Wednesday (2/25/09) at which the sole witness was CBO Director Douglas Elmendorf.

According to CongressDaily (2/25), Baucus, other lawmakers, and “some special interest groups have not been particularly pleased with what they view as CBO’s conservative scoring of some supposed cost-cutting efforts that are needed to help offset the enormous price tag” of overhauling the health care system under the Baucus plan.

Baucus said if healthcare reform is to pass, the CBO needs to “get ever more creative to find … pathways to get the savings that we have to have.” (Edney, CongressDaily, 2/25)

Baucus told the head of CBO at last Wednesday’s hearing that the Congressional Budget Office will play a significant role in efforts to overhaul the U.S. health care system because the agency’s cost assessments will “make or break this enterprise,” CQ HealthBeat. Experienced observers assert that this is Baucus’ way of pressuring the agency to come up with figures to justify the kind of healthcare reform Baucus wants. Similar pressure in the extreme was placed upon the CBO in the early 1990’s when the Clinton health plan was being debated.

The CBO is responsible for “scoring” any legislative proposal for its true costs and savings. CBO has been recognized for the accuracy of its findings and projections and for its non-partisanship. In fact, a 1991 CBO study found that a single payer system in the US could cover all the uninsured at the (then) current level of spending or less because of reduction in administrative costs. https://www.pnhp.org/facts/single_payer_system_cost.php?page=all

Many recently proposed healthcare plans, similar to the one Baucus says he is drafting, keep private-for-profit health insurance companies in the mix and are based on claiming hugh savings from such things as the introduction of computerized record keeping. These so called “savings” are then touted as the way the proposed plan can be “paid for”.

The CBO has issued a series of recent studies which have found that most savings claimed, in the effort to keep private-for-profit insurance companies in the mix, do not exist. Recent CBO studies of disease management, “medical homes,” electronic medical records, comparative effectiveness research, a public plan that competes with the private insurers and others, do not save money as claimed.

Call, write or fax Senator Baucus and tell him we need accurate numbers not creative figuring. Single payer should be on the table and should be given a full and fair hearing by the Senate Finance Committee.

Senator Max Baucus
511 Hart Senate Office Bldg.
Washington, D.C. 20510
(202) 224-2651(Office)
(202) 224-9412 (Fax)

#30#

HR 676 would institute a single payer health care system by expanding a greatly improved Medicare system to everyone residing in the U. S.

HR 676 would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, and long term care.

HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.

In the current Congress, HR 676 has 59 co-sponsors in addition to Conyers.

HR 676 has been endorsed by 485 union organizations in 49 states including 120 Central Labor Councils and Area Labor Federations and 39 state AFL-CIO’s (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NY, NV & MA).

For further information, a list of union endorsers, or a sample endorsement resolution, contact:

Kay Tillow
All Unions Committee For Single Payer Health Care–HR 676
c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
(502) 636 1551
Email: nursenpo@aol.com
http://unionsforsinglepayerHR676.org
03/02/09

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Email Pres. Obama: What happened to Openess and Transparency?

Published by Swing State
March 3, 2009
Washington, DC

One group is being left out of the White House’s health reform forum Thursday: supporters of single payer health care.

President Obama has promised an open discussion as he begins an aggressive push for health care reform. Obama said Monday he is “bringing together business and labor, doctors and insurers, Democrats and Republicans” to discuss.

Progressive Democrats of America and Physicians for a National Health Program, leading proponents of expanding Medicare, government-run health care to cover all Americans, have not been invited and are “seeking” an invitation.

John Conyers, Chair of the House Judiciary Committee, has become Congress’ leader for single payer. He has authored H.R. 676, the model bill for single payer advocates, which has 59 cosponsors. He too has not yet received an invitation.

Liberal health consumer advocate groups such as Families USA and Health Care for America Now are invited and are attending. Neither plan to push single payer.

Even Obama’s new nominee to be Secretary of Health and Human Services, Kathleen Sebelius’ own newly implemented state agency, the Kansas Health Policy Authority, recommended single payer as one of four policy options. Despite the government agency’s determination that single payer would be the cheapest, Kansas has also decided to reject that route thus far.

Despite President Obama’s pledge for an open discussion where every position has a seat at the table, one idea seems to be off the table.

---

UPDATE 3: What People Said at Obama’s Health Summit

by Chuck Idelson
California Nurses Association blog
February 26, 2009

Hours after President Obama’s speech to Congress in which he laid down a marker for achieving “comprehensive” healthcare reform, and getting it done this year, top administration aides have outlined the goals of what they want to achieve.

What Politico called “the 8 keys to his health plan,” certainly reflect a bold determination for action and a grand vision.

There’s only one problem. Virtually all the proposals being bandied about in various Congressional committees — and the administration made it clear this week they will let Congress figure out the details — fail to meet the test of those “8 keys.”

With one important exception — single payer reform, or expanding and updating Medicare to cover everyone.

So what are those lofty goals set by the administration?

Obama has endorsed eight guiding principles for health reform, the White House officials said on the conference call. They stressed that they intend to work with lawmakers and other stakeholders on how to accomplish the goals, but the principles will lay down a marker for any congressional plan.

Drum roll, please. A healthcare plan, they told reporters, should be:

* Universal, everybody in, nobody out

* Portable, not tied to your job, if you even have one

* Maintaining choice of doctor and insurance

* Ensuring affordable coverage

* Protecting Americans financial health

* Investing in prevention and wellness

* Improving patient safety and quality of care

* Fiscally responsible and sustainable

To the administration’s credit, these should be the benchmarks of any real reform. And to give them further props, the administration is even projecting progressive tax reform as a financing mechanism.

The combined effect of the two revenue-raising proposals, on top of Mr. Obama’s existing plan to roll back the Bush-era income tax reductions on households with income exceeding $250,000 a year, would be a pronounced move to redistribute wealth by reimposing a larger share of the tax burden on corporations and the most affluent taxpayers.

But on the construct of the plan itself, a huge barrier stands in the way. The present private insurance-based system is an implacable impediment to every one of these goals.

The insurance giants, of course, are not care providers. They are big corporations. They exist to make money, primarily to return profits for their shareholders. Every aspect of their operations are geared to that end.

Private insurance plans:

* Aren’t universal because they exclude people based on pre-existing conditions or age or anyone else they think will be expensive to cover.

* Don’t guarantee choice of physician or hospital, but limit you to their network of providers.

* Won’t assure affordability because they are constantly raising premiums, deductibles, co-pays, and other fees to generate high revenues and profits.

* Can’t guarantee safety and quality because they actively discourage the delivery of care or deny treatments, diagnoses, or referrals because they don’t want to pay for it.

* Will never be fiscally responsible because there is no independent oversight, decisions are made in secret in closed board rooms or CEO offices, and, again, their priority is profits.

Thus any plan which sustains, protects, or expands the role of the insurance industry in healthcare cannot, by definition, achieve any of these worthy aims.

One bill, however, does succeed in all eight areas. That is HR 676, the U.S. National Health Care Act by Rep. John Conyers, which also happens to be the one reform that has a broad, national grassroots constituency led by nurses, doctors, patients, and health care activists.

With the administration having laid our a vision, but deferred implementation to Congress, that should be a signal to all of us to put their feet to the fire and push for real reform, like HR 676.

By Susanne L. King
Boston Globe
March 2, 2009

Massachusetts has been lauded for its healthcare reform, but the program is a failure. Created solely to achieve universal insurance coverage, the plan does not even begin to address the other essential components of a successful healthcare system.

What would such a system provide? The prestigious Institute of Medicine, part of the National Academy of Sciences, has defined five criteria for healthcare reform. Coverage should be: universal, not tied to a job, affordable for individuals and families, affordable for society, and it should provide access to high-quality care for everyone.

The state’s plan flunks on all counts.

First, it has not achieved universal healthcare, although the reform has been a boon to the private insurance industry. The state has more than 200,000 without coverage, and the count can only go up with rising unemployment.

Second, the reform does not address the problem of insurance being connected to jobs. For individuals, this means their insurance is not continuous if they change or lose jobs. For employers, especially small businesses, health insurance is an expense they can ill afford.

Third, the program is not affordable for many individuals and families. For middle-income people not qualifying for state-subsidized health insurance, costs are too high for even skimpy coverage. For an individual earning $31,213, the cheapest plan can cost $9,872 in premiums and out-of-pocket payments. Low-income residents, previously eligible for free care, have insurance policies requiring unaffordable copayments for office visits and medications.

Fourth, the costs of the reform for the state have been formidable. Spending for the Commonwealth Care subsidized program has doubled, from $630 million in 2007 to an estimated $1.3 billion for 2009, which is not sustainable.

Fifth, reform does not assure access to care. High-deductible plans that have additional out-of-pocket expenses can result in many people not using their insurance when they are sick. In my practice of child and adolescent psychiatry, a parent told me last week that she had a decrease in her job hours, could not afford the $30 copayment for treatment sessions for her adolescent, and decided to meet much less frequently.

In another case, a divorced mother stopped treatment for her son because the father had changed insurance, leaving them with an unaffordable deductible. And at Cambridge Health Alliance, doctors and nurses have cared for patients who, unable to afford the new copayments, were forced to interrupt care for HIV and even cancers that could be treated with chemotherapy.

Access to care is also affected by the uneven distribution of healthcare dollars between primary and specialty care, and between community hospitals and tertiary care hospitals. Partners HealthCare, which includes two major tertiary care hospitals in Boston, was able to negotiate a secret agreement with Blue Cross Blue Shield of Massachusetts to be paid 30 percent more for their services than other providers in the state, contributing to an increase in healthcare costs for Massachusetts, which are already the highest per person in the world. Agreements that tilt spending toward tertiary care threaten the viability of community hospitals and health centers that provide a safety net for the uninsured and underinsured.

There is, though, one US model of healthcare that meets the Institute of Medicine criteria: Medicare. Insuring everyone over 65, Medicare achieves universal coverage and access to care, is not tied to a job, and is affordable for individuals and the country. Medicare simplifies the administration of healthcare dollars, thereby saving money. We need to improve Medicare, and expand this program to include everyone.

A bill before Congress, the United States National Health Insurance Act, would provide more comprehensive coverage for all. The bill includes doctor, hospital, long-term, mental health, dental, and vision care, prescription drugs, and medical supplies, with no premiums, copayments, or deductibles.

People would be free to choose doctors and hospitals, and insurance would not be tied to a job. Costs would be controlled because health planning in a national health program can reestablish needed balance between primary/preventive care and high-tech tertiary care. A modest, progressive tax would replace what people currently pay out of pocket. This program would pay for itself by eliminating the wasteful administrative costs and profits of private insurance companies, and save $8 billion to $10 billion in Massachusetts alone.

We must let Congress know we want improved access to affordable healthcare for all, not more expensive private health insurance we can’t afford to use when we are sick. Massachusetts healthcare reform fails on all five Institute of Medicine criteria. Congress should not make it a model for the nation.

---

Susanne L. King, M.D., practices in Berkshire County.

http://www.boston.com/bostonglobe/editorial_opinion/oped/articles/2009/03/02/mass_healthcare_reform_is_failing_us/

by Chuck Idelson
California Nurses Association blog
February 26, 2009

Hours after President Obama’s speech to Congress in which he laid down a marker for achieving “comprehensive” healthcare reform, and getting it done this year, top administration aides have outlined the goals of what they want to achieve.

What Politico called “the 8 keys to his health plan,” certainly reflect a bold determination for action and a grand vision.

There’s only one problem. Virtually all the proposals being bandied about in various Congressional committees — and the administration made it clear this week they will let Congress figure out the details — fail to meet the test of those “8 keys.”

With one important exception — single payer reform, or expanding and updating Medicare to cover everyone.

So what are those lofty goals set by the administration?

Obama has endorsed eight guiding principles for health reform, the White House officials said on the conference call. They stressed that they intend to work with lawmakers and other stakeholders on how to accomplish the goals, but the principles will lay down a marker for any congressional plan.

Drum roll, please. A healthcare plan, they told reporters, should be:

* Universal, everybody in, nobody out

* Portable, not tied to your job, if you even have one

* Maintaining choice of doctor and insurance

* Ensuring affordable coverage

* Protecting Americans financial health

* Investing in prevention and wellness

* Improving patient safety and quality of care

* Fiscally responsible and sustainable

To the administration’s credit, these should be the benchmarks of any real reform. And to give them further props, the administration is even projecting progressive tax reform as a financing mechanism.

The combined effect of the two revenue-raising proposals, on top of Mr. Obama’s existing plan to roll back the Bush-era income tax reductions on households with income exceeding $250,000 a year, would be a pronounced move to redistribute wealth by reimposing a larger share of the tax burden on corporations and the most affluent taxpayers.

But on the construct of the plan itself, a huge barrier stands in the way. The present private insurance-based system is an implacable impediment to every one of these goals.

The insurance giants, of course, are not care providers. They are big corporations. They exist to make money, primarily to return profits for their shareholders. Every aspect of their operations are geared to that end.

Private insurance plans:

* Aren’t universal because they exclude people based on pre-existing conditions or age or anyone else they think will be expensive to cover.

* Don’t guarantee choice of physician or hospital, but limit you to their network of providers.

* Won’t assure affordability because they are constantly raising premiums, deductibles, co-pays, and other fees to generate high revenues and profits.

* Can’t guarantee safety and quality because they actively discourage the delivery of care or deny treatments, diagnoses, or referrals because they don’t want to pay for it.

* Will never be fiscally responsible because there is no independent oversight, decisions are made in secret in closed board rooms or CEO offices, and, again, their priority is profits.

Thus any plan which sustains, protects, or expands the role of the insurance industry in healthcare cannot, by definition, achieve any of these worthy aims.

One bill, however, does succeed in all eight areas. That is HR 676, the U.S. National Health Care Act by Rep. John Conyers, which also happens to be the one reform that has a broad, national grassroots constituency led by nurses, doctors, patients, and health care activists.

With the administration having laid our a vision, but deferred implementation to Congress, that should be a signal to all of us to put their feet to the fire and push for real reform, like HR 676.