PNHP

Health care should be a right

Health care should be a right

By Kathryn Bourgoin
Bangor Daily News
Friday, July 20, 2007

Our country has had publicly funded education since 1643, when the first public school was started in Dedham, Massachusetts. Most people think education is a basic right, so why isn’t healthcare?

The United States is the only industrialized nation that does not have health care as a right of citizenship. As a result, 48 million Americans have no health insurance. Fifty percent of all bankruptcies in this country are now medically related. A recent Pew research poll shows that 65 percent of Americans would like a universal health care system, (facts from Physicians for a National Health Program, PNHP.org).

So why haven’t we done this already? It hasn’t happened because powerful lobbyists from the health insurance industry and pharmaceutical industry don’t want it to happen. They would lose their large profits. Since we have privately funded campaigns in this country, they have more clout with Congress than the American people do.

On March 21, the New Hampshire House of Representatives voted by a ratio of 2 to 1 to endorse HR 676, the National Health Insurance Act of Rep. John Conyers from Michigan. The bill would create a publicly financed, privately delivered health care program that expands Medicare to all Americans.

The National Health Insurance Act would cover hospital care, office care, eye care, dental care, mental health care, long-term care and prescription drugs. By covering prevention, we would keep people out of costly emergency rooms.

How would we pay for this plan for single-payer universal health care? The bill would cost $1.86 trillion a year. The U.S. currently spends $2.3 trillion a year on health care. The savings would be from overhead costs. Medicare has 3 percent overhead costs, private insurance has 20 percent overhead costs. Canada’s system has 1 percent overhead costs. We would also save money be allowing Medicare to negotiate with the drug companies for lower prices. There would be a 3 percent payroll tax on employers, and we would have to repeal the Bush tax cuts for the wealthy. There would be a 5 percent health tax for the top 5 percent of income earners.

Our country needs “Medicare for all” and we need it now. I urge our Maine legislators to follow the lead of New Hampshire and endorse HR 676, the National Health Insurance Act. I urge you to write or call your Congressmen and Senators to speak up for the right to single-payer universal health care.

Kathryn Bourgoin, MD, of Orono is a member of Physicians for Social Responsibility and Physicians for a National Health Program.

Groups pushing Medicare reform will weaken system

Sau Friedman
Newsday
July 21, 2007

Beware the front groups that claim they would help save Medicare or promote health care reform. More than likely they’re saving or promoting themselves – at the expense of Medicare and your health.

The “front group,” invented by the late father of public relations, Edward Bernays, is the quintessential tool of deceptive propaganda, says the Center for Media and Democracy, a nonprofit public-interest organization, for it is “an organization that purports to represent one agenda while in reality it serves some other party or interest.”

One prominent example is the Coalition for Medicare Choices, which said in a May press release it enlisted “more than 100,000 seniors … to urge Congress to protect the benefits they receive though Medicare Advantage plans. With the recent surge in membership, the Coalition now totals more than 350,000 members.”

The Coalition’s sponsorship is not hidden, but it may not be well known, among the unions and predominantly African-American organizations it lists as supporters, that it was organized in 1999 and is wholly financed by America’s Health Insurance Plans. That group has opposed the expansion of publicly supported health care and most measures to strengthen Medicare. It, as well as drug lobbies, wrote the 2003 legislation that gave administration of the new Part D drug benefit to insurers instead of Medicare and prohibited the government from negotiating prices with drug manufacturers.

Medicare Advantage (HMOs and PPOs) is private managed care that seeks to take the place of traditional Medicare. And for weeks the Coalition has been bombarding lawmakers and unsuspecting editors with letters, messages and press releases sounding alarms over Democratic proposals to slash the government subsidies paid to insurance companies to offer these plans. Letters to editors have listed how many beneficiaries in various states stand to lose their Medicare Advantage coverage if the proposals pass.

As I’ve reported, the government pays the insurers on average 12 percent more per beneficiary on a Medicare Advantage plan than it pays for an enrollee on traditional Medicare. That’s one reason insurance companies have been able to promise subscribers extra benefits and lure 19 percent of the 43 million Medicare beneficiaries away from traditional Medicare. But, as we reported on March 24, subscribers have complained that the insurers’ salespeople have been using deceptive practices and advertising to sell unwary Medicare beneficiaries on Advantage plans that may not serve them well.

Medicare Advantage insurers may refuse to pay for out-of-network services or deny coverage for some procedures. Drug benefits may be uncertain. Its policies require written referrals for specialists or lab work and frequent co-payments. Last month, America’s Health Insurance Plans president Karen Ignani announced that seven leading insurers have voluntarily suspended selling Medicare Advantage plans. She’s also the spokesperson for the Coalition for Health Care Choices, which has chosen to remain silent on the issue.

The official Medicare Payment Advisory Commission (MedPAC), the American Medical Association and most Medicare advocates have told members of Congress that the subsidies for the Medicare Advantage plans are not needed. The Congressional Budget Office estimated that cutting them would save Medicare more than $50 billion over five years – money that could be spent on the State Children’s Health Insurance Program and Medicare.

But Congressional Budget Office director Peter Orszag told the Senate Budget Committee that, if Medicare Advantage plans grow, they will strain the Medicare budget. Worse, he said, “I think the result would be a fundamental change in the nature of the Medicare system that may be hard to reverse.” The Centers for Medicare and Medicaid Services has acknowledged abuses in the sale of Medicare Advantage plans but has taken no position on the legislation.

The Coalition for Health Care Choices and America’s Health Insurance Plans maintain that, without the subsidy, insurers may have to abandon the Medicare Advantage business, as they did five years ago when they quit offering Medicare Plus Choice (HMO) plans because profits weren’t high enough. These are scare tactics, to be sure, but Medicare Advantage beneficiaries should be warned that they may, indeed, lose their coverage and have to switch to traditional Medicare, if Congress ends the insurers’ gravy train. The good news, however, is that traditional Medicare will be strengthened.

Another couple of front groups have formed to fight against government-sponsored universal health care, including Medicare. Health Care America, based in Washington, D.C., gets support from the drug industry, according to its Web site. More prominent is the recently formed Coalition to Advance Healthcare Reform, which describes itself on its Web site as group of “business leaders, employers and other like-minded leaders committed to healthcare reform” through “meaningful, market-based solutions to our health care crisis.”

Much of the reason for the crisis is the current market-based system. Nevertheless, the new coalition says its “core principles” include “a market-based” system, and “universal coverage with individual responsibility,” meaning requiring individuals and/or employers to buy insurance, perhaps with help from government.

This coalition includes more than 40 of the nation’s largest corporations, many of which helped make the American health care system what it is today, while profiting from it: Aetna, Cigna Health Care, Eli Lilly, CVS Caremark, GlaxoSmithKline, McKesson Corp., Kaiser Permanente, plus General Mills, The Kroger Co., Safeway and PepsiCo.

The coalition’s statement of purpose says business wants a “place at the table,” if and when the nation chooses a health care system, to make sure it’s based on private insurance. In a coming column, I’ll write about whether we need private insurance.

WRITE TO Saul Friedman, Newsday, 235 Pinelawn Rd., Melville, NY, 11747-4250, or by e-mail at saulfriedman@comcast.net

Nurses, doctors simpatico with ‘Sicko’

By LEO Weekly

The red that progressive doctors, nurses and other healthcare professionals are seeing over the roughly 47 million uninsured Americans probably looks a lot like the blood-colored, “Sicko”-branded scrubs they wore Friday morning as they shouted, “I get sick!” in unison outside Baxter Avenue Theatres. The boisterous demonstration actually inspired a neighborhood dog to bark its own outrage at the insurance-driven woes of the American healthcare system — or maybe it just had a cough.

The gathering of medical professionals and activists before the premiere of Michael Moore’s new documentary, “Sicko,” was part of a nationwide effort called “Scrubs for Sicko,” using the film as a springboard to cull support for universal healthcare legislation, specifically House Resolution 676, which would establish a national healthcare program by extending Medicare to every U.S. resident — that includes those visiting the United States and its territories.

Many of those same professionals spoke at a press conference before the screening, along with civic and government leaders, including state Rep. Jim Wayne, D-35. Suzy Post, a veteran of multiple social movements, said healthcare rights must be won the way civil rights and womens’ rights have been.

“Civil rights are no damn good if you’re dead,” Post said.

Others extolled the virtues of HR 676, which currently resides in the House Ways and Means, Veterans’ Affairs and Energy and Commerce committees. Third District U.S. Rep. John Yarmuth is a co-sponsor of the bill, one of 74 representatives on that list; Michigan Democrat John Conyers originally floated the resolution in 2003. Marty Meyer, a representative in Yarmuth’s district office, delivered a statement from the Congressman in support of the bill.

Though attendees rallied behind Moore’s latest film, most of the discussion focused on the issues presented in “Sicko” rather than the movie itself.

“Medical care is a necessity rather than a commodity,” Syed Quadri, medical director at a free medical clinic in Elizabethtown, said. “Many people don’t agree with Moore’s politics, but no one disputes the facts coming out of this film. People know about the problems.”

Volunteers handed out literature and “Free Universal Healthcare” cards — like the I.D. cards HR 676 would require — that could only be activated when the legislation passes. –Ryan Real

Review of Michael Moore's New Film,"SiCKO"

By USW International President Leo W. Gerard

Michael Moore, the activist author and filmmaker, has given every union member in the United States a great tool of advocacy for our health care agenda with his new movie, “SiCKO.” We should return that favor by attending the premiere of his movie June 29. Wear your USW gold and blue when you go.

With a compelling combination of humor and pathos, “SiCKO” documents how medical insurance companies act like cancer on this country’s health care system. This is what we want to eliminate with a national health care system.

Moore begins “SiCKO” by subjecting his viewers to excruciatingly painful insurance system failure scenes. They include an injured worker suturing up his own lacerated knee because he is one of the 47 million Americans without health insurance; a couple moving into a spare room in their daughter’s home after medical insurance co-payments for the husband’s three heart attacks and the wife’s cancer forced them into bankruptcy, the most common cause for personal bankruptcy today; and a young woman recounting the death of her 18-month-old baby because an ambulance took the critically ill girl to a hospital that refused to treat her because her insurance would not pay for services there.

Those disquieting scenes are thankfully interspersed with Moore’s often-comical antics in four countries with national health care: Canada, Britain, France and Cuba.

In Canada, he tools around in a golf cart with a conservative, who endorses the country’s national system of medicine and describes its creator, Tommy C. Douglas, as a Canadian hero, akin to George Washington or Abe Lincoln.

How could a conservative support socialized medicine, Moore asks the man. The conservative says it’s because not everyone can afford the medical services they need. The conservative, like Michael Moore and most of us, recognizes that health care is a human right, not some kind of privilege bestowed only on the rich or the lucky.

On his trip to Britain to investigate their national health care system, begun after World War II, Michael Moore searches a hospital for some department that will bill a patient. Finally, after numerous workers laugh at him, Moore discovers a cashier’s window. It turns out, however, money is dispensed from the window to patients, reimbursing them for public transit to the hospital.

Moore reports that his research shows that Canadian, British and French citizens live longer, healthier lives than Americans, and their infants are more likely to survive. The overhead costs for these health care systems are far less than America’s. In fact, the overhead for the one, already national system in America, Medicare, is 3 percent. It’s 30 percent for the insurance system. Apparently, Moore says, the government can do something right.

Moore ends up in Cuba after trying to take some American patients, including two 9-11 first responders who suffered lung injuries, to Guantanamo Bay to get some of that free health care American is dispensing to accused al Qaida war criminals imprisoned there.

After being refused entrance to the American portion of the island, Moore takes his patients to a Cuban hospital which provided free treatment to the foreigners, under the same procedures and circumstances that it gives care to Cuban citizens. The idea, again, was that medical treatment is a right of all humans, regardless of nationality, or religion or politics.

A Cuban firehouse conducted a ceremony to honor the first responders before they left because, the firemen said, they were all brothers and sisters. The Cubans said they wished they could have aided with the rescue on 9-11.

This kind of solidarity is essential for us to win a better health care system. The film advocates radical surgery on the American system to excise the insurance companies, which profit by denying coverage, treatments and pharmaceuticals, and by rescinding payments once made.

Michael Moore argues in “SiCKO” that this is not representative of American behavior. We show solidarity in crises. We rush to aid each other when there’s a tornado, a Katrina, a Virginia Tech. We bring food, build houses, give blood and clothes. We are generous. We are not the people of a stingy health care system. We have the right, the power and the opportunity to deliberately plan and build a health care system that would be fair and equitable and cover everyone as a human right. Let’s stand in solidarity for that.

We all know from our bargaining experiences how crucial it is to get health care off the table. That would eliminate much of the contentiousness in negotiations and make it much easier for American companies to compete in the global economy against nations that already provide national health care, including all of those in Western industrialized countries. We should act to radically reform the existing health care system that has resulted in 47 million uninsured Americans.

Make no mistake. Moore’s film advances our cause. It’s to our benefit to advance his film, which will play in only about 1,000 theaters its first weekend. The more people who clamor to get into those doors that first weekend, the more movie screens it will appear on the following week, and so on. The more popular the film, the more clear it will be to politicians that this issue must be addressed.

Again, I encourage you to go see the movie on opening night. Put on your USW cap or shirt when you go. Take your family and friends and neighbors. And take action outside the theatre, too. Stand in solidarity with your union brothers and sisters and Michael Moore to cure our SiCKO health care system.

Will single-payer buzz from "SiCKO" last?

Supporters hope Michael Moore’s latest movie will sway public opinion. The AMA and others counter that government-run health care isn’t the right solution.

By Doug Trapp
AMNews staff
July 23/30, 2007

Washington — Michael Moore’s latest film, “SiCKO,” has energized single-payer supporters and drawn attention to their cause. But what, if any, long-term effect the movie will have on the national debate on universal health care system reform is up for debate.

Moore created a buzz on Capitol Hill before “SiCKO” opened on June 29. He grabbed headlines with a rally, a crowded June 20 news conference with Democratic supporters, and two special screenings of his movie: one for lawmakers and one for health care lobbyists. Moore bought a full-page newspaper ad inviting 900 lobbyists to the screening, but only 11 showed up. The viewing for lawmakers, however, was better attended.

Organized labor, led largely by nurses unions, and single-payer advocates used the film as a vehicle to try to sway public opinion by “making moviegoers into health care activists.” Their nationwide “Scrubs for SiCKO” campaign on opening night featured nurses in red scrubs designed by Moore, “From SiCKO to Sanity” flyers and an invitation to join the single-payer movement.

The film grossed $11.5 million in its first two weeks, finishing ninth in box office totals. But it opened in only about 10% of the screens occupied by an average summer blockbuster, then expanded to nearly 20% in its second week, according to Rotten Tomatoes, a popular Web site that tracks the film industry. About 91% of media reviews in the site’s unofficial tally were positive.

The film was powerful, said Robert Blendon, ScD, a professor of health policy and political analysis at the Harvard School of Public Health. But with many Americans cynical about their government, “SiCKO” still won’t create a tidal wave of support for a government-run single payer health system, he said.

“What I think it will contribute to is a sense that it’s wrong that we don’t have some way of requiring or guaranteeing that people have some basic insurance coverage,” Dr. Blendon said.

Peter Clarke, PhD, a professor of preventive medicine and communication at the University of Southern California, said the film won’t change the health reform debate in a lasting way, partly because Moore is stereotyped easily by detractors.

In the film, Moore unapologetically targets the profits and influence of the health insurance and drug industries while questioning the profit motive of the American public-private system. He challenges the country’s inability to provide basic, affordable health care to everyone the way other countries do. The movie mentions the American Medical Association as a longstanding opponent to socialized medicine.

The AMA is working to increase access to health care and is worried about corporations putting profits before patients, said AMA Board of Trustees Chair Edward L. Langston, MD.

“We disagree, however, that the only solution is to give up and turn our health care system over to the government under a single-payer system,” Dr. Langston said. The AMA, as a member of the Health Coverage Coalition for the Uninsured, supports tax credits to help low-income families and individuals buy health insurance, among other reforms.

Rep. John Conyers (D, Mich.) hosted Moore at the Capitol Hill news conference for both “SiCKO” and the United States National Health Insurance Act, which would expand Medicare to cover everyone. The measure, which Conyers introduced, has 75 co-sponsors, all Democrats.

Moore was joined by 32 lawmakers, including Conyers, plus a few dozen members of the California Nurses Assn., which backs single-payer legislation in California. It’s the only state where the Legislature passed a single-payer bill, but Gov. Arnold Schwarzenegger vetoed the measure last fall.

With only one presidential candidate supporting single-payer health care — Rep. Dennis Kucinich (D, Ohio) — the odds are against the issue gaining traction. It takes the power of a newly elected president for such legislation to succeed, Dr. Blendon said.

Still, single-payer supporters are in a better position today than several months ago when the subject wasn’t mentioned as an option for health system reform, said Quentin Young, MD, president of Physicians for a National Health Program. “In recent months, before the movie, even, we moved up to the next higher stage. We were no longer irrelevant, we were the less-desirable alternative,” Dr. Young said.
Fairness an issue in “SiCKO”

“SiCKO,” like his previous documentaries, includes Moore’s sense of theatrics. He takes three 9/11 volunteer rescue workers from New York City to Guantanamo Bay, Cuba, in search of treatment for their various illnesses. Moore says they should be eligible for the same health care as terrorism detainees.

“SiCKO” also showcases horror stories, including an insured couple who went bankrupt because of expenses from multiple episodes of cancer and heart attacks.

Many critics pointed out the film’s lack of balance in discussing health care in the U.S. compared with Britain, France and Cuba. Moore solicited through a Web site thousands of complaints from Americans about their health plans but limited his examination of other countries’ nationalized health care to anecdotal encounters, such as a dinner with Americans living in France.

“There’s no question he did not in any way try to talk about the problems that are faced in those systems and the complaints that citizens have. They are major political issues — they have been in Britain and Canada — about waiting times,” Dr. Blendon said.

John Goodman, PhD, president of the National Center for Policy Analysis, a nonprofit research institute that promotes private-sector alternatives to government regulation, didn’t expect Moore to be fair.

“Since the whole purpose of the film is to compare the worst features of American health care with the best features of health care in Britain, Canada, France and even Cuba (!) who can complain about a few errors here and there?” he wrote on his blog.

Moore, at the Capitol Hill news event, said there are many myths about other countries’ health care systems. “Yes, they have their flaws. All human systems do. But ask a Canadian if they would trade their national health care card for your HMO card. You won’t find a Canadian willing to do that. Or a Brit or anyone from Ireland or from France.”

Review of Michael Moore’s New Film,”SiCKO”

By USW International President Leo W. Gerard

Michael Moore, the activist author and filmmaker, has given every union member in the United States a great tool of advocacy for our health care agenda with his new movie, “SiCKO.” We should return that favor by attending the premiere of his movie June 29. Wear your USW gold and blue when you go.

With a compelling combination of humor and pathos, “SiCKO” documents how medical insurance companies act like cancer on this country’s health care system. This is what we want to eliminate with a national health care system.

Moore begins “SiCKO” by subjecting his viewers to excruciatingly painful insurance system failure scenes. They include an injured worker suturing up his own lacerated knee because he is one of the 47 million Americans without health insurance; a couple moving into a spare room in their daughter’s home after medical insurance co-payments for the husband’s three heart attacks and the wife’s cancer forced them into bankruptcy, the most common cause for personal bankruptcy today; and a young woman recounting the death of her 18-month-old baby because an ambulance took the critically ill girl to a hospital that refused to treat her because her insurance would not pay for services there.

Those disquieting scenes are thankfully interspersed with Moore’s often-comical antics in four countries with national health care: Canada, Britain, France and Cuba.

In Canada, he tools around in a golf cart with a conservative, who endorses the country’s national system of medicine and describes its creator, Tommy C. Douglas, as a Canadian hero, akin to George Washington or Abe Lincoln.

How could a conservative support socialized medicine, Moore asks the man. The conservative says it’s because not everyone can afford the medical services they need. The conservative, like Michael Moore and most of us, recognizes that health care is a human right, not some kind of privilege bestowed only on the rich or the lucky.

On his trip to Britain to investigate their national health care system, begun after World War II, Michael Moore searches a hospital for some department that will bill a patient. Finally, after numerous workers laugh at him, Moore discovers a cashier’s window. It turns out, however, money is dispensed from the window to patients, reimbursing them for public transit to the hospital.

Moore reports that his research shows that Canadian, British and French citizens live longer, healthier lives than Americans, and their infants are more likely to survive. The overhead costs for these health care systems are far less than America’s. In fact, the overhead for the one, already national system in America, Medicare, is 3 percent. It’s 30 percent for the insurance system. Apparently, Moore says, the government can do something right.

Moore ends up in Cuba after trying to take some American patients, including two 9-11 first responders who suffered lung injuries, to Guantanamo Bay to get some of that free health care American is dispensing to accused al Qaida war criminals imprisoned there.

After being refused entrance to the American portion of the island, Moore takes his patients to a Cuban hospital which provided free treatment to the foreigners, under the same procedures and circumstances that it gives care to Cuban citizens. The idea, again, was that medical treatment is a right of all humans, regardless of nationality, or religion or politics.

A Cuban firehouse conducted a ceremony to honor the first responders before they left because, the firemen said, they were all brothers and sisters. The Cubans said they wished they could have aided with the rescue on 9-11.

This kind of solidarity is essential for us to win a better health care system. The film advocates radical surgery on the American system to excise the insurance companies, which profit by denying coverage, treatments and pharmaceuticals, and by rescinding payments once made.

Michael Moore argues in “SiCKO” that this is not representative of American behavior. We show solidarity in crises. We rush to aid each other when there’s a tornado, a Katrina, a Virginia Tech. We bring food, build houses, give blood and clothes. We are generous. We are not the people of a stingy health care system. We have the right, the power and the opportunity to deliberately plan and build a health care system that would be fair and equitable and cover everyone as a human right. Let’s stand in solidarity for that.

We all know from our bargaining experiences how crucial it is to get health care off the table. That would eliminate much of the contentiousness in negotiations and make it much easier for American companies to compete in the global economy against nations that already provide national health care, including all of those in Western industrialized countries. We should act to radically reform the existing health care system that has resulted in 47 million uninsured Americans.

Make no mistake. Moore’s film advances our cause. It’s to our benefit to advance his film, which will play in only about 1,000 theaters its first weekend. The more people who clamor to get into those doors that first weekend, the more movie screens it will appear on the following week, and so on. The more popular the film, the more clear it will be to politicians that this issue must be addressed.

Again, I encourage you to go see the movie on opening night. Put on your USW cap or shirt when you go. Take your family and friends and neighbors. And take action outside the theatre, too. Stand in solidarity with your union brothers and sisters and Michael Moore to cure our SiCKO health care system.

Will single-payer buzz from “SiCKO” last?

Supporters hope Michael Moore’s latest movie will sway public opinion. The AMA and others counter that government-run health care isn’t the right solution.

By Doug Trapp
AMNews staff
July 23/30, 2007

Washington — Michael Moore’s latest film, “SiCKO,” has energized single-payer supporters and drawn attention to their cause. But what, if any, long-term effect the movie will have on the national debate on universal health care system reform is up for debate.

Moore created a buzz on Capitol Hill before “SiCKO” opened on June 29. He grabbed headlines with a rally, a crowded June 20 news conference with Democratic supporters, and two special screenings of his movie: one for lawmakers and one for health care lobbyists. Moore bought a full-page newspaper ad inviting 900 lobbyists to the screening, but only 11 showed up. The viewing for lawmakers, however, was better attended.

Organized labor, led largely by nurses unions, and single-payer advocates used the film as a vehicle to try to sway public opinion by “making moviegoers into health care activists.” Their nationwide “Scrubs for SiCKO” campaign on opening night featured nurses in red scrubs designed by Moore, “From SiCKO to Sanity” flyers and an invitation to join the single-payer movement.

The film grossed $11.5 million in its first two weeks, finishing ninth in box office totals. But it opened in only about 10% of the screens occupied by an average summer blockbuster, then expanded to nearly 20% in its second week, according to Rotten Tomatoes, a popular Web site that tracks the film industry. About 91% of media reviews in the site’s unofficial tally were positive.

The film was powerful, said Robert Blendon, ScD, a professor of health policy and political analysis at the Harvard School of Public Health. But with many Americans cynical about their government, “SiCKO” still won’t create a tidal wave of support for a government-run single payer health system, he said.

“What I think it will contribute to is a sense that it’s wrong that we don’t have some way of requiring or guaranteeing that people have some basic insurance coverage,” Dr. Blendon said.

Peter Clarke, PhD, a professor of preventive medicine and communication at the University of Southern California, said the film won’t change the health reform debate in a lasting way, partly because Moore is stereotyped easily by detractors.

In the film, Moore unapologetically targets the profits and influence of the health insurance and drug industries while questioning the profit motive of the American public-private system. He challenges the country’s inability to provide basic, affordable health care to everyone the way other countries do. The movie mentions the American Medical Association as a longstanding opponent to socialized medicine.

The AMA is working to increase access to health care and is worried about corporations putting profits before patients, said AMA Board of Trustees Chair Edward L. Langston, MD.

“We disagree, however, that the only solution is to give up and turn our health care system over to the government under a single-payer system,” Dr. Langston said. The AMA, as a member of the Health Coverage Coalition for the Uninsured, supports tax credits to help low-income families and individuals buy health insurance, among other reforms.

Rep. John Conyers (D, Mich.) hosted Moore at the Capitol Hill news conference for both “SiCKO” and the United States National Health Insurance Act, which would expand Medicare to cover everyone. The measure, which Conyers introduced, has 75 co-sponsors, all Democrats.

Moore was joined by 32 lawmakers, including Conyers, plus a few dozen members of the California Nurses Assn., which backs single-payer legislation in California. It’s the only state where the Legislature passed a single-payer bill, but Gov. Arnold Schwarzenegger vetoed the measure last fall.

With only one presidential candidate supporting single-payer health care — Rep. Dennis Kucinich (D, Ohio) — the odds are against the issue gaining traction. It takes the power of a newly elected president for such legislation to succeed, Dr. Blendon said.

Still, single-payer supporters are in a better position today than several months ago when the subject wasn’t mentioned as an option for health system reform, said Quentin Young, MD, president of Physicians for a National Health Program. “In recent months, before the movie, even, we moved up to the next higher stage. We were no longer irrelevant, we were the less-desirable alternative,” Dr. Young said.
Fairness an issue in “SiCKO”

“SiCKO,” like his previous documentaries, includes Moore’s sense of theatrics. He takes three 9/11 volunteer rescue workers from New York City to Guantanamo Bay, Cuba, in search of treatment for their various illnesses. Moore says they should be eligible for the same health care as terrorism detainees.

“SiCKO” also showcases horror stories, including an insured couple who went bankrupt because of expenses from multiple episodes of cancer and heart attacks.

Many critics pointed out the film’s lack of balance in discussing health care in the U.S. compared with Britain, France and Cuba. Moore solicited through a Web site thousands of complaints from Americans about their health plans but limited his examination of other countries’ nationalized health care to anecdotal encounters, such as a dinner with Americans living in France.

“There’s no question he did not in any way try to talk about the problems that are faced in those systems and the complaints that citizens have. They are major political issues — they have been in Britain and Canada — about waiting times,” Dr. Blendon said.

John Goodman, PhD, president of the National Center for Policy Analysis, a nonprofit research institute that promotes private-sector alternatives to government regulation, didn’t expect Moore to be fair.

“Since the whole purpose of the film is to compare the worst features of American health care with the best features of health care in Britain, Canada, France and even Cuba (!) who can complain about a few errors here and there?” he wrote on his blog.

Moore, at the Capitol Hill news event, said there are many myths about other countries’ health care systems. “Yes, they have their flaws. All human systems do. But ask a Canadian if they would trade their national health care card for your HMO card. You won’t find a Canadian willing to do that. Or a Brit or anyone from Ireland or from France.”

Hospital consolidation increases disparities in insurance coverage

Hospital Consolidation And Racial/Income Disparities In Health Insurance Coverage

By Robert J. Town, Douglas R. Wholey, Roger D. Feldman and Lawton R. Burns
Health Affairs
July/August 2007

Non-Hispanic whites are significantly more likely to have health insurance coverage than most racial/ethnic minorities, and this differential grew during the 1990s. Similarly, wealthier Americans are more likely to have health insurance than the poor, and this difference also grew over the 1990s. This paper examines the role of provider competition in increasing these disparities in insurance coverage. Over the 1990s, the hospital industry consolidated; we analyze the impact of this consolidation on health insurance take-up for different racial/ethnic minorities and income groups. We found that the hospital consolidation wave increased health insurance disparities along racial and income dimensions.

This paper focuses on the role of hospital consolidation in increasing disparities in health insurance coverage from 1990 to 2003. The link between hospital consolidation and health insurance primarily occurs through the cost of inpatient care. It is well documented that increases in hospital concentration raise the price of inpatient care. These higher costs are potentially passed on to health insurance consumers in the form of higher premiums. Higher premiums, in turn, decrease health insurance coverage. Insurance take-up among racial and ethnic minorities (controlling for income and other household characteristics) and lower-income households (controlling for race/ethnicity and other household characteristics) might be more sensitive to premium increases than is the case for whites and higher-income households.

http://content.healthaffairs.org/cgi/content/full/26/4/1170#R6

Comment:

By Don McCanne, MD

What is the purpose of our health care system? Is it to create successful business models that fulfill the goals of the American entrepreneurial spirit? Or is it to provide health care for all of the people of our nation?

Our national policies should place a priority on health care for everyone, but instead we continue with policies that grant the health care entrepreneurs first priority, regardless of the negative impact on patient care.

Let’s change priorities. Let’s establish policies that mandate that everyone receives the health care that he or she needs. With that as a given, the providers can adopt business principles that would ensure maximum health care value for all of us, while meeting their legitimate costs plus fair profits. (For profits to be fair in health care, passive investors should be eliminated.)

The appropriate policy solutions are clear. It’s the politics that prevent us from enacting these policies. So let’s change the politics.

Premium subsidies are not the answer

RAND Study Finds Health Insurance Subsidies Won't Significantly Cut Number of Uninsured

RAND
July 16, 2007

Government subsidies that cut health insurance premium prices in half for people without insurance would reduce the number of uninsured Americans by just 3 percent, according to a RAND Corporation study issued today.

The study by the nonprofit research organization contradicts suggestions by some that large numbers of people without health insurance would sign up for coverage if government provided subsidies or tax credits to reduce the cost of health insurance.

“One implication of our findings is that if you really do want to get to universal health insurance coverage, voluntary solutions that rely on financial incentives aren’t going to get you there,” said M. Susan Marquis, senior economist with RAND and one of the study’s authors. “Government is probably going to have to mandate it.”

http://www.rand.org/news/press.07/07.16.html

Comment:

By Don McCanne, MD

Amazing. Using government subsidies to cut health insurance premiums in half would reduce the numbers of uninsured by only 3 percent if participation were voluntary. The initial experience in Massachusetts also indicates that mandating participation, even with government subsidies and penalties for non-compliance, also fails to achieve universal health insurance coverage.

Nothing short of making coverage automatic and permanent for everyone will work. If we do that then why should we create more complex and wasteful administrative inefficiencies in an attempt to make individual premiums affordable by collecting taxes and then redistributing them in an equitable manner based on the individual’s ability to pay the premiums? Equity is already established through the tax system. It would be much more efficient to merely transfer the tax revenues to a universal insurance pool that would pay out health care costs directly.

The only reason to create a program of government subsidies of premiums would be to perpetuate the role of private insurers. They sure haven’t taken care of us considering all of their waste of our premium dollars and their unwanted intrusions into our health care. Why should we adopt policies merely to take care of them when we would fare so much better with our own national health insurance program?

The private insurers have had their day. Now it’s our turn.

Six Ways to Fix America's Health Care System

Dear Reader,

Michael Moore’s new movie Sicko hit me hard. I found heartbreaking the unnecessary suffering our heath care system causes so many Americans. But I also felt this powerful film could change public opinion about U.S. health care the way An Inconvenient Truth changed the public view on global warming.

Real change, however, doesn’t come just from watching a film. It will happen only if a great many ordinary citizens seize the moment. Here are six suggestions for how you can stir the public dialogue and help get our lawmakers to fix the U.S. health care system.

See Sicko. No matter how you feel about Michael Moore, bring friends and encourage everyone you know to see this film. See the film in your local theater or contact Sicko producers to show it in your church, union, workplace, or community group.

Talk with others. Share your own health care experiences and ask your friends about theirs. Most of us know someone who’s had problems with the health care system. Learn about others’ experience and use those stories to push for change.

Learn the facts so you can counter arguments against changing the system. Did you know that the U.S. is the only major industrialized country without universal health care coverage? Do you know how we compare to other countries on costs and outcomes? Here are some important facts.

Choose a solution. Moore has a three-point proposal for fixing the U.S. healthcare system:

i) Provide free health care to all U.S. residents;

ii) Abolish the health insurance companies;

iii) Regulate the pharmaceuticals industry.

As an immediate step, he supports HR 676, a bill in the House of Representatives that would extend Medicare to everyone. Those are his views. What are yours? You may find helpful a chart we prepared at YES! that compares eight coverage models. We also outlined basic principles that should underlie a good health care system, and compared the U.S. with Canada. See more YES! health care articles.

Let your views be known. Tell your lawmakers in simple, heartfelt language what you think. Your voice gives your representatives cover to fight the lobbyists and do what’s right. Don’t forget your state legislators–there are many state initiatives pending. You can find state initiatives at the Physicians for a National Health Program. Write letters to your newspaper and call in to radio talk shows. Making your views public gives others courage to speak out.

Forward this email and invite friends and colleagues to discuss it with you. With elections on the horizon and discontent about the U.S. health care system running deep, we have a special window of opportunity to improve the system. You can be part of it.

Thanks for reading this. Together, we can bring the U.S. into the 21st century with a responsible and inclusive health care system.

Fran Korten
Publisher, YES! Magazine

Six Ways to Fix America’s Health Care System

Dear Reader,

Michael Moore’s new movie Sicko hit me hard. I found heartbreaking the unnecessary suffering our heath care system causes so many Americans. But I also felt this powerful film could change public opinion about U.S. health care the way An Inconvenient Truth changed the public view on global warming.

Real change, however, doesn’t come just from watching a film. It will happen only if a great many ordinary citizens seize the moment. Here are six suggestions for how you can stir the public dialogue and help get our lawmakers to fix the U.S. health care system.

See Sicko. No matter how you feel about Michael Moore, bring friends and encourage everyone you know to see this film. See the film in your local theater or contact Sicko producers to show it in your church, union, workplace, or community group.

Talk with others. Share your own health care experiences and ask your friends about theirs. Most of us know someone who’s had problems with the health care system. Learn about others’ experience and use those stories to push for change.

Learn the facts so you can counter arguments against changing the system. Did you know that the U.S. is the only major industrialized country without universal health care coverage? Do you know how we compare to other countries on costs and outcomes? Here are some important facts.

Choose a solution. Moore has a three-point proposal for fixing the U.S. healthcare system:

i) Provide free health care to all U.S. residents;

ii) Abolish the health insurance companies;

iii) Regulate the pharmaceuticals industry.

As an immediate step, he supports HR 676, a bill in the House of Representatives that would extend Medicare to everyone. Those are his views. What are yours? You may find helpful a chart we prepared at YES! that compares eight coverage models. We also outlined basic principles that should underlie a good health care system, and compared the U.S. with Canada. See more YES! health care articles.

Let your views be known. Tell your lawmakers in simple, heartfelt language what you think. Your voice gives your representatives cover to fight the lobbyists and do what’s right. Don’t forget your state legislators–there are many state initiatives pending. You can find state initiatives at the Physicians for a National Health Program. Write letters to your newspaper and call in to radio talk shows. Making your views public gives others courage to speak out.

Forward this email and invite friends and colleagues to discuss it with you. With elections on the horizon and discontent about the U.S. health care system running deep, we have a special window of opportunity to improve the system. You can be part of it.

Thanks for reading this. Together, we can bring the U.S. into the 21st century with a responsible and inclusive health care system.

Fran Korten
Publisher, YES! Magazine

Health insurance for the 21st Century

Upgrading To National Health Insurance (Medicare 2.0)

The Case For Eliminating Private Health Insurance

by Leonard Rodberg & Don McCanne
CommonDreams.org
July 13, 2007

Private health insurance was an idea that worked during part of the last century; it will not succeed through the 21st Century. With jobs increasingly service-based and short-term, the large employment-based risk pools that made this insurance system possible no longer exist. Medical care has become more effective and more essential to the ordinary person, but also more costly and capital-intensive. The multiple private insurance carriers that emerged during the last century can no longer provide a sound basis for financing our modern health care system.

Alone among the nations of the world, the U.S. has relied upon private insurance to cover the majority of its population. In the mid-20th Century, when medical care accounted for barely 1% of our gross national product, medical technology was limited, and jobs lasted for a lifetime, health care could be financed through such employment-based, premium-financed health insurance. But the time for private insurance has passed.

Health care has now become a major part of our national expenditures. The premium for an individual now averages more than $4,000 per year, while a good family policy averages more than $10,000 per year, comparable to the minimum wage and nearly one-fourth of the median family income. As a consequence, though the US spends far more on health care than any other nation, we leave millions of our people without any coverage at all. And those who do have coverage increasingly find that their plans are inadequate, exposing them to financial hardship and even bankruptcy when illness strikes.

If we believe that everyone should have health care coverage, and that financial barriers should not prevent us from accessing health care when we need it, then it has become clear that the private health insurance system cannot meet our needs. Health care has simply become too expensive to be financed through private insurance premiums.

Supporters of insurance companies claim that they create efficiency through competition. However, the truth is that insurance industry is increasingly concentrated, with three national firms, United Health, Wellpoint, and Aetna, dominating the industry. And the high and rising cost of health care shows that whatever competition there was in the past has not worked to hold down costs.

Supporters of private insurance also claim that it expands consumer choice. However, the choice of plans that these companies offer is not what consumers want; it is the choice of their physician and hospital, exactly the choice that private insurance plans, in the guise of managed care, increasingly deny us.

What has been the response of the health insurance industry to this situation? To protect their markets and try to make premiums affordable, they have reduced the protection afforded by insurance by shifting more of the cost to patients, especially through high-deductible plans. They have also targeted their marketing more narrowly to the healthy portion of the population, so as to avoid covering individuals with known needs for health care. Yet premiums continue to rise each year, increasing by nearly 70% above inflation in just the last six years.

The so-called “universal health care” proposals being put forward by mainstream politicians would simply expand the current system without addressing any of its problems. They would simply mandate that either our employers provide us with coverage or we, as individuals, purchase our own coverage in the private insurance market. These plans cannot work in the face of the high cost of premium-based coverage for even the average person. (Some proposals would offer the option of buying a competing public plan, under the theory that the public program would be more efficient and effective. The flaw here is that the public plan would attract those who are unable to afford private coverage or who are paying high premiums or have no insurance because of pre-existing conditions. Placing these high-cost individuals in a separate government pool would make it unaffordable for most other people. This “death spiral” would cause the public plan to fail.)

The main impetus for renewed interest in health care reform has been the rapid rise in costs over the last few years. Yet, while most of these proposals give lip service to the need to control costs, none actually addresses the problem in a serious way. (The introduction of health information technology and “disease management”, which some of them urge, are mere placebos; they may make politicians feel better, but studies have shown they will do little to reduce costs and may actually increase them.)

Everyone acknowledges that coverage for low-income individuals must be subsidized. But what about the average-income individual and family? If they must now be subsidized as well, we might as well throw in the towel and recognize that a more efficient, more equitable financing system has to be adopted if it has any chance of providing coverage while being affordable to the society. An individual mandate to purchase private insurance cannot provide good coverage while remaining affordable, while employer-provided coverage also can no longer be sustained as the premium costs to the employer become increasingly unaffordable.

The private insurance industry spends about 20 percent of its revenue on administration, marketing, and profits. Further, this industry imposes on physicians and hospitals an administrative burden in billing and insurance-related functions that consumes another 12 percent of insurance premiums. Thus, about one-third of private insurance premiums are absorbed in administrative services that could be drastically reduced if we were to finance health care through a single non-profit or public fund. Indeed, studies have shown that replacing the multiplicity of public and private payers with a single national health insurance program would eliminate $350 billion in wasteful expenditures, enough to pay for the care that the uninsured and the underinsured are not currently receiving.

Such a single payer plan would make possible a set of mechanisms, including public budgeting and investment planning, that would allow us to address the real sources of cost increases and allow us to rationalize our health care investments. The drivers of high cost such as administrative waste, deterioration of our primary care infrastructure, excessive prices, and use of non-beneficial or detrimental high-tech services and products could all be addressed within such a rationalized system.

In sum, we will not be able to control health care costs until we reform our method of financing health care. We simply have to give up the fantasy that the private insurance industry can provide us with comprehensive coverage when this requires premiums that average-income individuals cannot afford. Instead, the U.S. already has a successful program that covers more than forty million people, gives free choice of doctors and hospitals, and has only three percent administrative expense. It is Medicare, and an expanded and improved Medicare for All (Medicare 2.0) program would cover everyone comprehensively within our current expenditures and eliminate the need for private insurance. This is the direction we must go.

Leonard Rodberg is Research Director of the New York Metro Chapter, and Don McCanne, Senior Policy Fellow, of Physicians for a National Health Program. www.pnhp.org