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JUNE 2009
CANADIAN HEALTH CARE MYTHS
KEY LAWMAKERS DECIDING HEALTHCARE
POLICY HAVE $11-27 MILLION IN HEALTH INDUSTRY
WASHINGTON STATE HIKES HEALTH
PLAN PREMIUMS TO DRIVE POOR OFF ITS ROLLS
LIFE & HEALTH INSURERS INVEST
BILLIONS IN TOBACCO COMPANIES
MEDICAL BILLS BEHIND 60% OF AMERICAN BANKRUPTCIES
SIMPLE STEPS TOWARDS UNIVERSAL
HEALTH CARE
MAY 2009
STUDY: INSURED FIND MEDICARE BETTER
THAN PRIVATE PLANS
HEALTH INDUSTRY SAYS OBAMA MISLED
ON ITS PROMISE
HEALTH CZAR IS WALKING CONFLICT
OF INTEREST
OBAMA, MEDIA LAUNCH WAR ON SOCIAL
SECURITY & MEDICARE
STUDY FINDS MEDICARE FOR ALL BEST
HEALTH PLAN FOR POOR, BLACKS, LATINOS
APRIL 2009
LARGEST HEALTH INSURER LAUNCHES
CAMPAIGN AGAINST REFORM
HEALTH INSURANCE CON #342: FAKE
LETTERS TO NEWSPAPERS
60% OF AMERICANS HAVE TAX PAID
HEALTH INSURANCE
WHY A PUBLIC-PRIVATE HEALTH INSURANCE
SYSTEM WON'T WORK
BERNIE SANDERS INTRODUCES SINGLE
PAYER BILL
INSIDE OBAMA'S HEALTHCARE SHOW
SUMMIT: SINGLE PAYER PRESENT BUT GAGGED
NEAR TOTAL BLACKOUT OF SINGLE
PAYER BY MAJOR MEDIA
MARCH 2009
MASSACHUSETTS HEALTHCARE PLAN
FAILING
THE DEMOCRATS' LOUSY HEALTHCARE
PLAN & WHY SINGLE PAYER IS BETTER
KEY DEMOCRATS FAVOR REQUIREMENT
THAT CITIZENS SUBSIDIZE HEALTH INSURANCE CORPORATIONS
ESCALATING THE WAR ON SOCIAL SECURITY
& MEDICARE
BRITISH REPORT ON BLOOD SCANDAL
TARGETS U.S. FIRMS, USE OF PRISON INMATES
OBAMA'S BRAVE NEW WORLD
THE HEALTH PLAN THAT WORKS FOR
EVERYONE BUT THE POLITICIANS
59% SUPPORT FEDERAL HEALTH INSURANCE
FEBRUARY 2009
MASSACHUSETTS HEALTHCARE PLAN
FAILING
Suzanne L. King, Boston
Globe - 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. . .
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.
JANUARY 2009
THROW GRANNY FROM THE TRAIN: TALKING
UP HEALTHCARE RATIONING
PRIVATIZED HEALTH INSURANCE HURTS
AMERICAN ECONOMY
GREAT SLIDE SHOW ON SINGLE PAYER
SINGLE PAYER FAQ
TWO UNIONS BATTLE OVER HEALTHCARE
ISSUE
NOVEMBER 2008
AMERICANS CUTTING BACK ON HEALTHCARE
JULY 2008
AL GORE ENDORSES SINGLE PAYER
HEALTH CARE
A HISTORY OF MEDICARE AND EFFORTS
TO STOP IT
U.S. CONFERENCE OF MAYORS BACKS
SINGLE-PAYER
AMERICANS LEAST HAPPY WITH THEIR
HEALTHCARE AMONG DEVELOPED NATIONS
Reuters Americans are
the least satisfied with their health care system, while the
Dutch system is rated the best, according to new research. Polls
about health care in 10 developed countries by Harris Interactive
revealed . . . in the United States a third of Americans believe
their system needs to be completely overhauled, while a further
50 percent feel that fundamental changes need to be made.
"Given that all countries
other than the U.S. have universal health care systems in place,
this may invite questions on why the U.S. remains the only wealthy,
industrialized country without such a system," Harris president
George Terhanian told Reuters.
In the Netherlands, where
health care is financed by mandatory health insurance, 42 percent
of people think their system works well and needs only minor
changes.
And only nine percent
of the Dutch think a complete overhaul is necessary, compared
to 12 percent in Canada and Spain, 15 percent Britain and France,
17 percent in Germany and New Zealand, 18 percent in Australia
and 20 percent in Italy, according to the polls of more than
1,000 people in each country.
France's health system,
based on compulsory national insurance, was ranked best in the
world by the WHO in 2000, while Britain's National Health Service,
the world's largest publicly funded system, was in 18th place.
The Harris comparison
of the national surveys showed that 70 percent of the French
and 59 percent of Britons think their health services are "the
envy of the world."
Nearly 70 percent of Germans,
a majority of whom receive coverage from state-funded insurance
plans, feel that access to healthcare depends on a patient's
ability to pay for it.
But at least 47 percent
of those surveyed in all countries think there are some good
things in their systems but they need to be improved.
WORLD LEADERS DISCUSS GLOBAL FOOD
CRISIS
OVER GOURMET MEALS
WHY MCCAIN'S HEALTH CARE PLAN
WON'T WORK
LEAD AUTHOR OF STATIN FOR KIDS
REPORT HAS WORKED FOR MERCK
POLL FINDS ISRAELIS DEEPLY PREJUDICED
AGAINST ARABS
MERKEL TELLS OBAMA TO KEEP HIS
CAMPAIGNING AT HOME
59 MILLION AMERICANS ENDANGERED
BY INSURANCE BASED HEALTH POLICY
JUNE 2008
59% OF DOCTORS SUPPORT SINGLE
PAYER
SEIU ENDORSES CONYER'S SINGLE
PAYER PLAN
MCCAIN'S HEALTH PLAN WOULD COST
WOMEN MORE
ELIZABETH EDWARDS, THINK
PROGRESS Senator John McCain's health plan is based on the idea
that everyone should be on their own to buy their health insurance
on the individual market. And it's an approach fundamentally
at odds with the point of health insurance: that we share risks.
People with preexisting conditions, like McCain and myself, would
pay much more for health insurance under his health plan, if
we could get coverage at all.
Insurance companies have
all sorts of characteristics they look at in order to increase
premiums, such as preexisting conditions, occupation, age, and
residence. But I hadn't realized that the McCain plan would enable
insurers to "rate-up" my insurance bill for not only
my status as a breast cancer patient, but also my gender.
The ability to become
pregnant has long been understood as an excuse to charge women
more for health insurance (because, of course, men have nothing
to do with that particular health condition). But [a David] Lazarus
column . . . tells us that insurers are charging women higher
premiums even if pregnancy benefits are excluded. Blue Shield
of California (Blue Shield) is now charging woman more in the
individual market because:
"Our egghead actuaries
crunched the numbers based on all the data we have about healthcare,"
explained Tom Epstein, a Blue Shield spokesman. "This is
what they found."
That women get sicker
than men?
"It's all about the
statistics," Epstein said. . .
Whatever their reasoning,
one thing is clear - they don't want to enroll too many women:
"We don't want to
get a disproportionate share of high-risk people," added
Epstein.
SEIU ENDORSE CONYER'S
SINGLE PAYER PLAN
The SEIU convention went
on record in support of HR 676, single payer healthcare legislation
introduced by Congressman John Conyers (D-MI). The SEIU is the
thirteenth international union to endorse HR 676. Other international
unions that have endorsed HR 676 are UAW, NEA, ILWU, NALC, IAM,
Plumbers & Pipefitters, Musicians, UE, CNA/NNOC, SMWIA, IFPTE
& OPEIU.
HR 676 would institute
a single payer health care system in the U.S. by expanding a
greatly improved Medicare system to every resident. HR 676 would
cover every person in the U. S. 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, chiropractic and
long term care. HR 676 ends deductibles and co-payments. HR 676
would save billions annually by eliminating the high overhead
and profits of the private health insurance industry and HMOs.
HR 676 currently has 90 co-sponsors in addition to Conyers. It
has been endorsed by 435 union organizations in 48 states.
RESEARCH FIRM EXPOSES MYTH OF
'UNIVERSAL HEALTHCARE'
WASHINGTON BUSINESS JOURNAL Current
retirees will need tens or even hundreds of thousands of dollars
in savings to ensure that they can afford health care after leaving
the workplace. That is according to new data from nonpartisan
research firm EBRI. . .
For example, a married couple of two 65-year-olds retiring this
year would need current savings of $235,000 to have a 90 percent
chance of having enough cash to afford their health costs in
retirement. That's assuming the couple supplements Medicare with
subsidized insurance premiums from a former employer.
Couples who have unsubsidized insurance
from an old employer, on the other hand, would need $376,000
in current savings for a 90 percent chance of covering their
costs. And a couple with individually purchased insurance to
supplement Medicare would need $635,000.
MAY 2008
INSURANCE COMPANIES FOUND TO BE
ALREADY RIPPING OFF MEDICARE DRUG PATIENTS
PRIVATIZED MEDICAL INSURANCE SYSTEM
RESULTS IN UP TO 18,000 DEATHS A YEAR
APRIL 2008
A HEALTH CARE SYSTEM THAT WORKS
MARY CLINE, ABC NEWS The World Health Organization
has named the French health care system the best in the world.
(The U.S. ranked 37th). It's physician-rich, boasting one doctor
for approximately every 430 people, compared with a doctor for
every1,230 residents in the U.S. (and French docs tend to charge
significantly less). The average life expectancy is two years
longer than the U.S. And while the system is one of the most
expensive in the world, costing $3,500 per person, it's far less
than the $6,100 spend per capita in the U.S.
I've had a unique opportunity to see both
systems up close and personal: I had breast cancer in California
nine years ago and a recurrence in Paris this year. I received
excellent care in both places, though looking back now my California
oncologist's office was a bit of a meat market - always packed
with patients, from the seemingly not-so-sick to some a step
from the grave - a time-consuming disadvantage of living in a
much larger country with a lower doctor-to-patient ratio. My
French doctors and nurses have been sensitive, skillful, caring
- and not so harried.
But the biggest difference has been money.
My top-level health insurance paid for most of my U.S. care,
but it was often a struggle to shake loose the money. I was frequently
stuck in the middle of disputes between the company and my hospital
and doctors over "agreed to fees."
Continually dunned by the hospital for
fees and facing multiple complaining phone calls to my insurance
company, I sometimes simply caved in and wrote checks to cover
bills that I knew were the insurance company's responsibility
- part of a wearing-down strategy I was convinced was deliberate.
Here in France I have a green carte vitale
- literally a "life card" or social security card that
provides entree to the system. It's funded by worker contributions
and other taxes. My husband (and our family) is covered through
his work with a French subsidiary of a U.S. company, and so is
everyone else; coverage is universal. The French are responsible
for co-pays, but some 80% of them have supplemental private insurance
to cover the co-pay. People least able to pay and those with
chronic or serious illnesses often have the best coverage. .
.
The effect of a system where hospitals
and doctors don't worry about getting stiffed by a patient or
an insurance company seems to be a far more relaxed, generous
system. When my surgeon discussed breast surgery here, he suggested
that I stay in the hospital five days. "Of course I can
do it the American way, kind of an outpatient situation,"
he told me, apparently not wanting to sound unsophisticated.
"But I don't like pain."
Maternity stays for a normal delivery are
a minimum of five days, not the 48 hours mandated by U.S. federal
legislation in 1998 after many insurance companies insisted stays
be even shorter.. . .
There's no question you'll be treated in
France. Everyone is. The nation pays the bills and the hospitals
don't get stiffed. It's an all-encompassing cradle-to-grave system.
My fear now is that I won't be able to even get insurance when
and if I return to the states, much less be able to afford it.
MARCH 2008
59% OF DOCTORS FAVOR SINGLE PAYER
HEALTH SYSTEM THAT OBAMA & CLINTON ARE AFRAID TO ENDORSE
MASSACHUSETTS HEALTH PLAN AGAIN SHOWS IT
ISN'T WHAT THEY SAID IT WOULD BE
FEBRUARY 2008
BLUE CROSS ASKS DOCTORS TO RAT
ON PATIENTS WITH PRE-EXISTING CONDITIONS
NINE SECRETS HEALTH INSURERS DON'T
WANT YOU TO KNOWN
REALITY CHECK: THE FAKE DEBATE
OVER HEALTHCARE
WHY BANKS LOVE CLINTON'S HEALTHCARE PLAN
ROSE ANN DEMORO, HUFFINGTON POST - Behind
the escalating debate on the health care between Senators Hillary
Clinton and Barack Obama on individual mandate -- she's for it,
he's against it -- is a critical policy battle that not only
cuts across health care reform but also the neo-liberal privatization
dreams, the home mortgage crisis, and the recession that is no
longer looming, it's here. . .
Banks are already into health care in a
big way, serving as a repository for health savings accounts
and other tax credit schemes so beloved by the Bush administration
and the Republican presidential candidates. But the financiers
would like more.
Enter the neo-liberal think tanks and policy
wonks and plans they hawk to expand the reach of the market,
especially the financial market, in health care. Central to that
approach is shotgun insurance, forcing everyone not currently
covered to buy health insurance policies.
Compelling people to buy insurance, however,
is not the easiest sell. Big insurers and HMOs have a well deserved
bad reputation for heartless denials of care - that's how they
make money. And, it's pricey. Premiums the past decade have gone
up 87 percent, not to mention the ever climbing bills for deductibles,
co-pays, and a host of other transaction fees.
The finance industry is over the moon with
this scheme.
For insurers, it means millions of new
customers marched into their offices with the force of law. With
no controls on costs, many consumers will just add on more debt.
That's a boon for the credit card companies and other financial
institutions, but a heavy new burden on many of the same people
now losing their homes or struggling with other financial hardship.
. .
To shroud the colossal problems and the
real story of who actually makes out like bandits under this
scheme, the proponents, including some liberal policy experts,
have dressed it up with poll-tested rhetoric that mandatory insurance
is "universal health care."
But "having" insurance is not
the same as being able to use it. You're only being mandated
to purchase the premiums; they're not mandating the insurance
companies to make sure you get the care you need. Nor does "having"
insurance protect you from financial ruin.
It accelerates the dismantling of group
insurance plans with individuals forced to go it alone in the
individual market, and institutionalizes risk and cost shifting
on to the backs of individuals and families.
[DeMoro is executive director of the California
Nurses Association/National Nurses Organizing Committee]
JANUARY 2007
U.S. RANKS LAST AMONG INDUSTRIALIZED NATIONS IN
DEALING WITH PREVENTABLE DEATHS
REUTERS - France, Japan and Australia rated
best and the United States worst in new rankings focusing on
preventable deaths due to treatable conditions in 19 leading
industrialized nations. If the U.S. health care system performed
as well as those of those top three countries, there would be
101,000 fewer deaths in the United States per year, according
to researchers writing in the journal Health Affairs.
Researchers Ellen Nolte and Martin McKee
of the London School of Hygiene and Tropical Medicine tracked
deaths that they deemed could have been prevented by access to
timely and effective health care, and ranked nations on how they
did. . .
Nolte said the large number of Americans
who lack any type of health insurance -- about 47 million people
in a country of about 300 million, according to U.S. government
estimates -- probably was a key factor in the poor showing of
the United States compared to other industrialized nations in
the study.
HEALTHCARE INCREMENTALISM ISN'T
WORKING
MARK DUNLEA, COMMON DREAMS
- "Bold, new experiments in moving our state to universal
health care" have invariably withered away over time, often
in only a few years.
For instance, the media
coverage over the new "universal" health care system
in Massachusetts generally failed to mention similar pronouncements
from Governor Dukasis two decades previously that fell apart
in a few years. Because Massachusetts expanded its subsidies
for insurance premiums for low-income people, over 160,000 of
those eligible signed up this year. But only 7% of the nearly
250,000 who must buy unsubsidized insurance -- or face a fine
of $2,000 in 2008 -- purchased private health insurance this
year. Thus the plan will end its first year at least $147 million
over budget, with Massachusetts preparing to cut payments to
doctors and hospitals and ramp up out-of-pocket costs for patients.
And nearly 500,000 in Massachusetts remain uninsured. Yet the
leading Democratic Presidential contenders now embrace Massachusetts'
mandate for individual purchase of health insurance.
Maine's patchwork approach
to universal health care - the Dirigo plan - is not working.
Nor have the plans in Vermont, Minnesota, Washington and Oregon.
Tennessee's noteworthy TennCare program to help the poor and
uninsured is in the process of being dismantled. NY has added
targeted programs such as Child Health Plus and Family Health
Plus yet more than 5 million New Yorkers annually lack health
insurance.
This fall Vermont launched
"Catamount Health," a plan to cover all Vermonters
by subsidizing private health insurance from MVP and Blue Cross
Blue Shield with a combination of tobacco tax money, Medicaid
money and new taxes on employers who don't offer health insurance.
But as the plan takes its first steps, the inadequate insurance
for those who have it, with soaring co-pays, huge deductibles
and unaffordable prescription drugs has put the crisis in health
care back into the legislative agenda for 2008, front and center.
. .
Incremental approaches
evade the fundamental problems that are causing the ongoing crisis
in our health care system. Real change requires addressing the
entire structure of financing -- in which employer-based private
health insurance dominates. Without facing this, the problem
of costs cannot be solved. Most of the money spent on health
care in New York comes from government (federal and state) spending,
yet private health insurance dominates the system. As Governor
Spitzer has pointed out, NY's system of health care financing
is often not directly tied to the services being provided, its
complexity and irrationality a result of the backroom deal making
at the State Capitol.
Incremental approaches
have done little to nothing to control costs, while adding more
people to the system, thus causing more financial strain on both
the government and private sectors, especially in bad economic
times
DECEMBER 2007
MASSACHUSETTS HEALTHCARE
PLAN ALREADY FAILING
[From a group of Massachusetts physicians]
MASSACHUSETTS PHYSICIANS - In 2006, our state enacted a law designed to
extend health coverage to virtually all state residents. Political
leaders in other states as well as several Democratic presidential
candidates have embraced this model.
Massachusetts' law mandates that uninsured
individuals must purchase private insurance or pay a fine. The
law established a new state agency to ensure that affordable
plans were available; offered low income residents subsidies
to help them buy coverage; and expanded Medicaid coverage for
the very poor. (Immigrants are mostly excluded from these subsidized
programs.) Moneys that previously funded free care for the uninsured
were shifted to the new insurance program, along with revenues
from new fines on employers who fail to offer health benefits
to their workers. In addition, the federal government provided
extra funds for the program's first two years.
Starting January 1, 2008 Massachusetts
residents face fines if they cannot offer proof of insurance.
Yet as of December 1, 2007 only 37% of the 657,000 uninsured
had gained coverage under the new program. These individuals
often feel well served by the reform in that they now have health
insurance. However, 79% of these newly insured individuals are
very poor people enrolled in Medicaid or similar free plans.
Virtually all of them were previously eligible for completely
free care funded by the state, but face co-payments under the
new plan. In effect, public funds for care of the poor that previously
flowed directly to hospitals and clinics now flow through insurers
with their higher administrative costs.
Among the near poor uninsured (who are
eligible for partial premium subsidies) only 16% had enrolled
in the new coverage. And barely 7% of the uninsured individuals
with incomes too high to qualify for subsidies had enrolled according
to the official state figures. Few can afford premiums for even
the skimpiest coverage; the lowest cost plan offered for a couple
in their fifties costs $8,200 annually, and carries a $2,000
per person deductible.
Moreover, the state's cost for subsidies
is running $147 million over the $472 million budgeted for fiscal
year 2007. Meanwhile, collections from fines on employers who
fail to provide coverage are 80% below the original projections.
The funding gap will widen in future years as health care costs
escalate and insurers raise premiums. Already, state officials
speak of making up the shortfall by forcing patients to pay sharply
higher co-pays and deductibles, and by slashing funds promised
to safety net hospitals.
While patients, the state and safety net
providers struggle, private insurers have prospered under the
new law, and the costs of bureaucracy have risen. Blue Cross,
the state's largest insurer, is reaping a surplus of more than
$1 million each day, and awarded its chairman a $16.4 million
retirement bonus even as he continues to draw a $3 million salary.
All of the major insurers in our state continue to charge overhead
costs five times higher than Medicare and eleven-fold higher
than Canada's single payer system. Moreover, the new state agency
that brokers private coverage adds its own surcharge of 4.5%
to each policy it sells.
A single payer program could save Massachusetts
more than $9 billion annually on health care bureaucracy, making
universal coverage affordable. But because the 2006 law deepened
our dependence on private insurance, it can only add coverage
by adding costs. Though politically feasible, this approach is
already proving fiscally unsustainable. The next economic downturn
will push up the number of uninsured just as the tax revenues
needed to fund subsidies fall.
The lesson from Massachusetts is that we
still need real health care reform: single payer, non- profit
national health insurance.
NOVEMBER 2007
AMERICAN STYLE HEALTHCARE: HOSPICES FORCED TO REPAY
MEDICARE FOR PATIENTS WHO LIVE TOO LONG
NY TIMES - Hundreds of hospice providers
across the country are facing the catastrophic financial consequence
of what would otherwise seem a positive development: their patients
are living longer than expected.
Over the last eight years, the refusal
of patients to die according to actuarial schedules has led the
federal government to demand that hospices exceeding reimbursement
limits repay hundreds of millions of dollars to Medicare.
The charges are assessed retrospectively,
so in most cases the money has long since been spent on salaries,
medicine and supplies. After absorbing huge assessments for several
years, often by borrowing at high rates, a number of hospice
providers are bracing for a new round that they fear may shut
their doors. . .
In the early days of the Medicare hospice
benefit, which was designed for those with less than six months
to live, nearly all patients were cancer victims, who tended
to die relatively quickly and predictably once curative efforts
were abandoned.
But in the last five years, hospice use
has skyrocketed among patients with less predictable trajectories,
like those with Alzheimer's disease and dementia. Those patients
now form a majority of hospice consumers, and their average stays
are far longer - 86 days for Alzheimer's patients, for instance,
compared with 44 for those with lung cancer, according to the
Medicare Payment Advisory Commission. . .
Medicare, which pays the vast majority
of hospice bills, reimburses providers $135 a day for a patient's
routine home care. The hospice is then responsible for providing
nurses, social workers, chaplains, doctors, drugs, supplies and
equipment, as well as bereavement support to the family.
Studies have reached various conclusions
about whether hospice care actually saves money, especially for
long-term patients. But a new study by Duke University researchers
concluded that it saved Medicare an average of $2,300 per beneficiary,
calling hospice "a rare situation whereby something that
improves quality of life also appears to reduce costs."
In 1998, Congress removed limits on the
number of days that an individual could receive Medicare hospice
coverage, a move that encouraged physicians to refer terminal
patients.
WHY PRIVATE INSURANCE BASED HEALTH CARE
WON'T WORK
STEFFIE WOOLHANDLER AND DAVID U. HIMMELSTEIN
- In 1966 - just before Medicare and Medicaid were launched -
47 million Americans were uninsured. By 1975, the United States
had reached an all time low of 21 million without coverage. Now,
according to the Census Bureau's latest figures, we're back where
we started, with 47 million uninsured in 2006 - up 2.2 million
since 2005. But this time, most of the uninsured are neither
poor nor elderly.
The middle class is being priced out of
healthcare. Virtually all of this year's increase was among families
with incomes above $50,000; in fact, two-thirds of the newly
uncovered were in the above-$75,000 group. And full-time workers
accounted for 56 percent of the increase, with their children
making up much of the rest.
The new Census numbers are particularly
disheartening for anyone hoping for a Massachusetts miracle.
In the Commonwealth, 651,000 residents are uninsured, 65 percent
more than the figure used by state leaders in planning for health
reform. Their numbers came from a telephone survey done in English
and Spanish. But that misses people who lack a land-line phone
- 43.9 percent of phoneless adults are uninsured, according to
other studies.
It also skips over the 523,000 non-English
speakers in Massachusetts whose native language isn't Spanish
(e.g. Portuguese, Chinese, or Haitian-Creole), another group
with a high uninsurance rate. . .
Why has progress been so meager? Because
most of the promised new coverage is of the "buy it yourself"
variety, with scant help offered to the struggling middle class.
According to the Census Bureau, only 28 percent of Massachusetts
uninsured have incomes low enough to qualify for free coverage.
Thirty-four percent more can get partial subsidies - but the
premiums and co-payments remain a barrier for many in this near-poor
group.
And 244,000 of Massachusetts uninsured
get zero assistance - just a stiff fine if they don't buy coverage.
A couple in their late 50s faces a minimum premium of $8,638
annually, for a policy with no drug coverage at all and a $2,000
deductible per person before insurance even kicks in. Such skimpy
yet costly coverage is, in many cases, worse than no coverage
at all. Illness will still bring crippling medical bills - but
the $8,638 annual premium will empty their bank accounts even
before the bills start arriving. Little wonder that barely 2
percent of those required to buy such coverage have thus far
signed up. . .
Health reform built on private insurance
isn't working and can't work; it costs too much and delivers
too little. At present, bureaucracy consumes 31 percent of each
healthcare dollar. The Connector - the new state agency created
to broker coverage under the reform law - is adding another 4.5
percent to the already sky-high overhead charged by private insurers.
Administrative costs at Blue Cross are nearly five times higher
than Medicare's and 11 times those in Canada's single payer system.
Single payer reform could save $7.7 billion annually on paperwork
and insurance profits in Massachusetts, enough to cover all of
the uninsured and to upgrade coverage for the rest of us.
Of course, single payer reform is anathema
to the health insurance industry. But breaking their stranglehold
on our health system and our politicians is the only way for
health reform to get beyond square one.
[Dr. Steffie Woolhandler and Dr. David
Himmelstein co-founded Physicians for a National Health Program]
ANOTHER REASON FOR SINGLE PAYER
HEALTHCARE: INSURERS RENEGE ON AGREEMENTS
INSURANCE INDUSTRY (THAT ALL MAJOR DEMOCRATIC &
GOP CANDIDATES FAVOR) FOUND TO BE ALREADY RIPPING OFF MEDICARE
DRUG PATIENTS
ROBERT PEAR, NY TIMES - Tens of thousands of Medicare recipients
have been victims of deceptive sales tactics and had claims improperly
denied by private insurers that run the system's huge new drug
benefit program and offer other private insurance options encouraged
by the Bush administration, a review of scores of federal audits
has found.
The problems, described in 91 audit reports reviewed by The New
York Times, include the improper termination of coverage for
people with H.I.V. and AIDS, huge backlogs of claims and complaints,
and a failure to answer telephone calls from consumers, doctors
and drugstores.
Medicare officials have required insurance companies of all sizes
to fix the violations by adopting "corrective action plans."
Since March, Medicare has imposed fines of more than $770,000
on 11 companies for marketing violations and failure to provide
timely notice to beneficiaries about changes in costs and benefits.
The companies include three of the largest participants in the
Medicare market, UnitedHealth, Humana and WellPoint.
MORE THAN ONE THIRD OF AMERICANS UNDER 65 LACKED
HEALTH INSURANCE IN LAST TWO YEARS
REUTERS - More than one-third of the U.S.
population under the age of 65 went without health insurance
for all or part of the last two years. . . The nonprofit Families
USA group used data from last month's U.S. Census Bureau report
that found 47 million Americans went without health insurance
for all of 2006. Families USA broke down that figure and calculated
that 89.6 million people under age 65 -- 34.7 percent -- went
without health insurance at some point during 2006-2007. It used
a projection for the remaining months of this year.
ANOTHER REASON FOR SINGLE PAYER HEALTHCARE:
INSURERS RENEGE ON AGREEMENTS
VICTORIA COLLIVER, SF CHRONICLE
- Health Net Inc., one of the state's largest health insurers,
tied rewards and savings to its employees' ability to cancel
policies based on misrepresentations in members' applications,
according to documents in a lawsuit against the company.
The documents showed Health Net
saved $35.5 million in "unnecessary" health care expenses
for rescinding more than 1,000 policies between 2000 and 2006.
At the same time, a Health Net analyst received about $21,000
in bonuses for her work, which included exceeding company goals
for policy rescissions.
The information was revealed
during an arbitration hearing this week in San Bernardino County
in a lawsuit filed by Patsy Bates, a 51-year-old hairdresser
from Gardena (Los Angeles County) who is suing Health Net for
$6 million plus punitive damages for revoking her policy after
her breast cancer was diagnosed.
Health insurers in California
and nationwide have come under fire for reviewing applications
of members after they file medical claims and rescinding their
policies based on any discrepancies found in the original health
questionnaire. The issue affects members with individual, rather
than group, plans because those policies undergo medical underwriting
before an applicant is accepted.
Insurers say the practice is
legal and necessary because it protects them against fraud, and
keeps premiums lower for those members who truthfully reveal
their health history. But state regulators and plaintiffs' lawyers
have argued that the applications often are vague and confusing,
and that it's not fair for insurers to review applications only
after members file an expensive claim.
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/11/10/BUCLT9JOV.DTL
PRIVATIZED MEDICAL INSURANCE SYSTEM
RESULTS IN UP TO 18,000 DEATHS A YEAR
PROJECT CENSORED - The Sonoma State University
Institute of Medicine estimates that as many as eighteen thousand
Americans die prematurely each year because they do not have
health insurance. This figure does not include those who die
prematurely each year because their insurers delay, diminish,
or deny payment for promised benefits. Reports about people who
die unnecessarily from services denied or delayed by insurance
companies seldom receive broad coverage in the corporate media.
Lack of media coverage has led to a nation of people uninformed
about how national health and disability policies are controlled
by the private insurance industry and how government regulators
are powerless to do anything about it.
http://www.projectcensored.org/HCDI_1007.pdf
SEPTEMBER 2007
WHY UNIVERSAL HEALTHCARE IS GOOD BUSINESS
DAVID KARWACKI, SALT LAKE CITY TRIBUNE
- I'm the owner of a company in Canada and another in the United
States that distribute fresh produce around the globe. My Canadian
company has three corporate advantages over my U.S. company and
our U.S. competitors: healthy workers, lower operating costs
and better worker safety through social cohesion. In my experience,
healthy workers are more productive because they take less sick
time than those who don't, or can't afford, to take care of their
health. Lack of health-care access is a barrier to preventive
care. Those who ignore early symptoms of an illness because their
credit cards are maxed-out end up being less productive and may
have to leave the work force. Then the employer faces the expense
of training replacement workers.
The Organization for Economic Co-operation
and Development estimates that total health expenditures in Canada
amounted to 9.9 percent of GDP in 2004. In the United States
it was 15.3 percent. And even though Americans spend more on
health care, their life expectancy is, on average, two years
less than Canadians. Many U.S. companies enjoy a competitive
edge in technology because of the R&D of the military industrial
complex. In Canada it's our single-insurer health-care system
that provides us with a competitive advantage. My U.S. company
pays, on average, a premium of $9,300 per year for each employee
to provide just basic medical insurance. My Canadian firm pays
no premium. The costs are paid out of taxes and from resource
royalties. High health-care costs in the United States have been
cited as one very big reason for what some people are calling
"the outsourcing of America." Witness the steady decline
of the domestic auto manufacturing sector.
Finally, I would argue that universal health
care provides a social cohesion and increases our general security
by helping to lift people out of poverty. A healthy population
with access to health care is more likely to be productive and
beneficial to the community. The rates of violent crime in Canada
have yet to reach even a shadow of what is happening in America.
The economic reasons for universal medical
coverage are clear. Just as important, however, is what Medicare
says about our country and its people. We believe in the principle
that everyone should have access to reasonable health care. That
way life, liberty and the pursuit of happiness is for all of
us - not just those who can afford it.
[David Karwacki is the leader of the Liberal
Party]
http://www.sltrib.com/opinion/ci_6594374
JULY 2007
HOW THE NY TIMES RIGS THE HEALTHCARE
DEBATE
DEAN BAKER, PROSPECT - The NYT had a piece
on the health care plans being put forward by the presidential
candidates that seemed determined to frame the issues in a set
of caricatures, where Democrats push for big government while
Republicans like the market. It makes this assertion at several
points, at one point even telling readers mockingly that "Democrats
are competing furiously among themselves over who has the bigger,
better plan to control costs and to approach universal coverage."
But is this government/market distinction
accurate? Do the Republicans favor ending the subsidies for the
private insurers operating within the Medicare program that the
Medicare Payments Advisory Commission estimates at 12 percent
per beneficiary? Isn't a government subsidy a form of government
intervention?
Do the Republicans favor eliminating government
granted patent monopolies that raise the price of prescription
drugs and medical supplies to levels that are many times the
free market price? Aren't government imposed monopolies a form
of government intervention?
In short, the NYT piece is written entirely
from the Republican perspective in which the interventions they
support, which have the effect of redistributing income upward
and making health care more expensive, are disguised as being
simply the natural workings of the market. On the other hand,
the efforts of the Democrats to restructure the market to make
it more workable (e.g. mandating coverage to eliminate the problem
of adverse section) are mocked as "big government."
http://www.prospect.org/csnc/blogs/beat_the_press
HOW DEMOCRATS, SEIU CON VOTERS ON SINGLE
PAYER HEALTH CARE
CORPORATE CRIME REPORTER - On Capitol Hill
today, SEIU held a rally for a couple of hundred health care
workers. The group was addressed by six Senators. . . We asked
Dawn Lee, a spokesperson for SEIU, whether SEIU supported HR
676 -- the single payer bill in the House. She said SEIU takes
no position on that bill.
SEIU does not support single payer. At
the SEIU rally, all spoke in favor of "universal health
care." That is code for keep the insurance companies in
the game. Single payer would take them out.
Martese Chism was at a similar rally in
Chicago last month. Chism is a registered nurse at Cook County
Hospital in Chicago. She also sits on the board of the California
Nurses Association. . . Chism was attending an SEIU rally in
Chicago in support of Illinois Governor Rod Blagojevich's "universal
health care" bill that would keep the insurance companies
in the game.
Chism says that the SEIU members who gathered
for the rally were being actively misled by SEIU. "SEIU
members are being led to believe that universal health care means
free health care for all -- single payer. . .
CNA president Rose Ann DeMoro is a touch
less subtle. "Rather than being on the side of the workers,
SEIU continues to be on the side of the bosses," DeMoro
told Corporate Crime Reporter. "And it's a disgrace."
"And the problem is that SEIU is giving
cover to these Senators -- it makes them look like they are accomplishing
something when in fact they are accomplishing
http://www.counterpunch.org/ccr06262007.html
JUNE 2007
PUBLIC RANKS HEALTHCARE AS SECOND MOST
IMPORTANT ISSUE
KAISER FOUNDATION - Health care remains
the top domestic issue that the public wants presidential candidates
to address, trailing only Iraq on the public's overall priority
list, according to the latest Kaiser Family Foundation Health
tracking poll. The June poll finds that 43% of adults cite Iraq
as one of the most important issues for presidential candidates
to talk about, followed by health care (21%). Iraq ranks first
among Democrats, Republicans and independents alike.
Health care ranks second among Democrats
and independents, while Republicans rank immigration slightly
ahead of health (20% vs. 18%). Immigration rose sharply as an
issue since March and ranks third overall with 18% in the new
poll, which was taken as media attention focused on the Senate
debate about immigration reform legislation. The economy (13%)
and gas prices (12%) follow.
The poll also measures the public's perceptions
of the presidential candidates on health issues. To date, most
people don't know or can't name the candidate who they feel is
placing the biggest emphasis on health or the candidate who most
matches their own views. Across party identification, Sen. Hillary
Clinton remains the candidate that people are most likely to
name as placing the biggest emphasis on health care (23%) and
as agreeing with their views (17%). Sen. Barack Obama is in second
place (9% on each question).
Looking only at Democrats, one in three
name Sen. Clinton (33%, compared to 27% in March) as the candidate
who comes closest to their personal views on health care, compared
to 15% who name Sen. Obama (up from 8% in March) and 4% who name
former Sen. John Edwards (no change since March).
Few people name any of the Republican candidates
as placing the biggest emphasis on health care, with 2% overall
naming former New York Mayor Rudy Giuliani.
When asked what concerns them about rising
health care costs, the poll found people are twice as likely
to cite having to pay higher premiums and increased out-of-pocket
costs (38%) as they are to say increases in spending on government
health insurance programs like Medicare and Medicaid (18%) or
increases in what the nation as a whole spends on health (18%).
A smaller share (13%) cite increases in the health insurance
premiums that employers pay to cover their workers. These views
vary little based on party identification.
MAY 2007
LACK OF NATIONAL HEALTH INSURANCE MAY
EXPLAIN WHY EUROPEANS ARE TALLER THAN AMERICANS
SPIEGEL, GERMANY - For years, researchers
have been wondering why Americans stopped growing. US citizens
were among the tallest in the world up until World War II. But
since then, heights have stagnated while Europeans have been
getting taller and taller, with the average American now between
two and six centimeters shorter. The correlation between wealth
and height has long been understood, the most recent example
coming as Eastern Europeans shot up following the collapse of
communism. But why, in the richest country in the world, should
growth rates be stagnating?
A new study published in the current issue
of the Social Science Quarterly by researchers from Princeton
University in the US and the University of Munich in Germany
indicates that the difference may have to do more with politics
than biology. Specifically, the study, which involved the statistical
analysis of demographic and health data collected between 1959
and 2002, concludes that the spotty US health-care system and
weak welfare net could explain why Americans have stopped growing.
"We surmise that the health systems
and high degree of social security in Europe provide better conditions
for growth than the American health system, despite the fact
that the system costs twice as much," said study co-author
John Komlos from the University of Munich in a statement. "There
are also indications that American diets are deficient in several
areas."
From the Colonial times until roughly the
1970s, Americans were the tallest people in the world. But then,
growth stagnated while Europeans spent the second half of the
20th century growing like weeds. Now, the average Dutchman is
six centimeters taller than the average American -- "almost
an exact reversal of the relationship in the middle of the 19th
century," Komlos says.
Researchers have established in recent
years that wealthier families tend to provide better nutrition
for their children and, as a result, they tend to grow taller.
The drastic differences in the United States between rich and
poor, the researchers pointed out, mean that the US average is
pulled down by those who struggle to get by. Whereas in the US,
some 15 percent of the population has no health insurance and
those on welfare can barely get by, almost all citizens of northern
and western European countries enjoy universal health care and
a generous social net. The result is that even those children
dependent on welfare in Europe have a sufficient living standard,
the researchers concluded.
http://www.spiegel.de/international/zeitgeist/0,1518,484168,00.html
LACK OF SINGLE PAYER HEALTHCARE IS KILLING
US
NICHOLAS D. KRISTOF, NY TIMES - The medical
and insurance lobbies have been busy blocking national health
care programs since they were first seriously proposed back in
the 1920's - and the result has been millions of premature deaths
in this country because of people falling through the cracks.
Doctors fighting universal coverage have been saving lives in
their day jobs while costing lives with their lobbying. Over
all, a person without insurance is less likely to have diseases
diagnosed early, less likely to get routine preventive care -
and faces a 25 percent greater chance of dying early.
Americans with good jobs and complex needs
receive superb medical care. But a child in Costa Rica born today
is expected to live longer than an American child born today.
The U.S. now spends far more on medical care (more than $7,000
per person) than other nations, yet our infant mortality rate,
maternal mortality rate and longevity are among the worst in
the industrialized world. If we had as good a child mortality
rate as France, Germany and Italy, we would save 12,000 children
a year.
It is disgraceful that an American mother
has almost three times the risk of losing a child as a mother
in the Czech Republic. According to a new report from Save the
Children, a woman in the U.S. has a 1-in-71 chance of losing
a child before his or her fifth birthday. . .
The existing medical financing system also
creates perverse incentives for expensive procedures; that may
be why Americans are far more likely than Europeans to get C-sections.
Meanwhile, the burden of paying for these second-rate statistical
outcomes is crippling American business. By next year, the average
Fortune 500 company will spend more on health care than it earns
in net income, according to Steve Burd, the head of Safeway.
. .
There's evidence that the most efficient
financing system would be a single-payer structure, such as that
found in most Western countries. Some 31 percent of U.S. health
spending goes to administration, more than twice the rate in
Canada. . .
But universal coverage is only part of
the answer. We also need far greater attention to public health
programs focusing on prevention. Two of the most important life-saving
health interventions in recent decades weren't medical at all:
the cigarette tax and laws mandating air bags and seat belt use.
A national public health campaign on obesity (similar to the
one Gov. Mike Huckabee started in Arkansas) should be an essential
component of health care reform.
TRUE COSTS OF OUR CRAZY HEALTH CARE
SYSTEM
VIDURA PANDITARATNE, PRESSESC - A Commonwealth Fund report reveals that despite
spending more than twice as much per capita on health care as
other nations ($6,102 vs. $2,571 for the median of Organization
for Economic Cooperation and Development countries in 2004) the
US spends far less on health information technology - just 43
cents per capita, compared with about $192 per capita in the
UK. . .
In Mirror, Mirror on the Wall: An International
Update on the Comparative Performance of American Health Care,
by Karen Davis, Ph. D., and colleagues, compare surveys on physicians'
and patients' experiences and views of their health systems conducted
in Australia, Canada, Germany, New Zealand, the UK, and the US
between 2004 and 2006.
Key findings include:
- On measures of quality, the U.S. overall
ranked 5th out of 6 countries. The U.S. ranked fifth in coordinated
care, and last in patients reporting that they have a regular
doctor (84% vs. 92%-97% in other countries).
- On access measures the U.S. ranked last
overall, including last on timeliness of care: 61% of U.S. patients
said it was somewhat or very difficult to get care on nights
or weekends, compared with 25%-59% in other countries.
- On efficiency, the U.S. ranked last overall,
including last on percent of patients who have visited the emergency
room for conditions that could have been treated by a regular
doctor if one had been available (26% vs. 6%-21% in other countries).
Multinational Comparisons of Health Systems
Data, 2006, by Jonathan Cylus and Gerard Anderson, Ph.D., of
The Johns Hopkins University, compares health spending data in
nine Organization for Economic Cooperation and Development countries:
Australia, Canada, France, Germany, Japan, the Netherlands, New
Zealand, the United Kingdom, and the United States and, where
possible, the median of all 30 OECD countries.
Key findings include:
- In 2004 the US spent the most per capita
on hospital services, and Canada and Japan spent the least. Adjusted
for differences in cost of living, inpatient acute care spending
per day in the United States was nearly three times the median
OECD country ($2,337) and over five times more than Japan ($419).
- The US spent twice the OECD median per
capita on drugs in 2004 - $752 compared with $377.
- Nearly one-third (30.6%) of individuals
in the US were obese in 2004, compared with 13 percent of the
OECD median.
- The US had about two and a half times
the OECD median for years of potential life lost due to diabetes
- 101 per 1,000 people compared with 39 per 1,000 (U.S. data
is for 2002).
APRIL 2007
STUDY FINDS CANADA'S HEALTH SERVICE
BETTER THAN AMERICA'S
CANWEST NEWS SERVICE
- Canada's health-care system is as good or better than that
of the United States and is delivered at half the cost, new research
suggests. A review in the inaugural issue of online medical journal
Open Medicine, . . . found that while the United States spent
an average of $7,129 US per person on health care in 2006, compared
with $2,956 US per person in Canada, more studies favored the
latter country in terms of morbidity and mortality.
They covered a wide range of diseases and
conditions including cancer, coronary artery disease. . .
Of the 38 studies included in the analysis,
10 were considered to be of the highest quality because they
enrolled broad populations and included extensive statistical
adjustments. Results of five of those favored Canada, two favored
the United States and three showed equivalent or mixed results.
Of the 28 remaining studies that did not
meet one of the criteria, nine favured Canada, three favored
the United States and 16 showed equivalent or mixed results.
When all the studies were combined, the
17 doctors and researchers involved in the meta-analysis found
Canadians had a five per cent lower death rate than people in
the United States.
FEBRUARY 2007
GREEN PARTY HITS DEMOCRATS FOR RUNNING
FROM SINGLE PAYER HEALTHCARE
GREEN PARTY - Green Party leaders have
called on Congress to reject health care reform plans that maintained
corporate-based insurance and HMO coverage, and urged passage
of a single-player national health insurance program. Greens
were especially critical of Sen. Hillary Clinton's (D-N.Y.) continuing
role in obstructing needed health care reforms. "Hillary
Clinton should be banished from the room when health coverage
is discussed," said Rebecca Rotzler, co-chair of the Green
Party of the United States and Deputy Mayor of New Paltz, New
York. "Ms. Clinton's favoritism towards major insurance
companies undermined real health care reform when her husband's
administration crafted its managed-care monstrosity in 1993.
She and other Democrats remain at the top of the list of recipients
of contributions from insurance and pharmaceutical lobbies.
"Hillary Clinton, Barack Obama, John
Edwards, and other prominent Democrats are the greatest obstacle
to universal health coverage. Except for a few mavericks like
Rep. John Conyers [D-Mich.], who has regularly introduced single-payer
bills, Democrats have joined Republicans in favoring HMO and
insurance corporations over guaranteed publicly-financed quality
health care for every American. It's a safe bet that the 2008
Democratic nominee will -- like Bill Clinton, Al Gore, and John
Kerry before them -- follow the same pattern," said Kat
Swift, spokesperson for the National Women's Caucus of the Green
Party.
http://www.gp.org/newscenter.shtml
WHY THE DEMOCRATS ARE SO COWARDLY ABOUT
HEALTHCARE
CORPORATE CRIME REPORTER -
The majority of the American people want a single-payer health
care system - Medicare for all. The majority of doctors want
it. A good chunk of hospital CEOs want it. But what they want
doesn't appear to matter. Why?
Because a single-payer health care plan
would mean the death of the private health insurance industry
and reduced profits for the pharmaceutical industry.
Presidential candidates John Edwards, Barack
Obama, Hillary Clinton, and Mitt Romney and California Governor
Arnold Schwarzenegger talk a lot about universal health care.
But not one of them advocates for single-payer - because single-payer
too directly confronts the big corporate interests profiting
off the miserable health care system we are currently saddled
with.
"Currently, we are spending almost
a third of every health care dollar on administration and paperwork
generated by the private health insurance industry," said
Dr. Stephanie Woolhandler, an Associate Professor of Medicine
at Harvard Medical School and co-founder of Physicians for a
National Health Program. "Countries like Canada spend about
half that much on the billing and paperwork side of medicine.
If we go to a single-payer system and are able to cut the billing
and paperwork costs of health care, that frees up about $300
billion per year. That's the money we need to cover the uninsured
and then improve the coverage for those who have private insurance
but are under-insured."
"The idea behind single-payer is you
don't have to increase total health care spending," Woolhandler
said in an interview with Corporate Crime Reporter. "You
take the money we are now spending but cut the administrative
fat and use that money to cover people."
None of the declared Presidential candidates
- with the exception of Congressman Dennis Kucinich (D-Ohio)
- is supporting single-payer. Last year, Kucinich and Congressman
John Conyers (D-Michigan), introduced a single-payer bill, HR
676, which garnered support of more than 75 members of the House.
Woolhandler expects that number to grow substantially this year.
And Woolhandler says grassroots activists
have been mobilizing at the state level. "State single-payer
organizations have been very active," she said. "Early
in the process, you can get a lot of politicians interested -
they want to show up at your rallies to show support for national
health insurance. But as you get closer and closer to actual
passage of a law, it is harder to keep the politicians on board.".
. .
Woolhandler called the universal health
care law passed in Massachusetts by Governor Mitt Romney "a
hoax."
"The core idea is the individual mandate
- forcing uninsured people to go out and buy insurance,"
Woolhandler said. "And if they don't buy insurance, we are
going to fine them. The first year it is an $80 fine. The second
year, it's half the value of the lowest priced policy - we're
talking about a $2,000 fine. So, they are saying anyone who earns
more than three times poverty has to bear the entire price of
a private insurance policy."
"Romney's bill was written by Blue
Cross," Woolhandler said. "Romney was saying he was
going to offer health insurance starting at $200 a month. And
of course, that was a hoax. No insurance policy in Massachusetts
comes in at $200 a month. When Blue Cross was asked to produce
the policy, it turned out the policy was going to cost $380 a
month for a policy that had a $2000 deductible. So, you are going
to tell this poor bloke who is earning $29,400 a year that he
has to go out and spend $4,000 a year on an insurance policy.
And if he gets sick, he doesn't even have any coverage until
he has spent $2,000. And that's not family coverage. That's individual
coverage."
Former Senator John Edwards would have
a Medicare-like system compete with private insurance. "Edwards
plan is not going to work," Woolhandler says flatly. "We
know there is not going to be fair competition between Medicare
and the private plans. You have to take on the private health
insurance industry and tell them - you are out of here. This
is an entitlement program like traditional Medicare or Social
Security. We are going to get the administrative efficiencies
you get from running it as a single program and use that to expand
coverage. That's what you have to do."
Senator Hillary Clinton (D-New York) doesn't
want to get specific. "She is nowhere on this issue,"
Woolhandler says. Ditto Senator Barack Obama (D-Illinois).
A SHORT HISTORY OF HEALTHCARE MISSTEPS
PHIL MATTERA, CORPORATE RESEARCH PROJECT
- In the late 19th Century European countries began adopting
government-funded social insurance plans, but the U.S. failed
to follow suit. When progressives made a push in the 1910s there
was opposition not only from corporate interests but also from
organized labor. AFL President Samuel Gompers denounced national
health insurance as a paternalistic reform, fearing that its
adoption would weaken the role of unions in improving the living
conditions of workers.
Consequently, Americans both rich and poor
continued to pay the vast majority of medical costs out of pocket.
That began to change in the 1930s. While the Roosevelt Administration
focused on retirement benefits and unemployment insurance at
the expense of health coverage, physicians and hospitals struggling
to survive the Depression set up private group insurance plans
to bolster demand for their services. . .
In 1945 President Harry Truman proposed
a national program establishing a right to medical care and protection
from the "economic fears" of illness. But once again,
opposition to government involvement in healthcare emerged, this
time reinforced by a Cold War hysteria about "socialized
medicine" stoked by groups such as the American Medical
Association.
As Truman's plan went down to defeat, what
grew in its place was a system of employer-provided coverage,
stimulated by aggressive bargaining on the part of unions that
had come to regard improving employee benefits as a mission as
important as increasing wages. . .
http://www.alternet.org/stories/48371/
THE CASE FOR REAL UNIVERAL HEALTH CARE.
. . .BY A RETIRED BUSINESS OWNER
JACK E. LOHMAN, WIS POLITICS - With the
vast majority of the public -- and even the "non-healthcare"
business leaders -- supporting universal health care, why are
our politicians not on board?
It makes every bit of financial sense for
businesses to get out of providing health care and to turn it
over to the most successful ever public-private venture: Medicare.
As a Medicare patient I have the same coverage and physician
choice I had before retiring. It's just managed by a single payer:
WPS in Madison.
Don't think for a moment that single-payer
is just another liberal giveaway; it is the most fiscally conservative
way possible of financing health care for Wisconsin citizens.
. .
Medicare-for-all would do wonders for businesses
by reducing labor costs by 15 percent; reducing worker compensation
costs by 50 percent; and cutting their and everybody else's auto
insurance rates in half. With these reduced costs they could
add jobs in Wisconsin rather than sending them to other countries.
Health care would no longer be a labor union negotiation and
job changes would not involve gaps in insurance, preexisting
disease exclusions or delays, or COBRA costs.
New jobs would mean new tax revenues, increased
property values, and less unemployment, welfare and associated
costs. New businesses will move to Wisconsin and old businesses
will keep their doors open. And when businesses no longer have
to add their health costs to the price of their product, we will
see lower prices at the cash register and greater competitiveness
against foreign products that aren't burdened with health care
costs.
Who wouldn't like these single-payer benefits?
For one, the insurance companies that are
currently reaping 20-30 percent of health care dollars won't
like it a bit, and neither will the politicians who receive campaign
contributions from health care interests. Nor will the board
members that sit on both health care and non-health care corporate
boards, though business associations that serve both factions
owe it to the latter to sit this issue out. The conflicts of
interest that stand in the way of good public policy abound.
If corporations are not willing to provide
employee health care at least equivalent to Medicare, they should
get out of the way and let the government do it. We don't want
their inadequately funded solutions or a mish-mash of prohibitively
expensive half-way measures. Or health savings accounts that
are time bombs waiting to explode in credit card debt and bankruptcies.
Nor do we want an incremental approach
that will not cover all citizens and is sure to fail. The public
wants it done right and wants it done now.
Think about it. For the same amount of
money we are paying to cover 85 percent of the public now, we
could cover 100 percent under a single-payer plan like Canada's
-- but without the wait times. Over 80 percent of Canadians prefer
their system to ours. Their life expectancy is two years longer
and infant mortality 35 percent less than ours -- mostly because
everybody is insured under a single-payer plan.
Canada spends 10 percent of its gross domestic
product on health care while we spend 15 percent of GDP and get
less for it. They cover 100 percent of their people and we cover
85 percent and that is shrinking. Their administrative costs
are 10 percent compared to our 20-30 percent. They have no wait
times for urgent procedures, and those for elective care could
be eliminated with a simple increase in funding by 10 percent
-- to 11 percent of GDP. While their problem is funding, ours
is systemic.
http://wisopinion.com/index.iml?mdl=article.mdl&article=6227
THROW THE RASCALS OUT
http://www.ThrowTheRascalsOut.org
THE TRUE COST OF PRIVATE HEALTH INSURANCE
DAVID DYSSEGAARD KALLICK, FISCAL POLICY
INSTITUTE, BUFFALO NEWS - The current [health] insurance system
just isn't working. There are 2.8 million New Yorkers who don't
have insurance. For people who do have insurance, health care
is too expensive; no item in the family budget is rising faster.
As important as the effect on families,
though, is the effect on economic growth. The convoluted way
we finance health care is one of our nation's biggest job-killers.
Responsible companies that pay for health care are being crushed
by the rising cost of insurance.
The best solution would be a national single-payer
plan. But if Washington doesn't move, New York should look into
a state-based single-payer system.
Virtually all of the world's advanced economies
have universal coverage. There are models that integrate choice
of doctor, private insurance on top of the basic government plan
and the ability to pay to skip ahead of a queue.
Can we afford it? The United States spends
about 16 percent of gross domestic product on health care. Compare
that with 7.7 percent in the United Kingdom, 7.9 percent in Japan
and 9.9 percent in Canada. Universal insurance is much less expensive.
It's encouraging to see states like Massachusetts
and California moving forward on universal coverage. But their
models cost billions more, while a single-payer system would
cost billions less than current spending. According to one estimate,
cutting out administrative costs would allow a single-payer system
in New York to reduce spending by 19 percent, a savings of $23
billion.
http://www.buffalonews.com/editorial/20070129/1039189.asp
http://www.fiscalpolicy.org
ROMNEY STYLE UNIVERSAL HEALTHCARE: YOU
BUY IT OR WE FINE YOU
ALICE DEMBNER, BOSTON GLOBE
- More than 200,000 people with health insurance would have to
buy additional coverage to meet proposed minimum standards under
the state's new health insurance law, according to a count completed
by insurers yesterday. Most of the individuals do not have coverage
for prescription drugs or have drug coverage that is more restrictive
than the minimum proposed by the state board implementing the
law. . . Individuals would face a fine of about $200 next year
and more in future years, if they do not have insurance that
meets the standards.
"It's very troubling," said Richard
Lord, president of Associated Industries of Massachusetts and
a member of the Connector board. "The new law was about
expanding access for people without any health insurance. I don't
think we should be forcing people who do have some coverage to
spend more."
The number of residents whose insurance
would not meet the minimum standards is more than four times
the estimate made by the board's staff earlier this month before
the board altered the proposed standards.
JANUARY 2007
SEIU, DEMOCRATS JOINING IN HEALTHCARE
CON
[It's bad enough that centrist
Democrats are falling for this, but now the leading labor union
SEIU has joined in support of phony healthcare reform, backing
a plan whose major attribute is that it will continue to permit
insurance companies to make huge profits. Instead of a logical
approach, such as expanding Medicare, a disturbing consensus
is developing around a convoluted, inadequate, corporate-friendly
mishmash and calling it - in one of the great spin lies of our
times - "universal healthcare." Steven Pearlsein, a
corporate columnist of the Washington Post, naturally thinks
it's swell]
STEVEN PEARLSTEIN, WASHINGTON
POST - There, at the National Press Club, stood the president
of the Business Roundtable, representing the country's largest
corporations; the president of the Service Employees International
Union, the country's most vibrant union and one of its fastest-growing;
and the president of AARP, the formidable seniors lobby. They
put aside their usual differences to deliver a clear, simple
message to President Bush and congressional leaders of both parties:
We stand ready to give you the political cover you need for a
centrist, bipartisan fix for a broken health-care system. Or,
if you refuse, we stand ready to embarrass you and run you out
of office.
"Washington is behind where
the rest of the country is," said Andy Stern, a labor leader.
"Democratic leaders in Congress say this is not the time.
The White House has said now is not the time. And we are saying,
'Now is the time.' "
Stern and his new friends are
right about one thing: Something's going on.
A Republican governor of Massachusetts,
working with Sen. Ted Kennedy and a Democratic legislature, hammered
out a comprehensive reform plan last year. And last week, another
Republican governor proposed a similarly bold plan for California.
Not coincidentally, both state
plans conform roughly to a consensus that has been taking shape
in Washington over the past two years, in behind-the-scenes negotiations
among health insurers, hospitals, physicians, business and labor
groups, drug companies and consumer groups such as Families USA.
The first draft of their effort will be unveiled tomorrow. And
while the "consensus" will fudge some of the most difficult
issues in an effort to keep the coalition together, the outlines
of a genuinely comprehensive reform plan are coming into focus.
http://www.washingtonpost.com/wp-dyn/content/article/2007/01/16/AR2007011601578_pf.html
SCHWARZENEGGER'S HEALTHCARE CON
SHEILA JAMES KUEHL, CHAIR CALIFORNIA
SENATE HEALTH COMMITTEE, LA TIMES - Schwarzenegger's plan. .
. mandates that every individual have insurance (not just every
worker), yet it doesn't ensure that coverage will be comprehensive
and affordable. Schwarzenegger also calls for increasing reimbursements
paid to providers under public programs by billions of dollars.
. .
How does he pay for it? Individuals
and employers will contribute, but employers are required to
spend only 4% of payroll to insure their employees, or contribute
the same amount to a state fund. This is not sufficient to purchase
insurance for the working uninsured, who will be required to
have it. This means that the governor's plan can at best provide
high-cost, low-benefit plans for many Californians; it limits
what employers pay but not what individuals must pay or what
insurance companies can charge.
A portion of the funding for
the plan would also come from federal money that is at this point
only "hoped for." There also would be a tax on providers,
such as doctors and hospitals, and the governor would redirect
public money now spent on poor people in hospitals to insurance
companies. This would create an immediate problem for hospitals,
which are already closing because of inadequate reimbursement
from private insurance companies.
Finally, the governor would adopt
President Bush's plan for individual health savings accounts
by requiring employers to "allow" employees to put
away money, pretax, to pay for unreimbursed medical expenses.
These accounts effectively shift the costs and liability of healthcare
away from insurance companies and onto consumers. Such a plan
would not benefit people who are already too strapped to meet
current expenses, and it does nothing to expand coverage or affordability.
http://www.latimes.com/news/opinion/la-oe-kuehl9jan09,0,7944823.story
GOP GOVERNORS PROPOSING FAKE
UNIVERSAL HEALTH COVERAGE
WITH THE uncritical blessing
of the media, GOP governors of Massachusetts and now California
have gotten away with calling required purchase of private health
insurance "universal health coverage." Both the NY
Times and the Washington Post gave this badly misleading impression
of what appears a conservative plan to derail growing support
for real universal coverage. Much as the right and the media
have used grossly distorted phrases like "Social Security
reform," the Schwarzenegger and Romney plan create their
universality not by providing coverage but by forcing citizens
to buy it from private insurers. This falls somewhere between
being a con and being unconstitutional, not unlike being told
you have to buy telephone service from a private vendor because
it's good for you.
CHERRY PICKING HEALTH INSURANCE
COMPANIES REFUSE TO INSURE CERTAIN JOBS
LISA GIRION, LA TIMES - Health
insurers in California refuse to sell individual coverage to
people simply because of their occupations or use of certain
medicines, according to documents obtained by The Times.
Entire categories of workers - including roofers, pro athletes,
dockworkers, migrant workers and firefighters - are turned down
for insurance even if they are in good health and can afford
coverage, according to the confidential underwriting guidelines
of four health plans. . .
Such restrictions are legal in
California, and state regulators have no authority to stop them.
Health plans defend their restrictions as necessary to keep premiums
down. . .
At issue is individual insurance,
the type of coverage purchased by people who do not have job-based
group health benefits. Unlike group coverage, individual insurance
is granted case by case, meaning in effect that health plans
are free to choose whom to cover and what to charge them.
http://www.latimes.com/business/la-fi-reject8jan08,0,5668276.story?coll=la-home-headlines
DECEMBER 2006
SENATOR PROPOSES NATIONAL HEALTH INSURANCE
COMPANY CARE PLAN
[This plan's basic purpose is
to keep the health insurance business raking in big profits and
belongs in the same dump as Hillary Clinton's disastrous proposal.
It isn't national healthcare; it's national health insurance
company care]
MATTHEW DALY, ASSOCIATED PRESS
- An Oregon Democrat is readying a proposal to provide health
care coverage to all Americans through a pool of private insurance
plans. "Employer-based coverage is melting away like a Popsicle
on the sidewalk in August," said Sen. Ron Wyden, a member
of the Senate Finance subcommittee on health care.
Wyden's proposal, which he planned
to unveil on Wednesday, is an outgrowth of work by the Citizens'
Health Care Working Group, a 14-member panel that went to 50
communities around the country and heard from 28,000 people about
how to overhaul the nation's health care system.. . .
Wyden said his new plan would
allow workers to carry their health insurance from job to job
without penalty. More efficient administration and more promotion
of competition for health care plans, he said, would allow greater
coverage while costing no more than the government is paying
today for health insurance coverage.
Called the "Healthy Americans
Act," the plan would cover all Americans except those on
Medicare or those who receive health care through the military.
It would require that employers
"cash out" their existing health plans by terminating
coverage and paying the amount saved directly to workers as increased
wages. Workers then would be required to buy health insurance
from a large pool of private plans.
After two years, companies would
no longer have to pay the higher wages. Instead, Wyden said,
they would pay into an insurance pool, based on annual revenues
and the number of full-time workers. . .
Increases in premium payments
for individuals and families would be offset by higher wages
and subsidies provided under the plan, the report said. As an
example, Wyden cited a worker who earned $60,000 last year, and
received about $12,000 worth of health care coverage.
The worker's health insurance
would be terminated but his salary would increase to $72,000,
which would cover his health care coverage. The plan would bar
workers from buying a "bare-bones" health package and
pocketing the savings, Wyden said.
http://www.blueoregon.com/2006/12/wyden_announces.html
NOVEMBER 2006
MYTHS ABOUT SINGLE-PAYER HEALTHCARE
[From the Hunger Action Network
of New York]
Myth: The government would dictate
how physicians practice medicine.
In countries with a national
health insurance system, physicians are rarely questioned about
their medical practices (and usually only in cases of expected
fraud). Compare it to today's system, where doctors routinely
have to ask an insurance company permission to perform procedures,
prescribe certain medications, or run certain tests to help their
patients.
Myth: Waits for services would
be extremely long.
In countries with NHI, urgent
care is always provided immediately. Other countries do experience
some waits for elective procedures (like cataract removal), but
maintaining the US's same level of health expenditures (twice
as much as the next-highest country), waits would be much shorter
or even non-existent. Compared to most other countries with universal
health care, it is the US with the long waiting times - especially
for the tens of millions without health insurance. There would
be no lines under a universal health care system in the United
States because we have about a 30% oversupply of medical equipment
and surgeons, whereas demand would increase about 15%
Myth: People will over-use the
system.
Most estimates do indicate that
there would be some increased use of the system (mostly from
the 42 million people that are currently uninsured and therefore
not receiving adequate health care), however the staggering savings
from a single-payer system would easily compensate for this.
Myth: Universal Health Care Would
Be Too Expensive
The United States spends at least
40% more per capita on health care than any other industrialized
country with universal health care. Federal studies by the Congressional
Budget Office and the General Accounting office show that single
payer universal health care would save 100 to 200 billion dollars
per year despite covering all the uninsured and increasing health
care benefits. The United States spends 50 to 100% more on administration
than single payer systems. By lowering these administrative costs
the United States would have the ability to provide universal
health care, without managed care, increase benefits and still
save money.
Myth: A single payer system Would
Result In Government Control And Intrusion Into Health Care Resulting
In Loss Of Freedom Of Choice
There would be free choice of
health care providers under a single payer universal health care
system, unlike our current managed care system in which people
are forced to see providers on the insurer's panel to obtain
medical benefits. There would be no management of care under
a single payer system unlike the current managed care system
which mandates insurer pre-approval for services thus undercutting
patient confidentiality and taking health care decisions away
from the health care provider and consumer
Myth: Universal Health Care Is
Socialized Medicine And Would Be Unacceptable To The Public
Single payer universal health
care is not socialized medicine. It is health care payment system,
not a health care delivery system. Health care providers would
be in fee for service practice, and would not be employees of
the government, which would be socialized medicine. Repeated
national and state polls have shown that between 60 and 75% of
Americans would like a publicly financed, universal health care
system
http://www.hungeractionnys.org/health2a.htm
PHYSICIANS FOR A NATIONAL HEALTH
PROGRAM FAQ http://www.pnhp.org/facts/singlepayer_faq.php#socialized
OCTOBER 2006
MORE THAN HALF OF AMERICANS DISSATISFIED
WITH HEALTH COSTS
RICARDO ALONSO-ZALDIVAR, LA TIMES - The annual Health Confidence Survey,
released by the nonpartisan Employee Benefit Research Institute,
found that more than half of those surveyed — 52% —
were dissatisfied with health insurance costs, a sharp increase
from 33% last year. . .
Retirement plans took a big hit,
with 36% of those who reported higher costs over the last year
saying they had reduced their contributions to 401(k) plans.
Of that group, 28% said that because of health-related costs,
they had trouble paying for such basic necessities as housing,
heat and food. . . The institute's poll found that workers regard
their employer-sponsored coverage as an ever more valuable benefit,
even as many new jobs come with no coverage and employers cut
back or drop existing plans.
Overall, the proportion of employees
covered by a company plan dropped from 81% in 2001 to 77% in
2005. Asked to choose between a $6,700 raise and employer-sponsored
health insurance, 75% of those polled picked the health plan.
Of those, 13% said no raise would
be big enough to persuade them to give up their coverage. The
average cost of employer-provided coverage was about $6,700 per
worker in 2004. It has since gone up to more than $7,100.
QUARTER OF AMERICANS SAY THEY OR FAMILY
PUT OFF MEDICAL TREATMENT BECAUSE OF COST
KAISER FOUNDATION - One in four
Americans say that they or a family member in their household
had problems paying medical bills during the past 12 months,
according to a new poll conducted jointly by ABC News, the Kaiser
Family Foundation and USA Today. That's the highest share of
Americans reporting a problem paying medical bills in a series
of Kaiser surveys taken since 1997. Among those reporting a problem
this year, nearly seven in 10 have health insurance.
- About one in four (28%) Americans
say that in the past year they or a family member have put off
medical treatment because of its cost. Of those who delayed treatment,
seven in 10 (70%) say that the care was for a serious medical
condition.
- Among those with health insurance,
most (60%) are worried about not being able to afford coverage
over the next few years, with 27% saying they are very worried.
- More than half (54%) of those
without health coverage say the main reason is because they can't
afford it, while another 15% say they can't get it due to poor
health, illness or age. In comparison, just 4% say the main reason
they lack health insurance is because they think they don't need
it.
- Eight in 10 Americans (80%)
say they are dissatisfied with the overall cost of health care
to the nation. When asked about their own concerns about the
health care system, cost comes out far ahead of quality. Four
in 10 say that they are dissatisfied with their personal health
care costs, compared with one in 10 who say they are dissatisfied
with the quality of their health care.
JULIE APPLEBY, USA TODAY - Fifty-six percent say they would prefer
universal coverage to the current system. . . In the survey,
68% said providing coverage for everyone is more important than
keeping taxes down. . .
When survey respondents were
asked about possible trade-offs that might come with a universal
program, positive responses plummeted. The poll found:
76% would oppose universal coverage
if it meant some medical treatments currently covered by insurance
would no longer be covered.
68% would be against it if it
led to limits on the choice of doctors.
DEAN BAKER, PROSPECT - USA Today
had an article this morning on rising U.S. health care costs.
It never mentions the fact that the United States pays more than
twice as much per person as the average among other wealthy countries,
yet has shorter life expectancies.
SURVEY RESULTS
http://www.kff.org/kaiserpolls/pomr101606pkg.cfm
SEPTEMBER 2006
LACK OF HEALTH ISURANCE KILLS SIX TIMES
AS MANY AMERICANS EACH YEAR AS 9/11 DID
SARAH RUTH VAN GELDER AND DOUG
PIBEL, YES MAGAZINE - An estimated 50 million Americans lack
medical insurance, and a similar and rapidly growing number are
underinsured. The uninsured are excluded from services, charged
more for services, and die when medical care could save them
-- an estimated 18,000 die each year because they lack medical
coverage. But it's not only the uninsured who suffer. Of the
more than 1.5 million bankruptcies filed in the U.S. each year,
about half are a result of medical bills; of those, three-quarters
of filers had health insurance.
Businesses are suffering too.
Insurance premiums increased 73 percent between 2000 and 2005,
and per capita costs are expected to keep rising. . .
Employers who want to offer employee
health care benefits can't compete with low-road employers who
offer none. Nor can they compete with companies located in countries
that offer national health insurance. . .
Among politicians and pundits,
a universal, publicly funded system is off the table. . . The
United States leaves the health of its citizens at the mercy
of an expensive, patchwork system where some get great care while
others get none at all. The overwhelming majority -- 75 percent,
according to an October 2005 Harris Poll -- want what people
in other wealthy countries have: the peace of mind of universal
health insurance.
http://www.alternet.org/stories/42011/
PORTLAND PRESS HERALD - Patricia
LaMarche, the Green Independent candidate in Maine's five-way
race for governor, proposed a state-run universal health-care
plan Thursday that would tax employers to pay for the program.
. . [The] program would have no co-pays, no deductibles and no
out-of-pocket expenses for essential care. Elective procedures
would not be covered. . . Her plan, which has been described
as the cornerstone of her campaign, would impose a payroll tax
of 5 percent to 12 percent on employers, depending on the size
of their work force. Employers with no more than five workers
would pay atax equivalent to 5 percent of their payroll. The
rate would rise gradually as the number of employees increased,
hitting a maximum of 12 percent, for employers with more than
1,000 workers. State, county and municipal governments also would
be taxed, and their employees would be covered by the plan. Providers
would bill a state-appointed Maine Healthcare Authority, which
would pay the bills. . . . LaMarche said her plan would seek
a federal waiver to let state government roll Medicaid funds
into the new program, but it would not alter the Medicare program
for the elderly.
http://pressherald.mainetoday.com/news/state/060922lamarche.html
PAT LAMARCHE HEALTHCARE PLAN
http://www.pat2006.com/issues/healthcare/plan.php
HEALTH INSURANCE COST RISE TWICE INFLATION
RATE
JULIE APPLEBY, USA TODAY - Workers and employers won't find much
comfort in the smallest increase in health insurance costs since
1999. The 7.7% increase this year is still more than twice the
rate of inflation. And those rising costs have so far failed
to boost the percentage of employers offering what are touted
by some, including President Bush, as an answer to health care
inflation: high-deductible insurance policies coupled with savings
accounts. Despite being the biggest buzz among benefit consultants,
the Kaiser Family Foundation says only 7% of employers offered
such policies this year, unchanged from 2005. The results come
from the non-profit foundation's annual employer survey, released
Tuesday. . . The total premium increase is up 87% since 2000.
89% INDIVIDUAL HEALTH INSURANCE APPLICANTS
EITHER REJECTED OR FIND IT TOO EXPENSIVE
MEDICAL NEWS TODAY - Of working-age
U.S. residents who sought individual health coverage in the last
three years, 89% were rejected for medical reasons or felt that
the available plans were unaffordable, according to a study released
Thursday by the Commonwealth Fund, the Los Angeles Times reports.
. . According to the survey, 58% of respondents who applied for
individual coverage found the health plans unaffordable. Twenty-one
percent of those who sought individual coverage were rejected,
charged a higher premium or were offered a policy that excluded
coverage for a specific health condition they had. The study
also finds: Two in five people with individual coverage spend
at least 5% of their incomes on premiums, compared with one in
seven who have employer-sponsored coverage. More than half of
people with individual coverage pay at least $3,000 annually
in premiums, and about one-third paid at least $6,000 annually.
One-third of people with individual coverage have to pay $1,000
out-of-pocket each year before coverage takes effect;
http://www.medicalnewstoday.com/medicalnews.php?newsid=51931
MORE ADULT CHILDREN RELYING ON PARENTS'
HEALTH INSURANCE
JENNIFER 8. LEE, NY TIMES - With
18- to 34-year-olds the fastest growing group of uninsured, states
are extending the time that children can be a dependent for insurance
purposes. In New Jersey, which this year enacted the highest
age limit, children can "piggyback" until they turn
30, as long as they live in the state and don't have their own
children. The trend stems from a concern that a healthy - and
profitable - segment of the population is dropping out of the
insurance pool. About half of all states have studied such proposals,
and at least nine have passed laws, eight of them since 2003
and three just this year, according to the National Conference
of State Legislatures.
http://www.nytimes.com/2006/09/17/us/17insure.html?_r=1&ref=us&oref=slogin
BUSINESSES SLASHING RETIREE HEALTH BENEFITS
KIM DIXON, REUTERS - Most U.S.
employers are planning to further scale back health benefits
offered to retirees, as companies struggle with the upward march
in the cost of medical care and weigh increased contributions
from government's Medicare program, a survey found. Ninety-five
percent of the mostly Fortune 500 companies polled expect to
further restrict their retiree health plans over the next five
years, and 14 percent plan to stop providing coverage entirely,
the survey of 163 companies by benefits consultants Watson Wyatt
found. Employers have been exiting the retiree health business
for a decade-and-a-half. . .
About a third of U.S. employers
offered current workers retiree coverage in 2005, down from about
two-thirds in 1988, according to a recent study by the nonprofit
Kaiser Family Foundation.
MAY 2006
A DOCTOR COMES TO LIKE SINGLE PAYER
BENJAMIN BREWER, MD - It took
me a while to conclude that a single-payer health system was
the best approach. My fear had been that government would screw
up medicine to the detriment of my patients and my practice.
If done poorly, the result might be worse than what I'm dealing
with now.
But increasingly I've come to
believe that if done right, health care in America could be dramatically
better with true single-payer coverage; not just another layer
-- a part D on top of a part B on top of a part A, but a simplified,
single payer that would cover all Americans, including those
who could afford the best right now. Representatives and senators
in Washington should have to use the same system my patients
and I do were they to vote it in.
Doctors in private practice fear
a loss of autonomy with a single-payer system. After being in
the private practice of family medicine for 8 1/2 years, I see
that autonomy is largely an illusion. Through Medicare and Medicaid,
the government is already writing its own rules for 45% of the
patients I see.
The rest are privately insured
under 301 different insurance products (my staff and I counted).
The companies set the fees and the contracts are largely non-negotiable
by individual doctors.
The amount of time, staff costs
and IT overhead associated with keeping track of all those plans
eats up most of the money we make above Medicare rates. As it
is now, I see patients and wait between 30 and 90 days to get
paid. My practice requires two full-time staff members for billing.
My two secretaries spend about half their time collecting insurance
information. Plus, there's $9,000 in computer expenses yearly
to handle the insurance information and billing follow up. I
suspect I could go from four people in the paper chase to one
with a single-payer system.
It would be simpler and better
for the patient, and for me, if the patient could choose a doctor,
bring their ID card with them, swipe it in a card reader at the
time of service and have the doctor get paid on the spot with
electronic funds transfer.
Instead, patients have to negotiate
a maze of deductibles, provider networks, out-of-network costs,
exclusions, policy riders, ER surcharges, etc. Wouldn't a card
swipe be simpler? No preexisting conditions to worry about. No
indecipherable hospital bills. One formulary to deal with and
one set of administrative rules to learn instead of 300.
With a single-payer system, there
are concerns about waiting times for procedures and not getting
access to the "best doctors." These are real issues,
but not unsolvable ones. We have these disparities now. Fact
is, they are mostly a matter of geography, insurance status and
personal wealth.
A single-payer system would increase
access to care for the uninsured and the underinsured, including
the working poor. It would lower total health costs, in part
by replacing 50 different state Medicaid programs and umpteen
insurers with one system. This approach has the potential to
improve quality and lower costs by improving care for chronic
illnesses such as diabetes, high blood pressure and heart disease.
. .
I used to think a single-payer
system would keep my income down and inject bureaucracy into
my medical decision-making. But with the efficiency it could
bring, it would at worst be an economic wash; more likely, the
trimmed costs would more than make up for any foregone revenue.
As for autonomy, I'm already struggling to maintain it amid the
interference of insurers.
[Benjamin Brewer is a doctor
with a family practice in the rural village of Forrest, Il]
http://online.wsj.com/article/SB114528925682927634.html
BUSH HAS MORE THAN DOUBLED COST OF MEDICARE
IN COVERT ATTACK ON PLAN
BLOOMBERG - The U.S. Medicare
plan will ask elderly people to pay 11 percent more in health-insurance
premiums for doctors' visits next year, the program's trustees
said in a report released yesterday. Medicare intends to charge
a monthly premium of $98.20 in 2007, up from $88.50 this year,
the trustees said. The premium has more than doubled from the
$45.50 charged in 2000. The Senate Democrats yesterday said they
want to peg the premium increases to the Consumer Price Index,
a measure used to track economic growth, to slow rate hikes.
http://tinyurl.com/ltzw6
APRIL 2006
MIDDLE CLASS WITHOUT HEALTH INSURANCE
SOARING
NICK TIMIRAOS, LA TIMES - The number of uninsured adults who
earn between $20,000 and $40,000 annually is rising, according
to a study released today - suggesting that fewer employers are
providing healthcare coverage. That study, along with one that
says the uninsured are likely to seek treatment only when they
become seriously ill, coincides with a national campaign, Cover
the Uninsured, to make healthcare coverage a top legislative
priority.
Research by the Commonwealth
Fund, a nonpartisan New York-based foundation that examines healthcare
issues, found that the percentage of moderate-income Americans
who were without insurance for at least part of the year had
jumped sharply over four years - from 28% in 2001 to 41% in 2005.
ROMNEY HEALTHCARE PLAN IS A CON
STEFFIE WOOLHANDLER AND DAVID
HIMMELSTEIN, PHYSICIANS FOR A NATIONAL HEALTH PROGRAM - The politicians
assumed that only about 500,000 people in Massachusetts are uninsured.
The Census Bureau says that 748,000 are uninsured. Why the difference?
The 500,000 figure comes from a phone survey conducted in English
and Spanish. Anyone without a phone or who speaks another language
is counted as insured. The 748,000 figure comes from a door-to-door
survey carried out in many languages (including Portuguese and
Haitian Creole, common languages in Massachusetts). In sum, the
reform plan wishes away 248,000 uninsured people who don't have
phones or don't speak English or Spanish. It provides no funding
or means to get them coverage.
Second, the linchpin of the plan
is the false assumption that uninsured people will be able to
find affordable health plans. A typical group policy in Massachusetts
costs about $4500 annually for an individual and more than $11,000
for family coverage. A wealthy uninsured person could afford
that ­ but few of the uninsured are wealthy. A 25 year old
fitness instructor can find a cheaper plan. But few of the uninsured
are young and healthy. According to Census Bureau figures, only
12.4% of the 748,000 uninsured in Massachusetts are both young
enough to qualify for low-premium plans (under age 35) and affluent
enough (incomes greater than 499% of poverty) to readily afford
them. Yet even this 12.4% figure may be too high if insurers
are allowed to charge higher premiums for persons with health
problems; only half of uninsured persons in those age and income
categories report that they are in "excellent health".
The legislation promises that
the uninsured will be offered comprehensive, affordable private
health plans. But that's like promising chocolate chip cookies
with no fat, sugar or calories. The only way to get cheaper plans
is to strip down the coverage ­ boost co-payments, deductibles,
uncovered services etc.
Hence, the requirement that most
of the uninsured purchase coverage will either require them to
pay money they don't have, or buy nearly worthless stripped down
policies that represent coverage in name only.
Third, the legislation will do
nothing to contain the skyrocketing costs of care in Massachusetts
­ already the highest in the world. Indeed, it gives new
infusions of cash to hospitals and private insurers. Predictably,
rising costs will force more and more employers to drop coverage,
while state coffers will be drained by the continuing cost increases
in Medicaid. Moreover, when the next recession hits, tax revenues
will fall just as a flood of newly unemployed people join the
Medicaid program or apply for the insurance subsidies promised
in the reform legislation. The program is simply not sustainable
over the long ­ or even medium ­ term.
What Are the Alternatives?
A single payer universal coverage
plan could cut costs by streamlining health care paperwork, making
health care affordable. Massachusetts Blue Cross spends only
86% of premiums paying for care. It spends the rest - more than
$700 million last year - on billing, marketing and other administrative
costs. Harvard Pilgrim and Tufts Health Plan ­ our other
big insurers - are little better; each took in about $300 million
more than it paid out. That's ten times as much overhead per
enrollee as Canada's national health insurance program. And our
hospitals and doctors spent billions more fighting with insurers
over payments.
Overall, Massachusetts residents
will spend $13.3 billion on health care bureaucracy this year
­ nearly one third of our total health bill. If we cut bureaucracy
to Canada's levels we could save $9.4 billion annually, enough
to cover all of the 748,000 uninsured in Massachusetts and to
improve coverage for the rest of us.
Study after study ­ by the
Congressional Budget Office, the General Accounting Office and
even the Massachusetts Medical Society - have confirmed that
single payer is the only route to affordable universal coverage.
And single payer is popular.
The Massachusetts Nurses Association supports it along with dozens
of other labor, seniors and consumer groups; so do 62% of Massachusetts
physicians according to a recent survey. National polls find
that almost two-thirds of Americans favor a tax-funded plan like
Medicare that would cover all Americans.
But single payer national health
insurance threatens the multi-million dollar paychecks of insurance
executives, and the outrageous profits of drug companies and
medical entrepreneurs.
http://www.pnhp.org
MARCH 2006
PHARMACISTS SAY BUSH DRUG PLAN IS BAD
FOR THEM, TOO
ROBERT PEAR, NY TIMES Pharmacists say they have been losing
money under Medicare's new prescription drug benefit, and they
have taken their concerns to the White House, forcing the administration
to confront political problems caused by the rocky start of the
program. Bill C. Pittman arranged a meeting with the White House
on behalf of Texas pharmacists. In a meeting last week with Karl
Rove, the president's senior adviser, the druggists said many
independent pharmacies might have to shut their doors because
they were not being paid adequately or promptly under Medicare.
In the last two months, they said, pharmacists have given away
millions of dollars' worth of medications for which Medicare
drug plans should have paid. The pharmacists who visited the
White House were all from Texas. Several have close ties to Mr.
Rove and President Bush. But their concerns are shared by retail
pharmacists across the country, who said that Medicare drug plans
were paying them less than it cost to fill prescriptions for
the beneficiaries. . .
The pharmacists underscored the
political significance of their concerns in a report presented
to Mr. Rove and Allan B. Hubbard, assistant to the president
for economic policy. "Most independent community pharmacists
are small-business Republicans," the report said. "Pharmacists
want to be supportive of this administration, and they can play
an active role in the midterm elections. But pharmacists need
to be able to point to some corrective actions being taken by
the administration."
FIVE MYTHS ABOUT NATIONAL HEALTHCARE
[Tyler Zimmer, Campus Progress]
Myth #1: It would be too expensive
UHC would actually reduce the
cost of health care. The Congressional Budget Office estimated
that UHC could save up to $14 billion annually by spreading the
risk evenly over the entire population, eliminating deductibles
and co-pays and making preventive medicine available to the poor
and uninsured. The federal government already subsidizes private
health insurance in the form of tax deductions.
Private insurance companies also
spend billions on administration and overhead, advertising, and
determining and inspecting patient eligibility, all while trying
to make a profit. UHC would not be burdened with some of those
costs, like advertising, and unlike private business, it could
run at a loss and still be viable. . .
Myth #2: It would require a huge,
inefficient bureaucracy
The current system is already
a huge, inefficient bureaucracy! As previously mentioned, much
of the unnecessary overhead and micromanaging in the system now
could be eliminated if UHC were implemented. For example, the
bureaucracy and paperwork involved in determining patient eligibility
would be completely unnecessary if everyone were eligible and
covered. Insurance companies spend an estimated 25 cents of every
dollar on administration. Canada, which already has a comprehensive
UHC in place and still manages to pay 70 percent less per citizen
on health care, spends about the equivalent of about 12 cents
of every dollar on administration.
Myth #3: It would restrict patient
choice
UHC wouldn't directly dictate
what doctor you have to see in order to get treatment and would
thus enable more choice in selecting a physician than the current
system would for many, if not most, Americans.
Myth #4: It would be a socialist
seizure of the medical industry
It would be nothing of the sort.
Socialized medicine would entail hospitals and doctors becoming
employees of the state. UHC only provides funding for people's
health care, but doesn't provide the health care itself. . .
UHC would be no more socialist than Medicare and arguably less
so than public education.
Myth #5: UHC would impede economic
growth
An added benefit of UHC would
be that private business would no longer have to worry about
health-care benefits, and employees wouldn't have to remain in
unpleasant jobs just to keep their benefits. Benefits wouldn't
interfere with wage increases, and employers would have more
financial mobility. . .
http://www.alternet.org/wiretap/31196/
MEDICARE DRUG PLAN IS BIGGEST GOVERNMENT
LEGISLATIVE FRAUD SINCE THE S&L BAILOUT
PROGRESSIVE REVIEW - The new
Medicare drug plan is probably the biggest government fraud since
the S&L bailout. And as with the savings and loan scandal,
the media is simply going along with it, reporting what is massive
giveaway to the drug corporations as just another government
program. It isn't: the measure was specifically designed the
give the drug industry the biggest profits possible with Medicare
recipients the ultimate victims. It was deliberately written
to confuse, obscure and complicate use of the benefits. Name
one other such widely used federal program where you have to
go to a two hour workshop just to find out what the hell is going
on. Name one other with a permanent continuing penalty attached
to those who fail to sign up by a certain time. Name one other
with such a bewildering set of choices for no good purpose other
than to let the big corporations make more money.
Here for example, are just two
paragraphs from an attempt in the Texasrkanan Gazette to explain
the program to its readers:
"For example, your prescriptions
costs now run about $100 per month. You could choose a plan with
a '0' monthly premium and a $250 yearly deductible. You would
have met your deductible in less than three months. The rest
of the year, you would have no expense other than the amount
your plan charges for your prescription. Spending no more than
$100 per month or less on prescriptions, you will never reach
the $3,600 out of pocket expenses and the catastrophic coverage.
"On the other hand, your
prescription costs run $1,500 per month. You choose a plan with
a $250 deductible and a '0' or low monthly premium. You will
have reached your $250 deductible the first month and $3,600
"out of pocket expense" by the third month. Your prescriptions
would then cost no more than $2 for generics and $5 for brand
names."
This measure joins the S&l
bailout and a few others as legislation which by its very nature
borders on criminal intent, a deliberate effort to defraud the
those who were meant to benefit from it.
THE ISSUE THE MEDIA REFUSES TO ADDRESS
ROBERT KUTTNER, BOSTON GLOBE
- Health insurance is the most vivid case of what political scientist
Walter Dean Burnham calls a ''politics of excluded alternatives."
Polls consistently show that over two-thirds of Americans want
universal tax-supported health insurance. Gallup found that 79
percent of Americans want coverage for all, and 67 percent don't
mind if taxes are raised to pay for it. Fully 78 percent are
dissatisfied with the present system. Medicare, the one part
of the system that is true national health insurance (for seniors)
is overwhelmingly popular.
There is no hotter political
issue, nor one that strikes closer to home. So, if Americans
overwhelmingly want national health insurance, why don't we get
it? Three huge reasons: political, fiscal, and jurisdictional.
Politically, the immensely powerful
private insurance industry would be displaced by national health
insurance. Nearly all corporations would rather suffer with the
devil that they know (escalating premiums) than the devil they
hate (an expanded role for government). Ideologically, something
supported by overwhelming majorities is seen as radical. (So
was Social Security until it was enacted).
Fiscally, a shift to national
health insurance would require about $700 billion that currently
goes through the private sector in charges to workers and consumers
and shifted to the public sector in the form of taxes. The result
would be a far more efficient and reliable system, but many voters
would see the increased taxes but not appreciate the savings
in premium costs, payroll deductions, or out-of-pocket charges.
. .
The best first step would be
public, universal coverage for everyone under age 25, a group
relatively cheap to insure. That would be a big political step
toward true national health insurance, because it would accustom
working-age Americans to the value of a universal system. And
if it works for our kids and our parents, why not for everyone?
http://www.commondreams.org/views05/1126-26.htm
MEDICARE DRUG PLAN CUTS OFF AID TO THE
NEEDY
THOMAS GINSBERG, KNIGHT RIDDER - Under federal rules effective Jan.
1, low-income and elderly patients who enroll in the program,
known as Medicare Part D, will lose the ability to get free medications
through the drugmakers' tax- deductible charities, known as patient-
assistance programs. Some companies, going further, said this
week that they would drop patients who were merely eligible for
Part D, whether or not they actually enrolled in it, as allowed
under longstanding rules. As a result, in about six weeks, up
to half of the roughly 3 million to 4 million charity patients
nationwide may lose free access to more than 1,200 brand-name
drugs, according to estimates of three companies. Other recipients
should be unaffected. . . News of the cutoff followed a ruling
last week by the Inspector General of the Department of Health
and Human Services barring companies from giving free drugs to
Part D enrollees, hoping to prevent fraud. While suggesting an
alternative charity system, the ruling threw a confusing twist
into the already-baffling Medicare prescription-drug program.
''The last thing we need is one more variable in a hopelessly
complex situation," said Robert M. Hayes, president of the
Medicare Rights Center, an advocacy group based in New York.
On Tuesday, Americans could begin to sign up for the new voluntary
Medicare prescription-drug coverage. About 42 million Medicare
recipients are eligible for the program.
LEAVE NO SENIOR UNSTYMIED ACT CONT'D
USA TODAY - Using the Medicare
drug-benefit search tool requires patience. With a high-speed
Internet link, allow at least 20 minutes to do a simple search:
1. Go to www.medicare.gov. Select
the "Compare Medicare Prescription Drug Plans" link.
2. Enter a Medicare member's
number or select the general search button and type in a ZIP
code to find all the plans serving a region. You may get a long
list.
3. Narrow the selection by entering
the names of the prescription drugs taken by the Medicare member.
You can enter exact dosages or click a button that will enter
commonly prescribed dosages for you. Keep in mind that the list
that results includes plans that may not cover all the drugs
you've chosen.
4. Compare plans on cost, deductible,
premium and other factors by selecting up to three plans at a
time and clicking on the compare button. Choose several options
that look appealing and print out the list of your selections
for later reference.
5. Go back to the main home page.
Select the link to "Formulary Finder."
6. Enter your state and re-enter
all the drug names. You'll get two lists of plans. The list at
the top of the page shows plans that cover all your selected
drugs. The second list at the bottom shows plans that cover only
some of the drugs.
7. Refer to the printout of choices
you're considering in your ZIP code. By clicking on the plan
names, you can learn more about the drugs covered by each plan
and what restrictions, if any, are placed on them.
http://www.usatoday.com/money/industries/health/drugs/2005-11-14-medicare-navigate_x.htm
[This, mind you, only gives a
list of drug merchants who may offer some but not all of the
drugs a senior may need]
SENIORS JOIN CHILDREN IN BEING
LEFT BEHIND BY BUSH REGIME
ROBERT PEAR, NY TIMES Enrollment
in the new Medicare drug benefit begins in three days, but even
with President Bush hailing the plan as "the greatest advance
in health care for seniors" in 40 years, large numbers of
older Americans appear to be overwhelmed and confused by the
choices they will have to make. At a senior center in Urbana,
Lynn Heskett of the Ohio Senior Health Insurance Information
Program described the drug plan to a full house. "I have
a Ph.D., and it's too complicated to suit me," said William
Q. Beard, 73, a retired chemist in Wichita, Kan., who takes eight
prescription drugs, including several heart medicines. "I
wonder how the vast majority of beneficiaries will handle this.
. .
"The whole thing is hopelessly
complicated," said Pauline H. Olney, 74, a retired nurse
who attended a seminar at a hotel in Santa Rosa, north of San
Francisco. . .
In most states, beneficiaries
have a choice of more than three dozen prescription drug plans.
Premiums, deductibles, co-payments and covered drugs vary widely.
Many retirees also have other options: getting drug coverage
through former employers or through Medicare-managed care plans.
In Kansas, Medicare beneficiaries have a choice of 40 prescription
drug plans charging premiums from $9.48 a month to $67.88 a month.
. .
http://www.nytimes.com/2005/11/13/national/13drug.html
PAUL KRUGMAN, NY TIMES - At first,
the benefit will look like a normal insurance plan, with a deductible
and co-payments. But if your cumulative drug expenses reach $2,250,
a very strange thing will happen: you'll suddenly be on your
own. The Medicare benefit won't kick in again unless your costs
reach $5,100. This gap in coverage has come to be known as the
"doughnut hole." . . .
One way to see the bizarre effect
of this hole is to notice that if you are a retiree and spend
$2,000 on drugs next year, Medicare will cover 66 percent of
your expenses. But if you spend $5,000 - which means that you're
much more likely to need help paying those expenses - Medicare
will cover only 30 percent of your bills. A study in the July/August
issue of Health Affairs points out that this will place many
retirees on a financial "roller coaster."
People with high drug costs will
have relatively low out-of-pocket expenses for part of the year
- say, until next summer. Then, suddenly, they'll enter the doughnut
hole, and their personal expenses will soar. And because the
same people tend to have high drug costs year after year, the
roller-coaster ride will repeat in 2007.
How will people respond when
their out-of-pocket costs surge? The Health Affairs article argues,
based on experience from H.M.O. plans with caps on drug benefits,
that it's likely "some beneficiaries will cut back even
essential medications while in the doughnut hole." In other
words, this doughnut will make some people sick, and for some
people it will be deadly.
The smart thing to do, for those
who could afford it, would be to buy supplemental insurance that
would cover the doughnut hole. But guess what: the bill that
established the drug benefit specifically prohibits you from
buying insurance to cover the gap. That's why many retirees who
already have prescription drug insurance are being advised not
to sign up for the Medicare benefit.
http://select.nytimes.com/2005/11/11/opinion/11krugman.html?hp
AMERICANS PAY MORE, GET LESS HEALTH
CARE
MARGUERITE HIGGINS, WASHINGTON TIMES
- Out-of-pocket medical
expenses and medical errors were higher for patients in the United
States than for those in countries that have state-funded health
care systems, according to a new report. The study, which was
released yesterday by the Commonwealth Fund, surveyed nearly
7,000 patients from March to June in the United States, Britain,
Canada, Australia, Germany and New Zealand. Roughly 34 percent
of U.S. patients encountered a medical mistake in the past two
years, followed by 30 percent of Canadian patients, said the
New York health research organization, which promotes universal
health care coverage through government and corporate initiatives.
. .
Additionally, 34 percent of U.S.
patients paid more than $1,000 in out-of-pocket medical expenses
in the past year while only 14 percent of Canadian and Australian
patients paid that much in the same period, the report said.
ROB STEIN WASHINGTON POST - "What's striking is that we are
clearly a world leader in how much we spend on health care,"
said Cathy Schoen, senior vice president for the Commonwealth
Fund, a private, nonpartisan, nonprofit foundation that commissioned
the survey. "We should be expecting to be the best. Clearly,
we should be doing better." Other experts agreed, saying
the results offer the most recent evidence that the quality of
care in the United States is seriously eroding even as health
care costs skyrocket. "This provides confirming evidence
for what more and more health policy thinkers have been saying,
which is, 'The American health care system is quietly imploding,
and it's about time we did something about it,' " said Lucian
L. Leape of the Harvard School of Public Health.
OCTOBER 2005. . .
THE FAILURES OF HEALTH INSURANCE
JOHN LELAND, NY TIMES - After
decades in which private and government insurance covered a progressively
larger share of medical expenses, insurance companies are now
shifting more costs to consumers, in the form of much higher
deductibles, co-payments or premiums. At the same time, Americans
are saving less and carrying higher levels of household debt,
and even insured families are exposed to medical expenses that
did not exist a decade ago. . . Lawyers and accountants say that
for the more than 1.5 million American families who filed for
bankruptcy protection last year, the most common causes were
job loss and medical expenses. New bankruptcy legislation, which
went into effect Oct. 17, requires middle-income debtors to repay
a greater share of their debt.
http://www.nytimes.com/2005/10/23/national/23PATIENT.html
SEPTEMBER 2005. . .
NUMBER WITHOUT HEALTH INSURANE RISING
BOSTON GLOBE - With the exception of 1999 and 2000, the number
of Americans without health insurance has risen steadily from
just over 30 million in 1987. It is a bipartisan failure. After
President Clinton dropped his botched attempt for a more universal
form of healthcare in his first term, the numbers of the uninsured
soared from 35 million to nearly 45 million. Aided by a booming
economy, the numbers fell in Clinton's last two years to 40 million.
Under Bush, the number cracked the 45 million barrier for the
first time -- 45.8 million, to be exact.
WHY SMALL BUSINESSES SHOULD BE LOOKING
AT NATIONAL HEALTHCARE
SMALL BUSINESS TIMES - Health
care costs are rising at 10-15% per year and employers are struggling
for ways to pay these costs, which typically represent 15% of
their labor costs. Many are shifting the costs to their employees
by demanding high deductibles and co-pays, and in some cases
contracting with HMOs who make their money more by denying care
than providing it.
But what else can companies do?
They are competing with manufacturers in countries that have
taxpayer-paid universal health care systems, and these competitors
need not add health care to the cost of their products. Of course
our manufacturers can send their work abroad, but then American
jobs are lost.
Rising health care costs are
the result of only one thing, a medical community that has switched
from being humanitarian medical centers to for-profit corporations.
The industry has run amok. They are inefficiently operated and
they love it, because inefficiency is where they make much of
their profits. Medicare and private insurers are incurring 20%
to 30% of their costs from unnecessary and inappropriate medical
testing, and another 30% in exorbitant administrative waste.
Compare that 30% to Canada's 8% and Medicare's 3.5%. Wisconsinites
are supporting 400 for-profit insurance companies compared to
the ONE non-profit contractor in each Canadian province.
The 30% waste is not exclusive
to government systems; it also exists within the private sector.
It is the profit motive that is driving up health care costs,
and this motivation exists on all fronts: hospitals, physicians
and insurers, including for-profit HMOs. For-profit entities
are obligated by law to seek the highest profits possible for
their shareholders, and cutting care helps achieve this goal.
The United States and South Africa
are the only two industrialized countries that do not have universal
health care for their citizens. Over 45 million Americans, 15%
of our population, are totally without health care and just show
up at the emergency room for treatment, which is the most expensive
form of rationing possible. The E.R. charges sometimes force
them into bankruptcy, where the losses are shifted to those who
are insured or to the taxpayers. Over 18,000 Americans die prematurely
every year because they lack coverage - which is six times more
than died on 9/11. Another 50 million Americans are underinsured
and are a mishap away from bankruptcy and the societal costs
that result.
Why do we allow this? Because
our politicians are paid to allow it: it's called "$100
million per year in political contributions given by our health
care and pharmaceutical industries." Political money got
us into this mess and eliminating political money will be the
only way of getting us out of it. Unless, of course, business
leaders force the issue and demand change.
PERCENTAGE OF BUSINESSES OFFERING HEALTH
PLANS DROP
SAN FRANCISCO CHRONICLE - The
percentage of businesses offering health benefits to employees
dropped to 60 percent in 2005, down from 69 percent in 2000.
. . In 2005, for the fifth straight year, premium increases outpaced
both inflation and wage growth, the random survey of 3,000 public
and private employers found. Fewer firms -- especially small,
newly formed companies -- are offering coverage this year than
last. Companies that continue to offer medical benefits are asking
workers to pay more for skimpier coverage. The $10,880 average
annual premium for a family of four this year surpassed the yearly
gross earnings of $10, 712 for a full-time minimum-wage worker.
While employers pay most of that premium, workers are covering
about 25 percent. And, on average, they are paying $1,094 more
for their share of family coverage than in 2000.
http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2005/09/15/BUG8OENLE61.DTL
AMERICA'S TRAGIC HEALTH RECORD
PAUL VALLELY, INDEPENDENT, UK
- Parts of the United States are as poor as the Third World,
according to a shocking United Nations report on global inequality.
The US is the only wealthy country with no universal health insurance
system. . .
The annual Human Development
Report normally concerns itself with the Third World, but the
2005 edition scrutinizes inequalities in health provision inside
the US as part of a survey of how inequality worldwide is retarding
the eradication of poverty. It reveals that the infant mortality
rate has been rising in the US for the past five years - and
is now the same as Malaysia. America's black children are twice
as likely as whites to die before their first birthday. . .
- For half a century the US has
seen a sustained decline in the number of children who die before
their fifth birthday. But since 2000 this trend has been reversed.
- Although the US leads the world
in healthcare spending - per head of population it spends twice
what other rich OECD nations spend on average, 13 per cent of
its national income - this high level goes disproportionately
on the care of white Americans. It has not been targeted to eradicate
large disparities in infant death rates based on race, wealth
and state of residence.
- A baby boy from one of the
top 5 per cent richest families in America will live 25 per cent
longer than a boy born in the bottom 5 per cent and the infant
mortality rate in the US is the same as Malaysia, which has a
quarter of America's income.
- Blacks in Washington DC have
a higher infant death rate than people in the Indian state of
Kerala
- Throughout the US black children
are twice as likely to die before their first birthday.
- Hispanic Americans are more
than twice as likely as white Americans to have no health cover
- The US is the only wealthy
country with no universal health insurance system.
- If the gap in health care between
black and white Americans was eliminated it would save nearly
85,000 lives a year. Technological improvements in medicine save
about 20,000 lives a year.
- Child poverty rates in the
United States are now more than 20 per cent
http://www.commondreams.org/headlines05/0908-06.htm
AUGUST 2005. . .
HEALTH BILLS LEADING CAUSE OF BANKRUPTCY
MALCOLM GLADWELL, NEW YORKER
- The leading cause of personal bankruptcy in the United States
is unpaid medical bills. Half of the uninsured owe money to hospitals,
and a third are being pursued by collection agencies. Children
without health insurance are less likely to receive medical attention
for serious injuries, for recurrent ear infections, or for asthma.
Lung-cancer patients without insurance are less likely to receive
surgery, chemotherapy, or radiation treatment. Heart-attack victims
without health insurance are less likely to receive angioplasty.
People with pneumonia who don't have health insurance are less
likely to receive X rays or consultations. The death rate in
any given year for someone without health insurance is twenty-five
per cent higher than for someone with insurance. Because the
uninsured are sicker than the rest of us, they can't get better
jobs, and because they can't get better jobs they can't afford
health insurance, and because they can't afford health insurance
they get even sicker.
http://www.newyorker.com/fact/content/articles/050829fa_fact
JULY 2005 . . .
U.S SPENDS DOUBLE ON HEALTHCARE COMPARED
TO 29 INDUSTRIALIZED NATIONS
ST PETERSBURG TIMES - America's
fragmented health care system is the costliest in the world.
The latest study, conducted by Johns Hopkins University researchers
and reported this month in Health Affairs, offers more evidence
of the same. The United States spent $5,267 per person on health
care in 2002. That's more than double, per capita, what 29 other
industrialized nations spent. The total amounts to 14.6 percent
of the U.S. gross domestic product. The United Kingdom, by comparison,
spent 7.7 percent.
http://sptimes.com/2005/07/16/Opinion/The_wrong_Rx.shtml
ASSOCIATED PRESS MENTIONS UNIVERSAL HEALTH CARE
AP - A push for universal health
coverage is being rekindled in some states by the soaring cost
of health care and the lack of political support in Washington
for federal changes. Advocates of a single-payer system - where
the government would collect taxes and cover everyone, similar
to programs in Canada and across Europe - have introduced bills
in at least 18 state legislatures. Some are symbolic gestures,
but heated debate is taking place in California and Vermont.
. .
Not since Oregon in 2002 has a state voted on a single-payer
health system. Voters there soundly rejected it, as did Californians
in 1994. Both times, the proposals came under fierce assault
from the medical, insurance and pharmaceutical industries. However,
Oregon supporters are aiming for another ballot measure in 2008,
and a bill in California would have the government pay for health
care in a state where 7 million people are uninsured.
MAY 2005. . .
IT'S INSURANCE FEES, NOT AWARDS, THAT
ARE COSTING DOCTORS
LIZ KOWALCZYK, BOSTON GLOBE Re-igniting the medical malpractice overhaul
debate, a new study by Dartmouth College researchers suggests
that huge jury awards and financial settlements for injured patients
have not caused the explosive increase in doctors' insurance
premiums. The researchers said a more likely explanation for
the escalation is that malpractice insurance companies have raised
doctors' premiums to compensate for falling investment returns.
The Dartmouth economists studied
actual payments made to patients between 1991 and 2003, the results
of which were published yesterday in the journal Health Affairs.
Some previous studies have examined jury awards, which often
are reduced after trial to comply with doctors' insurance coverage
maximums or because the plaintiff settles for less money to avoid
an appeal. Researchers found that payments grew an average of
4 percent annually during the years covered by the study, or
52 percent overall since 1991, but only 1.6 percent a year since
2000. The increases are roughly equivalent to the overall rise
in healthcare costs, said Amitabh Chandra, lead author and an
assistant professor of economics at the New Hampshire college.
"One of the things we know
about medical malpractice payments is that they're usually made
when an injury occurred," he said. "The injury has
to be treated. And if it's more and more expensive to treat injuries,
then that will be reflected in payments."
Meanwhile, malpractice insurance
premiums for internists, general surgeons, and obstetricians
have skyrocketed since 2000, jumping 20 to 25 percent in 2002
alone. In Massachusetts, ProMutual Group, which covers about
one-third of the state's doctors, raised rates an average of
11 percent last year, 20 percent in 2003, and 12.5 percent in
2002. Some specialists, such as obstetricians, now pay almost
$100,000 annually for their malpractice insurance. Pro Mutual
executives said they will not raise premiums this July, primarily
because increases in the number of claims have slowed.
AMERICA'S LOUSY HEALTHCARE
RICHARD SCHWARTZ, NY DAILY NEWS
- America doesn't have the world's best health care system, just
the most expensive. For those of you who worry about your health
and wealth (i.e., everyone), that's mind-bogglingly bad news.
The numbers are grotesque. The United States spends 15.5 percent
of its gross domestic product on health care, about $1.7 trillion
a year. No other country comes close. Yet for all that money
- equal to the entire economic output of France - 45 million
Americans go without health insurance.
By the way, in France, which
on a per-capita basis spends about half what we do on health
care, everyone is insured. In fact, under France's universal
health system, patients can visit doctors, even specialists,
virtually any time they wish. . .
We're only No. 22 among industrialized
nations in life expectancy (77 years). Japan is No. 1 at 81 years.
We're No. 25 in infant mortality rate (6.8 infant deaths per
1,000 births). Sweden leads with only 3.5 deaths per 1,000. .
.
http://www.fortwayne.com/mld/newssentinel/news/editorial/11558567.htm
PROGRESS REPORT - In a study
conducted by the Robert Wood Johnson Foundation, 41 percent of
uninsured adults said they were unable to see a doctor when they
needed to during the previous year and 56 percent did not have
a personal doctor or other health care provider. In 2003, chronically
ill uninsured adults were more than four times more likely to
go without medical care or prescription drugs than chronically
ill insured adults." Nevertheless, more than one in five
uninsured adults with chronic conditions report spending at least
$2,000 out of pocket in a year for medical care. In last week's
Los Angeles Times, Barbara Ehrenreich pointed out the "average
visit to an ER now costs a little over $1,000, which is a high
price to pay for an asthma attack or an infant's fever."
RWJF estimates that 20 million
working Americans are uninsured and the Washington Times reports
rising health care costs are forcing companies to pass "more
of their health care costs on to employees in an effort to cut
business expenses." General Motors Corp., the nation's largest
buyer of health plans, recently reported it lost $1.1 billion
in the first quarter of 2005, its largest quarterly loss in more
than a decade." The company "cited the cost of providing
health coverage for its workers and retirees as a main culprit."
The first element of the Bush
administration's response to America's health care crisis has
been to cut funding for coverage and offer half-baked privatization
plans like Health Savings Accounts that exacerbate existing problems
and would help only 0.3 percent of uninsured adults. In his latest
"victory," President Bush successfully lobbied Congress
to cut federal funding for Medicaid, the nation's largest insurance
program for the poor. Medicaid was already facing increased costs
driven by "enrollment growth due to the economic downturn"
during Bush's first term. In addition, Congress recently passed
the White House-backed Bankruptcy Bill, which will make it harder
for uninsured Americans to recover from crippling debt brought
on by medical problems.
The second part of the Bush administration's
response appears to involve pretending health care problems don't
exist. For instance, the 2004 Economic Report of the President
concluded "many [of the uninsured] may remain uninsured
as a matter of choice," perhaps because "they are young
and healthy and do not see the need for insurance." Others,
the report offered, are probably covered but do not report it,
maybe because the "survey questions are confusing."
A more recent report funded by the Department of Health and Human
Services set out to prove the number of uninsured is overstated
http://www.americanprogressaction.org/site/pp.asp?c=klLWJcP7H&b=124597
APRIL 2005
AMERICA SPENDS MORE ON HEALHCARE, GETS
LESS
http://www.iht.com/bin/print_ipub.php?file=/articles/2005/04/15/opinion/edkrug.html
PAUL KRUGMAN, NY TIMES - In 2002,
the latest year for which comparable data are available, the
United States spent $5,267 on health care for each man, woman
and child. Of this, $2,364, or 45 percent, was government spending,
mainly on Medicare and Medicaid. Canada spent $2,931 per person,
of which $2,048 came from the government. France spent $2,736
per person, of which $2,080 was government spending. . .
U.S. health care is so expensive
that our government spends more than the governments of other
advanced countries, even though the private sector pays a far
higher share of the bills than anywhere else. . .
Most Americans probably do not
know that we have substantially lower life-expectancy and higher
infant-mortality figures than other advanced countries. . . Social
factors, notably America's high poverty rate, surely play a role.
Still, it seems puzzling that we spend so much, with so little
return.
A 2003 study published in Health
Affairs [found] that the United States scores high on high-tech
services - we have lots of MRIs - but on more prosaic measures,
like the number of doctors' visits and number of days spent in
hospitals, America is only average, or even below average. .
.
Above all, a large part of America's
health care spending goes into paperwork. A 2003 study in The
New England Journal of Medicine estimated that administrative
costs took 31 cents out of every dollar the United States spent
on health care, compared with only 17 cents in Canada.
FEBRUARY 2005
MEDICAL BANKRUPTCY: EVEN INSURANCE MAY
NOT SAVE YOU
http://www.commondreams.org/views05/0212-10.htm Published on
Saturday,
ELZABETH WARREN, COMMON DREAMS
- Health insurance? That didn't protect one million Americans
who were financially ruined by illness or medical bills last
year. A comfortable middle-class lifestyle? Good education? Decent
job? No safeguards there. Most of the medically bankrupt were
middle-class homeowners who had been to college and had responsible
jobs -- until illness struck.
As part of a study at Harvard
University, our researchers interviewed 1,771 Americans in bankruptcy
courts nationwide. To our surprise, half said that illness or
medical bills drove them to bankruptcy. So each year, 2 million
Americans -- those who file and their dependents -- face the
double disaster of illness and bankruptcy.
But the bigger surprise was that
three-quarters of the medically bankrupt had health insurance.
How did illness bankrupt middle-class Americans with health insurance?
High co-payments, deductibles, exclusions from coverage and other
loopholes left some holding the bag for thousands of dollars
in out-of-pocket costs. But medical problems often bankrupted
even families with Cadillac coverage.
Too sick to work, they suddenly
lost their jobs. With the jobs went most of their income and
health insurance -- a quarter of all employers cancel coverage
the day you leave work because of a disabling illness; another
quarter do so in less than a year. Many of the medically bankrupt
qualified for some disability payments and had the right under
the COBRA law to continue their health coverage -- if they paid
for it themselves. But how many families can afford a $1,000
monthly premium for coverage under COBRA, especially after the
breadwinner has lost his or her job?
Bankrupt families lost more than
just assets. One out of five went without food. A third had their
utilities shut off, and nearly two-thirds skipped needed doctor
or dentist visits. These families struggled to stay out of bankruptcy.
They arrived at the bankruptcy courthouse exhausted, brought
low by a healthcare system that could offer physical cures but
left them financially devastated.
SINGLE PAYER IS GOOD FOR BUSINESS
MORTON MINTZ, NATION - Publicly
financed but privately run healthcare for all--including free
choice of physicians--would cost employers far less in taxes
than their costs for insurance. Universal coverage could also
work magic in less obvious ways. For example, employers would
no longer have to pay for medical care under workers' compensation,
which in 2002 cost them more than $38 billion. Auto-insurance
rates would fall for them--and everyone--if the carriers were
no longer liable for medical and hospital bills. You'd think
that in its own selfish interest, Corporate America would be
fighting to replace the existing system with universal health
coverage. Yet it doesn't lift a finger. . .
Reacting to rising expenditures
on insurance, corporate managements cut back on employee health
benefits, triggering worker unrest. Consider the five-month strike
against supermarket chains in Southern California--the longest
in the industry's history. It left about 60,000 union workers
jobless, and it seriously hurt the owners as well. The central
issue--in a state where half of all personal bankruptcies are
related to medical bills--was the demand by Safeway, Kroger and
Albertsons that members of the United Food and Commercial Workers
union pay much more for health benefits. The settlement, reached
last February, sent a grim message to grocery workers everywhere.
. .
Business leaders worship marketplace
ideology "almost like religion," says Raymond Werntz,
who for nearly thirty years ran healthcare programs for Whitman
Corporation, a Chicago-based multinational holding company. "It's
emotional." In 1999 Werntz became the first president of
the Consumer Health Education Council in Washington, a program
of the Employee Benefit Research Institute, a nonprofit, nonpartisan
group. He saw it as his mission to try to persuade employers
to face the "huge, huge" issue of the uninsured because,
he told me, "business has to be involved with the solution."
The problem that emerged was its "unwillingness to even
think about a solution." Last year, after funding ran out,
a disappointed Werntz became the council's last and only president.
Publicly financed universal health
insurance comes in different forms. For Americans, however, none
should hold more interest than single-payer. It's "one and
the same thing" as Medicare for everybody, Werntz told me.
Does the Corporate America that's happy with Medicare understand
this? I asked. "It's a dialogue that hasn't happened yet,"
he replied. "My life for four years was trying to get business
people in a room with single-payer people. I couldn't do it."
CEOs of large corporations see it as something "that smacks
of socialism," Werntz said, and therefore as "heresy."
Somehow, they don't see Medicare
as heresy. Yet it's largely why the tax-financed share of US
health spending is "the highest in the world," according
to Drs. Steffie Woolhandler and David Himmelstein, associate
professors at Harvard Medical School and founders of Physicians
for a National Health Program. Writing in the July/August 2002
issue of Health Affairs, they put the share at 59.8 percent.
No wonder: Federal tax revenues pay for Medicare, Medicaid and
the medical-care systems for the military, the Veterans Administration,
federal employees and Congress; income-, sales- and property-tax
revenues buy coverage for state and local public employees. Taxation
also hugely subsidizes health insurance while benefiting mostly
"the affluent," the authors noted.
HEALTH INSURANCE COSTS SOAR UNDER BUSH
WASHINGTON POST - In the past
four years, Americans have spent an ever-growing portion of their
paychecks on health care and for the most part gotten less for
their money, forcing millions into the ranks of the uninsured
or personal bankruptcy, according to government figures and several
independent assessments.
Nationwide, workers' costs for
health insurance have risen by 36 percent since 2000, dwarfing
the average 12.4 percent increase in earnings since President
Bush took office, the liberal consumer group Families USA reports
in an analysis scheduled for release today. The number of Americans
spending more than a quarter of their income on medical costs
climbed from 11.6 million in 2000 to 14.3 million this year,
according to the group.
The news comes as many companies
are dropping medical coverage entirely or trimming their benefit
packages, while taxpayers are subsidizing millions of people
below the poverty line who have enrolled in the state-run Medicaid
and Children's Health Insurance Program, a separate survey by
the Kaiser Family Foundation found. Hardest hit have been low-income
working families, Hispanics and people with chronic conditions
such as diabetes, asthma or depression.
"The cost of family health
insurance is rapidly approaching the gross earnings of a full-time
minimum-wage worker," said Drew Altman, president and chief
executive of the nonprofit foundation, which compiled the data.
EARLIER
MAJORITY OF AMERICANS SUPPORT CANDIDIAN TYPE HEALTHCARE
RANDI F. MARSHALL, NEWSDAY
- - Rising health care costs and shrinking coverage have prompted
a significant majority of Americans to support government regulation
- or even universal health care, according to a survey released
yesterday. Two-thirds of those surveyed said they supported a
health care "guarantee," similar to the Canadian or
British systems, according to the survey, which was issued by
Results for America, a division of the Civil Society Institute,
a Newton, Mass.-based think tank. Additionally, 78 percent of
Americans advocate government regulation of health care, similar
to utilities such as gas and water, the survey found. "What
this survey shows is a nation in the grips of a health care crisis,"
said Civil Society Institute president Pam Solo. "Americans
are now prepared to embrace some tough ideas."
U.S. HEALTHCARE COMPARED WITH OTHER COUNTRIES
PAUL KRUGAMAN - The fact
is that the mainly private U.S. health-care system spends far
more than the mainly public health-care systems of other countries
but gets worse results. In 2001, we spent $4,887 on health care
per capita, compared with $2,792 in Canada and $2,561 in France.
Yet the United States does worse than either country by any measure
of health-care success you care to name - life expectancy, infant
mortality, whatever. And the U.S. system does have very high
overhead: Private insurers and HMOs spend much more on administrative
expenses, as opposed to actual medical treatment, than public
agencies at home or abroad.
Does this mean that the
American way is wrong and that we should switch to a Canadian-style
single-payer system? Well, yes. In Canada, business executives
are ardent defenders of "socialized medicine." Two
years ago the Conference Board of Canada - a who's who of the
nation's corporate elite - issued a report urging fellow Canadians
to bear in mind not just the "symbolic value" of universal
health care, but also its "economic contribution to the
competitiveness of Canadian businesses." - 9/04
NINE MILLION LOST HEALTH COVERAGE SINCE
2001
MSN -
The number of Americans with employer-paid health coverage fell
dramatically from 2001 to 2003, with about 9 million people losing
coverage, according to a national study released Aug. 2. The
Center for Studying Health System Change said the proportion
of Americans under 65 with employer coverage fell from 67% in
2001 to 63% in 2003. The center is a nonpartisan research group
funded by the Robert Wood Johnson Foundation. Public programs
such as Medicaid and the State Children's Health Insurance Program
took up the slack, preventing a big increase in the number of
uninsured. . .
Latinos
were the least likely to have employer coverage and the most
likely to be uninsured. Employer coverage for Latinos declined
from 46.7% in 2001 to 39.7% in 2003. During the same period,
public insurance enrollment among Latinos increased from 15.3%
to 22.1%. . . Trends for blacks were not statistically significant:
51.3% of blacks in 2003 had employer coverage, 21.5% had public
coverage and 17.9% were uninsured.
UNINSURED COST
TAXPAYERS MONEY EVEN WITHOUT NATIONAL HEALTHCARE
A KAISER COMMISSION STUDY on Medicaid and
the uninsured study finds that uninsured Americans could incur
nearly $41 billion in uncompensated health care treatment in
2004, with federal, state and local governments paying as much
as 85 percent of the care. Even with uncompensated care, the
study shows that people uninsured for the entire year can expect
to receive about half as much care as people fully insured.
Another
major finding of the study, authored by Urban Institute researchers
Jack Hadley and John Holahan, is that if the country provided
coverage to all the uninsured, the cost of additional medical
care provided to the newly insured would be $48 billion - an
increase of 0.4 percent in health spending's share of the gross
domestic product.
DETAILS OF THE CONYERS
MEDICARE BILL
JOHN CONYERS - The United
States National Health Insurance Act (HR676) establishes a new
American national health insurance program by creating a single
payer health care system. The bill would create a publicly financed,
privately delivered health care program that uses the already
existing Medicare program by expanding and improving it to all
U.S. residents, and all residents living in U.S. territories.
The goal of the legislation is to ensure that all Americans,
guaranteed by law, will have access to the highest quality and
cost effective health care services regardless of one's employment,
income, or health care status.
With over 42 million uninsured
Americans, and another 40 million who are under insured, the
time has come to change our inefficient and costly fragmented
health care system. The USNHI program would reduce overall annual
health care spending by over $50 billion in the first year. In
addition, because it implements effective methods of cost-control,
health spending is contained over time, ensuring affordable health
care to future generations.
In its first year, single-payer
will save over $150 billion on paperwork and $50 billion by using
rational bulk purchasing of medications. These savings are more
than enough to cover all the uninsured, improve coverage for
everyone else, including medication coverage and long-term care.
Employers who currently
provide coverage for their employees pay an average of 8.5% of
payroll towards health coverage, while many employers can't afford
to provide coverage at all. Under this Act, all employers will
pay a modest 3.3% payroll tax per employee, while eliminating
their payments towards private health plans. The average cost
to an employer for an employee earning $35,000 per year will
be reduced to $1,155, less than $100 per month.
95% of families will pay
less for health care under national health insurance than they
do today. Seniors and younger people will all have the comprehensive
medication coverage they need.
Who is Eligible
Every person living in
the United States and the U.S. Territories would receive a United
States National Health Insurance Card and i.d number once they
enroll at the appropriate location. Social Security numbers may
not be used when assigning i.d cards. No co-pays or deductibles
are permissible under this act.
Benefits/Portability
This program will cover
all medically necessary services, including primary care, inpatient
care, outpatient care, emergency care, prescription drugs, durable
medical equipment, long term care, mental health services, dentistry,
eye care, chiropractic, and substance abuse treatment. Patients
have their choice of physicians, providers, hospitals, clinics,
and practices.
Conversion to a Non-Profit
Health Care System
Private health insurers
shall be prohibited under this act from selling coverage that
duplicates the benefits of the USNHI program. They shall not
be prohibited from selling coverage for any additional benefits
not covered by this Act; examples include cosmetic surgery, and
other medically unnecessary treatments.
Cost Containment Provisions/
Reimbursement
The National USNHI program
will annually set reimbursement rates for physicians, health
care providers, and negotiate prescription drug prices. The national
office will provide an annual lump sum allotment to each existing
Medicare region, which will then administer the program. Payment
to health care providers include fee for service, and global
budgets.
The conversion to a not-for-
profit health care system will take place over a 15 year period,
through the sale of U.S. treasury bonds; payment will not be
made for loss of business profits, but only for real estate,
buildings, and equipment.
Funding & Administration
The United States Congress
will establish annual funding outlays for the USNHI Program through
an annual entitlement. The USNHI program will operate under the
auspices of the Dept of Health & Human Services, and be administered
in the former Medicare offices. All current expenditures for
public health insurance programs such as S-CHIP, Medicaid, and
Medicare will be placed into the USNHI program.
A National USNHI Advisory
Board will be established, comprised primarily of health care
professionals and representatives of health advocacy groups.
Proposed Funding For
USNHI Program: $1.86 Trillion Per Year
A payroll tax on all employers
of 3.3%. Maintain employee and employer Medicare payroll tax
of 1.45%. Implement a variety of mechanisms so that low and middle
income families pay a smaller share of their incomes for health
care than wealthiest 5% of Americans; i.e, a health income tax
on the wealthiest 5% of Americans, a small tax on stock and bond
transfers, and closing corporate tax shelters. A repeal of the
Bush tax cut of 2001. For more details, see PNHP's "Financing
National Health Insurance."
*For more information,
contact Joel Segal, legislative assistant, Rep. John Conyers,
at 202 225-5126, or e- mail at Joel.Segal@mail.house.gov
AMERICA SPENDS MORE, GETS LESS, FOR ITS
HEALTH POLICY
MAGGIE
FOX, REUTERS - The United States may spend twice as much on health
care as other rich countries but it is not getting results to
match, according to three studies released on Tuesday. . . But
in the studies of five wealthy countries, published in the journal
Health Affairs, researchers found no single nation had clearly
the worst or best health care system.
Gerard
Anderson at Johns Hopkins University's school of public health
and colleagues came up with a list of 21 health fields they could
evenly compare across the five countries -- Australia, Canada,
Britain, New Zealand and the United States.
"None
of the five countries ... is consistently the best or the worst
on all 21 indicators," Anderson told a telephone briefing
for reporters. . .
But, he
said, the United States is not getting value for money. "The
United States should be particularly concerned about these results,
given that we spend twice as much on health care as any other
country. So spending more doesn't necessarily result in better
outcomes."
MEDICARE'S HIDDEN BONANZA
MICHAEL SCHERER, MOTHER
JONES - For conservative leaders, the best part of the Medicare
bill President Bush signed in December had absolutely nothing
to do with Medicare. Rather, the provision that House Speaker
Dennis Hastert calls "the most important piece in the bill"
and former Speaker Newt Gingrich considers "the single most
important change in health care policy in 60 years" is a
little-noticed tax rebate set to cost the Treasury $6.4 billion
over the next decade. The measure allows Americans to open tax-free
"health savings accounts," which can be used to pay
medical bills-in effect removing their owners from the shared
risk that has been the core of the health-insurance system since
World War II. . .
No matter who is right
about the long-term impact, there is little doubt about the biggest
short-term winner. He is J. Patrick Rooney, a major Republican
campaign donor from Indiana who has done more than anyone else
to make health savings accounts a reality. Rooney is the chairman
emeritus of the Indianapolis-based Golden Rule Insurance Co.,
which has been selling health savings accounts through a now-expired
pilot program that Rooney helped convince Congress to approve
in 1996. Just days before the new Medicare bill passed, United
Health Group, the largest insurer in America, paid $500 million
in cash for Rooney's family-owned company-a move that analysts
said was directly tied to the Medicare bill's provisions broadening
the market for health savings accounts. Rarely has a basic federal
program been so tied to one man or one company. In their 10-year
campaign to promote health savings accounts, Rooney's family,
companies, and employees have given $3.6 million to political
candidates and committees, with 90 percent going to Republicans.
HEALTH PLANS TO CHARGE MORE FOR USING BETTER
DOCTORS AND HOSPITALS
[This article, albeit
written almost like a insurers' press release, tells of yet another
assault on American healthcare]
LIZ KOWALCZYK, BOSTON
GLOBE - Rising medical costs will force many Massachusetts residents
starting in July to pay steep surcharges for choosing treatment
at expensive teaching hospitals or high-priced doctors' offices.
Much the way health plans now charge consumers extra for brand-name
medicines, insurers are adopting "tiered" hospital
and doctor networks. These new plans judge hospitals and doctors
not only on their costs but on the quality of care they provide.
Consumers will pay the least to go to hospitals that are the
so-called best value -- ones that provide good care at a reasonable
cost. Now most consumers pay the same amount no matter where
they get care.
Employers nationally are
pushing insurers to rank providers and give consumers financial
incentives to choose the highest-quality, least-expensive doctors
and hospitals. Many insurers have set up Internet sites that
allow consumers to search for the best-rated hospitals for dozens
of specific surgeries or illnesses -- programs that have raised
the ire of hospital executives. The next step is to create financial
incentives for patients to use these highly ranked providers.
THE HALLIBURTON OF MEDICARE
TOM PAINE
- Just two days after President Bush signed the drug industry-backed
Medicare legislation into law, the White House announced the
details of the Medicare discount drug card program. In this new
program, Medicare will contract with private, pharmaceutical
benefit management companies to endorse existing discount cards.
The cards have been assailed for not guaranteeing any price discounts,
while potentially driving millions to these PBMs. So why, then,
is the President so adamant about the cards?
For one
thing, he has extremely close financial, professional and political
ties to Advance PCS - the company that stands to make a windfall
off the program. Specifically, Bush is close friends with David
Halbert - CEO of Advance PCS. As the Fort Worth Star-Telegram
reported on 8/18/02 "before starting what would become Advance
PCS, David Halbert helped clean up a deal with Harken Energy
that had prompted an SEC investigation of George W. Bush."
After the investigation, Halbert then invited Bush to become
one of the original investors in Advance PCS-a transaction that
made the President up to $1 million.
Soon after
assuming the Presidency, Bush paid Halbert back in kind-soliciting
his help in writing the 2001 drug discount card proposal that
is now part of the new Medicare law. Halbert brags about the
complicity, saying the White House specifically asked him to
help write parts of the plan. As the Fort Worth Star-Telegram
reported on July 18, 2001, "Advance PCS has been working
with the White House to create a nationwide private discount
card program.
VOICES YOU MAY NOT HAVE HEARD
ON MEDICARE
CONSUMERS UNION REPORT FINDINGS: "The funds set aside for
this 'benefit' - $400 billion over 10 years - cover just 22 percent
of the anticipated drug costs, leaving consumers to foot the
rest of the bill.". . . "Medicare is being moved down
the road to privatization by requiring competition between private
health plans and Medicare". . . "Private Pharmacy Benefit
Managers get to pick what drugs are covered under the plan, with
no transparency, methodology or public accountability. This means
patients who are sensitive to the choice of drug will be out
of luck if their needed drug is not on the plan.". . . The
deal "actually prohibits the government from negotiating
deep prescription drug discounts for consumers, meaning the average
Medicare beneficiary will pay more out-of-pocket for drugs in
2007 when the benefit begins, than what they currently pay now
without the 'benefit.'"
DON McCANNE, M.D., PHYSICIANS
FOR A NATIONAL HEALTH PROGRAM -
"The prescription drug benefit fails miserably on its alleged
purpose: making drugs affordable for seniors. It provides a blank
check for pharmaceutical firms to continue to gouge seniors,
and introduces the pharmacy benefit manager middlemen who profit
by taking away our choices in drug access. Worse, the legislation
provides financial incentives for the healthy and wealthy to
exit the traditional Medicare program and enroll in private PPO
plans. This concentrates high-cost, chronically ill patients
in the traditional program, driving up program costs. When forced
to compete with the private HMOs, which will be subsidized, the
higher costs will be shifted to Medicare beneficiaries in the
form of unaffordable premiums. This 'death spiral' of ever-higher
Medicare premiums will force patients into the private plan marketplace.
To keep premiums affordable, the plans will strip out benefits
and require unaffordable cost sharing. Then Medicare will no
longer ensure either health security or financial security for
our seniors."
JOHN HESS, HEALTH WRITER - "Once again, the AARP
has stabbed America's elderly in the back. For more than 30 years
now, it's been held up as a scarecrow - a monster representing
35 million greedy geezers. . . Briefly, the AARP is not a league
of the elderly, but a marketing agency with a shady past. It
peddles insurance, travel, advertising, and anything else it
can get its hands on. It has a mailing list - not a membership
- of 35 million customers. If you turn 50, they'll try to get
your name on it. It calls itself an 'association' and goes through
the motions in an effort to dodge taxes and commercial mailing
rates, and it's been in constant trouble with the IRS and the
Postal Service."
HEALTH INSURANCE BECOMING MIDDLE CLASS LUXURY
STEPHANIE STROM, NY TIMES
- mMore than 43 million people in the United States lack health
insurance, and their numbers are rapidly increasing because of
ever soaring cost and job losses. Many states, including Texas,
are also cutting back on subsidies for health care, further increasing
the number of people with no coverage. The majority of the uninsured
are neither poor by official standards nor unemployed. . . "Now
it's hitting people who look like you and me, dress like you
and me, drive nice cars and live in nice houses but can't afford
$1,000 a month for health insurance for their families,"
said R. King Hillier, director of legislative relations for Harris
County, which includes Houston. Paying for health insurance is
becoming a middle-class problem, and not just here. "After
paying for health insurance, you take home less than minimum
wage," says a poster in New York City subways sponsored
by Working Today, a nonprofit agency that offers health insurance
to independent contractors in New York. "Welcome to middle-class
poverty." In Southern California, 70,000 supermarket workers
have been on strike for five weeks over plans to cut their health
benefits.
EVEN LARGEST FIRMS SLASHING HEALTH INSURANCE
ALEXANDRA MARKS, CHRISTIAN
SCIENCE MONITOR - The foundations of America's private health-insurance
market appear to be slowly crumbling - not just for the poor,
but also for working Americans accustomed to middle-class lifestyles.
Large employers, which since World War II have provided comprehensive
health insurance to most American workers, are scaling back coverage.
In a few cases, they're doing away with it altogether.
That's sparking labor
unrest and swelling the ranks of the uninsured. In the 1960s,
more than 80 percent of US workers had health insurance through
their employers. Today, in the face of skyrocketing premiums,
that's down to 62 percent. . .
Some, like Wal-Mart, only
offer catastrophic plans to cover primarily life-threatening
situations. Others are requiring workers to pay significantly
higher portions of their care, both in terms of premiums and
deductibles.
The combination has fueled
a sharp increase in the number of uninsured who work in large
firms. Thirty-two percent of the uninsured, or nearly 1 in 3,
now work for companies that employ 500 workers or more. That's
up from 25 percent in 1987, according to a recent report from
the Commonwealth Fund.
MEDICARE PREMIUM TO TAKE BIG LEAP. . .
BIPARTISAN SUPPORT TO UP FEES FOR WEALTHIER TAXPAYERS
ROBERT PEAR, WASHINGTON
POST - The Medicare premium will shoot up next year to $66.60
a month, an increase of 13.5 percent, or $7.90 a month, the Bush
administration said on Wednesday. That is one of the largest
increases in the history of the program. . . The new premium
does not include the cost of new prescription drug benefits,
which would begin in 2006 under legislation that Congress is
working on. Nor does it reflect a plan to require elderly people
with high incomes to pay higher premiums than other beneficiaries.
House and Senate negotiators working on the Medicare bill discussed
that proposal on Wednesday. A Republican who attended the meeting
said he was "surprised to see almost unanimous philosophical
support for the idea that we should charge wealthier beneficiaries
more."
The monthly Medicare premium
started at $3 in 1966, climbed gradually to $7.20 in 1976, was
still under $25 in 1988 and reached $50 in 2001. The premium
will be 33 percent higher in 2004 than in 2001.
NEARLY TWO THIRDS OF AMERICANS IN POLL FAVOR
SINGLE PAYER HEALTH INSURANCE
GARY LANGER, ABC NEWS
- Americans express broad, and in some cases growing, discontent
with the U.S. health care system, based on its costs, structure
and direction alike - fueling cautious support for a government-run,
taxpayer-funded universal health system modeled on Medicare.
In an extensive ABC News - Washington Post poll, Americans by
a 2-1 margin, 62-32 percent, prefer a universal health insurance
program over the current employer-based system. That support,
however, is conditional: It falls to fewer than four in 10 if
it means a limited choice of doctors, or waiting lists for non-emergency
treatments.
Support for change is
based largely on unease with the current system's costs. Seventy-eight
percent are dissatisfied with the cost of the nation's health
care system, including 54 percent "very" dissatisfied.
Indeed, most Americans,
or 54 percent, are now dissatisfied with the overall quality
of health care in the United States - the first majority in three
polls since 1993, and up 10 points since 2000.
. . . Fifty-nine percent
of insured Americans are worried about being able to continue
to afford health insurance in the future (a quarter are "very"
worried). This doesn't include those who currently lack health
coverage - 17 percent of adults in this survey.
. . . In terms of the
future, 64 percent of Americans think the country is headed toward
a system of rationed health care, in which an increasing number
of treatments won't be covered because they're too costly, not
essential or have too little chance of success. And nearly eight
in 10 oppose those kinds of restrictions.
. . . As to be expected
in a primarily employer-based program, there is a huge income
gap in insurance haves vs. have-nots. Among Americans with household
incomes of $50,000 a year or more, just eight percent are uninsured.
Among those with incomes under $50,000, the number of uninsured
swells to one in five. Among just those with incomes under $20,000,
it grows to nearly one in three.
. . . All the concerns
cited above underlie the public's interest in universal care.
This poll asks people what they'd prefer - a "universal
health insurance program, in which everyone is covered under
a program like Medicare that's run by the government and financed
by taxpayers," or "the current system, in which most
people get their health insurance from private employers, but
some people have no insurance."
Previous polls have asked
this differently; one last year asked if people would support
or oppose "a national health plan, financed by taxpayers,
in which all Americans would get their insurance from a single
government plan," and found 40 percent support.
. . . Suspending customary
chauvinism, just 29 percent of Americans think the overall U.S.
health care system is better than Canada's; more, 37 percent,
think it's worse than Canada's.
THE SCORE
Current system: 32%
Universal coverage: 62%
Universal, with waiting lists for non-emergency treatment: 39%
Universal, with limited choice of doctors: 35%
RECOVERED HISTORY
THE CLINTONS AND NATIONAL HEALTHCARE
SAM SMITH, 'SHADOWS OF
HOPE,' 1994 - During the first months of the Clinton administration,
one of the biggest national policy changes of the past fifty
years was being forged by a secret committee led by Mrs. Clinton
under procedures that periodically defied the courts and the
Government Accounting Office and whose public manifestations
consisted of highly contrived media opportunities, carefully
staged "town meetings," and similar artifices.
Despite the contrary evidence
of public opinion polls, the concept of Canadian-style single-payer
insurance was dismissed early. Tom Hamburger and Ted Marmor in
the Washington Monthly tell of a single-payer proponent being
invited to the White House in February 1993. It was, he said,
a "pseudo-consultation;" the doctor was quickly informed
that "single payer is not politically feasible." When
Dr. David Himmelstein of the Harvard Medical School pressed Mrs.
Clinton on single payer, she replied, "Tell me something
interesting, David."
In other words, write
Hamburger and Marmor: "Fewer than six weeks into the Clinton
presidency, the White House had made its key policy decision:
Before the Health Care Task Force wrote a single page of its
22-volume report to the President, the single payer idea was
written off, and "managed competition" was in."
If there was any popular,
grassroots demand for "managed competition" it never
appeared. Managed competition had not been tested anywhere. Nonetheless,
reported Thomas Bodenehimer in Nation:
"Around Hillary Rodham
Clinton's health reform table sit the managed-competition winners:
big business, hospitals, large (but not small) commercial insurers,
the Blues, budget-worried government leaders and the 'Jackson
Hole Group,' the chief intellectual honchos of the managed competition
movement. . . Adherence to the mantra of managed competition
appears to be the price of a ticket of admission to this gathering.
"
What was finally proposed
involved a massive transfer of the American health industry -
by some accounts now larger than the military-industrial complex
- to a small number of the largest insurance companies and other
major corporations. These were companies that had the assets
to play the game being offered - a medical oligopoly that would
dispense health-care under the rules of the Fortune 500 rather
than according to those of Hipprocrates.
WORKERS LOSING HEALTH INSURANCE
COVERAGE
KIMBERLY BLANTON, BOSTON
GLOBE - Americans who receive health insurance through their
employers have dropped to less than one-half of all workers from
about two-thirds a decade ago, according to a report on the nation's
health coverage released yesterday by the US Bureau of Labor
Statistics. Health specialists said the decline in employer-sponsored
health coverage stems from soaring insurance premiums and the
inability of workers and small employers to afford the increasingly
costly coverage. The report said there was a 75 percent increase
in premiums paid by employees for their share of health coverage
over the past decade, outpacing wages or inflation.
Shifts in the composition
of the US work force and the recent economic decline also caused
coverage to fall. Manufacturing employment has dropped steadily,
and there has been a rise in the percentage of workers employed
by service companies, which are less likely to offer health coverage
to the extent that employers in traditional industries do. While
half of workers in blue-collar jobs have health insurance, only
22 percent of low-wage workers are covered in service occupations
such as waitresses, dental assistants, security guards, or childcare
workers, the bureau said.
THE FRAUD OF MARKET EFFICIENCY IN HEALTHCARE
CHRISTIAN PARENTI, ALTERNET
- We have a health care system in shambles: 40 million uninsured,
too many drugs and procedures not covered by most health plans,
medical staff overworked thanks to pressure from bean-counting
bureaucrats, and rising cost all around. . .
The boosters of market
mechanisms - from the House ranks of the GOP, to their allies
at think-tanks like Cato, Heritage and Olin - claim that the
discipline of the market create "efficiency," "innovation"
and "choice." On closer inspection, however, America's
for-profit healthcare does not match up with market myths about
efficiency and service. Instead it is marked by cruelty, lack
of choice and massive corporate welfare.
Take healthcare corporations
and insurance companies. Far from being "supple," "quality-oriented"
and "intellect" organizations delivering better service
at ever lower prices, these behemoths are more accurately described
as massive for-profit bureaucracies offering shoddy care at inflated
prices. When compared to "socialized" healthcare systems,
like those in Canada or Germany, Americans pay twice as much
per-capita in medical costs, roughly $4,000 per person.
The extra cash paid out
by Americans goes for "overhead." Private U.S. insurance
companies on average take 14 percent in administrative costs
while public healthcare systems like Medicare or the Canadian
health systems spend only around 2 percent of their income in
this manner. But it's not even accurate to describe the extra
surcharge paid by Americans as "overhead" - that implies
some productive use. In reality, much of the America surcharge
pays for bloated CEO salaries and boosting the value of medical
stocks. |