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UNIVERSAL HEALTHCARE
NEWS

The Progressive Review

PUBLIC OPTION VS. SINGLE PAYER
From Physicians for a National Healthcare Plan

JUST THE FACTS

SINGLEPAYER POLL RESULTS

WHAT'S WRONG WITH OBAMA'S HEALTH PLAN

SINGLE PAYER FAQ

GREAT SLIDE SHOW ON SINGLE PAYER

A HISTORY OF MEDICARE AND EFFORTS TO STOP IT

WHY SINGLE PAYER IS GOOD FOR BUSINESS

HEALTH COSTS COMPARED

WORLD HEALTH ORGANIZATION'S RANKING OF INDUSTRIALIZED COUNTRIES' HEALTHCARE SYSTEMS

REUTERS - A comparison of health care costs has found that 31 cents of every dollar spent on health care in the United States pays administrative costs, nearly double the rate in Canada. Americans spend $752 more per person per year than Canadians in administrative costs, investigators from Harvard and the Canadian Institute for Health Information found.

REALITY BASED COMMUNITY - According to the FBI, in 2006 there were 17,000 murders and non-negligent manslaughters in the United States. According to the Institute of Medicine, "Lack of health insurance causes roughly 18,000 unnecessary deaths every year.

The National Nurses Organizing Committee has released an analysis that claims that expanding and upgrading Medicare to cover all Americans (single-payer) would create 2.6 million new jobs, infuse $317 billion in new business and public revenues, and inject another $100 billion in wages into the U.S. economy. While 30 percent of the new jobs would be in health and social services, the ripple effect of job creation goes throughout the economy, according to updated data released today. Biggest additional gains would be in retail trade, accommodation and food services, manufacturing, and administrative services. All these benefits the study claims could be achieved at less cost than the federal bailouts for Wall Street giants such as AIG, CitiGroup, Fannie Mae and Freddie Mac, and other banks.

GROUPS

GRAY PANTHERS

HEALTH CARE NOW

MEDICARE DRUG PLAN TIPS

MEDICARE RIGHTS CENTER

NATIONAL COMMITTEE TO SAVE SOCIAL SECURITY & MEDICARE

PHYSICIANS FOR NAT HEALTH PROGRAM

WOMEN'S HEALTH INSURANCE BY STATE

WORLD HEALTHCARE SYSTEMS

NY HUNGER NETWORK FAQ

PHYSICIANS FOR NAT HEALTH PROGRAM FAQ

UNIONS FOR SINGLE PAYER


SEIU

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.