Thursday, December 31, 2009
"It's time to scrap this pro-insurance-company legislation and start over. A good starting point would be the improvement and expansion of Medicare to cover every person in the United States."
Friday, December 25, 2009
"Perverse Incentives" -- Yes high deductibles change the system. They delay needed care which increases costs long term. Now we see that they increase cost for things due to the end of year phenomena. Reminds me of the Federal government grant funding -- use it or lose it so the incentive is to waste money at the end of the year to avoid having to send it back. Medical decisions between me and my doc should be based on health issues - not this end of year foolishness.
Wednesday, December 23, 2009
A single payer governor -- could it be possible???
Monday, December 21, 2009
Most importantly, Sanders spoke about the national movement for single payer being led by nurses, doctors, medical students, faith and labor organizations, and people across the land of all backgrounds and beliefs. He declared that this strong movement is not going away and he announced that we will succeed."
"A comparison of the health care bills before Congress"
_Progressives. They had to give up on their long-held dream of a new government-run insurance plan so that Democratic leaders could lock down the necessary votes from moderates."
Wednesday, December 9, 2009
Tuesday, December 8, 2009
Not really bad principles. Good to know what the AMA is pushing for and we can build into our arguments.
Sunday, December 6, 2009
Canada's health care lessons for U.S.: more equity, efficiency The Stump - OregonLive.com: "A more fundamental distinction between the nations is that most Canadians have a basic belief in equality and, more importantly, their government and social support systems reflect that belief. On the other hand, Americans are more concerned about individual rights. In the United States, government and social support systems are often seen as necessary evils. When it comes to philosophy, there is a continental divide."
Aetna Health to drop 650,000 insured to raise profits – single payer one step closer - Rick Ungar - The Policy Page - True/Slant
A great take on how private insurance companies can be their own worst enemy -- like car makers and big banks. Sad thing is that these arguments also support the current efforts in Washington to "Bail Out" those insurance companies.
Friday, December 4, 2009
"The debate is about values." This is a good column on a core difference between our country and the other industrialized ones regarding access to health care. Is it a right or is it a luxury you have to earn and be worthy of? Too many in this country choose the later. And too many who have everything they need are only concerned with accumulating more even at the expense of the pain and suffering of those less fortunate.
Sunday, November 29, 2009
An example of a casualty of reform -- but that would be a good thing. Interesting that insurance companies pay to subsidize this plan but refuse coverage for the same people.
Wednesday, November 25, 2009
A reminder of how personal this issue is and how that can screw up the politics and possibilities of reform as much as the self interest of insurance and drug companies. As the author says "Just as all politics is local, all health care is personal."
Sunday, November 22, 2009
Some interesting thoughts here on the dilemma Labor and other single payer supporters have in the current political environment. Also, an interesting history lesson on how Medicare got passed.
Friday, November 6, 2009
But the negative side far outweighs the positive: Click Here to see them."
Thursday, November 5, 2009
'Unfortunately, the House Leadership has rejected the many appeals on behalf of the amendment and will not reverse their decision, which removed the amendment from the bill. Therefore, the Kucinich Amendment for a state single payer option will not be included in the Manager's Amendment and is not in the bill which will come before the House soon.'"
Saturday, October 31, 2009
"But this time, broadly similar health-care bills have made it through multiple committees in both houses of Congress. And on Thursday, Nancy Pelosi, the speaker of the House, unveiled the legislation that she will send to the House floor, where it will almost surely pass. It’s not a perfect bill, by a long shot, but it’s a much stronger bill than almost anyone expected to emerge even a few weeks ago. And it would lead to near-universal coverage."
This column lays out the conundrum we are in concerning whether or not to support what is now coming out of that huge sausage machine in D.C.
Friday, October 30, 2009
Keep the calls and letters coming!
Some of these changes are massive, some would be invisible to those outside the industry, but all could be legislated or regulated, and all would “bend the curve” toward lower costs. Choose any you like, though some are “and” choices, others are “or” choices:"
"Grayson, who has taken the lead in highlighting a Harvard study that shows 44,000 Americans die annually because they have no health insurance, told the House and the nation: "I think it dishonors all those Americans who have lost their lives because they had no health coverage, by ignoring them, by not paying attention to them, and by doing nothing to change the situation that led them to lose their live."
With that in mind, he announced the launch of a Names of the Dead website. "
Thursday, October 29, 2009
"The insurance industry's actions in the current health care reform debate have too often just been wrong. Their opposition to a public option, and the efforts to protect themselves, rather than Americans, are simply wrong."
Wednesday, October 28, 2009
Sunday, October 25, 2009
This is a wonderful argument FOR single payer. It is written by a finance columnist and is intended to be a helpful 'how to' article. I think it shows one of the main reasons we need single payer - to simplify and cut all that expensive red tape for us and the vendors.
"No one knows how many customers have fallen into this trap. But dubious health plans are "spreading like poison oak all over the country," says James Quiggle of the Coalition Against Insurance Fraud, a nonprofit watchdog in Washington, D.C."
Friday, October 23, 2009
This is the No Child Left Behind version of Health Care Reform:
The article on Walz and Kind working to link payment to care outcomes raises concerns. This article points to some nice sounding rhetoric. It is not backed up by good science. All would agree that MN/WI providers should not get short changed. All would agree that good providers should not get paid less. The devil is in the details. Encouraging, if not requiring, a hospital to use process improvement practices to create high quality, cost effective methods of delivering care is a great idea. Paying them for patient health outcomes will create the wrong incentives unless there is some cost effective way to control for all the other variables that affect the patient’s health outcome. Location is everything. Who your patients are and where they come from is everything. If you are located in a poor area, in an area with pollution that is causing more illnesses, in an area with little or much poorer coverage for poor people, you will have worse outcome results. Cherry picking healthy people is already done by insurance companies. We don't need to set up an incentive system for docs and hospitals to do the same.
Again, quality improvement as meaning process improvement is important and will result in better outcomes. But you cannot compare health outcomes without adjusting for all the other variables and that is a very expensive endeavor. You can make dramatic changes in hospital costs if you:
Make them all non-profit.
Put them all on a budget. That means an independent entity would approve an annual budget and they would be paid out of the $ pool to cover that budget. They would submit annual audits and requests for any changes. There would cease to be incentives to over build, etc. and eliminating all of the time spent on those horrendous itemized bills would cut costs dramatically. No longer would they feel obligated to create the exec. jobs with pay and perks set to be like the big U.S. companies who pay ridiculous amounts for top level corporate management. They can focus on providing health care to their service area instead of focusing on making money. (Mayo is in a world of its own in terms of service area since they serve the whole world.)
And, they must provide services and tech. offerings that are approved by the independent entity. No more having two hospitals next to each other buying the same big buck items and then competing to get the tests ordered to pay for them. No more closing a unit like an ER , even though desperately needed, just to satisfy the stockholders' bottom line.
Thursday, October 22, 2009
"UnitedHealth Group, the nation's biggest health insurer, found itself in a touchy sideshow to the great health care debate Wednesday after a Colorado family came forward with a poignant story about how their 2-year-old daughter had been denied coverage."
This is a great personal story that helps show why we need to change our current private helath insurance model and to get away from the employer based coverage model.
Sunday, October 11, 2009
Friday, October 9, 2009
Kristof does a good job of hitting the moral/ethical issues that are really at the core of our we/they debate in this country. When you take out the greedy insurance companies you mostly have the underlying feelings of citizens afraid of losing something and that history in this country seeing others as either "deserving/worthy" versus those lazy good for nothings we are not about to help. I believe that attitude is eroding but it sure is a slow process.
Thursday, October 8, 2009
"Hawaii followed Vermont, and Iowa was ranked third on the scorecard. Neither state has a plan to reform healthcare, but Minnesota, which has created public-private collaborations on healthcare, ranks fourth, followed by Maine, which has also implemented sweeping reforms. Massachusetts -- the Vermont neighbor that recently began a universal health insurance program -- was seventh.
At the other end of the spectrum, Mississippi has the worst healthcare, according to the scorecard. Oklahoma fares mildly better, followed by Louisiana and Arkansas.
Generally, the report found, states in the South, Southwest and lower Midwest have worse insurance rates and less access to good medical treatment."
Monday, October 5, 2009
Some interesting comments by Cohen. An excerpt below. Whole column at NYT.
" Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.
Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.” "
Sunday, October 4, 2009
A question of health and women’s equality - The Boston Globe
Strange bedfellows? This Ellen Goodman column shows how it is very likely that anti-abortion groups could join in the push for passage of health care reform as long as it means that ALL insurance companies would be banned from paying for abortion. We must be very careful of the hidden agendas.
Saturday, October 3, 2009
"Now we know why they've stopped calling this health care reform, and started calling it insurance reform. The current bills advancing in Congress look more like rearranging the deck chairs on the insurance Titanic than actually ending our long health care nightmare."
See the list of 13 by following the link.
Read more at:
Friday, September 25, 2009
This shows the fallacy in the idea that choice exists or that large companies won't control our health care.
Wednesday, September 23, 2009
Tuesday, September 22, 2009
This is a fun article on how seniors view health care reform debates. People say kids say the darndest things. Well, I am getting old and I think seniors do to.
These quotes from two of them pretty well sums up the debate going on right now:
"You know, it's really not that complex," Benevides said. "If you believe, as I do, that health care is not only a right for everyone but beneficial socially and economically for the whole country, then you reorganize it so that the people -- through our government -- are in charge. We call the shots, not the insurance companies or the drug companies or the hospitals, but all of us."
Jacobs agreed that the issue is "not complex," asking: "Do you want health care run by government bureaucrats or by the industries that actually understand how to do it?"
Monday, September 21, 2009
Great Story; Great Message!
"Two weeks ago, you were waltzing around feeling young and attractive, and now you are the object of Get Well cards and recipient of bouquets of carnations. Rich or poor, young or old, we all face the injustice of life -- it ends too soon, and statistical probability is no comfort. We are all in the same boat, you and me and ex-Gov. Palin and Congressman Joe Wilson, and wealth and social status do not prevail against disease and injury. And now we must reform our health insurance system so that it reflects our common humanity. It is not decent that people avoid seeking help for want of insurance. It is not decent that people go broke trying to get well. You know it and I know it. Time to fix it."
A positive spin on the Mass. Model.
Saturday, September 19, 2009
"Achieving comprehensive health reform has emerged as a leading priority of the President and Congress. President Obama has outlined eight principles for health reform, seeking to address not only the 45 million people who lack health insurance, but also rising health care costs and lack of quality. In Congress, a number of comprehensive reform proposals have been announced as the debate proceeds over how to overhaul the health care system.
This interactive side-by-side compares the leading comprehensive reform proposals across a number of key characteristics and plan components. Included in this side-by-side are proposals for moving toward universal coverage that have been put forward by the President and Members of Congress. In an effort to capture the most important proposals, we have included those that have been formally introduced as legislation as well as those that have been offered as draft proposals or as policy options. It will be regularly updated to reflect changes in the proposals and to incorporate major new proposals as they are announced. "
Friday, September 18, 2009
"As policymakers in Washington consider health reform, those on both sides of the debate frequently note
that most Americans who have health insurance are satisfied with their coverage. Opponents cite it as a
reason to reject comprehensive reform, while proponents say they want to reform the parts of the health
system that don't work while allowing Americans who are happy with their insurance to keep the coverage
that they have.1 This data note digs deeper into Americans’ reported satisfaction with their health
insurance, examines Americans’ reported health care experiences and worries, and explores who is more
and less likely to say they are satisfied with the cost and quality of their coverage."
Use this link site to easily get a call through to your Senator.
"The Baucus bill will not provide you and me with good quality, affordable health care. It fails to ask employers to share responsibility and provide health care to their workers. And it does not keep the insurance companies honest because it lacks the choice of a national public health insurance option.
It does one thing, however. It gives the insurance industry a monopoly and millions of new, captive customers.
The bill works for the insurance industry, but not for you. It must be fixed.
Fill out the form to the right to call your Senator and demand they fix the Baucus bill."
Monday, September 7, 2009
"Come on, Mr. President. Show us America is more than a circus or a market. Remind us of our greatness as a democracy. When you speak to Congress next week, just come out and say it. We thought we heard you say during the campaign last year that you want a government run insurance plan alongside private insurance — mostly premium-based, with subsidies for low-and-moderate income people. Open to all individuals and employees who want to join and with everyone free to choose the doctors we want. We thought you said Uncle Sam would sign on as our tough, cost-minded negotiator standing up to the cartel of drug and insurance companies and Wall Street investors whose only interest is a company's share price and profits."
Check out the TPM article by Josh Marshall - Adventures in the Rabbit Hole.
Saturday, September 5, 2009
Book Review - 'The Heart of Power - Health and Politics in the Oval Office,' by David Blumenthal and James A. Morone - Review - NYTimes.com
"So we will get to single-payer.
The only question is how and when.
One answer, perhaps the best, is offered by Congresswoman Tammy Baldwin, D-Wisconsin, who has proposed and promoted the idea of allowing states to experiment with different healthcare systems.
Under Baldwin's plan, a progressive state such as Oregon or Vermont could develop a "Medicare for all" program within its borders. At the same time, a more traditionally conservative state such as Mississippi or Alabama could muck around with so-called "medical-savings accounts" and other gimmicks developed by the insurance industry and its political mouthpieces.
Then it would be a case of may the best state win -- with the evidence of which model works best developing over time."
This needs to be supported to allow states like Minnesota and Wisconsin to do the RIGHT thing!
Friday, September 4, 2009
Rally Against Wall Street's Health Care Takeover | CommonDreams.org
Go to this article from Potter. Well worth reading even if a bit long.
An excerpt: "I'm ashamed that I let myself get caught up in deceitful and dishonest PR campaigns that worked so well, hundreds of thousands of our citizens have died, and millions of others have lost their homes and been forced into bankruptcy, so that a very few corporate executives and their Wall Street masters could become obscenely rich.
But It was only during the last few years of my career that I came to realize the full scope of the harm my colleagues and I had caused, and the lengths that insurance companies will go to increase their profits at the expense of working families."
Thursday, September 3, 2009
"Throughout the industrialized world, there are a handful of these areas where governments fill needs better than free markets: fire protection, police work, education, postal service, libraries, health care. The United States goes along with this international trend in every area but one: health care.
The truth is that government, for all its flaws, manages to do some things right, so that today few people doubt the wisdom of public police or firefighters. And the government has a particularly good record in medical care."
Sunday, August 30, 2009
"Here is what Mr. Scott’s “protesters” probably don’t know: In the last 10 years, the healthcare insurance industry has increased their profits by 450%. In fact, if Rick Scott’s plan succeeds in ending reform, profits will get even bigger for the cash fat insurance industry."
Friday, August 28, 2009
This is a great opinion piece on how for profit insurance IS the problem.
Caused me to make these comments:
Remove the Millionaire Middleman
Insurance is an experiment that has failed as a part of our health care system. The red tape and high CEO salaries associated with hundreds of insurance/HMO companies is the major part of wasted cost. They add no value to my health care. They take my time to figure out paperwork and they take much time of doctor's offices and hospitals to figure out all the different billing rules and forms. No one wants government to own and operate all medical services such as clinics, hospitals, dental care and drug stores. Why do people even think that is being considered? The only function of use that an insurance company plays in our health care system is to pay bills. All the rest is a waste, especially the millions paid to all those CEOs. Health insurance should be non-profit, hospitals should be non-profit and neither should be allowed to make campaign contributions or lobby our elected officials.
Sunday, August 23, 2009
This is a long, yet thought provoking article. An excerpt:
"Insurance company plans have failed to care for our people. They profit from denying care. Americans care about one another. An American plan is both the moral and practical alternative to provide care for our people.
The insurance companies are doing their worst, spreading lies in an attempt to maintain their profits and keep Americans from getting the care they so desperately need. You, our citizens, must be the heroes. Stand up, and speak up, for an American plan."
"You'd think, with the money in this country, that we'd be able to look after people's health properly," she said. "But the truth is that the rich, and the insurance firms, just don't realise what we are going through, or simply don't care. Look around this room and tell me that America's healthcare don't need fixing."
Tuesday, August 18, 2009
"I don’t quibble that the health insurance system needs some work. Yet, I am grateful for what I have had. I’m alive and it didn’t bankrupt me. But others aren’t. Therein lies the dilemma. I want a system that offers secure and stable coverage, with primary concern for the well-being of the patient and, in the end, one that won’t bankrupt the country. And at the top of the list, access for everyone to quality, affordable health care. Can we insure that?" - Click on the link to see her list of goals - sounds like the proposal so many, even Obama, are willing to flush down the toilet.
Thursday, August 13, 2009
Sunday, August 9, 2009
Excerpt from article: "While it should go without saying that correlation is not causation—and MSNBC’s example proves that interlocking directorates are hardly the only factor in media coverage—this study indicates that, at the very least, corporate media and the insurance and pharmaceutical industries’ interests are fundamentally aligned."
Friday, August 7, 2009
The Swift Boat tactics are in motion. Health Care reform will kill babies and old people? How gullible are we in this country? I laugh at these ridiculous allegations but then feel sad and embarrassed. I need to be sure not to ignore this and to speak up and call it what it is - outright lies intended to kill any reform of how health care is paid for in this country. It is being perpetrated by those who benefit financially from our current system. We need to keep finding ways to expose them.
Wednesday, August 5, 2009
"Stephen Hemsley, the CEO of UnitedHealth, is not intimidated. "Leading companies take advantage of disruptive change in the marketplace," he told reporters recently. "Our shareholders will prosper."
They have for years. Under longtime chief executive William McGuire, who left in 2006 amid a stock-options scandal, UnitedHealth diversified rapidly and found one new profit opportunity after another.
In the old days, insurers simply collected premiums, negotiated contracts with doctors and hospitals, and paid bills.
Today, actually insuring health risk makes up less than half of UnitedHealth's earnings, $3 billion last year. The rest comes from managing benefits for large employers, administering public programs such as Medicare and Medicaid, and selling various technology and data services.
With a grip on almost every aspect of health care, UnitedHealth and a handful of other big insurers have become juggernauts -- simultaneously loved by Wall Street and despised by critics who see them as unnecessary middlemen.
Some members of Congress, doctors and consumer advocates think the country should simply get rid of private insurers and go to a single-payer system, often dubbed Medicare-for-all."
Thursday, July 30, 2009
Reform will deliver security and stability to Middle America:
You will get stable coverage that you can count on to be there.
-You will always have options for coverage, even if you change or lose a job.
-If you can't afford insurance, you'll get help with your premiums. If you hit a rough patch, you'll get help to maintain coverage.
-If you run a small business, you'll get tax breaks to buy coverage for yourself and your workers, and you'll have a choice of affordable options.
You will have stable costs that won't eat more and more of your paycheck.
-If you fall ill, your premiums won't go up just because you've been sick.
-As you grow older, your insurance will remain affordable.
-If you work for yourself or a small business, what you pay for coverage will be the same as what large companies pay.
You will have peace of mind that you can always get the care you need, when you need it, and from the doctor you choose.
-You'll never be denied coverage because you fall sick.
-You will have choice of your doctor and health plan
-You'll never leave the hospital with a bill too big to pay because your benefits have run out.
-Your doctors will be paid to make you well, not to order up procedure after procedure.
Wednesday, July 29, 2009
"The White House has said that the president moved away from a single-payer approach both because of philosophical objections (consumers should be allowed to keep their coverage) as well as political realities (limited support for the proposal in Congress). The administration's position increasingly resembles the maxim, Don't let the perfect be the enemy of the good.
"It's a good question," Scheiner said, when asked if having watered-down reform become law was better than getting a single-payer system stalled in Congress. "Is something better than nothing? That is a hard one for me. That is a difficult one, because, in the end, I think [Obama's] program is going to fail.""
Sunday, July 26, 2009
Saturday, July 25, 2009
Wednesday, July 22, 2009
from Kaiser Foundation
[Jul 21, 2009]
Health companies and their employees gave Sen. Max Baucus, D-Mont., nearly $1.5 million in 2007 and 2008, just as the Senator was readying the Senate Finance Committee to consider health reform, The Washington Post reports.
Baucus and his aides say they began refusing contributions from health care political action committees after June 1. "But the policy does not apply to lobbyists or corporate executives, who continued to make donations, disclosure records show. Baucus declined requests to comment for this article. Spokesman Tyler Matsdorf said the senator 'is only driven by one thing: what is right for Montana and the country.'" The health care sector gave "nearly $170 million to federal lawmakers in 2007 and 2008, with 54 percent going to Democrats, according to data compiled by the Center for Responsive Politics, which tracks money in politics."
Other Senators, including Sen. Charles Grassley, R-Iowa, have also been the target of health care giving. "Grassley, the Finance Committee's ranking Republican, received more than $2 million from the health and insurance sectors since 2003. House Ways and Means Chairman Charles B. Rangel (D-N.Y.) took in $1.6 million from the health sector and its employees over the past two years; ranking Republican Dave Camp (Mich.) received nearly $1 million."
"But Baucus, a senator from a sparsely populated and conservative Western state who is serving his sixth term, stands out for the rising tide of health-care contributions to his campaign committee, Friends of Max Baucus, and his political-action committee, Glacier PAC. Baucus collected $3 million from the health and insurance sectors from 2003 to 2008, about 20 percent of the total, data show. Less than 10 percent of the money came from Montana. Top out-of-state corporate contributors included Schering-Plough, New York Life Insurance, Amgen, and Blue Cross and Blue Shield; individual executives such as Richard T. Clark, chief executive and president of drugmaker Merck, have also made regular donations" (Eggen, 7/21).
Sen. Chris Dodd, acting chairman of the Senate Health, Education, Labor and Pensions Committee, has also taken money from health care lobbying interests, The Hill reports.
"Dodd ... has branched out his fundraising operation by tapping healthcare-related companies for more than $112,000 in the second quarter of 2009. The sum represents a good chunk of the more than $450,000 Dodd accumulated from PACs in the second quarter. In addition, fundraising records reviewed by The Hill show that Dodd accepted contributions from 32 lobbyists representing healthcare interests between April 1 and June 30, the weeks preceding Dodd's markup of legislation overhauling the nation's healthcare system."
Dodd's spokespeople say he has taken the money without letting it influence his policymaking (Bolton and McCaffrey, 7/20).
The revelations come as the drug lobby is spending more money than other health organizations as reform ramps up, The Associated Press reports: "With the fight over President Barack Obama's effort to revamp the nation's health care system escalating, the Pharmaceutical Research and Manufacturers of America said it spent $6.2 million lobbying in April, May and June, according to reports to Congress due Monday. Pfizer Inc., the New York-based producer of numerous drugs, ranked second in the health care sector at $5.6 million. In reports filed by 11 p.m. Monday, 22 health-related associations and companies had reported spending at least $1 million each lobbying during the quarter."
"According to the nonpartisan Center for Responsive Politics, the health sector reported spending $127 million in lobbying during the first three months of this year, more than any other area." PhRMA has spent $13.1 million on lobbying this year and Pfizer has spent $11.7 million (Fram, 7/21).
The AARP spent $5.3 million in the same time frame, CQPolitics reports: "AARP, a highly visible participant in the contentious debate, has backed a plan by the drug companies to reduce prescription costs by $80 billion over the next decade. The group also has praised the $1 trillion plan developed by three House committees that would provide near-universal health insurance." Wal-Mart has spent $2.58 million and the U.S. Chamber of Commerce spent $7.4 million (Roth and Knott, 7/21).
Roll Call: "America's Health Insurance Plans reported spending $3.9 million, compared with $3.7 million for the first half of 2008. 'Our central focus is on comprehensive health care reform,' said AHIP spokesman Robert Zirkelbach. 'The numbers reflect that there's a lot more focus on health care this year.'" (Palmer and Ackley, 7/20).
The lobbying firm winner is Patton Boggs, which took home $18.5 million in the first half of 2009 in revenues, Politico reports. The Podesta Group, run by Tony Podesta -- brother to Obama transition team head John Podesta -- took $11.6 million (Abrahamson, 7/20).
In the meantime, biotech firms too have stepped up their own efforts on lobbying as legislators work to allow generic biotech drugs, The Boston Globe reports: "Pharmaceutical interests alone, including many from Massachusetts, spent more than $66 million on lobbying in just the first quarter of this year, up 25 percent from last year, according to the nonpartisan Center for Responsive Politics. Drug companies accounted for more than half of all healthcare lobbying. 'They are on pace to obliterate their total lobbying expenditures from any other previous year,' said Dave Levinthal, the center's communications director" (Wangsness, 7/21).
Sunday, July 19, 2009
This is a long article but a good one on the tough topic of what rationing means or could mean. We do ration now - based on what you can afford. It is interesting that so many seem to want to be able to get life extending treatments that they can afford or that their insurance will pay for but at the same time we have millions working on health care directives to avoid being subjected to tube feeding and other life extending measures for their own quality of life. Seems contradictory and makes me wonder where the truth lies.
Thursday, July 16, 2009
Monday, July 6, 2009
"....last week the budget office scored the full proposed legislation from the Senate committee on Health, Education, Labor and Pensions (HELP). And the news — which got far less play in the media than the downbeat earlier analysis — was very, very good. Yes, we can reform health care."
Krugman sounds optimistic here. He still says it will be mostly in the hands of the insurance companies but at least even with that he says it will be affordable relative to current projections continuing business as usual. I just wish he hadn't caved and gave up on the possibility of single payer.
Monday, June 29, 2009
Reform in the payment system is critical. Actually, it is so simple that most don't see it. Remove the insurance companies from the system. We can't seem to believe that you don't have to have employer based access to coverage and that you don't have to have a profit driven, high admin. cost, red tape filled insurance industry controlling cost and access. Imagine a world where access to health care does not depend on where you work. Imagine a doctor or hospital office where you don't have to deal with 500 different payment sources with all different forms and procedures. Imagine a world without co-pays, deductibles or premiums that depend on where you live and your health history. You have now imagined a world without the insurance industry sticking their nose in between you and your health care providers. You have imagined a world that will cost 30% less by removing the $ that go to feed the middle man. Providing access to all and equalizing payment rates can be done with that 30%. If we try to cover all with new insurance policies by paying the insurance companies to cover the uninsured, we will not be able to afford it. The only way is to kick out the middle man. Have one source of payment and put hospitals on a budget based reimbursement system instead of fee for service and we can afford real reform. Without payment reform like that all we will do is feed the insurance monster.
Sunday, June 28, 2009
"A study published by the Annals of Internal Medicine last year found that 59 percent of about 2,200 physicians surveyed supported national health insurance. The researchers from Indiana University found that was up from 49 percent in a 2002 survey.
Yet the results show the many faces of medicine. Doctors in lower-paid practices -- psychiatry, pediatrics, emergency medicine and internal medicine -- were most likely to support national health insurance. Those in higher-paid areas -- surgical subspecialties, anesthesiology and radiology -- were least likely."
Wednesday, June 24, 2009
Follow the link to this article. Statements being made by those companies and politicians fighting any reform in our health care payment system are often untrue or very mis-leading and NOT based on sound research or real facts. This column shows one of these concerning the assertion that requiring employers to pay in will cause a lose of jobs. NOT.
But, I also urge you focus on how this relates to the real reform we need -- a one payer system that allows access to care for all - "everyone in - nobody out".
We can accomplish this reform by shifting around how our system is paid for. If I am an employer who provides insurance, I am contributing money. If that money now goes to a single payer system and stays about the same, I don't see how I get hurt. I will gain by not having to put the insurance out for bids and have my human resource employees dealing with insurance coverage issues. If I work for that place, I am paying toward my premiums, I am paying a co-pay and I am paying a deductible. If I pay that amount of money to a single payer system and I stop having to deal with bills and figuring out what I really owe and fighting to get things covered and trying to hide certain medical facts that will put my coverage at risk - I am better off. If I look at my doc's office and see that I now only have to bill one place instead of 200 insurance companies, a couple of welfare programs, Medicare and deal with collections of co-pays and deductibles from patients and have rates set uniformly instead of private payers needing to subsidize for non or under payers -- I will save money and net out as much as I now have as income. So, we need to stop having coverage tied to a job. Requiring empoyers to help pay for this -- but likely not more than they now pay anyway - will not cause layoffs and will put them all on a more even playing field for recruitment.
Sunday, June 21, 2009
"It's time to turn the medical profession back over to the doctors. The government must step in, eliminate health insurance companies and create the single payer system, one government-owned insurer that has no bottom line, no conflict of interest, but responds only to the needs of doctors and their patients. The single payer system doesn't tell the doctors what to do; the doctors dictate the system. Americans will save trillions of dollars in wasted costs, paperwork, redundancy and corporate profits."
Saturday, June 13, 2009
So here’s a far more representative “real-life story.”"
t r u t h o u t | The Rise of Single-Payer Health Care
" The president always rejects single payer on the grounds that some Americans are too fond of their health insurance companies to part with them. A report by Fairness and Accuracy in Reporting last week found that the corporate media still virtually bans coverage of single payer. A Senate bill being championed by Sen. Chris Dodd in place of ailing Sen. Edward Kennedy, does not include single payer (which is supported by only one US senator, Bernie Sanders). The Kennedy-Dodd bill, at least in its initial draft, does not even include a "public option," that is a Medicare-like program to exist alongside the private insurance companies. The House bill is being drafted by one current and two former co-sponsors of HR 676, Congressmen George Miller, Henry Waxman and Charles Rangel, but it avoids single payer, championing a public option instead. Other competing Senate bills are expected to complicate things further."
Monday, June 8, 2009
"But we progressives are not the ones who need to be convinced. In any great national political debate, there are partisans on our side and partisans against us. To achieve victory, we have to persuade people in the middle—and they don’t know what we know about health care.
Consider three central facts:
Nearly all persuadable voters—those who don’t automatically side with or against us—have health insurance. (In fact, about 94 percent of voters are insured. The uninsured, unfortunately, don’t tend to vote.)
About 3/4ths of insured Americans are satisfied with their health insurance.
When Americans hear about a health care proposal, they immediately think “how is it going to affect me and my family.” That’s their overarching, overwhelming concern.
That means when average American voters consider a new health care policy, their paramount concern is that the policy allows them to keep the health insurance they have. Union members—who usually can be counted on to support progressive policy—are among the most adamant that they be permitted to keep their health insurance. Why? Because unions tend to negotiate better insurance for their members than the rest of us have!"
t r u t h o u t | "Single-Payer" Supporters Challenge Democrats: "The 'single-payer' activists had struck again. As Obama and congressional Democrats work to hammer out landmark health-care legislation, they face increasingly noisy protests from those on the left who complain that a national program like those in Europe has been excluded from the debate."
This NYT piece shows various views on "manadatory insurance". I just wish it would be universal access and not something to build the business of the insurance companies -- but this article helps see the issues under debate right now. Then the Washington Post has one on Kennedy and what he is now pushing, which includes reference to 'mandatory' being in legislation.
"Unless you're a Warren Buffett or Bill Gates, you're one illness away from financial ruin in this country," says lead author Steffie Woolhandler, M.D., of the Harvard Medical School, in Cambridge, Mass. "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that's the major finding in our study."
Sunday, June 7, 2009
This is a great summary of where things are at in Washington right now in terms of any health financing reforms.
Friday, June 5, 2009
"So let me offer Congress two pieces of advice:
1) Don’t trust the insurance industry.
2) Don’t trust the insurance industry."
I found this summary about the recent meeting Baucus had an interesting summary and it includes a letter from Obama you might find of interest.
Thursday, June 4, 2009
Everyone knows that lots of Canadians come to America in search of medical care. But what everyone knows is wrong: a careful study concluded,
The numbers of true medical refugees—Canadians coming south with their own money to purchase U.S. health care—appear to be handfuls rather than hordes.
On the other hand:
Driven by rising health care costs at home, nearly 1 million Californians cross the border each year to seek medical care in Mexico, according a new paper by UCLA researchers and colleagues published today in the journal Medical Care."
Wednesday, April 29, 2009
"With the integrity of the medical field at stake, the influential Institute of Medicine said financial deals between the drug industry and doctors, medical schools and the medical profession need to be restricted.
The institute's sweeping recommendations call on medical professionals — from university professors to family doctors — to shun financial arrangements with companies that flourished over the past three decades."
Also, note the side bar list of past articles about the conflict of interest issues.
Now, in addition to stopping this drug trade business with docs, I sure hope Congress will outlaw those drug ads on TV.
Tuesday, April 28, 2009
Conservatives for Patient Rights will run a month of 60-second ads on CNN and Fox News that feature doctors from Britain and Canada describing the pitfalls of their nations’ health care."
Sunday, April 26, 2009
Michele Swenson: Insurance Does Not Equal Health Care: Specious Arguments by 'Free-Market' Opponents of Colorado Single Payer Bill
"Paralysis around health care reform is exacerbated by specious rhetoric surrounding Single-Payer health care. Lazy media fail to look behind corrupted rhetoric, while corporate interests spin the debate to serve their bottom lines."
Thanks to Tim at GMHCC for this link.
Friday, April 24, 2009
Before the HELP Subcommittee
April 23, 2009
Mr. Chairman, members of the Committee. My name is David Himmelstein. I am a
primary care doctor in Cambridge, Massachusetts and Associate Professor of Medicine at
Harvard. I also serve as National Spokesperson for Physicians for a National Health
Program. Our 15,000 physician members support non-profit, single payer national health
insurance because of overwhelming evidence that lesser reforms will fail."
Full five minute testimony - click here.
Monday, April 20, 2009
He has all this summarized in a short book available for free on line at
The direct link to the pdf file for the book is
Some of his ideas may be off base but some are right on. He is trying to present a simple solution and some of his ways of explaining things could be useful.
Tying the possibility for major change to the concept of Disruptive Innovation is intriguing. Focusing on one payment system that is non-profit as a way to get past the anti-government arguments has possibilities.
Sunday, April 19, 2009
“The single payer option, or Medicare for All, should be part of the discussion in Congress, said Frank Borgers, of the National Nurses Organizing Committee. “Unbridled corporate power has brought the banking and auto industries to its knees and we fear it will happen in the health care industry as well.”
Wednesday, April 15, 2009
Move to single-payer system is crucial
By Richard C. Dillihunt, M.D.
As America prepares to reform our health care system, I wish to add some convictions reached while practicing surgery for nearly a half-century. Until about 15 years ago, doctors were powerful leaders in the health care system, taking their responsibilities seriously, and the system worked well. Then, dark clouds began to assemble and physicians began to lose their grip.
As the system faltered, physicians were not part of any changes except as pawns and bystanders. In short supply, we had crushing demands due to patient loads and were required to run practices of increasing complexity.
New arrivals appeared, calling themselves “health care professionals.” Seemingly overnight, they were “stakeholders,” and a metamorphosis occurred as medicine became big business. A new gold rush was on, lured by the attraction of the health care dollar.
The language of medicine changed with the arrival of HMOs, PPOs, surgicenters, for-profit hospitals and other schemes popping up like dandelions, fertilized by health care dollars totaling more than 15 percent of our GDP. Special interests arrived in the form of the health insurance and pharmaceutical industries, distributing lobby dollars in all directions and receiving free range in return. Multimillion-dollar salaries and billions in stock options were awarded while the steely-gray clenched faces of bankruptcy adorned middle America.
Hospitals joined in, finding a way to control pesky doctors — they hired them — spawning an undesirable side effect of antagonistic competition. Hospital bills joined inflation in the health care sector, and ear-popping predictions were heard that health care soon would become 20 percent of gross domestic product — up from 7.2 percent in 1970. The cost of all U.S. health care surged to top $8,000 per person annually while Canada’s cost for universal health care was half that, and our outcomes were no better than theirs.
Our system lacks social justice for some 45 million Americans without health insurance and more who are underinsured. Huge layoffs due to the current recession are adding to these alarming numbers daily, with workers and dependents suddenly uninsured. Another surge is expected soon, when unemployed new college graduates hit the streets. We are ready to improve this situation by passage of universal health care legislation now.
Beyond that is a way to really fix the health care system. It is called “single payer.” Call upon our federal government to implement such a program, recalling that it already runs some of the world’s best and most efficient health care programs including Medicare, the National Institutes of Health, the Centers for Disease Control and Prevention and military medicine.
Be aware that single-payer is not socialized medicine. Single payer just means the government is acting as an administrator and best understood as being “Medicare for all.” Note that only about 5 percent of Medicare dollars are used in administering the program, while private cost for the same service consumes 30 percent of premium dollars — largely due to profit.
The new administration seems set on reducing health care costs and instituting a system of universal health care while leaving the current system in place, and adding a new federal health care insurance option. This is not adequate. The prior administration wanted an income tax deduction for health care insurance costs, plus health savings accounts — both are flawed and inadequate.
In his June 13, 2005, column in The New York Times, “One Nation Insured,” Paul Krugman convincingly extols the virtues of single payer. Krugman, a Times writer and professor at Princeton, was recently awarded the Nobel Prize in economics. Ask Paul. If still skeptical, ask Joe. Joseph Stiglitz, when recently asked “Do you support single-payer health care?” answered. “I think I’ve reluctantly come to the view that it’s the only alternative.” Stiglitz is a Columbia professor — and also a Nobel Prize-winning economist.
Single payer could lead a powerful surge to recovery — sort of an economic wonder drug. Polls of Americans strongly favor single payer, yet our government seems reluctant to address this eye-to-eye preferring lesser action and tweaking along as before. We need to send a message to Washington, reminding it who their employers are. There is enough unemployment already, so we do not want to send pink slips to D.C. Feeling bad for the fat -cat special interests is intolerable, not after what they have done to us. Anything less may result in further collapse of a frail, teetering relic. We are near a solution of a serious issue confronting our economy. Doing the right thing now is crucial.
Richard C. Dillihunt, M.D.
"...why go halfway? Insurance companies already oppose this part of the proposal and are prepared to fight tooth and nail to this threat to their racket. Obama should learn the lesson of Bill Clinton, who tried to play ball with the insurance companies but found that they don't want to change the way they do business.
A Single Payer proposal is already available in the form of HR 676, The United States National Health Insurance Act, introduced by Rep. John Conyers (D-MI), but it has been ignored by the Obama Administration. In fact, no Single Payer advocates were initially invited to a recent White House summit on health care. Conyers was brought in at the last minute in response to considerable pressure from HR 676 supporters.
The mainstream media has similarly paid little attention to Single Payer. As an example, a recent Time cover story told of the difficulties the brother of one of its reporters had in dealing with the health care system. But the author, who has written extensively on the issue, never mentioned Single Payer as a possible method to prevent such problems. She didn't even tell the readers that her brother would never have run into such a mess in any other industrialized country."
Monday, April 13, 2009
But going without health insurance is still seen as a personal issue, a misfortune for many and a choice for some. People who lose coverage often struggle alone instead of turning their frustration into political action."
Thursday, April 9, 2009
"And the film didn't present Reid's bottom line for health care reform – don't let health insurance companies profit from selling basic health insurance.
They can sell for-profit insurance for extras – breast enlargements, botox, hair transplants.
But not for the basic health needs of the American people.
Instead, the film that aired Monday pushed the view that Americans be required to purchase health insurance from for-profit companies."
Monday, March 30, 2009
Friday, March 6, 2009
A Great Debate Video
"The Obama administration says its repeal of Bush-era tax cuts for wealthier Americans will help pay for a $634 billion reserve fund for what it calls its top fiscal priority: healthcare reform. But can the US achieve real healthcare reform without adopting single-payer? We host a debate between Dr. David Himmelstein of Physicians for a National Health Program and Len Nichols of the New America Foundation."
Friday, February 27, 2009
"The Minnesota Health Act (HF135/SF118) would replace the existing, costly maze of private insurers and public programs with a “single payer” system to handle all administration. Everyone would be covered for all necessary care, including medical, mental health, dental, chemical dependency, medications and home health care. "
Saturday, February 7, 2009
"In an attempt to encourage dialogue in advance of the legislative battles to come, In These Times invited representatives from two leading reform groups -- Steffie Woolhandler, co-director of Physicians for a National Health Program, and Richard Kirsch, the national campaign manager for Health Care for America Now -- to talk out their differences."
The authors note that: Full Report
HSA/HDHPs are a highly tax-advantaged savings vehicle appealing to people who have high incomes and to those who are expected to have low use of health care services. For the uninsured, these approaches are less attractive since they often have low income and neither benefit significantly from the tax advantages now have the financial assets necessary to cover the large deductibles associated with the plans.
Their ability to reduce system-wide spending is very limited.
The plans have the potential to increase segmentation of health care risk in private insurance markets unless employers set premiums to offset the healthier selection into the plans or government subsidizes the higher costs associated with the remaining non-HSA market.
The plans have thus far been less attractive that prononents envisioned, the authors add, so their potentially negative ramifications on populations with high medical needs have been limited. However, they say, "efforts to expand enrollment in these plans through further tax incentives, for example, could place growing financial burdens on those least able to absorb them, leading to more barriers to medical care for the low-income and the sick and fewer insurance options."
Sunday, February 1, 2009
This book, "Do Not Resuscitate: Why the Insurance Industry is Dying, and How We Must Replace It?", is a good one to go along with other resources like "The Health Care Mess".
Either costs less than $15.00.
Saturday, January 31, 2009
"The bottom line, then, is that this is no time to let campaign promises of guaranteed health care be quietly forgotten. It is, instead, a time to put the push for universal care front and center. Health care now!"
"The alternative to single payer is multiple payer. That means massive waste and inefficiency, not what a new government ostentatiously looking for solutions that really work should settle on. It also means maintaining the only things in America less popular than Dick Cheney: health insurance companies, and funding them with public money as well as money directly from citizens. In a multiple-payer system, one of the payers is you If you can't pay, you may be out of luck. If you can and do pay, you are often out of luck as well."
Tuesday, January 27, 2009
Sunday, January 25, 2009
Yet Daschle proposes not much more than tinkering -- improving Medicare, Medicaid and the Veterans Health Administration, all examples of "single-payer health care" -- in which the government is the single payer for the health care -- while preserving the inefficient, multipayer, for-profit insurance model. "
If you want to read a good story on the split between single payer advocates and those that want the government to pay for private insurance for all, take a look at this article by Kip Sullivan.
Tuesday, January 20, 2009
Monday, January 19, 2009
A very good essay on single payer. Thanks to Joel Clemmer for finding it.
"Most Americans believe lack of health insurance is a “serious problem” (NPR/KFF survey, Feb 2008). Current reform proposals claim to be the way forward. However, expanding our flawed system will not solve the serious problems we face – rising costs and lack of coverage (for uninsured and under insured). Unfortunately, having coverage in our system does not guarantee care. One-fourth of the insured go without needed care due to cost; three-fourths of individuals bankrupted by medical bills had insurance when they became ill. Is this a system worth perpetuating?
Reform efforts such as those proposed by HCAN and outlined by Senator Daschle maintain a central role for private insurance companies, and are thus doomed to fail because they cannot control costs."
Thursday, January 8, 2009
This is an article about expanding insurance coverage to all. That is laudable but it is not sustainalble and is too costly. The only way we can afford the reform needed is single payer universal care. Giving more money to the insurance companies is just throwing good money after bad.