Thursday, August 31, 2017
Wednesday, August 30, 2017
DISCUSSION at recent Eau Claire event:
The group watched and discussed this documentary, which was produced by BLTH, a campaign initiated by employers whose mission is to transform the healthcare system so that processes are transparent, evidence-based and priced as a function of measurable value. The narrator, Richard Master, is the CEO of MCS Industries who was motivated to research why the US has the most expensive health care system in the world and why the cost of health insurance for his company increased every year. His findings led him to creating this film, which makes a compelling case for scrapping our complex and needlessly expensive multi-payer system for a single-payer system, similar to Canada’s. The key points include:
- Every physician in the US has to spend $84,000, on average, just to interact with private health insurance companies, which includes staff making multiple contacts with the insurance companies, trying to get payment for services or getting authorization for procedures.
- Of every premium dollar, 3 cents goes to the insurance agent who helps companies select an insurance plan and negotiate rates with the insurer; 20 cents goes to the insurance company to help pay for its sales and marketing and other administrative functions, which includes the work of a huge staff that does nothing more than approve or deny care; another 10 cents goes to cover what it costs doctors and hospitals to handle the massive amount of paper work and phone time required for getting pre-approvals, denials, and other payment issues. So 33 cents of every premium dollar paid has nothing to do with the actual delivery of health care.
- The total spending health care surpasses $3 trillion a year and is growing. It’s more than 17 percent of the GDP, compared with Canada, which spends less than 11 percent of their GDP and Taiwan, which switched to a single-payer system in 1995, spends 1.6 percent of its operating health care budget on administration.
- There are companies who have decided against doing business in the US because of the cost of health insurance for their employees. Conversely, there are American companies that have built plants in Canada who said the reduced cost of health care was an important part of the decision.
- The Conservative political party in Canada supports single-payer because it is the least expensive, reduces waste and inefficiencies, and is most supportive of a free market, which helps businesses.
- More than 60 percent of bankruptcies in the US are related to medical expenses, and many of those people had insurance coverage, but it wasn’t nearly adequate. The costs can bankrupt a small business, which affects not only the owners, but the employees who are out of a job. Many in the US are only one accident away from unemployment.
- The US system discourages people from seeing doctors because insurance companies have become experts in figuring out how NOT to pay for care. The US is the most rationed health care system in the world. Americans are much more likely to defer care, causing unnecessary deaths.
- Medicare has really been a success, partly because it doesn’t incur the marketing and administrative costs that commercial companies have.
- Nurses in US hospitals and clinics are often pulled into administrative duties, taking them away from giving care to patients.
- Providers are frustrated with the inconsistent answers from insurance staff regarding approved length of stays, drugs, tests, etc.
- From a business perspective, commercial insurance doesn’t bring anything to the table – has no added value to the enterprise. Also, health insurance is often a major part of labor negotiations, often a contentious issue with employee-employer relations.
- Single-payer systems reduce confusion and increase simplification and quality of care with no out-of-pocket costs. The revenue comes from a simple payroll fee. Also, single-payer systems have more clout to control costs. (the VA, for example, uses a competitive process and it pays 41% less than the rest of the US)
- There’s no accountability in the current commercial system. The charges of many procedures are variable and no one knows how much they actually cost.
- The film dispels many of the myths about a single-payer system. The government does not take over the delivery of health care. Hospitals are operated privately and doctors are in private practice. Patients have complete freedom of choice of providers. By contrast, many Americans are restricted by their insurance plans in choice of providers (see a provider “out of network” and pay the full cost out of pocket.)
People put on waiting lists do not die; there is a priority process. Canada spends half as much, but life expectancy is higher – 82 compared with 79 in US.
- It could be possible to saves $710 billion a year with a single-payer system. The savings could cover the uninsured and out-of-pocket expenses. Nationally, the money saved could be shifted to investing in infrastructure and improving economic activity.
Group discussion brought up a variety of responses.
- Price Point Wisconsin http://www.wipricepoint.org/ is a good source for finding the average costs of medical procedures and tests. Check it out to see if a provider’s charges are in line with the average cost and, possibly, use the data to contest a bill.
- Commercial insurance companies’ expenses also include the costs of lobbyists. A move to single-payer will be opposed by big Pharma and the insurance lobby. It’s likely that going to single-payer would expose all sorts of hidden profit centers and scams in the current system. The opposition will also employ messaging strategies suggesting that single-payer will move the US to socialism.
- Many people don’t truly understand where their health care comes from, e.g. being opposed to “government-run health care,” but liking their care through the VA.
- Private insurance costs are higher because Medicare reimbursements to hospitals are lower and hospitals bill private insurance companies at higher rate to subsidize Medicare patient costs.
- Future trends: What will be the impact of another hospital in Eau Claire – higher or lower charges? What shortages are on the horizon with the coming “Silver Tsunami,” as Sarah calls it? There already is a shortage of home health care workers. The aging population is increasing, while the influx of young people into Wisconsin is decreasing.
- The documentary suggests that corporate America could be a catalyst for change. The film underscores that insurance companies are just “pass throughs” for our money.
- Reminder: Hillary Clinton was the first to advocate for a universal health care insurance system in the US.
- Suggestion: send Thank You letters to supportive Republicans.
- There is a bipartisan effort underway now to reform the system. Some states are moving to offering an option for people to buy into Medicare. However, we need to remember that Medicare doesn’t cover everything and people still need supplemental policies. Medicare is not a true single-payer system. Canada’s system cover dental, too.
- The question was raised, “Why isn’t the DNC and Democratic Congressional leadership pushing for single-payer?” Part of the answer is “Rome is burning” and Democrats have to focus on priorities, which right now is to get Dems elected in key races. The rank-and-file, however, would like to see leadership be more assertive and vocal.
- Democratic vs Republican messaging was discussed. One observer said that Republicans focus on winning first and then go to working on party unity; Democrats do it backwards and focus on party unity first, which impairs the efforts to win elections. Slogans are more effective than recitation of facts. Suggestion: sloganize GOP – the party of Greed, Oppression, and Power which leads to the Corruption of Democracy. Look to Senator Heidi Heitkamp (D-N.D.) for some good messaging: “We are the party of the many, not the few.” Also, check out Bernie Sanders’ Facebook for key messaging points.
5 Ways Congress Might Shore Up Health Insurance Markets : Shots - Health News : NPR
5 Ways Congress Might Shore Up Health Insurance Markets : Shots - Health News : NPR
Wish this were not today's reality. Need to put a single payer like HF676 on this list as the goal and enact only those measures that build toward that. Stop having coverage linked to my job. Stop having insurance companies involved between me and my doc. Put hospitals on budgets and regionalize accessibility of their services rather than the competitive profit motive approach (public utility model).
Wish this were not today's reality. Need to put a single payer like HF676 on this list as the goal and enact only those measures that build toward that. Stop having coverage linked to my job. Stop having insurance companies involved between me and my doc. Put hospitals on budgets and regionalize accessibility of their services rather than the competitive profit motive approach (public utility model).
Monday, August 28, 2017
Sunday, August 27, 2017
Friday, August 25, 2017
Charlottesville: symptomatic of a broader pain - The Lancet
Charlottesville: symptomatic of a broader pain - The Lancet
" But as uncomfortable as it can feel, we must work to illuminate the causes of the causes of the feelings of disenfranchisement among disadvantaged white Americans. Universal access to high-quality health care can be one important means to strengthen these frayed social bonds."
" But as uncomfortable as it can feel, we must work to illuminate the causes of the causes of the feelings of disenfranchisement among disadvantaged white Americans. Universal access to high-quality health care can be one important means to strengthen these frayed social bonds."
Thursday, August 24, 2017
Wednesday, August 23, 2017
Tuesday, August 22, 2017
The False Promise Of 'Medicaid For All'
The False Promise Of 'Medicaid For All'
"If Medicaid is paying doctors and hospitals less than they need to cover their costs, then someone else has to pay more for those providers to stay in business. That someone is the typical private insurer.....Medicaid patients who are unable to find a doctor end up in the emergency room."
Vendor needs to be paid one rate from all sources (best if only one source). All need equal access to equal quality of health care. There will be so much savings by getting insurance out of our health care that the equalized rates will be fair and adequate thus not a part of our current inequitable system that withholds adequate health care from so many.
"If Medicaid is paying doctors and hospitals less than they need to cover their costs, then someone else has to pay more for those providers to stay in business. That someone is the typical private insurer.....Medicaid patients who are unable to find a doctor end up in the emergency room."
Vendor needs to be paid one rate from all sources (best if only one source). All need equal access to equal quality of health care. There will be so much savings by getting insurance out of our health care that the equalized rates will be fair and adequate thus not a part of our current inequitable system that withholds adequate health care from so many.
Comment from Don McCanne:
"Of course, a Medicaid buy-in would have no resemblance to a Medicaid that covered everyone, just as a Medicare buy-in would not either. Both would leave in place the most expensive and least efficient health care financing infrastructure of all wealthy nations.
Medicaid, as a chronically underfunded program with a welfare stigma, would not be an appropriate model for a single payer system. Neither would Medicare as it is, but it is more suitable as a program that could be redesigned so that it serves all of us well. An IMPROVED Medicare for All would ensure truly universal access to essential healthcare services while being affordable for each of us. With appropriate redesign, financing could be sustained and queues reduced to appropriate levels, obviating the fears of single payer dysfunction that Sally Pipes keeps instilling in us."
Monday, August 21, 2017
Dorf on Law: Some initial steps if the Democrats are really serious. Start by looking different.
Dorf on Law: Some initial steps if the Democrats are really serious. Start by looking different.
"While there may be disagreements about the political tactics the Party should take to get there, it seems obvious that clear advocacy of a Medicare-for-all as a goal, rather than mealy-mouthed advocacy of tinkering with the ACA (who votes for tinkering?), would start to set them apart from the Republicans."
"While there may be disagreements about the political tactics the Party should take to get there, it seems obvious that clear advocacy of a Medicare-for-all as a goal, rather than mealy-mouthed advocacy of tinkering with the ACA (who votes for tinkering?), would start to set them apart from the Republicans."
Saturday, August 19, 2017
Friday, August 18, 2017
Community health workers lead to better health, lower costs for Medicaid patients
Community health workers lead to better health, lower costs for Medicaid patients
A great idea for how to retrain all those insurance company and clinic/hospital billing staff to do something actually related to my health care.
A great idea for how to retrain all those insurance company and clinic/hospital billing staff to do something actually related to my health care.
Thursday, August 17, 2017
Tuesday, August 15, 2017
Monday, August 14, 2017
Health care reform should point to single-payer - Loveland Reporter-Herald
Health care reform should point to single-payer - Loveland Reporter-Herald
LETTERS TO THE EDITOR
Health care reform should point to single-payer
POSTED: 08/13/2017 08:35:15 PM MDT
The Affordable Care Act was signed into law March 23, 2010. The GOP immediately began calling for its repeal, yet until recently, they gave no thought about a replacement.
Seven years! When they finally began proposing replacements, they all had one thing in common: depriving access to health care for millions. This after the president promised that "everyone" would be covered and for less.
Republicans control all levels of the federal government. They have no one to blame but themselves, because they're trying to reconcile one faction that wants to do something (especially GOP governors who fear cuts to Medicaid), with another that would have the market solve the problem — the market that before Obamacare allowed people to be refused insurance for pre-existing conditions or because a lifetime limit was reached.
The fact is, Obamacare works pretty well, especially in states that expanded Medicaid for those who can't afford insurance. Most of its failures have come in red states that refused to do so. Also, how many shortcomings might have been avoided had the GOP decided to participate in the process instead of just saying no since day one? But maybe there's an even better way.
After World War II, we helped Japan and much of Europe set up universal health care. Yet in 1949, when President Truman proposed it for the U.S., it was defeated by calling it socialized medicine. You will note that not one of those nations ever repealed it. Nor has anyone in those countries ever gone bankrupt or lost a house because of medical expenses. Or had to beg for proper medical care. Plus it's cheaper because no profits are added or huge salaries paid and far fewer people deal with billing. Maybe it's time for Americans to follow our own lead and reconsider universal health care.
Ken Bublitz
Loveland
LETTERS TO THE EDITOR
Health care reform should point to single-payer
POSTED: 08/13/2017 08:35:15 PM MDT
The Affordable Care Act was signed into law March 23, 2010. The GOP immediately began calling for its repeal, yet until recently, they gave no thought about a replacement.
Seven years! When they finally began proposing replacements, they all had one thing in common: depriving access to health care for millions. This after the president promised that "everyone" would be covered and for less.
Republicans control all levels of the federal government. They have no one to blame but themselves, because they're trying to reconcile one faction that wants to do something (especially GOP governors who fear cuts to Medicaid), with another that would have the market solve the problem — the market that before Obamacare allowed people to be refused insurance for pre-existing conditions or because a lifetime limit was reached.
The fact is, Obamacare works pretty well, especially in states that expanded Medicaid for those who can't afford insurance. Most of its failures have come in red states that refused to do so. Also, how many shortcomings might have been avoided had the GOP decided to participate in the process instead of just saying no since day one? But maybe there's an even better way.
After World War II, we helped Japan and much of Europe set up universal health care. Yet in 1949, when President Truman proposed it for the U.S., it was defeated by calling it socialized medicine. You will note that not one of those nations ever repealed it. Nor has anyone in those countries ever gone bankrupt or lost a house because of medical expenses. Or had to beg for proper medical care. Plus it's cheaper because no profits are added or huge salaries paid and far fewer people deal with billing. Maybe it's time for Americans to follow our own lead and reconsider universal health care.
Ken Bublitz
Loveland
Sunday, August 13, 2017
Friday, August 11, 2017
Medicare for All Should Be a Litmus Test
Medicare for All Should Be a Litmus Test
"With Improved and Expanded Medicare for All, we are aiming to improve health care for all — which is precisely what makes our project so politically potent, and hence possible: it is a universal program that, by giving something to nearly everybody, is designed to bring together the admittedly enormous coalition required to win it."
"With Improved and Expanded Medicare for All, we are aiming to improve health care for all — which is precisely what makes our project so politically potent, and hence possible: it is a universal program that, by giving something to nearly everybody, is designed to bring together the admittedly enormous coalition required to win it."
Wednesday, August 9, 2017
Liberals Strike Back... Against Single Payer | By Michael Lighty | Common Dreams
Liberals Strike Back... Against Single Payer | By Michael Lighty | Common Dreams
"Our health is not a commodity—it doesn't belong in the "market"—it is a human right."
"Our health is not a commodity—it doesn't belong in the "market"—it is a human right."
Tuesday, August 8, 2017
Saturday, August 5, 2017
Employer-based health coverage likely to stay awhile | AM 1440 KYCR - Minneapolis, MN
Employer-based health coverage likely to stay awhile | AM 1440 KYCR - Minneapolis, MN
Health care access should NOT be linked to your job. It is not good for small employers and it certainly is not good for the individual's ability to choose their job.
Health care access should NOT be linked to your job. It is not good for small employers and it certainly is not good for the individual's ability to choose their job.
Universal healthcare bill attracted lots of lobbying | The Sacramento Bee
Universal healthcare bill attracted lots of lobbying | The Sacramento Bee
So much of our health care money (which includes our tax money) goes to pay for non-medical care things. Lists like this need to be made public all over the country. Example of cost seldom, if ever, mentioned that would be saved via Medicare for All are lobbying, campaign contributions and advertising.
So much of our health care money (which includes our tax money) goes to pay for non-medical care things. Lists like this need to be made public all over the country. Example of cost seldom, if ever, mentioned that would be saved via Medicare for All are lobbying, campaign contributions and advertising.
Douglas Turner: Dems divided on universal health care - The Buffalo News
Douglas Turner: Dems divided on universal health care - The Buffalo News
A negative view on possibilities. Points our need to plan for what to do with all those currently working to sell health insurance.
A negative view on possibilities. Points our need to plan for what to do with all those currently working to sell health insurance.
Friday, August 4, 2017
Thursday, August 3, 2017
Molina Healthcare to drop out of Wisconsin's Obamacare marketplace
Molina Healthcare to drop out of Wisconsin's Obamacare marketplace
This does show a big impact in WI for ACA members. But, my main reason for posting this is 2fold.
1. This company, like many, many more nationwide, find it financially workable to continue managing Medicaid and state government welfare medical plans even though they say ACA is no longer financially feasible. That tells us we really need to learn more about how our tax money is going to profit them and why.
2. The decisions by these and other for profit insurance corporations to drop out of ACA is based on making a profit. The ACA says they can't use more than 20% of their premium income/subsidies for administrative overhead. Medicare and such costs in other countries is like 2% or 3%. Their top lever execs get millions in compensation. Millions are and will lose health care because millionaires aren't making enough profit.
This does show a big impact in WI for ACA members. But, my main reason for posting this is 2fold.
1. This company, like many, many more nationwide, find it financially workable to continue managing Medicaid and state government welfare medical plans even though they say ACA is no longer financially feasible. That tells us we really need to learn more about how our tax money is going to profit them and why.
2. The decisions by these and other for profit insurance corporations to drop out of ACA is based on making a profit. The ACA says they can't use more than 20% of their premium income/subsidies for administrative overhead. Medicare and such costs in other countries is like 2% or 3%. Their top lever execs get millions in compensation. Millions are and will lose health care because millionaires aren't making enough profit.
Wednesday, August 2, 2017
Tuesday, August 1, 2017
Understanding Republican Cruelty - NYTimes.com
Understanding Republican Cruelty - NYTimes.com
"Or to put it another way, Republicans start from a sort of baseline of cruelty toward the less fortunate, of hostility toward anything that protects families against catastrophe.
"Or to put it another way, Republicans start from a sort of baseline of cruelty toward the less fortunate, of hostility toward anything that protects families against catastrophe.
In this sense there’s nothing new about their health plan. What it does — punish the poor and working class, cut taxes on the rich — is what every major G.O.P. policy proposal does. The only difference is that this time it’s all out in the open."
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