Thursday, May 18, 2023

It’s time to guarantee healthcare to all Americans as a human right

It’s time to guarantee healthcare to all Americans as a human right Bernie Sanders It is time to end the international embarrassment of the US being the only major country that does not guarantee healthcare

Tuesday, May 9, 2023

This is Go Time

This is go time- Medicare for All will be reintroduced in both the House and Senate in 8 days, which means now is a crucial time to contact your members of Congress to make sure they sign on as an original cosponsor of the bill. To catch you up: In each new session of Congress, the Medicare for All Act must be reintroduced, and all members of Congress must sign on (or back on) as cosponsors of the bill. Can you take three minutes to call your members of Congress today to ask them to sign on as a Medicare for All cosponsor? You can find the number and a sample script below: → HOUSE: (202) 858-1717 ← → SENATE: (202) 519-0494 ← You will hear a short message; then we’ll connect you directly with your House rep and senators. Hi, my name is ______, and I'm calling from ________. I'm calling to urge [NAME] to cosponsor the Medicare for All Act when it is reintroduced in Congress on May 17. Health care is a human right that must be guaranteed for all – and Medicare for All is the only policy solution that will achieve guaranteed health care for all people. Will they commit to being an original cosponsor on the bill? Thank you. TELL US HOW IT WENT » These calls are tremendously important, William. Together we can make sure that Medicare for All gets as much, or even more, support than it did last time it was introduced in Congress. But it will take all of us making calls, writing letters, meeting with representatives, and more. Your reps need to hear from you, and all their constituents. We need you to call right now and to share this call to action with your friends and networks in your district. Please make a call today to help us secure as many cosponsors on the new Medicare for All bill as possible. Thank you for taking the time. Jasmine Ruddy Organizer Nurses’ Campaign to Win Medicare for All P.S. We put together a toolkit that has everything you need to help amplify our call for Congress to pass Medicare for All. Check it out here!

Friday, April 14, 2023

Researchers find flaws in WI Medicaid restrictions bill, and in the ideas behind it

They damn well better include a big increase in $ for staff to do all this crap. I agree that redetermination of eligibility, no more frequently than annually, might be a good idea -- BUT. They are including doing this twice a year and adding all kinds of paperwork/steps for the recipient AND for the public servants -- with no $ for the staff time. This just would add more barriers to folks getting medical care and WI already is one of the only states to NOT take advantage of expanded MA eligibility. "DHS must determine an individual's eligibility every six months under the bill. DHS is also prohibited from using prepopulated forms or otherwise supplying information, except for name and address, to a recipient under the BadgerCare Plus program that has been supplied to DHS. Additionally, any recipient under the BadgerCare Plus program that fails to timely report to DHS or its designee any change that may affect eligibility is ineligible for benefits for six months from the date DHS discovers the failure to report the change. Under current law, knowingly concealing or failing to disclose any event that an individual knows affects the initial or continued right to a Medical Assistance benefit is subject to a forfeiture of not less than $100 nor more than $15,000 for each concealment or failure."   Article # 1 Aricle #2

Wednesday, March 29, 2023

LTE on health care access - Mark Martin: More health coverage options needed

More health coverage options needed 3/29/23 "Minnesota Care is a state-supported income-limited health insurance program that is set up to act as a bridge between medical assistance and private health insurance. Isn’t it time that all Minnesotans have all options available to them in choosing health insurance? Most of our health insurance is covered by employers (think private insurance companies) or government-backed programs (think medical assistance, Medicare, and MinnesotaCare). I reside in Wabasha County and have maintained a private medical practice in Winona since 1999. Almost daily I see patients that struggle to pay for co-pays, deductibles, premiums, and just basic care. Patients that have employer-based insurance complain that it is becoming more expensive with increases almost yearly in premiums, deductibles, and co-pays – with a corresponding decrease in covered services. I see many patients whose spouse works a job just for health insurance, which is especially hard on farmers and other self-employed people. There are also people who only work at a certain level because if they make over a set income limit, they will lose their MinnesotaCare insurance and they will be financially unable to afford health care, even with subsidies."

Tuesday, March 28, 2023

The quiet privatization of government health insurance programs

"The biggest public health insurance programs have become increasingly privatized over the last decade, even while politicians sparred over whether government-run health care should be expanded to cover more Americans. Why it matters: Although privately run Medicare and Medicaid plans are still highly regulated and funded by the government, the commercialization has complicated efforts to rein in medical spending and unleashed fierce partisan fights like the ongoing one over Medicare Advantage. Driving the news: The insurers that administer Medicare benefits and their allies are running an enormous lobbying blitz against proposed regulations by the Biden administration that they say will cut their government funding and, in turn, harm enrollees. Supporters of the cuts say that the proposal corrects overpayment, which plans obtain by manipulating the billing system. The potency of the lobbying is a sign of just how ingrained Medicare Advantage has become among seniors over the years — and how important it is to some insurers' business mix. The big picture: Medicare for All rose to prominence during Democrats' 2016 presidential primary, championed by Sen. Bernie Sanders. Four years later, it returned as a key litmus test for Democratic presidential hopefuls. More moderate candidates, including President Biden, instead embraced a public option, which would extend eligibility for government-run insurance to more Americans. But as Democrats aired out whether or not to abolish private insurance, existing public programs became increasingly commercialized. Meanwhile, attempts to expand Medicare eligibility or benefits as part of Democrats' domestic policy agenda during Biden's first two years in office fizzled largely over the cost. By the numbers: Medicare Advantage enrollment has grown from 22% of eligible Medicare beneficiaries in 2008 to 48% of beneficiaries in 2022, per KFF. This year's enrollment numbers, when they're released, will likely reveal that the majority of seniors are now enrolled in a Medicare Advantage plan. Private plans are even more ubiquitous in state Medicaid programs. In 2020, 72% of Medicaid beneficiaries were enrolled in a Medicaid managed care plan, also per KFF. In fiscal year 2021, more than half of state and federal Medicaid spending went to managed care organizations. Although Medicaid managed care organizations can be private for-profit, private non-profit or government plans, as of 2020 half of the market was covered by plans owned by one of five companies: Centene, Molina, Elevance, UnitedHealth Group and CVS. Between the lines: Administering entitlement benefits is an increasingly lucerative line of work for insurers. Another KFF analysis found that in 2021, plans had gross margins of $1,730 per enrollee — more than double those of other markets. The second highest were in Medicaid managed care, which had gross margins of $768 per enrollee — higher than both the group and individual market. The analysis cautions that gross margins aren't equivalent to profitability but are indicative of trends. A clear one presented in the analysis is that the employer-sponsored and individual markets were significantly less profitable in 2021 than they were in 2018, while managed care plans did better."

Monday, March 27, 2023

WI Spring Election will impact health issues

Up North News Article on WI Abortion issue that will be impacted by the Spring Election "OB/GYN: Wisconsin's Current Abortion Ban Isn't Just Dangerous, It's Deadly Right now, Wisconsin is facing a health crisis on multiple fronts. Students who want to become OB-GYNs are forced to leave the state to finish their training because they're unable to learn basic, standard care for cases of ectopic pregnancy or miscarriage under current Wisconsin law. Dr. Kristin Lyerly knows just how difficult this will be for her industry and the future of women's health. Today, she's answering a few of our questions. UpNorthNews: How has your job changed since Wisconsin's 1849 abortion ban went back into effect? Dr. Kristin Lyerly: There is a lot more fear and uncertainty related to women's health care now for both patients and providers. Women have become more afraid to ask questions about their reproductive health, and doctors are often unsure whether they can offer basic services like contraception and management of miscarriages, which are technically spontaneous abortions. What hasn't changed? Our desire to ensure that our patients have access to quality, affordable, comprehensive, compassionate health care. It's just so much harder to deliver that in the post-Dobbs era. What do you believe is the biggest lie anti-choice activists are currently spreading about abortion? Their goal is to tie issues like abortion to a political side in order to win votes, so they use hyperbolic language that plays on people's emotions. The one that infuriates me the most is the "abortion up until the time of birth" trope that conservative radio hosts love because it sounds so terrible. It is terrible because abortions that happen after viability, when a baby has a reasonable chance of survival outside of the mother, are only offered when either the baby or the mother have a profound medical problem that threatens the health, well-being, and future reproductive potential of the mother. These are heartbreaking situations where families are already suffering in tragic ways that most of us will never understand. Politicians and activists who retraumatize these people for their own gain should be ashamed. What is one thing most people don't know about abortion, but you wish they did? Abortion is health care and it's common—one in four women in the US will have an abortion in her lifetime. How does this tie into next week's election? We all want the freedom to make our own decisions about our own bodies within the context of our own lives, whether we're talking about a new cancer diagnosis or a complicated pregnancy. The conservative [state Supreme Court] candidates have shown us that they don't trust women to make these decisions."

Friday, March 3, 2023

Is Wisconsin the only Midwest state to not accept the federal Medicaid expansion?

Fact Brief : Is Wisconsin the only Midwest state to not accept the federal Medicaid expansion? | Gigafact NO Both Wisconsin and Kansas have not adopted the federal Medicaid expansion, which expanded Medicaid coverage to those with incomes up to 138% of the federal poverty level. Despite not adopting the expansion, Wisconsin allows all uninsured adults who fall below the federal poverty line to be eligible for Medicaid, according to the Kaiser Family Foundation. In his previous budgets and a special session, Democratic Gov. Tony Evers has proposed funding an expansion of Medicaid, but it has failed to make it into the final budget under the Republican-controlled Legislature. In his 2023-25 budget, Evers has again proposed accepting the expansion. The Evers administration estimates the move would save the state $850 million in its first year and add 897,000 low-income people to its Medicaid program, including 30,000 people who currently do not have insurance.

Wednesday, March 1, 2023

post to Great Northern States Health Care Initiative - question about racism

As a new blog participant, I am curious if the issue of American racism, specifically white supremacy, has been discussed here as the fundamental barrier preventing the U.S. from terminating its present health care chaos and switching over to the sanity of a health care system which is funded through a one-payer administrator?


Diane J. Peterson

St. Paul, Minnesota

Monday, February 27, 2023

End Government Discrimination Against Medical Assistance Patients Pass the Freedom to Choose Bill

End Government Discrimination Against Medical Assistance Patients

Pass the Freedom to Choose Bill

Mission of the Freedom to Choose bill:
Restore equal access to all Medical Assistance patients to choose their own doctors
and other health care providers.
SF404 Author: Dr. Alice Mann
Co-Authors: Jim Abeler, DC; John Marty, Dr. Matt Klein, Liz Boldon
HF816 Author: Kim Hicks

Co-Authors: Tina Liebling, Peter Fischer, Brion Curran, Athena Hollins,
Hodan Hassan, Amanda Hemmingsen-Jaeger, Samantha Vang

 Eliminates discrimination, enforced by state government, among Medical Assistance patients.
Currently, a minority of them are granted the Freedom to Choose their preferred doctors and
other health care providers, but the state withholds this right to choose from the majority of
Medical Assistance patients.
 Reduces racial disparities, allowing Medical Assistance patients the Freedom to Choose
culturally appropriate health care providers.
 Provides good transparency and accountability on the tax funds paying for patients who
exercise the Freedom to Choose their preferred health care providers. There is no payment
transparency, and only the most minimum accountability, on tax funds devoted to the
majority of patients who lack the Freedom to Choose due to receiving care through managed
care organizations.
 The 2022 fiscal note on this bill demonstrated that it would save the state millions of dollars.
Such savings present funding opportunities for other needs in your district.
ENDORSED BY: Health Care For All Minnesota (HCAMN)

Our Revolution Twin Cities
Minnesota Nurses Association
ACTION: Support this bill: 1. Become a co-author

2. Speak up in favor of the bill in committees and in floor sessions.
3. Vote for the bill in committee hearings and in floor sessions.
Health Policy Advocates initiated this bill. We are a multi-partisan citizen
group in Minnesota for improved health care access and ending
discrimination against Medical Assistance patients.  
Contact Diane Peterson, 651 487 8007,; or Sharon
Schmidt, 952 996 9070,

Tuesday, January 31, 2023

Pervasive Greed Destroying US Health Care

Summary: Esteemed medical care quality leader Donald Berwick condemns the pervasive and crippling role of financial gain-seeking in US health care. As he said recently, single payer is the solution. Salve Lucrum: The Existential Threat of greed in US Health Care Link to Article

Sunday, January 22, 2023

Galluping In the Wrong Direction: Higher Cost Barriers & Lower Quality

Health Justice Monitor - January 21, 2023 No Commentson Galluping In the Wrong Direction: Higher Cost Barriers & Lower Quality Summary: National polls show that the US is losing ground on two major indicators of health system performance: access to care and perceived quality. Who thought it could get worse? Gallup shows we’re galloping to disaster. Record High in U.S. Put Off Medical Care Due to Cost in 2022 Gallup January 17, 2023 By Megan Brenan The percentage of Americans reporting they or a family member postponed medical treatment in 2022 due to cost rose 12 points in one year, to 38%, the highest in Gallup’s 22-year trend. Americans were more than twice as likely to report the delayed treatment in their family was for a serious rather than a nonserious condition in 2022. In all, 27% said the treatment was for a “very” or “somewhat” serious condition or illness, while 11% said it was “not very” or “not at all” serious. [This] 16-point gap in the perceived seriousness of forgone treatment in 2022 is the second largest on record … Americans Sour on U.S. Healthcare Quality Gallup January 19, 2023 By Lydia Saad For the first time in Gallup’s two-decade trend, less than half of Americans are complimentary about the quality of U.S. healthcare, with 48% rating it “excellent” or “good.” The slight majority now rate healthcare quality as subpar, including 31% saying it is “only fair” and 21% — a new high — calling it “poor.” Americans’ evaluations of the quality of healthcare they personally receive are also at a low ebb — albeit higher than their U.S. rating — with 72% giving it excellent or good marks. This low reading has been two years in the making, with the metric falling six points to 76% in 2021 and another four points in the past year. Comment by: Jim Kahn This pair of national Gallup polls demonstrates our health care is headed in the wrong direction. The care is less affordable and lower quality. Why less affordable? In brief, under-insurance. As the Kaiser Family Foundation showed in its 2022 annual survey of job-based insurance, deductibles continue increasing (Fig. 7.18), even as employee premium contributions rise or stay flat (Fig. 6.23). Drug prices are extraordinarily high due to the industry’s relentless pursuit of profit, and cost controls in the Inflation Reduction Act are anemic. A commentary from last week noted that drug cost-sharing under the now ubiquitous pharmacy benefit managers (PBMs) can be devastating for patients who depend on expensive brand-name medicines with no generic options. Two main causes: First, a shift from fixed co-payments to percentage-of-cost coinsurance, which is based on inflated list prices. Second, exclusion of manufacturer patient assistance from deductible credit. The difference for patients can be tens of thousands of dollars a year (see sample calculations here). Wendell Potter wrote recently on the painful results for patients. Financial barriers have clinical consequences. Research by Gaffney et al in late 2022 found rationing of insulin by 17% of patients or 1.3 million US adults. Research by Chandra et al in 2021 found that a 34% ($10) rise in out-of-pocket cost for seniors reduces drug use by 23% and increases mortality by one-third, specifically for statins and antihypertensives. Why lower quality? It’s multi-factorial. Clearly COVID has burdened health care capacity, leading to worker stress, burnout, and staffing shortages. But I believe patient frustration also carries over from the financial challenges. When people have to pay more – which they can barely afford – they demand and expect more. When the system is failing in multiple ways, it feels like it’s completely falling apart. Which it is. Saddle up for single payer.

Thursday, January 5, 2023

The Problems with Job-Based Insurance January 5, 2023 No Commentson The Problems with Job-Based Insurance Summary: The Chamber of Commerce uses the results of its online poll to claim overwhelming worker support for job-based health benefits. However, the methods and reporting are biased. Survey findings by the Commonwealth Fund tell a far more worrisome story. New Poll of American Workers Reveals Tremendous Value Placed on Workplace Health Benefits U.S. Chamber of Commerce December 15, 2022 Health insurance is the most important benefit an employer can offer workers and their families, according to a new survey on how American workers view employer-sponsored health coverage. Workers report that they overwhelmingly prefer to receive health insurance directly from an employer rather than through other means. The poll found that as high as 96% of Americans believe it is important that a job offer health insurance. Ninety-three percent of respondents said they were satisfied with their insurance. Employer-sponsored health insurance remains far more popular than insurance plans available on the individual market: 89% of Americans expressed a preference for obtaining their health coverage through an employer than through other means. 81% of respondents reported that they would rather receive their insurance from an employer than a government-provided health plan. “I expected there to be a high level of satisfaction with employer health benefits, but I was stunned by the level of intensity,” said Matt George of Seven Letter Insight, who ran the survey. “It is not an exaggeration to say Americans love, trust, and rely on their workplace health care coverage.” The survey was commissioned by the Protecting American’s Coverage Together (PACT) campaign, a coalition including the U.S Chamber of Commerce, Business Roundtable, Vermeer Corporation, The National Association of Manufacturers and Council for Affordable Health Coverage. PACT represents leading employer voices focused on strengthening the ESI system and protecting the coverage and benefits that American families depend on for their health. The State of U.S.Health Insurance in 2022 The Commonwealth Fund September 29, 2022 By Sara R. Collins, Lauren A. Haynes, Relebohile Masitha Forty-three percent of working-age adults were inadequately insured in 2022. These individuals were uninsured (9%), had a gap in coverage over the past year (11%), or were insured all year but were underinsured, meaning that their coverage didn’t provide them with affordable access to health care (23%). Twenty-nine percent of people with employer coverage and 44 percent of those with coverage purchased through the individual market and marketplaces were underinsured. Among the world’s high-income countries, the U.S. stands alone for the complexity of its health insurance system. Americans are eligible for different types of coverage depending on whether their employer offers it, what their income level is and what their age and health care needs are. There is no national enrollment mechanism for people who don’t have employer coverage; they must know which program they are eligible for and then sign up for coverage. Consequently, people can experience insurance gaps at different points in their lives, like when they lose a job. The average insurance deductible for employer health plans with single coverage is more then $1,000 ($1,434 for all covered workers in 2021), and out-of-pocket maximums average $4,272 for single coverage in employer plans. Half of survey respondents said they would not have the money to cover an unexpected $1,000 medical bill within 30 days. Comment by: Don McCanne & Jim Kahn With our inordinately high costs of health care and persistent gaps and inequities in access, many hope that 2023 is going to be the year that we finally start to enact and implement health care justice for all. Remarkably, however, there is still resistance to the tested and proven concept that will get us there: single payer Medicare for All. Some argue that Medicare has too many defects, but we know what they are and can revise the program to meet widely accepted standards of care. Other nations have shown that to achieve the goals of equity, accessibility, and affordability for all, the government must have a central role. To those who advocate for reliance on a private sector strategy, we point to its clear failings. Our health system failings reflect the shift of health care funds from patient care to wealthy investors, such as through public fund privatization (eg Medicare Advantage and Medicaid managed care) and the massive acquisition of providers by private equity. That’s why we must pay for health care through public insurance on the model of traditional Medicare. Employers and insurer organizations tout the benefits of employer-sponsored health insurance. Admittedly, these plans provide a welcome financial backstop for expensive medical problems, such as a heart attack or a fracture requiring surgery. Unsurprisingly, workers value getting health benefits with a significant employer contribution. Yet most job-based plans have large deductibles (thousands of dollars) and provider networks are limited. This mixed picture is evident in the Commonwealth poll and reports by the Kaiser Family Foundation and others. The Chamber of Commerce poll and report grossly exaggerate the level of support for job-based coverage. It’s biased, in four ways (please excuse geek detour): 1) Biased sample of respondents: it’s an online survey, with no sampling frame or response rate specified. This is a red flag for self-selection: the individuals who see and participate in the poll have a special perspective. The report doesn’t indicate the recruitment message, but if it was something like “What do you like about your health insurance?” or “Do you appreciate your health benefits?”, who do you think would click over to the survey? 2) Biased presentation: Statistics are presented in a way that favors the pro-benefits view. E.g., 52% do NOT strongly agree that insurance is affordable, and a similar % do NOT say that it’s high quality. More than 70% do NOT say it’s comprehensive or convenient. 3) Unfair comparison with public insurance like single payer. Respondents are asked if they prefer private work-based coverage or “government insurance”. No hint at what that means – is it Medicaid? The responses would be quite different if phrased fairly, e.g., “an improved Medicare for All, with coverage for all medical needs; no premiums, deductibles, or copays; and increased taxes only if you earn >$250,000”. 4) Omission. They don’t ask if workers are pleased that employer contributions to health benefits come out of wage or salary levels. (They do, to a very large degree.) Polling as advocacy isn’t real information. Ok geek mode off. Single payer would enable access to the entire health care system whenever needed. In contrast, employer insurance depends, first of all, on employment status and employer benefit plans. Second, details of the insurance contract matter: there may not be freedom to choose health care providers, hospitals, pharmacies, or even what care is covered. Workers may fall prey to job lock, required to stay in a job because insurance may not be available if they quit. Voluntary and highly varied job-based insurance guarantees that coverage is inequitable and unreliable, in contrast to the equity and universality of single payer. It is understandable how, through the years, individuals have liked employer sponsored plans, since they have been among the better options to provider, under the right circumstances, heath care for workers and for their families. (Less true these days due to the skyrocketing deductibles, and obscuring the lower wage effect.) Also, taking solace in decent job-based insurance undermines a principle that most of us care about: solidarity. Most of us really would like to see health care for everyone. Not long ago, we experimented on a large scale with trying to fix the private insurance approach. The Affordable Care Act aimed to preserve, improve, and expand employer sponsored insurance as a pillar of our health care coverage, filling in the voids with a regulated market for private insurance and more Medicaid. The ACA seemed to enhance solidarity while preserving employment sponsored plans. The problem, as reviewed well recently, is that this experiment in health policy was a dismal failure in providing decent coverage for everyone, and thus a failure in the solidarity we seek. Tens of millions remain uninsured, and under-insurance exploded with the rapid growth of high deductible plans. If solidarity is building, it’s of the wrong variety: shared pain. Other nations provide us with ample highly successful examples of single payer. They are effective in providing affordable care for everyone and thus also fulfill the goal of solidarity. We really can have high performance universal health care, and save money in the process. A single payer system would guarantee better health care choices than in employer sponsored plans, for workers and for everyone. We have the opportunity to reject the current, fragmented, dysfunctional employer-sponsored system and adopt policies of social solidarity that would bring affordable, comprehensive high quality health care to everyone. Look around you. This really seems to be the year to fix the health care financing system in the United States. We can use our ingenuity to create a uniquely American system of social and economic justice. Let’s do it. In solidarity, single payer for all!