Where's the Single-Payer Advocate?
By Michael McAuliff
New York Daily News
February 23, 2010
Reps. Anthony Weiner and Peter Welch are reprising a question that proved thorny for President Obama’s last health care summit: Where’s the single-payer advocate?
Weiner and Welch — single-payer advocates who are not invited, yet — argue in a letter to the President today that someone from the single-payer side should be at the Blair House summit on Thursday.
“Dear Mr. President,” they write. “During the State of the Union address, you stated, ‘But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.’
“We’d like to take you up on the offer.”
Their idea is pretty easy to understand: Medicare for all.
.
Dear Mr. President:
During the State of the Union address, you stated, “But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know.”
We’d like to take you up on the offer. The best way to advance these goals is to expand what we know already works. We and many Americans propose Medicare for All. We would urge you to make sure that someone is invited to the summit that supports this position.
Building on Medicare, which has a 1% overhead rate, would reduce costs by eliminating insurance company profits and cut administrative costs which currently consume 31%, nearly double that of other nations. A universal Medicare for All system would provide Americans with complete autonomy in choosing their health care provider without regard to provider networks or referrals from primary care doctors. Patients would no longer be responsible for premiums, deductibles or co-payments. Government safety net programs, such as Medicaid and SCHIP, as well as the State and local government portions for these programs, would no longer be needed.
Furthermore, a Medicare for All system would be easily understandable by the American public. Medicare has been an enormous success for seniors and there is no reason, we believe, to not expand Medicare coverage to all Americans.
Thank you in advance for your consideration.
Put Single Payer Back on the Table
By Dr. Quentin Young
The Huffington Post
February 22, 2010
One year after its much-ballyhooed launch, the Obama administration's approach to health reform is now in serious disarray.
The president's health care summit on Feb. 25 is being portrayed as a last ditch bid to find some common ground with his "just say no" Republican opposition. He also faces an increasingly wary group of disgruntled Democrats, whose memory of the Massachusetts massacre -- the election of a Republican to Sen. Edward Kennedy's seat -- remains fresh.
The summit proceedings, which will be televised in the name of "transparency," will no doubt be laden with a formidable amount of stagecraft. They will be preceded by the unveiling of the president's own legislative proposal -- presumably the odious Senate bill with some tweaks -- a few days before.
But it's almost certain that this latest White House initiative, undertaken with the stated goal of salvaging and passing at least some elements of the stalled congressional bills, is foredoomed.
The House bill, contrary to many who believe otherwise, is disastrous. And if such a thing is possible, its Senate counterpart is even worse. Both would shovel hundreds of billions of taxpayer dollars into the coffers of the private health insurance industry. Both would make it a federal offense, with fines, for a person to fail to buy the insurers' shoddy products.
Even so, at least 23 million people would remain uninsured under the new law. And those who have insurance would remain vulnerable to extort premium increases, not unlike Anthem Blue Cross' recently announced premium hikes of up to 39 percent in California.
While one could imagine the enactment of certain piecemeal measures that might ameliorate our condition -- e.g., a simple prohibition of insurance company denials of coverage because of pre-existing conditions -- these are precisely the stand-alone measures most stubbornly opposed by Republicans, conservative Democrats and their corporate patrons. Such concessions, in their eyes, must be linked to shoring up the very culprits who are most responsible for our health care mess.
The presence of the for-profit health industry -- the private health insurance conglomerate and the Big Pharma drug companies in the first place -- in the legislative process has certainly been "transparent" from the get go. Through their lobbyists and campaign contributions, they shaped a bill that would enhance their domination of our health system. They are at the root of the catastrophe that passes for health care financing in the United States today.
Of course, the conspicuous omission in the debate has been single-payer national health insurance proposal, an improved Medicare for All. This was assured on the Senate side when the powerful chairman of its Finance Committee, Max Baucus, D-Mont., informed the world that everything was on the table but single payer.
How the chairman of a congressional committee, however powerful, can set the terms of debate in a democratic society by excluding such a popular and well-substantiated solution is hard to rationalize. Baucus did, of course, prevail, and what came out of the Senate was execrable. Like the House bill, it fails the three tests of genuine reform: universal coverage, quality improvement and cost control.
One can reasonably suspect that President Obama now wants something -- anything -- to pass in Congress as evidence of the fulfillment of his campaign pledge to accomplish health care reform. But if he looks to the House and Senate bills as the starting point, his efforts will be in vain.
It's not too late for the president to re-embrace his earlier support for single-payer national health insurance and set the nation on the right path. Were he to lay out the facts to the American people and provide energetic leadership for this eminently rational proposal, he would get strong, grassroots support from the public.
We're now spending $8,000 per capita annually on health care, $2.5 trillion in total. That's nearly one-fifth of our GDP. Yet our health outcomes rank among the lowest in the industrialized world. Some 45,000 people die each year chiefly because they have no health insurance, and medical bills and illness are now linked to nearly two-thirds of personal bankruptcies. This reality in the richest country in the world is unnecessary and intolerable.
I suggest the president look to an improved and expanded Medicare program as the solution. Medicare, which was enacted in 1965 and which has served our elderly and the totally disabled so well, is a solid foundation to build upon.
Enactment of an improved Medicare for All would save our nation $400 billion annually by eliminating the bureaucracy and paperwork inflicted on our system by the private insurers. That's more than enough to provide universal, comprehensive care to everyone and to eliminate all co-pays and deductibles. A single-payer system would also allow us to rein in costs and better allocate resources.
We have a talented health care workforce. But to fully unlock their potential, we need to get out from under the greedy dictates of the health industry.
Mr. President, it's time to put single payer back on the table.
How much does President Obama expect us to pay for health care?
The President's Proposal
The White House
February 22, 2010
Policies to Improve Affordability and Accountability
Example for a family of four with income of $66,000:
Maximum percent of income paid for premiums: 9.5%
Percent of costs paid by health insurance plan: 70%
Penalty for remaining uninsured: (in 2016) the higher of $695 (with indexed increases) or 2.5% of income
Hardship exemption - threshold income below which the penalty is waived: The income tax filing threshold ($9,350 for a single or $18,700 for a married couple in 2009)
http://www.whitehouse.gov/health-care-meeting/proposal
Comment:
By Don McCanne, MD
The greatest significance of President Obama's health care reform proposal released today is that he has now formally placed his stamp of approval on the fundamental policies already contained in the House and Senate reform bills. While remaining silent on some of the third rail issues (public option, Medicare buy-in, pregnancy termination, etc.), he and his staff merely tweaked the bills and added insurance premium rate review, whatever that's worth, and some rhetoric on waste, fraud, and abuse.
His proposal still falls far short on two of the most important goals of reform: 1) insuring everyone, and 2) ensuring that health care is affordable for each of us. Merely tweaking the Senate version, which is what they did, could not have attained these goals since the most effective policies were already traded away before serious negotiations began.
That said, let's look at what the President expects a family of four with an income of $66,000 to pay for health care. The premium contribution would be 9.5% of income, or $6270 for the basic plan with an actuarial value of 70%. If they wanted or needed a better plan, they would have to pay the full difference in the premium. At an actuarial value of 70%, they would also have to pay an average of 30% of all health care costs. This can vary considerably because of plan design in the form of deductibles, copayments, coinsurance, non-covered benefits, stop loss, out-of-network care exempt from stop loss, and other factors. If they either elected not to or were unable to pay the premium, they would have to pay a penalty of $1650, but then, of course, they would have no protection at all against potential health care costs.
Clearly, President Obama has not done any better than Congress in protecting families from financial hardship should they have the misfortune of developing significant medical problems. Unaffordable underinsurance is not the change that we needed.
3, 2010
Don’t It Make Your Wide Eyes Cry, Iowa? Another Cancer Patient Grovels
by Donna Smith
CommonDreams.org
Tuesday, February 23, 2010
Some patient stories just fill me with anger and shame. This one -- from Iowa -- is one of those stories. By now, we all know the plot. Patient has insurance. Patient gets sick. Patient cannot afford to keep insurance or find insurance that will cover illness. Patient goes without coverage. Providers demand up-front payment for cancer care. Patient calls on friends, family and community to help. Patient grovels. Cancer spreads. Patient grovels.
Ah, the mid-western values. This is Iowa. My mom was born in Boone during the Great Depression. Iowa is the place many think of when we think of those salt-of-the-earth, kind and hard-working Americans with traditional, perhaps even faith-based values. A kind and gentle place with a no-nonsense work-ethic. Iowa. Fields of farmers' dreams and the stuff of mid-America at its finest.
So, why in Iowa should we allow Deb, a cancer patient who is currently receiving chemotherapy, to beg and grovel for her care?
Is her life less valuable than her two Senators' lives? Come on, Senators Harkin and Grassley. Fess up. Is your constituent's life less worthy of protection and care than your own? And what about you, President Obama? Didn't the Iowans who braved the cold and ice of the primary day way back in 2008 help catapult you to the presidency? Deb's vote sure as hell mattered then. What happened? When did Deb's life become so expendable?
Do any of the leaders know what it feels like to face a cancer fight and have to come up with $2,000 up front every single month or be denied chemotherapy? Do they care enough to actually create a US healthcare system that would stop this horror from unfolding in Iowa?
Come on now, boys. And girls. This is clearly not rocket science. Other civilized countries have not abused their cancer patient like this for many years. We clearly could stop this through a proven and effective and enhanced Medicare for all. No more begging, groveling Iowa patients. No more providers booting patients like Deb to the curb to die. Just healthcare for all.
It's the ethical, moral, economical and sensible way to go -- so why are we stuck trying to have a bipartisan measure to keep the for-profit insurance companies, the pharmaceuticals and the big hospital corporations happy? I'll tell you why. Because Deb isn't invited to the summit. She's back in Iowa raising money for her next round of chemo. Shame on us all.
Donna Smith is a community organizer for National Nurses United (the new national arm of the California Nurses Association) and National Co-Chair for the Progressive Democrats of America Healthcare Not Warfare campaign.
