A new ad from Conservatives for Patients' Rights says that a public health insurance plan now being proposed in Congress "could crush all your other choices, driving them out of existence, resulting in 119 million off their current insurance coverage."
That's misleading. The 119 million figure comes from an analysis of a plan that would mirror Medicare and be open to every individual and business that wanted it. But that's not the type of public plan President Obama has proposed. Nor is such a plan gaining acceptance on Capitol Hill.
The author of the study says that while some have backed the Medicare-like proposal, using the 119 million number "overstates the impact of what now is being considered."
The ad also falsely cites the New York Times as the source of a statement that what's being proposed would leave no consumer choices and "government in control of your health care." The Times didn't say that at all. The newspaper was just quoting claims made by insurance companies and members of Congress. (cont)
Click link in title for More or type in URL http://www.factcheck.org/politics/more_health_care_scare.html
Monday, June 15, 2009
Americans Who've Used Canada's Health-Care System Respond to Current Big-Lie Media Campaign
The scare ads and op-ed pieces featuring Canadians telling us American how terrible their government health-care systems have arrived - predictably.
There's another, factual view - by those of us Americans who've lived in Canada and used their system.
My wife and I did for years, and we've been incensed by the lies we've heard back here in the U.S. about Canada's supposedly broken system.
It's not broken - and what's more, Canadians like and fiercely defend it.
Example: Our son was born at Montreal's Royal Victoria Hospital. My wife got excellent care. The total bill for three days in a semi-private room? $21.
My friend Art Finley is a West Virginia native who lives in Vancouver.
"I'm 82, and in excellent health," he told me this week. "It costs me all of $57 a month for health care, and it's excellent. I'm so tired of all the lies and bullshit I hear about the system up here in the U.S. media."
Finley, a well-known TV and radio host for years in San Francisco, adds,
"I now have 20/20 vision thanks to Canadian eye doctors. And I haven't had to wait for my surgeries, either."
A Canadian-born doctor wrote a hit piece for Wingnut Central (the Wall Street Journal op-ed page) this week David Gratzer claimed:
"Everyone in Canada is covered by a single payer -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system."
Vancouverite Finley: "That's sheer b.s." (continued)
click link in title for more or cut and paste this URL http://www.huffingtonpost.com/bill-mann/americans-whove-used-cana_b_215256.html
There's another, factual view - by those of us Americans who've lived in Canada and used their system.
My wife and I did for years, and we've been incensed by the lies we've heard back here in the U.S. about Canada's supposedly broken system.
It's not broken - and what's more, Canadians like and fiercely defend it.
Example: Our son was born at Montreal's Royal Victoria Hospital. My wife got excellent care. The total bill for three days in a semi-private room? $21.
My friend Art Finley is a West Virginia native who lives in Vancouver.
"I'm 82, and in excellent health," he told me this week. "It costs me all of $57 a month for health care, and it's excellent. I'm so tired of all the lies and bullshit I hear about the system up here in the U.S. media."
Finley, a well-known TV and radio host for years in San Francisco, adds,
"I now have 20/20 vision thanks to Canadian eye doctors. And I haven't had to wait for my surgeries, either."
A Canadian-born doctor wrote a hit piece for Wingnut Central (the Wall Street Journal op-ed page) this week David Gratzer claimed:
"Everyone in Canada is covered by a single payer -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system."
Vancouverite Finley: "That's sheer b.s." (continued)
click link in title for more or cut and paste this URL http://www.huffingtonpost.com/bill-mann/americans-whove-used-cana_b_215256.html
Monday, May 25, 2009
Single Payor Q&A
I found some interesting numbers on this site. Perfect for discussing pro and con with those who dont understand the argument For universal healthcare and think they are against it. URL to comparison/data chart points >>>http://www.grahamazon.com/sp/compare.php
In a single-payer health system, everyone has health insurance. According to the Institute of Medicine, 18,000 people in the United States die every year from a lack of health insurance--that's two people every hour.
Let's look at the systems side-by-side. You make up your mind. If you'd like to know where the numbers are coming from, you can always dig deeper. More comparisons are made in the Financing and Other Questions sections.
Think of how much less-crowded emergency rooms would be if people could see a primary care doctor when they were sick, instead of only going to an ER when they become sicker.
Click link in title or type www.grahamazon.com/sp/
In a single-payer health system, everyone has health insurance. According to the Institute of Medicine, 18,000 people in the United States die every year from a lack of health insurance--that's two people every hour.
Let's look at the systems side-by-side. You make up your mind. If you'd like to know where the numbers are coming from, you can always dig deeper. More comparisons are made in the Financing and Other Questions sections.
Think of how much less-crowded emergency rooms would be if people could see a primary care doctor when they were sick, instead of only going to an ER when they become sicker.
Click link in title or type www.grahamazon.com/sp/
Sunday, May 17, 2009
Achieving Universal Health Care
Currently 47 million Americans do not have health care coverage. Millions more Americans are under-insured, causing bankruptcy and tearing families apart. Every other industrialized nation in the world provides a basic standard of universal care for its citizens. DFA members are working to make sure America's sick are no longer left behind.
DFA members have taken this fight local. From the California legislature to the Governor of Massachusetts, we've been on the ground lobbying local leaders to fix our broken system....
DFA members supported the expansion of the State Children Health Insurance Program (S-CHIP) to cover more than 10 million American kids. We wrote letters, made calls and met directly with elected members of both parties. ...we worked in coalition with our partners in the Service Employees International Union and others to... overturn the President's veto.
In the words of Governor Howard Dean, "we can guarantee healthcare for all if we give every American the freedom to choose between keeping their private insurance - if they have any - and a universally available public healthcare option like Medicare." That is why DFA has launched StandwithDrDean.com -- the online organizing hub for healthcare reform.
select link in Title for Democracy for America Issues Healthcare
DFA members have taken this fight local. From the California legislature to the Governor of Massachusetts, we've been on the ground lobbying local leaders to fix our broken system....
DFA members supported the expansion of the State Children Health Insurance Program (S-CHIP) to cover more than 10 million American kids. We wrote letters, made calls and met directly with elected members of both parties. ...we worked in coalition with our partners in the Service Employees International Union and others to... overturn the President's veto.
In the words of Governor Howard Dean, "we can guarantee healthcare for all if we give every American the freedom to choose between keeping their private insurance - if they have any - and a universally available public healthcare option like Medicare." That is why DFA has launched StandwithDrDean.com -- the online organizing hub for healthcare reform.
select link in Title for Democracy for America Issues Healthcare
Sunday, May 10, 2009
The Health Care Reserve Fund: A Historic Commitment to Reform
From The President via Whitehouse.gov
As I have said more than a few times before (even on this blog) reducing health care costs is the key to the country’s fiscal future and also to providing relief to American families from rising health care bills.
We began that process in February in the budget overview, which included a $634 billion health care reserve fund -- a substantial down payment toward health care reform. On Monday, when we release the Summary Tables and Analytical Perspectives of the Budget, you will see that the full Budget does exactly the same thing and includes $635 billion in a health care reserve fund.
As in the February overview, about half of the health care reserve fund in the full Budget comes from savings in Medicare and Medicaid that would improve the health care system’s efficiency and quality. There is a change (the "$635 billion" in the above paragraph is not a typo). In the time since we released the February overview, the health care reforms in the reserve fund have been re-estimated to save about $7 billion less over the next 10 years, while the limitation on itemized deductions has been re-estimated to save about $51 billion less over this period. We closed this gap by dedicating some other tax enforcement measures and loophole closers totaling $60 billion. This then brings the reserve fund in the full Budget to almost exactly the same total as before.
How do we do it?
(select link in title above to read more @ Whitehouse.gov also, follow the Obama administration on Twitter and Facebook)
As I have said more than a few times before (even on this blog) reducing health care costs is the key to the country’s fiscal future and also to providing relief to American families from rising health care bills.
We began that process in February in the budget overview, which included a $634 billion health care reserve fund -- a substantial down payment toward health care reform. On Monday, when we release the Summary Tables and Analytical Perspectives of the Budget, you will see that the full Budget does exactly the same thing and includes $635 billion in a health care reserve fund.
As in the February overview, about half of the health care reserve fund in the full Budget comes from savings in Medicare and Medicaid that would improve the health care system’s efficiency and quality. There is a change (the "$635 billion" in the above paragraph is not a typo). In the time since we released the February overview, the health care reforms in the reserve fund have been re-estimated to save about $7 billion less over the next 10 years, while the limitation on itemized deductions has been re-estimated to save about $51 billion less over this period. We closed this gap by dedicating some other tax enforcement measures and loophole closers totaling $60 billion. This then brings the reserve fund in the full Budget to almost exactly the same total as before.
How do we do it?
(select link in title above to read more @ Whitehouse.gov also, follow the Obama administration on Twitter and Facebook)
Friday, March 27, 2009
Sen. Bernie Sanders introduces single payer bill
PNHP
Press release
March 26, 2009
Single-payer health reform bill introduced in Senate
Challenging head-on the powerful private insurance and pharmaceutical industries, Vermont’s Sen. Bernie Sanders introduced a single-payer health reform bill, the American Health Security Act of 2009, in the U.S. Senate Wednesday.
The single-payer approach embodied in Sanders’ new bill stands in sharp contrast to the reform models being offered by the White House and by key lawmakers like Senators Max Baucus (D-Mont.) and Edward Kennedy (D-Mass.). Their plans would preserve a central role for the private insurance industry, sacrificing both universal coverage and cost containment during the worst economic crisis since the Depression.
In contrast, Sanders’ new legislation would cover all of the 46 million Americans who currently lack coverage and improve benefits for all Americans by eliminating co-pays and deductibles and restoring free choice of physician. The most fiscally conservative option for reform, single payer slashes private insurance overhead and bureaucracy in medical settings, saving over $400 billion annually that can be redirected into clinical care.
Highlights of the bill include the following:
* Patients go to any doctor or hospital of their choice.
* The program is paid for by combining current sources of government health spending into a single fund with modest new taxes amounting to less than what people now pay for insurance premiums and out-of-pocket expenses.
* Comprehensive benefits, including coverage for dental, mental health, and prescription drugs.
* While federally funded, the program is to be administered by the states.
* By eliminating the high overhead and profits of the private, investor-owned insurance industry, along with the burdensome paperwork imposed on physicians, hospitals and other providers, the plan saves at least $400 billion annually - enough money to provide comprehensive, quality care to all.
* Community health centers are fully funded, giving the 60 million Americans now living in rural and underserved areas access to care.
* To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.
Sanders, who serves on the Senate Committee on Health, Education, Labor, and Pensions, is a longtime advocate of fundamental health care reform. His new bill draws heavily upon the single-payer legislation introduced by the late Sen. Paul Wellstone (D-Minn.) in 1993, S. 491, and closely parallels similar legislation pending before the House, H.R. 1200, introduced by Rep. Jim McDermott (D-Wash.).
Click the Link in the Title to access a PDF of the Bill or use the URL below in your browser >>
S.703 - American Health Security Act of 2009 - full text:
http://pnhp.org/PDF_files/American-Health-Security-Act-single-payer.pdf
Press release
March 26, 2009
Single-payer health reform bill introduced in Senate
Challenging head-on the powerful private insurance and pharmaceutical industries, Vermont’s Sen. Bernie Sanders introduced a single-payer health reform bill, the American Health Security Act of 2009, in the U.S. Senate Wednesday.
The single-payer approach embodied in Sanders’ new bill stands in sharp contrast to the reform models being offered by the White House and by key lawmakers like Senators Max Baucus (D-Mont.) and Edward Kennedy (D-Mass.). Their plans would preserve a central role for the private insurance industry, sacrificing both universal coverage and cost containment during the worst economic crisis since the Depression.
In contrast, Sanders’ new legislation would cover all of the 46 million Americans who currently lack coverage and improve benefits for all Americans by eliminating co-pays and deductibles and restoring free choice of physician. The most fiscally conservative option for reform, single payer slashes private insurance overhead and bureaucracy in medical settings, saving over $400 billion annually that can be redirected into clinical care.
Highlights of the bill include the following:
* Patients go to any doctor or hospital of their choice.
* The program is paid for by combining current sources of government health spending into a single fund with modest new taxes amounting to less than what people now pay for insurance premiums and out-of-pocket expenses.
* Comprehensive benefits, including coverage for dental, mental health, and prescription drugs.
* While federally funded, the program is to be administered by the states.
* By eliminating the high overhead and profits of the private, investor-owned insurance industry, along with the burdensome paperwork imposed on physicians, hospitals and other providers, the plan saves at least $400 billion annually - enough money to provide comprehensive, quality care to all.
* Community health centers are fully funded, giving the 60 million Americans now living in rural and underserved areas access to care.
* To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.
Sanders, who serves on the Senate Committee on Health, Education, Labor, and Pensions, is a longtime advocate of fundamental health care reform. His new bill draws heavily upon the single-payer legislation introduced by the late Sen. Paul Wellstone (D-Minn.) in 1993, S. 491, and closely parallels similar legislation pending before the House, H.R. 1200, introduced by Rep. Jim McDermott (D-Wash.).
Click the Link in the Title to access a PDF of the Bill or use the URL below in your browser >>
S.703 - American Health Security Act of 2009 - full text:
http://pnhp.org/PDF_files/American-Health-Security-Act-single-payer.pdf
Monday, March 23, 2009
CHILDREN’S HEALTH INSURANCE PROGRAM of 2009
On January 29th, the U.S. Senate approved the Children’s Health Insurance Program Reauthorization Act of 2009, better known as the State Children's Health Insurance Program or SCHIP. Once signed into law, this legislation will continue coverage for six to seven million children and increase that coverage to four million more.
CHILDREN'S HEALTH INSURANCE PROGRAM 2009 PDF file
CHILDREN'S HEALTH INSURANCE PROGRAM 2009 PDF file
Lying with Dogs
Comment: The Blue Dog coalition in the House of Representatives has often assisted Republicans in preventing the advancement or even the introduction of progressive legislation that increases government spending. Supposedly their mission is merely to avoid deficit spending by enforcing "paygo" rules (all new spending is offset with other program cuts or with new revenues), but all too often they seem to not only support elimination of deficit spending, but also the policy of "no new taxes." It appears that they are not only concerned about deficits, but they also seem to want to avoid an increase in the size of the federal budget.
Now Sen. Evan Bayh and fifteen of his colleagues have decided to establish a Blue Dog-type coalition in the Senate. In an obvious effort to wield more power from the middle, they "are joined by a shared commitment to pursue pragmatic, fiscally sustainable policies across a range of issues, such as... health care reform..." Ouch!
Although most observers of the Washington political scene believe that the make or break on comprehensive health care reform will occur in the Senate, there are enough Blue Dogs in the House to not be discounted as major players since they could side with the Republicans if new taxes are used to comply with paygo.
But look at what has happened in the Senate. The moderate Democrats are no longer passive observers (not that they ever really were). Now with their newfound power, the battle for cloture has shifted. Instead of Democrats simply requiring one or two Republican votes to invoke cloture, they must also meet the demands of these sixteen Senate Blue Dog look-alikes. The Republicans now not only have one vote to spare on preventing cloture, they also have a very large buffer in the Democratic Party to prevent comprehensive tax-and-spend health care reform.
There goes any adequate government option to the private plans - "because of adverse selection, we can't pay for it." There goes adequate subsidies for private plans for average-income Americans - "without new taxes, we can't pay for it." There goes adequate regulatory oversight for the private plans - "unless we have high deductibles and stripped down benefits, the people can't pay for the plans."
Single payer would provide the Blue Dogs with the reform they want, or should want. Health care budgets would be balanced without increasing spending over our current level. They just have to understand that funneling health care dollars through our tax system is more efficient than turning them over to private insurers. They need to look at all dollars going into health care, and not just the public dollars.
Quote-of-the-day@mccanne.org
Now Sen. Evan Bayh and fifteen of his colleagues have decided to establish a Blue Dog-type coalition in the Senate. In an obvious effort to wield more power from the middle, they "are joined by a shared commitment to pursue pragmatic, fiscally sustainable policies across a range of issues, such as... health care reform..." Ouch!
Although most observers of the Washington political scene believe that the make or break on comprehensive health care reform will occur in the Senate, there are enough Blue Dogs in the House to not be discounted as major players since they could side with the Republicans if new taxes are used to comply with paygo.
But look at what has happened in the Senate. The moderate Democrats are no longer passive observers (not that they ever really were). Now with their newfound power, the battle for cloture has shifted. Instead of Democrats simply requiring one or two Republican votes to invoke cloture, they must also meet the demands of these sixteen Senate Blue Dog look-alikes. The Republicans now not only have one vote to spare on preventing cloture, they also have a very large buffer in the Democratic Party to prevent comprehensive tax-and-spend health care reform.
There goes any adequate government option to the private plans - "because of adverse selection, we can't pay for it." There goes adequate subsidies for private plans for average-income Americans - "without new taxes, we can't pay for it." There goes adequate regulatory oversight for the private plans - "unless we have high deductibles and stripped down benefits, the people can't pay for the plans."
Single payer would provide the Blue Dogs with the reform they want, or should want. Health care budgets would be balanced without increasing spending over our current level. They just have to understand that funneling health care dollars through our tax system is more efficient than turning them over to private insurers. They need to look at all dollars going into health care, and not just the public dollars.
Quote-of-the-day@mccanne.org
Sunday, September 07, 2008
Insurance Claims-GOP candidate misrepresents Dem Plan
i just want to put out a correction to the typical GOP misrepresentations about this specific plank of the Democratic Platform. We've lived the GOP plan, and the results of that plan put into action for the last 8 years are Distastrous. Do they really expect that we will give them ANOTHER FOUR years?? I wont, and i hope you wont either.
McCain claimed that Obama's health care plan would "force small businesses to cut jobs" and would put "a bureaucrat ... between you and your doctor." In fact, the plan exempts small businesses, and those who have insurance now could keep the coverage they have.
The claim that "small businesses" would have to "cut jobs, reduce wages," runs counter to Obama's actual proposal. Obama's plan would require businesses to contribute to the cost of insurance for employees or pay some unspecified amount into a new public plan. But his proposal specifically says, "Small businesses will be exempt from this requirement." And it offers additional help to small businesses that want to provide health care in the form of a refundable tax credit of up to half the cost of premiums.
Furthermore, Obama's plan wouldn't "force" families into a "government-run health care system." His plan mandates that children have coverage; there's no mandate for adults.
People can keep the health insurance they have now or chose from private plans, or opt for a new public plan that will offer coverage similar to what members of Congress have. Obama would also expand Medicaid and the State Children's Health Insurance Program. His plan certainly expands government-offered insurance – and McCain's doesn't – but it's not a solely government-run plan
McCain claimed that Obama's health care plan would "force small businesses to cut jobs" and would put "a bureaucrat ... between you and your doctor." In fact, the plan exempts small businesses, and those who have insurance now could keep the coverage they have.
The claim that "small businesses" would have to "cut jobs, reduce wages," runs counter to Obama's actual proposal. Obama's plan would require businesses to contribute to the cost of insurance for employees or pay some unspecified amount into a new public plan. But his proposal specifically says, "Small businesses will be exempt from this requirement." And it offers additional help to small businesses that want to provide health care in the form of a refundable tax credit of up to half the cost of premiums.
Furthermore, Obama's plan wouldn't "force" families into a "government-run health care system." His plan mandates that children have coverage; there's no mandate for adults.
People can keep the health insurance they have now or chose from private plans, or opt for a new public plan that will offer coverage similar to what members of Congress have. Obama would also expand Medicaid and the State Children's Health Insurance Program. His plan certainly expands government-offered insurance – and McCain's doesn't – but it's not a solely government-run plan
Friday, August 01, 2008
Physicians for a National Health Program
July 9, 2008
Press Release
Pro-single-payer Doctors' Group Announces New Blog
Physicians for a National Health Program (PNHP) today launched a new blog that looks at the politics of health care reform, the obstacles to care created by the for-profit, private health insurance industry, and the urgency of the U.S. adopting a Medicare-like, single-payer national health insurance program.
Dr. Quentin Young, the group's national coordinator, said: "Our failing health care system weighs heavily on the minds of doctors and patients alike. In this election year, our members felt we needed to enhance the timeliness of informed commentary on the worsening crisis and on the only effective remedy – a single-payer plan, which would guarantee comprehensive, quality care for all."
Since its founding in 1987, PNHP members have produced numerous groundbreaking, peer-reviewed articles on health policy, including studies that show 31 percent of every U.S. health care dollar goes to administrative overhead, higher than anywhere else in the world, and that half of all personal bankruptcies are caused by medical bills.
Initial contributors to the blog include Dr. John Geyman, author of the new book "Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It," writing on some of the substandard insurance products being marketed to healthier people in the individual insurance market, products that have very high deductibles or benefit caps as low as $1,000 a year.
Dr. Suzanne King writes about how Blue Cross and Blue Shield of California has decided to charge women more for health insurance than their male counterparts, reflecting the pervasive discrimination in the private health insurance industry against women because, among other things, "they are the ones who get pregnant, have babies, and use obstetrical services."
Dr. SteveB, a health policy blogger at DailyKos.com, offers "Four Questions to Ask When Analyzing Any Health 'Reform' Proposal." Dr. SteveB will be regularly tracking support for the U.S. National Health Insurance Act, H.R. 676, a single-payer bill sponsored by Rep. John Conyers of Michigan and 90 others.
Dr. David Himmelstein, a PNHP co-founder, and Dr. Don McCanne, PNHP's senior policy fellow, offer their respective assessments of Health Care for America Now, a new coalition launched this week, which, in the words of Himmelstein, pushes "a superficially attractive health reform model that has a long record of failure." He said that, despite good intentions, the HCAN proposal is "akin to prescribing a placebo for a serious illness when effective treatment is available," that treatment being single payer.
Another blogger is Dr. Andy Coates of upstate New York, who will be writing on support for single payer in the labor movement and in The Empire State; and Dr. Mary O'Brien of New York City on physician support for single-payer national health insurance. A survey published in April showed 59 percent of U.S. physicians now support national health insurance, a jump of 10 percent from five years ago.
Dr. Young said, "Our aim is to provide a lively but well-grounded source of news and commentary on the hot topics of the day, trying to cut through some of the fog and myths that often accompany discussions of health care reform. We hope our readers will join in the dialogue."
Physicians for a National Health Program (www.pnhp.org), a membership organization of over 15,000 physicians, supports a single-payer national health insurance program. PNHP is headquartered in Chicago and has chapters across the United States. To contact a physician-spokesperson in your area, contact info@pnhp.org or call (312) 782-6006.
PNHP:
PNHP's Blog:
http://www.pnhp.org/blog/
Comment: It's your turn to contribute to the national dialogue on health care reform. Frequent postings will be made by some of the leaders in the movement for a single payer national health program. Your responses are not only invited, they are encouraged.
Press Release
Pro-single-payer Doctors' Group Announces New Blog
Physicians for a National Health Program (PNHP) today launched a new blog that looks at the politics of health care reform, the obstacles to care created by the for-profit, private health insurance industry, and the urgency of the U.S. adopting a Medicare-like, single-payer national health insurance program.
Dr. Quentin Young, the group's national coordinator, said: "Our failing health care system weighs heavily on the minds of doctors and patients alike. In this election year, our members felt we needed to enhance the timeliness of informed commentary on the worsening crisis and on the only effective remedy – a single-payer plan, which would guarantee comprehensive, quality care for all."
Since its founding in 1987, PNHP members have produced numerous groundbreaking, peer-reviewed articles on health policy, including studies that show 31 percent of every U.S. health care dollar goes to administrative overhead, higher than anywhere else in the world, and that half of all personal bankruptcies are caused by medical bills.
Initial contributors to the blog include Dr. John Geyman, author of the new book "Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It," writing on some of the substandard insurance products being marketed to healthier people in the individual insurance market, products that have very high deductibles or benefit caps as low as $1,000 a year.
Dr. Suzanne King writes about how Blue Cross and Blue Shield of California has decided to charge women more for health insurance than their male counterparts, reflecting the pervasive discrimination in the private health insurance industry against women because, among other things, "they are the ones who get pregnant, have babies, and use obstetrical services."
Dr. SteveB, a health policy blogger at DailyKos.com, offers "Four Questions to Ask When Analyzing Any Health 'Reform' Proposal." Dr. SteveB will be regularly tracking support for the U.S. National Health Insurance Act, H.R. 676, a single-payer bill sponsored by Rep. John Conyers of Michigan and 90 others.
Dr. David Himmelstein, a PNHP co-founder, and Dr. Don McCanne, PNHP's senior policy fellow, offer their respective assessments of Health Care for America Now, a new coalition launched this week, which, in the words of Himmelstein, pushes "a superficially attractive health reform model that has a long record of failure." He said that, despite good intentions, the HCAN proposal is "akin to prescribing a placebo for a serious illness when effective treatment is available," that treatment being single payer.
Another blogger is Dr. Andy Coates of upstate New York, who will be writing on support for single payer in the labor movement and in The Empire State; and Dr. Mary O'Brien of New York City on physician support for single-payer national health insurance. A survey published in April showed 59 percent of U.S. physicians now support national health insurance, a jump of 10 percent from five years ago.
Dr. Young said, "Our aim is to provide a lively but well-grounded source of news and commentary on the hot topics of the day, trying to cut through some of the fog and myths that often accompany discussions of health care reform. We hope our readers will join in the dialogue."
Physicians for a National Health Program (www.pnhp.org), a membership organization of over 15,000 physicians, supports a single-payer national health insurance program. PNHP is headquartered in Chicago and has chapters across the United States. To contact a physician-spokesperson in your area, contact info@pnhp.org or call (312) 782-6006.
PNHP:
PNHP's Blog:
http://www.pnhp.org/blog/
Comment: It's your turn to contribute to the national dialogue on health care reform. Frequent postings will be made by some of the leaders in the movement for a single payer national health program. Your responses are not only invited, they are encouraged.
Saturday, October 06, 2007
Bush Vetoes CHIP
From FamiliesUSA.org
As he had been promising to do since early this summer, President Bush vetoed the bipartisan compromise bill that would have reauthorized CHIP. Now it's up to the House to muster the votes needed (268) to override his harmful decision. This vote could take place any time in the next few weeks.
This bill represents a historic, bipartisan compromise to reach out to the growing number of low-income, uninsured children in this country and ensure that they get access to the healthy start they deserve. The compromise bill is substantively similar to the bill the Senate passed last month with a broad, veto-proof majority.
Adds $35 billion to the program over the next five years to cover approximately 10 million children: 6.6 million children who are currently enrolled and 4 million children who will be uninsured without this bill. The majority of the new children the bill will cover are eligible for coverage today; the bill does not dramatically expand coverage.
Better allocates funding to states to cover uninsured children and helps avoid funding shortfalls that prevent children from receiving coverage.
Gives states new tools to conduct outreach to enroll eligible uninsured children.
Strengthens the CHIP benefit package by guaranteeing dental health and mental health benefits.
For more highlights of the compromise bill and how it compares to the original Senate and House bills, see Families USA's new side-by-side.
(click link in title to find out more,or to contact your representatives)
CHIPS is an insurance that has discount premiums which are paid by the insured, it is not free like Medicaid, it is a program for the working class who cannot afford, or are not offered insurance through their job, yet they do not qualify for Medicaid, because they work. Important in this debate are the arbitrary,contentious and archaic Federal Poverty Income Guidelines---rw
As he had been promising to do since early this summer, President Bush vetoed the bipartisan compromise bill that would have reauthorized CHIP. Now it's up to the House to muster the votes needed (268) to override his harmful decision. This vote could take place any time in the next few weeks.
This bill represents a historic, bipartisan compromise to reach out to the growing number of low-income, uninsured children in this country and ensure that they get access to the healthy start they deserve. The compromise bill is substantively similar to the bill the Senate passed last month with a broad, veto-proof majority.
Adds $35 billion to the program over the next five years to cover approximately 10 million children: 6.6 million children who are currently enrolled and 4 million children who will be uninsured without this bill. The majority of the new children the bill will cover are eligible for coverage today; the bill does not dramatically expand coverage.
Better allocates funding to states to cover uninsured children and helps avoid funding shortfalls that prevent children from receiving coverage.
Gives states new tools to conduct outreach to enroll eligible uninsured children.
Strengthens the CHIP benefit package by guaranteeing dental health and mental health benefits.
For more highlights of the compromise bill and how it compares to the original Senate and House bills, see Families USA's new side-by-side.
(click link in title to find out more,or to contact your representatives)
CHIPS is an insurance that has discount premiums which are paid by the insured, it is not free like Medicaid, it is a program for the working class who cannot afford, or are not offered insurance through their job, yet they do not qualify for Medicaid, because they work. Important in this debate are the arbitrary,contentious and archaic Federal Poverty Income Guidelines---rw
Monday, September 17, 2007
Democratic Presidential Candidates & Their Healthcare Reform Plans
I thought it might be a good idea to post some of the Healthcare reform plans supported and put forward by some of the candidates. For now I've got three, I'll post a teaser and then a link to the specific candidate's website, where their respective platforms and more details on their healthcare plans can be found.
I think it's important to remember that incremental steps to improving healthcare access in America are important. I dont believe there could be an overnight reconfiguration of our system that would not have it's own set of pitfalls.
So, that said, no plan we see here presented by likely candidates, will be perfect, but any one of them is an improvement and the beginning of the journey to a better, more efficient system.
Hillary Clinton:
It puts the consumer in the driver's seat by offering more choices and lowering costs. If you're one of the tens of million Americans without coverage or if you don't like the coverage you have, you will have a choice of plans to pick from and that coverage will be affordable. Of course, if you like the plan you have, you can keep it.
Affordable: ... the plan provides tax credits for working families to help them cover their costs...
Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition.
Reliable: It's portable. If you change or lose your job, you keep your health care.
If you have a plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose from dozens of the same plans available to members of Congress, or you can opt into a public plan option like Medicare. And working families will get tax credits to help pay their premiums.
Small businesses are the engine of new job growth in the U.S. economy but face bigger challenges when it comes to providing health care for their employees. Hillary would give tax credits to small businesses ...
Insurance companies won't be able to deny you coverage or drop you...
Barak Obama
Obama’s plan will provide affordable, comprehensive and portable health coverage for all Americans by:
• ...national health program that will allow individuals and small businesses to buy affordable health care similar to that available to federal employees.
• Making available a National Health Insurance Exchange to reform the private insurance market.
• Ensuring all of the 9 million currently uninsured children have affordable,
high-quality health coverage
• Expanding Medicaid and SCHIP and ensuring they continue to serve their critical safety net function.
• Requiring employers to make a meaningful contribution to the health coverage of their employees.
Obama’s plan will reduce costs and save a typical American family up to $2,500 each year by:
• Driving adoption of state-of-the-art health information technology systems
Improving access to preventive care and chronic disease management programs
• Requiring hospitals to collect and report health care cost and quality data
• Reforming our market structure to increase competition in the insurance and drug markets
• Reducing the costs of catastrophic illnesses for employers and their employees
• Lowering drug costs by allowing importation of safe medicines from other developed countries and increasing use of generics in public programs
John Edwards:
Under the Edwards Plan:
Families without insurance will get coverage at an affordable price.
Families with insurance will pay less and get more security and choices.
Businesses and other employers will find it cheaper and easier to insure their workers.
The Edwards Plan achieves universal coverage by:
Requiring businesses and other employers to either cover their employees or help finance their health insurance.
Making insurance affordable ...
Creating regional "Health Care Markets" to let every American share the bargaining power...
I think it's important to remember that incremental steps to improving healthcare access in America are important. I dont believe there could be an overnight reconfiguration of our system that would not have it's own set of pitfalls.
So, that said, no plan we see here presented by likely candidates, will be perfect, but any one of them is an improvement and the beginning of the journey to a better, more efficient system.
Hillary Clinton:
It puts the consumer in the driver's seat by offering more choices and lowering costs. If you're one of the tens of million Americans without coverage or if you don't like the coverage you have, you will have a choice of plans to pick from and that coverage will be affordable. Of course, if you like the plan you have, you can keep it.
Affordable: ... the plan provides tax credits for working families to help them cover their costs...
Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition.
Reliable: It's portable. If you change or lose your job, you keep your health care.
If you have a plan you like, you keep it. If you want to change plans or aren't currently covered, you can choose from dozens of the same plans available to members of Congress, or you can opt into a public plan option like Medicare. And working families will get tax credits to help pay their premiums.
Small businesses are the engine of new job growth in the U.S. economy but face bigger challenges when it comes to providing health care for their employees. Hillary would give tax credits to small businesses ...
Insurance companies won't be able to deny you coverage or drop you...
Barak Obama
Obama’s plan will provide affordable, comprehensive and portable health coverage for all Americans by:
• ...national health program that will allow individuals and small businesses to buy affordable health care similar to that available to federal employees.
• Making available a National Health Insurance Exchange to reform the private insurance market.
• Ensuring all of the 9 million currently uninsured children have affordable,
high-quality health coverage
• Expanding Medicaid and SCHIP and ensuring they continue to serve their critical safety net function.
• Requiring employers to make a meaningful contribution to the health coverage of their employees.
Obama’s plan will reduce costs and save a typical American family up to $2,500 each year by:
• Driving adoption of state-of-the-art health information technology systems
Improving access to preventive care and chronic disease management programs
• Requiring hospitals to collect and report health care cost and quality data
• Reforming our market structure to increase competition in the insurance and drug markets
• Reducing the costs of catastrophic illnesses for employers and their employees
• Lowering drug costs by allowing importation of safe medicines from other developed countries and increasing use of generics in public programs
John Edwards:
Under the Edwards Plan:
Families without insurance will get coverage at an affordable price.
Families with insurance will pay less and get more security and choices.
Businesses and other employers will find it cheaper and easier to insure their workers.
The Edwards Plan achieves universal coverage by:
Requiring businesses and other employers to either cover their employees or help finance their health insurance.
Making insurance affordable ...
Creating regional "Health Care Markets" to let every American share the bargaining power...
Tuesday, September 11, 2007
Recap and Analysis of Legislative Floor Debates on California Health Care
California Progress Report
September 11, 2007
Recap and Analysis of Yesterday's Legislative Floor Debates on
California Health Care
By Hanh Kim Quach, Health Care Policy Coordinator, Health Access
California
The California Senate and Assembly passed historic health care reform
legislation Monday... AB 8 (Nunez/Perata).
Yet even before the debate on AB 8 (Nunez/Perata) was finished in the
Assembly, Gov. Arnold Schwarzenegger announced -- though not
unexpectedly -- that he would veto the bill and call the Legislature
back to work in a "special session" to "keep working until we achieve
the kind of historic solution that all of us and the people of
California want."
Sen. Sam Aanestad and other Republican legislators attempted to
disparage AB 8 by comparing it with the Massachusetts plan, pointing
out that Governor Romney in "running from it." While AB 8 certainly
shares certain features with the Massachusetts plan, one missing
provision is glaringly obvious: the absence of any mandate to buy
coverage in the individual market. Even for group coverage, AB 8 does
not require anyone to have coverage if they can't afford it.
Affordability is explicitly defined in the bill – unlike in
Massachusetts. No worker would have to take up coverage if their
health care costs – premiums and out-of-pocket costs --would exceed 5
percent of a person’s wages.
Many lawmakers, including Assembly Speaker Fabian Nunez, said AB 8
was California's opportunity to provide a model for the federal
government to implement health care reform. "We have a broken health
care system in California and we must do something to fix it now...
This health care package will deliver what the federal government has
failed to do: to provide all Americans with affordable health care
coverage," Nunez said.
As part of a special session, (Sen. Don Perata said), "we would
continue where we left off..."
Click link in Title to article or cut and paste:
http://www.californiaprogressreport.com/2007/09/recap_and_analy.html
September 11, 2007
Recap and Analysis of Yesterday's Legislative Floor Debates on
California Health Care
By Hanh Kim Quach, Health Care Policy Coordinator, Health Access
California
The California Senate and Assembly passed historic health care reform
legislation Monday... AB 8 (Nunez/Perata).
Yet even before the debate on AB 8 (Nunez/Perata) was finished in the
Assembly, Gov. Arnold Schwarzenegger announced -- though not
unexpectedly -- that he would veto the bill and call the Legislature
back to work in a "special session" to "keep working until we achieve
the kind of historic solution that all of us and the people of
California want."
Sen. Sam Aanestad and other Republican legislators attempted to
disparage AB 8 by comparing it with the Massachusetts plan, pointing
out that Governor Romney in "running from it." While AB 8 certainly
shares certain features with the Massachusetts plan, one missing
provision is glaringly obvious: the absence of any mandate to buy
coverage in the individual market. Even for group coverage, AB 8 does
not require anyone to have coverage if they can't afford it.
Affordability is explicitly defined in the bill – unlike in
Massachusetts. No worker would have to take up coverage if their
health care costs – premiums and out-of-pocket costs --would exceed 5
percent of a person’s wages.
Many lawmakers, including Assembly Speaker Fabian Nunez, said AB 8
was California's opportunity to provide a model for the federal
government to implement health care reform. "We have a broken health
care system in California and we must do something to fix it now...
This health care package will deliver what the federal government has
failed to do: to provide all Americans with affordable health care
coverage," Nunez said.
As part of a special session, (Sen. Don Perata said), "we would
continue where we left off..."
Click link in Title to article or cut and paste:
http://www.californiaprogressreport.com/2007/09/recap_and_analy.html
Monday, September 03, 2007
Response to Jonathan Cohn's "case for thinking big" on health care By Don McCanne
Okay. If we're going to get anywhere in our discussion on how to fix
our health care system, we'd better look at some numbers that will
give us a better perspective of the problem.
This year, according to CMS, our projected health care spending is
$2.2 trillion, or $7500 per each individual in the United States.
With a median household income of about $46,000, it is easy to
understand why a family of four would have difficulty paying its
equal (not equitable) share of $30,000. (Before you divert the debate
into the subject of apples and oranges, keep in mind that that the
topic is health care reform, and the numbers are being used to
demonstrate merely the magnitude of the problem.)
When there is general agreement that everyone should be covered,
these numbers lead us to the insurance function of pooling risk - for
all of us. Traditionally, health insurance provided for a transfer
from the many who are healthy to the few with significant health care
needs. Distributing costs evenly over the risk pool worked.
Something happened in the interim. Health care costs skyrocketed, but
we were caught off guard because they were gradually phased in at
high single or low double digit annual rates. But here we are. At
$7500 per person, health care simply costs too much for average
income individuals to pay their equal (again, not equitable) share of
any system of universal coverage. Like it or not, we are now faced
with the need to transfer not only from the healthy to the sick, but
also from the wealthy to average- and lower-income individuals with
health care needs.
Our current fragmented system of multiple private plans and public
programs is not serving us well in this transfer function. Economists
may not have a definition of unaffordability, but polls show that
over 90 percent of us recognize it when we see it in our health care
system.
Actually, we could resolve this problem quite readily by establishing
a single national risk pool and fund it equitably through progressive
tax policies. Not only would that make health care affordable for
each individual, based on ability to pay, it would also establish a
single payer that could use its monopsony powers to slow health care
inflation to a more sustainable rate (which raises other issues that
may be covered this week).
Regarding reform, there are two basic models under consideration.
Either we could establish a single national health insurance program,
or we could build on our current system of private plans and public
programs (with many sub-variations such as employer mandate,
individual mandate, Medicaid and SCHIP welfare programs, or a new
Medicare-as-an-option program available to everyone).
A crucial question is how well would private plans serve us in a
universal system? Well, let's see how they are serving us now. 59
percent of us are insured through our employment, yet employer-
sponsored plans are paying only 19 percent of our health care costs.
Already we have a problem. Private insurers have skimmed off the
healthiest sector of our society - healthy, gainfully employed
individuals and their young, healthy families - and they are
sticking us with the other four-fifths of our nation's health care
bill. The insurers have already defeated the insurance function of
transferring funds from the many who are healthy to the few who have
significant health care needs.
And how efficient are the insurers in performing this transfer
function for their cream-skimmed risk pools of healthy individuals?
In 2005, the six largest private insurers in the nation had an
average medical-loss ratio of about 80 percent. This means that they
used about 20 percent of health insurance premiums for their own
intrinsic purposes - administrative functions and profits. Further,
about 12 percent of premiums were used by physicians and hospitals to
pay for the administrative burden of billing and insurance functions
related to the private plans. So one-third of these private insurance
premiums were burned up in administrative costs. Who says that the
private market is always more efficient than the government?
This leads us to one of the most important questions facing those
concerned about the reform process. When private insurers have
abandoned their crucial function of transferring risk, and they have
demonstrated their profound administrative inefficiencies, why would
any policymaker insist that private insurers must be a part of any
model of reform? The resources we waste on them would be far better
spent on health care for the uninsured and underinsured.
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
our health care system, we'd better look at some numbers that will
give us a better perspective of the problem.
This year, according to CMS, our projected health care spending is
$2.2 trillion, or $7500 per each individual in the United States.
With a median household income of about $46,000, it is easy to
understand why a family of four would have difficulty paying its
equal (not equitable) share of $30,000. (Before you divert the debate
into the subject of apples and oranges, keep in mind that that the
topic is health care reform, and the numbers are being used to
demonstrate merely the magnitude of the problem.)
When there is general agreement that everyone should be covered,
these numbers lead us to the insurance function of pooling risk - for
all of us. Traditionally, health insurance provided for a transfer
from the many who are healthy to the few with significant health care
needs. Distributing costs evenly over the risk pool worked.
Something happened in the interim. Health care costs skyrocketed, but
we were caught off guard because they were gradually phased in at
high single or low double digit annual rates. But here we are. At
$7500 per person, health care simply costs too much for average
income individuals to pay their equal (again, not equitable) share of
any system of universal coverage. Like it or not, we are now faced
with the need to transfer not only from the healthy to the sick, but
also from the wealthy to average- and lower-income individuals with
health care needs.
Our current fragmented system of multiple private plans and public
programs is not serving us well in this transfer function. Economists
may not have a definition of unaffordability, but polls show that
over 90 percent of us recognize it when we see it in our health care
system.
Actually, we could resolve this problem quite readily by establishing
a single national risk pool and fund it equitably through progressive
tax policies. Not only would that make health care affordable for
each individual, based on ability to pay, it would also establish a
single payer that could use its monopsony powers to slow health care
inflation to a more sustainable rate (which raises other issues that
may be covered this week).
Regarding reform, there are two basic models under consideration.
Either we could establish a single national health insurance program,
or we could build on our current system of private plans and public
programs (with many sub-variations such as employer mandate,
individual mandate, Medicaid and SCHIP welfare programs, or a new
Medicare-as-an-option program available to everyone).
A crucial question is how well would private plans serve us in a
universal system? Well, let's see how they are serving us now. 59
percent of us are insured through our employment, yet employer-
sponsored plans are paying only 19 percent of our health care costs.
Already we have a problem. Private insurers have skimmed off the
healthiest sector of our society - healthy, gainfully employed
individuals and their young, healthy families - and they are
sticking us with the other four-fifths of our nation's health care
bill. The insurers have already defeated the insurance function of
transferring funds from the many who are healthy to the few who have
significant health care needs.
And how efficient are the insurers in performing this transfer
function for their cream-skimmed risk pools of healthy individuals?
In 2005, the six largest private insurers in the nation had an
average medical-loss ratio of about 80 percent. This means that they
used about 20 percent of health insurance premiums for their own
intrinsic purposes - administrative functions and profits. Further,
about 12 percent of premiums were used by physicians and hospitals to
pay for the administrative burden of billing and insurance functions
related to the private plans. So one-third of these private insurance
premiums were burned up in administrative costs. Who says that the
private market is always more efficient than the government?
This leads us to one of the most important questions facing those
concerned about the reform process. When private insurers have
abandoned their crucial function of transferring risk, and they have
demonstrated their profound administrative inefficiencies, why would
any policymaker insist that private insurers must be a part of any
model of reform? The resources we waste on them would be far better
spent on health care for the uninsured and underinsured.
Quote-of-the-day mailing list
Quote-of-the-day@mccanne.org
http://two.pairlist.net/mailman/listinfo/quote-of-the-day
Sick: The Untold Story of America's Health Care Crisis
TPMCafe Book Club
Sick: The Untold Story of America's Health Care Crisis---and the
People Who Pay the PriceBy Jonathan Cohn
Health care: The case for thinking big
By Jonathan Cohn
One of the most fascinating products of researching my new book,
Sick, was also one of the most depressing: the realization that we've
been here before.
If you go back to the late 1920s and early 1930s, you'll find a
situation that looks more than vaguely familiar. As medical care was
becoming more expensive, large numbers of people were finding they
literally could not afford to get sick. Many of these people weren't
indigent in the narrow sense of the word. They had homes. They had
jobs. And yet when they got sick, their lives unraveled. Some went
into debt to pay for it. Some rationed their own care. The result was
financial misery, medical hardship, or both.
That situation eventually gave birth to the insurance system we have
today - a system, based primarily upon job-provided private
insurance, that is now faltering as the price of medical care rises.
If you read the eight stories in the book, you'll get a sense not
just of how devastating loss of insurance can be today, but also of
how vulnerable to this problem even the middle class has become -
just like it was nearly a century ago.
It's this increasingly vulnerability that has provoked a new debate
about universal health care - and given would-be reformers some cause
for optimism. But now that this debate is unfolding, it's brought us
to yet another familiar place: The argument about what kind of system
to create.
On one extreme of the progressive political spectrum you have...
(Click Title Link to the rest of the story)
TPMCafe Book Club features an ongoing discussion on health care reform led off by Jonathan Cohn, timed with release of his new book, "Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price."
The online discussion will feature such notables as Jonathan Cohn,
Jacob Hacker, Ezra Klein, Matthew Holt, Roger Hickey, Diane Archer,
Don McCanne and others (incomplete list). Responses of readers are
welcome.
With the renewed enthusiasm for reform, this discussion is very
timely and should be very informative, if not provocative. You can
follow it at:
http://bookclub.tpmcafe.com/
Sick: The Untold Story of America's Health Care Crisis---and the
People Who Pay the PriceBy Jonathan Cohn
Health care: The case for thinking big
By Jonathan Cohn
One of the most fascinating products of researching my new book,
Sick, was also one of the most depressing: the realization that we've
been here before.
If you go back to the late 1920s and early 1930s, you'll find a
situation that looks more than vaguely familiar. As medical care was
becoming more expensive, large numbers of people were finding they
literally could not afford to get sick. Many of these people weren't
indigent in the narrow sense of the word. They had homes. They had
jobs. And yet when they got sick, their lives unraveled. Some went
into debt to pay for it. Some rationed their own care. The result was
financial misery, medical hardship, or both.
That situation eventually gave birth to the insurance system we have
today - a system, based primarily upon job-provided private
insurance, that is now faltering as the price of medical care rises.
If you read the eight stories in the book, you'll get a sense not
just of how devastating loss of insurance can be today, but also of
how vulnerable to this problem even the middle class has become -
just like it was nearly a century ago.
It's this increasingly vulnerability that has provoked a new debate
about universal health care - and given would-be reformers some cause
for optimism. But now that this debate is unfolding, it's brought us
to yet another familiar place: The argument about what kind of system
to create.
On one extreme of the progressive political spectrum you have...
(Click Title Link to the rest of the story)
TPMCafe Book Club features an ongoing discussion on health care reform led off by Jonathan Cohn, timed with release of his new book, "Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price."
The online discussion will feature such notables as Jonathan Cohn,
Jacob Hacker, Ezra Klein, Matthew Holt, Roger Hickey, Diane Archer,
Don McCanne and others (incomplete list). Responses of readers are
welcome.
With the renewed enthusiasm for reform, this discussion is very
timely and should be very informative, if not provocative. You can
follow it at:
http://bookclub.tpmcafe.com/
Sunday, September 02, 2007
Mirror, Mirror on the Wall
The Commonwealth Fund
May 15, 2007
Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care
By Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report — an update to two earlier editions — includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations — Australia, Canada, Germany, New Zealand, the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill. The findings indicate room for improvement across all of the countries, especially in the U.S. If the health care system is to perform according to patients' expectations, the nation will need to remove financial barriers to care and improve the delivery of care. Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home.
Full report:
http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalupdate_1027.pdf?section=4039
Quote-of-the-day mailing list Quote-of-the-day@mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day
May 15, 2007
Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care
By Karen Davis, Ph.D., Cathy Schoen, M.S., Stephen C. Schoenbaum, M.D., M.P.H., Michelle M. Doty, Ph.D., M.P.H., Alyssa L. Holmgren, M.P.A., Jennifer L. Kriss, and Katherine K. Shea
Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report — an update to two earlier editions — includes data from surveys of patients, as well as information from primary care physicians about their medical practices and views of their countries' health systems. Compared with five other nations — Australia, Canada, Germany, New Zealand, the United Kingdom — the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. The U.S. is the only country in the study without universal health insurance coverage, partly accounting for its poor performance on access, equity, and health outcomes. The inclusion of physician survey data also shows the U.S. lagging in adoption of information technology and use of nurses to improve care coordination for the chronically ill. The findings indicate room for improvement across all of the countries, especially in the U.S. If the health care system is to perform according to patients' expectations, the nation will need to remove financial barriers to care and improve the delivery of care. Disparities in terms of access to services signal the need to expand insurance to cover the uninsured and to ensure that all Americans have an accessible medical home.
Full report:
http://www.commonwealthfund.org/usr_doc/Davis_mirrormirrorinternationalupdate_1027.pdf?section=4039
Quote-of-the-day mailing list Quote-of-the-day@mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day
Monday, July 31, 2006
Illinois' dubious claim of first to cover all kids
State of Illinois
All Kids Illinois' Program to Provide Health Care for All Kids
Governor Rod R. Blagojevich ...more than a quarter of a million children right here in Illinois do not have health insurance. That means they can't see a doctor or get medicine when they need to. When they do get medical care, it's often in the emergency room, after a small problem has grown into a big problem. That's wrong. I believe every child should be able to get medical care when they need it, before it becomes an emergency. That's why I created the All Kids program: to make health care a reality for hundreds of thousands of families across the state. Illinois will be the first state in the nation to provide affordable, comprehensive health insurance for every child. Of the 250,000 children in Illinois without health insurance, more than half come from working and middle class families who earn too much to qualify for state programs like KidCare, but not enough to afford private health insurance. Through All Kids, comprehensive health insurance will be available to every uninsured child at rates their parents can afford...
Comment:
Gov. Blagojevich and the state of Illinois are to be commended for taking this initiative to become "the first state in the nation to provide affordable, comprehensive health insurance for every child." Although our one goal is to enact a single payer national health insurance program covering everyone, as individuals most of us support interim incremental measures that do expand access and coverage.
Dedicated advocates of universal health insurance, such as Sen. Ted Kennedy and Sen. Hillary Clinton, insist that adopting a single program of national health insurance is not politically feasible, so we should abandon that effort and direct our attention to incremental steps that will eventually result in universal coverage. One of the most radical steps that currently has some political traction is to provide universal coverage for all children.
Supporting health care for innocent little children is a political winner, not to mention that it is not much of a budget buster since most children are quite healthy and have only very modest health care needs. Although most incremental measures have been referred to as baby steps, covering all children would be a major giant step, even if incremental. So Illinois is the first state to enact universal coverage for children.
Let's look at some of the specifics.
* Current employer-sponsored and individually purchased insurance programs remain in place. Very low income families may qualify for a rebate if they follow a complex process. Adding administrative complexities to the current excessive administrative burden is flawed policy.
* In the future, individuals who wish to switch their children from private coverage to the All Kids program, primarily because of its premium structure, will have to wait one year without any coverage whatsoever before they can be enrolled (except for very low income families). Mandating a period of uninsurance is flawed policy.
* The program is means tested. Not only are premiums adjusted by income level, but also co-payments are tiered based on income, and even the total out-of-pocket maximum for cumulative co-payments is adjusted. This results in administrative complexities that are compounded by the fact that income levels change, creating instability in the benefit level for which the children qualify. Also, means tested programs are somewhat intrusive and demeaning and NEVER result in 100 percent participation. Means testing for a universal program is flawed policy.
* Failure to pay premiums results in cancellation of coverage. Reinstatement requires retroactive payment of all premiums plus a three month penalty of having no coverage. The majority of uninsured children are in families on tight budgets. Periodic problems paying bills are inevitable. Terminating coverage for personal financial difficulties is flawed policy.
* Under All Kids, physicians and pharmacies may refuse to provide services if co-payments are not paid. Including program requirements that obstruct access to care is flawed policy.
* The cost to the state is to be offset by the dubious savings theoretically attained by shifting state health insurance programs to a managed care system. Failure to establish a permanent, reliable source of funding is flawed policy.
* The application is eight pages and requires submission of various supporting documents. To improve enrollment rates, a large network of Application Agents has been established. Even with this costly administrative program, it is anticipated that only 50,000 of the 250,000 uninsured children will be enrolled this year. A true universal program should automatically enroll everyone. Even though all children uninsured for over a year are qualified for this program, administrative barriers will keep many out. Anything less than automatic enrollment is flawed policy.
* Physicians must contract with the state to provide services under this program. It is clear that many physicians are unwilling to do so, partly because of distrust due to a backlog of claims under the state's Medicaid program (which will be folded into All Kids). Parents may lose the option of taking their children to their current primary care physicians merely because of provider contracting considerations. Establishing restricted primary care provider lists is flawed policy.
* Primary care physicians will serve as the gatekeeper for specialized services. Although the specifics are not yet clear, presumably primary care providers will have to use restricted, in-network provider lists when referring children for specialty care, if such services are even covered. Such restrictions may not allow the primary care physician to use established, coordinated referral patterns, possibly resulting in fragmented, disruptive, and less accessible care. Not including all providers of health care services is flawed policy.
This is that giant incremental step of covering all children that everyone is talking about. It is a truly beneficial program. But it fails to provide universal coverage. It fails to reduce costly administrative excesses but rather adds more to our fragmented system of funding care.
It fails to remove financial barriers to access. It fails to provide free choice of health care providers. Simply stated, it costs more than a single payer system and it fails to establish single payer policies that would ensure accessible, comprehensive health care for everyone.
The next legislator that tells you that single payer should be rejected because it's not politically feasible, tell him or her that the election of obstructionists to health care justice is no longer politically feasible. Then share the word with others and follow through on election day.
DMc-QOTD
All Kids Illinois' Program to Provide Health Care for All Kids
Governor Rod R. Blagojevich ...more than a quarter of a million children right here in Illinois do not have health insurance. That means they can't see a doctor or get medicine when they need to. When they do get medical care, it's often in the emergency room, after a small problem has grown into a big problem. That's wrong. I believe every child should be able to get medical care when they need it, before it becomes an emergency. That's why I created the All Kids program: to make health care a reality for hundreds of thousands of families across the state. Illinois will be the first state in the nation to provide affordable, comprehensive health insurance for every child. Of the 250,000 children in Illinois without health insurance, more than half come from working and middle class families who earn too much to qualify for state programs like KidCare, but not enough to afford private health insurance. Through All Kids, comprehensive health insurance will be available to every uninsured child at rates their parents can afford...
Comment:
Gov. Blagojevich and the state of Illinois are to be commended for taking this initiative to become "the first state in the nation to provide affordable, comprehensive health insurance for every child." Although our one goal is to enact a single payer national health insurance program covering everyone, as individuals most of us support interim incremental measures that do expand access and coverage.
Dedicated advocates of universal health insurance, such as Sen. Ted Kennedy and Sen. Hillary Clinton, insist that adopting a single program of national health insurance is not politically feasible, so we should abandon that effort and direct our attention to incremental steps that will eventually result in universal coverage. One of the most radical steps that currently has some political traction is to provide universal coverage for all children.
Supporting health care for innocent little children is a political winner, not to mention that it is not much of a budget buster since most children are quite healthy and have only very modest health care needs. Although most incremental measures have been referred to as baby steps, covering all children would be a major giant step, even if incremental. So Illinois is the first state to enact universal coverage for children.
Let's look at some of the specifics.
* Current employer-sponsored and individually purchased insurance programs remain in place. Very low income families may qualify for a rebate if they follow a complex process. Adding administrative complexities to the current excessive administrative burden is flawed policy.
* In the future, individuals who wish to switch their children from private coverage to the All Kids program, primarily because of its premium structure, will have to wait one year without any coverage whatsoever before they can be enrolled (except for very low income families). Mandating a period of uninsurance is flawed policy.
* The program is means tested. Not only are premiums adjusted by income level, but also co-payments are tiered based on income, and even the total out-of-pocket maximum for cumulative co-payments is adjusted. This results in administrative complexities that are compounded by the fact that income levels change, creating instability in the benefit level for which the children qualify. Also, means tested programs are somewhat intrusive and demeaning and NEVER result in 100 percent participation. Means testing for a universal program is flawed policy.
* Failure to pay premiums results in cancellation of coverage. Reinstatement requires retroactive payment of all premiums plus a three month penalty of having no coverage. The majority of uninsured children are in families on tight budgets. Periodic problems paying bills are inevitable. Terminating coverage for personal financial difficulties is flawed policy.
* Under All Kids, physicians and pharmacies may refuse to provide services if co-payments are not paid. Including program requirements that obstruct access to care is flawed policy.
* The cost to the state is to be offset by the dubious savings theoretically attained by shifting state health insurance programs to a managed care system. Failure to establish a permanent, reliable source of funding is flawed policy.
* The application is eight pages and requires submission of various supporting documents. To improve enrollment rates, a large network of Application Agents has been established. Even with this costly administrative program, it is anticipated that only 50,000 of the 250,000 uninsured children will be enrolled this year. A true universal program should automatically enroll everyone. Even though all children uninsured for over a year are qualified for this program, administrative barriers will keep many out. Anything less than automatic enrollment is flawed policy.
* Physicians must contract with the state to provide services under this program. It is clear that many physicians are unwilling to do so, partly because of distrust due to a backlog of claims under the state's Medicaid program (which will be folded into All Kids). Parents may lose the option of taking their children to their current primary care physicians merely because of provider contracting considerations. Establishing restricted primary care provider lists is flawed policy.
* Primary care physicians will serve as the gatekeeper for specialized services. Although the specifics are not yet clear, presumably primary care providers will have to use restricted, in-network provider lists when referring children for specialty care, if such services are even covered. Such restrictions may not allow the primary care physician to use established, coordinated referral patterns, possibly resulting in fragmented, disruptive, and less accessible care. Not including all providers of health care services is flawed policy.
This is that giant incremental step of covering all children that everyone is talking about. It is a truly beneficial program. But it fails to provide universal coverage. It fails to reduce costly administrative excesses but rather adds more to our fragmented system of funding care.
It fails to remove financial barriers to access. It fails to provide free choice of health care providers. Simply stated, it costs more than a single payer system and it fails to establish single payer policies that would ensure accessible, comprehensive health care for everyone.
The next legislator that tells you that single payer should be rejected because it's not politically feasible, tell him or her that the election of obstructionists to health care justice is no longer politically feasible. Then share the word with others and follow through on election day.
DMc-QOTD
Thursday, June 22, 2006
HealthCast
Comment: The conservative policy community has long advocated for an end to employer-sponsored coverage. They believe that insurance should be an individual choice while recognizing that government has to play some role in funding care for low-income individuals.What are we hearing from these voices in the progressive community? They agree that the regressive tax policies are highly inequitable and must be changed.
Andrew Stern goes even further and states that the deterioration in employer-sponsored coverage, declining enrollment, and the financial burden placed on employers leaves no real option other than to replace it with a better system.The progressives acknowledge that the policy issues are well understood. In fact, single payer would certainly accomplish our goals (though Furman conjectures on the well-documented and irrefutable efficiency of single payer).
So what do they say? Let's adopt any better system, except single payer.The policy issues are well understood. Simply changing tax policy (Furman) or adopting a universal, multi-payer system (Stern) perpetuate and expand some of the crucial policy flaws that we face today.Single payer won't fix all of the problems in our health care system, but it will fix all of the problems with the financing of health care. And isn't that what the debate is all about?
QOTD 6/22
Click the title link for transcript and video
6/16/2006
Employment-Based Health Insurance: A Prominent Past, But Does It Have A
Future?
Hosts: Brookings Institution and the New America Foundation
Andrew Stern, president, Service Employees International Union:
...this is not a matter of policy. If we could solve this health care system
by policy it would have been solved every single year. There's more good
policy about health care in America than I can imagine. It is the most
studied, researched, you know, we have commissions and committees publicly
and privately all throughout Washington and the United States. It's really
about politics and leadership.
Our choice is we could keep making incremental changes in the health care
system. And I certainly appreciate that everyone would like to build a
better funding stream for the health care system but the truth is we're way
past incremental change. It's not going to work.
...so the fundamental change for me means one, you have to recognize that
employer based health care is ending, it's dying in front of our very eyes. The
charts say it there. It will not rebound, I believe, in the next economic
upturn in America. It was a good friend. It served America well in the 20th
Century. We love it dearly. Employers, to their credit, lived with it for a
long time despite all of the distortions that it created. But it's
collapsing in front of our eyes. It may still be breathing but anybody who
can look into the future says, "This employer based health care system is
over in America."
I'm here to also say I don't think we need to import Canada or any other
system. We're going to build an American system because we're Americans and
we don't like anybody else's system.
I think the single payer issue is kind of a stalking horse for I'm not sure
what, because we're going to have a multi-payer system or some kind of
system, you know, that it's built into the cost of goods in America.
Andrew Stern goes even further and states that the deterioration in employer-sponsored coverage, declining enrollment, and the financial burden placed on employers leaves no real option other than to replace it with a better system.The progressives acknowledge that the policy issues are well understood. In fact, single payer would certainly accomplish our goals (though Furman conjectures on the well-documented and irrefutable efficiency of single payer).
So what do they say? Let's adopt any better system, except single payer.The policy issues are well understood. Simply changing tax policy (Furman) or adopting a universal, multi-payer system (Stern) perpetuate and expand some of the crucial policy flaws that we face today.Single payer won't fix all of the problems in our health care system, but it will fix all of the problems with the financing of health care. And isn't that what the debate is all about?
QOTD 6/22
Click the title link for transcript and video
6/16/2006
Employment-Based Health Insurance: A Prominent Past, But Does It Have A
Future?
Hosts: Brookings Institution and the New America Foundation
Andrew Stern, president, Service Employees International Union:
...this is not a matter of policy. If we could solve this health care system
by policy it would have been solved every single year. There's more good
policy about health care in America than I can imagine. It is the most
studied, researched, you know, we have commissions and committees publicly
and privately all throughout Washington and the United States. It's really
about politics and leadership.
Our choice is we could keep making incremental changes in the health care
system. And I certainly appreciate that everyone would like to build a
better funding stream for the health care system but the truth is we're way
past incremental change. It's not going to work.
...so the fundamental change for me means one, you have to recognize that
employer based health care is ending, it's dying in front of our very eyes. The
charts say it there. It will not rebound, I believe, in the next economic
upturn in America. It was a good friend. It served America well in the 20th
Century. We love it dearly. Employers, to their credit, lived with it for a
long time despite all of the distortions that it created. But it's
collapsing in front of our eyes. It may still be breathing but anybody who
can look into the future says, "This employer based health care system is
over in America."
I'm here to also say I don't think we need to import Canada or any other
system. We're going to build an American system because we're Americans and
we don't like anybody else's system.
I think the single payer issue is kind of a stalking horse for I'm not sure
what, because we're going to have a multi-payer system or some kind of
system, you know, that it's built into the cost of goods in America.
Our Unhealthy Tax Code
Democracy: A Journal of Ideas
Issue #1, Summer 2006
Our Unhealthy Tax Code
By Jason Furman
American health care is beset by a well-known litany of problems.If this were a government-run health care system, the voting public and policymakers would be up in arms. Yet, perhaps because health care is largely perceived as a private-sector concern, there is relative quiet: while voters tell pollsters that it is a top priority, there appears not to be comparable political pressure for serious reform or any fundamental change in the government's involvement, either in the provision or funding of health care.
This is in part because much of the federal government's involvement with the health care system is through the hidden backdoor of the tax code. An important principle for modern progressives is that when the government has to intervene in the marketplace, it should not prop up failure. Yet the federal government is, in fact, deeply involved in perpetuating the current "private" health care system and all its flaws, spending approximately $200 billion annually in subsidizing employer-provided insurance. It is the single biggest subsidy in our tax system, more than twice as costly as the mortgage interest deduction.
The only government programs that cost more are Social Security, national defense, and Medicare.The fact that the tax subsidy, which supports the employer-sponsored system, is better than nothing is a feeble excuse for resisting any changes to the status quo. This massive program of tax breaks is ineffective and regressive, wasting money on those who have health insurance while doing little for those who can barely afford it and nothing at all for those without it.A single-payer national health care system would, by definition, remedy the problem, but it is unlikely to happen any time soon, if ever at all. Beyond the political limitations, it is also an open question whether a single-payer system would be the most efficient way to provide quality health care for all Americans.
In the meantime, reforming health care will come down to a set of incremental changes that build on the current system. But that does not mean that change cannot be ambitious. As Massachusetts has shown, achieving a plan for universal health insurance coverage need not wait for the establishment of single-payer government insurance like Medicare or a national health care system like the United Kingdom's.
Wednesday, June 21, 2006
APA President Advocates for Single-Payer
Psychiatr News June 16, 2006
Volume 41, Number 12, page 1
© 2006
American Psychiatric Association
Association News
APA President Urges Support For Single-Payer Insurance System Catherine F. Brown
Steven Sharfstein, M.D., ends his year as president of APA in the same way that he began it: by urging APA members to become or stay involved in advocating for psychiatric patients.
Steven Sharfstein, M.D., presents his presidential address last month in Toronto. David Hathcox
Psychiatrists need to "tirelessly advocate" for a single-payer, universal health care system so every American has access to care as a right, not a privilege.
That was the message that outgoing APA President Steven Sharfstein, M.D., delivered to those attending the Opening Session of APA's 2006 annual meeting last month in Toronto.
"To advocate and to lead, we must say five simple words about the state of our health care system in the U.S. today: the emperor has no clothes," said Sharfstein, president and CEO of the Sheppard Pratt Health System in Maryland.
Sharfstein reminded his audience that in the speech he had delivered at last year's Opening Session, he challenged fellow APA members to become involved in advocating for patients and the profession of psychiatry at the local, state, and national levels.
His challenge did not end with his presidency, however. "We cannot slow down," he said. "Advocacy is not just calling on others to do what we want; it is a shining light for others to follow." ....
Psychiatrists must be vigilant over other core values of the profession as well, he said. After reading in the New England Journal of Medicine that psychiatrists were participating in the interrogation of detainees at the U.S. Naval Station at Guantanamo Bay, Sharfstein expressed his concern in a letter to the assistant secretary for health in the Department of Defense. That letter led to an invitation to tour Guantanamo with the top health leaders in the military and other leaders of medical and psychological organizations. They were briefed on the involvement of "behavioral science consultation teams" and were told that while stress techniques had been used in the past, current techniques focused on building rapport with detainees because the development of positive relationships was found to be more effective. That wasn't an acceptable alternative for Sharfstein, however.
"It is the thinnest of thin lines that separate such consultation from involvement in facilitating deception and cruel and degrading treatment," he said. The detainees, being held as enemy combatants with no legal rights, live in despair, and multiple suicide attempts and hunger strikes are common. "Our profession is lost if we play any role in inflicting these wounds."
Psychologists have taken a position allowing them to provide consultations in interrogations, Sharfstein noted, "and if you ever wondered what makes us different from psychologists, here it is." Earlier that day, he announced, the Assembly, and then the Board of Trustees, voted in favor of a position statement reconfirming that psychiatrists should not participate in prisoner interrogations .
Two other major events during Sharfstein's presidential year demonstrated the Bush administration's failure to take care of the poor and disadvantaged in this country, he said. The first was Hurricane Katrina late last summer, and the second was the launching of the Medicare Part D prescription drug benefit on January 1.
"To advocate and to lead, we must say five simple words about the state of our health care system in the U.S. today: the emperor has no clothes."
Regarding Katrina, he praised the many APA members who helped traumatized survivors—some of whom were survivors themselves—but expressed outrage over the government's failure to follow through on promises to provide health care and other assistance to them. Many survivors were poor and had lost everything to the violence of the storm and flooding.
Four months later, APA had a front-row seat for the train wreck that occurred when Medicare Part D went into effect. APA and other advocacy groups had warned the government about the serious flaws and limitations of Part D, Sharfstein said, but these warnings went largely unheeded. In particular, APA and its partners were concerned about the 6.5 million patients dually eligible for both Medicaid and Medicare; beginning January 1, their drug coverage was moved from Medicaid to Medicare. Within days of the new year, reports proliferated about patients who could not get the medications they needed for a variety of reasons, from confusion over which plan they had been enrolled in to high copays they could not afford, he noted.
The program's unreasonably complex design and rocky start, said Sharfstein, represented "another abandonment of the most poor and vulnerable of our patients, another shocking insight into the failure to care for the less fortunate."
The federal government needs to address Part D's many inadequacies, but more than modest tinkering is required, said Sharfstein. "The solution is for the federal government to establish a basic drug plan that works for those who fail in the private Part D plans," he advised. "This is a concept so obvious that it is easy to be pessimistic that it will ever be adopted."
The events that Sharfstein weathered this past year underscored the importance of the advocacy mission in which he had challenged his fellow APA members to join him. He left them with this simple but weighty message:
"We must tirelessly advocate for [single-payer universal health reform]. As the health care crisis extends and mushrooms, with more and more Americans without adequate coverage, the opportunity for such change will come at national, state, and local levels. And we must be there as advocates for our patients."
Volume 41, Number 12, page 1
© 2006
American Psychiatric Association
Association News
APA President Urges Support For Single-Payer Insurance System Catherine F. Brown
Steven Sharfstein, M.D., ends his year as president of APA in the same way that he began it: by urging APA members to become or stay involved in advocating for psychiatric patients.
Steven Sharfstein, M.D., presents his presidential address last month in Toronto. David Hathcox
Psychiatrists need to "tirelessly advocate" for a single-payer, universal health care system so every American has access to care as a right, not a privilege.
That was the message that outgoing APA President Steven Sharfstein, M.D., delivered to those attending the Opening Session of APA's 2006 annual meeting last month in Toronto.
"To advocate and to lead, we must say five simple words about the state of our health care system in the U.S. today: the emperor has no clothes," said Sharfstein, president and CEO of the Sheppard Pratt Health System in Maryland.
Sharfstein reminded his audience that in the speech he had delivered at last year's Opening Session, he challenged fellow APA members to become involved in advocating for patients and the profession of psychiatry at the local, state, and national levels.
His challenge did not end with his presidency, however. "We cannot slow down," he said. "Advocacy is not just calling on others to do what we want; it is a shining light for others to follow." ....
Psychiatrists must be vigilant over other core values of the profession as well, he said. After reading in the New England Journal of Medicine that psychiatrists were participating in the interrogation of detainees at the U.S. Naval Station at Guantanamo Bay, Sharfstein expressed his concern in a letter to the assistant secretary for health in the Department of Defense. That letter led to an invitation to tour Guantanamo with the top health leaders in the military and other leaders of medical and psychological organizations. They were briefed on the involvement of "behavioral science consultation teams" and were told that while stress techniques had been used in the past, current techniques focused on building rapport with detainees because the development of positive relationships was found to be more effective. That wasn't an acceptable alternative for Sharfstein, however.
"It is the thinnest of thin lines that separate such consultation from involvement in facilitating deception and cruel and degrading treatment," he said. The detainees, being held as enemy combatants with no legal rights, live in despair, and multiple suicide attempts and hunger strikes are common. "Our profession is lost if we play any role in inflicting these wounds."
Psychologists have taken a position allowing them to provide consultations in interrogations, Sharfstein noted, "and if you ever wondered what makes us different from psychologists, here it is." Earlier that day, he announced, the Assembly, and then the Board of Trustees, voted in favor of a position statement reconfirming that psychiatrists should not participate in prisoner interrogations .
Two other major events during Sharfstein's presidential year demonstrated the Bush administration's failure to take care of the poor and disadvantaged in this country, he said. The first was Hurricane Katrina late last summer, and the second was the launching of the Medicare Part D prescription drug benefit on January 1.
"To advocate and to lead, we must say five simple words about the state of our health care system in the U.S. today: the emperor has no clothes."
Regarding Katrina, he praised the many APA members who helped traumatized survivors—some of whom were survivors themselves—but expressed outrage over the government's failure to follow through on promises to provide health care and other assistance to them. Many survivors were poor and had lost everything to the violence of the storm and flooding.
Four months later, APA had a front-row seat for the train wreck that occurred when Medicare Part D went into effect. APA and other advocacy groups had warned the government about the serious flaws and limitations of Part D, Sharfstein said, but these warnings went largely unheeded. In particular, APA and its partners were concerned about the 6.5 million patients dually eligible for both Medicaid and Medicare; beginning January 1, their drug coverage was moved from Medicaid to Medicare. Within days of the new year, reports proliferated about patients who could not get the medications they needed for a variety of reasons, from confusion over which plan they had been enrolled in to high copays they could not afford, he noted.
The program's unreasonably complex design and rocky start, said Sharfstein, represented "another abandonment of the most poor and vulnerable of our patients, another shocking insight into the failure to care for the less fortunate."
The federal government needs to address Part D's many inadequacies, but more than modest tinkering is required, said Sharfstein. "The solution is for the federal government to establish a basic drug plan that works for those who fail in the private Part D plans," he advised. "This is a concept so obvious that it is easy to be pessimistic that it will ever be adopted."
The events that Sharfstein weathered this past year underscored the importance of the advocacy mission in which he had challenged his fellow APA members to join him. He left them with this simple but weighty message:
"We must tirelessly advocate for [single-payer universal health reform]. As the health care crisis extends and mushrooms, with more and more Americans without adequate coverage, the opportunity for such change will come at national, state, and local levels. And we must be there as advocates for our patients."
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