From the Burlington Free Press (Burlington, VT)
Politics and Government
Single-payer health legislation on the move in Vermont
By Nancy Remsen, Free Press Staff Writer • Sunday, March

MONTPELIER — By the end of this week, the House Health Care Committee will vote on a bill that authorizes the building blocks for a future single-payer health care system.

The bill will largely follow the template provided to the Legislature by Gov. Peter Shumlin, who set transformation of health care as a priority for his first term in the state’s top job....

Although Democratic majorities in the Vermont House and Senate are expected to be supportive of the health care bill, it has plenty of opponents inside and outside the Statehouse.

House Republicans, for example, are expected to balk at the provisions that establish Green Mountain Care, the entity that would eventually become a health insurance program for all Vermont residents....

There are lots of reasons why a single-payer health care initiative would be on a fast-track this year.

The obvious political explanation is the election of a governor who made the issue a priority and sympathetic majorities in the House and Senate.
There are the bundles of federal dollars that come with the federal health care reform law — money that ... would make it easier to carry out reforms. For example, the state will be eligible for a 90 percent federal match on money used to upgrade its Medicaid systems....

Read the full article at  sponsorshttp://www.burlingtonfreepress.com/article/20110306/NEWS03/110305007/Single-payer-health-legislation-on-the-move-in-Vermont

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Blue Cross Proposes Yet Another Rate Hike
Victoria Colliver
Thursday, March 3, 2011
San Francisco Chronicle

A  year after Anthem Blue Cross created a public uproar by proposing rate  hikes as high as 39 percent, the health insurer is at it again.

This time a year ago, Anthem, which is based in Woodland Hills (Los  Angeles County), unwittingly helped intensify the debate over national  health legislation by proposing rate hikes as high as 39 percent for its  700,000
individual California policyholders and giving the law's proponents some key talking points. A review commissioned by the state  Department of Insurance
later found mathematical inaccuracies in  Anthem's rate filings, and the insurer
scaled back its increases.

The two insurers are not the only health insurers imposing rate  hikes. Aetna
customer Dean Donovan said he just received a notice that  his rates would go up
11 percent in May, following a 28.5 percent jump  in September. Donovan, of San Carlos, suspects that health insurers are trying to  get their
licks in when they can, before the new health care law fully  takes effect.

Anthem and other health insurers insist runaway medical costs have  forced them
to raise rates. Blue Shield and Anthem both said they lose  money on their
individual policies and that their new rates were  reviewed by an external
actuary and found to comply with the law.

At the request of the state Department of Insurance, four health  insurers,
including Anthem and Blue Shield, agreed recently to delay  planned rate
increases for 60 days to allow the department to conduct a  review of their
proposals. That review has yet to be completed.

A state law that went into effect this year gives the department the  authority
to review, but not approve or deny rate increases. Because  Anthem submitted its
proposal just days before the end of the year, the  department can only make
sure consumers are given proper notice.

Read the full article at:
http://www.sfgate.com/cgi-bin/article.cgi?file=/c/a/2011/03/03/MNFH1I2CU5.DTL

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House Republicans Consider Privatizing Medicare
January 28, 2011 by Healthcare-NOW!   
 
HOUSE REPUBLICANS CONSIDER PRIVATIZING MEDICARE

WASHINGTON

 

Months after they hammered Democrats for cutting Medicare, House Republicans are debating whether to relaunch their quest to privatize the health program for seniors. House Budget Committee Chairman Paul Ryan, R-Wis., is testing support for his idea to replace Medicare with a fixed payment to buy a private medical plan from a menu of coverage options. Party leaders will determine if the so-called voucher plan will be part of the budget Republicans put forward in the spring.

 

But replacing Medicare’s open-ended benefit with a fixed payment would cut projected spending much more deeply. “Anyone who doesn’t think privatization will mean severe cuts to Medicare benefits, I have a bridge I’d like to sell them,” said Sen. Chuck Schumer, D-N.Y. “Privatization will make the cuts previously proposed by either party look tame.”

Under Ryan’s plan, current Medicare recipients would get to stay in the program. People within 10 years of eligibility – ages 55 to 64 – would also go into Medicare. But those now 54 and under would get a fixed payment from the government when they become eligible at age 65. They would be able to use the voucher to buy a Medicare-approved private plan from a menu of coverage levels and options.

Americans are wary of the idea. An Associated Press-GfK poll last year found 51 percent opposed a voucher plan for Medicare, while 35 percent said they supported it. Opposition was strong among seniors and baby boomers. But those born after 1980 favored the approach by 47 percent to 41 percent.

Read the full article at:   http://www.healthcare-now.org/house-republicans-consider-privatizing-medicare/

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Waiting Times for Care? Try Looking at the U.S.
Nurses, Doctors Say It’s Time to Debunk the Myths
Even Aetna Admits U.S. System ‘Is Not Timely’
Medical News,  July 7, 2007

Waiting times in U.S. hospitals and clinics are becoming so lengthy that even one of the nation’s biggest insurers, Aetna, has admitted to its own investors that the U.S. healthcare system is “not timely” and patients diagnosed with cancer wait “over a month” for needed medical care, said two leading organizations of doctors and nurses today.

While the problem has been largely overlooked by the major media, it was quietly exposed by the chief medical officer of Aetna, Inc. late in Aetna’s Investor Conference 2007 in March.

In his talk, Troy Brennan conceded that “the (U.S.) healthcare system is not timely.” He cited “recent statistics from the Institution of Healthcare Improvement… that people are waiting an average of about 70 days to try to see a provider. And in many circumstances people initially diagnosed with cancer are waiting over a month, which is intolerable,” Brennan said.

“There are significant differences between the U.S. and Canada, too,” said ,” said Deborah Burger, RN, president of the 75,000-member CNA/NNOC. “In Canada, no one is denied care because of cost, because their treatment or test was not ‘pre-approved’ or because they have a pre-existing condition.”

Read the full article at:  http://www.medicalnewstoday.com/articles/76295.php

Blue Shield of California today announced a 60-day reprieve for the
unconscionable rate hike of up to 59 percent it intends to foist on individuals and families. The announcement coincided with announced plans by nurses, patients, and consumer advocates who stormed Blue Shield's posh California corporate headquarters in downtown San Francisco. Coincidence? That's what Blue Shield insisted, even though they scurried to get out their press release the same morning they were surrounding their doors with barricades, chains, and security guards to protect their property from families facing bankruptcy with outrageous rate hikes and nurses who care for the collateral damage from insurance abuses. No, it wasn't hard toconnectthe dots here between nurses and patients turning up the heat on Blue Shield's barricaded doorstep the same day it agreed to an  all too brief reprieve in its egregious rate increase.People always ask me, 'Why are the nurses doing this?' My response? The nurses are doing this because they are at ground zero. They see the fall out. One example is the almost surreal rate of claims that the big insurers reject. We presented new data, which the insurers themselves report to the state Department of Managed Care, documenting that insurers denied 26 percent of all claims last year. Since 2002, these seven firms, which account for more than three-fourths of all insurance enrollees in California, have rejected 67.5 million claims. Others joining the protest were representatives of Consumer Watchdog, the Courage Campaign, Healthcare Now, Physicians for a National Health Program, and the San Francisco Labor Council, along with other seniors, community, and healthcare activists.
 
Follow Rose Ann DeMoro on Twitter: www.twitter.com/NationalNurses

Some health insurers raising rates again
Victoria Colliver, Chronicle Staff Writer
Thursday, December 9, 2010

Some health insurers are bumping up rates yet again to reflect changes mandated by the new federal health overhaul law as well as state reforms that will go into effect Jan. 1. Blue Shield of California, for example, has sent letters informing customers with individual policies that their premiums will go up in the low single digits because of the federal law. But Scott Morgan, a Blue Shield customer in San Francisco, says attributing massive raises to health care reform is bogus:  "The federal reform is going to add 3.4 percent. That's fair. But do I believe that means my rates should go up another 30 percent above that?" said Morgan, 52, a self-employed consultant for corporate meetings. "I think what they're doing is they're getting their licks in while they can." Federal regulators have called for state and federal reviews of "unreasonable" rate increases, but have yet to define what such an increase is. "Beyond unaffordable" is how another Blue Shield customer, Terry Seligman, described it.

Read the full article at:

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/12/09/MN8I1GLJ8L.DTL

 Judge's Ruling May Help Single Payer

Dr. Quentin Young, who is the National Coordinator of Physicians for a National Health Program, writes that U.S. District Judge Henry Hudson of Richmond, Va who ruled the individual mandate under the health reform law unconstitutional, may have inadvertently helped the cause of single-payer health care or Medicare for All. Dr. Young writes "Judge Hudson and the American people should be aware that this kind  of problem wouldn't come up under a single-payer national health  insurance plan, an improved Medicare for all. Unlike the administration's law, which requires that people carry or buy health  insurance -- generally from a private health insurance company -- or  face a penalty, a single-payer plan would automatically cover everyone  and be financed by taxes and federal appropriations, much like Medicare  is financed today (but on an stronger foundation)."Medicare has been with us for 45 years, and no judge has ever ruled that unconstitutional.". President Obama could have simply pushed for improved Medicare for All and demanded passage by majority vote in the Senate as stated in this article.  You can read the full article at:

Can't Afford Your Deductible?

Physicians for a National Health Program has published an article describes one of the many problems with the newly enacted Patient Protection and Affordable Care Act. It’s the looming menace of high-deductible health insurance plans.  Another way to state the problem, already seen in Massachusetts, is that more people have insurance, but this is insurance they can't afford to use.

Families will still be exposed to medical costs in the tens of thousands of dollars per year under the new law.  For many, especially those with chronic diseases which need continuing care, this will still cause bankruptcies.  What kind of country would allow its most vulnerable citizens to die or go bankrupt simply because they had the misfortune of getting sick?

http://pnhp.org/news/2010/october/more-evidence-of-the-expanding-menace-of-high-deductible-health-plans

US slips to 49th in life expectancy: study
By Sahil Kapur

Monday, October 18th, 2010

The United States currently ranks 49th in the world in overall life expectancy,  according to a study published in the academic journal Health Affairs, slipping dramatically during the last decade.

"As of September 23, 2010, the United States ranked forty-ninth for both male and female life expectancy combined," concludes the study, conducted by Columbia University health policy professors Peter A. Muennig and Sherry A. Glied, which will appear in the November edition of the influential peer-reviewed journal.

The noteworthy decline is highlighted by the fact that in 1999, the World Health Organization ranked the US as 24th in the world in the same category, life expectancy. The report by Muenning and Glied found the prime culprit of the plunge to be America’s deteriorating health care system, marred by ever-rising costs and growing numbers of uninsured and under-insured individuals.

Noting that the United States spends over twice as much per capita on health care than other industrialized nations, it adds:  "Theobservation that Americans are  spending relatively more on health but living relatively shorter less healthy  lives has led some critics to allege that the US health care system is 'uniquely  inefficient.'"

The findings present a stark contrast to the claim – today an article of faith in the American conservative movement – that the United States has the best health  care system in the world.

The United States, as is widely known, remains the only advanced democracy  without a universal health care program. But sweeping reform legislation enacted by this March, while limited in its capacity for cost controls, offers a significant step towards universality – it is projected by the nonpartisan Congressional Budget Office to insure 94 percent of Americans in ten years, up from 83 percent today.

The authors of the report also posited that high rates of obesity, smoking, homicides and traffic fatalities may have contributed to the decline.

The study was flagged by a Daily Kos blogger and elevated by Glenn Greenwald of Salon. Apart from coverage in some blogs, medical journals, and an article by Reuters, it received scant attention in the mainstream US press.

Source:  http://www.rawstory.com/rs/2010/10/slips-49th-life-expectancy-study/

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Massachusetts doctors snub state’s health reform as model for country, pick single-payer system instead

October 26, 2010 by Healthcare-NOW!  

Source:  http://www.healthcare-now.org/massachusetts-doctors-snub-state’s-health-reform-as-model-for-country-pick-single-payer-system-instead
 
BOSTON – For the first time the Massachusetts Medical Society has asked doctors what they think about health reform in its annual “Physician Workforce Survey” of 1,000 practicing physicians in the state, and the results may strike some as surprising.

A plurality of the physician respondents, 34 percent, picked single-payer health reform as their preferred model of reform, followed by 32 percent who favored a private-public insurance mix with a public option buy-in. Seventeen percent voted for the pre-reform status quo, including the permissibility of insurers offering low-premium, high-deductible health plans.

Remarkably, only 14 percent of Massachusetts doctors would recommend their own state’s model as a model for the nation. A small number of respondents, 3 percent, chose an unspecified “other.”
In other words, the doctors with the most on-the-ground experience with the Massachusetts plan, after which the Obama administration’s new health law is patterned, regard it as one of the least desirable alternatives for financing care.

The findings contrast with an earlier survey of Massachusetts physicians’ opinions on health reform funded by the Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation. That survey, published in the New England Journal of Medicine in October 2009, found that three-fourths of doctors in the state support the Massachusetts reform law. However, the survey did not allow respondents to express their preference for alternative models of health reform.
Dr. Rachel Nardin, chair of neurology at Cambridge Hospital and president of the Massachusetts chapter of Physicians for a National Health Program, said: “Massachusetts physicians realize that the state’s health reform has failed to make health care affordable and accessible, and won’t work for the nation. These findings show the high support for single-payer Medicare for all by physicians on the front lines of reform.”
While many in the country look to Massachusetts as a role model for the country, Dr. Patricia Downs Berger, co-chair of Mass-Care, the single-payer advocacy coalition in Massachusetts, and a member of the Massachusetts Medical Society, notes, “Physicians in Massachusetts, particularly after health reform, know from experience that the current health care system is not sustainable and is not addressing the deep inequalities and high costs faced by patients, and they are calling for a more fundamental change.”
A survey published in the Annals of Internal Medicine in April 2008 showed that 59 percent of U.S. physicians support government action to establish national health insurance, an increase of 10 percentage points over similar findings five years before.
Link to the 2010 Physician Workforce Survey (relevant pages: 86-90):
http://www.massmed.org/AM/Template.cfm?Section=Research_Reports_and_Studies2&TEMPLATE=/CM/HTMLDisplay.cfm&ContentID=36167

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Millions Die Due to Withheld Medical Treatment

Writing in Huffington Post, Dr. Mark Hyman asks:  "Imagine we found the cure for heart disease or diabetes, but as a society chose to withhold that treatment from those who need it most. Would it be ethical to withhold effective treatments when the result is unnecessary suffering and death that costs our health care system hundreds of billions of dollars a year?" He argues that the current health care system is doing exactly that. Citing the Tuskeegee Experiment, where from  1932 to 1972 scientists from the US Public Health Service conducted the Tuskegee syphilis study on 399 impoverished African American sharecroppers from Tuskegee, Alabama without their consent, he argues that "We are in the midst of a similar experiment, but few know about it."  Dr. Hyman's father was denied care for his diabetes that cost less than his failed treatment and would have been covered by single payer. He argues further that "Overwhelming evidence proves that the most effective prevention and treatment for chronic diseases such as heart disease and diabetes is what we eat, how much we exercise, how we handle stress, and our social connections....We're targeting the wrong things--we need to treat the cause, not the effects. High blood pressure, high cholesterol, and high blood sugar are NOT the cause of heart disease or diabetes. The real culprit is what we eat, how much we exercise, stress, and environmental toxins. Our lifestyle and environment influences the fundamental biological mechanisms that lead to disease: Changes in gene expression, which modulate inflammation, oxidative stress, and metabolic dysfunction. Treating risk factors is like blowing away the smoke while the fire rages on. Lifestyle medicine puts out the fire....Unfortunately, insurance doesn't usually pay for it. No one profits from lifestyle medicine, so it is not part of medical education or practice. It should be the foundation of our health care system, but doctors ignore it because doctors do what they get paid to do."  You can read the full article and get linked up to Dr. Hyman's website at http://www.huffingtonpost.com/dr-mark-hyman/millions-die-due-to-withh_b_705114.html

In March, PNHCP issued a statement criticizing the health care bill. They said: "As much as we would like to join the celebration of the House's passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer. Instead of eliminating the root of the problem - the profit-driven, private health insurance industry - this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money." The statement includes evidence that 23 million people will remain uninsured nine years into the program. Other statistics discuss the cost of insurance, the cost to underfunded Medicare, and polls showing that both physicians and voters want a single-payer system." Read the full article on our Resourcespage.

Physicians for a National Health Program has published an article describing the effects of Taiwan's single-payer health care program. Summarizing the results, Dr. Don McCanne, writes: "Taiwan's 1995 introduction of a single payer system of universal National Health Insurance provides us with a natural experiment on the impact of single payer reform on health outcomes. The results are dramatic. The rate in reductions of deaths due to disorders that are amenable to health care were nine times the reductions in deaths from non-amenable causes. Nine times! The United States should be especially interested in these results since, in a study of nineteen industrialized nations, we have the worst rate of amenable mortality (link above). We have over 100,000 excess deaths per year due to disorders amenable to health care." He concludes: "After enacting a single payer system, Taiwan not only greatly reduced amenable mortality, but it was done at a fraction of our spending, with great patient satisfaction, with Taiwan established a system of universal National Health Insurance (NHI) in March, 1995. Today, the NHI covers more than 98% of Taiwan's population and enrollees enjoy almost free access to healthcare with small co-payment by most clinics and hospitals."

Read the full article at PNHP News

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President Lyndon B. Johnson signed Medicare and Medicaid into law on July 30, 1965. To mark Medicare’s anniversary, Senator Bernie Sanders joined House colleagues Dennis Kucinich and John Conyers in a letter supporting the expansion of the quality, affordable comprehensive coverage for all Americans.  They wrote:  “Now that a new health care bill has been signed into law, it has never been more important to have a strong movement behind Medicare for All.” But they warn: “The truth is not enough.[...] Now we must make it so that the truth can no longer be ignored.”

Alex Nussbaum writes for Bloomberg News that a conference in Florida, it was announced that UnitedHealth’s "Golden Rule" subsidiary won’t sell new policies that cover only children, foreclosing an option for parents seeking cheaper care. The company replied to charges saying, “Where we have been writing these policies, we are still writing them.” The law championed by President Barack Obama bans insurers from denying coverage to children based on their health, and the Obama administration is "disappointed that a small number of insurance companies are taking this unwarranted and unnecessary step,” said Jessica Santillo, a spokeswoman for the U.S. Health and Human Services Department. The issue may be a harbinger of 2014, when the health law requires insurers to cover adults regardless of medical condition,

Read the full article at Bloomberg News Source: http://www.bloomberg.com/news/2010-07-23/health-care-law-may-cost-children-as-unitedhealth-ends-kid-only-coverage.html

Grace-Marie Turner, President of the Galen Institute, writes in a Kaiser Health Newsletter: "Former Massachusetts Governor Mitt Romney sold his plan in 2006 with the promise that, 'Every uninsured citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced.' It hasn’t turned out that way.  On average, health insurance now costs $14,723 for a family of four in the state, compared to $13,027 nationally -- nearly 12 percent more." 

Problems cited by Turner include higher costs from providers (in an already high-cost medical environment), people "gaming" the system by jumping in and out, and continued use of emergency rooms for nonemergency treatment (chiefly because of an undersupply of doctors).

She concludes: "Health reform in the Bay State has increased demand without increasing the supply of health care providers, it continues to keep people in the dark about the true cost of health care and health insurance, and has not changed incentives for people to seek more affordable options or for a truly competitive marketplace."

Read the full story at http://www.kaiserhealthnews.org/Columns/2010/July/072210Turner.aspx

League of Women Voters calls for 'Medicare for all'
June 17, 2010

Noting the Obama administration's new health law falls short of providing affordable care to all U.S. residents, the national convention of the League of Women Voters passed a resolution earlier this month calling on the group's board to "advocate strongly" for "an improved Medicare for all." The resolution was introduced at the Atlanta meeting by Karen Green Stone of Bloomington, Ind., who argued that the new law lacks effective cost controls and does nothing to eliminate wasteful paperwork and bureaucracy in the U.S. health system.

Read the full story at http://www.healthcare-now.org/league-of-women-voters-us-endorses-improved-medicare-for-all/

More Americans Delay Health Care:
Cost Concerns Drive Even the Insured To Forgo Treatment
June 28, 2010

Sara Rubenstein writes in the Wall Street Journal that an increasing array of Americans, many with health insurance, are delaying or forgoing medical care because of concern about cost, according to a report from the Center for Studying Health System Change. About 20% of the respondents in a 2007 survey of 18,000 people said that they had put off or gone without needed medical treatment at some point in the year earlier, up from 14% in a 2003 survey. Peter Cunningham, lead author of the report, commented: "As health-care costs increase, more of those costs are shifting to people and families," often in the form of large deductibles or other requirements that patients pay for a significant share of their care out of their own pockets.