By Shailagh Murray
Washington Post Staff Writer
Tuesday, November 18, 2008; A03
Sen. Edward M. Kennedy (D-Mass.), making his second appearance on Capitol Hill since he began treatment for a malignant brain tumor in June, told reporters yesterday that he would advance a bill early next year calling for universal health care.
Some Democrats, including members of President-elect Barack Obama's circle, have begun to view expanded coverage as a longer-term goal.
The brief appearance by Kennedy, who made a surprise return in July to vote on a Medicare bill, represented an opportunity for him to show colleagues that he remains energetic and engaged, and that he intends to reclaim his committee post in January and take charge of the Obama health-care agenda. Some Democrats had speculated that Sen. Hillary Rodham Clinton (D-N.Y.) would attempt to assume the chairmanship of the Senate Health, Education, Labor and Pensions Committee.
Senate Finance Committee Chairman Max Baucus (D-Mont.) rolled out his own health-care bill days after Obama was elected, and Sen. Ron Wyden (D-Ore.) also expects to be a leading participant in the effort to establish universal health care.
Kennedy has a head start on them all. Despite his illness, he directed his staff months ago to begin work on legislation that would vastly expand health coverage, a career-long goal of his.
But as the economy has worsened, attention has shifted to measures aimed at creating jobs and stabilizing the housing market. Obama is particularly eager to advance his alternative energy agenda.
Kennedy acknowledged the competition. "There's some major issues, obviously, the economy and also environmental issues," Kennedy said on his way to a staff meeting, where he was greeted with cheers.
"But the president-elect has indicated that this is going to be a priority, and I certainly hope it will."
View all comments that have been posted about this article.
© 2008 The Washington Post Company
Monday, December 22, 2008
Wednesday, December 3, 2008
STILL NEED SINGLE PAYER HEALTH PLAN
Leaving the bloated insurance industry in place perpetuates the pain and cost of the current health care system.
Massachusetts pays the most in the nation for its health care, and yet it’s plagued by an ongoing crisis of access, affordability, and quality. Although our experiment in health care reform already has deep problems, policy wonks influencing the country’s health care debate tout Massachusetts as the model for universal health care nationwide.
If Massachusetts is a model, it’s a model of what not to do.
When the legislature passed “shared responsibility” legislation two years ago, nearly every suit in the state’s health care industry celebrated. The concept grew from an October 2005 assembly convened by the Blue Cross-Blue Shield Foundation of Massachusetts that made a bald assertion: there was no way to achieve universal coverage in Massachusetts without an “individual mandate,” the enforceable legal requirement that everyone have health insurance.
OFF THE TABLE
The problem was that the assembly was not allowed to consider Canadian-style single-payer health care—which would eliminate private insurance companies—as an option. It was off the table.
So a new bureaucracy was established, the Commonwealth Health Insurance Connector Board, with broad powers to set rates, approve cut-rate private policies, and define affordability.
Subsidies are offered on a sliding scale for those earning up to 300 percent of the federal poverty line (about $63,000 for a family of four). Those earning below the line are covered free.
The tangle of private insurance companies, with their expensive bureaucracies and profits, remains in place.
The only new source of revenue for these subsidies is the $295 per employee fee paid anually by employers of 11 or more workers who fail to show that they are making a “fair and reasonable” contribution to their employees’ coverage.
The tangle of private insurance companies, with their expensive bureaucracies and profits, remains in place.
Given these constraints, how does the system measure up?
Access. The ability to get care has expanded for some, with an increase in Medicaid enrollment for some of the poorest. But this comes at the expense of many, particularly undocumented workers and their families, who in the past had depended on the uncompensated care pool, or free-care pool, through community health centers and safety-net hospitals.
The pressure is now on to deny free care to low-income immigrants who would be eligible for subsidized programs if their papers were in order.
Out of a population of six million, a quarter of a million residents remain uninsured. About 60,000 have been granted waivers as unable to afford even the subsidized plans.
Others fall through the cracks of a complex bureaucracy, and an unknown number simply defy the system and refuse to fill out the additional pages of questions about their insurance status with their state income tax form.
Affordability. For many, paying for health care without the threat of bankruptcy or giving up other necessities of life remains impossible. Governments and many employers are staggering, too.
Rising costs for public employees’ and retirees’ health insurance has led to round after round of service cutbacks, affecting every resident who uses public services. Attempts at cost-shifting have provoked strikes by teachers and turnovers in city halls.
Employers successfully pressure the Connector Board to keep copays and deductibles high in the subsidized health plans. This keeps those covered by commercial plans from switching to the public ones.
But ironically, those high deductibles and copays are not counted when calculating who qualifies for taxpayer subsidies.
A diabetic stay-at-home mom on the subsidized plan, for example, pays $110 a month for insurance. But the array of drugs and procedures she requires and the limits on her coverage leave her with copayments of about $165 a month.
Quality. The new system doesn’t seem to have improved patient outcomes. A recent study showed that 45,000 patients are injured and 2,000 patients die in Massachusetts each year from hospital-acquired infections and accidents. That’s six patients dying each day.
And hospital executives fiercely resist steps to improve quality. In July they blocked a bill—again—to establish minimum nurse-to-patient ratios. Such ratios have made California hospitals much safer.
STILL NEED SINGLE PAYER
In July Massachusetts Senator Ted Kennedy announced a bipartisan initiative to achieve “universal health care” quickly, in the first days of a new administration. And then came Health Care for America Now, a new 80-member coalition that includes the AFL-CIO, SEIU, and AFSCME. HCAN champions a system—similar to Massachusetts’s—that would leave the insurance companies at their troughs.
During the Great Depression, FDR was elected with a mandate for change, but the specifics were vague and the direction of the new administration nebulous. Like today, an upsurge of grassroots action was needed to set a progressive agenda.
It took 3,000 locals, for example, ignoring AFL President Bill Green’s aversion to “the dole,” as he called it, to establish unemployment insurance.
This may well prove to be just as fluid a moment in history. Nothing of consequence—like universal, single-payer health insurance—will succeed without solid grassroots organizing that sets the agenda for the next administration.
Sandy Eaton is Region 5 president of the Massachusetts Nurses Association and vice chair of the Massachusetts Campaign for Single Payer Health Care.
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Massachusetts pays the most in the nation for its health care, and yet it’s plagued by an ongoing crisis of access, affordability, and quality. Although our experiment in health care reform already has deep problems, policy wonks influencing the country’s health care debate tout Massachusetts as the model for universal health care nationwide.
If Massachusetts is a model, it’s a model of what not to do.
When the legislature passed “shared responsibility” legislation two years ago, nearly every suit in the state’s health care industry celebrated. The concept grew from an October 2005 assembly convened by the Blue Cross-Blue Shield Foundation of Massachusetts that made a bald assertion: there was no way to achieve universal coverage in Massachusetts without an “individual mandate,” the enforceable legal requirement that everyone have health insurance.
OFF THE TABLE
The problem was that the assembly was not allowed to consider Canadian-style single-payer health care—which would eliminate private insurance companies—as an option. It was off the table.
So a new bureaucracy was established, the Commonwealth Health Insurance Connector Board, with broad powers to set rates, approve cut-rate private policies, and define affordability.
Subsidies are offered on a sliding scale for those earning up to 300 percent of the federal poverty line (about $63,000 for a family of four). Those earning below the line are covered free.
The tangle of private insurance companies, with their expensive bureaucracies and profits, remains in place.
The only new source of revenue for these subsidies is the $295 per employee fee paid anually by employers of 11 or more workers who fail to show that they are making a “fair and reasonable” contribution to their employees’ coverage.
The tangle of private insurance companies, with their expensive bureaucracies and profits, remains in place.
Given these constraints, how does the system measure up?
Access. The ability to get care has expanded for some, with an increase in Medicaid enrollment for some of the poorest. But this comes at the expense of many, particularly undocumented workers and their families, who in the past had depended on the uncompensated care pool, or free-care pool, through community health centers and safety-net hospitals.
The pressure is now on to deny free care to low-income immigrants who would be eligible for subsidized programs if their papers were in order.
Out of a population of six million, a quarter of a million residents remain uninsured. About 60,000 have been granted waivers as unable to afford even the subsidized plans.
Others fall through the cracks of a complex bureaucracy, and an unknown number simply defy the system and refuse to fill out the additional pages of questions about their insurance status with their state income tax form.
Affordability. For many, paying for health care without the threat of bankruptcy or giving up other necessities of life remains impossible. Governments and many employers are staggering, too.
Rising costs for public employees’ and retirees’ health insurance has led to round after round of service cutbacks, affecting every resident who uses public services. Attempts at cost-shifting have provoked strikes by teachers and turnovers in city halls.
Employers successfully pressure the Connector Board to keep copays and deductibles high in the subsidized health plans. This keeps those covered by commercial plans from switching to the public ones.
But ironically, those high deductibles and copays are not counted when calculating who qualifies for taxpayer subsidies.
A diabetic stay-at-home mom on the subsidized plan, for example, pays $110 a month for insurance. But the array of drugs and procedures she requires and the limits on her coverage leave her with copayments of about $165 a month.
Quality. The new system doesn’t seem to have improved patient outcomes. A recent study showed that 45,000 patients are injured and 2,000 patients die in Massachusetts each year from hospital-acquired infections and accidents. That’s six patients dying each day.
And hospital executives fiercely resist steps to improve quality. In July they blocked a bill—again—to establish minimum nurse-to-patient ratios. Such ratios have made California hospitals much safer.
STILL NEED SINGLE PAYER
In July Massachusetts Senator Ted Kennedy announced a bipartisan initiative to achieve “universal health care” quickly, in the first days of a new administration. And then came Health Care for America Now, a new 80-member coalition that includes the AFL-CIO, SEIU, and AFSCME. HCAN champions a system—similar to Massachusetts’s—that would leave the insurance companies at their troughs.
During the Great Depression, FDR was elected with a mandate for change, but the specifics were vague and the direction of the new administration nebulous. Like today, an upsurge of grassroots action was needed to set a progressive agenda.
It took 3,000 locals, for example, ignoring AFL President Bill Green’s aversion to “the dole,” as he called it, to establish unemployment insurance.
This may well prove to be just as fluid a moment in history. Nothing of consequence—like universal, single-payer health insurance—will succeed without solid grassroots organizing that sets the agenda for the next administration.
Sandy Eaton is Region 5 president of the Massachusetts Nurses Association and vice chair of the Massachusetts Campaign for Single Payer Health Care.
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Saturday, November 15, 2008
Single Payer national Health Care
November 15, 2008
Letter
Health Care for All
To the Editor:
Re “Deported in Coma, Saved Back in U.S.” (“Getting Tough” series, front page, Nov. 9):
Your exposé delineates the cruel results of a health care system primarily governed by market forces.
These tragic stories would be less likely to occur if we had a single-payer national health care system in which hospitals were properly reimbursed and their rules of behavior were transparent to the public.
Tim Lachman
Philadelphia, Nov. 11, 2008
The writer is an assistant professor of neurology at Temple University School of Medicine.
Letter
Health Care for All
To the Editor:
Re “Deported in Coma, Saved Back in U.S.” (“Getting Tough” series, front page, Nov. 9):
Your exposé delineates the cruel results of a health care system primarily governed by market forces.
These tragic stories would be less likely to occur if we had a single-payer national health care system in which hospitals were properly reimbursed and their rules of behavior were transparent to the public.
Tim Lachman
Philadelphia, Nov. 11, 2008
The writer is an assistant professor of neurology at Temple University School of Medicine.
Wednesday, November 12, 2008
US Sen Baucus to unveil Health Policy Vision
US Sen Baucus to Unveil Health-Policy Vision Wednesday
By Patrick Yoest, Of DOW JONES NEWSWIRES
WASHINGTON -(Dow Jones)- A top Senate Democrat will make his pitch on broad- scale health-care overhaul to cover more people without insurance, with a growing consensus emerging that Congress will have to tackle health issues with a single bill.
Senate Finance Chairman Max Baucus, D-Mont., will unveil a package Wednesday that has been billed as his vision for comprehensive health-care change. Baucus, along with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., controls the bulk of Senate jurisdiction over health-care issues.
Kennedy aides have said that he plans to move aggressively on health care in 2009, with the arrival of President-elect Barack Obama providing a boost to Democratic efforts to bring about fundamental change. But Kennedy will need the cooperation of Baucus, who could have a more cautious approach.
"I'm looking for Baucus to establish a strong centrist position that will give Obama real insight into what's happening in the Senate," said Alexander Vachon, a health-policy consultant and a former Finance Committee staffer.
It won't be the first time Baucus has discussed major health-care changes. Last year, he drew up a series o of principles on providing universal coverage, including the idea of "pooling" individuals and small businesses to allow them to get more competitive rates for health insurance.
It appears that the pooling concept will be part of the proposal Baucus offers Wednesday as well.
"Sen. Baucus has long said that he believes that pooling arrangements should be a necessary part of comprehensive heatlh-care reform, and he intends to discuss that in detail that at tomorrow's press conference," said Baucus spokeswoman Carol Guthrie.
The legislative process for incorporating competing policy ideas on health care is an initial hurdle for congressional Democrats, who are keen to avoid President Bill Clinton's failure to enact a health-care overhaul in 1993. Kennedy staffer Michael Myers said Nov. 6 at a Families USA event that a "one- bill strategy" is in the works in the Senate, which would preclude tackling health care changes piecemeal.
"Certainly as politicians, people will want to say 'here was my idea, I was a leader on health care," Myers said, but added that "I think there's a growing recognition that the best way, maybe the only way that this gets done is for Democrats to unite behind a single bill."
It is unclear exactly what a single-bill strategy means. Guthrie said that Baucus is seeking a "consensus product" and has reached out to Sen. Kennedy, but the single-bill concept would have even larger significance if Baucus announces he wants an overarching health package to also include items such as a Medicare reimbursement fix for physicians.
Such an approach could put Baucus into conflict with Rep. Pete Stark, D- Calif., who on Monday said he wants to pass a series of policy initiatives -- including expanding the state children's health-insurance program, chnages in Medicare reimbursements for physicians and health technology legislation -- in advance of a broad health-care measure. Starks chairs the House Ways and Means health subcommittee.
The idea of a comprehensive approach that ties measures to cover more uninsured people to other health-care initiatives has gained the support of some who assert that it will be easier to accomplish a fundamental restructuring of the health-care system.
"You could do all that in a comprehensive package," said Karen Ignagni, president and chief executive of America's Health Insurance Plans, a health insurers' trade group. "To approach this comprehensively actually gives you an opportunity to lay out the issues.
Much depends on Obama, whose transition team is meeting with congressional staff to lay out the groundwork for health overhaul. Stark said that, upon receiving Obama's health policy priorities, he expected the House and Senate to each produce bills that would see a conference to reconcile them -- a process that would require long, difficult negotiations.
"I think we are awaiting the president-elect's program, and when it arrives, we will proceed in regular order," Stark said on Monday.
-By Patrick Yoest, Dow Jones Newswires; 202-862-3554; patrick.yoest@ dowjones.com
Click here to go to Dow Jones NewsPlus
By Patrick Yoest, Of DOW JONES NEWSWIRES
WASHINGTON -(Dow Jones)- A top Senate Democrat will make his pitch on broad- scale health-care overhaul to cover more people without insurance, with a growing consensus emerging that Congress will have to tackle health issues with a single bill.
Senate Finance Chairman Max Baucus, D-Mont., will unveil a package Wednesday that has been billed as his vision for comprehensive health-care change. Baucus, along with Senate Health, Education, Labor and Pensions Chairman Edward Kennedy, D-Mass., controls the bulk of Senate jurisdiction over health-care issues.
Kennedy aides have said that he plans to move aggressively on health care in 2009, with the arrival of President-elect Barack Obama providing a boost to Democratic efforts to bring about fundamental change. But Kennedy will need the cooperation of Baucus, who could have a more cautious approach.
"I'm looking for Baucus to establish a strong centrist position that will give Obama real insight into what's happening in the Senate," said Alexander Vachon, a health-policy consultant and a former Finance Committee staffer.
It won't be the first time Baucus has discussed major health-care changes. Last year, he drew up a series o of principles on providing universal coverage, including the idea of "pooling" individuals and small businesses to allow them to get more competitive rates for health insurance.
It appears that the pooling concept will be part of the proposal Baucus offers Wednesday as well.
"Sen. Baucus has long said that he believes that pooling arrangements should be a necessary part of comprehensive heatlh-care reform, and he intends to discuss that in detail that at tomorrow's press conference," said Baucus spokeswoman Carol Guthrie.
The legislative process for incorporating competing policy ideas on health care is an initial hurdle for congressional Democrats, who are keen to avoid President Bill Clinton's failure to enact a health-care overhaul in 1993. Kennedy staffer Michael Myers said Nov. 6 at a Families USA event that a "one- bill strategy" is in the works in the Senate, which would preclude tackling health care changes piecemeal.
"Certainly as politicians, people will want to say 'here was my idea, I was a leader on health care," Myers said, but added that "I think there's a growing recognition that the best way, maybe the only way that this gets done is for Democrats to unite behind a single bill."
It is unclear exactly what a single-bill strategy means. Guthrie said that Baucus is seeking a "consensus product" and has reached out to Sen. Kennedy, but the single-bill concept would have even larger significance if Baucus announces he wants an overarching health package to also include items such as a Medicare reimbursement fix for physicians.
Such an approach could put Baucus into conflict with Rep. Pete Stark, D- Calif., who on Monday said he wants to pass a series of policy initiatives -- including expanding the state children's health-insurance program, chnages in Medicare reimbursements for physicians and health technology legislation -- in advance of a broad health-care measure. Starks chairs the House Ways and Means health subcommittee.
The idea of a comprehensive approach that ties measures to cover more uninsured people to other health-care initiatives has gained the support of some who assert that it will be easier to accomplish a fundamental restructuring of the health-care system.
"You could do all that in a comprehensive package," said Karen Ignagni, president and chief executive of America's Health Insurance Plans, a health insurers' trade group. "To approach this comprehensively actually gives you an opportunity to lay out the issues.
Much depends on Obama, whose transition team is meeting with congressional staff to lay out the groundwork for health overhaul. Stark said that, upon receiving Obama's health policy priorities, he expected the House and Senate to each produce bills that would see a conference to reconcile them -- a process that would require long, difficult negotiations.
"I think we are awaiting the president-elect's program, and when it arrives, we will proceed in regular order," Stark said on Monday.
-By Patrick Yoest, Dow Jones Newswires; 202-862-3554; patrick.yoest@ dowjones.com
Click here to go to Dow Jones NewsPlus
Thursday, November 6, 2008
IMPROVING HEALTH CARE
November 6, 2008
Letter
Improving Health Care
To the Editor:
Re “Don’t Blame the Uninsured” (editorial, Oct. 30):
I agree with your clarion call to action for universal health coverage. But expanded coverage needs to be coupled with comprehensive change in how health care is provided and how it is reimbursed. Simply insuring the 45 million uninsured under the current system is economically unsustainable and doesn’t cure what really ails the system.
To improve care, reduce the burden of illness and be cost-effective, access to primary care emphasizing prevention, wellness and disease management must be financed adequately, and all health records must be made electronic and universally portable. Our technological infrastructure allows us to withdraw money at any A.T.M. in the world, yet two physicians practicing in the same neighborhood have no way to gain access to or share crucial patient information.
Let’s hope that the next administration will see the wisdom of acting — not just talking — so Americans get the care they deserve, at the right place and time.
Steven M. Safyer
Bronx, Oct. 31, 2008
The writer, a medical doctor, is president and chief executive of Montefiore Medical Center.
Letter
Improving Health Care
To the Editor:
Re “Don’t Blame the Uninsured” (editorial, Oct. 30):
I agree with your clarion call to action for universal health coverage. But expanded coverage needs to be coupled with comprehensive change in how health care is provided and how it is reimbursed. Simply insuring the 45 million uninsured under the current system is economically unsustainable and doesn’t cure what really ails the system.
To improve care, reduce the burden of illness and be cost-effective, access to primary care emphasizing prevention, wellness and disease management must be financed adequately, and all health records must be made electronic and universally portable. Our technological infrastructure allows us to withdraw money at any A.T.M. in the world, yet two physicians practicing in the same neighborhood have no way to gain access to or share crucial patient information.
Let’s hope that the next administration will see the wisdom of acting — not just talking — so Americans get the care they deserve, at the right place and time.
Steven M. Safyer
Bronx, Oct. 31, 2008
The writer, a medical doctor, is president and chief executive of Montefiore Medical Center.
Monday, August 25, 2008
Health Care Reform
Are the democrats likely to pass bold health reforms or are they afraid to rock the private insurance boat? The country has a consensus for expanded health coverage, but experience shows you can't achieve universal coverage at an affordable price unless you throw out the insurance companies overhead and profit. Have the Democrats learned this lesson or is 'universal coverage,' merely a euphemism for the right to purchase private health insurance? Has health reform flatlined
Monday, August 18, 2008
Single Payer Plan
HR 676 now has 77 congressional co-sponsors in addition to John Conyers.
The legislation would cover every person in the United States for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, chiropractic and long term care. HR 676 ends deductibles and co-payments and would save billions of dollars annually by eliminating the high overhead and profits of the private health insurance industry and HMOs
The legislation would cover every person in the United States for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, chiropractic and long term care. HR 676 ends deductibles and co-payments and would save billions of dollars annually by eliminating the high overhead and profits of the private health insurance industry and HMOs
Thursday, August 14, 2008
Single Payer Health Insurance
“Single payer”—the system used in Canada and other countries—gets its name from its most essential feature: One payer, a public agency, replaces the 1,500 insurance companies. It becomes the sole reimburser of clinics and hospitals. That one agency has the authority to set limits on what doctors, hospitals, and drug companies can charge. Patients go to doctors and hospitals of their choosing. The traditional Medicare program is an example of a single-payer system.
Leaving the bloated insurance industry in place perpetuates the pain and cost of the current health care system. Photo: Jim West/jimwestphoto.com.The U.S. spends twice as much per person on health care as other industrialized nations. Single payer is the only system that can achieve universal coverage for the same or less money than the nation spends now.
Replacing all those insurance companies and dozens of government programs with one payer slashes the huge costs incurred by doctors, clinics, and hospitals on billing and arguing with insurance companies about how to treat patients. It wipes out what insurers spend on marketing and excessive salaries, and what they take in profits.
The issue that unions are sidestepping is whether the mere presence of a public program in the jungle of private insurance companies would force private insurers to lower premiums without resorting to delaying or denying care to some.
What is more likely to happen is that the insurance industry would “compete” with the public program by rationing the care received by their sicker enrollees, pushing some to sign up with the public program instead.
For another view of the health care dilemma in this issue of Labor Notes:
Sandy Eaton: In Health Care Reform, Massachusetts Shows How Not To Do It
This would in turn drive the public program’s premiums up and the private premiums down. Eventually the public program would be driven out of the market.
Some liberals say they support single payer but won’t work for it because the insurance industry is too powerful to beat. But Stern bases his trash talk on a more baseless and insidious claim—that average Americans oppose single payer.
He says we embrace a hyper-patriotism that causes us to resist adopting good ideas from other countries—even Canada—and are so satisfied with our current insurance companies that we will fight any attempt to replace them.
Stern’s perception is contradicted by many polls and focus groups. A December 2007 AP poll, for example, found that 65 percent of Americans support “a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.” A poll by ABC News in 2003 found 62 percent in favor.
WHY BACK A BAD PLAN?
Leaving the bloated insurance industry in place perpetuates the pain and cost of the current health care system. Photo: Jim West/jimwestphoto.com.The U.S. spends twice as much per person on health care as other industrialized nations. Single payer is the only system that can achieve universal coverage for the same or less money than the nation spends now.
Replacing all those insurance companies and dozens of government programs with one payer slashes the huge costs incurred by doctors, clinics, and hospitals on billing and arguing with insurance companies about how to treat patients. It wipes out what insurers spend on marketing and excessive salaries, and what they take in profits.
The issue that unions are sidestepping is whether the mere presence of a public program in the jungle of private insurance companies would force private insurers to lower premiums without resorting to delaying or denying care to some.
What is more likely to happen is that the insurance industry would “compete” with the public program by rationing the care received by their sicker enrollees, pushing some to sign up with the public program instead.
For another view of the health care dilemma in this issue of Labor Notes:
Sandy Eaton: In Health Care Reform, Massachusetts Shows How Not To Do It
This would in turn drive the public program’s premiums up and the private premiums down. Eventually the public program would be driven out of the market.
Some liberals say they support single payer but won’t work for it because the insurance industry is too powerful to beat. But Stern bases his trash talk on a more baseless and insidious claim—that average Americans oppose single payer.
He says we embrace a hyper-patriotism that causes us to resist adopting good ideas from other countries—even Canada—and are so satisfied with our current insurance companies that we will fight any attempt to replace them.
Stern’s perception is contradicted by many polls and focus groups. A December 2007 AP poll, for example, found that 65 percent of Americans support “a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.” A poll by ABC News in 2003 found 62 percent in favor.
WHY BACK A BAD PLAN?
Wednesday, August 13, 2008
Massacusetts etc Health Insurance Reform
FOR IMMEDIATE RELEASE Contacts:
Aug. 11, 2008 David Himmelstein, M.D., (518) 794-8109, (617) 312-0970
(cell), Benjamin Day, (617) 777-3422, director@masscare.org , Mark Almberg, (312) 782-6006, mark@pnhp.org
Copy Massachusetts' health reform?
Not so fast, researchers say
Citing the failure of seven state-based health reforms over the past two
decades - initiatives that bear a strong resemblance to the
Massachusetts health reform of 2006 - a group of Massachusetts-based
researchers cautions that early declarations of the latter's success may
be premature.
In an article titled "State Heath Reform Flatlines," published in the
most recent issue of the International Journal of Health Services, three
researchers, two of whom teach at Harvard Medical School, examine the
experiences of earlier reforms in Massachusetts, Oregon, Minnesota,
Tennessee, Vermont, Washington state and Maine. The plans were enacted
from 1988 through 2003.
All seven reforms, which when launched were widely trumpeted by
political leaders and leading newspapers as breakthroughs in providing
universal health care, were based on the expansion of private insurance
coverage, the authors say. But in each case the plan had little impact
on the state's number of uninsured persons and produced no sustained
improvements in delivering care.
Dr. David Himmelstein, a co-author of the study, said the 2006
Massachusetts reform appears poised to follow the pattern of the 1992
Tennessee plan, which featured a large expansion of coverage under a
Medicaid-like program. "In Tennessee, the number of uninsured dipped for
two years, then rose to levels higher than ever," he said. "And the plan
proved to be unaffordable in the long term.
"According to the latest figures on Massachusetts from the National
Health Interview Survey," he continued, "the uninsurance rate has fallen
by only 2 percent, from 7.7 percent to 5.8 percent, since the reform was
passed, while the plan is already $147 million over budget."
Himmelstein, who is an associate professor of medicine at Harvard and a
primary care physician in Cambridge, Mass., said the seven failed plans
incorporated virtually all of the reform elements being advanced today
by leading Democrats, including Sen. Barack Obama. The problem, he said,
is that such reforms leave the private health insurance industry in a
dominant position.
"Politicians like to claim they've passed bold health reforms, but
they're afraid to rock the private insurance boat," he said. "So they
keep pushing gussied-up versions of reforms that have failed time after
time. Our health care system is sick to death, and our politicians keep
prescribing placebos."
The authors note that all of the failed plans included expansions of
Medicaid or similar programs for the poor and near-poor. Three states'
reforms (Massachusetts in 1988, Oregon in 1989-1992 and Washington state
in 1993) included mandates requiring employers to cover their workers,
and the Massachusetts and Washington plans also included an individual
mandate on the self-employed.
The authors analyzed Census Bureau data on uninsurance rates in each of
the seven states. Massachusetts' uninsurance rate rose from 7.2 percent
to 9.7 percent in the three years after the passage of then-governor
Michael Dukakis' universal health care reform in 1988. Uninsurance went
from 14.1 percent to 14.7 percent in the three years after
implementation of Oregon's universal health care reform in 1993. The
percentage of residents lacking coverage in Washington state increased
from 10.7 percent to 11.6 percent in the three years after passage of
its universal health care initiative.
Similar patterns occurred in Vermont and Maine. Tennessee's program
(which included the largest Medicaid expansion) was probably the most
successful, dropping the share of uninsured in the state from 12 percent
to 9 percent in its first year, before a rebound to 14 percent by year
three. (See charts in links below.)
All of the plans eventually "flatlined," or died quiet deaths, the
authors said.
According to Benjamin Day, executive director of Mass-Care, a health
care advocacy coalition based in Boston, "It's easy to build political
consensus for expanded health coverage. But experience shows that you
can't achieve universal coverage at an affordable price unless you throw
out the insurance companies with their massive overhead and profit, and
replace them with a more efficient single-payer national health
insurance program.
"Senator Obama should learn this lesson," Day said. As for Sen. John
McCain's health care proposals, "they are so obviously unworkable that
it's hard to take them seriously."
*******
The text of the study is available in PDF to the press at
www.pnhp.org/states_flatline
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=zNcwNfjJAnJf0TMLo94BkfXmr35TzF3j
Password: *himmelstein*
Additional charts in PowerPoint format are available at
www.pnhp.org/five_states
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=YNqed33VWwZ3%2FwCWnJiiV%2B8pcMbyAF%2B6
"State Health Reform Flatlines," Steffie Woolhandler, MD, MPH; Benjamin
Day; and David U. Himmelstein, MD. International Journal of Health
Services, Vol. 38, No. 3.
Physicians for a National Health Program, a membership organization of
over 15,000 physicians, supports a single-payer national health
insurance program. To contact a physician-spokesperson in your area,
visit www.pnhp.org/stateactions
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=W1SCD%2BJYJOe309bI23pT%2B%2B8pcMbyAF%2B6
or call (312) 782-6006.
*Physicians for a National Health Program*
29 E Madison Suite 602, Chicago, IL 60602
Phone (312) 782-6006 | Fax: (312) 782-6007
www.pnhp.org
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=cGQcvuaDs3pWB3gv9jboUO8pcMbyAF%2B6
| info@pnhp.org mailto:info@pnhp.org
PNHP 2008
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=mgJJAv5YFLJ2XnjhLax%2Fe%2B8pcMbyAF%2B6
--------------------------------------------------------------------------------
Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos.
Aug. 11, 2008 David Himmelstein, M.D., (518) 794-8109, (617) 312-0970
(cell), Benjamin Day, (617) 777-3422, director@masscare.org , Mark Almberg, (312) 782-6006, mark@pnhp.org
Copy Massachusetts' health reform?
Not so fast, researchers say
Citing the failure of seven state-based health reforms over the past two
decades - initiatives that bear a strong resemblance to the
Massachusetts health reform of 2006 - a group of Massachusetts-based
researchers cautions that early declarations of the latter's success may
be premature.
In an article titled "State Heath Reform Flatlines," published in the
most recent issue of the International Journal of Health Services, three
researchers, two of whom teach at Harvard Medical School, examine the
experiences of earlier reforms in Massachusetts, Oregon, Minnesota,
Tennessee, Vermont, Washington state and Maine. The plans were enacted
from 1988 through 2003.
All seven reforms, which when launched were widely trumpeted by
political leaders and leading newspapers as breakthroughs in providing
universal health care, were based on the expansion of private insurance
coverage, the authors say. But in each case the plan had little impact
on the state's number of uninsured persons and produced no sustained
improvements in delivering care.
Dr. David Himmelstein, a co-author of the study, said the 2006
Massachusetts reform appears poised to follow the pattern of the 1992
Tennessee plan, which featured a large expansion of coverage under a
Medicaid-like program. "In Tennessee, the number of uninsured dipped for
two years, then rose to levels higher than ever," he said. "And the plan
proved to be unaffordable in the long term.
"According to the latest figures on Massachusetts from the National
Health Interview Survey," he continued, "the uninsurance rate has fallen
by only 2 percent, from 7.7 percent to 5.8 percent, since the reform was
passed, while the plan is already $147 million over budget."
Himmelstein, who is an associate professor of medicine at Harvard and a
primary care physician in Cambridge, Mass., said the seven failed plans
incorporated virtually all of the reform elements being advanced today
by leading Democrats, including Sen. Barack Obama. The problem, he said,
is that such reforms leave the private health insurance industry in a
dominant position.
"Politicians like to claim they've passed bold health reforms, but
they're afraid to rock the private insurance boat," he said. "So they
keep pushing gussied-up versions of reforms that have failed time after
time. Our health care system is sick to death, and our politicians keep
prescribing placebos."
The authors note that all of the failed plans included expansions of
Medicaid or similar programs for the poor and near-poor. Three states'
reforms (Massachusetts in 1988, Oregon in 1989-1992 and Washington state
in 1993) included mandates requiring employers to cover their workers,
and the Massachusetts and Washington plans also included an individual
mandate on the self-employed.
The authors analyzed Census Bureau data on uninsurance rates in each of
the seven states. Massachusetts' uninsurance rate rose from 7.2 percent
to 9.7 percent in the three years after the passage of then-governor
Michael Dukakis' universal health care reform in 1988. Uninsurance went
from 14.1 percent to 14.7 percent in the three years after
implementation of Oregon's universal health care reform in 1993. The
percentage of residents lacking coverage in Washington state increased
from 10.7 percent to 11.6 percent in the three years after passage of
its universal health care initiative.
Similar patterns occurred in Vermont and Maine. Tennessee's program
(which included the largest Medicaid expansion) was probably the most
successful, dropping the share of uninsured in the state from 12 percent
to 9 percent in its first year, before a rebound to 14 percent by year
three. (See charts in links below.)
All of the plans eventually "flatlined," or died quiet deaths, the
authors said.
According to Benjamin Day, executive director of Mass-Care, a health
care advocacy coalition based in Boston, "It's easy to build political
consensus for expanded health coverage. But experience shows that you
can't achieve universal coverage at an affordable price unless you throw
out the insurance companies with their massive overhead and profit, and
replace them with a more efficient single-payer national health
insurance program.
"Senator Obama should learn this lesson," Day said. As for Sen. John
McCain's health care proposals, "they are so obviously unworkable that
it's hard to take them seriously."
*******
The text of the study is available in PDF to the press at
www.pnhp.org/states_flatline
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=zNcwNfjJAnJf0TMLo94BkfXmr35TzF3j
Password: *himmelstein*
Additional charts in PowerPoint format are available at
www.pnhp.org/five_states
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=YNqed33VWwZ3%2FwCWnJiiV%2B8pcMbyAF%2B6
"State Health Reform Flatlines," Steffie Woolhandler, MD, MPH; Benjamin
Day; and David U. Himmelstein, MD. International Journal of Health
Services, Vol. 38, No. 3.
Physicians for a National Health Program, a membership organization of
over 15,000 physicians, supports a single-payer national health
insurance program. To contact a physician-spokesperson in your area,
visit www.pnhp.org/stateactions
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=W1SCD%2BJYJOe309bI23pT%2B%2B8pcMbyAF%2B6
or call (312) 782-6006.
*Physicians for a National Health Program*
29 E Madison Suite 602, Chicago, IL 60602
Phone (312) 782-6006 | Fax: (312) 782-6007
www.pnhp.org
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=cGQcvuaDs3pWB3gv9jboUO8pcMbyAF%2B6
| info@pnhp.org mailto:info@pnhp.org
PNHP 2008
http://salsa.democracyinaction.org/dia/track.jsp?v=2&c=mgJJAv5YFLJ2XnjhLax%2Fe%2B8pcMbyAF%2B6
--------------------------------------------------------------------------------
Looking for a car that's sporty, fun and fits in your budget? Read reviews on AOL Autos.
Monday, August 4, 2008
FAQs on the New Health Reform Law
What is the goal of the new law?
Access to health care is a basic human need. Massachusetts became the first state to put in place a practical plan to expand affordable health care when it passed comprehensive health reform in 2006.
Why is this law important?
Almost one out of ten adults in Massachusetts go without health insurance coverage. The cost of health insurance in Massachusetts has been rising for many years. The annual increase is a drag on businesses and is hurting our economy. Unless we begin to solve our health care problems now, they will only grow more serious over time.
The escalating cost of health care is in part because too many people don’t have health insurance and get their medical care at the emergency room, where the costs are the highest. By moving towards near universal health coverage individuals and families will be able to see a doctor on a regular basis and have access to preventive care. This means people will get the care they need when they need it, and hopefully before it’s reached a crisis point.
What are the primary features of this new law?
The new law will:
Provide low income people with incomes slightly above or below the poverty level health insurance for free.
For low and moderate-income people with no source of coverage, health insurance will be available on a sliding scale basis.
Set up the Connector - a new source for coverage with different choices of affordable health insurance plans for individuals and their families.
Require adults who do not have health insurance to get coverage if affordable coverage is available. Adults who do not qualify for free or subsidized health insurance or a waiver must pay a penalty.
Require all employers — except for very small businesses – to offer their employees health insurance and pay a fair share of the cost, or else pay a penalty.
How does the law make affordable health insurance choices available to the public?
The law requires health insurance companies to offer reduced-cost coverage plans through the Commonwealth Connector. You can contact the health plans directly or call the Commonwealth Connector at: 1-877-MA-ENROLL (1-877-623-6765) or visit www.mahealthconnector.org for more information.
If your employer offers coverage, but you can't afford it, you and your employer may be eligible for assistance through the Insurance Partnership. The Insurance Partnership helps uninsured employers and employees pay for company-sponsored health insurance. For more information, visit www.insurancepartnership.org or call 800-399-8285.
At what income levels does an individual or a family qualify for assistance in paying for health insurance?
An individual with an income of around $30,000 or less and a family of four with an income of up to about $60,000 can receive help from the state. The assistance is on a sliding scale so individuals and families with lower incomes pay less for health insurance. Families and individuals with incomes slightly above or below the poverty level will receive health insurance for free.
Where can I get more information?
The following links contain detailed information about the law:
Commonwealth Connector
www.mahealthconnector.org
The Commonwealth Care Health Insurance Program
www.macommonwealthcare.com
Blue Cross Blue Shield of Massachusetts Foundation
www.bcbsmafoundation.org
Highlights of the law
Good summary of the law
Health Care for All
http://www.hcfama.org
WBUR CommonHealth Blog
http://www.wbur.org/weblogs/commonhealth
Massachusetts Medicaid Policy Institute
www.massmedicaid.org
Access to health care is a basic human need. Massachusetts became the first state to put in place a practical plan to expand affordable health care when it passed comprehensive health reform in 2006.
Why is this law important?
Almost one out of ten adults in Massachusetts go without health insurance coverage. The cost of health insurance in Massachusetts has been rising for many years. The annual increase is a drag on businesses and is hurting our economy. Unless we begin to solve our health care problems now, they will only grow more serious over time.
The escalating cost of health care is in part because too many people don’t have health insurance and get their medical care at the emergency room, where the costs are the highest. By moving towards near universal health coverage individuals and families will be able to see a doctor on a regular basis and have access to preventive care. This means people will get the care they need when they need it, and hopefully before it’s reached a crisis point.
What are the primary features of this new law?
The new law will:
Provide low income people with incomes slightly above or below the poverty level health insurance for free.
For low and moderate-income people with no source of coverage, health insurance will be available on a sliding scale basis.
Set up the Connector - a new source for coverage with different choices of affordable health insurance plans for individuals and their families.
Require adults who do not have health insurance to get coverage if affordable coverage is available. Adults who do not qualify for free or subsidized health insurance or a waiver must pay a penalty.
Require all employers — except for very small businesses – to offer their employees health insurance and pay a fair share of the cost, or else pay a penalty.
How does the law make affordable health insurance choices available to the public?
The law requires health insurance companies to offer reduced-cost coverage plans through the Commonwealth Connector. You can contact the health plans directly or call the Commonwealth Connector at: 1-877-MA-ENROLL (1-877-623-6765) or visit www.mahealthconnector.org for more information.
If your employer offers coverage, but you can't afford it, you and your employer may be eligible for assistance through the Insurance Partnership. The Insurance Partnership helps uninsured employers and employees pay for company-sponsored health insurance. For more information, visit www.insurancepartnership.org or call 800-399-8285.
At what income levels does an individual or a family qualify for assistance in paying for health insurance?
An individual with an income of around $30,000 or less and a family of four with an income of up to about $60,000 can receive help from the state. The assistance is on a sliding scale so individuals and families with lower incomes pay less for health insurance. Families and individuals with incomes slightly above or below the poverty level will receive health insurance for free.
Where can I get more information?
The following links contain detailed information about the law:
Commonwealth Connector
www.mahealthconnector.org
The Commonwealth Care Health Insurance Program
www.macommonwealthcare.com
Blue Cross Blue Shield of Massachusetts Foundation
www.bcbsmafoundation.org
Highlights of the law
Good summary of the law
Health Care for All
http://www.hcfama.org
WBUR CommonHealth Blog
http://www.wbur.org/weblogs/commonhealth
Massachusetts Medicaid Policy Institute
www.massmedicaid.org
Health Care Reform
On April 12, 2006, Massachusetts made an official commitment to reducing the number of its residents without healthcare coverage. When Health Care Reform became law, everyone in Massachusetts - from state officials to employers to ordinary citizens - stood up for the hundreds of thousands of people living in our communities without the security they need.
The victories achieved in April did not mark the end of the fight for health care coverage in Massachusetts. To build on the success of the new legislation, leaders from every part of the health care community came together to realize the goals that Health Care Reform laid out. They formed the Massachusetts Health Care Reform Coalition to begin a grassroots campaign of education and outreach across the Commonwealth, and to provide every single uninsured individual the safety and security of health insurance. If you want to join their efforts to bring health care into every home and business in Massachusetts, visit their website today: www.masshealthreform.org
The victories achieved in April did not mark the end of the fight for health care coverage in Massachusetts. To build on the success of the new legislation, leaders from every part of the health care community came together to realize the goals that Health Care Reform laid out. They formed the Massachusetts Health Care Reform Coalition to begin a grassroots campaign of education and outreach across the Commonwealth, and to provide every single uninsured individual the safety and security of health insurance. If you want to join their efforts to bring health care into every home and business in Massachusetts, visit their website today: www.masshealthreform.org
Tuesday, July 8, 2008
COMPRENSIVE HEALTH COVERAGE
Doctors have historically been the watchdogs of the U.S. medical system, with the American Medical Association scaring New Dealers into dropping national health coverage from the Social Security Act and then the AMA shredding Harry Truman's reform efforts in the late 1940s. But a new poll and other significant indicators suggest that doctors are turning against the health-insurance firms that increasingly dominate American health care.
The latest sign is a poll published recently in the Annals of Health Research showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.
The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.
"What this means is the usual bloc of anti-reform is breaking up," he told The Toledo Blade. "These doctors are looking in the eyes of sick [uninsured] patients every day."
The poll results underscore mounting signs that doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine. And, increasingly, doctors seem to be showing support for a single-payer system that would essentially eliminate for-profit insurers and curb the power of big provider chains.
The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments…
The statistics indeed suggest a major breakdown: Premiums have climbed 87 percent since 2000, and workers' meager pay raises have been far outstripped by major increases in their share of the premiums. While the U.S. ranks 37th on a variety of quality measurements used by the World Health Organization, per-capita spending in the U.S. is twice as high as any other nation. For example, the U.S. spent $6,697 per person in 2005 compared with $3,326 in Canada. Meanwhile, the sharply escalating costs in the U.S. are leading to shrinkage of insurance coverage provided by employers. Some 47 million Americans are uninsured, with the present economic downturn certain to significantly increase those numbers…
State-level polls reinforce the just-released national survey from Indiana's Center for Health Policy. A remarkable 64 percent of the Minnesota doctors surveyed in 2006 expressed support for a Canadian-style single-payer system that would drive insurers from their commanding role in the health system, reported Minnesota Medicine. The Minnesota poll aligned closely with a Massachusetts survey of doctors in 2004, which reflected 61 percent backing for single-payer, according to the Archives of Internal Medicine. Doctors' views seem to be coming into closer alignment with those of the general public, of which 67 percent explicitly support a system like Canada's or Britain's…
Meanwhile, members of the American College of Physicians -- the nation's second-largest doctors' organization with 124,000 internal-medicine physicians and related specialists -- voted in December 2007 to endorse the single-payer idea. The vote followed an analysis of health care in the United States and 12 other industrialized countries, after which the ACP concluded that universal coverage had been successfully attained elsewhere through single-payer or mixed public/private systems...
Roger Bybee is a Milwaukee-based writer and progressive activist, who formerly edited the official labor weekly Racine Labor. He has written for a number of state and national publications and websites on issues such as health care reform and corporate globalization.
http://www.prospect.org/cs/articles?article=the_doctors_revolt
The latest sign is a poll published recently in the Annals of Health Research showing that 59 percent of U.S. doctors support a "single payer" plan that essentially eliminates the central role of private insurers. Most industrial societies -- including nations as diverse as Taiwan, France, and Canada -- have adopted universal health systems that provide health care to all citizens and permit them free choice of their doctors and hospitals. These plans are typically funded by a mix of general tax revenues and payroll taxes, and essential health-care is administered by nonprofit government agencies rather than private insurers.
The new poll, conducted by Indiana University's Center for Health Policy and Professionalism Research, shows a sharp 10 percent spike in the number of doctors supporting national insurance: 59 percent in 2007 compared to 49 percent five years earlier. This indicates that more physicians are eager for systematic changes, said Toledo physician Dr. Johnathon Ross, past president of Physicians for a National Health Program.
"What this means is the usual bloc of anti-reform is breaking up," he told The Toledo Blade. "These doctors are looking in the eyes of sick [uninsured] patients every day."
The poll results underscore mounting signs that doctors are resenting the increasingly short leash on which they are held by insurers and large hospital chains, the current masters of American medicine. And, increasingly, doctors seem to be showing support for a single-payer system that would essentially eliminate for-profit insurers and curb the power of big provider chains.
The ever-accelerating corporatization of health care is producing a seismic shift in the way that doctors look at universal health care. Doctors are experiencing an extreme and relatively sudden loss of control at the hands of insurers and hospital networks, while being snowed under by paperwork and bureaucratic battles with insurance companies over authorizations and payments…
The statistics indeed suggest a major breakdown: Premiums have climbed 87 percent since 2000, and workers' meager pay raises have been far outstripped by major increases in their share of the premiums. While the U.S. ranks 37th on a variety of quality measurements used by the World Health Organization, per-capita spending in the U.S. is twice as high as any other nation. For example, the U.S. spent $6,697 per person in 2005 compared with $3,326 in Canada. Meanwhile, the sharply escalating costs in the U.S. are leading to shrinkage of insurance coverage provided by employers. Some 47 million Americans are uninsured, with the present economic downturn certain to significantly increase those numbers…
State-level polls reinforce the just-released national survey from Indiana's Center for Health Policy. A remarkable 64 percent of the Minnesota doctors surveyed in 2006 expressed support for a Canadian-style single-payer system that would drive insurers from their commanding role in the health system, reported Minnesota Medicine. The Minnesota poll aligned closely with a Massachusetts survey of doctors in 2004, which reflected 61 percent backing for single-payer, according to the Archives of Internal Medicine. Doctors' views seem to be coming into closer alignment with those of the general public, of which 67 percent explicitly support a system like Canada's or Britain's…
Meanwhile, members of the American College of Physicians -- the nation's second-largest doctors' organization with 124,000 internal-medicine physicians and related specialists -- voted in December 2007 to endorse the single-payer idea. The vote followed an analysis of health care in the United States and 12 other industrialized countries, after which the ACP concluded that universal coverage had been successfully attained elsewhere through single-payer or mixed public/private systems...
Roger Bybee is a Milwaukee-based writer and progressive activist, who formerly edited the official labor weekly Racine Labor. He has written for a number of state and national publications and websites on issues such as health care reform and corporate globalization.
http://www.prospect.org/cs/articles?article=the_doctors_revolt
COMPRENSIVE HEALTH COVERAGE
John F. Wasik July 2, 2008
Healthcare will become one of the most onerous personal-finance issues in coming years unless the system is changed to ensure universal access, cost control, and long-term financing.
US families now pay more than $12,000 a year for health coverage, according to the Kaiser Family Foundation. Yet why doesn't any presidential candidate fully endorse a comprehensive national plan?
What would make healthcare available to more than 47 million who don't have coverage and the majority of American families whose premiums have risen 78 percent since 2001? Massive buying power through consolidation of separate programs and a public-private partnership.
To understand what a pervasive problem medical spending is, you need to digest some numbers. Health expenditures consume about 16 percent of US gross domestic product. Translated to an individual family, medical insurance claims 20 percent of median income. That's compared with 8 percent in 1987, according to the nonpartisan New America Foundation. Life expectancy is directly connected to medical coverage. Uninsured and underinsured (an additional 25 million) Americans visit doctors less frequently, pay more for care, and have the highest rate of preventable deaths before age 75, according to the Institute of Medicine.
Employers who do offer coverage are less competitive in a global marketplace. Workers who don't have policies end up in emergency rooms demanding costly care that taxpayers will ultimately finance.
Unless the growing bite of health costs is addressed, related spending will double by 2017 from 2007 levels, consuming one out of every five dollars produced in the United States, according to the Center for Medicaid and Medicare Services.
How do you save the best of US healthcare while providing it to everyone at a reasonable cost? Creating one new, entirely government-run public program may be untenable and politically unacceptable. The road to a solution can merge both private and public interests. What would such a hybrid look like? It would:
1) Outsource cost controlling. That means hiring audit firms to see where costs can be cut. The government could act like a huge accounts-payable department; a private firm would police billing and implement best practices.
2) Negotiate the best price. Maybe Wal-Mart's purchasing practices could be the model.
3) End fees for service. Medical expenses should be based on performance and outcomes, not on number of procedures.
4) Make technology a big part of the system. A major overhaul focusing on efficient technology use is in order.
The healthcare picture of the future isn't cloudy. There will be devastating financial consequences if we don't hunker down and prepare for a much more severe fiscal storm.
John F. Wasik is a Bloomberg News columnist. He can be reached at jwasik@bloomberg.net. Copyright 2008 Globe Newspaper Company.
http://www.boston.com/business/healthcare/articles/2008/07/02/healthcare_costs _must_be_brought_under_control_or_the_economy_will_surely_suffer/
Healthcare will become one of the most onerous personal-finance issues in coming years unless the system is changed to ensure universal access, cost control, and long-term financing.
US families now pay more than $12,000 a year for health coverage, according to the Kaiser Family Foundation. Yet why doesn't any presidential candidate fully endorse a comprehensive national plan?
What would make healthcare available to more than 47 million who don't have coverage and the majority of American families whose premiums have risen 78 percent since 2001? Massive buying power through consolidation of separate programs and a public-private partnership.
To understand what a pervasive problem medical spending is, you need to digest some numbers. Health expenditures consume about 16 percent of US gross domestic product. Translated to an individual family, medical insurance claims 20 percent of median income. That's compared with 8 percent in 1987, according to the nonpartisan New America Foundation. Life expectancy is directly connected to medical coverage. Uninsured and underinsured (an additional 25 million) Americans visit doctors less frequently, pay more for care, and have the highest rate of preventable deaths before age 75, according to the Institute of Medicine.
Employers who do offer coverage are less competitive in a global marketplace. Workers who don't have policies end up in emergency rooms demanding costly care that taxpayers will ultimately finance.
Unless the growing bite of health costs is addressed, related spending will double by 2017 from 2007 levels, consuming one out of every five dollars produced in the United States, according to the Center for Medicaid and Medicare Services.
How do you save the best of US healthcare while providing it to everyone at a reasonable cost? Creating one new, entirely government-run public program may be untenable and politically unacceptable. The road to a solution can merge both private and public interests. What would such a hybrid look like? It would:
1) Outsource cost controlling. That means hiring audit firms to see where costs can be cut. The government could act like a huge accounts-payable department; a private firm would police billing and implement best practices.
2) Negotiate the best price. Maybe Wal-Mart's purchasing practices could be the model.
3) End fees for service. Medical expenses should be based on performance and outcomes, not on number of procedures.
4) Make technology a big part of the system. A major overhaul focusing on efficient technology use is in order.
The healthcare picture of the future isn't cloudy. There will be devastating financial consequences if we don't hunker down and prepare for a much more severe fiscal storm.
John F. Wasik is a Bloomberg News columnist. He can be reached at jwasik@bloomberg.net. Copyright 2008 Globe Newspaper Company.
http://www.boston.com/business/healthcare/articles/2008/07/02/healthcare_costs _must_be_brought_under_control_or_the_economy_will_surely_suffer/
Monday, April 21, 2008
SICK AROUND THE WORLD
Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a health care system? Reported by T. R. Reid
These foreign health care ideas aren't really so foreign to us. For American veterans, health care is just like Britain's NHS; for seniors on Medicare, like Taiwan; for working Americans with insurance, we're Germany; and for the tens of millions without health insurance, we're just another poor country. But almost all of us can agree that this fragmented health care mess cannot be ignored. The longer we leave it, the sicker it becomes, and the more expensive the cure.
Don McCanne’s Comment: Washington Post reporter T. R. Reid takes a look at the health care systems of the United Kingdom, Japan, Germany, Taiwan, and Switzerland, and shows how each has settled on different models that are simpler, fairer, cheaper, and include everyone. He contrasts these nations with the United States which is "unlike every other country because it maintains so many separate systems for separate classes of people."
Passionate single payer supporters (like me) might be disappointed (I'm not) to see that each of the other systems was touted as a definite improvement over ours, while single payer was not selected out as being superior to the rest. However, we are entitled to a certain level of smugness on observing the discussion, during both the program and the KFF forum, of Taiwan's single payer system. From a pure policy perspective, it seems clear to me that single payer beats out the rest, even though all of the others are far better than what we now have.
The United States really can learn much by observing the application of health policies in other nations with less expensive, higher-performance systems. The first step is to better understand social solidarity.
To view "Sick Around the World" and for other resources:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
To view a KFF forum on "Sick Around the World" featuring Jackie Judd, T. R. Reid, Tsung-Mei Cheng and Uwe Reinhardt:
http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2576
These foreign health care ideas aren't really so foreign to us. For American veterans, health care is just like Britain's NHS; for seniors on Medicare, like Taiwan; for working Americans with insurance, we're Germany; and for the tens of millions without health insurance, we're just another poor country. But almost all of us can agree that this fragmented health care mess cannot be ignored. The longer we leave it, the sicker it becomes, and the more expensive the cure.
Don McCanne’s Comment: Washington Post reporter T. R. Reid takes a look at the health care systems of the United Kingdom, Japan, Germany, Taiwan, and Switzerland, and shows how each has settled on different models that are simpler, fairer, cheaper, and include everyone. He contrasts these nations with the United States which is "unlike every other country because it maintains so many separate systems for separate classes of people."
Passionate single payer supporters (like me) might be disappointed (I'm not) to see that each of the other systems was touted as a definite improvement over ours, while single payer was not selected out as being superior to the rest. However, we are entitled to a certain level of smugness on observing the discussion, during both the program and the KFF forum, of Taiwan's single payer system. From a pure policy perspective, it seems clear to me that single payer beats out the rest, even though all of the others are far better than what we now have.
The United States really can learn much by observing the application of health policies in other nations with less expensive, higher-performance systems. The first step is to better understand social solidarity.
To view "Sick Around the World" and for other resources:
http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
To view a KFF forum on "Sick Around the World" featuring Jackie Judd, T. R. Reid, Tsung-Mei Cheng and Uwe Reinhardt:
http://www.kaisernetwork.org/health_cast/hcast_index.cfm?display=detail&hc=2576
Saturday, April 19, 2008
Massachusett "Universal Health Law"
More than 110,oo people--one fifth to one-quarter of the state's uninsured--have been given free or heavily subsidized health coverage in the past year 2007. But the big tests of the statate's "universal health" insurance law are yet to come
Monday, April 14, 2008
HR 676 UNIVERSAL HEALTH CARE
The North Shore Labor Council is the one hundredthCentral Labor Council to endorse HR 676, single payer healthcarelegislation introduced by Congressman John Conyers (D-MI).Jeff Crosby, Council President, said: “We in Massachusetts have ampleexperience with the fraud of health-care ‘reform’ that claims to provideuniversal coverage without containing costs. The Massachusetts bill iscollapsing as we speak. And the only way to contain costs is to go afterthe drug companies and the insurance companies with a chain-saw. HR 676does that best.”
Wednesday, April 9, 2008
Tourism for Medical Treatment
Medical Tourism: Seeking Affordable Healthcare Overseas
Medical tourism provides high-quality care with less financial suffering
Published on:
Monday, March 10, 2008
Written by:
Melana Yanos
Click a star to rate.
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Because the cost of U.S. healthcare remains high, medical tourism could save an American patient thousands of dollars on procedures such as cosmetic or dental surgeries—as long as they are willing to travel to a foreign country where the costs are considerably lower. Foreign real estate investors can also indirectly benefit from the medical tourism industry, which appears to have a positive impact on the economies of developing destination countries.
The concept of traveling for medical care is nothing new, but the modern concept of medical tourism—traveling to foreign countries specifically for lower cost of care—has only emerged in the past 10 to 15 years, David E. Williams, cofounder and principal of MedPharma partners, and author of HealthBusinessBlog.com, said.
But “in a mainstream way it’s really only started to take off in the past year or two,” because more people are traveling around the world than they were ten years ago, and because the Internet has made long-distance communication more practical, he said.
The numbers of clients for MedRetreat, an American medical tourism services company, have nearly doubled each year since 2005, with approximately 200 clients in 2005, 350 clients in 2006 and 650 clients in 2007, Patrick Marsek, the company’s managing director, said.
Most clients are paying for health care procedures out of their pocket, specifically uninsured or under-insured American patients in need of costly medical surgeries, and clients who seek elective cosmetic or dental procedures, Marsek said.
“There’s a huge range of potential cost savings, anywhere from 50 to 80 percent depending on where [they] go and which procedures [are done],” Marsek said.
Medical tourism is most often for cosmetic surgeryIt is possible for patients to pay for foreign medical expenses with money from their health savings account (HSA). As the number of people with HSAs increases, and people have to take more responsibility for their medical costs, medical tourism could grow even more.
Cosmetic and dental surgeries are the most popular procedures because “those are services that typically are not covered by insurance,” Williams said. Many patients travel to South or Central American countries such as Brazil, Argentina or Costa Rica for cosmetic procedures, where it is cost effective to travel and cosmetic surgery is advanced. For example, a full face and neck lift procedure could cost $12,000 in the U.S., while the same procedure could cost as little as $3,800 abroad, Marsek said.
In vitro fertilization procedures are also becoming popular because the cost of the procedure is high in the U.S., Williams said.
The savings for uninsured clients in need of cardiovascular or orthopedic procedures are perhaps the most dramatic because costs for those procedures are so exorbitant in the U.S. Hip replacement surgery, for example, could cost anywhere between $40,000 and $65,000 in the U.S., whereas a patient might pay between $8,000 and $18,000, which includes travel costs, to receive the procedure overseas, Marsek said.
Marsek said some of the least expensive destinations to receive hip replacement surgery are in India; however, “there’s [a different] price to be paid for going [there],” he said.
“It’s a huge culture shock for Americans to go to India,” Marsek said. “Patients should know that medical tourism is not only about receiving a high-quality procedure...it’s [also] about the total experience of when [they are] there. You have to be emotionally and psychologically prepared...as well as physically prepared.”
Quality of care
Patients might have questions about the quality of care overseas; however, one quarter of physicians in the U.S. are foreign-born, “so the concept of having a Thai...or an Indian physician is really nothing very new or very foreign to an American patient these days,” Williams said.
Furthermore, “people are also coming to realize that the U.S. health system, despite being the most expensive, is not perfect,” he said.
It’s difficult to figure out the quality of any particular overseas provider, and “if anything goes wrong you’re far away from your support network,” Williams said.
Consequently, patients should “do their homework” and work with a professional organization that has experience with overseas medical travel, Marsek said.
MedRetreat, for example, has performed extensive, on-the-ground due diligence on foreign hospitals that wish to participate in the medical tourism industry and has turned down more than half of candidate hospitals because they fell short of the company’s quality standards, Marsek said on a MedRetreat.com podcast.
Medical tourists can find high quality of careHospitals that participate in medical tourism usually reserve the highest quality of care and best physicians for international patients, Marsek said.
In terms of the actual procedure, “they really err on the side of caution overseas,” Marsek said.
“The absolute worst thing that could happen to a hospital overseas is to have a procedure go bad, and [for that patient to] come back to the U.S. and talk to CNN the next day,” he said. “That hospital could potentially be out of the medical tourism industry...forever.”
MedRetreat clients generally spend three times as much time in a hospital overseas than they would in the U.S. after having a similar procedure performed, Marsek said. Clients also tend to experience more hospitality—friendliness, compassion and caring—overseas.
“They’re not trying to push you out of the hospital,” Marsek said.
In a paper issued by MedPharma and MedTripinfo.com last fall, Williams and his colleague John Seus predicted that U.S. physicians, in general, will not object to medical tourism. Many U.S. physicians are familiar with foreign doctors, or are originally from foreign countries themselves, and understand the credibility of receiving care abroad, Williams said. Furthermore, physicians are probably not worried about losing business because of a shortage of physicians in the U.S. that is causing many patients to be turned away.
Thus far, the prediction seems accurate and there doesn’t seem to be any “huge outcry” by doctors against medical tourism, Williams said.
Considerations and risks of medical tourism
Quality of care abroad is not necessarily cause for concern, especially for patients who book their medical tour through a reliable company. However, other considerations about medical tourism should be taken into account.
First, patients need to decide whether or not opting for a medical tour makes sense, financially and physically. MedRetreat's website recommends “The $6,000 Rule.” A procedure that costs $6,000 in the U.S. would probably “realize a break-even scenario” if the patient elected to go abroad, because the overhead created by travel costs would cancel out the money saved for the actual procedure.
Nevertheless, some clients choose to go for the experience as well as the care, and Medretreat has “perpetual medical tourists,” Marsek said.
“Many people still choose to travel abroad to achieve complete privacy and anonymity, peaceful recuperation, and the avoidance of daily hometown distractions,” according to the MedRetreat website. The company’s clients enjoy a two- to three-week vacation in luxury accommodations following their procedure.
American patients with a medical condition should have their diagnosis performed in the U.S., Marsek said. After finding out what procedure needs to be done, they can ask the approximate cost and their physician should be able to give them “a ballpark figure,” he said. That figure can then be compared with the cost of having the same procedure performed overseas.
In addition to financial considerations, medical tourism is not physically appropriate for all patients, especially patients in need of high-risk medical procedures.
“We can’t [take patients in need of] quadruple-bypass [surgery] and facilitate those [procedures] overseas,” Marsek said.
Communication barriers are one cause of concern for medical touristsOnce a patient has traveled to a foreign country for care, he or she may face the risk of miscommunication resulting from a lack of familiarity with a foreign culture and language barriers, Williams said.
Because of all the risks involved, clients might want to have the option of canceling their procedure after they arrive in their destination country without taking a huge financial hit, Marsek said. MedRetreat promises to return the 20 percent deposit for a procedure if the client should change their mind after arriving. As a result, the financial risk to the client is only the cost of travel and cost of stay.
But none of their clients have ever felt the need to use this option, according to the MedRetreat podcast.
Refund policies vary between companies, so consumers should research multiple companies before making a decision.
Impacts on economic health
Foreign real estate investors might be interested to know that the impact on medical tourism destination economies should be “very positive,” according to Williams. Popular medical tourist destinations include developing countries such as India, the Phillipines and South and Central American countries, as well as fairly developed countries, such as Singapore and South Korea.
One important benefit of medical tourism for these countries is that the influx of international patients will create career opportunities that encourage foreign physicians to remain in their home countries as opposed to moving to the U.S. to make a living.
Furthermore, medical tourism has a positive impact “all the way down the economic ladder,” from high-educated occupations in medicine and hospital administration to the unskilled trades.
Overall, medical tourism will have a positive impact “directly by improving the health care infrastructure within a country, and indirectly because of all the new economic activity that’s generated and opportunity for growth,” Williams said.
Destination countries are realizing the value of medical tourism, and “there are [initiatives] at the government level or at the individual hospital level...to try to lure tourists from the [U.S.], Western Europe or Canada,” Williams said. As a result of the increasing supply of participating hospitals, an increasing number of medical tourism companies are emerging onto the scene to get between care providers and consumers to arrange medical tours.
As for the effects of medical tourism on U.S. health care costs, the direct impact will probably not be large, Williams said.
“At the end of the day...most procedures are not suitable for going abroad, and most patients, even if offered the opportunity, won’t take advantage of it,” he said.
Still, the secondary impact on the U.S. health care industry will be substantial; for instance, an increasing number of “mini-med plans” will begin covering medical procedures performed overseas. According to the results of a survey called Health Care Benefits: Eligibility, Coverage and Exclusions, medical tourism is already being covered by 11 percent of organizations surveyed—a surprisingly large number, Williams said.
“U.S. hospitals and physicians [will be] competing for the first time on an international basis and not just on a local or regional basis,” Williams said.
Medical tourism provides high-quality care with less financial suffering
Published on:
Monday, March 10, 2008
Written by:
Melana Yanos
Click a star to rate.
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Because the cost of U.S. healthcare remains high, medical tourism could save an American patient thousands of dollars on procedures such as cosmetic or dental surgeries—as long as they are willing to travel to a foreign country where the costs are considerably lower. Foreign real estate investors can also indirectly benefit from the medical tourism industry, which appears to have a positive impact on the economies of developing destination countries.
The concept of traveling for medical care is nothing new, but the modern concept of medical tourism—traveling to foreign countries specifically for lower cost of care—has only emerged in the past 10 to 15 years, David E. Williams, cofounder and principal of MedPharma partners, and author of HealthBusinessBlog.com, said.
But “in a mainstream way it’s really only started to take off in the past year or two,” because more people are traveling around the world than they were ten years ago, and because the Internet has made long-distance communication more practical, he said.
The numbers of clients for MedRetreat, an American medical tourism services company, have nearly doubled each year since 2005, with approximately 200 clients in 2005, 350 clients in 2006 and 650 clients in 2007, Patrick Marsek, the company’s managing director, said.
Most clients are paying for health care procedures out of their pocket, specifically uninsured or under-insured American patients in need of costly medical surgeries, and clients who seek elective cosmetic or dental procedures, Marsek said.
“There’s a huge range of potential cost savings, anywhere from 50 to 80 percent depending on where [they] go and which procedures [are done],” Marsek said.
Medical tourism is most often for cosmetic surgeryIt is possible for patients to pay for foreign medical expenses with money from their health savings account (HSA). As the number of people with HSAs increases, and people have to take more responsibility for their medical costs, medical tourism could grow even more.
Cosmetic and dental surgeries are the most popular procedures because “those are services that typically are not covered by insurance,” Williams said. Many patients travel to South or Central American countries such as Brazil, Argentina or Costa Rica for cosmetic procedures, where it is cost effective to travel and cosmetic surgery is advanced. For example, a full face and neck lift procedure could cost $12,000 in the U.S., while the same procedure could cost as little as $3,800 abroad, Marsek said.
In vitro fertilization procedures are also becoming popular because the cost of the procedure is high in the U.S., Williams said.
The savings for uninsured clients in need of cardiovascular or orthopedic procedures are perhaps the most dramatic because costs for those procedures are so exorbitant in the U.S. Hip replacement surgery, for example, could cost anywhere between $40,000 and $65,000 in the U.S., whereas a patient might pay between $8,000 and $18,000, which includes travel costs, to receive the procedure overseas, Marsek said.
Marsek said some of the least expensive destinations to receive hip replacement surgery are in India; however, “there’s [a different] price to be paid for going [there],” he said.
“It’s a huge culture shock for Americans to go to India,” Marsek said. “Patients should know that medical tourism is not only about receiving a high-quality procedure...it’s [also] about the total experience of when [they are] there. You have to be emotionally and psychologically prepared...as well as physically prepared.”
Quality of care
Patients might have questions about the quality of care overseas; however, one quarter of physicians in the U.S. are foreign-born, “so the concept of having a Thai...or an Indian physician is really nothing very new or very foreign to an American patient these days,” Williams said.
Furthermore, “people are also coming to realize that the U.S. health system, despite being the most expensive, is not perfect,” he said.
It’s difficult to figure out the quality of any particular overseas provider, and “if anything goes wrong you’re far away from your support network,” Williams said.
Consequently, patients should “do their homework” and work with a professional organization that has experience with overseas medical travel, Marsek said.
MedRetreat, for example, has performed extensive, on-the-ground due diligence on foreign hospitals that wish to participate in the medical tourism industry and has turned down more than half of candidate hospitals because they fell short of the company’s quality standards, Marsek said on a MedRetreat.com podcast.
Medical tourists can find high quality of careHospitals that participate in medical tourism usually reserve the highest quality of care and best physicians for international patients, Marsek said.
In terms of the actual procedure, “they really err on the side of caution overseas,” Marsek said.
“The absolute worst thing that could happen to a hospital overseas is to have a procedure go bad, and [for that patient to] come back to the U.S. and talk to CNN the next day,” he said. “That hospital could potentially be out of the medical tourism industry...forever.”
MedRetreat clients generally spend three times as much time in a hospital overseas than they would in the U.S. after having a similar procedure performed, Marsek said. Clients also tend to experience more hospitality—friendliness, compassion and caring—overseas.
“They’re not trying to push you out of the hospital,” Marsek said.
In a paper issued by MedPharma and MedTripinfo.com last fall, Williams and his colleague John Seus predicted that U.S. physicians, in general, will not object to medical tourism. Many U.S. physicians are familiar with foreign doctors, or are originally from foreign countries themselves, and understand the credibility of receiving care abroad, Williams said. Furthermore, physicians are probably not worried about losing business because of a shortage of physicians in the U.S. that is causing many patients to be turned away.
Thus far, the prediction seems accurate and there doesn’t seem to be any “huge outcry” by doctors against medical tourism, Williams said.
Considerations and risks of medical tourism
Quality of care abroad is not necessarily cause for concern, especially for patients who book their medical tour through a reliable company. However, other considerations about medical tourism should be taken into account.
First, patients need to decide whether or not opting for a medical tour makes sense, financially and physically. MedRetreat's website recommends “The $6,000 Rule.” A procedure that costs $6,000 in the U.S. would probably “realize a break-even scenario” if the patient elected to go abroad, because the overhead created by travel costs would cancel out the money saved for the actual procedure.
Nevertheless, some clients choose to go for the experience as well as the care, and Medretreat has “perpetual medical tourists,” Marsek said.
“Many people still choose to travel abroad to achieve complete privacy and anonymity, peaceful recuperation, and the avoidance of daily hometown distractions,” according to the MedRetreat website. The company’s clients enjoy a two- to three-week vacation in luxury accommodations following their procedure.
American patients with a medical condition should have their diagnosis performed in the U.S., Marsek said. After finding out what procedure needs to be done, they can ask the approximate cost and their physician should be able to give them “a ballpark figure,” he said. That figure can then be compared with the cost of having the same procedure performed overseas.
In addition to financial considerations, medical tourism is not physically appropriate for all patients, especially patients in need of high-risk medical procedures.
“We can’t [take patients in need of] quadruple-bypass [surgery] and facilitate those [procedures] overseas,” Marsek said.
Communication barriers are one cause of concern for medical touristsOnce a patient has traveled to a foreign country for care, he or she may face the risk of miscommunication resulting from a lack of familiarity with a foreign culture and language barriers, Williams said.
Because of all the risks involved, clients might want to have the option of canceling their procedure after they arrive in their destination country without taking a huge financial hit, Marsek said. MedRetreat promises to return the 20 percent deposit for a procedure if the client should change their mind after arriving. As a result, the financial risk to the client is only the cost of travel and cost of stay.
But none of their clients have ever felt the need to use this option, according to the MedRetreat podcast.
Refund policies vary between companies, so consumers should research multiple companies before making a decision.
Impacts on economic health
Foreign real estate investors might be interested to know that the impact on medical tourism destination economies should be “very positive,” according to Williams. Popular medical tourist destinations include developing countries such as India, the Phillipines and South and Central American countries, as well as fairly developed countries, such as Singapore and South Korea.
One important benefit of medical tourism for these countries is that the influx of international patients will create career opportunities that encourage foreign physicians to remain in their home countries as opposed to moving to the U.S. to make a living.
Furthermore, medical tourism has a positive impact “all the way down the economic ladder,” from high-educated occupations in medicine and hospital administration to the unskilled trades.
Overall, medical tourism will have a positive impact “directly by improving the health care infrastructure within a country, and indirectly because of all the new economic activity that’s generated and opportunity for growth,” Williams said.
Destination countries are realizing the value of medical tourism, and “there are [initiatives] at the government level or at the individual hospital level...to try to lure tourists from the [U.S.], Western Europe or Canada,” Williams said. As a result of the increasing supply of participating hospitals, an increasing number of medical tourism companies are emerging onto the scene to get between care providers and consumers to arrange medical tours.
As for the effects of medical tourism on U.S. health care costs, the direct impact will probably not be large, Williams said.
“At the end of the day...most procedures are not suitable for going abroad, and most patients, even if offered the opportunity, won’t take advantage of it,” he said.
Still, the secondary impact on the U.S. health care industry will be substantial; for instance, an increasing number of “mini-med plans” will begin covering medical procedures performed overseas. According to the results of a survey called Health Care Benefits: Eligibility, Coverage and Exclusions, medical tourism is already being covered by 11 percent of organizations surveyed—a surprisingly large number, Williams said.
“U.S. hospitals and physicians [will be] competing for the first time on an international basis and not just on a local or regional basis,” Williams said.
Wednesday, March 26, 2008
Sen Tseii summary Mass Health Care Law
Tisei: Senate takes next step in health care reform
Thu Mar 13, 2008
Malden - In 2006, Massachusetts made history when it became the first state to mandate health care coverage for all of its residents.
Since the passage of this landmark bill, nearly 300,000 individuals have obtained health insurance, and use of the state’s free care pool has declined by 16 percent. Payments to hospitals and health centers for treating the uninsured, which totaled $680 million in Fiscal 2007, are projected to fall to $438 million this year, as more people sign up for coverage.
By most measures, the new law has been a success. As with all major undertakings, however, the transition to universal health care in Massachusetts has not been without a few bumps in the road.
Small businesses, for example, have seen huge premium increases each year, and are now paying an additional $175 million annually under the new health care law. Unless this problem is addressed, the private sector’s ability to continue to insure its employees will be put at serious risk.
From the beginning, critics and skeptics have warned that spiraling costs could undermine this historic undertaking and ultimately lead to its failure. This year, $618 million is being spent on Commonwealth Care, the state program that subsidizes health insurance for low-income residents, but Gov. Patrick has allocated $869 million for this program in his Fiscal 2009 budget — an increase of more than 40 percent.
Obviously, annual cost increases of this magnitude cannot continue without universal health care becoming unsustainable. Fortunately, Senate President Therese Murray is determined not to see that happen.
Last week, Sen. Murray put forth a plan to help rein in costs and ensure that the state’s experiment with universal health care will succeed and not collapse under its own costs. Her bill — known as “An Act to Promote Cost Containment, Transparency and Efficiency in the Delivery of Quality Health Care” — contains a series of reforms she says will “modernize the health care system, reduce waste and inefficiencies, and improve health care quality for every citizen of the Commonwealth.”
Here are just a few of the provisions contained in the bill:
Cost transparency
To get a handle on rising health care costs, the bill calls for the “Health Care Cost and Quality Council” to convene annual public hearings with health care providers. Maintaining an ongoing dialogue will help identify what factors are driving costs and allow all parties to work together to reduce those costs.
The bill also establishes a special commission to review how health insurers manage their reserves and surpluses, and requires hospitals and insurance companies to fully disclose all costs passed on to consumers. If an insurer asks for a rate increase of more than 7 percent, the Division of Insurance and the Attorney General’s Office would launch a public review process, taking a close look at the company’s administrative costs and executive compensation packages to determine if the requested increase is justified.
Gift Ban
Under the proposed bill, drug and medical-device companies would be prohibited from offering gifts of any kind to physicians, their staff and their families, including meals, entertainment, and travel expenses. Violators would face a $5,000 fine, two years imprisonment, or both. However, companies would still be able to offer doctors free drug samples for their patients.
Other states have placed restrictions on the use of marketing gifts by pharmaceutical companies, but Massachusetts would be the first to ban them outright. Minnesota prohibits gifts from pharmaceutical companies valued at more than $50, while Vermont requires companies to disclose any gifts to doctors that exceed $25.
Critics have long maintained that accepting gifts can persuade some doctors to prescribe medications that may not be the most cost-effective treatment for their patients. Given the many ethical questions that arise when companies are allowed to “wine and dine” doctors, this ban will eliminate a major conflict of interest.
Electronic Records
To protect patient safety and reduce medical errors, the bill mandates that all medical records be entered and stored electronically by 2015, and that physicians demonstrate their proficiency in electronic record keeping for certification by the Board of Registration in Medicine.
The bill also mandates that by 2012, Computerized Physician Order Entry systems must be in use statewide. Hospitals that have not implemented the system by this date would not be licensed. The bill also establishes a statewide standard for uniform billing and coding by health care providers and insurance companies to reduce the operational expenses associated with claims processing and eliminate duplication.
The next level
The bill contains several other provisions to move health care reform to the next level, including a requirement that hospitals create “Patient and Family Advisory Councils,” and a proposal to encourage providers to use lower cost generic drugs and therapeutic alternatives instead of automatically prescribing expensive brand name drugs.
The bill also establishes a Purchasing Reform subcommittee to coordinate public and private “pay-for-performance” efforts. The subcommittee will develop strategies for promoting and rewarding health care quality and efficiency.
Murray deserves credit for developing a comprehensive proposal to bring health care costs under control and improve the quality of care. As the Boston Globe recently noted, she has put health care providers and insurers on notice.
While some of the proposed reforms may not drive down costs significantly on their own, collectively they represent a concerted attempt to address a serious problem and ensure that universal health care succeeds in Massachusetts.
Thu Mar 13, 2008
Malden - In 2006, Massachusetts made history when it became the first state to mandate health care coverage for all of its residents.
Since the passage of this landmark bill, nearly 300,000 individuals have obtained health insurance, and use of the state’s free care pool has declined by 16 percent. Payments to hospitals and health centers for treating the uninsured, which totaled $680 million in Fiscal 2007, are projected to fall to $438 million this year, as more people sign up for coverage.
By most measures, the new law has been a success. As with all major undertakings, however, the transition to universal health care in Massachusetts has not been without a few bumps in the road.
Small businesses, for example, have seen huge premium increases each year, and are now paying an additional $175 million annually under the new health care law. Unless this problem is addressed, the private sector’s ability to continue to insure its employees will be put at serious risk.
From the beginning, critics and skeptics have warned that spiraling costs could undermine this historic undertaking and ultimately lead to its failure. This year, $618 million is being spent on Commonwealth Care, the state program that subsidizes health insurance for low-income residents, but Gov. Patrick has allocated $869 million for this program in his Fiscal 2009 budget — an increase of more than 40 percent.
Obviously, annual cost increases of this magnitude cannot continue without universal health care becoming unsustainable. Fortunately, Senate President Therese Murray is determined not to see that happen.
Last week, Sen. Murray put forth a plan to help rein in costs and ensure that the state’s experiment with universal health care will succeed and not collapse under its own costs. Her bill — known as “An Act to Promote Cost Containment, Transparency and Efficiency in the Delivery of Quality Health Care” — contains a series of reforms she says will “modernize the health care system, reduce waste and inefficiencies, and improve health care quality for every citizen of the Commonwealth.”
Here are just a few of the provisions contained in the bill:
Cost transparency
To get a handle on rising health care costs, the bill calls for the “Health Care Cost and Quality Council” to convene annual public hearings with health care providers. Maintaining an ongoing dialogue will help identify what factors are driving costs and allow all parties to work together to reduce those costs.
The bill also establishes a special commission to review how health insurers manage their reserves and surpluses, and requires hospitals and insurance companies to fully disclose all costs passed on to consumers. If an insurer asks for a rate increase of more than 7 percent, the Division of Insurance and the Attorney General’s Office would launch a public review process, taking a close look at the company’s administrative costs and executive compensation packages to determine if the requested increase is justified.
Gift Ban
Under the proposed bill, drug and medical-device companies would be prohibited from offering gifts of any kind to physicians, their staff and their families, including meals, entertainment, and travel expenses. Violators would face a $5,000 fine, two years imprisonment, or both. However, companies would still be able to offer doctors free drug samples for their patients.
Other states have placed restrictions on the use of marketing gifts by pharmaceutical companies, but Massachusetts would be the first to ban them outright. Minnesota prohibits gifts from pharmaceutical companies valued at more than $50, while Vermont requires companies to disclose any gifts to doctors that exceed $25.
Critics have long maintained that accepting gifts can persuade some doctors to prescribe medications that may not be the most cost-effective treatment for their patients. Given the many ethical questions that arise when companies are allowed to “wine and dine” doctors, this ban will eliminate a major conflict of interest.
Electronic Records
To protect patient safety and reduce medical errors, the bill mandates that all medical records be entered and stored electronically by 2015, and that physicians demonstrate their proficiency in electronic record keeping for certification by the Board of Registration in Medicine.
The bill also mandates that by 2012, Computerized Physician Order Entry systems must be in use statewide. Hospitals that have not implemented the system by this date would not be licensed. The bill also establishes a statewide standard for uniform billing and coding by health care providers and insurance companies to reduce the operational expenses associated with claims processing and eliminate duplication.
The next level
The bill contains several other provisions to move health care reform to the next level, including a requirement that hospitals create “Patient and Family Advisory Councils,” and a proposal to encourage providers to use lower cost generic drugs and therapeutic alternatives instead of automatically prescribing expensive brand name drugs.
The bill also establishes a Purchasing Reform subcommittee to coordinate public and private “pay-for-performance” efforts. The subcommittee will develop strategies for promoting and rewarding health care quality and efficiency.
Murray deserves credit for developing a comprehensive proposal to bring health care costs under control and improve the quality of care. As the Boston Globe recently noted, she has put health care providers and insurers on notice.
While some of the proposed reforms may not drive down costs significantly on their own, collectively they represent a concerted attempt to address a serious problem and ensure that universal health care succeeds in Massachusetts.
Sunday, March 9, 2008
Thursday, February 28, 2008
Health Care for all
Health Insurance Does Not Equal Health Care, Opinion Piece Writes28 Feb 2008 The presidential candidates "assume that universal health insurance means universal health care" and that "once the law enables or requires everyone to buy health insurance, everyone will have adequate health care," Caroline Poplin -- a physician, attorney and visiting scholar at the Georgetown University Law Center -- writes in an Philadelphia Inquirer opinion piece. However, she continues, "health insurance and health care are two different products for two different markets": health insurance "is for healthy people" and health care "is for the sick." According to Poplin, what U.S. residents need "to lead full, productive lives is good health care," and health insurance "may be one way to get there." She uses the example of car insurance -- which "works well in this country" -- stating that despite the fact that "[m]ost drivers don't get into accidents," we "require all drivers to have insurance to cover the expenses of innocent victims." She adds that two key features of car insurance are limits on insurers' liability and the fact that insurance does not cover routine maintenance. Poplin states that health insurance "was never designed" to care for people who survive illnesses and live with chronic conditions. According to Poplin, "There are some goods the private market just cannot provide efficiently that we need to purchase collectively: defense, roads, sanitation." She writes, "The rest of the developed world believes that health care is another." Poplin proposes "split[ting] the difference" to let "those who can obtain good insurance buy it" and to let "those who can't get decent insurance at a reasonable price buy into Medicare." She adds that "wherever the debate goes," U.S. residents must remember that the "real goal is not health insurance, but universal health care" (Poplin, Philadelphia Inquirer, 2/25). Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
Article URL: http://www.medicalnewstoday.com/articles/98834.php
Main News Category: Health Insurance / Medical Insurance
Also Appears In: Public Health,
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Article URL: http://www.medicalnewstoday.com/articles/98834.php
Main News Category: Health Insurance / Medical Insurance
Also Appears In: Public Health,
Save time! Get the latest medical news headlines for your specialist area, in a weekly newsletter e-mail. See http://www.medicalnewstoday.com/newsletters.php for details.
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UNIVERSAL HEALTH CARE FOR ALL
Wed Feb 27, 7:48 PM ET
Hillary Clinton opened fire on Barack Obama across an array of issues, but saved the really big guns for health care: "Of all our differences," said Hillary in Rhode Island (the forgotten primary state), "the one that is just inexplicable to me is his refusal to put forth a plan on universal health care and his continuing attacks on my plan to do so."
How hard can it be to offer a universal health care plan? "John Edwards had a plan, I had a plan, Chris Dodd had a plan, Dennis Kucinich had a plan, Bill Richardson had a plan. Because we're Democrats ..." Clinton said.
But Obama, in his Bob the Builder campaign designed to appeal to the toddler in every American, offers a plan that is all gain and no pain: subsidized health insurance for anyone who wants to buy it, whenever they want to buy it. More money, more choice, no cost. Gee, what's not to like?
Nothing, except that Hillary is correct. Obamacare can't possibly work, because it doesn't make sense to buy insurance when you are young and healthy if you are guaranteed access anyway when you are older and sicker.
And that's the problem.
The exchange between the two Democrats highlights the dirty little secret that not even Hillary will tell you about a universal government health insurance program. The problem with our current system that mandatory national health insurance will solve is not that people don't get health care -- it's that they don't pay for it.
Young healthy folks are more and more likely to go without health insurance. That means the pool of insured people is older and sicker and, therefore, more expensive to insure. Health insurance premiums rise, which makes health insurance an even worse deal for the relatively young and healthy, guaranteeing that more and more twentysomethings are uninsured, and health insurance costs for us middle-aged and older folks skyrocket.
What kind of people in the U.S. are uninsured? A whole lot of people like Brandy Coons, a 23-year-old Atlanta waitress highlighted on the front page of The New York Times as the new face of the "free rider" problem. Brandy admits she could probably afford a policy if she cut back on her gym membership and her photography hobby, but why should she do that?
"I'm young and in pretty good shape ... The insurance premium was more than what I would pay for my prescriptions, so I just decided not to deal with it," Coons said.
But even The New York Times cannot admit the real "free rider" problem here. It's not that the health care needs of uninsured twentysomethings like Brandy are bankrupting the system. It's that not enough twentysomethings like Brandy are paying for the health care of fortysomethings and older. That's the only way insurance makes sense: We pay into it when we are young and healthy, and we get something out of it when we are older and more likely to get sick.
But try running on that as your platform: Make the young people pay more!
Here's the other dirty little secret: National health insurance is going to cost Brandy and other taxpayers a whole lot more than either Hillary or Obama admits. Just ask Gov. Deval Patrick in Massachusetts, where just two years into operation, the state's mandatory health insurance plan is already costing $400 million more than budgeted.
Meanwhile we have a Medicare system that is going to go bankrupt.
Here's a question neither Hillary nor Barack will answer: How can we justify spending billions to insure the Brandys of the worlds, when we haven't yet secured the health care financing for our existing promises to senior citizens?
Hillary Clinton opened fire on Barack Obama across an array of issues, but saved the really big guns for health care: "Of all our differences," said Hillary in Rhode Island (the forgotten primary state), "the one that is just inexplicable to me is his refusal to put forth a plan on universal health care and his continuing attacks on my plan to do so."
How hard can it be to offer a universal health care plan? "John Edwards had a plan, I had a plan, Chris Dodd had a plan, Dennis Kucinich had a plan, Bill Richardson had a plan. Because we're Democrats ..." Clinton said.
But Obama, in his Bob the Builder campaign designed to appeal to the toddler in every American, offers a plan that is all gain and no pain: subsidized health insurance for anyone who wants to buy it, whenever they want to buy it. More money, more choice, no cost. Gee, what's not to like?
Nothing, except that Hillary is correct. Obamacare can't possibly work, because it doesn't make sense to buy insurance when you are young and healthy if you are guaranteed access anyway when you are older and sicker.
And that's the problem.
The exchange between the two Democrats highlights the dirty little secret that not even Hillary will tell you about a universal government health insurance program. The problem with our current system that mandatory national health insurance will solve is not that people don't get health care -- it's that they don't pay for it.
Young healthy folks are more and more likely to go without health insurance. That means the pool of insured people is older and sicker and, therefore, more expensive to insure. Health insurance premiums rise, which makes health insurance an even worse deal for the relatively young and healthy, guaranteeing that more and more twentysomethings are uninsured, and health insurance costs for us middle-aged and older folks skyrocket.
What kind of people in the U.S. are uninsured? A whole lot of people like Brandy Coons, a 23-year-old Atlanta waitress highlighted on the front page of The New York Times as the new face of the "free rider" problem. Brandy admits she could probably afford a policy if she cut back on her gym membership and her photography hobby, but why should she do that?
"I'm young and in pretty good shape ... The insurance premium was more than what I would pay for my prescriptions, so I just decided not to deal with it," Coons said.
But even The New York Times cannot admit the real "free rider" problem here. It's not that the health care needs of uninsured twentysomethings like Brandy are bankrupting the system. It's that not enough twentysomethings like Brandy are paying for the health care of fortysomethings and older. That's the only way insurance makes sense: We pay into it when we are young and healthy, and we get something out of it when we are older and more likely to get sick.
But try running on that as your platform: Make the young people pay more!
Here's the other dirty little secret: National health insurance is going to cost Brandy and other taxpayers a whole lot more than either Hillary or Obama admits. Just ask Gov. Deval Patrick in Massachusetts, where just two years into operation, the state's mandatory health insurance plan is already costing $400 million more than budgeted.
Meanwhile we have a Medicare system that is going to go bankrupt.
Here's a question neither Hillary nor Barack will answer: How can we justify spending billions to insure the Brandys of the worlds, when we haven't yet secured the health care financing for our existing promises to senior citizens?
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