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
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