Idaho Health Care for All

October 7, 2009

Dear PNHP colleagues and friends,

While media coverage of the health reform debate is focused on the Senate Finance Committee's bill (which was largely drafted by current and former executives at Wellpoint, the nation's largest private health insurance company), several portentous congressional votes on single-payer Medicare-for-All loom on the horizon.

You can help determine the outcome of these votes, which are truly without historical precedent.  

Some recent media highlights

1. A new study estimating that lack of health insurance causes 45,000 deaths annually, by Dr. Andrew Wilper and PNHP co-founders Drs. David Himmelstein and Steffie Woolhandler, was covered by the New York Times, CBS Evening News, Reuters, Amednews, and more.  Dr. John Geyman wrote an opinion piece about the study at The Huffington Post (see below). Dr. Deb Richter's op-ed citing the study appeared in The Progressive. 

Political figures, commentators and editorial writers are now routinely citing the study's finding of 45,000 deaths annually in their discussions of our health care crisis.   Even Sen. Max Baucus has cited it, erroneously asserting that "[my] bill would fix that." (Actually, his bill would leave some 25 million uninsured, which translates into about 25,000 deaths annually.) 

2. PNHPer and "Mad as Hell Doctor" Dr. Paul Hochfeld was admitted at the last minute to Obama's press event with physicians Monday and appeared on Keith Olbermann's "Countdown" show on MSNBC.  The Mad as Hell Doctors, led by Hochfeld and Dr. Mike Huntington, wound up their 26-city, nationwide tour with a rally in Washington, D.C., on Sept. 30.  They received extensive regional press.

3. Finally, an excellent article by Michael Moore and the California Nurses Association's Rose Ann DeMoro explains "Why the current bills don't solve our health care crisis," and why an improved and expanded Medicare for All is the only effective Rx (see below). Activists are encouraged to use the article's talking points for their own op-eds and letters.

Yours truly,

Mark Almberg Communications Director	Quentin Young, MD National Coordinator

P.S. Register today for PNHP's Annual Meeting on Saturday, Oct. 24, in Cambridge, Mass., at the Royal Sonesta Hotel. Guest speakers include Dr. Marcia Angell, former editor of the New England Journal of Medicine; Harvard health economist William Hsiao, Ph.D.; journalist T.R. Reid; Sen. Bernie Sanders and Rep. Anthony Weiner and more. You won't want to miss this extraordinary gathering!

A Death Every 12 Minutes: The Price of Not Having Medicare for All

By John Geyman
The Huffington Post
Posted: September 18, 2009

Americans are dying at a faster rate - 1 every 12 minutes, 5 an hour, 120 a day, 45,000 a year - not from war or natural disaster, but from lack of health insurance.

That's the stunning finding of a study published today in the American Journal of Public Health by leading researchers at Harvard Medical School. The report, "Health Insurance and Mortality in U.S. Adults," reveals that the uninsured have a 40 percent higher risk of death than those with private insurance, resulting in 45,000 preventable deaths annually.

These are our friends and neighbors, our fellow Americans who can't afford or otherwise get private health insurance. Increasingly, this group includes nearly all lower-income and a growing majority of middle-class Americans.

The Institute of Medicine estimated in 2002 that more than 18,000 Americans between the ages of 19 and 64 were dying each year as a result of being uninsured. The new number is two and a half times that figure.

Trying to get by, the uninsured and underinsured delay necessary care, put off filling drug prescriptions or take only some of their medications each day. Most are just one major illness or accident away from financial ruin.

A growing number of patients with cancer have to turn down recommended chemotherapy or radiation treatment because of inability to pay for care. If they have insurance, many find that the small print in their policies excludes such coverage. If they are uninsured, their risk of death multiplies. No one in dire need of medical care should be put in this lose-lose situation.

We're not talking about a third world country. This is the United States, one of the most industrialized nations in the world. But increasingly, we look more like a developing country - 42nd in the world for life expectancy (behind Japan and most of Europe), and ranked last among 19 OECD countries in preventable deaths that should not occur in the presence of timely and effective health care.

Meanwhile, the charade goes on, as our elected representatives in Congress dither over health care reform. None of the bills in Congress will resolve the affordability and access problems.

The Congressional Budget Office estimates the House health reform bill would still leave 17 million persons uninsured and that Sen. Baucus' bill, unveiled yesterday, would leave 25 million uninsured. That translates into tens of thousands of unnecessary deaths every year.

There are now 3,300 health industry lobbyists running around Washington, D.C., trying to shape the small print to their advantage in whatever bill finally gets passed (if any). The insurance and pharmaceutical companies and their hangers-on are spending $5 million a week to block real reform. Suffice it to say that none of these companies have the best interests of the uninsured or the underinsured at heart.

Through its trade group, America's Health Insurance Programs, the industry is fighting for its life (but not our lives). And so far, it is winning. By "cooperating" with health care "reform" by pledging to eliminate pre-existing conditions as a barrier to coverage, and saying they will take all comers in return for a government mandate that everyone be required to buy its shoddy products, the insurers are poised to reap a massive financial windfall.

So far, the bills in Congress set no limits on what the insurers can charge for premiums, and the legal requirements for covered benefits are likely to be minimal.

If a "reform" bill along these lines passes, it will be a bonanza for insurers, drug and medical device manufacturers, and other players in the medical-industrial complex, all at our expense. Since their revenues are our costs (as patients and taxpayers), there will be no cost containment.

We can prevent another 45,000 Americans from dying next year. An effective cure to the health care crisis is within our reach, and it lies within a single-payer, Medicare-for-All plan. By cutting out private insurance companies, we would not only save taxpayers billions, but deliver quality care to everyone. We shouldn't have to wait another 12 minutes.

Dr. John Geyman is professor emeritus of family medicine at the University of Washington School of Medicine in Seattle, a past president of Physicians for a National Health Program and author of Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It.

Why the Current Bills Don't Solve Our Health Care Crisis

By Michael Moore
Huffington Post
Posted: September 29, 2009

Co-authored with Rose Ann DeMoro, executive director, California Nurses Association/National Nurses Organizing Committee

Now we know why they've stopped calling this health care reform, and started calling it insurance reform. The current bills advancing in Congress look more like rearranging the deck chairs on the insurance Titanic than actually ending our long health care nightmare.

Some laudable elements are in various versions of the bills, especially expanding Medicaid, cutting the private insurance-padding waste of Medicare Advantage, and limiting the ability of the insurance giants to ban and dump people who have been or who ever will be sick.

But, overall, the leading bills and the President's proposal are, like the dog that didn't bark, more notable for what is missing.

Here are 13 problems with the current health care bills (partial list):

1. No cost controls on insurance companies. The coming sharp increases in premiums, deductibles, co-pays, co-insurance, etc. will quickly outpace any projected protections from caps on out-of-pocket costs.

2. Insurance companies will continue to be able to use marketing techniques to cherry-pick healthier, less costly enrollees.

3. No restrictions on insurance denials of care that insurers don't want to pay for. In case you missed it, the California Nurses Association/National Nurses Organizing Committee uncovered data on the California Department of Managed Care website recently that found six of the biggest California insurers rejected, on annual average, more than one-fifth of all claims every year since 2002.

4. No challenge to insurance company monopolies, especially in the top 94 metropolitan areas, where one or two companies dominate, severely limiting choice and competition.

5. A massive government bailout for the insurance industry through the combination of the individual mandate requiring everyone not covered to buy insurance, public subsidies which go for buying insurance, no regulation on what insurers can charge, and no restrictions on their ability to decide what claims to pay.

6. No controls on drug prices. The White House deal with Big Pharma, which won bipartisan approval in the Senate Finance Committee, opposes the use of government leverage to negotiate real cost controls on inflated drug prices.

7. No single standard of care. Our multi-tiered system remains with access to care still determined by ability to pay.

8. Tax on comprehensive insurance plans. That will encourage employers to reduce benefits, shift more costs to employees, promote proliferation of bare-bones, high-deductible plans, and lead to more self-rationing of care and medical bankruptcies.

9. Not universal. Some people will remain uncovered, including those exempted, and undocumented workers, denying them treatment, exposing everyone to communicable diseases and inflating health care costs.

10. No definition of covered benefits.

11. No protection for our public safety net. Public hospitals and clinics will continue to be under-funded and a dumping ground for those the private system doesn't want. Public monies going to hospitals serving low-income communities will be shifted to subsidies for private insurance.

12. Long delay in implementation. Many reforms don't go into effect until 2013.

13. Nothing changes in basic structure of the system; health care remains a privilege, not a right.

We may be slow learners, but the rest of the industrial world has figured it out: Universal, single-payer or national health care systems. That's the reason why all those other countries cover everyone, have better patient outcomes, cause no one to declare bankruptcy or lose their homes because of medical bills, and spend less than half per capita on health care than we do.

We could do it too, by reducing the starting age for Medicare from 65 to 0. There's still time to act.

Call on your Congress member to support the vote coming up on the House floor on the Anthony Weiner amendment to protect, expand and improve Medicare for All. Senators have the same opportunity in a vote on Senate bill 703, being offered as a floor amendment by Senator Bernie Sanders.

Democrats must also ensure that whatever bill passes includes a provision enabling states to set up their own single-payer systems. These votes are the true litmus tests of the Democrats' commitment to guaranteeing health care for all, and finally solving our health care crisis.