Edith Kenna writing in the Fort Wayne News-Sentinel 5/1/08

May 9, 2008


Article published May 1, 2008
This is ‘Cover the Uninsured Week;’ let’s find common-sense health plan

 

by Edith Kenna

There are 47 million Americans without health insurance; about 18 percent of those are children. Shockingly, 2 million of the uninsured are veterans, along with 4 million of their family members.

This means that one in eight of the uninsured population is a veteran or a member of a veteran’s household. The majority of the uninsured work, many at more than one job that don’t offer health insurance, or if offered, the policy is not affordable.

This week is “Cover the Uninsured Week.” Hoosiers for a Commonsense Health Plan, a grass-roots citizens movement in Indiana, supports this effort, but also adds, “And the rest of us, too, with a health care policy that is accessible, affordable, portable and of quality.” Simply having health insurance does not guarantee adequate and appropriate access to health care. Americans need a health care system that provides universal access for all, regardless of ability to pay. We need a system that works to control costs while offering high-quality care.

Americans must have comprehensive care that is not employment-based, as rarely today will one person work for the same company for his entire life. Small businesses and entrepreneurs now cannot afford insurance for themselves, their families or their employees.

Premiums and co-pays increase for all those covered by group plans, while profits for insurance companies grow dramatically. Our market-based system is failing badly. The health insurance companies can only make profit by denying care. From a business perspective, profit is the goal.

No one cares that Bill Gates makes money by selling software, but at a time when 22,000 people die annually due to lack of health insurance, we must wonder if the market-based health care system any longer serves the public interest. In Indiana, 750,000 people lack health insurance.

According to a recent report by Families USA, 460 Hoosiers died last year as a direct result of not being insured. The cost of private insurance in Indiana is higher than the national average, and Hoosier workers are being asked to contribute an increasing amount of their insurance costs. A single-payer system, like Medicare, will cover everyone and reduce health care costs for most businesses and individuals.

Rex Nutting, writing for Market Watch, a subsidiary of Dow Jones, said, “Enrolling every American in a health insurance system like Medicare would extend care to millions of uninsured Americans, cut costs by eliminating unnecessary paperwork and improve quality of care. None of the leading candidates has endorsed such a simple solution, preferring elaborate Rube Goldberg plans that might bring a few more people under insurance coverage but would not fundamentally change what most Americans believe to be a deeply flawed system.”

Sens. Clinton, Obama and McCain all endorse reform, but all of their policies will ensure that the Rube Goldberg contraption of a health care system will clunk along ineffectively, inefficiently and inequitably, and we, the greatest industrialized nation in the world, will continue to pay in lives, in creativity, in moral standing and in money to preserve an antiquated system leaking from all sides that no longer performs its function.

Sen. McCain proposes that each individual carry his own health insurance policy and it be portable for his entire life. McCain’s plan ignores the fact that companies such as General Motors and Ford Motor Company can barely afford to provide health insurance for their employees. It has been reported that GM has spent as much money on health care as it has on steel. Starbucks Chairman Howard Shultz stated in September 2005 that Starbucks would spend more on health insurance for its employees than it would on raw materials to brew its coffee.

Both Obama and Clinton support tax subsidies so that the uninsured can purchase insurance policies. Milton Fisk, Ph.D., professor emeritus, Indiana University, has called these proposed policies “insurance protection plans” as insurance companies will reap huge profits, but there is no guarantee that actual care accessible under these policies will be adequate, affordable or retainable.

No candidate is talking about controls or regulations on the health insurance industry. It will be business as usual — inadequate, expensive care, policies that are hard to get and easy to lose, bureaucrats and not physicians making medical decisions, mountains of paperwork leading nowhere — with taxpayers, who may have our hearts and heads in the right place, contributing more tax dollars to a for-profit health care system that spends 31 cents of every dollar on administrative costs and provides obscene salaries to top executives.

The average income in Indiana is $41,567. The average Hoosier would have to work 282 years in order to make what now retired Wellpoint/Anthem CEO Larry Glasscock made in 2004. I’m just not interested in contributing anymore, and I’m sure you’re not either.

There is one plan that was first introduced in Congress in 2003 by Rep. John Conyers from Michigan. It now waits to be reintroduced this year into the House Ways and Means Committee. It is known as “Medicare for All,” HR 676. This bill has 88 co-sponsors in the U.S. House of Representatives. It has been endorsed by 15,000 physicians and 397 labor unions in 48 states, including 100 central labor councils. Thousands of U.S. citizens have signed petitions in favor of HR 676. Interestingly enough, this bill has never had a Congressional hearing under either a Democratic or Republican administration.

Health care is indeed one of the country’s greatest problems, but no congressman or senator likely spends sleepless nights worrying about himself or his family, since members of both the House and the Senate have adequate coverage. Even those legislators who lose their Washington jobs (not re-elected) manage to keep this comprehensive plan that, according to journalist Eugene Robinson, Washington Post, (Jan. 6) might just be considered “socialized medicine,” since a large portion of its costs are borne by taxpayers.

The powerful insurance and pharmaceutical industries do not want a public conversation and debate about HR 676, when the public interest calls out for information, public discussion and illumination of the facts, leading to a comprehensive and new health care policy for the citizens of the United States. So far, these powerful lobbies have been successful and our legislators appear timid and complacent, not creative, bold or courageous.

Somehow, the beltway around Washington, D.C., has acted as a sound barrier to the nation’s cry for relief from the most expensive health care system in the world that leaves millions of Americans without the care they need to be full contributing members of society.

Please learn about us, Hoosiers for a Commonsense Health Plan and Physicians for a National Health Program. Take it upon yourself during the week of “Cover the Uninsured” to become informed. Support us in calling for a Congressional hearing on HR 676, “Medicare for All” — a single-payer, universal health care plan. Citizens need all the information on options made available to us.

Let private plans defend themselves with fact, not myth and fear. It is we, not the powerful lobbies, who should and will make the decision about health care in America.

 

Edith Kenna is a Fort Wayne resident and board member of Hoosiers for a Commonsense Health Plan.

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U.S. must look for a health care system to cover everyone

April 25, 2008

HeraldTimesOnline.com

Guest column U.S. must look for a health care system to cover everyone  April 25, 2008
This guest column was written by Robert Stone, M.D., director of Hoosiers for a Commonsense Health Plan, and state coordinator, Indiana chapter, Physicians for a National Health Program.

Nationally, the week of April 27 to May 3 is Cover the Uninsured Week. Locally, many of the 883 GE employees and their families are getting closer every day to becoming uninsured. Since World War II, access to health care in this country has been based on employer-sponsored insurance, but the percentage of workers covered by their employers peaked in 2001 at 65 percent and has been dropping ever since. The projections are that in a very few years less than half of Indiana workers will have coverage through their work. We’ve heard about the problems the auto industry has in paying for health care, but small businesses are feeling it even more, dropping their coverage at an even higher rate. The problem of the uninsured is not just “their” problem, it’s “our” problem. We are all just a layoff, a plant closing or a divorce away from being uninsured.

To make matters worse, we have a new epidemic of under-insurance. From 2000 to 2006, insurance premiums rose 87 percent while earnings increased only 20 percent over that same six-year period. The national average cost is now $1,000 a month for family coverage. While premiums have soared, deductibles and co-pays have gone up, too. In the desperate attempt to find a policy with affordable premiums, the fine print becomes crucial. For example, the official plan offered to Indiana University students has an annual maximum benefit of $75,000 per injury or illness. You can spend that much in one week in the intensive-care unit!

It is becoming clear that our current medical economic situation is unsustainable, with medical costs rising faster than inflation, insurance premiums rising much faster than earnings, while the number of uninsured just keeps rising. We don’t even need to go into the moral dimension of the richest country in the world allowing a rapidly growing number of its people to live under Third World medical conditions.

Taking into account that costs are out of control, how can we possibly contain them? The essence of insurance is that the greatest efficiency is achieved with the largest risk pool. The essence of bargaining for good prices is the use of bulk purchasing. The most cost-effective medical care is preventive care. How can you incorporate all that in one solution? By setting up an all-inclusive system that brings everyone into one big risk pool, in other words, a universal system.

How can we run a universal system in the most cost-effective way? The government will have to be the paymaster. Doctors and hospitals should stay private and independent.

Where is the model that we can use? Our 40-plus years of experience with Medicare. In the mid 1990s, when officials in Taiwan decided that their market-based health insurance system was failing, they looked at the experiences of other countries around the world and ended up with a system very much like our Medicare, but for everyone, not just those over age 65.

Is that socialism? I hardly think so. If Medicare is not socialism for everyone over age 65 right now, why is it socialism if we cover the rest of us? Is it any different from our “socialized” police force or fire department?

Is Medicare perfect? No, but it is a solid foundation to build on. Do you see long lines of seniors waiting outside of doctors’ offices around town? No, waiting lines are not a problem. Do Medicare patients get second-rate care? No, quality is no worse in Medicare than private insurance, and in many ways better.

Cover the uninsured? Aid for the under-insured? And those at risk of losing their insurance? That’s getting to be about everyone under Medicare age. Let’s cover everyone. Medicare for all! 
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Providing health care for all shouldn’t make insurers rich

April 25, 2008

Guest column
Providing health care for all shouldn’t make insurers rich

Herald-Times
April 24, 2008


This guest column was written by Milton Fisk and Kay Mueller, who are members of the research committee of Hoosiers for a Commonsense Health Plan. Fisk is also an author of a book on health care reform.

Government subsidies and outsourcing may be good for business without always being good for the public. Medicare outsources the administration of its prescription drug program, Medicare D, to private insurers. Medicare Advantage — Medicare C — subsidizes managed care insurance plans for seniors choosing them. Several current presidential aspirants — Clinton and Obama — would subsidize the purchase of insurance for the low-income uninsured. Each of these plans offers private insurers protection against a less wasteful plan, one that does without private insurers.

Involving the insurers in the Medicare drug and Advantage plans is a needless drain of Medicare funds.

The drug companies charge much more for the drugs used under Medicare D than they do for the same drugs bought by Medicaid. The law forbids Medicare to negotiate prices of Medicare D drugs with the pharmaceuticals. Medicaid bargains a 30 percent discount on drugs while the insurers running Medicare D bargain only a 5 to 10 percent discount. Medicare C’s Advantage Plan turns over managed care to private insurers, paying them 10 to 12 percent more than Medicare pays for seniors in its regular program.

Suppose one of those presidential aspirants wins. What would the subsidies they want cost? They want subsidies to help at least the poorest two-thirds of the 47 million uninsured buy insurance.

The insurers would be in for a windfall injection — from the government and low-income individuals — of about $150 billion each year. Any industry would love this. But would it serve the public interest?

The answer comes from looking at how to get quality health care to the uninsured for much less. The private insurers operate with enormous overhead. Profit is an essential part of it, since without it, investors turn away.

Then there is marketing, lobbying, paperwork, computer systems, colossal salaries for upper level managers and the expense of constantly merging and reorganizing. In sum, overhead accounts for roughly 25 percent of premium income, while overhead for Medicare is five times less!

The presidential aspirants who promote this kind of insurer protection plan recognize the waste involved. So what is their response? They would make subsidies contingent on reducing overhead. Sen.Clinton’s plan says premiums are not to be dedicated to “excessive profits and marketing.” This might reduce overhead from 25 percent down to 15 or 20 percent of premium income — still three or four times more than Medicare’s overhead. How can anyone stand before the public and say they want to waste billions of taxpayers’ dollars just to protect the insurers?

It is not right to use the uninsured as an excuse for making the insurers richer. We don’t need the insurers to provide the uninsured with health care.

Those proposing insurance protection plans spread the view that we shouldn’t help the uninsured unless the corporations make a buck out of it. Whatever happened to the public interest? 

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Best Article Yet on Why Mandates are Bad Policy, by Miles Mogulescu

March 31, 2008
Why Not Single Payer? Part 5: The Single Payer Health Care Movement and the Plans of the Democratic Presidential Nominee 

Posted March 31, 2008 | 11:11 AM (EST)

  • Following is the text of my speech at the Take Back America Conference panel on “The Single Payer Health Care Movement and the Plans of the Democratic Presidential Nominee.” I was honored to be on the panel with Courtney Farr of the California Nurses Association and Congressman John Conyers, Chairman of the House Judiciary Committee and chief sponsor of H.R. 676, the single payer Medicare For All bill.
 

Miles Mogulescu, on the Huffington Post

Most progressives agree that the government has an important role to play in guaranteeing health care for all Americans, in contrast to most Republicans who want to leave people at the mercy of the private market. But the Conference also revealed differences among progressives on strategies for achieving universal health care. For many years, most progressives have supported the principal of Medicare For All — a system in which all Americans have guaranteed health care from cradle to grave, financed through taxes instead of insurance premiums, and in which medical decisions are made between patients and doctors and not by private insurance bureaucrats. The Campaign For America’s Future, which sponsored the Conference, supports a compromise private/public hybrid, in which most people continue to get private insurance through their employers, but in which companies and uninsured individuals can also buy into a public alternative. Most versions of this plan, including that supported by Hillary Clinton, include an individual mandate in which the uninsured are required by the government to buy health insurance, although they are given the “choice” between private insurance and the public plan.

Such difference threaten to divide the progressive movement when it comes to health care reform. This was evident in California recently. A year ago, both houses of the California legislature passed a bill which would have established a single payer system for California’s 37 million citizens, which was vetoed by Republican Gov. Schwarzenegger. This year some Democrats, led by California Assembly Speaker Nunez, tried to forge a compromise with Schwarzenegger for a health insurance mandate similar to that enacted in Massachusetts under Mitt Romney. The compromise was supported by some progressives, most notably Andy Stern of the SEIU. It was defeated 8-1 in committee in the State Senate after being opposed by the majority of the progressive health care movement, including the California Nurses Association and the California One Care Coalition.

Progressives will need to take great care not to let these differences undermine the movement for universal health care nationally.

Here’s the speech: Before introducing Chairman John Conyers and Courtney Farr of the California Nurses Association, let me outline a few principals for our discussion this afternoon about how progressives should respond to the health care proposals of the leading Democratic presidential contenders.

First, if we have a Democratic president and an increased Democratic Congressional majority after November, we will have the best opportunity to enact Universal Healthcare in America since the Truman administration. If we blow it, the opportunity could be lost for another generation.

Second, this kind of fundamental social change will never take place only from the top. It requires a mass movement pushing from below. If history proves anything, it’s that Washington only enacts major social change if prodded by large scale social movements such as the union movement, the civil rights movement, the women’s movement and the anti-war movement. There already is a strong mass movement of unions, doctors, nurses, churches and community organizations building support for Medicare for All as embodied In HR 676 sponsored by Chairman Conyers. It has, I believe, over 80 Congressional co-sponsors–that’s nearly 1/3 of the Democrats in the house– and has been endorsed by over 235 union organizations in 40 states, as well as many citizens, religious and medical organizations.

Third, any healthcare reform plan that’s based on private insurance is fatally flawed. A. The incentive of private insurance is upside down. The less care a private insurance company provides for the same premiums, the higher their profits. Most of us saw the cases in “Sicko” of insurance companies paying bonuses to employees who rejected healthcare claims from the sick. B. With hundreds or thousands of different private health insurance plans, it’s impossible to negotiate consistently lower costs with health care providers and drug companies. A single payer system has the market clout to reign in costs. C. Most important, private insurance is a colossal waste of money. Administrative costs for Medicare are 2-3%. Approximately 30% of private insurance premiums go to overhead, profits, and executive salaries. Doctors and hospitals have to employ huge staffs just to process insurance claims from a multiplicity of insurance companies. About 20% of the income of private doctors goes to pay for this staff. Overall, the administrative costs of private insurance exceed $400 billion a year. That.s enough to cover all of the uninsured without raising taxes.

Fourth, as Barack Obama has said, “Change is hard.” You do not bring about fundamental social change by surrendering on basic principals without firing a shot. Let me say that again: You do not start by surrendering on basic principals without firing a shot. That’s the problem with the approach of the leading Democratic presidential contenders and some progressives like those who spoke this morning on the Campaign for American’s Future panel led by Jacob Hacker. Before the political battle even begins, they ask the mass movement for universal healthcare to abandon the principal of not-for-profit universal health care for a plan based on employer and individual mandates to buy private health insurance (albeit with a public alternative). George Lakoff’s Rockridge Institute calls that approach “Surrender In Advance”.

Read the rest of this entry »

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Even Doctors are Coming Around! by Dr. Rob Stone

March 31, 2008

People often say that doctors are too conservative, too concerned about their income, or just too selfish to favor universal health insurance.  My experience working in the ER of a busy hospital goes contray to that sentiment.  More and more I will hear from a colleague, “Rob, I used to not support this single payer stuff you talk about, but now I think that it makes sense.”  Doctors are realizing that they would rather take their chances with Medicare for All than remain at the mercy of AnthemWellpoint and the other big insurance behemoths.  They get it that too many of our healthcare dollars go to overhead, inefficiency and waste.Now there is  just-released evidence that backs up my anecdotal experience.  Dr. Aaron Carroll at IU School of Medicine has a new study “Support for National Health Insurance among U.S. Physicians:  5 Years Later” published in the April 1, 2008 issue of the prestigious Annals of Internal Medicine.  The study shows that 59% of physicians across the country support legislation to establish national health insurance.  This is up from 49% when the study was first done in 2002.  It is the largest study ever conducted among doctors on the issue of health care reform.  Dr. Carroll, Director of Indiana University’s Center for Health Policy and Professionalism Research, commented: “Many claim to speak for physicians and reflect their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support the government creating national health insurance.” In Minnesota, the proposed Minnesota Health Plan would move health insurance out of the private sector and create a single payer system for the state.  A recent survey through the University of Minnesota and St. Olaf College found that 64 percent of Minnesota’s physicians support a single-payer system much like the Minnesota Health Plan.  Dr. Ann Settgast explained “As a physician, my job would become simpler as I could make medical decisions based on my expertise and the patients’ best interests — not based on regulations [from insurance companies] that often do not have these interests in mind,” she said. “The single-payer solution is the only choice that makes sense given my motivation to provide the highest-quality care to each of my patients.”  Don’t be afraid to talk to your doctor or other providers and encourage them to join PNHP and support the only commonsense solution that we know will work! 

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Welcome

March 31, 2008

Welcome to the new HCHP Blog! As our group has grown from a small group of folks in Indianapolis and Bloomington gathering monthly on the IU campus to a state wide group with multiple chapters, the need has become obvious for new ways to communicate and keep in touch. Please participate and make this blog a lively way to share information and ideas, and to discuss issues surrounding healthcare at the state level and nationally.

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