Health Care Current State and Important Links

 

PNHP: Setting The Record Straight on Medicare Overhead


CMS Annual Report 2015 and Kaiser Family Foundation (page 4) - Medicare overhead is less than 3% and if Medicare Advantage overhead is excluded, it’s about 1%. Canada’s level of overhead is about 1.5%.


OECD Health Data 2014 - Of the 34 OECD (“industrialized”) countries, USA outcomes exceed only the Czech Republic, Poland, Estonia, Slovak Republic, Hungary, Turkey and Mexico. Total health expenditure is by far the highest.


Healing Health Care - Minnesota State Senator John Marty is pushing for a state plan that mimics Single Payer. While no state plan can really accomplish the economics of scale of a Medicare-For-All system, this link provides some brief excerpts from his book where he gives a concise explanation of why we really need to go there.


Fair Reporters: The Best Healthcare Systems In The World - An oddly written summary of some of the highest ranked healthcare systems. Very high level, but a decent overview. I wish there were better sources for this.


#cureALL - 7 minute video outlining the case for Single Payer


Physicians For A National Health Program


National Nurses United


Single Payer Action


Single Payer Now


Labor for Single Payer


Fix It: Health Care At the Tipping Point


American College for Emergency Physicians: It’s Time For Single-Payer - A great summarization destroying all of the myths that claim that Single-Payer won’t work in the US.


Art As Social Inquiry > Health Care - A very interesting approach to an examination of our current state of health care. Be sure and read the John Boehner profile first.


Health Care is a basic human right. It is not just for the privileged rich. We live in the most advanced and powerful country that the world has ever known. But the fact is that today, even with the recently passed heath care reform act, we still live in a country where we are all just one serious illness away from homelessness. Therefore we do not live in a ‘civilized’ country. This is not true of any other advanced industrialized country in the world. They all have some way to provide basic care for their sick. And each one of them is also an example of how medical costs can be reduced/contained by getting rid of the overhead and profit inherent in the health insurance model, while at the same time reducing mortality, increasing access and overall patient satisfaction. We don’t have it today, but we easily could. Why don’t we just do it?


The new law “Patient Protection and Affordable Care Act” (PPACA) doesn’t directly address the above or the problems faced by sick people in this country. It is built on the foundation of a dysfunctional, for-profit, insurance company model which can never be tweaked enough to overcome its inherent short falls.


The bill was signed into law by Obama on 3/23/10.


The Senate Vote


The House of Representatives Vote


What’s wrong with the health care law:


  1. -No public option (not even an anemic one) - see especially entry of 3/16/10. The public option was originally supposed to be a ‘realistic’ compromise on Single Payer - which is the only plan that will actually solve the biggest issues preventing Americans from getting what every other industrial country in the world has.


  2. -Mandate forces IRS penalty if you don’t buy health insurance, at whatever rate is available - forcing people to purchase policies so limited that they won’t help when a catastrophic health issue arrises. It will be ‘medical apartheid.’


  3. -No curb or control of any type on health care premiums. The law calls for first an ‘internal review’ - by the very insurance company that hiked the rates to begin with. Yeah that’ll work. Then a second review by the state insurance commissioner. This part is an unfunded mandate. Most states have no or very anemic regulation in this regard and many states are a revolving door between the insurance commission and the health insurance industry. Not gonna work. See ‘Anti-trust...’ bullet below.


  4. -Restrictions on abortion and other women’s access to health care. Obama signed an Executive Order codifying the ‘Hyde Amendment’ into canonical law. The Hyde Amendment had been a year to year restriction on govt funding for abortion, but by Obama’s action has now been permanently mandated. Outrageous! This bill is especially bad for women in several ways. Check out the comments of Terry O’Neill (president of NOW) in 3/26/10 entry for the Bill Moyers show, noted just below.


  5. -Tax on “cadillac plans” that aren’t really, just because the insurance companies have jacked the premiums sky high. Eventually we’ll all be in a plan categorized as “cadillac.”


  6. -Anti-trust exemption still exists for insurance companies. And see entry of 2/23/10: AMA Report on lack of competition in health insurance industry and entry of 3/8/10 on competition.


  7. -Does not do away with ‘recision.’ There is some confusion on this. The law actually states that recision must end in Sept. 2010, and some insurers have promised to end it immediately. However, there is an exception and that is for ‘fraud or intentional misrepresentation’ which is the reason they have always used to drop people when they get catastrophic medical problems. There is supposed to be some unspecified ‘3rd party oversight.’ You can see where this goes. Recision is still in place and will remain in place.


  8. -reduces Medicare coverage and reimbursement


What’s right with the bill:


  1. - Theoretically expands Medicaid to between 16 and 20 million people. But this is under-funded, so the states have to pay. Since most doctors won’t accept Medicaid, it will stretch the ones that do very thin. Although Medicaid patients do well when they get so sick they have to go to the ER and then admit to hospitals, for preventative care, cancer and other diseases that cause death like diabetes, hypertension, high cholesterol they do no better than people without any form of health care. It’s ‘medical apartheid.’


  1. -Increase funding for community health centers. This is actually the most positive thing about the bill.


  1. -Reduces but does not eliminate the ‘donut hole.’


  1. -Very weakened (from the Kucinich proposal) waiver of some federal regulations and allows some states to experiment with Single Payer, but only after 4 years.


All 4 of these ‘right’ items could have been passed as stand alone measures without making us slaves to the health insurance industry.


“Hijacked” - a book we all should read. The editor’s note is informative as to why.


Health Reform . GOV


Also see “Key Provisions That Take Effect Immediately”, but take this with a grain of salt. Most of them have not been enacted and so far my research indicates there is no concrete detailed plan in place to make them happen. Ex: Immediate availability of high-risk pools for those with pre-existing conditions. Here in GA, our insurance commissioner just simply refuses to do it. I have tried numerous times in vain to reach someone at HHS and at their office of ‘Health Care Reform’ to get details on how it will be implemented and the result has been NADA (non-working numbers, messages not answered, etc).


Urban Legend:


PolitiFact: Obamacare Cuts $716 Billion From Medicare to Pay for Obamacare - Half-true. Obamacare institutes cost saving measures, such as cutting subsidies to Medicare Advantage - started under George Bush under the ruse that ‘more competition would reduce costs.’ In fact Medicare Advantage costs are actually much higher than traditional Medicare. Obamacare also reduces reimbursements to hospitals that do not meet certain efficiency measures, such as re-admissions. The implication of the statement is that money was removed from the ‘Medicare Fund’ and added to the ‘Obamacare Fund’ is completely false.


Memorable links:


11/17/17


Truth Out: Single-Payer: A Reproductive Justice Value - Twenty eight states now have at least 2 restrictions on abortions that conflict with proven science.


The reproductive justice movement focuses on expanding the ability of all people to access the full spectrum of reproductive health care...Reproductive justice is focused on each and every person having the resources and tools to exercise agency over their sexual and reproductive lives.”


Reproduction is a normal function of human beings. Laws that restrict specifically women from receiving the full spectrum of necessary reproductive health services essentially restrict their access to full gender equity, and to full personhood in society.


7/25/17


Forbes: The Hidden Costs of Medicare Advantage Plans


6/1/17


OpenSecrets: Health Care Overhaul: Total Contributions From Healthcare Industry PACS to R’s and D’s - No Difference.


4/6/17


Economist Poll: Another Poll Shows 60% of Americans, Including 40% of Self-Identified Republicans/Trump Voters Favor Medicare For All - See item 81 of this poll. This comes on the heels of the Gallup poll last May and the Pew Research poll in January, both showing the same numbers. Hard to argue with 3 separate polls that all show the same numbers.


3/31/17


Health Over Profit: Democrats Against Single Payer - Dems only advocate for Single Payer when it doesn’t cost them anything. But time after time, they renege time.


2/21/17


Annals of Internal Medicine: Single-Payer Reform: The Only Way to Fulfill the President’s Pledge of More Coverage, Better Benefits, and Lower Costs - “Researchers estimate a $500+ Billion savings per year.” This is a ‘breakthrough article’ because it’s the first time such a prestigious medical journal has published anything so pro-Single-Payer. Here are the major points in the article, just in case you don’t happen to belong to the American College of Physicians. 58% of Americans favor Single-Payer over ACA or any other system, including 73% of Democrats and 41% of Republicans. And yet strangely it’s not ‘DP’ approved - except maybe as a great talking point. None of the party bosses from either the ‘DP’ or the ‘RP’ will allow it past committee. Oh, that’s right. It’s not “realistic.” Even though it is realistic in every other industrialized country in the world and even though overhead costs would drop from 20+% to less than 3%. Time for a new approach?


1/13/17


Pew Research: More Americans (60%) Say Government Should Ensure Health Care Coverage - This is the highest percentage in 10 years and is up from 51% of all Americans who felt this way last year. 85% of Democrats and 32% of Republicans agree that it is the government’s responsibility to make sure that all Americans have health care coverage.


5/16/16


Gallup Poll: Majority of US Supports Fed-Funded Health Care System - 58% of US adults are in favor of repealing ACA and replacing it with Single-Payer, including 41% of Republicans and right-wing voters.


5/5/16


American Journal of Public Health: Moving Forward From the Affordable Care Act to a Single-Payer System - A milestone, detailed proposal for how to switch from the current system that still leaves out 33 million and underinsures another 36 million, saving $500 Billion/year in the process - signed by 2,231 doctors. The Summary; Background Fact Sheet.


12/17/15


Kaiser Family Foundation: 58% of Americans Favor Medicare-For-All


6/4/15


NYTimes: In Vermont, Frustrations Mount Over Affordable Care Act - This article is simply stating the obvious, and it’s not just Vermont. Just one more piece of evidence that ACA is NOT a ‘bridge to Single Payer.’ The frustration is nationwide, with the result that for most Americans, “health reform” is now a dirty word. The Republicans/Democrats and their health insurance, Big Pharma corporate backers have scored a huge victory over proponents for Single Payer. Corporations will be in control of our health care for decades.


12/12/13


Politifact: Lie of the Year: “If You Like Your Health Plan You Can Keep It” - Barack Obama


12/3/14


The Hill: Tom Harkin, Co-Author of ACA Says “We Blew It” - “We had the power to do it in a way that would have simplified healthcare, made it more efficient and made it less costly and we didn’t do it. Congress should have enacted single-payer right from the get-go or at least put a public option would have simplified a lot. We had the votes to do that and we blew it.” Exactly what this web site has advocated from the very start (2/15/09). Absolutely stupid and galling!


11/4/13


British Medical Journal: Non-Publication of Large Randomized Clinical Trials - Many studies which show that commercial drugs are not effective, or worse are detrimental just don’t get published. Thus, the scientific method goes out the window.


10/30/13


Truth Out: Obamacare: The Biggest Insurance Scam in History


7/31/13


Univ. of Massachusetts Study: ‘Medicare For All’ Would Cover Everyone, Save $592 Billion Per Year - “With enough left over to pay down the national debt.” The presentation. Summarized in Beckers Hospital Review.


11/3/12


American Public Health Assoc: President Tsou Speaks Out - Synopsis: In 2012 the total bill for health care in the US is $2.85 T. By 2019, we will be spending $4.8 T per year. Over the next decade we will spend $37 T. We spend about 50% more on health care in the US than most other industrialized countries and get poorer outcomes. Obamacare will leave 50 million people without health care. The biggest drag on the balance sheets of every local, state, and the federal government and on the balance sheets of almost every major corporation in the US is Retiree Health Benefits (RHB). The main reason that GM had to declare bankruptcy and restructure its balance sheet was that it had an unfunded liability of $60 B for RHB. In 2009, the GAO calculated that state and local governments in the US had a combined unfunded liability for RHB of $530 B. The only plan that is going to fix this and put US businesses on a level playing field with overseas companies is Single Payer. This is the main reason that large businesses are sending jobs overseas. Apple has moved its manufacturing to a country (Taiwan) that has implemented Single Payer. The US is $16 T in debt and the current market based health delivery system is the primary reason. The most radical idea ever proposed in the US would be to keep what we’ve got and thus bankrupt every local, state and federal government and every large company in America. That is exactly where we are headed if we don’t adopt Single Payer.


10/3/12


Common Dreams: Worse Than War: Deaths From Uninsurance


8/25/12


NYTimes: A Glitch in Health Care Reform - Millions more than expected will be too poor to afford employer health care premiums but will not be poor enough to qualify for expanded Medicaid. About 3.9 million will fall into this category. So as of now 27 million that PPACA proponents originally admitted would not be able to afford health care insurance, plus 3 million from states that will ‘opt out’ based on the recent Whore Court decision (see entry of 7/24) plus 3.9 million as a result of this ‘glitch’ = 34 million. The number keeps rising. Whenever someone calls PPACA ‘Universal Care,’ point this out to them.


8/22/12


Washington Post: Does Medicare Advantage Cost Less? Or Does it Cost More? - Clearly more. MA pays private plans a higher per-enrollee cost than the public plan and it always has. And it covers less. How come? Because insurance companies skim 20% off the top.


9/13/11


You Tube: Tea Partiers Cheer Death of Uninsured


5/15/10


Health Affairs: Phantoms In The Snow: Canadians Use of Health Care Services in the US - Conclusion: “Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectible relative to the use of care by Canadians at home.”


3/26/10


Bill Moyer’s interview with John Nichols and Terry O’Neill, president of NOW - in which O’Neill describes the three ways that Obama stabbed the very women who campaigned so hard for him in the back. She does a good job of concealing her anger, but it shows through. She reminds the audience that NOW put out a statement after the bill became law that NOW is ‘incensed’ and ‘the women’s movement has been betrayed’ and she stands by those statements. This law hits women, and especially poor women, especially hard. And yet all of the Democrats, liberals and progressive-wannabes hail it as if it were the second coming.

  1. 1)The first time we get a ‘comprehensive health care law’ in this country, it singles out a whole class of people to get second-class treatment: women - over half the population. They are deprived of ordinary health care that they need. Abortion is a common medical procedure. 40% of women will get an abortion at some time in their lives. It needs to be safe and equally accessible to all women. Right after he signed the health care bill, he issued an executive order codifying the ‘Hyde Amendment.’

  2. 2) The ‘age rating’ - The insurance companies are specifically permitted under the law to charge 3 times the premiums to old people. This hits middle-aged women the worst because they have been subject all their lives to wage discrimination.

  3. 3) Employers with over 100 employees will be allowed to buy into a plan on an exchange. Plans covered by this provision will be permitted to charge up to 50% higher premiums for women than for men just because of their gender.


3/24/10


Healthcare-NOW!’s statement regarding the new law


9/17/09


PNHP: Harvard Study Finds 45,000 Deaths Annually Linked to Lack of Health Care


Reuters: 45,000 die every year because they lack health care - Abstract American Journal of Public Health: Lack of health insurance is associated with as many as 44,789 deaths per year in the United States. The increased risk of death attributable to no insurance suggests that alternative measures of access to medical care for the uninsured, such as community health centers, do not provide the protection of private health insurance. Despite widespread acknowledgment that enacting universal coverage would be life saving, doing so remains politically thorny. Now that health reform is again on the political agenda, health professionals have the opportunity to advocate universal coverage.


This is roughly equivalent in terms of deaths to 15 9/11’s. So if the US Congress and the AHIP umbrella group are colluding to deny Americans health care, shouldn’t they be considered a domestic terrorist group?


8/11/08


New Yorker: Super Bugs: A New Generation of Superbugs Almost Impossible to Treat - Drug resistant, gram-negative Klebsiella, Acinetobacter, Enterobacter, Pseudomonas probably originating on industrial livestock farms and able to alter their own DNA to thwart new antibiotics, on the fly. These bacteria put us almost back to the pre-antibiotic era. The most dangerous places to be in or near: livestock farms and hospitals. These bacteria are even able to communicate (“quorum sensing”) and wait until there is a critical number present before turning on their virulence gene, at which point it is too late for the host’s immune system to fight them.


7/17/08


Commonwealth Fund: Results from the National Scorecard on US Health System Performance - No comparison to other countries here, but the results are dismal. The overall score is 65 out a possible 100. The really bad news is that this score had dropped from the 2006 study.


7/12/2000


World Health Organization rankings of country by health care - Not to worry. We’re still ahead of Slovenia!


Health care company profits - they report 2-3% while the actual number is closer to 30%. And Here.


The insurance company literally wrote the law for Congress to pass. See entries of 3/29/10 “Baucus thanks Wellpoint VP” and 12/01/09 “AHIP Health Care Proposal


The 18 most commonly held myths about the new health law.


Physicians For A National Health Program (PNHP) side by side comparison: Single Payer vs. Current Law


Health insurers’ industry web site - insight into how they will circumvent and ‘cherry-pick’ the law


Other particularly outrageous entries below:


White House admits deal on drug costs - 8/5/09

and

Deal to prevent consideration of the Public Option - so for months, Obama signaled in newspaper interviews that he was not opposed to the Public Option, but in private he had already dealt it away.


NPR: Obama’s “Quid Pro Quo” With AHIP - Be sure and listen to what Howard Dean says at 5:17. AHIP had several ‘seats at the table.’ Single-Payer had none.


What health industry gets in return for its HCR support - 7/8/09

  1. 1.Hospitals, Insurers, Drug makers promise to reduce the cost of health care by 1.5% per year. So the people who have been stealing us blind for years promise to steal 1.5% less, but only going forward.

  2. 2.See ‘deal on drug costs above.’ Drug makers agree to limit cost of drugs over 10 years - cost to them $80B but in return Baucus promised them an additional $250B in Medicare reimbursements.

  3. 3.Hospitals originally pledged to save $150B over 10 years and in return get monopoly power forcing everyone to buy health care from them. But then hospitals backed out of their side of the deal but got the monopoly power anyway.

  4. 4.Big companies (like Wal-Mart) agreed to insure all of the full time workers, but they don’t have to pay a portion of part time workers Medicaid. So they just continue to do what they are doing - hiring indigents and not allowing them to work full time. So the government - You - pay Wal-Mart’s employee health benefits.

  5. 5.Employer provided health benefits will now be taxed.

  6. 6.All of the above provisions were ‘off the table’ if the Public Option is approved.


Health Insurance CEO compensation - 5/20/09

It ranges from $3.2M to $24M per year. Money that could have gone to help sick people.


The new law was supposed to cover more people. Instead, it’s covering fewer.


Kucinich Is Picketed by MoveOn When He Won’t Violate His Pledge Not To Vote For A Health Care Bill That Does Not Contain a Public Option


Democratic Congressmen Signed a Pledge Not To Vote For A Health Care Bill That Did Not Contain A Public Option, Collected over $400,000 in Contributions Because of it, Broke the Pledge, Kept The Money


Pelosi laughs out loud at the prospect that progressives will not support whatever crumbs she decides to throw their way, even if it doesn’t include Public Option - "Are you asking me, 'Are the progressives going to take down universal, quality, affordable health care for all Americans?' I don't think so," Pelosi told reporters Friday, breaking into laughter at the question.


ProPublica: Ongoing Investigation of Influence of Big Pharma in US Medicine


California Nurses Assoc. and Healthcare-NOW! Gather the Polls - Time after time, Americans support Single Payer/improved Medicare for all by a very large majority.


PNHP: What HCAN Is Really About - And all the other ‘progressive-wannabee’ groups (MoveOn, PDA, etc)


Forbes Flash! Congress passes Socialized Medicine (in 1798) - Most of the Congressmen who voted for this measure did not have to try to figure out what the founding fathers meant in the Constitution. They WERE the founding fathers.


NEJM: Health Insurance Companies Add $380 Billion per Year to Overall Cost of US Healthcare


NYTimes: Your Soaring Health Insurance Premiums - Correctly pointing out that the main reason for the soaring is obscene insurance company profits - raising premiums way more than the increasing cost of health care. But then as usual, the Times vainly attempts to justify the new law. It says there are two ways it will hold down premiums: 1. Insurers will have to spend 80% of premium revenue on actual health care. So this is ‘cost plus.’ Whatever activity the insurers can define as ‘medical management’ or ‘health policy’ or “activities that improve health care quality”, for every $0.80 they charge for that, they can add another $0.20 on top. These activities include intrusive ‘health care managers,’ implementation of new diagnostic codes used for care/claims denial, administrative functions to ‘detect fraud.’ Basically just the same old activities now redefined to fit under the 80% umbrella so they can then charge an additional 20% icing. 2. The second premium control is state regulatory bodies. But the effectiveness varies greatly from state to state and generally there is a revolving door between the regulatory bodies and the insurance companies they are supposed to regulate. All the Feds are allowed to do is ‘review’ and ‘recommend.’ Bottom line: We have a dysfunctional law attempting to control a corporate-centric industry where the corporate representatives get the red carpet treatment in Washington, and call all the shots and the people get shoved out the side door. There is a very simple solution.


Health Insurers Weighing Options to Get Ahead of Reform - How insurers are going to game the requirements for less than 20% ‘medical loss ratio.


The one year anniversary of this law (PPACA): 3/23/11. Here are PNHP’s 7 reasons why the hype is all wrong, issued when the law was first signed and even more true now.


PPACA TimeLine