Health Reform 2016



Medical Economics: Top 10 Challenges Facing Physicians in 2017 - Not a single one has anything to do with achieving better outcomes for sick people. They all have to do with requirements imposed on doctors by inefficient insurers, superfluous administrators, bureaucrats and legislative bodies. None of these would be a part of Medicare for All.


Des Moines Register: Don’t Pay Managed Care Firms a Penny More - Here’s what happens when health care gets ‘outsourced.’


NYTimes: GOP Plans to Replace Obamacare with ‘Universal Access’ - As opposed to universal coverage. Funny how these days both parties name the legislation the opposite of what it really is. Let them repeal Obamacare and then own the results.


Washington (state) Herald: Democrats Should Let GOP Own Obamacare Repeal


NYTimes: New Coalition Will Push Back on Repeal of Obama Health Care Law - This is not a ‘new’ coalition. This is the very same set of people who originally kicked Single Payer to the ditch, while they pushed for the current dysfunctional system that serves only to enrich the insurance, pharmaceutical and hospital corporations while still leaving over 30 million people with no insurance at all and another 30 million with overpriced, inadequate insurance that will immediately drive them into bankruptcy and make them homeless the moment they suffer a serious illness. Another opportunity to push for the best solution wasted by a bunch of center-right conciliators: NAACP, SEIU, Families USA, Center on Budget and Policy Priorities, HCAN, Healthcare-NOW, Center for American Progress, Neera Tanden, etc.


Health Affairs: More Evidence of Financial Burdens of High-Deductible Plans - This study shows that people at lower income levels choose high-deductible plans more frequently than people at higher income levels. Due to this fact people at lower income levels more often experience high financial burdens when faced with health care needs. This wouldn’t happen with Single Payer, because premiums would disappear and the system would be more equitably funded through a progressive tax system.


VOX: By Picking Tom Price to Lead HHS, Trump Shows He’s Absolutely Serious About Dismantling Obamacare - Here’s Tom Price’s replacement plan. The young, healthy and rich will benefit. The old, poor and sick will suffer. Most of the people who favored Trump are poor and getting older. Wonder what they’ll think of him in a couple of years. There are enough Dems left in Congress who want to “work with” a Trump Admin. to guarantee that a filibuster won’t work. This means that both Dems and Reps are moving the neoliberal ‘austerity’ agenda. All wealth is moving to the top 1%. There will be no limits on premiums, deductibles, etc. Sick people, with ‘preexisting conditions,’ will not be able to afford coverage. Insurance company executives will make even more $$$ hundreds of millions. It’s time for a political revolution, and that can’t be accomplished from our comfy sofas.


Modern Health Care: House Republicans Seek Delay in Case to End ACA Cost-Sharing Subsidies - They are seeking a delay in a case they started, because they realize they don’t have a viable alternative and the results of a ruling ‘in their favor’ would be catastrophic for the American people. Ooops!


PNHP: Health Reform in the Trump Era

The Hill: Which Way For Trump and Progressives on Pharmaceutical Reform? - Synopsis: Trump said during the campaign that Medicare should be allowed to negotiate drug prices with Big Pharma, a move that would save the federal government between $230 Billion and $500 Billion over the next 10 years, and that 74% of Americans favor. However, his new web site makes no mention of this and pharmaceutical company stocks have skyrocketed since his election. Currently Americans pay 4 X as much per capita for medicine as the OECD average - essentially an extra $150 Billion per year. Big Pharma R&D cost is less than half of that. However if we invested that $150 Billion in public sector drug research, directed at real health needs instead of Big Pharma profits, the drugs would be in the public domain and manufactured as generics from day one. Of course Single Payer, favored by the majority of Americans, would make this entire discussion moot.


Black Agenda Report: Time for the Real Left to Double Down on Single Payer Medicare for All - Gallup poll: It’s what the majority of Americans want.


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.


The Lancet: Reaction to US Election: Interview with Dr. David Himmelstein, PHNP - Here’s the transcript. Roughly 1,000 people die every year for every 1,000,000 who are uninsured. If ACA is thrown out with no replacement, that’s an additional 20,000 deaths, added to the 30,000 current deaths from uninsurance. Death rates for lower-income white Americans - mainly Trump voters - are already rising. They will be disproportionately affected. Medical bankruptcy is extraordinarily common among people with insurance. Trump voters may soon very sorry, for this and many other reasons.


CNN: Obamacare Woes to Linger Long After Obama is Gone


NYTimes: Increase in Costs of US Health Care Plans Average 25% and Reuters - Under Obamacare, this money will be transferred directly from the US Treasury (the taxpayers) into the coffers of the insurance companies.


NYTimes: Harvard Health Policy Professors Ignore the Needs of Their Own Dining Hall Workers

NYTimes: Why the US Still Trails OECD Countries in Access to Health Care


The Hill: Affordable Care Act: Imploding and Beyond Repair - A very succinct summary of all of the problems with Obamacare and what we need to do to fix it.


Hartford Courant: More Than 1 Million in Obamacare to Lose Plans As Insurers Quit


International Business Times: Clinton Campaign Fails to Support Single Payer Ballot Measure in CO - Health insurance companies are major contributors to Democrats and to the measure fighting this initiative.


Bloomberg: Secret Rebates: Why Patients Pay $600 For Drugs That Cost $300 - Patient buys a high-deductible insurance policy that includes expensive drug in its formulary. Patient is prescribed and pays for a $600 drug before meeting the deductible. The insurance company automatically gets a $300 rebate from pharmaceutical company even though it pays out nothing to patient. The pharmaceutical company jacks up the price of the drug to cover the rebate to the insurance company. The patient received no benefit from the policy, but we all pay more for the drug. Insurance companies donate $Millions to Dems and Rethugs to keep things just the way they are.


Wellmark: Wellmark Gradually Putting the Squeeze on Their Customers - A trend that will only continue under Obamacare.


Family Practice Management: Is Direct Primary Care The Solution to Our Health Care Crisis? - Nope. This article shows why.


PNHP: The Public Option is Back - Why it is not the same as Single Payer, and at this point could actually set Single Payer back by decades.


Kaiser Health News: Employer Costs Moderate, Employee Deductibles Soar - Wouldn’t happen with Single Payer.

Modern Health Care: Uninsured Rate Drops, But Medical Expenses Drag Millions Into Poverty


USA Today: As Obamacare Choices Dwindle, Feds Face Consumer and Political Backlash

NYTimes: Obama Marketplaces Are In Trouble. What Can Be Done? - Obamacare is slowly failing. The healthcare system in this country has become just one more way to transfer $$$Trillions from the middle class and poor into the pockets of the very richest. These proposed ‘solutions’ simply take a totally dysfunctional health care system and layer it with new kludges, bandaids and duct tape. Instead of the only fix that makes sense, Single-Payer, this article proposes these fixes:

  1. -Public Option: But insurers won’t allow this because they know that if properly funded, it would eventually become Single-Payer and run them out of business. That’s why it was not included in the first place.

  2. -Further limit doctors and hospitals that a patient can choose. So they want to send you to doctors who have to see so many patients in so little time that they really don’t have time to properly diagnose and treat the illness. Assembly line medicine. That’s not a solution.

  3. -27 million people still can’t afford even subsidized insurance. So the proposal is to give even more generous subsidies to insurance companies than the current $10B per year transferred directly from the Treasury Dept. to insurance company coffers. Make the penalties for not signing up even more severe - then what? Start throwing people in jail if they don’t pay the new penalties? Also proposed: Remove the requirement to cover certain conditions - which eventually means a return to pre-existing conditions. Not a solution.

  4. -Shift more of the costs to taxpayers. So essentially the taxpayers will be subsidizing the 8 digit compensation packages for insurance company executives and board members. This is insane.


Intercept: Obamacare is Failing For Ones Simple Reason: Profit


Robert Reich: Why a Single-Payer Healthcare System is Inevitable


Des Moines Register: Editorial: Government Should Not Rely on Private Health Insurers - A good summarization of everything we’ve tried so far. Correctly argues that profit driven insurance companies should not be in charge of our health care. It also points out that taxpayers pay 14% more for seniors in Medicare Advantage, than those in traditional Medicare. It points out the flaws in every other solution that we’ve tried and failed. The only one that works is the only one we haven’t tried (except for seniors, for whom it works very well): Single Payer.


Health Affairs: Medicare Advantage Plans Pay Hospitals Less Than Traditional Medicare Pays - This “pro-market” article kind of shoots itself in the foot. They argue that the fact that Medicare Advantage pays providers less than regular Medicare proves that Med Advantage is controlling costs better. The fact is that Med Advantage is reimbursed from the federal government at higher rates than the actual providers. So Med Advantage insurance companies are receiving more and paying out less. This extra money goes to pay administrative overhead, higher profits and gargantuan compensation for corporate executives - all courtesy of you and I. Wouldn’t happen with Single Payer.


Bernie Sanders Press Release: Statement on Aetna’s Decision to Withdraw From Health Insurance Exchanges

Bloomberg: Aetna to Quit Most Obamacare Markets, Joining UnitedHealth and Humana and NYTimes - Remember that AHIP, the trade association and lobbying group that represents America’s health insurance corporations, essentially wrote Obamacare and then gave it to Max Baucus to pass - which he and the rest of the dems and rethugs did. Their essential idea was that if everyone, both sick and healthy was required to sign up, then the insurance corporations could make a nice profit. Now their model is falling apart because even though 80% of enrollees are receiving government subsidies, they still can’t afford the premiums, deductibles and other out of pocket expenses if they get really sick. Now the insurers have decided that they really don’t want to cover actual health care for sick people, they just want to sell us wasteful administrative services. This model (ACA) does not work and the big insurers are dropping out, making the market much more concentrated and much less competitive. Obama stated at the start of the process that “all voices got a seat at the table.” That was a lie. Single Payer advocates - the one model that would work - were excluded and when they tried to show up anyway, they were frog-marched out of the room.


Dallas Morning News: Are Free Standing ERs Helping Only the Wealthy?

Florida Times-Union: Single Payer Is Best Solution - a GOP politician no less...


Health Affairs Blog: Struggling to Stabilize: 3Rs Litigation and the Future of the ACA Exchanges - Instead of achieving the goals originally set out for ACA, the insurers are consolidating and gaming the current system. There is a very simple solution.


RAND Corporation: Exploring Single-Payer Alternatives For Health Care Reform (short summary) -A lengthy doctoral dissertation, which compares several different definitions of the single payer model, but the basic results show that for the model presented by Bernie Sanders, which is very close to that proposed by Physicians for a National Health Plan, the net savings in national health care spending ranges from a mean of $550 Billion (almost the same as the UMass/Friedman analysis of the Sanders plan) to $1.5 Trillion per year. This is a seminal study.  PNHP comments. The Full Dissertation.


Bloomberg: Obamacare’s Other Success Under Threat - When the Dems and their cable news talking puppets were selling Obamacare, they said the goal was to make health care universal and affordable. It still is neither. Now they just say the goal was to give more people health insurance, even if it’s inadequate.


Kaiser Health News: Covered California Health Plan Rates Jump 13.2% - Wouldn’t happen with Single Payer.


International Business Times: Anthem-Cigna Seeking Merger Approval, Makes Major Donations to State Political Groups - And where do major corporations get the money to make these major donations? From premium payers, the very people who will then pay more when there is less competition in the insurance market. Wouldn’t happen with Single Payer.


NYTimes: Insures, Pushing for Higher Rates, Challenge Key Component of Health Law - States don’t do much to control rates because state officials in charge know they have a cushy job waiting for them in a couple of years if they cooperate - the old ‘revolving door.’ And the Feds don’t have any real control as this article points out. Their excuse is: it’s all subsidized anyway, and there are very cheap policies available to consumers. What they don’t say is: this law amounts to a direct transfer of $Billions per year from the US Treasury to insurance companies coffers, and the cheap policies aren’t so cheap if you actually get sick because of high deductibles, co-pays, narrow networks, etc. Wouldn’t happen with Single Payer.


Health Affairs: Access to Providers and Network Accuracy Lacking in the Marketplace and Commercial Plans - Synopsis: Many people try to pick an insurance policy based on access to a doctor they prefer. After signing up for a particular network for a year, they find that their insurance company’s web site was inaccurate and they have to go out of network to see their preferred ‘provider.’ This doesn’t happen with Medicare today, and wouldn’t happen with Single Payer.


Health Affairs: Health Spending For Low-, Middle-, and High-Income Americans, 1963-2012 and CNBC and PNHP and Common Dreams - Since 2004 actual health care is being redistributed upwards, with highest income Americans receiving the most care. This income disparity was not reflected in those over 64 ;-)


NYTimes: UnitedHealthcare Sues Dialysis Chain Over Billing - A nefarious scheme made possible only because of Medicare Advantage - usually welfare for health insurance companies, but only if their members don’t get sick very often. This particular scheme cheated the insurance company but the real victims were the funders of Medicare - that’s you and me. Sick people in rural Florida and Ohio, where no in-network dialysis machines were readily available, were illegally pushed from regular Medicare, to which almost all doctors/providers participate, and which pays $200 per dialysis, into Medicare Advantage which pays these particular providers up to $4,000 per treatment. Essentially UnitedHealth care is suing the provider, but only because they don’t want sick people in their plans. Here is JAMA’s perspective on Medicare vs. Medicare Advantage. Here is an audit of Medicare Advantage done by the Center for Public Integrity.


Shadowproof: Clinton Democrats Claim to Support Healthcare as a Right, But Oppose It In Their Platform - Sanders’ delegated RoseAnn DeMoro: ““The Affordable Care Act, while an improvement, is not good enough, it is structurally deficient, leaves healthcare as a system based on profit and ability to pay rather than patient need.” It still means tens of millions of American have no “health coverage or ‘insurance'” because they cannot afford “high out of pocket costs.” Plus, the law has systemic problems which undermine quality of care, and it is easy for the health care industry to game the system.” She was over-ruled by the Clinton/Schultz faction. Clearly this is not the party for progressives. It is a party of smug conformists who repeat empty phrases, and never take responsibility for their actions. They are on the wrong side of history.


AJC: Medicare: An Effective Program That Needs to be Expanded


PNHP: Republicans Offer Only Detrimental Tweaking to Our Health Care System

NYTimes: House Republicans Unveil Long-Awaited Replacement for Health Law - Ryan has been hinting around at this for months. This time they reveal a little more, but not much. Raising the eligibility age for Medicare, Social Security and Medicaid will cost more in terms of overall health care costs, not less. Voucher money and block grants to the states will be quickly eaten up by increases in insurance premiums. Then expecting the states to pay for 2/3 of the $3 Billion we spend per year on health care is absurd. As with most rethug proposals it only makes sense if you don’t think about it too hard. That’s why Ryan’s proposal is long on hot-button items, but short on the how and any cost estimates. He and the rest of the beltway politicians are working for insurance corporations, not you and me. See entries of 5/3, 4/27.


PNHP: AMA Adopts Resolution for Study of Payment Models, Including Single Payer


JAMA: Why Many Medicare Beneficiaries Cling to an Allegedly Worse Deal - A pretty good, short article, putting into perspective the ‘cheap’ Medicare Advantage (MA) programs. The private insurance companies wouldn’t be pushing MA so hard if they weren’t reaping significant profits at both retiree and taxpayer expense. See entry of 5/9 below for further clarification.

Dallas Morning News: Blue Cross Asking for 60% Rate Hike for Obamacare Plans in Texas


PR Newswire: Milliman Medical Index: Healthcare Costs for a Typical American Family  Will Exceed $25,000 in 2016


Kaiser Family Foundation: Survey of Non-Group Health Insurance Enrollees, Wave 3 - PNHP: “One of the most important functions of health insurance is to provide financial security in the face on medical need. In spite of the Affordable Care Act, that security is deteriorating.”


Progressive Physician: What’s Wrong With Sanger-Katz’s Single Payer Analysis - A critique of the ridiculous “Worst Single Payer Study Ever.” Here’s the study we should all be focused on. See entry of 5/5. All of the ‘progressive’ critics that have come out of the woodwork critiquing single-payer (the “puppies and rainbows” brigade: Ezra Klein (Vox), Paul Krugman (NYTimes), Paul Starr (Princeton), Ken Thorpe (Emory)), were proponents of single payer before Bernie started to threaten Hillary. This debate is really not about single-payer. It’s about keeping the Democratic party base in line. Here’s a short video that debunks the faux-progressive line. Ken Thorpe is cherry-picking his numbers and uses statistical sleight of hand. Here’s a review of studies that have shown that single-payer reduces costs, and another. Here’s a more comprehensive run down of what’s right with Sanders’ over-all economic plans.


Boston Globe: How to Provide Medicare For All

Vice: More Americans Want Socialist Healthcare Than You Think


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

Philadelphia Inquirer: Single-Payer Essential to Controlling Health-Care Costs - By the former editor-in-chief of the Journal of the Canadian Medical Association, who moved to the US for personal reasons only to discover how superior the Canadian single-payer really is.


NYTimes: Sorry, We Don’t Take Obamacare - Remember when the Democrats said, “If you like your current policy, you can keep it.”? “Everybody in, Nobody Out”? Remember when all 65 members of the Congressional Progressive Caucus took a solemn oath never to vote for a health law that did not contain a Public Option, collected $400,000 in donations for taking that pledge, then broke the pledge and kept the money? Well all except for Dennis Kucinich. Although 20 million people previously without health care now have it, 33 million still don’t. And this article is about the 20 million. It’s a “two-tiered system” aka medical apartheid. Yes you can insure your children up to 26 years of age, but not if they live or go to school in another state. You can buy a plan that includes your favorite doctor or your most necessary medication, but if the plan removes either one in the middle of the year, you can’t change with it. Most of these 20 million people who now nominally have insurance are no better off financially than they were before the law. The article describes how regulators are trying, mostly in vein, to fix these problems. Why are we trying all kinds of kludges to a dysfunctional system when Single Payer would fix all of these issues?


The Hill: GOP Closing In On Obamacare Alternative, Lawmakers Say - Also buried in this article are some of the details for how the GOP plans to defund Medicare by making it a voucher system. See remarks under the Center for Public Integrity article of 5/9 below. Apparently they intend to conflate ‘the replacement for Obamacare’ into the destruction of Medicare.

NYTimes: Judge Backs House Challenge to a Key Part of Health Law - This will most likely be overturned on appeal, but the interesting part is: $130 Billion over 10 years transferred directly from the Treasury Dept. to health insurance company coffers. Staggering. Wouldn’t happen with Single Payer, which would save $500 Billion per year.


Change.Org: Worst Single Payer Study Ever - Prior to this election cycle, over 40 single-payer studies have been conducted by government agencies, actuarial firms and think thanks. Every one concluded that Single-Payer reduces costs while providing universal coverage. Every country with single-payer spends less on health care (by % of GDP, per-capital, and absolute, real dollars), and gets better outcomes. This new study pulls assumptions out of nowhere, and leaves out the largest sources of savings: reducing administrative overhead from 20% to 1% and the monopsony power of one payer to force hospitals and pharmaceuticals to reduce prices.


Portside: Urban Institute’s Attack on Single-Payer: Ridiculous Assumptions Yield Ridiculous Estimates - The more popular Bernie’s plan gets, the more entrenched, duopoly institutions try to create false narratives. This article shoots down another one.

Center for Public Integrity: Auditors: Feds Failed to Rein in Billions in Over-Billing By Medicare Advantage - A great report by this fantastic watchdog group.

Synopsis: Medicare Advantage (MA) is the private insurance alternative to Medicare, introduced by Congress in an effort to starve out Medicare and replace it with a private voucher system. The Center for Medicare and Medicaid Services (CMS), driven by Congressional pressure, is complicit in allowing this to go on. MA reimbursements to insurance companies are about 14% higher than than Medicare reimbursements directly to providers for the same services.

On top of that, the insurance companies are gaming the system by ‘upcoding’ their services, reaping an extra $160 Billion annually. Because of all this, the insurance companies are able to offer these plans to retirees at a cost very much lower than the already low Medicare costs. This in turn is bleeding retirees away from Medicare and onto MA. Upcoming audits may result in the recovery of only about 3% of these overcharges from the insurance companies. Already almost 1/3 of Medicare enrollees, deceived by the temporary and artificially low costs, opt for MA, and that fraction is increasing steadily.

Look for Congress to start reducing funding for Medicare, based on reduced enrollments, which will reduce reimbursements to providers causing many of them to drop out. Once most of the enrollees are in MA, Congress can then enact its “premium support” plan - essentially vouchers. At that point, traditional Medicare will be dead.

Once everyone is on the voucher program, Congress can ratchet down the voucher amounts and insurance companies will be free to increase premiums, co-pays, deductibles, etc etc.

Despicable! Wouldn’t happen with Single Payer.


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.


Intercept: Prominent Democratic Consultants Sign Up to Defeat Single Payer

Healthcare-NOW: Seth Meyers Explains Single Payer and Its Colorado Corollary - See entry of 4/22.

Health Affairs: Traditional Medicare Vs. Private Insurance: How Spending, Volume, and Price Change At Age 65 - In a nutshell: For people who move from private insurance to Medicare, the volume of services they use remains the same, but their spending and overall healthcare spending goes down - not exactly a bombshell. But moving the eligibility age from 65 to 67 as some neolibs have suggested, would increase national health care spending - mainly because of increased Medicaid spending, increases in ACA premium tax credits and cost-sharing subsidies resulting in tax revenue losses and greater overall outlays - again leaving the volume of services unchanged. From a national healthcare spending perspective, that’s moving in the wrong direction. And the corollary is: Moving the eligibility age down would decrease overall healthcare spending while leaving volume of services unchanged. You have to wonder when the light is finally going to come on.


Monthly Review: Obamacare: The Neoliberal Model Comes Home to Roost - Another interesting, but long scholarly article. But the last two paragraphs are eye-openers. Essentially: the collapse of Obamacare - which is the culmination of the oligopolistic, neoliberal model, where the top wealth strata of  society becomes fantastically rich and everyone else, including doctors, move successively lower - could ultimately become the catalyst for a drastic turn towards a more socialist democratic society overall.


Reuters: Ryan Wants to End Obamacare Cost Protections for Sick People - Republicans keep saying they want to repeal Obamacare. But what’s the replacement going to be and how will it contain the overall cost of health care in the US? Paul Ryan is beginning the reveal. Their idea is to move the responsibility for the care of the sickest people - those with ‘pre-existing conditions’ - to the states, much as the Clintons did with welfare. The top 10% of individuals in health care spending account for 65% of overall health care costs. Telling the states to cover 2/3 - about $2 Trillion per year - of the overall cost for health care in the US is not going to happen.

In the words of PNHP: “With a single payer system this problem disappears. Funding is based on ability to pay, through the tax system, and not on the basis of anticipated medical expenses. Everyone receives the care they need, regardless of their health status. The fragmented plans supported by the repeal and replace people cannot do that.”


Reuters: Health Insurer Centene’s Profits Beat Expectations as Medical Costs Fall - The insurer spent less on health care for sick people - they call it “loss.” They spent proportionally more on administrative overhead and profit. Wall Street considers this a good thing. That’s the upside-down logic that ACA has perpetuated.


Intercept: Health Care Industry Moves Swiftly to Stop Colorado’s “Single Payer” Ballot Measure - From the article: There are a couple of things wrong with this measure - it’s really not ‘single payer’ when a state does it because there are still other ‘payers’ in play: Medicare, etc., and this measure is financed by the workers, not by a steeply progressive income tax as it should be - but it’s a step in the right direction. What’s really interesting is how the insurance companies, who stand to lose a lot of business are trying to kill it. They are about to flood the media, not with an honest discussion of the details, but rather with completely false soundbites: “doubling our state budget”, “diminishing the accessibility and quality of care”, “creating an unaccountable, massive bureaucracy.” None of that is true - but it probably doesn’t matter. Voters are easily fooled by simple soundbites. And to top it off, the Koch Bros. are financing most of the media flood. This strategy has already worked in California and Oregon.


Kaiser Family Foundation: Is ACA Coverage Affordable for Low-Income Families? - Stating that ACA is good because it has allowed lots of people to gain health insurance is disingenuous at very best. The originally stated intent of the law was to make health care universal and affordable. It has done neither. CBO has found that half of the people (27 million) that were not covered before ACA are still not covered. The other half are greatly under-insured. In this study, low-income families respond that having insurance has not alleviated their financial struggles with respect to medical debt, and many can neither afford the total overall costs of coverage nor can they find appropriate providers within their narrow networks.


New England Journal of Medicine: The Virtues and Vices of Single Payer - “When we look at the entire patchwork of the American medical care system and our insurance system there’re still so many holes in it, there’s so much redundancy, and it’s so inefficient. And that’s why the single payer idea is going to resonate far beyond whatever the outcome of the 2016 election is. Because when you have a health insurance that leaves tens of millions uninsured, tens of millions underinsured, that is beset by administrative complexity and is governed too often by profit, there’s going to be an appetite for sweeping change. And whatever its political fortunes are, and I don’t think they’re particularly good, single payer is going to continue to speak to those who are disaffected by what’s going on in American medical care and are looking for something different, something better.”


Peterson-Kaiser Health Tracker: Payments for Cost Sharing Increasing Rapidly


Salt Lake Tribune: High Cost of Hepatitis Meds Makes Good Case for Universal Medicare - People across the nation are slowly beginning to wake up.


BCBS, Health of America Report: ACA Compliant Plans Have Been Subject to Adverse Selection - In a nutshell: Some, but by no means all, sicker people who could not afford health care before ACA, have been signing up for insurance, mostly because they are getting government subsidies (actually these subsidies are $Billions transferred directly from the US Treasury to insurance company coffers). This has driven up the overall cost of these plans. But what about the middle income, hard working families that do not qualify for these subsidies? Costs for their plans has skyrocketed, with no help from the ACA. Wouldn’t happen with Single Payer.


NYTimes: How to Stop the Bouncing Between Insurance Plans Under Obamacare - There’s no way to tweak this totally dysfunctional system. None of this would be necessary with Single Payer.


KQED: Pharmaceutical Companies Hiked Price For Aid-In-Dying Drug


Business In Savannah: Medicare for All Is Way Forward


Healthcare-NOW: Setting the Record Straight: Busting the Media Myths About the Sanders’ Plan

Health Affairs: Don’t Let the Talking Points Fool You, It’s All About the Risk Pool - A very Darwinian article. But think of it this way: If you’re healthy and you buy insurance, then you pay a little bit for the few that are really sick. If you don’t buy, then you’re a little better off...except if you all of a sudden get really sick. Oops! Then you’re screwed. But aside from all that, none of this would be a consideration with Single Payer.

ProMarket: “There Is Regulatory Capture But It Is By No Means Complete” - Wikipedia: “Regulatory capture is a form of political corruption that occurs when a regulatory agency, created to act in the public interest, instead advances the commercial or political concerns of special interest groups that dominate the industry or sector it is charged with regulating.[1] Regulatory capture is a form of government failure; it creates an opening for firms or political groups to behave in ways injurious to the public (e.g., producing negative externalities). The agencies are called "captured agencies".” Kenneth Arrow, youngest person ever to win the Nobel Prize in Economics, and one of the most influential economists of the 20th century discusses Single Payer Health Care. His conclusion: “It’s better than any other system.”


CNN: Full Transcript Hillary Clinton TV One Democratic Presidential Town Hall - About half way down a Teresa O’Donnell asks Hillary a question about the skyrocketing cost of health care. Just search on Teresa O’Donnell. From there you can see Hillary’s approach.

PNHP response:

Hillary Clinton says that one of her proposals is to bring health care costs down. This town hall exchange is significant because it reveals the depth, or lack thereof, as to how she might accomplish this.

She says that she would lower co-pays and deductibles. But the question was about high premiums, and the market is using higher deductibles and other cost sharing to lower premiums. Lowering deductibles will cause higher premiums, not lower.

She says that we need more non-profit insurers like Blue Cross and Blue Shield used to be. But if you compare premiums in California for for-profit Anthem Blue Cross and non-profit Blue Shield, they are the same. The non-profit insurers share the same inefficiencies and administrative excesses as the for-profits.

She says that she wants more competition in the exchanges so that less expensive plans will be available for diligent shoppers, but, again, lower premiums are possible only by reducing coverage - higher deductibles, less accessible narrower networks, etc.

Private plans competing in the marketplace is what we already had before the Affordable Care Act was passed. We merely continued the same system. Adding exchanges did very little except to enable the administration of subsidies and credits for lower-income individuals. For those not eligible for government subsidies and credits, nothing was done to control the very high costs of health care and the insurance products that pay for that care.

Unfortunately, Hillary’s proposal is more of the same. Perpetuate the fiction of lower prices through competition while manipulating the insurance products to have either lower premiums or poorer coverage. In fact, included in ACA is the excise tax (Cadillac tax) which is designed to prevent the marketing of full benefit plans. Making health care less affordable through greater out-of-pocket cost exposure is the exact opposite of where Clinton says she wants to take us. The problem is that the current financing infrastructure will not allow us to go there.

If we want affordable care for everyone, we need a single payer improved Medicare-for-all which will control costs and make the financing more equitable.”


International Journal of Health Services: “Cadillac Tax” On Health Benefits Will Hit the Middle Class the Hardest


HuffPo: Cherry-Picking Statistics to Bash Sanders’ Medicare-For-All Plan


Bloomberg: Bad Debt Is The Pain Hospitals Can’t Heal - Having health insurance is NOT the same as having health care when you need it. Advocates for Obamacare like to say that more people have health insurance, including those with pre-existing conditions - even though sign ups are much lower than predicted. But most of the ones that do sign up can barely afford the premiums. When deductibles, co-pays, procedures not covered, doctors or hospitals out of network, medications not covered, etc. are added on, they very often go bankrupt. Insurance policies can drop your doctor or hospital from your network, and can drop the medications you need from their formularies at any time - but when they do that, you cannot change policies until another year rolls around. Obamacare has amounted to a direct transfer of $Hundreds of Billions from the US Treasury to the coffers of private insurance corporations. It is not a step towards Single Payer.


Intercept: Wall Street Analyst Says Hillary Would Be the Best President for Healthcare Investors


Jacobin Mag: Meet the New Harry and Louise - Maybe you’ve heard on cable news that Bernie’s Single Payer plan is all “puppies and rainbows.” This is a very long article that meticulously dissects each of those recent opinion pieces and shows in detail why they are based on false assumptions, and in all cases were written by so-called experts who several years ago were actually proponents of Single Payer. Essentially those articles are not meant to inform. They are meant to control the Democratic party ‘base’ and keep Hillary on track.


HuffPo: Medicare’s History Belies Claim that Single Payer Would Disrupt Care - 11 months after the original Medicare law was signed, it went live. 99% of those eligible were signed up. The overhead for signup AND coverage for 6 months totaled $882 Million in today’s dollars. By contrast, just setting up the insurance exchanges under Obamacare cost more than $6 Billion. Also, Medicare eliminated several smaller federal health assistance programs, saving $383 Million in today’s dollars (so a net cost of $499 Million). Just like today, industry spokesmen all said there would be major disruptions in health care, and that doctors would not accept the program. None of that came to pass. And today, practically everyone who turns 65 - even those who rail against it - immediately signs up.

USA Today: Costs, Changes Led Obamacare Enrollment to Fall Short of Estimates - Sad. But in a small way funny. After CBO estimated that 21 million formerly uninsured people would sign up for health insurance under Obamacare, only 12.7 million people did so. Then Health and Human Resources Secretary Sylvia Burwell lowered her estimate to 10 million and immediately declared that sign ups exceeded estimates. Talk about spin. So after all of the turmoil surrounding the implementation of Obamacare, and after basically turning over the well-being of the American people to insurance companies, what was supposed to create affordable, universal health care has achieved neither of its goals and the best thing you can say about it is that a very marginal number of additional individuals are now covered.


NYTimes: Disparity in Life Spans of the Rich and Poor Is Growing - On top of everything else, now the rich are actually killing us. How much longer can we avoid calling this a class war?


Columbus Dispatch: InHealth Customers Mad About Late Notice Dropping OhioHealth - Health plans are free to change provider networks anytime during the year, but customers of those health plans are not free to change plans when they do. One more gotcha! with Obamacare. Wouldn’t happen with Single Payer.


PNHP: Review of Studies Showing How Much Single Payer Would Save Over Current System - Reviews by everybody from GAO, CBO to Economic Policy Institute and others all agree. It’s a no-brainer.


Philadelphia Inquirer: Single-Payer Health Plan Would Not Cost US More


Kaiser Health News: Licking Wounds, Insurers Accelerate Moves to Limit Health-Law Enrollment - Broker disincentives help insurance companies avoid the sickest.


New England Journal of Medicine: Effect of Removal of Planned Parenthood from the Texas Women’s Health Program - Result: Low-income Texas women are losing access to all forms of health care, family planning services and pregnancy prevention. Birth rates from unintended pregnancy in this group will now skyrocket, swamping Medicaid rolls. State expenditures for neonatal, early child and female health care will correspondingly skyrocket. Wouldn’t want to be a Texas taxpayer.


NYTimes: Drug Shortages Forcing Hard Decisions on Rationing Treatments

HuffPo: On Kenneth Thorpe’s Analysis of Senator Sanders’ Single-Payer Reform Plan


NPR: Insurers Are Refusing to Pay for Some Common Medications - Drug companies have all started doing what Martin Shkreli (and Here, Here) did: start raising the prices of all of their drugs to whatever they think they can charge. Then drug plans remove those drugs from their ‘formularies.’ Result: Sick people who think they have health/drug care can’t get the drugs they need. This is the result of the deal that Obama struck with BigPharma before Obamacare passed which allows them never to have to negotiate their drug prices. Thanks Democrats!


Kaiser Health News: Check the Fine Print. Some Work-Based Health Plans Exclude Outpatient Surgeries


PNHP: Myths Surrounding the Single Payer Debate

Truthdig: Finding a Cure for Bernie Sanders’ and Hillary Clinton’s Health Care Plans - By Margaret Flowers (Popular Resistance) and Jill Stein (Green Party). Remember that 58% of Americans favor Single Payer. 34% strongly favor. 81% of Democrats favor. Hillary’s approach, to tweak ACA around the edges until everyone gets coverage is clearly pie-in-the-sky. But Bernie’s plan also has issues. ACA is not a ‘step in the right direction’ because it has essentially turned the control of US health care over to the insurance companies. Bernie’s plan gives too much power to the states (which he modified in his latest release), and we’ve seen the results of that in the refusal of red states to expand Medicare under ACA.


Healthcare-NOW: Clinton Opposes Single Payer


Common Dreams: Sanders’ Medicare-For-All Plan Takes Aim at For-Profit Healthcare System - Saving $6 Trillion over the next 10 years and $592 Billion per year.


NYTimes: Even the Insured Can Face Crushing Medical Debt, Study Finds - Patient Protection and Affordable Care Act”...Seriously?


John Geyman MD: The Human Face of Obamacare: Promises vs Reality and What Comes Next - By one of the most well respected researchers in the field, Dr. Geyman starts with 50 patient and family stories, then looks at the major problems with Obamacare - out-of-control insurance costs, narrow networks making it impossible to find the right doctors/hospitals when needed and thus forcing patients to pay out-of-network costs, unacceptable levels of care, inability to keep favorite doctors or original plans, having ‘coverage’ that does not translate into having affordable care - to the point that it is no longer called by its original name “Patient Protection and Affordable Care Act” PPACA. Finally he looks at options for the future: 1) muddle through with what we’ve got, 2) Republican plans for repeal and replace with government ‘voucher’ programs, 3) Single Payer. There is really only one answer.

Health Reform 2015