Return of Medicare For All

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Although Obamacare is an improvement over what existed before, it was clear from the beginning of the health care debate that the compromised plan would deliver neither truly universal nor truly affordable access to health care. The greatest fear of liberals who opposed it was that, by embedding the insurance industry in the health care infrastructure, it would prevent either of these goals from ever being achieved. As the deficiencies of the Patient Protection and Affordable Care Act have become more recognized, however, a new opportunity has opened up for Congress to do what should have been done in the first place: establish a single-payer system.

The insurance industry will oppose single-payer with scalpels and skull saws, of course, but the fight will be somewhat fairer because the industry's reputation is even lower than that of Congress. Still, with little or no help to be expected from the White House, it promises to be a hell of a battle, one that will be won only if ordinary citizens are mobilized. You can help right

from the start by asking your representative today to become an original cosponsor of H.R. 676: "The Expanded and Improved Medicare For All Act" (Capitol switchboard: 866-220-0044).

Rep. John Conyers will reintroduce national, single-payer healthcare legislation sometime this week. Before he introduces the bill, Conyers would like to have as many original cosponsors as possible. Please call your rep today and let them know you want them to cosponsor H.R. 676. Help them out by mentioning that in order to become an original cosponsor of H.R. 676 your member will need to contact Michael Darner from Rep. Conyers' office at michael.darner@mail.house.gov or 202-225-5126.

Already on board (thank them if you're in their district): Nadler, Schakowsky, Pingree, Grijalva, Ellison, Hank Johnson, Eddie Bernice Johnson, Takano, Holmes-Norton, Lofgren, Rangel, Moore, Chu, Al Green, Farr, McGovern, Welch, Clarke, Lee, Nolan, Pocan, Doyle, Engel, Gutierrez, Frederica Wilson, Cohen, Edwards, McDermott, Clay, Huffman, Roybal-Allard, Cummings, Yarmuth, George Miller, Honda, Christensen, Rush.

If you live on the liberal west side of Los Angeles, note the following absences from this list: Waxman, Hahn, Sherman and Bass (Capitol switchboard: 866-220-0044).

Resources: PNHP.org: Physicians for a National Health Program is a non-profit research and education organization of 18,000 physicians, medical students and health professionals who support single-payer national health insurance
Healthcare-Now!: Organizing for a National Single-Payer Healthcare System
PublicCitizen: the Health Research Group of one of the country's most effective citizen's organizations

Healthcare bills could jeopardize states' consumer protection laws

"Healthcare overhaul bills working their way through Congress could jeopardize laws in California and other states that require insurers to pay for treatments such as AIDS testing, second surgical opinions and reconstructive surgery for breast cancer patients.

"What's more, the federal legislation could make it virtually impossible for states to enforce other consumer protection laws, such as the right to appeal if an insurer denies coverage for a particular treatment."

The rest of the story: Healthcare bills could jeopardize states' consumer protection laws by Lisa Girion (Los Angeles Times 2009-11-16)

Health Care Reform: Or Not

The big players in the insurance industry are very happy with the direction "reform" is headed:

"eHealth looks forward to being an active partner in implementing meaningful health reform legislation, and is poised and ready to connect the uninsured to coverage quickly." (CNN)

eHealth says it's "Ready to Connect America to Coverage."

Contrast that with the Physicians for a National Health Program Quote of the Day from by Don McCanne, M.D.: "This is yet one more reason why the model of reform selected by Congress and the Obama administration is the most expensive of all. With all of the other wasteful administrative expenses, brokers' fees are added on top, though often hidden in the premium as a commission rather than a fee.

"Compare this to Medicare enrollment. The administrative costs for automatic enrollment in Medicare, at that only once in a lifetime, are negligible for the government and its taxpayers."

"Imagine the simplicity and efficiency of automatic, lifetime Medicare enrollment at birth for everyone. But Congress won't go there... not until the nation demands it."

Physicians for National Health Plan: http://www.pnhp.org

Health Insurance: Long-term care

 The Next Big Health Care Reform Fight

What finally kills people -- financially, physically, psychologically, metaphorically -- is trying to figure out how to pay for long-term medical expenses. According to the government, one year of care in a nursing home, based on the 2008 national average, costs over $68,000 for a semi-private room. A year of home care, assuming the need for periodic personal help from a home health aide (the average is about three times a week), costs almost $18,000 a year. While conservatives have been preoccupied with saving Americans from having socialized medicine foisted on them by Commissar Obama, it hasn't completely escaped their attention that an even more nefarious insurance program -- a plan to create public insurance for long-term care that would have the government interceding to prevent citizens in long-term care from being driven bankrupt or crazy by medical bills -- has been sneaking through Congress.

The proposal is known as the CLASS Act, short for Community Living Services and Support. The idea has been around for years, and the late Sen. Edward M. Kennedy (D-Mass.) pushed to have the measure included in the health-care overhaul package that passed the Senate health committee in July. A similar measure was also adopted by voice vote in one of the three House committees handling health care.

This diabolical, morale-destroying scheme would be, get this, "available to anyone, including those who are already disabled." Similarly to Comrade Reid's public option plan for the states, people would be strong-armed into the program automatically, unless, of course, they themselves chose to opt out, and would pay a premium in exchange for insurance against "the cost of home care, adult day programs, assisted living or nursing homes after they had been enrolled for at least five years. Premiums and benefit levels would be set by federal health officials," you know, bureaucrats, "but advocates predict that the program would provide beneficiaries with a minimal sum, around $75 a day" (you do the math).

(Okay, I'll do it: $68,000/yr. comes to a little less than $5,700/mo. $75/day adds up to roughly $2,250/mo. Rounding off generously on both ends, you still end up with a gap of $3,000/mo or $36,000/yr. Considering that the annual median household income is around $50,000 -- and much lower for many seniors and anyone unable to work because they're in need of long-term care, under the best of circumstances the program isn't going to head off a lot bankruptcies).

The proposal has gained momentum in recent days as Democrats in both the House and Senate cast about for cash to help finance a final health package. Because the program would begin taking in premiums immediately but would not start paying benefits until 2016, congressional budget analysts have forecast that it would generate a nearly $60 billion surplus over the next 10 years, cash that would help the larger measure's balance on paper.

Predictably, the usual antis -- "including the Congressional Budget Office and the American Academy of Actuaries," a group I know I rely on for political judgments, especially around Halloween -- have popped up with dire warnings about spiraling costs. Descending into self-parody, Sen. Kent Conrad called the CLASS Act "a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of," and he vowed to block its inclusion in the Senate bill. As befits a member of the people's house, Rep. Earl Pomeroy, also a Blue Dog Dem, admitted there is a problem that needs addressing, but warned the solution would require some tough decision-making, of which he avowed he is capable, "not some provision cooked up by advocacy groups at the last hour" (see, "idea has been around for years," above).

"It is not a Ponzi scheme," said Larry Minnix, president of the American Association of Homes and Services for the Aging, which represents nonprofit providers and is one of more than 200 consumer and other groups supporting the legislation. "It is a consumer-funded insurance pool that provides people a cash benefit to help with simple chores of daily living so they can remain independent."

Oh, sure. Who're you going to believe, some non-profit consumer activist Little Goody Two-Shoes or a seasoned, tough decision-making legislative adept beefed-up like Popeye on the carloads research spinach trucked in to Washington every day by the insurance industry out of the goodness of their hard little hearts?

The rest of the story: Proposed long-term insurance program raises questions by Lori Montgomery (Washington Post 2009-10-27)

Health Care: There will be a health care bill. It just won't be anything recognizable as reform.

Dear Dr. Healthcare Reform,

I know I've been a bit disconnected lately, but what exactly IS Obama's health care plan? It seems that he would be well advised to do a little proactive sales on his plan, but does anyone know what it actually is?

-- Perplexed.

Dear Perplexed,

You haven't missed anything. It's true that the Right has been attacking "Obamacare" for months, but they don't have any better idea what it is than you do. We may find out more tomorrow when the president addresses congress, but then again, maybe not. He seems to have a problem with any kind of governing that doesn't involve an executive order or a signing statement. Still gives a hell of speech, sometimes, though.

The Obama administration, committed to "health insurance reform" by the candidate's vague promises during the campaign, knew it wanted something it could call health reform, but apparently didn't know what. They parsed the failure of the Clintons to pass health care reform, not necessarily coming away with the lessons you might have. The Clintons' massive bill was drawn up in secret without input from the legislature. That might have led to the conclusion a) that the process should include elected representatives and b) that it should be public and transparent. The White House decided that the corrective of too much control by the White House was none. The president should stay completely out of the process -- in other words, he would decline to lead at all. The part about transparency went right by them -- at the same time that they left the legislature to tack this way and that without a rudder, White House officials were holding secret meetings with drug companies, insurers and other big players in the health care industry. Instead of the promised "change," as far as secrecy goes it was business as usual in the new administration.

It's not like the Obama White House had to lay out a program in Clintonian detail, every t crossed, every i dotted. But he owed it to other leaders in his party to make clear, in general outline at least, what he expected. Since House bill HR 676 that would establish Medicare for All only takes up 13 pages, it's obvious that you can say a lot in a very few words. During the campaign, Obama stood to Hillary's right on insurance reform, so it's not as if anyone expected him to propose socialized medicine, but his supporters were not wrong to anticipate some minimal changes: even those of us with the lowest expectations thought that, at the least, health care insurance would be made more affordable, universal and portable; costs would be controlled; and no one would be denied coverage because of a pre-existing condition.

Naturally, because no one can think of any other way to control costs, many believed that Medicare for All, or single-payer health insurance, would have to be considered. But in another misreading of the Clinton health care debacle, the administration, in its only glimmer of leadership, took Medicare for All "off the table" for being too radical, even though the president himself acknowledged that it is the only way to bring down the cost of health care. It never seems to have occurred to anyone in the White House that part of the reason the Clinton plan foundered was the degree complexity that came from trying to devise a mechanism that would save the parasitic insurance industry. Like the massive bill that has emerged from the House of Representatives, Clintonian health care reform lacked the simple directness that made "Medicare for All" an easier sell.

The "public option" that has the Right so exercised is a compromise introduced in an attempt to put a brake on costs by providing a publicly financed alternative to exploitative private insurance. It probably wouldn't have worked as intended, so we shouldn't be too disappointed if the president throws it under a bus tomorrow. But it has to be understood that with out it, or Medicare for All, or the conversion of the insurance companies into not-for-profits, whatever the president conjures up tomorrow will be as a bandaid on a hemorrhaging wound. A public option that is triggered a decade from now by some vague set of circumstance is the same as no public option; probably worse, because it will leave the impression that something was done.

At the end of the day, this is what is likely to happen: every person in the United States not eligible for Medicare or other existing government programs, will be forced into a private insurance plan, with the tab for those who can't pay picked up by the taxpayer. In other words, the insurance companies will sell many millions of additional policies and get massive government subsidies for the trouble. Businesses will probably still be on the hook for huge insurance expenditures, although some industries may be excepted. Insurance may become more "portable," that is you will be more able to carry it from job to job, and to a much larger extent than now insurance companies will not be able wriggle out medical payments. There will be no significant reduction in insurance industry overhead, however, beyond the loss of a few claims adjusters.

Should this pass -- by no means a sure thing given the profoundly undemocratic nature of the U.S. Senate -- the administration will call it a victory and move on to less vexing tasks. Like bombing the crap out of Afghanistan.

Health Care: California's Real Death Panels Insurers Deny 21% of Claims

This is a press release from the Nurses Association, sent out on PRNewswire and redistributed by Reuters. In other words, widely available. Wonder if Fox and CNN picked up on these death panels.

PacifiCare's Denials 40%, Cigna's 33% in First Half of 2009

OAKLAND, Calif., Sept. 2 /PRNewswire/ -- More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released today by the California Nurses Association/National Nurses Organizing Committee.

CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, the six largest insurers operating in California rejected 31.2 million claims for care - 21 percent of all claims.

The rest of the story: California's Real Death Panels

Health Care Reform: The real "captains" of capitalism

Health Care: What will you not do for your country

Now that the nation's hospitals have offered to give up $155 billion in future Medicare and Medicaid payments and America’s largest private health care insurers say they'll give back as much as $2 trillion by reducing the growth rate of health care spending by 1.5% per year during the next decade, all to help defray the cost of President Barack Obama's health care plan, I've decided the least I can do as an average citizen is not to opt for expensive elective surgery during the same period.

Between now and 2020, therefore, I pledge not to get hair transplants ($10,000), Invisalign braces ($5,000), a neck and profile lift ($5,300), calf implants ($4,500) or buttock augmentations ($18,000 -- I know that sounds expensive, but I'm giving up a trip to Brazil), rhinoplasty ($5,500), otoplasty (as you age, your ears just get bigger and bigger -- $2,800 each or $5,600), and liposuction (hips -- $2,400; outer thighs -- $3,000; buttocks -- $1,800); plus non-surgical fees (figure $128,000 spread out over all these procedures), for a grand total of $189,100.

Doesn't sound like much compared to the billions and trillions being donated by the hospitals and insurance companies, but if even 1% of 300 million Americans make the same contribution I am, we will save $567,300,000,000, and be happy to do it.

Actually, I'm even willing not to have these procedures every year, increasing the savings ten fold!

So, my fellow Americans, the challenge is this: ask not what your country cannot do for you, ask what you can not do for your country.

Single Payer: Fight Fake Health Care Reform

While public policy should not be made on the basis of polls, polling can help elected officials to get a sense of what voters want overall. In a democracy, policy makers are expected to do their utmost to reflect the will of the people, collectively arriving at the greatest good for the greatest number. And understanding the public's wants and needs makes it easier to explain in terms that people can understand why one solution to a problem may be preferable to another.

As rough as sledding in Congress is for universal health care, in poll after poll Americans overwhelmingly support the creation of a health care option that is publicly funded. What's more, despite the endless drumbeat against single-payer (Canadian-style) health care insurance, citizens are ready in large numbers to scrap the private insurance industry altogether. This is why insurance industry lapdogs like Joe Lieberman, Susan Collins, Ben Nelson and Max Baucus are so busy trying to come up with alternatives that will appear to provide universal health care without really challenging the current system.

With single-payer being kept "off-the-table" by the Obama administration and the Democratic legislative leadership, supporters of universal health care are reduced to fighting off frauds, such as the health care "cooperatives" advanced by insurance industry apologist North Dakota Democrat Kent Conrad. For example, the political action group MoveOn.Org will send a fax to senators in your name demanding that a "strong public health insurance option must be part of health care reform this year." The fax argues that any plan that is adopted has to be:

Available to all of us: A strong public health insurance option should be available to anyone who chooses to participate. If you like your current plan, you can keep it; if you want to participate in the public health insurance plan, you can choose that.

A national plan with real bargaining clout: In order to truly control costs and compete with private health insurance plans, a strong public health insurance option must be available nationwide.

Ready on day one: Every day we wait on real reform, health care costs continue to rise. A strong public health insurance option with a broad network of providers right out of the gate is key to building a competitive program that will help control costs.

A truly public plan: To ensure it's held to the highest standards of accountability, a public health insurance option must be truly publicly run—accountable and transparent to Congress and to voters.

Don't give up the fight for single-payer, but in the meantime access MoveOn's petition here to express your feelings about the alternatives.

Go. Read. New Poll Shows Tremendous Support for Public Health Care Option.

Update: The Sickening Addiction That May Kill Reform by Joe Conason (Rasmussen Reports):

If Congress fails to enact health care reform this year -- or if it enacts a sham reform designed to bail out corporate medicine while excluding the "public option" -- then the public will rightly blame Democrats, who have no excuse for failure except their own cowardice and corruption. The punishment inflicted by angry voters is likely to be reduced majorities in both the Senate and the House of Representatives -- or even the restoration of Republican rule on Capitol Hill.

National Health: Insurance Industry Superheroes (YouTube)

An animated cartoon about the health insurance industry by Troy Campbell of Austin, Texas, brought to you by a Connecticut advocacy organization, HealthCare4Every1.org (the group has other excellent videos, including Poor Coverage). YouTube