Comment by Don McCanne of PNHP: The deductibles are out of control. The anecdotes in the full article (link above) demonstrate that many people find that their insurance is “all but useless” simply because they cannot afford to pay the deductibles. Anecdotes do not constitute a scientifically valid study, but they certainly do tell us what is happening to individuals out in the real world.

Insurers needed to keep premiums affordable in order to maintain a viable market of private plans. They do that by shifting costs to patients through ever higher deductibles. This was inevitable through the reform model selected for the misnamed Patent Protection and Affordable Care Act. Because of the large deductibles, actual health care is not affordable for individuals with modest incomes and thus patients do not have the protection that they need.

The three trillion dollars that we are already spending on health care is enough to provide all essential health care services for everyone. With a properly designed financing system there is no need to erect financial barriers to care since cost containment can be achieved through patient-friendly policies such as those of a single payer national health program.

Without proper reform, “degradation of health insurance” will progress. People will face greater financial hardship because of medical bills. People will suffer more because of forgone health care. People will die.

This isn’t right. We need an improved Medicare that includes everyone.

American Journal of Public Health study





Comment by Don McCanne of PNHP: Opponents of the Affordable Care Act have been using the Oregon Health Insurance Experiment (OHIE) to supposedly show that Medicaid does not improve health outcomes even though the study was not powered to demonstrate such. Thus this new study is important because it does show that Medicaid improves access, improves awareness of important chronic conditions, and improves control of hypertension. The OHIE trial did show that “Medicaid coverage increased health care use, improved patients’ financial security and self-reported health, lowered depression rates, and raised diabetes diagnosis rates.”

Clearly Medicaid is of benefit. However, as a chronically underfunded welfare program, Medicaid does have significant deficiencies. Last week, a UC Davis study reported that cancer care is worse for Medicaid patients than for other insured patients. The question is, what should we do about it?

Some conservatives would convert Medicaid into a block grant to the states, limiting federal contributions, likely compounding the problem of underfunding. Other conservatives would eliminate Medicaid and place everyone in high-deductible private plans, perhaps with some federal contributions to health savings accounts for low-income individuals. Narrow networks and cost sharing would surely limit access for this population.

A much better solution would be to replace our fragmented health care financing system with a single payer national health program, eliminating cost sharing and network barriers. Since the program would cover all of us, chronic underfunding for a sector of us would not be tolerated.

Go NHS!! Maybe one day we'll get universal health care.

http://www.dailykos.com/story/2015/03/25/1373229/-91-year-old-veteran-brings-audience-to-tears-as-he-explains-the-importance-of-National-Health-Care


No one in our community was safe from poor health, sickness and disease. In our home, TB came for my oldest sister, Marion, who was the apple of my dad’s eye. Her sickness and his inability to pay for medicine broke his heart.

Tuberculosis tortured my sister and left her an invalid that had to be restrained with ropes tied to her bed. My parents did everything in their power to keep Marion alive and comfortable but they just didn’t have the dosh to get her to the best clinics, doctors or medicines.

Instead she wasted away before our eyes until my mother could no longer handle her care and she was dispatched to our workhouse infirmary where she died 87 years ago. Mum and dad couldn’t afford to bury their darling daughter. So like the rest of our country’s indigent, she was dumped nameless into a pauper’s pit.

My family’s story isn’t unique. Rampant poverty and no health care were the norm for the Britain of my youth. That injustice galvanized my generation to become, after the Second World War, the tide that raised all boats.

In 1945, at the age of 22, still in the RAF after a long hard Great Depression and a savage and brutal war, I voted for the first time.

Election Day 1945 was one of the proudest days in my life. I felt that I was finally getting a chance to grab destiny by the shirt collar and that is why I voted for Labour and for the creation of the NHS.

Today my heart is with all of those people from my generation who didn’t make it past childhood, didn’t get an education, didn’t grow as individuals, didn’t marry, didn’t raise a family and didn’t enjoy the fruits of retirement. They died needlessly and too early. But my heart is also with the people of the present, who are struggling once more to make ends meet, and whose futures I fear for.

Today, we must be vigilant. We must be vocal. We must demand that the NHS will always remain an
nstitution for the people and by the people.

http://www.commondreams.org/views/2015/11/04/corporate-case-single-payer

Mingling among the doctors, nurses and activists at the single payer conferences in Chicago this weekend was one Richard Master.

Master is the owner and CEO of MCS Industries Inc., the nation’s leading supplier of wall and poster frames — a $200 million a year company based in Easton, Pennsylvania.

Master has just produced a movie — Fix It: Healthcare at the Tipping Point.

He was in Chicago to show it to the single payer advocates gathered there attending two conferences — the Physicians for a National Health Program annual meeting and the Single Payer Strategy Conference put on by nurses and other labor unions.

In a way, Master was a fish out of water — a businessman among activists.

But he had reached the same conclusion.

“My company now pays $1.5 million a year to provide access to healthcare for our workers and their dependents,” Master said. “When I investigated where all the money goes, I was shocked.”

What he found was that fully 33 cents of every health care premium dollar “has nothing to do with the delivery of health care.” Thirty-three percent of the healthcare budget was being spent on administrative costs.

That’s why he reached out to a couple of award winning filmmakers to produce Fix It — which makes the corporate case for scrapping the current multi-payer system for a single payer.

Yep--the co-ops really cannot compete if they want to be good guys. ANY for profit insurance allowed to exist at all will guarantee that the good guys are going to finish last. And the Repukes can't wait to help make that happen.

http://www.democracynow.org/2015/11/3/the_co_ops_collapse_how_gop

We welcome you all to Democracy Now! Steffie Woolhandler, let’s begin with you. In New York, there are well over 200,000 people who are—have insurance under what’s called Health Republic, one of these healthcare co-ops. Suddenly, last Friday, to the shock of many—even people working within the system—they were told that this healthcare co-op will close by the end of the month. That’s November. That’s before you can even get coverage in this open enrollment period. The next time is January 1st. So they have to sign up twice—right now, to fill the gap to the end of December, and then, because of IT issues—they can’t just sign up now and get that insurance from now on in another company—they have to sign up now ’til the end of December, and sign up within the open enrollment period, like a day later, for getting insurance in January. Over 200,000 people are out of insurance.

DR. STEFFIE WOOLHANDLER: Yes.

AMY GOODMAN: Just in New York alone.

DR. STEFFIE WOOLHANDLER: Just in New York. And 10 of the 23 co-ops have closed, and several more are expected to close soon. These nonprofit co-ops, many of us felt they were never going to be viable. These tiny insurance co-ops was like the peewee football going against the NFL. They just didn’t have the size to make it in the marketplace.

But also, they weren’t cheaters. And the way the health insurance market works is good guys finish last, and cheaters win. The way you make a killing in the health insurance market is by signing up lots of healthy people, collecting as high premiums as possible and giving them as little care as possible—and, if they get sick, figuring out ways to force them out of the insurance. That’s the way the U.S. insurance market works. And these small nonprofit co-ops were not very good at playing the game. Many of them didn’t want to play that game.

So, we’re not surprised they went under. You know, the only way to insure a population, that has worked, is through some form of nonprofit national health insurance. That’s what every other developed nation uses. And then you have everybody in what we call the same risk pool—everyone in, nobody out.

http://www.commondreams.org/views/2015/11/02/our-nation-needs-balm-single-payer-action-surges-forward

Over the past few days, more than 700 people from all over the country came together for the annual single-payer strategy conference. This year, we were in Chicago, my hometown, Of course we shared ideas, successes, concerns, and knowledge about the kind of healthcare reform that might truly give us the best healthcare system in the world through an improved Medicare for all for life model.

The convening groups represented Healthcare-NOW, the Labor Campaign for Single-Payer Health Care, One Payer States, and Physicians for a National Health Program.Leaders from this movement get precious little time to gather face-to-face during the year. There were scores of nurses from all over the country -- New York, Massachusetts, Illinois, Texas, California, Minnesota, Pennsylvania and beyond. There were doctors from all over the place. And there were those of us who are patients who have been injured (or might be injured) by our aggressively greedy healthcare system. Labor leaders brought the hopes of their rank and file membership that someday we will actually allow contract bargaining to surround much more than healthcare benefits and costs that have squeezed out other issues like wages, vacation and other leave benefits and so on.

The conference opened with a joint protest at the Blue Cross/Blue Shield building in Chicago. One of the great moments for me was seeing the medical students passionately calling for changes to their chosen profession. It gave me hope for the future and the potential for real change.

But the highlight of the conference for me came in something much less quantifiable but much more powerful -- the balm of knowing that this wonderful nation is filled with compassionate, decent people who believe in the promise of our Declaration of Independence in which we read that all men are endowed by their creator of certain unalienable rights, and that among these rights are life, liberty and the pursuit of happiness. There can be none of those dearly held rights for Americans when our healthcare system snuffs out any chance for equality and the opportunity to live life to its fullest extent.


A special shout out to National Nurses United for their support of the conference and continued support of the movement to advance single-payer in our states.

We missed those of you who were not with us.

If you would like to check out the conference materials, there is a wiki page at: http://singlepayer2015.wikidot.com/

Ben and Stephanie at Healthcare-NOW will be adding PowerPoints and other documents over the next few days, so even if you missed being with us this time, you will be able to take advantage of a great deal of our work.

If you would like to get a feel for the conference, I have written a blog that you may wish to read and/or share. And if others have photos or other writings, I urge you to share them on the Wiki page or send them to Ben and Stephanie (emails above) so that they may post them

http://donnasicko.blogspot.com/2015/11/our-nation-needs-this-balm-as-single.html

or if you wish to read this on Common Dreams: http://www.commondreams.org/views/2015/11/02/our-nation-needs-balm-single-payer-action-surges-forward

Finally, we screened the terrific new documentary film, Fix It: Healthcare at the Tipping Point (.
http://fixithealthcare.com/) Most of those who attended left with a DVD and/or thumb drive with a trailer, a shortened 38-minute version of the film, and the full 58-minute film ready to be used to do outreach to your business community. The demand for the film was so high that all of the copies the Fix It team brought (more than 500) were handed out in Chicago, and we took down the names and contact information for many, many more to be sent along.

If you did not get a copy, you did not leave your information with us or if you need assistance with your outreach plan, please let us know. We will also be spending some time on the November OPS call with strategies and suggestions for connecting with the business community using this great new tool.

Thank you to all who attended and all who continue to make OPS a great way to connect with other state single-payer activists.

https://www.ncpssm.org/PublicPolicy/SocialSecurity/Documents/ArticleID/1159/The-CPI-E-%E2%80%93-A-Better-Option-for-Calculating-Social-Security-COLAs

President Obama’s 2014 budget proposal includes a plan to change the way Social Security cost-of-living adjustments, or COLAs, are calculated by adopting the “chained” consumer price index (CPI). The National Committee has been vocal in its opposition to the chained CPI because it does not accurately measure the purchasing patterns of our elderly population. We urge the adoption of a CPI for the elderly, or CPI-E, as a more accurate means of calculating Social Security COLAs. An in-depth examination of the CPI-E follows.

The CPI-E uses the same formulas and prices as the CPI-W, but their importance is determined, or weighted, differently. The CPI-E uses expenditure weights for households with individuals age 62 or older. This sample size is 26 percent of the size used for the other BLS indices, so is subject to a greater sampling error than the other indices. This is one reason the CPI-E continues to be classified as “experimental”.

From December 1982 to December 2011, the experimental CPI-E has tended to rise more rapidly than the CPI-W. Using the CPI-E to determine the Social Security COLA would increase the expected average COLA by about 0.2 percentage points per year. In contrast, using the chained CPI would result in COLAs lower than under current law. COLAs using the chained CPI are estimated to reduce expected average COLAs by 0.3 percentage points per year. That means a typical 65 year-old would see a decrease of about $130 in

Social Security benefits using the chained CPI after the change has been effective for three years. At age 95, the same senior would face a 9.2 percent reduction—almost $1,400 per year. The BLS acknowledges the current CPI does not “produce official estimates for the rate of inflation experienced by subgroups of the population, such as the elderly or the poor.” Neither the current CPI-W nor the proposed chained CPI takes into account the spending patterns of America’s seniors. This is why we need an elderly index.

According to the BLS, in order to move to an “official” CPI-E, it would need to conduct additional research including where elderly households are located, where the elderly actually shop, and what mix of products the elderly purchase. The CPI-E has been under review for nearly three decades. It is time for the federal government to provide the resources for BLS to conduct this research and to expand the sample size of individuals age 62 and older, to conclude its analysis, and adopt a more accurate consumer price index for the elderly.

Comment by Don McCanne of PNHP: The performance of competing private insurance plans within the ACA exchanges is not much different from the performance of the pre-ACA private plans in the individual market. Trends in higher insurance costs, greater cost sharing, and narrower choices were already occurring, and they continue to grow progressively worse. Access and affordability can only suffer.

Higher premium credits and out-of-pocket subsidies are helping individuals with incomes near poverty levels, but, for middle-income families, they are inadequate to provide much benefit.

Higher premiums and more cost-shifting to patients are adequate to maintain profits for most larger insurers, but where even these measures are inadequate, insurers are pulling out of the exchanges, and some of the smaller insurers are even folding. Market manipulations create instability.

The insurers show their true colors through statements such as that of Anthem’s Chief Financial Officer Wayne Deveydt. Reporting to Wall Street analysts, Deveydt said about the market, “When you have fewer national enrollees and you have price points that we don’t believe are sustainable, we’ve just made a
conscious decision we’re not going to chase it.”

Higher premiums, greater cost-sharing, narrower networks - the behavior of the private insurers is not changing in spite of the promise of higher value and lower costs through the ACA Marketplaces. The ACA
exchanges are a creeping failure that is growing worse. Congress enacted the wrong model of reform. We
need single payer.

My comment: Health insurance should never be allowed to make a profit, any more than fire departments.

Comment by Don McCanne of PNHP: Out of a population of about 322 million, 32 million US residents remain uninsured. Because of the complex eligibility requirements for various insurance programs under the Affordable Care Act, there are many reasons that so many remain uninsured. Regardless, this latest data from HHS shows that the success in reducing the numbers who are uninsured is leveling off, and one of the most important reasons is that the Affordable Care Act did not make health insurance affordable for far too many of us.

Four-fifths of the uninsured have less than $1,000 in savings. Half have difficulty affording food or housing. Even if they had more money, many would feel obligated to use it to pay down debt, or to repair their homes, or to repair their automobiles that provide them transportation for employment. They still wouldn’t have enough left to purchase health insurance.

Yet when these people turn 65, they can afford Medicare. The program is automatically funded, primarily through the tax system.

If we improved Medicare, funded it completely through progressive taxes, and then provided it to everyone, not only would it be affordable for all of us, none of us would ever have to make a decision on whether our health care dollars needed to be used for food, housing or any other essentials. Medicare would automatically always be there for all of us.

Comment by me: Not all who are 65 can afford Medicare either. But they are able to supplement it with Medicaid--the so called dual eligibles. Why have all those systems separate?

Comment by Don McCanne of PNHP: Although Fareed Zakaria has wavered in the past on what we need to do to improve the health care system in the United States, he has now come to the firm conclusion that we need single payer.

As he states, “There's absolutely no question that when we look at the ability to provide good healthcare at an affordable price, lower levels of massive inequality in healthcare outcomes or provision, a single government payer and multiple private providers is the answer. It's absolutely clear that is the only way you can achieve that goal.”

He cites the 1963 landmark article by Nobel laureate Kenneth Arrow, “Uncertainty and the Welfare Economics of Medical Care,” (link below)) explaining why health care cannot achieve a competitive equilibrium in the marketplace. In today’s terms, Arrow’s work explains why it is foolish to continue to rely on a marketplace of private health plans plus various public programs to try to manage spending in our $3 trillion health care industry.

As Nobel laureate Paul Krugman states, “health care can't be marketed like bread or TVs.”

Imagine marketing fire or police or disaster relief services like bread or TVs. Those services should be there, ready for any of us whenever we need them. The same is true for health care. That would work just fine if we made our government the single payer.