By RoseAnn DeMoro writing for San Francisco Chronicle.

In contrast to the health care horror show unfolding in Washington, California can establish real health care security for our families, neighbors and communities with the Healthy California Act, SB562.

SB562 would guarantee coverage for every Californian. It would end the nightmare for those who pay premiums for “insurance” they can’t use because of the huge deductibles.

It would end restrictive insurance networks that limit access to specialists, or slam patients with unexpected medical bills from a doctor’s group even when going to an “approved” network provider.

SB562 is the only way to achieve real patient choice. One medical card, good at any hospital, doctor’s office, lab or clinic.

Insurance companies are working feverishly to deceive the public about SB562 with claims such as this proposal will suddenly cost taxpayers $400 billion. But most of that is what is already spent on health care in California, an amount engorged by profiteering, inflated charges, mountains of billing paperwork, excessive executive pay packages, and other waste.

Here’s what the opponents of SB562 have hidden: A study from the University of Massachusetts-Amherst’s Political Economy Research Institute that illustrates how nearly every California household and business would actually spend less on health care costs than they do now.

Companies that now provide health benefits for employees will spend less, in large part because they will no longer have to subsidize the $26.7 billion in profits that California insurers made in the past six years.

Under the study’s financing proposal, a modest 2.3 percent gross receipts tax for SB562 that exempts the first $2 million in revenue would slash what businesses with fewer than 10 employees pay now for health benefits by 22 percent. Large companies with up to 500 workers would spend 6 percent less on health care.

A 2.3 percent sales tax that exempts spending on housing, utilities, groceries and multiple personal savings would cut what most families now spend on health care as a share of their income by up to 9 percent — effectively a 9 percent raise.

In exchange, we could provide coverage for 2.7 million Californians still uninsured and eliminate the ever-rising costs of premiums, deductibles and other health charges for 12 million people who now pay premiums but face financial distress or bankruptcy if they go to the doctor or endanger their health by not getting the care they need — even if “insured.”

How do those charges affect real Californians? Meet Sharon, an “insured” North Bay resident with a pre-existing condition who recently told us that “my deductible was supposed to be $5,000, but after expensive surgery I had to pay more than $7,000 out of pocket because only certain expenses apply to the deductible in spite of the fact I paid more than $6,000 in premiums through the year.”

“Enough of this nickel-and-diming me and my family so we can worry about whether we can keep our insurance each month or pay for enough groceries. Give us single-payer health care for all, regardless of income,” she wrote.

Californians face a moral choice. To be a caring society, as envisioned by Martin Luther King Jr., a “beloved community” in which health care is genuinely a human right, guaranteed for all, we must pass SB562.

RoseAnn DeMoro is executive director of the California Nurses Association and National Nurses United, lead sponsor of SB562.

Original Post: http://www.sfchronicle.com/opinion/openforum/article/SB562-would-bring-health-care-not-just-11228179.php

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Dear Governor Brown,

I have campaigned for you in every election.  I did so because I believed that you would work on behalf of the people of California. Californians need your help now.  My wife has a  terminal illness. She requires frequent doctor visits and expensive medication in order to stay out of the hospital.  As she is not yet 65, she stands to lose all health coverage, if our Republican Congress wins their war against the nation’s health.  So the political is now personal.

I, too have been diagnosed with a precursor for a very bad cancer.  My elderly mother is likely to be soon placed in a nursing facility.  So many other Californians are in similar, or even worse positions.  Our lives hang in the balance, and Congress does not care.

Governor Brown, we need your help to bring SB562 Healthy California to the Assembly floor.  The bill may not yet be perfect, but it cannot be improved if it remains shelved as you asked Speaker Rendon to do.  This bill, according to the already completed financial study, will save the state billions of dollars.  The economic impact, though, does not stop there.  Without access to healthcare, more people will be forced to rely on emergency rooms for treatment.

Businesses who currently contribute to their employees’ insurance, will no longer be able to afford to do so.  They will suffer from decreased productivity because of declining employee health.  This will result in lay-offs, decreased purchasing power, and reduced revenue to the state.  Hospitals, clinics, psychiatric facilities, and adjunct health providers will be faced with laying off staff, or closing their doors, if people cannot afford their services.  In short, it could potentially tank the entire economy of the state.

This is a matter of deciding whether you care more about the very short-term interests of insurance and pharmaceutical corporations, or the lives of the people of California, and the overall health of the state.

We need your help.  This is not hyperbole.  There is, make no mistake, a war on.  The people of California (by extension, the rest of the nation who are looking to us to lead the way) need you to stand up for our very lives.  Which side you take now will, ultimately, be your legacy as governor.

Please side with the people, not the corporations.

Respectfully,

Mark A. Hirshfeld, LCSW
Ventura County Activists for Bernie Sanders

CC:  Assembly Speaker Anthony Rendon
Assembly Member Monique Limon
California Nurses Association
Healthy California
National Nurses United
MSNBC
Huffington Post
Los Angeles Times
Ventura County Star
Multiple Social Media

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by RoseAnn DeMoro, writing for Common Dreams.

There’s a significant danger that a public option would not only fail to improve the ACA, it could undermine the movement for Medicare for All

With the collapse of the dismal Republican healthcare bill, some Democrats are reviving talk of a public option as the cure for the holes in the Affordable Care Act that opened the door for the GOP attack.

Some even project the public option as the path to real transformative reform, an improved and expanded Medicare for all. It’s not. The public option bears more in common with fool’s gold. It may look shiny, but it will still leave you broke.

And there’s a significant danger that a public option would not only fail to improve the ACA, it could undermine the movement for single payer, discrediting a fully publicly financed system that is not a feeble adjunct to the private insurance market.

Granted, the ACA did enact some important course corrections, especially the expansion of Medicaid, to a profit-focused healthcare system that had plummeted to 37th in World Health Organization rankings.

But ignoring the highly successful and popular model of a proven system, Medicare, the ACA architects instead opted for an alternative that left 28 million Americans uninsured and failed to reign in the price gouging practices of the private market.

The inevitable result was millions of newly insured people paying premiums for insurance they increasingly could not use because of ever-rising deductibles, co-pays and other out of pocket costs.

Enter the proposal for a public option, now again in vogue as the solution for driving down costs by offering competition for the private insurers. The public option, the argument goes, can offer less expensive coverage because it doesn’t have to divert massive sums for administrative costs, mainly profits, lush executive pay packages, claims denial paperwork, and marketing.

But in practice, the outcome would be far different. Medicare works in large part by including all the people it covers in one large risk pool so that healthier patients balance out sicker patients in costs that must be reimbursed to providers. But the public option would not have that protection. One of two scenarios is likely:

A. To actually compete, the public option has to employ the same cutthroat tactics private insurers employ to limit their costs.

Insurance companies reap profits by collecting premiums and restricting payments for care. They accomplish that goal by denying claims—data from California and Connecticut have shown insurers deny from one-fifth to one-fourth of all claims—or excluding patients likely to be sicker and in need of more costly care.

The ACA barred insurers from refusing to sell plans to people they used to summarily reject with even minor pre-existing conditions. But the insurers have decades of experience in gaming the system, such as the use of restrictive provider networks and drug formularies.

As Adam Gaffney and Danny McCormick wrote in The Lancet in April, in the massive New York market only one insurer, a consumer cooperative that ultimately collapsed financially, covered care at the city’s top cancer center. Another popular scam is charging their enrollees more for essential drugs for AIDS, cancer or other serious illnesses.

So the public option can engage in the same skullduggery to exclude sicker, more costly patients, or

B. The public option becomes the ACA escape valve by welcoming in the sickest people selected out by the private insurers, in effect another bailout for a failed private insurance market.

Noble, but fatal. Thus the public option has far higher operating costs than the private plans. To effectively compete, it must either greatly jack up its rates, eliminating it as a less expensive alternative, or endure the bankrupted fate of that consumer coop in New York.

To top it all off, the Congressional Budget Office in 2013 concluded that adding a public option would not even slice the number of uninsured, and could even encourage employers to dump workers they now cover into the ACA exchanges.

With millions still either uninsured or paying exorbitant costs for care, imagine promoting a publicly financed Medicare for all to a public that sees a public option that is just as unethical as the notorious private insurers, or a financial wreck that just went belly up.

In 1957, the Ford Motor Co. had the hot idea of a glitzy new car that would capture new market share. It was called the Edsel, which soon become a synonym for a flop. Nurses have a message to the public option purveyors. Stop trying to sell us an Edsel.

Original Post: https://www.commondreams.org/views/2017/07/20/public-option-doomed-start

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By Jean Ross writing for Common Dreams.

With liberals across the land breathing a huge sigh of relief after the abrupt collapse of the Senate scheme to repeal and somewhat replace the Affordable Care Act, all is good again with healthcare in America. Right?

Well, there have been a few troubling signs if you can dig past all the news about Donald Trump’s latest tweets.

Americans are dying younger. A Bloomberg news report found that in 2015 the death rate rose slightly for the first time in 2015 since 1999 (though that has brought some cheer, , said Bloomberg, into some corporate boardrooms, who can revise down how much they’ll have to pay out in pension payments to retirees). https://www.bloomberg.com/news/articles/2017-08-08/americans-are-dying-younger-saving-corporations-billions

• Colon cancer mortality rates for white Americans under age 55 are climbing, as detailed in a study the Journal of the American Medical Association. https://www.washingtonpost.com/news/to-your-health/wp/2017/08/08/mortality-rates-are-rising-for-colon-cancer-but-only-for-white-americans/?utm_term=.d96b0ca141e6
• More than four in ten adults with health insurance struggle with the high cost of deductibles, according to a Kaiser Family Foundation survey. Nearly 30 percent had trouble paying medical bills, with 73 percent of those cutting back on spending on food, clothing or other basic items. Significant numbers skipped dental care, going to the doctor, getting a recommended medical test or treatment, or filling a prescription. http://www.kff.org/health-costs/poll-finding/data-note-americans-challenges-with-health-care-costs/
• Blue Cross and Blue Shield of Georgia informed enrollees that if they go to the emergency room with a health problem that insurance bean counters later decide was not an “emergency” the insurer will not pay their care, reported Michael Hiltzik of the Los Angeles Times. That’s right, patients will get stuck with the bill, after all how much could an ER visit cost? http://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-er-20170602-story.html
• About 114 million Americans have no insurance coverage for dental care. Gum disease, the New York Times reported, increases the risk of heart disease, diabetes and lower baby birth weights. Dental emergencies in California alone rose by 50 percent from 2005 to 2011. https://mobile.nytimes.com/blogs/kristof/2017/05/23/our-teeth-are-making-us-sick/

But the news is not all bad. It’s a great time to be a healthcare chief executive. CEOs of the 70 largest U.S. health care companies have taken home a cumulative $9.8 billion since the enactment of the ACA. John Martin, former CEO of Gilead Sciences collected $863 million just by himself. https://www.axios.com/the-sky-high-pay-of-health-care-ceos-2442398819.html

If the name Gilead sounds vaguely familiar, here’s a refresher. They’re the people behind Sovaldi, the hepatitis C drug for which Gilead charges $1,000 a pill or $84,000 for a 12-week treatment course, an amount that is threatening to bankrupt public programs which now commonly ration the drug.

It’s also a banner time for creative new companies that profit off contracting health care services, like emergency care. The New York Times reports that more than 20 percent of ER visits result in much higher costs for patients who unexpectedly get a massive bill because their care was provided by doctors who are not part of their insurance “network.” https://www.nytimes.com/2017/07/24/upshot/the-company-behind-many-surprise-emergency-room-bills.html

Yes, but haven’t all the policy wonks assured us we have the best healthcare system in the world?

Not if you’re counting “amenable mortality,” which the Washington Post defines as deaths that “could have been avoided by timely and effective medical care.” By that score, according to University of Washington researchers, the U.S. ranked just 35th among 195 countries. https://www.washingtonpost.com/news/to-your-health/wp/2017/05/18/an-embarrassment-u-s-health-care-far-from-the-top-in-global-study

Of course, that’s an unfair comparison. All those other countries ahead of us actually prioritize healthcare as a public good, a societal benefit not to be mortgaged off to corporations that exploit their peoples’ health for profit.

What they all have is rational, coordinated national healthcare systems. Even if they have a role for private insurers, the government is still setting the rates and health benefits, and everyone, bar none, is guaranteed care. https://www.commondreams.org/views/2017/08/08/liberals-strike-back-against-single-payer

We could, of course, have such a system too; you just have to be 65 or older to get access to it. It’s called Medicare, and it remains one of the most popular reforms in U.S. history, far more beloved than those not so charming insurance companies whose principal mission is to collect your premiums and avoid paying anything out for your care.

We can, and should, all celebrate the defeat, for now, of call it McConnellcare or Ryancare or Trumpcare. But let’s not forget that the huge holes in Obamacare on access and out of pocket costs in particular have left tens of millions of people without care or hammered by the high cost.

There’s a reason 60 percent of Americans believe it is the government’s obligation to ensure health coverage for all. http://www.pewresearch.org/fact-tank/2017/06/23/public-support-for-single-payer-health-coverage-grows-driven-by-democrats/

And, there’s a straightforward way to accomplish that, building on 52 years of our successful Medicare experience – improve, strengthen Medicare, and lower the eligibility age to zero.

The Medicare for all movement is growing, climb on board.

Original Post: https://www.commondreams.org/views/2017/08/10/we-still-have-lot-work-do-healthcare

The post We Still Have A Lot of Work To Do On Healthcare appeared first on Healthy California Campaign.

Deborah Burger writing for the Eureka Times-Standard.

How long are we going to ask North Coast residents who have no health coverage or who struggle to pay inflated costs for medical care to wait for help?

A long time, apparently, in the view of North Coast Assemblyman Jim Wood and Assembly Speaker Anthony Rendon.

In Wood’s district, 24 percent of adults delayed filling prescriptions or getting medical services in 2014. One fifth of those adults were in only fair or poor health, according to the UCLA Center for Health Policy Research.

It will soon get worse. Insurance premiums are projected to jump on average 12.5 percent next year. But the worst hit will be across rural Northern California counties, many in Wood’s district, where increases could soar as high as 30 percent.

SB 562, now stalled in the Assembly, could provide relief. It would not only guarantee coverage for all currently uninsured Californians, it would also eliminate premiums, deductibles, co-pays that prompt far too many to self-ration the care they need.

After SB 562 passed the California Senate in June, Speaker Rendon unilaterally prevented the bill from moving forward.

Wood publicly backed Rendon (“I strongly believe health care is a right,” Times-Standard, Aug. 28, Page A4). The irony is that Wood is hardly an innocent bystander. Few Californians are in a better position to improve legislation he claims falls short.

Wood chairs the Assembly Health Committee, the first Assembly body that would hold hearings and consider changes Woods claims are required. No doubt the authors of SB 562 would welcome Wood’s willingness to work on potential improvements.

Instead, Wood now touts a “Select Committee” that is not a policy body and cannot pass legislation as an alternative to a real bill frozen in the Assembly that could end the health care emergency for so many in crisis.

Assemblyman Wood and Speaker Rendon should do the job they are elected to do. Hold hearings and make any fixes on actual legislation that immediately addresses an overwhelming public need.

And as with climate action, transportation and housing, and previous healthcare legislation, if further refinements to major programs are subsequently desired, they can be implemented through additional legislation.

Thousands of Californians, who have been campaigning for SB 562 for months, have made it clear they will not settle for the empty promises of a Select Committee that has no power and looks more like a cover for inaction.

That includes volunteers who knocked on the doors of 375 Eureka residents in mid-August, one-third of whom said they’d contact Wood to urge him to push the bill forward.

It also includes the California Democratic Party whose executive board, with over 300 members, voted unanimously August 27 to endorse SB 562.

For anyone who claims that health care is a right, it’s past time to move beyond rhetoric to action. For all of those in pain today, or who are one car accident, exposure to a deadly disease or one super storm away from calamity.

Deborah Burger is a registered nurse, co-president of the California Nurses Association, and a resident of Assemblyman Jim Wood’s district.

Original Post: http://www.times-standard.com/opinion/20170902/stalling-health-care-helps-no-one

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By Augie Lindmark, Vanessa Van Doren, Bryant Shuey, and Andy Hyatt – writing for STAT News.

Underneath a heap of hospital blankets, Stephen seemed small for a 7-year-old. His chest rose and fell rapidly, a frightening rhythm given his history of asthma. His parents stood nearby as veteran witnesses — Stephen had been admitted to a Cleveland safety net hospital for asthma four times already this year — but familiarity offers little comfort when your child struggles to breathe. When asked if their son used his asthma inhalers, they replied, “It depends. When we can afford them, he takes them. But when we can’t, it could be a few weeks.”

Stephen represents one of more than 430,000 hospitalizations each year due to asthma. At a cost of $56 billion annually, complications from asthma can be prevented with regular medications (inhalers), avoidance of triggers like dust and mold, and access to health care, which usually means access to health insurance. Stephen didn’t have the latter.

Of the diseases we are taught in medical school, a sudden worsening of asthma, known as an exacerbation, is a relatively common cause of illness in children and adults. To identify the cause of a disease, doctors are trained in the differential diagnosis. This bedrock of medical education encourages doctors — those in training, like us, as well as those with years of experience — to compile a list of causes that match a patient’s symptoms. In a way, the differential is half medicine, half Sherlock Holmes.

Chest pain, for example, might include differential diagnoses that range from heart attack to having eaten too many buffalo wings. Yet there’s a particular cause of illness — in Stephen’s case, a nonpulmonary culprit — that is unique to American health care: America’s private health insurance system.

Recent months provide ample context. As the latest Obamacare repeal efforts took the form of Graham-Cassidy 1.0 and 2.0, the GOP bill would have kicked 32 million Americans off their health insurance. Patients with preexisting conditions like asthma would have seen sharp increases in their health insurance premiums (in the case of metastatic cancer, to the tune of six digits), and Medicaid reimbursements to Planned Parenthood would have been banned, effectively barring millions of women from reproductive and preventive health care.

Both Republican and Democratic efforts have done little to change the fact that thousands of Americans die from lack of health coverage. America’s fragmented and inequitable health system is a sinking ship and recent fixes — often in the form of private health insurance industry bailouts or shutouts — are like placing tissue paper over the leaks in this doomed vessel.

No bacteria or viruses harm health more than policies that effectively prevent millions of individuals from access to affordable health insurance to pay for life-altering health care, including the recent ill-conceived executive order. As American health care maintains its appalling position as a leading cause of financial burden and bankruptcy, an equitable response is essential. That means creating a system in which access to health care is based on need, not the ability to pay. As future doctors, we are being trained to identify root causes of disease. That’s why we support Medicare for all.

Momentum toward an improved and expanded Medicare for all health system is at historic highs. The majority of American physicians now support single-payer health care, and 60 percent of Americans believe that the federal government has a responsibility to ensure health care for all citizens.

Last month, the Medicare for All Act was rolled out with fanfare as Sen. Bernie Sanders — joined by 16 co-sponsors — offered a blueprint for universal health care in America. Its sister bill in the House of Representatives, the Expanded and Improved Medicare For All Act, has 120 Democratic co-sponsors, making it the first single-payer bill in history to have a majority of Democratic support.

The overwhelmingly popular Medicare and Medicaid programs have saved millions of lives and offer strong, supportive health care to millions of Americans. Why not offer that to all Americans? As the life expectancy gap between rich and poor increases, the only path forward is to ensure that all Americans have affordable health care, regardless of socioeconomic background.

President Trump recently declared his desire to “stabilize markets” which, historically, has meant diverting funds to private insurers who have done an outstanding job of shrinking coverage and fattening corporate profits. Trump’s latest executive order, which eliminates select private insurance subsidies, will ironically dampen private profits at the expense of escalating premiums for the middle class.

Private insurance subsidies are Band-Aids on an already oozing wound, an inefficient private industry that prioritizes the depth of shareholder pockets over patient health. And while subsidies are short-term fixes inadequate for a long-term solution, removing them altogether, as has been the procedure in the latest GOP bills, would further limit patient access to affordable, comprehensive care. This worse-worst situation could be healed with an improved Medicare-for-all system that eliminates profit motives and preferentially places health above all else.

As medical students, we occupy a unique seat from which to view America’s health system. Our inexperience means we haven’t been indoctrinated into the damaging practices of the private health insurance industry. Our optimism tells us that the system can be changed. We entered medicine out of a desire to help people. But if we participate in a flawed health care system without advocating for structural and equitable change, we trend toward hypocrisy rather than Hippocrates.

Because Stephen’s parents couldn’t afford asthma medications, their son’s breaths were figuratively assigned a price tag. His family, like millions of Americans, is forced to make an impossible decision: pay for food and rent, or purchase medications and health insurance. Recent months have seen patients, students, and health professionals realize this crisis and mobilize toward a better alternative: Medicare for all. We advocate to practice in such a system, where every patient has health care. And where every patient can breathe freely.

Augie Lindmark, Vanessa Van Doren, Bryant Shuey, and Andy Hyatt are medical students the University of Minnesota, Case Western Reserve University, University of New Mexico, and Boston University, respectively, as well as board members of Physicians for a National Health Program, an organization that advocates for an improved and expanded Medicare for All health system.

Original Post: https://www.statnews.com/2017/10/25/medicare-health-insurance-asthma

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By Jessica Glenza, The Guardian.

In a major international intervention in the US debate, the former UN secretary general said the current system ‘ultimately functions to prioritize profit over care’

The former UN secretary general Ban Ki-moon called on Americans to pass universal health coverage at a speech in New York City on Tuesday, marking a dramatic intervention of world leaders into the US healthcare debate.

Ban called on the US to stop “powerful interests” from prioritizing “profit over care” as part of a global delegation pushing the US to adopt a publicly financed health system similar to those in other wealthy countries.

The US spends more on healthcare than any nation in the world, yet 28 million Americans still lack care.

“In the US, all too often only rich people get access to expensive life-saving treatments,” said Ban. “This is unjust and threatens everybody’s health when working- and middle-class people with communicable diseases cannot afford treatment for their infections.”

“Even routine preventive care is often prohibitively expensive,” said Ban. “As America is demonstrating, you simply cannot reach universal health coverage if your health system is dominated by private financing and ultimately functions to prioritize profit over care.”

Enacting universal health coverage would be a revolution in US healthcare. Currently, the US relies on a complex network of for-profit health insurers, government subsidies and limited public insurance programs to provide healthcare access to Americans.

Of the 25 richest countries in the world, the United States is the only one without universal health coverage. The political prospects of passing such a law remain remote with conservatives in power, yet calls for universal healthcare in the United States have grown louder since President Trump’s election as Republicans try to dismantle healthcare regulations.

Currently, about 28 million Americans have no health insurance. For people without insurance, an emergency room trip could easily be a financial disaster costing tens thousands of dollars.

In his speech, Ban highlighted that the gap in access to healthcare meant victims of the recent mass shootings at a Las Vegas concert and Texas church were left without affordable care.

“It simply breaks my heart to see victims of tragic mass shootings then be potentially bankrupted because they cannot afford the hospital and recovery bills,” said Ban. “This is one of the clearest indictments of America’s health system today.”

Ban spoke at an event called “Health for All: #WalkTogether” organized by The Elders, a group of global leaders working for human rights. The Elders was founded by Nelson Mandela and is chaired by Kofi Annan.

Gro Harlem Brundtland: ‘Denying health coverage for poor children for tax cuts for the rich is not what we would expect of a compassionate society.’ Photograph: Andrew Seng

Robert Yates, a political health economist and expert on universal health coverage at the international thinktank Chatham House, said the international community is increasingly hoping to help Americans achieve universal health coverage.

“We think this is the very first time that the global community has engaged so directly with the US healthcare debate,” he said. “The World Health Organization is thinking as well about how we can help here in the US.”

“I and my fellow Elders are fully aware that healthcare debates in the US somehow are different,” said Gro Harlem Brundtland, former director general of the World Health Organization. “They are fought with more tension and divisiveness than other places.”

Although Trump has called Sanders’ plan for universal healthcare in the US a “curse”, the US has already agreed to work toward that goal. One of the sustainable development goals adopted by the UN was an agreement to work toward universal healthcare by 2030, including in the US.

“President Trump seems intent on dismantling his predecessor’s reforms through excessive executive orders … denying health coverage for poor children for tax cuts for the rich is not what we would expect of a compassionate society, and hopefully the story will end there and it will not happen,” she said.

Original Post: https://www.theguardian.com/us-news/2017/nov/09/ban-ki-moon-us-universal-healthcare

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By Editor, Corporate Crime Reporter.

Richard Master is the CEO of a $200 million a year company – MCS Industries in Easton, Pennsylvania.

MCS is  the nation’s leading supplier of wall and poster frames.

Master has a problem. He provides health insurance for his 200 employees.

Enough said.

Last year, he decided to do something about it.

He’s organizing to enlist other business leaders to speak out for the need for single payer health care.

Last year, he made the case in a documentary movie – Fix It: Healthcare at the Tipping Point.

Last month, he released a second movie – Big Pharma – Market Failure.

And next year, he will release a third – a yet untitled documentary about how money in politics is blocking the will of the American people.

Master got involved in the issue of health policy when he was traveling in 2013 in Chile.

“It was one of these spontaneous reactions to a personal situation,” Master told Corporate Crime Reporter in an interview last week. “My son, my wife and I were in Santiago, Chile. My son was introducing us to his future in laws. He developed an asthmatic reaction. He didn’t have enough firepower in his inhaler. We ran out to the local pharmacy, expecting to pay $80 to $100 for an Albuterol inhaler. It was $15. I asked through an interpreter — what about my blood pressure medicine? It was $4. I looked at our future daughter in law and my son and said — we have got to do something about this. And we are going to do something about this.”

“We actually filmed on our iPhones that encounter. It was November, 2013 or so. At the same time, we were confronting in our business the annual renewal negotiating for insurance. And we were facing a higher double digit increase, as we do every year. We are trying to negotiate down to single digits. And we are not having very much success. That whole set of circumstances led to some research on my part. We began to overturn these rocks and seeing what a dysfunctional, messy, inefficient system we have.”

“I talked to a good friend of mine who is a director for the Biography Channel and the History Channel. And I said — you have to come on board. We have to do something about this. It was expected to be modest. And then it turned into a full blown documentary — Fix It: Healthcare at the Tipping Point. Then we have this second documentary — Big Pharma: Market Failure.”

“A third documentary will be more involved with the difficulty in gaining solutions when you have a huge entrenched special interest like our healthcare system.”

Master says a majority of the American people support a single payer plan.

“I just saw the Economist poll last month. Sixty percent of Americans favor expanding Medicare to provide coverage for every American. Sixty-two percent favor creating a new federal program that covers everyone.”

“Eighty percent of Democrats and 43 percent of Republicans support this. Many more Republicans are in favor of this than are opposed to it.”

“The American people are in favor of replacing the Affordable Care Act with a single payer or Medicare for all system. And we are not getting it. And it’s not part of the Congressional dialogue. And we all know why. And we all throw our hands up and say — there is very little we can do about it. And that is a national disgrace. That is an affront to our sense of an American democracy. We have given up on the concept of participatory democracy to allow a major special interest to dominate our society the way it has.”

The gold standard for single payer is HR 676. As of now, 112 members of the House have signed onto it. They are all Democrats. There are no Republicans in the House who are supporting it.

Why not?

“That’s the great mystery,” Master said. “And why aren’t more corporations signing on to it? Why aren’t more conservatives recognizing that single payer costs less. It’s more efficient. It’s more transparent. These are business disciplines that Republicans in general embrace. But they can’t reach the same conclusions. I don’t think there is a major single payer group in the United States that is advocating that the government take over the delivery of care. We are talking about having the government be an escrow agent. We raise money through taxes and they pay the bill — similar to Canada — and pay it more efficiently.”

“There is gridlock. It’s more partisan gridlock than it is truly ideological.”

Did I get it right from your film that something like 40 percent of your health care expenditures comes from just a couple of patients?

“MCS is the leading supplier of picture frames and decorative mirrors in the United States. We sell to major mass market retailers. We are approaching $200 million in sales. We have about 200 workers in the United States. Most of our products are made overseas. We have a wholly owned subsidiary in Mexico. We have doctors and nurses around the clock in that plant. We have good medical care in that plant at a small fraction of the cost of insuring our employees in the United States.”

How many employees do you have in Mexico?

“Upwards of 700 employees in Mexico.”

“Our cost of insurance in the United States for a single person is about $7 an hour. Our cost for a family member is $12 to $13 an hour. The Kaiser study shows that we are spending over $13,000 to insure a working family. And that is with the high deductible plan — even with those high hourly costs.”

“We do the high deductible plan because every dollar we give to the insurance company is an inefficient dollar vis a vis health care expense. We actually pay the deductible to the employees as they are confronted with it.”

How much of their premiums do you pay?

“We pay about 75 percent, 77 percent if they don’t smoke, of the employee’s premiums. The employee pays the remainder. The employees then have co-pays and deductibles. But we now cover the deductibles.”

Did I get it right from the film that a big chunk of your health care costs comes from just a couple of employees?

“You are absolutely right. Four or five employees in a company our size can really change the whole economics of our company. And they have. One person with cancer can cost now a million in a year. We have two people with Hepatitis C — that was $300,000 to $400,000 in a year. And it’s so dramatic.”

If we had a single payer system in the United States, how would that change your business?

“We wouldn’t have an HR professional involved in the process. We would not be so concerned about the health of applicants for jobs because it wouldn’t be our responsibility to pay for illnesses.”

“We are a good company that respects the laws. But we have a problem in this country that people aged 55 are not highly regarded as potential employees by American businesses because of their vulnerability to illness and the burden they can have economically on the company. Those issues would not be at MCS if we had a Canadian style system.”

You would be paying more in payroll taxes. Your employees would be paying more in taxes. Are you convinced that your company and your employees would be paying less in taxes than you now pay overall in premiums, co-pays and deductibles?

“Certainly. We are approaching 15 percent of payroll for healthcare. A single payer system could be financed with about an 11 percent payroll tax. The employees may pay 3.75 percent and the employer would pay 7.25 percent. That is particularly significant for lower wage employees — employees making $30,000 a year — $15 an hour. They would essentially be paying about $1,000 a year as a premium share. Now, they could be paying $3,000 or $4,000 in premiums and have higher co-pays and deductibles to be concerned about.”

Who is your member of Congress?

“Matt Cartwright is the member for Easton, Pennsylvania. He’s a progressive Democrat and he’s a co-sponsor of HR 676. And for the rest of the Lehigh Valley, it’s Charlie Dent, a moderate Republican. He’s not now in favor of single payer. But he voted no on the Republican plan.”

There are no Republican co-sponsors of HR 676. And it has been rumored that Dent might be one of the first. Do you see that in the cards?

“I see that in the cards if we can mobilize enough support in the district to encourage him to change his position. To date, he has not changed his position. He has seen our movie — Fix It. Charlie is approachable. He’s mostly a reasonable person. If he steps out of line, he’s vulnerable to the attack from the more right wing doctrinaire members of his party who will come in, challenge him in a primary fight. He is a long time member. He’s very well financed. He’s the chairman of the subcommittee for the VA. And as such, he gets substantial contributions from the healthcare sector — including pharmaceutical companies.”

You are organizing to get other corporations to sign on to single payer. The name of the organization is Business Leaders Transforming Healthcare.

How many business leaders have signed on?

“We started the campaign last month with the launch of our movie — Big Pharma: Market Failure. So far, we have about 150 business leaders who have signed on. Many of them are smaller businesses. Some businesses of our size have signed on.”

“Two weekends ago at the Berkshire Hathaway meeting,Warren Buffett gets up and in response to a question, he says that business leaders should not be focusing so much attention on taxation. The real issue is health care, he said. Health care is the tapeworm in the belly of American competitiveness. And his vice chair, Charlie Munger says in an interview shortly after that meeting that he’s for single payer. Munger is a Republican. Buffett is a Democrat. But they both agree that single payer is the solution for American health care. That’s the green light that we needed. An iconic business leader saying — it’s time for you to rethink this issue. We have to do something about this.”

“The aspirational goal of our group is to bring single payer to the United States. But we also want to discipline the healthcare system with basic good business practices. We don’t need insurance companies or pharmacy benefit managers between patients and their doctors or hospitals.”

“Thirty percent or more of health care dollars are just wasted.”

[For the complete q/a format Interview with Richard Master, see 31 Corporate Crime Reporter 22(12), June 4, 2017, print edition only.]

Original Post: https://www.corporatecrimereporter.com/news/200/richard-master-conservative-case-single-payer/

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By Michael Lighty, Director of Public Policy, National Nurses United.

The announcement by the CEO’s from JP Morgan Chase, Amazon and Berkshire-Hathaway that they are forming a new healthcare company signals the symbolic end of the ACA-reform era. They recognize the inefficiencies and profiteering of the private insurance companies, who add no value to businesses dealing with healthcare. And should there be any doubt that the end of the ACA is nigh, there’s this from Trump: “We repealed the core of disastrous Obamacare. The individual mandate is now gone.”

Given the record of the CEO-in-chief who now occupies the White House, it’s doubtful we can expect improved healthcare, or lower costs, under his leadership, which should give us pause before putting CEOs in charge of our health.

If the ACA had fulfilled its promises, a new company by these CEOs would not be needed. The ACA sought to lower costs by forcing consumers to put more “skin in the game,” in Obama’s Budget Director Peter Orzag’s infamous phrase. Yes, patients are spending more, and in 2017 insurance premiums went up over 25% in many areas, deductibles have continued to climb to an average of $1440 for employees in large groups, and drug prices have skyrocketed for long-standing medications like Insulin and newer specialty drugs like Harvoni for Hepatitis C. High-deductible plans and a steady shift so workers pay more for insurance (on average 30% of premiums that are $18,000/year) has not lowered overall costs. Even worse, patients who have paid high premiums are not able to get care because they cannot afford the out-of-pockets costs their expensive insurance does not cover.

Into the breach come the heroic CEOs Bezos, Dimond and Buffett (BDB*). What do they offer? A company that can control costs. How will they do it? With technology, of course. Apparently we have come full circle: since the government regulatory program couldn’t enact effective cost control and utilize technology to save money, let’s have a corporation do so. But it is precisely the industry model that has created our dysfunctional, “money is the metric” approach to health. In the present healthcare industry, the war for revenue between insurers, drug companies, and hospital corporations, along with medical equipment manufacturers and other suppliers, has raised prices and created immense profits. Electronic Medical Records, and other technological innovations are supposed to anchor the new healthcare system. They are expensive, in fact more expensive than any savings they generate. The result of the ACA push to pay for “performance” has been to punish clinicians and hospitals with high-needs patients, no lowering of costs, and increased denials of care since there is an incentive to avoid rather than treat patients who will lower your “performance” score.

Somebody or some entity is going to make the decisions regarding the healthcare we get. Do we really believe CEO’s rather than clinicians should make those decisions? If the decisions are based on corporate bottom lines we can expect continued cost shifts to workers, deployment of labor-displacing technologies with unproven impacts on patient care quality, and fragmentation as each corporate castle fortifies its strategic market position: Aetna-CVS will go toe-toe-toe with BDB* as the Ascension hospital corporation (nation’s largest) pushes back, for example. Since less care equals greater profits, and more covered lives means greater revenue, we can see that money will likely remain the metric.

Those who control capital, like the richest guy in the world, investment banks and investors, favor capital-intensive approaches to social problems. Technology fits that bill. Yet, technology only serves the purposes for which it is designed: it is neither socially neutral nor a panacea. Nurses know, however, that human health cannot be reduced to an algorithm, subject as it is to the particularities of an individual’s family history, environment and most fundamentally, socio-economic status. Let’s hope the technologists and CEOs quickly learn from direct care RNs. Standardization of treatments whether through algorithms, protocols, or budget-mandates do not match the needs of individual patients.

Alternatively, the US could expand and improve the current program that puts clinicians in charge, is popular, and works at controlling costs: Medicare. With administrative costs as low as 5–6% compared to the 13% or higher for private insurance, Medicare is more efficient. The growth in Medicare spending, around 2.4% annually, is much less than growth in overall healthcare spending and far less than recent premium increases. Under Improved Medicare for All, benefits would be expanded to include those that ACA, Medicaid and CHIP provide, and Medicare will negotiate prescription drug prices. The biggest shortfalls in Medicare, the escalating privatization pushed by the insurance-financed politicians that have resulted in higher out of pocket costs for seniors, over payments to the private Medicare Advantage plans and the “donut hole” in the private the prescription drug benefit, would be eliminated through a robust Medicare for all plan, such as proposed nationally in Sen. Bernie Sanders S 1804 bill or the California single payer bill SB 562.

Moreover, traditional Medicare enables physicians to deliver the care their patients need without onerous “gate-keeping,” prior authorizations or narrow networks that insurers use to restrict access, limit choice of providers and undermine the clinical judgment of doctors and nurses. In fact, since older Americans tend to be the most intensive users of health services, expanding the pool by including everybody especially low-needs patients will make the program more sustainable.

Should patients, workers and employers be on the hook for the excessive compensation and enormous profits of the health insurance industry? In California between 2011–16, insurers made $27 billion in profits/net income. Why should we subsidize the failed business model of health insurers? (Employers get $342 billion each year in tax subsidies to lessen the cost to them of private health insurance.)

On this BDB is right — health insurance companies add no value, and the profits in healthcare are obscene. That recognition matters and can point the way toward real reform. The solution is not more of the same. We must contain prices in order to control costs. An industry approach cannot do that and also place patient care at the center of a reformed system.

The post Meet the New Boss, Same as the Old Boss appeared first on Healthy California Campaign.

Revelations Sunday by CNN that Aetna’s former Southern California medical director admitted under oath that he never looked at patient records when deciding whether to approve or deny care highlights a widespread abuse in the insurance industry that can have catastrophic consequences for patients, said the California Nurses Association/National Nurses United today

The case, which only came to light following litigation about a denial of care, is hardly an isolated incident, notes CNA.

Just last week CNA reported new data its researchers had uncovered that documented that 60 percent to 80 percent of health insurance denials are reversed by independent medical review by the California Department of Managed Health Care.

“California can end this behavior and protect our families and neighbors by changing to a system based on patient need, as proposed by SB 562 which would guarantee coverage for everyone and eliminate premiums, deductibles, and insurance denials. The Assembly should act on the bill now,” said CNA Co-President Deborah Burger, RN.

“Denials of care are increasingly common, with insurers creating a variety of pretexts which all amount to nothing more than the insurance company doesn’t want to pay for needed care, regardless of how much suffering it causes a patient,” said Burger.

In 2016 alone, the most recent year for which there is data:

• 60 percent of cases insurers denied as “not medically necessary” were either overturned by CDMCH independent medical review or ultimately reversed by the insurer.
• 80 percent of cases insurers denied as “experimental” or “investigational” were overturned or reversed by the insurer.
• 52 percent of cases where insurers refused to authorize payment for emergency or urgent care provided to a patient were overturned or reversed by the insurer.

Aetna is a prime example, says CNA. Of the cases that went to independent medical review in 2016, Aetna denials were upheld only 40 percent of the time.

“Everything about the case reported by CNN is a reminder why we need SB 562 – from the admission that Aetna’s former medical director to the case itself, in which a young patient was denied critical care, said Burger.

For years, California insurers were required to report total numbers of claims denials, until CNA researchers uncovered that data and published findings that from 2002 through 2010, the state’s largest insurance companies denied 26 percent of all claims. The state stopped publishing that data after it was widely reported in the media.

But while that data is no longer publicly reported, the independent medical review data is. The process is triggered after the insurer has denied a specific medical treatment, diagnostic test, or referral to a specialist, or a certain prescription medication.

In most cases, members must first file a grievance with their insurer and allow 30 days for it to be processed before filing for an independent medical review. Yet, grievance systems are rife with abuse, says CNA, such as failure to establish a grievance system, failure to respond to patients in a timely manner, and similar violations. For the largest insurers, those with more than 400,000 enrollees, 64 percent of violations with monetary penalties were related to the insurer’s improper grievance process.

“If anything, claims denials are actually under reported,” notes Burger. “It’s deliberately an arduous, burdensome process, buried in insurance fine print so that many patients are either unaware that they can appeal a care denial, or get so frustrated by the lengthy delay and bureaucracy that they stop fighting. That’s the disgraceful game that insurance companies play with people’s lives,” Burger said.

The post Dramatic Aetna Admission a Window Into Widespread Abuse of Patients in Insurance Claims Denials Say RNs appeared first on Healthy California Campaign.

I am a retired registered nurse who worked for 40 years in acute care hospitals. I watched all those years as our health care system morphed into the heath insurance for profit system now in place, which is a disgrace and denies health care access to millions of people, and which often results in death and/or needless stress and suffering.

I wish people understood that the California single payer health care bill now being discussed by many is not complete because the Assembly refuses to do the work of completing it. It is their job and why they were elected. The financing mechanism is their responsibility to study, discuss, and amend to include the needed finance piece. It was intended to work that way. This bill was never moved through one Assembly committee. Upon arriving in the California Assembly, after a positive vote in the California Senate, it was immediately shelved with the intention of killing it … on purpose. Why? Easy answer… follow the money. Look at who those corporate Assembly members obstructing this bill have as big donors. It is the health insurance industry, the pharmaceutical industry, and the entities who benefit from the dysfunctional status quo. I suggest everyone who keeps blaming the bill become educated about this rotten group of self-serving legislators. Stop regurgitating the disingenuous words of those same legislators who are the obstructionists and the recipients of many campaign donation dollars from those who oppose a single payer system.

Kathryn Donahue, R.N., McKinleyville

Source: Times-Standard – Letters »

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by RoseAnn DeMoro, writing for Common Dreams.

There’s a significant danger that a public option would not only fail to improve the ACA, it could undermine the movement for Medicare for All

With the collapse of the dismal Republican healthcare bill, some Democrats are reviving talk of a public option as the cure for the holes in the Affordable Care Act that opened the door for the GOP attack.

Some even project the public option as the path to real transformative reform, an improved and expanded Medicare for all. It’s not. The public option bears more in common with fool’s gold. It may look shiny, but it will still leave you broke.

And there’s a significant danger that a public option would not only fail to improve the ACA, it could undermine the movement for single payer, discrediting a fully publicly financed system that is not a feeble adjunct to the private insurance market.

Granted, the ACA did enact some important course corrections, especially the expansion of Medicaid, to a profit-focused healthcare system that had plummeted to 37th in World Health Organization rankings.

But ignoring the highly successful and popular model of a proven system, Medicare, the ACA architects instead opted for an alternative that left 28 million Americans uninsured and failed to reign in the price gouging practices of the private market.

The inevitable result was millions of newly insured people paying premiums for insurance they increasingly could not use because of ever-rising deductibles, co-pays and other out of pocket costs.

Enter the proposal for a public option, now again in vogue as the solution for driving down costs by offering competition for the private insurers. The public option, the argument goes, can offer less expensive coverage because it doesn’t have to divert massive sums for administrative costs, mainly profits, lush executive pay packages, claims denial paperwork, and marketing.

But in practice, the outcome would be far different. Medicare works in large part by including all the people it covers in one large risk pool so that healthier patients balance out sicker patients in costs that must be reimbursed to providers. But the public option would not have that protection. One of two scenarios is likely:

A. To actually compete, the public option has to employ the same cutthroat tactics private insurers employ to limit their costs.

Insurance companies reap profits by collecting premiums and restricting payments for care. They accomplish that goal by denying claims—data from California and Connecticut have shown insurers deny from one-fifth to one-fourth of all claims—or excluding patients likely to be sicker and in need of more costly care.

The ACA barred insurers from refusing to sell plans to people they used to summarily reject with even minor pre-existing conditions. But the insurers have decades of experience in gaming the system, such as the use of restrictive provider networks and drug formularies.

As Adam Gaffney and Danny McCormick wrote in The Lancet in April, in the massive New York market only one insurer, a consumer cooperative that ultimately collapsed financially, covered care at the city’s top cancer center. Another popular scam is charging their enrollees more for essential drugs for AIDS, cancer or other serious illnesses.

So the public option can engage in the same skullduggery to exclude sicker, more costly patients, or

B. The public option becomes the ACA escape valve by welcoming in the sickest people selected out by the private insurers, in effect another bailout for a failed private insurance market.

Noble, but fatal. Thus the public option has far higher operating costs than the private plans. To effectively compete, it must either greatly jack up its rates, eliminating it as a less expensive alternative, or endure the bankrupted fate of that consumer coop in New York.

To top it all off, the Congressional Budget Office in 2013 concluded that adding a public option would not even slice the number of uninsured, and could even encourage employers to dump workers they now cover into the ACA exchanges.

With millions still either uninsured or paying exorbitant costs for care, imagine promoting a publicly financed Medicare for all to a public that sees a public option that is just as unethical as the notorious private insurers, or a financial wreck that just went belly up.

In 1957, the Ford Motor Co. had the hot idea of a glitzy new car that would capture new market share. It was called the Edsel, which soon become a synonym for a flop. Nurses have a message to the public option purveyors. Stop trying to sell us an Edsel.

Original Post: https://www.commondreams.org/views/2017/07/20/public-option-doomed-start

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By Jean Ross writing for Common Dreams.

With liberals across the land breathing a huge sigh of relief after the abrupt collapse of the Senate scheme to repeal and somewhat replace the Affordable Care Act, all is good again with healthcare in America. Right?

Well, there have been a few troubling signs if you can dig past all the news about Donald Trump’s latest tweets.

Americans are dying younger. A Bloomberg news report found that in 2015 the death rate rose slightly for the first time in 2015 since 1999 (though that has brought some cheer, , said Bloomberg, into some corporate boardrooms, who can revise down how much they’ll have to pay out in pension payments to retirees). https://www.bloomberg.com/news/articles/2017-08-08/americans-are-dying-younger-saving-corporations-billions

• Colon cancer mortality rates for white Americans under age 55 are climbing, as detailed in a study the Journal of the American Medical Association. https://www.washingtonpost.com/news/to-your-health/wp/2017/08/08/mortality-rates-are-rising-for-colon-cancer-but-only-for-white-americans/?utm_term=.d96b0ca141e6
• More than four in ten adults with health insurance struggle with the high cost of deductibles, according to a Kaiser Family Foundation survey. Nearly 30 percent had trouble paying medical bills, with 73 percent of those cutting back on spending on food, clothing or other basic items. Significant numbers skipped dental care, going to the doctor, getting a recommended medical test or treatment, or filling a prescription. https://www.kff.org/health-costs/poll-finding/data-note-americans-challenges-with-health-care-costs/
• Blue Cross and Blue Shield of Georgia informed enrollees that if they go to the emergency room with a health problem that insurance bean counters later decide was not an “emergency” the insurer will not pay their care, reported Michael Hiltzik of the Los Angeles Times. That’s right, patients will get stuck with the bill, after all how much could an ER visit cost? https://www.latimes.com/business/hiltzik/la-fi-hiltzik-insurance-er-20170602-story.html
• About 114 million Americans have no insurance coverage for dental care. Gum disease, the New York Times reported, increases the risk of heart disease, diabetes and lower baby birth weights. Dental emergencies in California alone rose by 50 percent from 2005 to 2011. https://mobile.nytimes.com/blogs/kristof/2017/05/23/our-teeth-are-making-us-sick/

But the news is not all bad. It’s a great time to be a healthcare chief executive. CEOs of the 70 largest U.S. health care companies have taken home a cumulative $9.8 billion since the enactment of the ACA. John Martin, former CEO of Gilead Sciences collected $863 million just by himself. https://www.axios.com/the-sky-high-pay-of-health-care-ceos-2442398819.html

If the name Gilead sounds vaguely familiar, here’s a refresher. They’re the people behind Sovaldi, the hepatitis C drug for which Gilead charges $1,000 a pill or $84,000 for a 12-week treatment course, an amount that is threatening to bankrupt public programs which now commonly ration the drug.

It’s also a banner time for creative new companies that profit off contracting health care services, like emergency care. The New York Times reports that more than 20 percent of ER visits result in much higher costs for patients who unexpectedly get a massive bill because their care was provided by doctors who are not part of their insurance “network.” https://www.nytimes.com/2017/07/24/upshot/the-company-behind-many-surprise-emergency-room-bills.html

Yes, but haven’t all the policy wonks assured us we have the best healthcare system in the world?

Not if you’re counting “amenable mortality,” which the Washington Post defines as deaths that “could have been avoided by timely and effective medical care.” By that score, according to University of Washington researchers, the U.S. ranked just 35th among 195 countries. https://www.washingtonpost.com/news/to-your-health/wp/2017/05/18/an-embarrassment-u-s-health-care-far-from-the-top-in-global-study

Of course, that’s an unfair comparison. All those other countries ahead of us actually prioritize healthcare as a public good, a societal benefit not to be mortgaged off to corporations that exploit their peoples’ health for profit.

What they all have is rational, coordinated national healthcare systems. Even if they have a role for private insurers, the government is still setting the rates and health benefits, and everyone, bar none, is guaranteed care. https://www.commondreams.org/views/2017/08/08/liberals-strike-back-against-single-payer

We could, of course, have such a system too; you just have to be 65 or older to get access to it. It’s called Medicare, and it remains one of the most popular reforms in U.S. history, far more beloved than those not so charming insurance companies whose principal mission is to collect your premiums and avoid paying anything out for your care.

We can, and should, all celebrate the defeat, for now, of call it McConnellcare or Ryancare or Trumpcare. But let’s not forget that the huge holes in Obamacare on access and out of pocket costs in particular have left tens of millions of people without care or hammered by the high cost.

There’s a reason 60 percent of Americans believe it is the government’s obligation to ensure health coverage for all. https://www.pewresearch.org/fact-tank/2017/06/23/public-support-for-single-payer-health-coverage-grows-driven-by-democrats/

And, there’s a straightforward way to accomplish that, building on 52 years of our successful Medicare experience – improve, strengthen Medicare, and lower the eligibility age to zero.

The Medicare for all movement is growing, climb on board.

Original Post: https://www.commondreams.org/views/2017/08/10/we-still-have-lot-work-do-healthcare

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Deborah Burger writing for the Eureka Times-Standard.

How long are we going to ask North Coast residents who have no health coverage or who struggle to pay inflated costs for medical care to wait for help?

A long time, apparently, in the view of North Coast Assemblyman Jim Wood and Assembly Speaker Anthony Rendon.

In Wood’s district, 24 percent of adults delayed filling prescriptions or getting medical services in 2014. One fifth of those adults were in only fair or poor health, according to the UCLA Center for Health Policy Research.

It will soon get worse. Insurance premiums are projected to jump on average 12.5 percent next year. But the worst hit will be across rural Northern California counties, many in Wood’s district, where increases could soar as high as 30 percent.

SB 562, now stalled in the Assembly, could provide relief. It would not only guarantee coverage for all currently uninsured Californians, it would also eliminate premiums, deductibles, co-pays that prompt far too many to self-ration the care they need.

After SB 562 passed the California Senate in June, Speaker Rendon unilaterally prevented the bill from moving forward.

Wood publicly backed Rendon (“I strongly believe health care is a right,” Times-Standard, Aug. 28, Page A4). The irony is that Wood is hardly an innocent bystander. Few Californians are in a better position to improve legislation he claims falls short.

Wood chairs the Assembly Health Committee, the first Assembly body that would hold hearings and consider changes Woods claims are required. No doubt the authors of SB 562 would welcome Wood’s willingness to work on potential improvements.

Instead, Wood now touts a “Select Committee” that is not a policy body and cannot pass legislation as an alternative to a real bill frozen in the Assembly that could end the health care emergency for so many in crisis.

Assemblyman Wood and Speaker Rendon should do the job they are elected to do. Hold hearings and make any fixes on actual legislation that immediately addresses an overwhelming public need.

And as with climate action, transportation and housing, and previous healthcare legislation, if further refinements to major programs are subsequently desired, they can be implemented through additional legislation.

Thousands of Californians, who have been campaigning for SB 562 for months, have made it clear they will not settle for the empty promises of a Select Committee that has no power and looks more like a cover for inaction.

That includes volunteers who knocked on the doors of 375 Eureka residents in mid-August, one-third of whom said they’d contact Wood to urge him to push the bill forward.

It also includes the California Democratic Party whose executive board, with over 300 members, voted unanimously August 27 to endorse SB 562.

For anyone who claims that health care is a right, it’s past time to move beyond rhetoric to action. For all of those in pain today, or who are one car accident, exposure to a deadly disease or one super storm away from calamity.

Deborah Burger is a registered nurse, co-president of the California Nurses Association, and a resident of Assemblyman Jim Wood’s district.

Original Post: https://www.times-standard.com/opinion/20170902/stalling-health-care-helps-no-one

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By Augie Lindmark, Vanessa Van Doren, Bryant Shuey, and Andy Hyatt – writing for STAT News.

Underneath a heap of hospital blankets, Stephen seemed small for a 7-year-old. His chest rose and fell rapidly, a frightening rhythm given his history of asthma. His parents stood nearby as veteran witnesses — Stephen had been admitted to a Cleveland safety net hospital for asthma four times already this year — but familiarity offers little comfort when your child struggles to breathe. When asked if their son used his asthma inhalers, they replied, “It depends. When we can afford them, he takes them. But when we can’t, it could be a few weeks.”

Stephen represents one of more than 430,000 hospitalizations each year due to asthma. At a cost of $56 billion annually, complications from asthma can be prevented with regular medications (inhalers), avoidance of triggers like dust and mold, and access to health care, which usually means access to health insurance. Stephen didn’t have the latter.

Of the diseases we are taught in medical school, a sudden worsening of asthma, known as an exacerbation, is a relatively common cause of illness in children and adults. To identify the cause of a disease, doctors are trained in the differential diagnosis. This bedrock of medical education encourages doctors — those in training, like us, as well as those with years of experience — to compile a list of causes that match a patient’s symptoms. In a way, the differential is half medicine, half Sherlock Holmes.

Chest pain, for example, might include differential diagnoses that range from heart attack to having eaten too many buffalo wings. Yet there’s a particular cause of illness — in Stephen’s case, a nonpulmonary culprit — that is unique to American health care: America’s private health insurance system.

Recent months provide ample context. As the latest Obamacare repeal efforts took the form of Graham-Cassidy 1.0 and 2.0, the GOP bill would have kicked 32 million Americans off their health insurance. Patients with preexisting conditions like asthma would have seen sharp increases in their health insurance premiums (in the case of metastatic cancer, to the tune of six digits), and Medicaid reimbursements to Planned Parenthood would have been banned, effectively barring millions of women from reproductive and preventive health care.

Both Republican and Democratic efforts have done little to change the fact that thousands of Americans die from lack of health coverage. America’s fragmented and inequitable health system is a sinking ship and recent fixes — often in the form of private health insurance industry bailouts or shutouts — are like placing tissue paper over the leaks in this doomed vessel.

No bacteria or viruses harm health more than policies that effectively prevent millions of individuals from access to affordable health insurance to pay for life-altering health care, including the recent ill-conceived executive order. As American health care maintains its appalling position as a leading cause of financial burden and bankruptcy, an equitable response is essential. That means creating a system in which access to health care is based on need, not the ability to pay. As future doctors, we are being trained to identify root causes of disease. That’s why we support Medicare for all.

Momentum toward an improved and expanded Medicare for all health system is at historic highs. The majority of American physicians now support single-payer health care, and 60 percent of Americans believe that the federal government has a responsibility to ensure health care for all citizens.

Last month, the Medicare for All Act was rolled out with fanfare as Sen. Bernie Sanders — joined by 16 co-sponsors — offered a blueprint for universal health care in America. Its sister bill in the House of Representatives, the Expanded and Improved Medicare For All Act, has 120 Democratic co-sponsors, making it the first single-payer bill in history to have a majority of Democratic support.

The overwhelmingly popular Medicare and Medicaid programs have saved millions of lives and offer strong, supportive health care to millions of Americans. Why not offer that to all Americans? As the life expectancy gap between rich and poor increases, the only path forward is to ensure that all Americans have affordable health care, regardless of socioeconomic background.

President Trump recently declared his desire to “stabilize markets” which, historically, has meant diverting funds to private insurers who have done an outstanding job of shrinking coverage and fattening corporate profits. Trump’s latest executive order, which eliminates select private insurance subsidies, will ironically dampen private profits at the expense of escalating premiums for the middle class.

Private insurance subsidies are Band-Aids on an already oozing wound, an inefficient private industry that prioritizes the depth of shareholder pockets over patient health. And while subsidies are short-term fixes inadequate for a long-term solution, removing them altogether, as has been the procedure in the latest GOP bills, would further limit patient access to affordable, comprehensive care. This worse-worst situation could be healed with an improved Medicare-for-all system that eliminates profit motives and preferentially places health above all else.

As medical students, we occupy a unique seat from which to view America’s health system. Our inexperience means we haven’t been indoctrinated into the damaging practices of the private health insurance industry. Our optimism tells us that the system can be changed. We entered medicine out of a desire to help people. But if we participate in a flawed health care system without advocating for structural and equitable change, we trend toward hypocrisy rather than Hippocrates.

Because Stephen’s parents couldn’t afford asthma medications, their son’s breaths were figuratively assigned a price tag. His family, like millions of Americans, is forced to make an impossible decision: pay for food and rent, or purchase medications and health insurance. Recent months have seen patients, students, and health professionals realize this crisis and mobilize toward a better alternative: Medicare for all. We advocate to practice in such a system, where every patient has health care. And where every patient can breathe freely.

Augie Lindmark, Vanessa Van Doren, Bryant Shuey, and Andy Hyatt are medical students the University of Minnesota, Case Western Reserve University, University of New Mexico, and Boston University, respectively, as well as board members of Physicians for a National Health Program, an organization that advocates for an improved and expanded Medicare for All health system.

Original Post: https://www.statnews.com/2017/10/25/medicare-health-insurance-asthma

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