Medicare Isn’t the Problem, It Is the Solution

Republicans are traveling the country conducting town halls where they are trying to explain their votes for Congressman Ryan’s radical Medicare overhaul.  Their talking points include repeating that Medicare isn’t sustainable and something must be done to halt runaway health care spending.  They are mistaken because what is unsustainable is our broken health care system.  Medicare isn’t the contributing factor to that.  Private health insurers abusing clients, patients and taxpayers are the problem.

Twenty five per cent of our health care dollars are wasted.  We spend double the amount on medical care per capita than any other western civilized nation.  We have only the 37th best health care system.  Our dollars aren’t buying us quality because too many of them are wasted.

Waste in health care is vast.  CEO salaries in the millions of dollars, marketing expenses, salaries for doctors whose sole mission is to deny coverage to critically ill patients when they need it most.  Overhead costs in private industry dwarf that of Medicare:  2-3% compared to 25-30%.  59 million uninsured people wait until care is far more expensive before seeking treatment.  18,000 Americans die each year due to lack of coverage.  We went to war for seven years (so far) because 3200 of our fellow citizens die yet every year we allow 18,000 to expire because we won’t fix our health care system.

Our priorities are all out of order.  People going to an emergency room instead of a community clinic raises costs astronomically.  This is waste.  Insurance companies continue shifting costs to consumers and patients until our out of pocket costs are more than we can bear.  We aren’t getting quality and we aren’t getting good outcomes.  If our health care system were a Defense Department program we would scrap it and start anew.  This is where medicare becomes the solution.

At present Medicare is only eligible for people over age 65, the permanently, totally disabled and orphans.  It pays on an 80/20 basis meaning it covers 80% of costs and either the patient or supplemental insurance the remaining 20%.  It also covers most prescription drugs.  By expanding the coverage and extending it to every American we can create a health care for all single payer system.  We already have a management system in place and people love Medicare.  Eliminating the waste in the current broken system means we can cover everyone 100% with no co-pays or deductibles.

Vermont just passed, and its Governor signed, a single payer system.  Here in Pennsylvania efforts by a non profit group called Healthcare For All PA led by Chuck Pennacchio is trying to pass a comprehensive single payer system.  All medical expenses would be covered including mental health.  It would have no co-pays, no deductibles and cost each person a 3% personal income tax each year and a 10% tax on gross payrolls.  It would save the Commonwealth, counties, school districts and other municipalities billions every year over the current system.  That would balance our state budget and lower many local taxes.  Meanwhile every Pennsylvanian would have full access to quality medical care.  That, in turn, would lure businesses and jobs.  A healthy workforce is a productive workforce.

Therefore we see that Medicare isn’t the problem but the solution.  What is being proposed on these state levels can be easily done nationally by expanding Medicare and enrolling everyone.  We can cover everyone, make health care a right, save 18,000 lives per year, have a better system and better outcomes while cutting costs to something we can afford.

McConnell: “Ryan Medicare Plan Is Sensible”

Sen. Mitch McConnell says Paul Ryan’s Path to Prosperity plan to dismantle Medicare and replace it with private industry vouchers “is a very sensible way to go to try to save Medicare,” adding that President Barack Obama’s Medicare plan would empower “a board that would ration health care.”

Let’s take a good look at that statement.  Rationing of healthcare is a reality in any and every situation anywhere.  Unless everyone is given full access to medical care anywhere, anytime and for any reason (a hypochondriacs dream situation) there is “rationing.”  Some sensible management of a person’s medical care is important.  Too many x-rays, cat scans, MRI’s and such imperil one’s life from exposure to radiation.  Even getting too many, frequent dental x-rays is irresponsible.

So now we accept that some management is necessary so abusers don’t bankrupt the rest of us let’s actually examine the current situation in the U.S.  Most Americans receive their health care either from a government program or from private health insurers.  If you work for the government, are in the Armed Forces, are a senior citizen, disabled or an orphan you already have government healthcare.  Medicare and Medicaid are two of these programs.  A substantial portion of our population is covered by these programs including both Mitch McConnell and Paul Ryan.  I haven’t seen either of them renounce their coverage.

Private insurers, for profit companies and “non-profit” Blues which retain hundreds of millions in “profits” provide the balance of everyone’s coverage.  Except for the 59 million Americans who have been rationed out of the system entirely.  So we already have rationing.

Now we have a situation where those with pre-existing conditions get rationed in their coverage.  If you have had a “condition” in the past your private health coverage may likely exempt you from benefits for future treatment for it.  This is also rationing.

If you get seriously ill, cancer, MS, heart disease, need an organ transplant or whatever your private insurer can opt to drop you completely rather than pay for your medical care.  Unfortunately this happens frequently.  This is also a form of rationing.

You also have lifetime coverage limits.  Whether $1 million, $10 million or whatever coverage limits ration the healthcare available if you have private insurance coverage.  Your policy also rations how many times you can be hospitalized in a year, how many tests you may have done, where you go for treatment, who you may see and what you may have done.  This is all rationed healthcare.

If your primary physician refers you to a specialist and you cannot get into see them immediately and must wait for several days or weeks that is a waiting line.  We have always had “waiting lines” except for the most urgent situations.  Even going to an emergency room involves waiting your turn.  I’ve rarely gone to a doctor without having to wait in their office.  Mental health is severely restricted in our current health care system for example.  That care is severely rationed.  

Rationing and waiting lines have been intrinsic parts of health care for as long as there has been health care.  Republicans concocted these terms to scare people about single payer government health care.  Death panels is their latest fear mongering term.  Imagined by opponents to the Affordable Care Plan a feature which paid for a consultation for a person with their doctor to review end of life decisions, a Living Will for example, was twisted to mean a panel of bureaucrats would determine who might receive life saving treatments and who would not.  Gullible, stupid people swallowed this obscenity and actually believed it would happen.

Actually it did, under a Republican Governor in Arizona.  Faced with a mounting state deficit issue Jan Brewer decided that Arizona transplant patients would die rather than get life saving medical care.  They did.

An actual government managed single payer system would fix this broken system with which we currently suffer.  The underlying weaknesses are costs which remain out of control and which keep forcing more and more people out of the pool.  The employer based coverage developed in the 1940’s to provide incentive for workers when wages were frozen has not worked well long term.

With no cost controls and 59 million uninsured citizens and millions more under insured we must re-examine how we deliver health care.  A single payer system means the government replaces private, for profit industry and the Blues and collects all premiums.  They then remit payments to all private providers of health care under rules, guidelines and regulations mutually agreed upon.  Now any huge insurance company can arbitrarily determine whether you get coverage, your coverage continues, you have access to medical care, what you receive and whether it can summarily determine it will no longer cover your illness, injury or situation.  

In the proposals for a single payer system all providers of health care would remain private.  No doctors, nurses, lab technicians or other providers of your medical care would become government employees.  This makes Congressman John Conyer’s bill a hybrid public/private method in which every person had an automatic right to health care.

The Paul Ryan plan which Sen. McConnell embraces in his quote would further ration health care by eliminating Medicare as we know it.  Currently eligible recipients (those 65 and over, the disabled and orphans) as they become eligible would get a voucher worth $6000 to use to obtain health insurance in the private market.  It replaces a system (Medicare) with 3% overhead with a market based system with average 25% overhead.  That means for every dollar you provide for coverage instead of 3 cents going to administer the program 25 cents is wasted.  That rations health care by sending your premiums to the pockets of shareholders, executives and CEO’s earning multiple millions in salaries each year.  That is rationing.

It means instead of getting Medicare automatically regardless of your health you will be sent to private insurers who could refuse coverage, exempt certain conditions or at any time in the future decide you will no longer be covered.  That is rationed health care.

I ask Mitch McConnell if he simply spoke from ignorance, callousness or stupidity?

Obama to Allow State Innovation on HCR

President Obama announced today he will support efforts in Congress to allow individual states to enhance health care reform as long as they follow certain criteria such as not adding tot he deficit.  This effort could advance the enaction of single state single payer.  Healthcare4AllPA under Chuck Pennacchio has been trying to pass such legislation here.  It could cut local, county and state costs for employee provided health care by billions.  The Affordable Care Act requires that no such individual state effort be allowed until 2017.  President Obama now supports bringing that down to 2014.

On February 28, President Obama reiterated his belief that States should have the power and flexibility to innovate and find the health care solutions that work best for them and announced his support for accelerating State Innovation Waivers and allowing states to apply for them starting in 2014.  

Beginning in 2017, the law allows States the flexibility to receive a State Innovation Waiver so they may pursue their own innovative strategies to ensure their residents have access to high quality, affordable health insurance.  These strategies – which must provide affordable insurance coverage to at least as many residents as the Affordable Care Act and must not increase the federal deficit – could include allowing large employers to purchase coverage through State Exchanges or increasing the number of benefit levels to provide more choices for individuals and small businesses.

Under the bipartisan “Empowering States to Innovate Act” introduced by Senators Ron Wyden, Scott Brown, and Mary Landrieu, State Innovation Waivers would be available three years earlier than under current law, so long as States meet certain criteria, including certifying that their proposals would cover at least as many of their residents as the policies in the Affordable Care Act would have covered.

The proposal offers States more flexibility while ensuring that all Americans, no matter where they live have access to affordable, accessible health insurance.  Additionally, the proposal includes built-in protections to ensure that these waivers do not increase the Federal budget deficit.  

The Affordable Care Act already creates a critical role for States.  It provides them with the flexibility and resources necessary to innovate and implement reform in the manner that works best for them. The law has already made nearly $2.8 billion available to states and every State has taken steps – and, in some cases, bold actions – to implement the law and improve health insurance accountability and affordability for their citizens. States can design their own Exchanges, shape their Medicaid programs, and take the lead in enforcing patient protections and reviewing rates increases of private insurers.  

Empowering States to Innovate

Under the Affordable Care Act, State Innovation Waivers allow States to propose and test alternative ways to meet the shared goals of making health insurance affordable and accessible to all Americans, including those living with pre-existing conditions.  Specifically, State Innovation Waivers are designed to allow States to implement policies that differ from the new law so long as they:

·         Provide coverage that is at least as comprehensive as the coverage offered through Exchanges – a new competitive, private health insurance marketplace.

·         Make coverage at least as affordable as it would have been through the Exchanges.

·         Provide coverage to at least as many residents as the Affordable Care Act would have provided.

·         Do not increase the Federal deficit.

 

Reforming Health Care Reform

It is time to begin anew in health care reform.  We tried it the President’s way and Congress’ way and failed again because, for some forsaken reason they didn’t anticipate the actions of those with a vested interest in the status quo.  No surprise that these were the same fear tactics used to block progress for decades Obama thought this would be different because he cut a deal with Big Pharma for $150 billion.  Since when do we trust the corporate health care industry?

The song “What A Fool Believes” keeps popping into my head as I write this article.  Obama is proving he didn’t have the experience yet to be President…  Still, we’re stuck with him and need to help him on his journey.  The next step needs to be voting on Congressman Weiner’s single payer amendment and getting it passed.  The industry and right wing talking heads are defining the reform proposal as single payer so let’s pass what they’re scaring people about instead of some half hearted approach with no support?  At least a majority of Americans support single payer and keep turning up in polls as supporting “other” when the media asks questions.  Clue:  “other” means single payer.

Meanwhile some good video keeps popping up of tea baggers getting embarrassed.  This one is of Sen. Franken:

The best was Barney Frank though.  He pulled no punches.  T.R. Reid of The Washington Post wrote an article titled “5 Myths About Health Care Around the World” where he debunks some of the lies being perpetrated out there by some major media networks and websites.  We keep hearing these talking points at town halls even though there isn’t a shred of truth to them.  News flash:  Canadians love their health care system and don’t flock here for care.  The five points addressed by Reid:

1. It’s all socialized medicine out there.

In some ways, health care is less “socialized” overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet’s purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation’s 200 private health insurance plans — a broader choice than any American has.

But studies by the Commonwealth Fund and others report that many nations — Germany, Britain, Austria — outperform the United States on measures such as waiting times for appointments and for elective surgeries.

In Japan, waiting times are so short that most patients don’t bother to make an appointment.

3. Foreign health-care systems are inefficient, bloated bureaucracies.

It may seem to Americans that U.S.-style free enterprise — private-sector, for-profit health insurance — is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world

4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who’s had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

That’s right Joe Pa’s hip replacement is thanks to the French and that “little blue pill” you crave is a product of foreigners.

I keep hearing tales of rationing and waiting lines but we have far worse rationing and waiting lines here than anywhere else.  50 million Americans can get in no line for medical care so that is extreme rationing.  Caps on treatment and treatment exclusions are rationing.  Having to make an appointment to see any doctor is a waiting line.  14,000 Americans are becoming uninsured every day.  In California 21% of all claims are being denied, that’s rationing care.  Health insurers employ armies of staff to deny people care or find reasons to and that means we actually do have death panels determining who lives and who dies.  They are employed by the insurance industry however and NOT the government.

We cannot even have a civil discourse about these issues because the idiots who think these are fine as they are shout us down.  A wheelchair bound woman in New Jersey was victimized by this insane extremism at a recent town hall.  

It’s time to get back to basics.  Single payer is easy to explain, expanded Medicare for all.  No bureaucrats at all getting between you and your doctor.  Pay a percentage of your income as a premium and get all your care covered, no questions asked.  Providers, doctors, hospitals, labs, clinics all remain private and compete for your care.  This is what people want but the Administration refuses to give it to us.  Let’s vote on this this fall and change the discussion back to what we need.

The Road to Universal Health Care

The road to single payer health care does NOT run through the Oval Office.  This was the foremost reason why I would not support Barack Obama when he ran for President.  He has not advocated for truly universal health care and is even considering dropping a national, public option in his new proposal.  There is no such thing as “affordable” comprehensive health insurance which everyone can obtain.  As long as there are pre-existing conditions and giant lopholes for the private, for profit industry people will be excluded.

We see that everywhere this has been attempted.  Massachusetts is the latest example.  Two years into the Romney approach that program has failed to achieve any semblance of universal coverage.  Too many low income people simply cannot afford the premiums.

Until we eliminate the 30% of our healthcare dollars NOT going to medical care we cannot acheive universal coverage.  It really is that simple.  The incrementalists have their heads in the sand and that includes the president.  Add Gov. Rendell and other corporate Democrats who take millions from the industry and combine them with Republicans who vehemently oppose any government run system and the climate on the national level is bad.

This is why the best method is to do this in several states first to prove it works.  Pennsylvania is in position to be first.  Other states, notably Maryland (just getting started), Colorado and California are seeking to follow.  The state first to establish a publicly financed, privately delivered, civilized medical care and treatment program will be a magnet for new job growth as companies will no longer need to go to Canada to eliminate their gigantic health care expenses.

Businesses already here will be able to forecast into the future knowing what their actual expenses will be and see them cut in half.  The Commonwealth, in these harsh budget times, stands to save $335 million/year.  The City of Philadelphia can save $227 million per year from its massive deficit.  School districts statewide will see about a 50% cut in health care expenses saving taxpayers huge amounts in property taxes.  Meanwhile every Pennsylvanian would have complete freedom to choose their doctors, clinics, labs, nursing care, dentists, opticians and other medical professionals.  Everything medically necessary, a decision no longer made by bean counters at the Blues, determined solely by you and your doctor, would be covered.  Prescriptions, eye exams and glasses, dental, long term care and whatever.  Every individual would pay a 3% personal income tax and every business a 10% payroll tax as premiums.  

Why President Obama will not consider such a plan for the country has many of his supporters upset and, at the minimum, calling for a public option in his proposal to overhaul health care.  It is necessary to win at least this small concession.  Contact your Member of Congress and our Senators to demand such a proposal be passed.  Then you can at least opt for a publicly financed health care program some compare to an expanded Medicare for All system.  It would be comparable to the plan our Representatives and Senators already enjoy.  If it is good enough for them why not for us?

Healthcare 4 All PA is collecting data from every county in the Commonwealth to ascertain the savings to taxpayers of the state plan proposed in Harrisburg.  Go to their website to see how much your city or county could save and what coverage you would get for your 3% premium.

Medical Students Rally For Their Patients

One hundred medical students from every med school in the Commonwealth rallied and lobbied legislators in Harrisburg today.  Kicking off their day with a rally under the Capitol Rotunda Weston Scott Fisher, Rep. Kathy Manderino, Sen. Jim Ferlo and Rep. Babette Josephs showed their unwavering support to provide health care for all.

The Family and Business Healthcare Security Act would take the 30-40% overhead wasted in our current system and redistribute those dollars to provide fully comprehensive medical care for every Pennsylvanian.  Think in terms of an expanded Medicare for all program with no copays, no deductibles but coverage from cradle to grave.

My apologies to Sen. Ferlo as his video clip didn’t come out.  Meanwhile here are Mr. Fisher and Rep. Manderino speaking this morning:


It was interesting to see how much attention Gov. Rendell’s office paid to these young people. They were greeted with a flier which asked them to also discuss the Governor’s plan while talking with State Senators, especially Republicans. Perhaps if the Governor’s point person on healthcare had actually agreed to sit down with advocates of single payer, health care for all, they’d have received a warmer welcome today.

Rendell’s press secretary Chuck Ardo appeared very briefly during Manderino’s speech then left. Rosemarie Grieco, the head of Rendell’s Governor’s Office on healthcare showed up in the cafe with the students but only had her assistants engage a few. The fact the Governor’s office is recognizing the effort these young people are making on behalf of us says the issue has gained traction in Harrisburg and around Pennsylvania.

Friday I was in Washington, D.C. with Chuck Pennacchio, the Executive Director of Healthcare For All PA and we visited legislative staffers for three U.S. Senators and one Congresswoman. The meetings were all very good and touched on advancing healthcare for all.

I found an interesting piece of data last week in the Economic Policy Institute’s study of healthcare in Pennsylvania. Their estimate of the number of uninsured here agrees with that of Healthcare For All PA that there are 1.2 million. Rendell’s office continue’s to downplay this with their figure of 900,000. Why is the Governor refusing to acknowledge the real number? Because his plan is so inadequate?

I think Ed Rendell has been a great Governor, the best in my lifetime for Pennsylvanians. I disagree with him on two major issues: healthcare and privatization. I would hope he doesn’t allow these two disagreements to color the many areas in which we agree and on which he has my wholehearted support.