They say this is the week. This is it....I've heard that before. I'm thinking something may get voted on, or the goal posts may move once again.
Dennis Kucinich is holding a press conference this morning. Rumour says he'll be switching his vote to "yes" albeit with deep personal reservations, as this will be "only a first step." If so, it will give cover to progressives in the House, support the President, and perhaps make the Blue Dogs in the Senate more willing to compromise. (Okay, those first two are likely, the third is a pipe dream.)
So what do you think? Will the House pass something this week? If so, will they demand something in writing from the Senate indicating that there will be additional changes in the near future? Do you believe this bill affects you personally in any way? If it passes, and you have health insurance, do you think it will either make your premiums reduce, or at least not rise at the current rate? If you don't have health insurance, will you now qualify for Medicaid? For an underwrite? Do any of you see yourselves being harmed by this bill?
I have not watched the news in about a week. I have not read a newspaper nor news on the web. Until about an hour ago. The why is after the jump, but the politics are that it appears that in a week, there has been lots and lots of health care. Plus another sex scandal, and something about Charlie Crist now being a Democrat....
Here in Pennsylvania we are a major hurdle closer to getting an Economic Impact Statement on Single Payer health care. Kudos to all at HealthCare4AllPA, especially Chuck Pennachio, Jerry Policoff and Cindy Purvis, who have worked tirelessly for years to get us to this point. As of last night, there are now 31 state senators, including 11 Republicans, who support it. Out of 50 total. While scanning my 600+ unread emails, I found the following video, which explains everything you need to know about how all the changes about health care at the Federal level mean things might well stay the same, but hope still rules at the state level:
I will be getting caught up over the next several days on what is going on with health care in DC. In addition, I'm sure I'll have some snarky comments on Eric Massa, as well as John Edwards who I've heard will be given his own headliner week on the new Mea Culpa cable channel. Finally, before "the phone call" I had promised Matt an update on the DCW Senate rankings so he can update the chart, and I'll be working on that, too.
There are two pieces of legislation winding around the state legislatures of Kansas and Pennsylvania. They could not be more different. They have impacts not only for the state policies, but for all of health care, for economic recovery, and on the issue of morality.
Let's start with the positive. There are 50 State Senators in Pennsylvania. 27 of them have signed on, so far, to agree to an economic impact study for Single Payer health care. And, um, the majority of the members are Republicans. This means a study indicating the costs and benefits of Single Payer to the 6th largest state population in America will be enacted, which will prove the health AND ECONOMIC benefits of the proposal. This is the first step to passage of the full legislation. Imagine living in a place where health care is a right not a privilege. Where some hospitals have already implemented easily copied programs which greatly reduce secondary infections, readmissions, and death rates AT A LOWER COST than the "traditional" method. Where you can start a small business without having to stay with a large employer because it's the only way to get affordable benefits. Where illness cannot bankrupt you. And for businesses: a set amount for health insurance premiums for employees without the uncertainty of unreasonable and unknown annual increases. For the doctors and other medical professionals: the ability to spend more time with patients, and less time arguing with insurance companies. As for jobs? New jobs for the implementation and administration of the program. More jobs in direct health care as more people move to the state, or stay when they are graduated from college. No down side.
And then you have Kansas. A state House committee may vote next week on a state Constitutional amendment:
The amendment would add a provision to the constitution prohibiting the state from requiring any individual or business to buy health insurance. It also would prevent the state from requiring anyone to participate in a particular health care plan.
Where would YOU rather live?
Want to help in Pennsylvania? Join HealthCare4AllPA here. Even if you don't live in the state,you can join the mailing list, make a contribution, and help with other efforts. It only has to pass in ONE PLACE, and then "coming soon to a town near you."
Want to help in Kansas? Call your reps and just say NO!
Some days, "health care" is a moment: a speech, a vote, a heartbreaking story. Today, it is a series of anecdotes which, taken together, still lead to "crapshoot".
First, we have Nancy Pelosi on the Sunday shows saying that she'll have the votes in the House to pass health care. But, voting for the bill might cost several reps their seats. If, in fact, there were a bill, which there isn't. She seems confident that while there are major differences between the House and Senate, a compromise will be able to be reached. One that will seemingly need to pass the Senate via reconciliation.
Then, Barack Obama had a physical yesterday. He's in good health. Still having a bit of trouble with tobacco, but they told him to stay on the gum. A physical. Something so easy for those of us with health insurance, and such a pipe dream for those of us who don't. To the best of my knowledge (although I'm certainly willing to be wrong) there is no law that mandates a president must have a physical. IMAGINE the leadership had President Obama said that he would forgo any and all physicals for himself and his family until all families could have preventative care via a true health reform bill. Imagine the power of that. The commitment. The honour. Leading by example.
Meanwhile, we have the White House, via Nancy DeParle, saying the Obama administration wants a straight up or down vote. And indicating they'll help push it through that way.
Remember, this is the Senate that has 290 House bills already waiting for a vote. The one led by Harry Reid who split the jobs bill, pulled out the unemployment extension, passed the corporate part, and then allowed Jim Bunning to hold everyone hostage Friday night so that today 1.2 million Americans lose that part of the safety net. THAT Senate.
We all understand the need for health reform to pass, in some form, for political reasons. Believe it or not, even the Republicans want some form of health reform to pass. No, I'm not misspeaking: the difference is that most (NOT ALL) Democrats want some form of reform to pass which actually makes the situation better for actual Americans. The Republicans want something to pass which makes things worse.
In all of this, the thing I find most interesting is the idea that Pelosi believes that she can whip her members to get something passed that will cost them their livelihood. I wonder if she would be willing to give up her seat to pass health care. If she wouldn't, she'll never be able to convince someone else to. It is once again a matter of leadership. One of the things that could have been done a while back would have been for those Reps and Senators who believe in reform to opt out of government coverage (remember, they all have health care paid for by OUR tax dollars) until every American has the options they do. Again, incredibly powerful. To the best of my knowledge, there is only one person who has done that, but I just can't remember his name. If memory serves, he's a doctor from Wisconsin serving in the House.
You can imagine what my life has been if I missed commenting on the health care summit. ("Highlights" after the jump.) And yes, I have a comment or two. What an incredible waste of time. It's like putting 50 vegans in the same room with 50 beef ranchers and seeing if they can come to an agreement on what they should all eat for dinner that night. On the up side, 52 million watched per Nielson, and the White House claims that another 3.9 watched their direct feed. Both numbers are likely low: for example, DCW ran the White House feed and we likely counted as "one" even though a few hundred individuals watched on our link. Not to mention the groups who watched a single TV in a bar or office. I am pleased that so many people had interest, and furious that people seem to think bipartisanship trumps action. 18% of liberals think Obama is doing too much to compromise with Republicans, but overall 44% think he is doing too little. Then again, 58% of the polled respondents think the Republicans are doing too little to compromise. I am stunned that that number is so very low.
While there is more than enough blame to go around on health care, I think the lion's share of the blame needs to rest with the Senate. I am ashamed of so many in my party for their refusal to sign the Public Option letter: only 24 Senators have signed. On an individual basis, let's start with Robert Byrd. He who never committed to a Public Option last year. He wrote a "Dear Colleague" letter last week indicating his opposition to changing the Senate's filibuster rules in any meaningful way. Only 20 Senators favour a 51-vote Senate or are leaning that way. The Democrats in the Senate need to use the majority we have left: there isn't going to be a deal with the evil empire. And they're not just sitting on health care: the Senate is sitting on 290 other House bills. Yup really: 290. You can read the list here. While a lot of them are minor, and don't affect many people, the stall on unemployment will hit millions very hard this coming week.
For that particular disaster, we have Jim Bunning (IIE-KY) who put a hold on the bill, and then said "tough s**t" when asked to remove it. Honest, "tough s**t": even Politico reported it. It doesn't phase me in the least that a lackluster moron like Jim-Bob would do this. What astounds me is that every Democrat in every race didn't release a statement to the press, and send an email to all constituents saying that the Republicans are allowing one of their own to try to see children starve in the streets in March of 2010 in America. An over-the-top reaction? Perhaps: but the IIE uses those sorts of imagery all the time - refer to "killing grandma" and "death panels". Difference is, this time it could be true.
Another thing I can't get my head around is why this group of IIE senators voted FOR the jobs bill after having voted to not let it come to the floor. I can't even pretend to see any clarity in that.
So that's what I've got for now. If you read after the jump, you'll see why I'm much more likely to be posting this coming week.
A great blog entry on WhiteHouse.com by Dan Pfeiffer asking the Republicans to send their plan over so it can be posted on the site.
What you can’t do just yet is read about the Republicans’ consensus plan – because so far they haven’t announced what proposal they’ll be bringing to the table. To be sure, there are many Republicans who share the President’s conviction that we need to act on reform, and there are several pieces of Republican health care legislation out there. Previously we were told this was the House Republican bill. Is it still? We look forward to hearing whether this the proposal they'll bring. The Senate Republicans have yet to post any kind of plan, so we continue to await word from them. As of right now, the American people still don’t know which one Congressional Republicans support and which one they want to present to the public on Thursday.
President Obama has been clear that his proposal isn’t the final say on legislation, and that’s what Thursday’s meeting is all about. But after a year of historic national dialogue about reform, it’s time for both sides to be clear about what their plan is to lower costs, hold insurance companies accountable, make health insurance affordable for those without it, and reduce the deficit. A collection of piecemeal and sometimes conflicting ideas won’t do.
As we said today, we’ll be happy to post the Republican plan on our website once they indicate to us which one we should post. We hope they won’t pass up this opportunity to make their case to the American people.
There has been discussion of whether or not the Senate can/will pass a Public Option via reconciliation, independent of the proposed Obama plan. I pulled the chart from last summer, and Matt kindly appended the columns to include the new count, and any support announced on voting for/against the President's plan.
The Public Option came up because Michael Bennet sent a letter to Harry Reid urging consideration of it. You can read the letter here. The MSM has reported that there are 20 Senate signatories, but as of 22 February, I can only account for 19. I am hoping this number rises in the next days and weeks. As new data come in, I'll append the chart.
Since there is no evidence that anyone saying "no" the first time has changed his/her mind, I carried over the no votes. In addition, I left Senator Kennedy in the mix as true reform was his wish at his death. I added Scott Brown at the bottom. It won't affect the total tally.
As I'm sure you will, please leave updates in the comments. If you live in a state with a Senator who was pro-public option last summer, but hasn't signed on to Bennet's letter, why don't you give them a call? I am surprised as some of the names I don't see on the list.
I am NOT surprised to NOT see my own Senator Casey's name on the list. My conversation with his office staffer was that while Casey supports the Public Option, he is "weighing his options" to see if he supports doing ANY health care reform via reconciliation. As I mentioned to the staffer (and for some reason, she didn't ask my name, go figure) Casey won against Rick "Spawn of Satan" Santorum in a year when anyone could have won against Rick. Bob won't have that luxury next time.
President Obama will unveil his health care plan this morning. It is supposed to be available on the White House web site at precisely 10 a.m. and we'll have a copy as soon as we can.
There is a conference call for media at 8, for a frame of the proposal, but Q&A is embargoed until 10 a.m.
This whole process is leaky as a sieve, so we know some of the things that are in the proposal:
Individual mandates, but no corporate mandates
Insurers must allow all comers: no denials for pre-existing conditions
No annual or lifetime caps
NO PUBLIC OPTION
Basically, it looks like Baucus Redux.
Just so we're all clear here, if this is the plan, it is the worst of all possible groupings Obama could join together. If you think that the Anthem proposed California premium raises of up to 39% are steep, know that this plan will encourage similar growth in all classes of insurance premium.
It saddens me that Obama and his team have learned virtually nothing from that past year. I hope that at the final moment, a Public Option goes into the mix. As candidate Obama promised. As the White House has signaled it would support if it came out of Congress. As the American people want.
When you look at the Anthem California situation, you can see a microcosm of the American dilemma. As insurance becomes unaffordable, people who are healthier drop out, upping the costs of the pool, and therefore increasing premiums. Premiums rise to cover both actual costs and profits. And profits are perfectly legitimate so long as insurance companies continue to be for-profit corporations. "Making money" is what they are supposed to do, whether the product is milk, drywall, books, or insurance which means the difference between life and death for its customers.
Increasing costs for the insurance companies, like the proposed Obama plan, without the counterweight of a Public Option, only quickens the pace of increased premiums leading to more drop-outs and still higher premiums.
If Obama talks about selling across state lines, don't fall for it. When you look at the sheer size of California, and you look at the pool problems there, you'll understand that the 'state lines' thing is a tall tale. In California, about 2.5 million people have individual policies, and about 21 million have employer-backed policies. Only 6 states (Texas, New York, Florida, Illinois, Pennsylvania, Ohio) HAVE more than 10 million people as total population. We know that, depending on whose number you believe, between 33% and 50% of all people have government-backed insurance. Therefore, there is not an economy of scale which would be large enough to offset the problem of people leaving because premiums are getting too high. How high? Could you and your spouse afford health insurance premiums of over $20,000/year? With median incomes ranging from $42,000 - $60,000 depending on whose numbers you believe, that means health insurance premiums could be a family's highest expenditure of the year.
The House is back this week. They'll not only be talking about a public option, but there is scuttlebutt that they will also be looking at refusing to fund Obama's Afghanistan troop increase. GOOD FOR THEM! It's nice to see one group of elected officials at least trying to represent the people who voted for change.
So we'll see if Obama learned anything through this whole health care debate: whether there will be actual change or an adherence to government-by-corporation.
We'll have more later today - I've got the mold removal people here this morning to make sure they got all the water out of my walls and floors, and a construction team here this afternoon to quote the rebuilding of my home, and to mitigate the hole that has opened between my sliding glass doors and the wall to the outside. In between, I'll get up the information I can: if you find the links and can put them in the comments so I can move them quickly, I'd appreciate it.
As you know, President Bill Clinton didn't feel well on Tuesday, called his cardiologist, made an appointment for Wednesday, delayed until Thursday due to snow, and yesterday had two stents inserted in his coronary arteries.
Clinton has had heart disease for a number of years now, and has been (according to what was on the news) eating better and exercising since the initial diagnosis. Still, once you have cardiovascular (CV) disease, there is damage, and you will always be at high risk for additional complications. It should be noted that he never actually had a "heart attack", but did have surgery back in 2004.
And so what better time to remind you -- CV doesn't come from "nowhere" in the overwhelming majority of cases. Whether you are 18 or 118, take care of your heart. If you eat meat, try a few vegetarian meals a week, in any case, eat more fruits and vegetables. (No, french fries do NOT count.) Try to make the grains you eat whole and less processed. If you drink too much, drink less. If you smoke, smoke less or hopefully not at all. Get some exercise: walking is normally an option for most people. If you've got a bunch of snow and you're out of shape, get some help with the shoveling, using your upper body to move heavy snow puts a great stress on one's heart, and large snowstorms always increase the number of heart attacks. Meditate. Do some yoga. Get your blood pressure checked twice a year, and have a bunch of bloodwork once a year to check cholesterol, triglyceride and other levels.
Some heart disease is not directly caused by lifestyle: your heart can be infected from disease. Believe it or not, your chances of such infection have a correlation to periodontal disease. So, brush, floss, and see your dentist twice a year. In case you're wondering, the relationship is that periodontal disease provides a pathway for bacteria to get directly into your bloodstream. True in humans, true in dogs, so consider your canine companion's dental health, too.
As always, fingers, nails, fingers, fingers, fingers.
It's like an alien land here. If you live in the northeast, or any place else that gets a fair amount of snow, you will be familiar with the words "flashing" "ice dam" "cascading ice gutters" and you'll be familiar with what my local world, and the past few days, involve....DC is closed for the week, including all of Congress. Here in the Philadelphia region we received the second largest snowfall on record, and we are expecting an additional 12 to 18 inches tonight. There is not a good place to put it, and not all the region is dug out from the weekend.
So having returned from a day of chipping, re-organizing snow piles, and calculating the approximate strength of the roof trusses relative to the snow stuck behind the chimney 30 feet up, I feel I've done everything I can so that my house will withstand one more blizzard onslaught. Maybe not, but I've done the best any vertically-challenged person can.
So I sit down with my cup of great Keurig coffee and see something in my inbox I would never in my wildest dreams believed I would. The subject line read:
Republicans for Single Payer
I am not making this up.
Tag line:
Single-Payer is a Conservative Value
Again, I am not making this up, you can view their site here.
If you look at their site, and you're familiar with Single Payer, you won't see anything new in terms of the reasons for implementation, nor the sources cited, except for the parts about Republican support.
President Obama has offered to meet with the Republicans to discuss health care. It's what they wanted, right? It's what they asked for. W-e-l-l-l-l, it turns out that they're only willing to meet if Obama scraps everything that has been accomplished already.
These are the same people who voted against a bill regarding deficits that they put forth.
The same people who put holds on nominees they intend to vote for, and then do vote for.
So the question becomes, will Obama's insanelyridiculouspipe dream desire for bipartisanship trump getting health care reform (in its limited form) accomplished? The latest stats indicate that we now pay slightly over 17% of our GDP for health care. Compared, for example, to Great Britain, which spends 7% with better outcomes and longer lifespans. I have heard the rumour that Obama might scrap everything provided the GOP agrees to a straight up or down vote when the new legislation comes to the floor. Bad idea. Bad, BAD idea. There is nothing to prevent the IIE from reneging on that as they have on everything else.
At what point does the President realize that the GOP will say no, will obstruct and obfuscate no matter what?
If you were Obama, what would you do? And if I missed your answer, please feel free to use the comments.
The last time a major snow fell in Washington, the Senate Health Care bill emerged. And then everyone went home for Christmas break. They're expecting over a foot there today through tomorrow. Here, too.
New data is out about health care since the Senate passed their piece of c--- legislation. Here is the Cliff Notes version:
[A] new report published in Health Affairs finds that if Congress doesn’t do anything to reduce health care costs, by 2020, “about one in five dollars spent in the U.S. will go to health care, a proportion far beyond any other industrialized nation.” “For the first time, government programs next year will account for more than half of all U.S. health-care spending.”
Ugly.
What this means is that the cost of doing nothing REALLY DOES HAVE A COST - which is something that most people don't pay attention to, and most politicians don't mention. What are some of those costs?
- U.S. health spending hit $2.5 trillion in 2009, up 5.7% from the previous year. That represents 17.3% of GDP, up from 16.2% in 2008.
- Public spending on health care will rise to 50.4% by 2011. Last year, the federal actuaries had predicted the 50% mark wouldn’t be reached until around 2016.
- Total health spending is expected to grow increasingly faster each year after bottoming out in 2010, reaching 7.0 percent by 2016
- For 2009–2019, health spending is expected to grow at an average annual rate of 6.1 percent (1.7 percentage points faster than GDP) and to climb to $4.5 trillion by 2019
And that doesn't address the hundreds of thousands of people who will this year lose access to health care services. Drawn from the USA Today, 2 February, page 3A:
Washington: 65,000 people will lost Basic Health, the state-subsidized program, in July if $160 million in new funding is not found. 300 people a day are added to that waiting list.
Tennessee: Cover TN, which subsidizes insurance for workers at certain small businesses, ceased new enrollments in December.
Connecticut: Charter Oak, their subsidized insurance plan for those at lower incomes, but above Medicaid levels, will freeze enrollments this year unless there is a huge influx of funds.
Pennsylvania: In 2009, the waiting list for adult-Basic more than doubled from 165,318 to 353,301. Office visit charges have doubled and users will be responsible for the first $1,000 of hospital care.
Minnesota: General Assistance Medical Care, covering adults earning less than $8,000/year will end in March without new funding.
Remember, Medicaid is different from Medicare in that states contribute up to 50% of the costs. Each state has a program with varying coverages, and many states have additional programs for people over the poverty line.
Put those two data sets together and it turns out that even while throwing people off government-paid rolls, the amount of money spent by the government on health care will comprise more than half of all domestic monies spent on health care by next year, if nothing changes. In case you're wondering how the government can cover fewer people and the costs still rise as a percentage....
First, while people who make slightly over the poverty rate may lose coverage, the number of people who used to make above the poverty level but fall below it (and therefore qualify for Medicaid) will continue to rise.
Second, on the private side, as more people lose their jobs, or lose the COBRA subsidy, or go from full employment at a medium-to-large company to part time work, self-employment or temporary work, there will be fewer dollars spent on the private side. Less money to private insurers in the form of premiums, and often people with no health insurance put off diagnostic tests (mammograms, pap smears, colonoscopies, etc), medication and office visits.
Whenever I put up a post like this, I get emails asking what can be done. The answer lies with the states. Pennsylvania and California, for two. There are movements in many states. JOIN THEM. Help gather signatures and lobby elected reps and raise money. One day, hopefully this year, one state will pass Single Payer. And then the benefits will become so obvious TO THE BUSINESS COMMUNITY that the economy of that state will flourish (relatively) -- and then change will spread.
Don't look at state action as a fall back: look at it as another option. A different form of grassroots.
As an aside, and a closing comment, I received a call from OFA recently asking if I'd phone bank in support of the Senate Health Care bill. I'll spare you the details of the conversation, except to point out that during the call I was emailing the OFA guy back up data on all the facts I was spewing, and his final comment to me was "so, I guess we should take you off the call list, huh?"
Yesterday, President Obama smacked down the House Republicans. In GRAND style. If you haven't seen it, click here for the video. For a lot of us who elected Obama in part because he is brilliant, this is the best kind of payback: he was prepared for anything they could throw at him. He had complete control of facts and figures. He didn't dodge, he didn't equivocate. I don't know of a time in American history when a president went to a function like this, completely unscripted, fully televised (by everyone except Fox) stared down the opposition, and put them in their collective place.
He even spoke truth. Well, except for one thing.
There was an arrest outside the GOP House gathering.
Dr. Margaret Flowers and Dr. Carol Paris were carrying a sign that said: Just Letting You Know: Medicare for All.
"We were on the hotel property holding our sign," Dr. Flowers said. "The Secret Service said we had to go across the street. We said we would go across the street if our letter was delivered to the President. The Secret Service said that wasn't possible. They said if we didn't go across the street we would be arrested. We refused to leave because we didn't want to continue to be excluded, marginalized and ignored. And they arrested us."
This is the letter they wanted delivered:
President Barack Obama 1600 Pennsylvania Avenue Washington, D.C. 20500
Dear President Obama,
I was overjoyed to hear you say in your State of the Union address on Wednesday night:
"But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know."
My colleagues, fellow health advocates and I have been trying to meet with you for over a year now because we have an approach which will meet all of your goals and more.
I am a pediatrician who, like many of my primary care colleagues, left practice because it is nearly impossible to deliver high quality health care in this environment. I have been volunteering for Physicians for a National Health Program ever since. For over a year now, I have been working with the Leadership Conference for Guaranteed Health Care/National Single Payer Alliance. This alliance represents over 20 million people nationwide from doctors to nurses to labor, faith and community groups who advocate on behalf of the majority of Americans, including doctors, who favor a national Medicare-for-All health system.
I felt very optimistic when Congress took up health care reform last January because I remember when you spoke to the Illinois AFL-CIO in June, 2003 and said:
"I happen to be a proponent of a single-payer universal health care program." (applause) "I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care cannot provide basic health insurance to everybody. And that's what Jim is talking about when he says everybody in, nobody out. A single-payer health care plan, a universal health care plan. And that's what I'd like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House."
And that is why I was so surprised when the voices of those who support a national single-payer plan/Medicare-for-All were excluded in place of the voices of the very health insurance and pharmaceutical industries which profit off the current health care situation.
There was an opportunity this past year to create universal and financially sustainable health care reform rather than expensive health insurance reform. As you well know, the United States spends the most per capita on health care in the world yet leaves millions of people out and receives poor return on those health care dollars in terms of health outcomes and efficiency. This poor value for our health care dollar is due to the waste of having so many insurance companies. At least a third of our health care dollars go towards activities that have nothing to do with health care such as marketing, administration and high executive salaries and bonuses. This represents over $400 billion per year which could be used to pay for health care for all of those Americans who are suffering and dying from preventable causes.
The good news is that it doesn't have to be this way. You said that you wanted to "keep what works" and that would be Medicare. Medicare is an American legacy of which we can feel proud. It has guaranteed health security to all who have it. Medicare has lifted senior citizens out of poverty. Health disparities, which are rising in this nation, begin to disappear as soon as patients reach 65 years of age. And patients and doctors prefer Medicare to private insurance. Why, our Medicare has even been used as a model by other nations which have developed and implemented universal health systems.
Mr. President, we wanted to meet with you because we have the solution to health care reform. The United States has enough money already and we have the resources, including esteemed experts in public health, health policy and health financing. Our very own Dr. William Hsiao at Harvard has designed health systems in five other countries.
I am asking you to meet with me because the solution is simple. Remove all of the industries who profit off of the American health care catastrophe from the table. Replace them with those who are knowledgeable in designing health systems and who are without ties to the for-profit medical industries. And then allow them to design an improved Medicare-for-All national health system. We can implement it within a year of designing such a system.
What are the benefits of doing this?
It will save tens of thousands (perhaps hundreds of thousands) of American lives each year, not to mention the prevention of unnecessary suffering.
It will relieve families of medical debt, which is the number one cause of bankruptcy and foreclosure despite the fact that most of those who experienced bankruptcy had health insurance.
It will relieve businesses of the growing burden of skyrocketing health insurance premiums so that they can invest in innovation, hiring, increased wages and other benefits and so they can compete in the global market.
It will control health care costs in a rational way through global budgeting and negotiation for fair prices for pharmaceuticals and services.
It will allow patients the freedom to choose wherever they want to go for health care and will allow patients and their caregivers to determine which care is best without denials by insurance administrators.
It will restore the physician-patient relationship and bring satisfaction back to the practice of medicine so that more doctors will stay in or return to practice.
It will allow our people in our nation to be healthy and productive and able to support themselves and their families.
It will create a legacy for your administration that may someday elevate you to the same hero status as Tommy Douglas has in Canada.
Mr. President, there are more benefits, but I believe you get the point. I look forward to meeting with you and am so pleased that you are open to our ideas. The Medicare-for-All campaign is growing rapidly and is ready to support you as we move forward on health care reform that will provide America with one of the best health systems in the world. And that is something of which all Americans can be proud.
I want someone to explain to me why the administration won't even LISTEN to the idea of Single Payer. I understand what the president said to the IIE yesterday: that some things are political. He said that you couldn't promise to insure an additional 30 million people and undertake insurance reform and have it cost nothing. He could say that, he said, but it would be politics and not reality.
Single Payer is a bad political move, but it is a great reality move. I understand why it can't be implemented politically, but to not even take half an hour and hear a proposal? What is so frightening that those 30 minutes cannot be allocated?
And you thought you had to wait for Congress to act...From HHS:
The Departments of Health and Human Services, Labor and the Treasury today jointly issued new rules providing parity for consumers enrolled in group health plans who need treatment for mental health or substance use disorders.
“The rules we are issuing today will, for the first time, help assure that those diagnosed with these debilitating and sometimes life-threatening disorders will not suffer needless or arbitrary limits on their care,” said Secretary Sebelius. “I applaud the long-standing and bipartisan effort that made these important new protections possible.”
“Today’s rules will bring needed relief to families faced with meeting the cost of obtaining mental health and substance abuse services,” said U.S. Secretary of Labor Hilda L. Solis. “The benefits will give these Americans access to greatly needed medical treatment, which will better allow them to participate fully in society. That’s not just sound policy, it’s the right thing to do.”
“Workers covered by group health plans who need mental health and substance abuse care deserve fair treatment,” said Deputy Treasury Secretary Neal Wolin. “These rules expand on existing protections to ensure that people don't face unnecessary barriers to the treatment they need.”
The new rules prohibit group health insurance plans—typically offered by employers—from restricting access to care by limiting benefits and requiring higher patient costs than those that apply to general medical or surgical benefits. The rules implement the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA).
MHPAEA greatly expands on an earlier law, the Mental Health Parity Act of 1996 which required parity only in aggregate lifetime and annual dollar limits between the categories of benefits and did not extend to substance use disorder benefits.
The new law requires that any group health plan that includes mental health and substance use disorder benefits along with standard medical and surgical coverage must treat them equally in terms of out-of-pocket costs, benefit limits and practices such as prior authorization and utilization review. These practices must be based on the same level of scientific evidence used by the insurer for medical and surgical benefits. For example, a plan may not apply separate deductibles for treatment related to mental health or substance use disorders and medical or surgical benefits—they must be calculated as one limit. MHPAEA applies to employers with 50 or more workers whose group health plan chooses to offer mental health or substance use disorder benefits. The new rules are effective for plan years beginning on or after July 1, 2010.
The Wellstone-Domenici Act is named for two dominant figures in the quest for equal treatment of benefits. The late Senator Paul Wellstone (D-MN), who was a vocal advocate for parity throughout his Senate career, sponsored the ultimately successful full parity act. He was joined by former Senator Pete Domenici (R-NM) who first introduced legislation to require parity in 1992. Champions of the legislation also included the bipartisan team of Representative Patrick Kennedy (D-RI) and former Representative Jim Ramstad (R-MN).
The issue of parity dates back over 40 years to President John F. Kennedy, and was also supported by President Clinton and the late Senator Edward Kennedy.
President Obama will unveil his health care plan this morning. It is supposed to be available on the White House web site at precisely 10 a.m. and we'll have a copy as soon as we can.
