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Keeping Single-Payer "On The Table"


 
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Health Law's Flaws Will Spur Drive for Single-Payer Reform

by David Himmelstein and Steffie Woolhandler
http://www.commondreams.org/view/2012/07/20-4

It’s good the Supreme Court decided to follow the Constitution rather than
play politics. But, from a medical point of view, there’s little to celebrate
in its upholding of the Affordable Care Act.

The health reform will leave 26 million uninsured even when it’s fully
implemented, and force tens of millions to buy lousy coverage from private
insurers. Instead of cutting out the insurance middlemen who caused the health
care crisis, Obamacare hands them a trillion-dollar windfall from federal
subsidies, mandated premiums and Medicaid managed-care contracts

Because of this sweetheart deal with the insurance industry, the ACA offers
no relief from spiraling health care costs.

The results are predictable. Twenty-six million uninsured means 26,000
deaths each year from lack of coverage. Soaring health costs and ever-skimpier
insurance mean financial ruin for more and more Americans; already 800,000
middle-class families are driven into medical bankruptcy each year.

In Massachusetts (where Mitt Romney enacted the model for the ACA in 2006)
the number of uninsured has fallen by half to 5.6 percent, but costs have
skyrocketed. The premium for the cheapest mandated coverage for a 55-year-old
is $5,000, and the policy has a $2,000 deductible – that’s $7,000 out of pocket
before insurance kicks in.

Little wonder that medical bankruptcies haven’t fallen in Massachusetts, and
surveys have found little improvement in how easy it is to get or afford care.

The unrelenting health crisis in Massachusetts has led doctors there to
support more radical reform – single-payer national health insurance – by more
than 2 to 1 over Romney/Obamacare; even fewer want to go back to the pre-2006
system.


 

Physicians for a National Health Program- Chico

Paul O'Rourke-Babb / 530-321-9646 / pobnkin@sunset.net

 

Butte County Health Care Coalition

Forest Harlan / 530- 680-9441 / forest1950@yahoo.com

 

CITIZENS CONCERNED PP-ACA IS NOT ENOUGH; CALL FOR PUBLIC OPTION

Chico, CA: June 28, 2012 – Today’s decision by the U.S. Supreme Court to maintain the constitutionality of the Patient Protection and Affordable Care Act (PP-ACA) has provoked response from the North State Health Care Alliance (NSHCA), a progressive health reform advocacy coalition based in Chico, California.
According to NSHCA member Forest Harlan, the PP-ACA does represent an incremental step towards totalhealthcare reform. Unfortunately, the act does little to rein in the rapidly rising cost of healthcare.

NSHCA spokesman Paul O'Rourke-Babb explained that the PP-ACA is “not enough”” to provide health coverage for everyone in Northern California who needs it. A recent study by County Health Rankings has indicated that socioeconomic and environmental factors in Butte, Tehama and Yuba Counties have led to poor health outcomes, making area residents particularly in need of expanded health services.

“The most effective way to ensure an equal standard of comprehensive, affordable medical care for all is to adopt a universal system,” reiterated Brittany Whitman-Hall of the California Health Professional Student Alliance. For that reason, NSHCA endorses California Senate Bill 810, the “California Universal Healthcare Act” and House Resolution 676, the national “Expanded and Improved Medicare for All Act.”

The North State Health Care Alliance represents a coalition of groups which advocate for the implementation of a publicly funded, privately delivered universal healthcare system in California and the nation. NSHCA represents: the California Nurses Association, Butte County Health Care Coalition, Physicians for a National Health Program-Chico Chapter, League of Women Voters of Butte County, , California Health Professional Student Alliance, Democratic Action Club of Chico, Butte-Glenn Central Labor Council, and Independent Living Services of Northern California and Occupy Chico.

For a full press kit contact: Brittany Whitman-Hall / (530) 828-3706 / brittany@pnhpcalifornia.org

# # #

 
If Air Travel Worked Like Health Care

Imagine the most inefficient, fragmented and maddening healthcare non-system and apply the same principles to air travel and it would look like this. I. Check out this U-Tube Video. 

 


Who Killed SB 810?: Gutless Democrats


David Atkins reports in the Daily Kos that "gutless democrates" were responsible for the failure of California's "Medicare for all" universal health care legislation fell short of the 21 votes needed to pass the state Senate today in late January. Senate Bill 810 failed on a 19-15 vote , with four moderate Democrats abstaining and one voting no. Democratic Sen. Mark Leno, who authored the bill, said the proposal would stabilize health care costs and expand access to coverage. He called the bill the first step in a "many year project" that will likely require asking voters to approve financing. No Republicans voted for the bill. Read the full story.



Patients May Die When Doctors Moonlight as
Big Pharma's "Key Opinion Leaders"

Kathleen Sharp, Truthout | News Analysis
24 January 2012

Somebody else's doctor could be killing you by contaminating the 
thought processes of your doctor. The article describes how the pharmas
woo doctors to use their products and to produce testimony that verges
on hearsay. Click for: Very interesting reading.
Editorial: If U.S. is serious about debt,
there's a single-payer solution.

St. Louis Post Dispatch
August 10, 2011  
Sooner or (probably) later.
 
If America truly is serious about dealing with its deficit problems, there's a fairly simple solution. But you're probably not going to like it: Enact a single-payer health care plan.
 
See, we told you weren't going to like it.
 
But the fact is that everyone who has studied the deficit problem has agreed that it's actually a health care problem — more specifically, the cost of providing Medicare benefits to an aging and longer-living population. The bipartisan National Commission on Fiscal Responsibility and Reform reported last December: "The Congressional Budget Office (CBO) projects if we continue on our current course, deficits will remain high throughout the rest of this decade and beyond, and debt will spiral ever higher, reaching 90 percent of GDP in 2020.
 
"Over the long run, as the baby boomers retire and health care costs continue to grow, the situation will become far worse. By 2025 revenue will be able to finance only interest payments, Medicare, Medicaid, and Social Security. Every other federal government activity — from national defense and homeland security to transportation and energy — will have to be paid for with borrowed money."
 
That being the case — and nobody argues that it isn't — there are two broad ways for the government to address its spiraling health care costs. One, shift more of those costs to recipients, by trimming benefits and/or extending eligibility ages and indexing eligibility to personal income. This is politically unpalatable, particularly to most Democrats, President Barack Obama being a conspicuous exception.
 
The second way for government to address its health costs is not to shift them, but to reduce them. This is what a single-payer health care system would do, largely by taking the for-profit players (insurance companies for the most part) out of the loop.
 
The advocacy group Physicians for a National Health Program estimates that "private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for all Americans."
 
Once everyone is covered, the government would have the clout to bring discipline into the wild west of health care spending. It could insist that providers be paid for quality of service, not quantity. Health facilities and equipment could be managed by regional boards. Medical services could be "bundled" — rather than paying hospitals and doctors and laboratories separately, there would be fixed prices for treatments. And so on.
 
The Patient Protection and Affordable Care Act passed in 2009 contains many pilot programs designed to test cost-reduction strategies. Most of them won't kick in for another six to eight years, by which time health care costs will be approaching 20 percent of U.S. gross domestic product. Thecombined state and federal share of that will be 49 percent, up from 45 percent today.
 
Indeed, a study published this month in the journal Health Affairs estimates that while the Affordable Care Act will pay for itself by 2020, it won't actually "bend the cost curve," as the Obama administration had hoped. But the study, done by the Actuary Centers for Medicare and Medicaid Services, says the ACA will significantly slow the rise of health care costs to state and local governments.
 
But consider those two findings: In effect, they say that if the goal is reducing overall health care costs, then the ACA didn't go far enough. Thirty million more people will be insured and government costs will grow more slowly. But overall health care costs will continue to explode.
 
Sooner or later, a nation serious about controlling spending must take broad control of the health care system.
 
It surely won't be sooner. Compared to the political fight that would erupt over a single-payer plan, the congressional battle over the Affordable Care Act would seem as tame as resolution praising mom, the flag and apple pie.
 
The ACA was a compromise. Mr. Obama brought everyone to the table — doctors, insurance companies, drug companies, hospitals — and came away with a "best we can get" kind of bill. Many of those at the table turned around and lobbied against it or sought special favors once the bill came before Congress.
 
It passed by narrow margins, and Congress is decidedly more conservative now. Indeed, the new House majority has voted to repeal the ACA and challenges to its constitutionality continue to work their way toward the Supreme Court.
 
But now, like a baby discovering its toes, Congress has discovered the deficit. And the plain fact is that unless you want to commit political suicide and cut Medicare to the bone — as Rep. Paul Ryan's, R-Wis., budget plan would do — the best way to seriously address long-term deficits is to get control of health care costs through a single-payer plan.
 
In 2008, when health care costs amounted to "only" 16 percent of U.S. gross domestic product, Great Britain was spending 8.7 percent of its GDP on health care, and Canada was spending 10.4 percent. Both nations have single-payer plans. Quality of care scores in both nations are at least comparable, and in most cases, better.
 
Eventually, the United States will have a single-payer plan. But we'll waste a lot of money and time getting there.

Source:
http://www.stltoday.com/news/opinion/editorial/article_97afa329-42f8-5f12-adb0-97fa305c3e4b.html


Death Panels Real and Imagined
Wendell Potter

 
Wendell Potter is a health insurance industry whistleblower and author of 'Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans' July 7th, 2011 12:56 PM

 
On behalf of Grigor and Hilda Sarkisyan, I would like to invite Republican Rep. Phil Gingrey of Georgia to attend the 21 st birthday celebration of the Sarkisyans' only daughter, Nataline, this coming Saturday, July 9, in Calabasas, Calif.
 
Gingrey could consider it a legitimate, reimbursable fact-finding mission. He clearly needs to have more facts about the U.S. health care system before he starts talking about death panels again.
 
Gingrey seems determined to keep alive the lie that the Affordable Care Act (a.k.a., Obamacare) will create government-run death panels in the Medicare program.
 
Sarah Palin started the death panel fabrication when she claimed during the health care reform debate that a proposal to allow Medicare to reimburse doctors for talking to their patients about advance directives would be tantamount to establishing death panels deep in the federal bureaucracy. So many people believed her lie that Democrats felt they had no choice but to strip that provision from the final bill.
 
Taking a page from Palin's playbook, Gingrey is now alleging, also falsely, that excising that provision didn't do the trick, that the bill signed by President Obama still creates death panels somewhere inside the federal government. He says a new board created by Congress to look for ways to reduce Medicare spending would have to operate those panels.
 
"Under this IPAB (Independent Payment Advisory Board)... that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you when you withdraw that the patient is going to die," Gingrey said recently. "It's rationing."
 
No, Congressman, that's not true. And I suspect you're well aware that the charter creating the board forbids it to ration care.
 
But, Congressman, death panels do exist in the United States, and Grigor and Hilda Sarkisyan, sadly, are in a position to explain to you exactly how they work and where you should be looking for them. You see, the real death panels that operate in this country are not run by a bunch of government bureaucrats but by a bunch of corporate bureaucrats who work deep inside U.S. insurance companies.
 
When Nataline was 14, she was diagnosed with leukemia. Initial treatments were successful and the cancer went into remission. It came back two years later, however, and this time the same treatments were not working. She underwent a bone marrow transplant, but it weakened her liver to the point that her doctors at UCLA Medical Center said she would need a liver transplant.
 
Her doctors were optimistic the transplant would save her life. In mid-December 2007, they told the family that Nataline would likely have a 65 percent chance of living at least five years if she had the transplant. Believing there would be no problem getting the family's insurer, CIGNA, to cover the cost of the surgery and after-care, the doctors scheduled the transplant as soon as a match became available.
 
But when Nataline's parents arrived at the hospital on the morning the transplant was to have been performed, one of the doctors took them aside to tell them that there was a problem. "CIGNA has not given us clearance," he said.
 
"What are you talking about?" Mrs. Sarkisyan said she asked the doctor, not understanding why CIGNA would have a say in the matter. "We have insurance, and I know it covers transplants, so what kind of clearance do you need?"
 
Nataline was covered under a policy that her father had obtained through his employer, Mercedes-Benz. As part of its contract with Mercedes, CIGNA assumed the responsibility of handling medical claims and making decisions as to whether or not to pay for expensive procedures like transplants.
 
The decision not to cover Nataline's transplant was made by a CIGNA medical director 2,500 hundred miles away in Pittsburgh. Although they are doctors, medical directors are corporate employees just as I was when I worked in the insurance industry. One of the responsibilities of these employees is to do their part to assure that their companies' are constantly meeting Wall Street's earnings expectations.
 
After receiving the initial denial from CIGNA, Nataline's doctors quickly faxed additional information to bolster their case, but the medical director continued to refuse to authorize payment for the transplant. UCLA told the Sarkisyans that if they could make a $70,000 down payment right away, the transplant team could proceed with the surgery. But the family didn't have that kind of cash. So they decided to try to shame CIGNA into paying for the transplant.
 
They enlisted the support of the California Nurses Association and friends in the Los Angeles-area Armenian community to help them stage a protest in front of CIGNA's regional headquarters in Glendale. They also reached out to the media about Nataline's plight.
 It worked.
 
As head of corporate communications at CIGNA, I was on the hot seat trying to explain the company's point of view. I told reporters that transplant experts whose opinion the company had sought as external reviewers backed the medical director's decision not to pay for the transplant. They agreed with him that, despite what Nataline's doctors said, the transplant would be "experimental."
 
That didn't quell the media storm. Seeking to end the bad publicity as soon as possible, CIGNA agreed to pay for the transplant on December 20, 2007.
 
Unfortunately, the decision came too late. So much time had passed since the original request for coverage had been made that Nataline's other organs had begun to shut down. She died just hours later.
 
I had helped handle a lot of what we called "horror stories" during my 20 years in the industry. When Nataline died, I didn't have it in me to handle any more of them. I left my job a few months later.
 
In 2008, to keep her memory alive, Nataline's family and friends began hosting a "Fashion Legacy" on what would have been Nataline's 18 th birthday, July 10. Nataline wanted to be a fashion designer. Had she lived, she might have graduated this spring from the Fashion Institute of Design and Marketing in Los Angeles. Nataline was looking forward to enrolling there after high school. 
 
After Nataline's death, her mother found several design sketches Nataline had drawn but never shown anyone. The highlight of every Fashion Legacy is when the last model walks down the makeshift runway set up inside the Calabasas Mercedes Benz dealership where Mr. Sarkisyan works -- wearing one of Nataline's designs. Beverly Hills designer Pol Atteu brings one of Nataline's designs to life every year.
 
The Fashion Legacy is a fundraiser for three scholarships in Nataline's name -- in medicine, fashion design and the culinary arts.
 
I know from having attended last year's Fashion Legacy that Hilda and Grigor Sarkisyan and Nataline's brother, Peter, are always busy with last minute details before every show, but I also know they would gladly take time to talk with Rep. Gingrey about real and imagined death panels. They know all too well about the real death panels inside insurance companies, where life and death decisions are made every day by corporate "bureaucrats," people who will never face real patients and their families. 
 
So, please, Rep, Gingrey, consider taking the Sarkisyans up on their offer to meet with you face to face. If you can't make it, I know the Sarkisyans would be quite willing to meet with you at your convenience. You just name the time and place.
 
(For more information about Nataline's Fashion Legacy or to contribute to the scholarship fund, go to
www.natalinesarkisyan.com.)
 
Source:
http://www.michaelmoore.com/words/mike-friends-blog/death-panels-real-imagined



Vouchercare Is Not Medicare
Paul Krugman
New York Times

What’s in a name? A lot, the National Republican Congressional Committee obviously believes. Last week, the committee sent a letter demanding that a TV station stop running an ad declaring that the House Republican budget plan would “end Medicare.” This, the letter insisted, was a false claim: the plan would simply install a “new, sustainable version of Medicare.”

But Comcast, the station’s owner, rejected the demand — and rightly so. For Republicans are indeed seeking to dismantle Medicare as we know it, replacing it with a much worse program.

I’m seeing many attempts to shout down anyone making this obvious point, and not just from Republican politicians. For some reason, many commentators seem to believe that accurately describing what the G.O.P. is actually proposing amounts to demagoguery. But there’s nothing demagogic about telling the truth.

Start with the claim that the G.O.P. plan simply reforms Medicare rather than ending it. I’ll just quote the blogger Duncan Black, who summarizes this as saying that “when we replace the Marines with a pizza, we’ll call the pizza the Marines.” The point is that you can name the new program Medicare, but it’s an entirely different program — call it Vouchercare — that would offer nothing like the coverage that the elderly now receive. (Republicans get huffy when you call their plan a voucher scheme, but that’s exactly what it is.)

Medicare is a government-run insurance system that directly pays health-care providers. Vouchercare would cut checks to insurance companies instead. Specifically, the program would pay a fixed amount toward private health insurance — higher for the poor, lower for the rich, but not varying at all with the actual level of premiums. If you couldn’t afford a policy adequate for your needs, even with the voucher, that would be your problem.

And most seniors wouldn’t be able to afford adequate coverage. A Congressional Budget Office analysis found that to get coverage equivalent to what they have now, older Americans would have to pay vastly more out of pocket under the Paul Ryan plan than they would if Medicare as we know it was preserved. Based on the budget office estimates, the typical senior would end up paying around $6,000 more out of pocket in the plan’s first year of operation.

By the way, defenders of the G.O.P. plan often assert that it resembles other, less unpopular programs. For a while they claimed, falsely, that Vouchercare would be just like the coverage federal employees get. More recently, I’ve been seeing claims that Vouchercare would be just like the system created for Americans under 65 by last year’s health care reform — a fairly remarkable defense from a party that has denounced that reform as evil incarnate.

So let me make two points. First, Obamacare was very much a second-best plan, conditioned by perceived political realities. Most of the health reformers I know would have greatly preferred simply expanding Medicare to cover all Americans. Second, the Affordable Care Act is all about making health care, well, affordable, offering subsidies whose size is determined by the need to limit the share of their income that families spend on medical costs. Vouchercare, by contrast, would simply hand out vouchers of a fixed size, regardless of the actual cost of insurance. And these vouchers would be grossly inadequate.

But what about the claim that none of this matters, because Medicare as we know it is unsustainable? Nonsense.

Yes, Medicare has to get serious about cost control; it has to start saying no to expensive procedures with little or no medical benefits, it has to change the way it pays doctors and hospitals, and so on. And a number of reforms of that kind are, in fact, included in the Affordable Care Act. But with these changes it should be entirely possible to maintain a system that provides all older Americans with guaranteed essential health care.

Consider Canada, which has a national health insurance program, actually called Medicare, which is similar to the program we have for the elderly, but less open-ended and more cost-conscious. In 1970, Canada and the United States both spent about 7 percent of their G.D.P. on health care. Since then, as United States health spending has soared to 16 percent of G.D.P., Canadian spending has risen much more modestly, to only 10.5 percent of G.D.P. And while Canadian health care isn’t perfect, it’s not bad.

Canadian Medicare, then, looks sustainable; why can’t we do the same thing here? Well, you know the answer in the case of the Republicans: They don’t want to make Medicare sustainable; they want to destroy it under the guise of saving it.
So in voting for the House budget plan, Republicans voted to end Medicare. Saying that isn’t demagoguery, it’s just pointing out the truth.



Health Insurers Have Had Their Chance
Wendell Potter
The Huffington Post, 05/31/11

 
Of the many supporters of a single-payer health care system in the United States, some of the most ardent are small business owners who have struggled to continue offering coverage to their workers.
 Among them are David Steil, a small business owner and former Republican -- yes, Republican -- state legislator in Pennsylvania who earlier this year became president of the advocacy group Health Care 4 All PA.

Another supporter is Vermont Gov. Peter Shumlin, who last Thursday signed a bill that sets the stage for the country's first single-payer plan. If all goes as Shumlin and the bill's many backers hope, all 620,000 Vermonters will eventually be enrolled in a state-run plan to replace Blue Cross, CIGNA and other private insurers whose business practices have contributed to the number of Vermonters without coverage -- approximately 60,000 and growing.

Both men told me last week that their feelings were shaped by their backgrounds. Their experiences as businessmen convinced them that a health care system controlled by private insurers cannot be sustained, regardless of attempts to force those insurers to provide affordable access to care for all Americans. They are both skeptical that the Obama administration's Affordable Care Act will provide the fix the country needs, even with the new regulations and consumer protections. Steil, president and owner of a small manufacturing company in Bucks County, Pa., told me he grew increasingly frustrated about having no leverage in dealing with private insurers, which demanded double-digit premiums increases every year. Shumlin, who along with his brother took over the management several years ago of a travel business their parents founded, echoed the same frustration. Shumlin, who also served as a legislator, shared another frustration with Steil: not being able to help political constituents, many of them farmers and small business owners, who called begging for help in finding coverage.[...]

The number of employers of any size still offering coverage dropped from 69 percent to 60 percent between 2000 and 2009, according to the Kaiser Family Foundation. The decline has been much steeper among small businesses with 10 or fewer workers. In 2009, far fewer than half of them were still offering coverage.

The Affordable Care Act, which provides tax breaks to small employers if they offer coverage and subsidize premiums for their workers, might at least slow that trend. Some of the big insurance companies have reported a recent uptick in the number of small businesses offering coverage -- many for the first time -- as a result of those tax breaks.

But even with financial help from the government, most small companies are still finding it difficult to pay what insurance firms are demanding.[...] 

Private insurers, say Steil and Shumlin, have had their chance to control costs and expand access and have failed miserably. It is time, they believe, to replace them with a single payer -- the government.
 
Read the full article at: http://www.pnhp.org/news/2011/may/health-insurers-have-had-their-chance



Medicare for All Is the Solution
Robert Reich, Robert Reich's Blog
13 April 11

 
Mr. President: Why Medicare Isn't the Problem, It's the Solution
 
hope when he tells America how he aims to tame future budget deficits  the President doesn't accept conventional Wasington wisdom that the  biggest problem in the federal budget is Medicare (and its poor cousin Medicaid).
 
Medicare isn't the problem. It's the solution.
 
The real problem is the soaring costs of health care that lie beneath Medicare. They're costs all of us are bearing in the  form of soaring premiums, co-payments, and deductibles.
 
Americans spend more on health care per person than any other advanced nation and get less for our money. Yearly public and  private healthcare spending is $7,538 per person. That's almost two and a  half times the average of other advanced nations.
 
Yet the typical American lives 77.9 years - less than  the average 79.4 years in other advanced nations. And we have the  highest rate of infant mortality of all advanced nations.
 
Medical costs are soaring because our health-care  system is totally screwed up.Doctors and hospitals have every incentive  to spend on unnecessary tests, drugs, and procedures.[…]

So what's the answer? For starters, allow anyone at  any age to join Medicare.

Medicare's administrative costs are in the  range of 3 percent. That's well below the 5 to 10 percent costs borne by  large companies that self-insure. It's even further below the  administrative costs of companies in the small-group market (amounting  to 25 to 27 percent of premiums). And it's way, way lower than the  administrative costs of individual insurance (40 percent). […]
 
Estimates of how much would be saved by extending  Medicare to cover the entirepopulation range from $58 billion to $400  billion a year. More Americans would get quality health care, and the  long-term budget crisis would be sharply reduced.
 
Let me say it again: Medicare isn't the problem. It's the solution.
 
Robert Reich is Chancellor's Professor of Public  Policy at the University of California at Berkeley. His latest book is, "AFTERSHOCK: The Next Economy and America's Future." Read the full article at:
 http://www.readersupportednews.org/opinion2/272-39/5605-medicare-for-all-is-the-solution 


  
The House Republican Budget Plan Destroys Medicare and Makes Health Care Unaffordable for Beneficiaries

 

On April 6, 2011, the House Budget Committee passed a budget proposal for Fiscal Year 2012 that would destroy the Medicare program and dramatically increase health care costs for America's seniors, especially future retirees. Chairman Ryan's plan privatizes Medicare and achieves savings by shifting costs to Medicare beneficiaries.
 
Raising Medicare's Eligibility Age
 
In addition to privatizing Medicare, the Ryan budget would increase the age of eligibility for Medicare from 65 to 67 by increasing the age two months per year from 2022 to 2033.
 
Privatizing Medicare
 
Beginning in 2022, Medicare would be converted from a program providing guaranteed benefits to a program providing vouchers to purchase private insurance. When people become eligible for Medicare beginning in 2022 they would not enroll in the current Medicare program. Rather they would receive a voucher, also referred to as a premium support payment, to be used to purchase private health insurance.
 
Chairman Ryan's proposal establishes a Medicare Exchange made up of competing private insurance plans from which Medicare beneficiaries would choose to purchase insurance. Although the government would set standards for the plans, benefits and premiums could vary. It is also unclear whether or not private plans would choose to participate - in the past, they did not want to enroll older people - or would ration care if they did participate in order to increase their profit margins.
 
The amount of the voucher would be increased each year by an amount that reflected the increase in the consumer price index for all urban consumers (CPI-U) and the age of the enrollee. In addition, the amount of federal assistance a person receives would be based on income and health status. However, the amount the federal government would pay (voucher) would grow less rapidly than health care costs and would become increasingly inadequate over time. The Congressional Budget Office (CBO) estimates that seniors would pay much more for their health care under the voucher plan than under the current Medicare program.
 
Medical savings accounts (MSA) would be established for low-income Medicare beneficiaries, those currently eligible for both Medicare and Medicaid. Rather than receiving guaranteed health care benefits, low-income Medicare beneficiaries would receive a fixed amount of money to pay for their health care expenses. The annual contribution to MSAs, would be indexed to the CPI-U rather than to the growth in health spending.
 
Medicare Beneficiaries 55 and Older
 
Beneficiaries 55 and older would be able to remain in traditional Medicare, with the option of converting to the new voucher program in 2022. The Ryan plan intends to keep premiums to what they would be under current law through a "hold harmless" provision. Whether or not this happens, it is likely that costs will increase to the federal government as the pool of beneficiaries in Medicare becomes increasingly older and sicker.
 
Source: http://www.ncpssm.org/news/archive/ryan_medicare/

 On Wisconsin: 

 

David Lindorff writes "The dramatic and inspiring occupation of the  Wisconsin Statehouse in Madison by angry public workers and their  supporters over the past few weeks is an exciting preview of what we can  expect to see in the halls of Congress before long, as right-wing  forces, funded by corporate lobbies and corporate-funded think-tanks  push hard for cutbacks in Social Security and Medicare... Here's the big  point: Corporate America, and its political lackeys in the Republican  and Democratic Parties, know that they are about to confront a  dramatically more powerful protagonist in their campaign to kill Social  Security and Medicare: the Boomer Retirees," and "As the number of Boomers nearing or  entering retirement soars, and the number anticipating or signing up for  Medicare soars over the next few years, we will see massive national  campaigns grow around not just saving these programs but expanding and  improving them. With traditional pensions vanishing, and with IRAs and  401(k) plans having been exposed as the shams they are, we are going to  see an irresistable demand grow for Social Security benefits to be  raised, particularly for poorer retirees, so that allAmericans can have  a secure old age. And we will see another irresistable political drive  to have Medicare not just improved but broadened to cover all Americans,  as we Boomers recognize that it makes no sense at all to have a program  that only covers the oldest and sickest of Americans, and not the  younger and healthier population (our own kids and grandkids!). We will  realize that it is in our interest to have all Americans invested fully  in supporting a well-funded national Medicare program." Here's Lindorff's article in full.
 
Submitted by BCHCC board member Walter Ballin
 
http://www.truth-out.org/madison-a-foretaste-things-come-next-big-occupation-could-be-boomers-taking-over-capitol-building682


Federal Health Reform a Tipping Point, Not the End Game
 by Senator Mark Leno

 
As California faces another year of skyrocketing health care costs, many of us have followed the developments of federal health care reform with anticipation. Even though I recognize that federal health care reform in 2010 will bring positive and worthwhile changes, it was disappointing to see the insurance industry succeed at scaling back reform. However, we should not be discouraged. Underneath this historic step forward is a true groundswell of support for universal health care. Across the nation, Americans are coming to the conclusion that private insurance companies have failed in their obligation to administer health coverage, and polls show that strong majorities support a Medicare for all model of health care.
 
With every passing year, rising insurance premiums suffocate economic growth and threaten the middle class standard of living. As premiums skyrocket, quality of care and access to care are rapidly declining. Benefits are being cut, medical bankruptcy is on the rise and provider reimbursements are stagnating. Public infrastructure like schools, roads, police and fire departments are directly threatened by these rising costs since public revenues can never hope to increase fast enough to keep up with health care premiums for teachers, police officers, and fire fighters.
 
Fortunately, California is leading the nation with a plan to establish a universal health care system that will strike directly at the heart of rising health care costs.
 
The California Universal Health Care Act, which I introduced last year, provides every Californian with comprehensive universal health care and is fully funded with the money that California already spends on health care. Senate Bill 810 builds on our current system of privately delivered health care but is funded by a single, comprehensive health insurance plan that covers all residents of the state, allowing them to choose their own doctors and hospitals.
 
SB 810 works by pooling together the money that government, employers and individuals spend on health care each year and using that money more efficiently to ensure that 95% of every health care dollar is devoted to actual health care, rather than clinical and administrative waste. Californians will spend about $200 billion this year on health care, but more than 30% of our health care budget is wasted on the administrative bureaucracy – the result of having thousands of different health care plans. We already spend more than enough money to care for our entire population, and yet we have millions of people who remain uninsured. Numerous studies have shown that a single-payer, universal health care system not only cuts costs in the first year, but it also contains the growth of health care spending over the long term.
 
You may hear some antagonists argue that we cannot afford single-payer, universal health care because of our ongoing state budget crisis. On the contrary, we cannot continue to ignore the cost savings a single-payer health care plan will provide our state and its residents. That is why cities, counties, school districts, health care providers and others have joined the hundreds of organizations that support single-payer, universal health care. The State of California, local agencies and businesses spend a large percent of payroll dollars on health care costs, which continue to grow three times faster than wages each year. Stabilizing crushing health care costs not only makes sense, but is critical in helping us address our fiscal challenges.
 
SB 810 provides immediate relief to California businesses that are struggling to pay for their employee health benefits, saving them millions of dollars in the first year alone. Such a policy will inevitably bring new business to the state since health care costs in California would be significantly lower than in other states and more competitive with other industrial nations.
 
Californians want and deserve the state-of-the-art, modern universal health care system that is envisioned in SB 810. I hope you will join me in supporting reform at the state level. California needs this bill. Californians support it, and we will not stop until we achieve it.
 
To learn more about the California Universal Health Care Act, visit our website, www.senate.ca.gov/leno or California OneCare at www.californiaonecare.org.
 
Senator Mark Leno represents the Third Senate District of California, which includes portions of San Francisco and Sonoma Counties and all of Marin County. He can be reached via the web at www.sen.ca.gov/Leno or by e-mail, Senator.Leno@senate.ca.gov.






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