Newsletter, What's Going On, November 9, 2010
November 9, 2010
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Annual meeting, Physicians for a National Health Program, Denver:
There seemed to be a surprising, curious optimism among single-payer enthusiasts, though perhaps not so surprising after all. Cost of health care continues to rise much faster than the cost of living. Cost control measures in the Affordable Care Act are very weak. Political pressure for real reform will continue to increase, and only single payer, adopted at the national or at state levels, will solve the problem.
The employer-based system of health insurance provision is crumbling. It’s the system from within which the great majority of American workers get their insurance coverage, and it’s going down. Listen: “I don’t think you are going to hear anybody publicly say ‘We’ve made a decision to drop insurance,’ ” said Paul Keckley, executive director of the Deloitte Center for Health Solutions. “What we are hearing in our meetings is, ‘We don’t want to be the first one to drop benefits, but we would be the fast second.’ We are hearing that a lot.” Deloitte is a major accounting and consulting firm.
There were good, practical models for organization at the state level that we’ll discuss at the Birmingham meeting Thursday and at other meetings in the near future.
Dr. Pippa Abston from Huntsville received the Quentin Young Activist of the Year award! Visit her blog, where she’s working her way through the Affordable Care Act, section by section, trying to translate it from Legalese into English and to make the reasoning behind each section understandable!
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Blogs this week were consumed with analysis of what the election will mean to health care reform. Two representative samplings:
Health-care reform will probably be changed on the margins, but neither repealed nor defunded, writes Ezra Klein: Politicians of both parties are risk-averse, and the likeliest outcome is that this fight is effectively tabled - particularly if, as looks likely, Democrats hold the Senate. Republicans might mount a mostly symbolic vote on repealing the bill, and they could make a show of holding up appropriations in exchange for some smaller compromises on provisions that Democrats won't fight to the death over. But in the end, they are more likely to try to persuade their base to take the longer view and see this battle as one that will really be decided in 2012, when conservative voters will have the opportunity to replace President Obama with a leader who has no intention of protecting -- or implementing -- the bill. The Wonkbook.
Recently, in the New England Journal of Medicine, Dr. Henry J. Aaron discussed the repeal and defund alternatives, and concluded (in part) with this paragraph: “Perhaps the more likely — and in some ways more troubling — possibility is that the effort to repeal the bill will not succeed, but the tactic of crippling implementation will. The nation would then be left with zombie legislation, a program that lives on but works badly, consisting of poorly funded and understaffed state health exchanges that cannot bring needed improvements to the individual and small-group insurance markets, clumsily administered subsidies that lead to needless resentment and confusion, and mandates that are capriciously enforced.”
The New York Times reported what many expected: that Republicans plan to use their majority in the House to block funding for major parts of the Affordable Care Act. The Times quoted appropriate Republican leadership.
In exit polls, about half – 48 percent – of voters want the health care law repealed. Another 31 percent said it should be expanded and 16 percent want it left in place as is. Politico, quoted by Peter Van Vranken
Single Payer Ballot Questions Pass in All Fourteen Massachusetts Districts! Massachusetts voters have, for the second straight election, overwhelmingly affirmed their support for single payer health reform by turning in majority ‘Yes’ votes in all fourteen districts where local single payer ballot questions appeared on November 2. (editor’s note: these were non-binding ‘advisory’ questions). Single-payer health insurance: “Should the state representative from this district be instructed to support legislation establishing health care as a human right regardless of age, state of health, or employment status, by creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts?’ 222 of 228 precincts reporting: Yes - 63.5% No - 36.5% http://masscare.org/announcements/single-payer-ballot-questions-pass-in-all-fourteen-massachusetts-districts/ From Don McCanne’s Quote of the Day.
Minnesota had an advanced proposal for state single-payer health insurance in late stages of development until this past week’s election. The candidate for governor who supported single-payer is trailing, though a recount is probable. Progressives unexpectedly lost control of both house and senate. Every single one of the legislators supporting single-payer lost their elections except those from very progressive districts. From Amy Lange of the Minnesota Universal Health Care Coalition.
A health law program that directs $5 billion for coverage of otherwise uninsurable people through state-run high-risk insurance pools has attracted only 8,011 people according to health department enrollment figures, The New York Times reports. That's a paucity compared to the hundreds of thousands of people government actuaries predicted would flock to the program causing it to run out of money too early. The pools opened two or three months ago in most states. The high-risk pools are among the health reform ideas that have found historic support from Republicans. "New York and Florida, for instance, have each enrolled fewer than 300, and 21 states have fewer than 50" (Sack, 11/4). Kaiser Daily Health Policy Report. And: Kaiser Health News staff writer Phil Galewitz reports: "Trying to spur enrollment in a new health insurance program for uninsured people with pre-existing medical conditions, the federal government is doing something private insurers almost never do: slashing rates" (Galewitz, 11/5). Read the story.
A compromise is under discussion on health care reform's small business disclosure provisions. The dramatic adverse impact of those provisions on Democrats in the mid-term is discussed here.
Conservatives have proposed privatizing the Veterans Administration health care system as a way of “tamping down big government.” Dr. Maggie Kozel thinks that’s not a good idea.
GEORGIA HAS NO CONFIDENCE IN AMA- The Medical Association of Georgia has voted "no confidence" in the current AMA leadership, a move designed to signal its opposition to the national group's role in the health debate. The group recognized that the current leadership wasn't in place when the reform law was passed, but the group said it has "serious reservations about the AMA effectiveness and its ability to represent physicians' interest," according to a letter sent to the national group. POLITICO Pulse.
Texas Considers Medicaid Withdrawal New York Times by EMILY RAMSHAW. Some Republican lawmakers — still reveling in Tuesday’s statewide election sweep — are proposing an unprecedented solution to the state’s estimated $25 billion budget shortfall: dropping out of the federal Medicaid program. Far-right conservatives are offering that possibility in impassioned news conferences. Moderate Republicans are studying it behind closed doors. And the party’s advisers on health care policy say it is being discussed more seriously than ever, though they admit it may be as much a huge in-your-face to Washington as anything else….The Heritage Foundation, a conservative research organization, estimates Texas could save $60 billion from 2013 to 2019 by opting out of Medicaid and the Children’s Health Insurance Program.. Peter VanVranken. Suzie Khimm considers the consequences.
Suzy Khimm, writing for Ezra Klein, (who was honeymooning) wonders what health insurers want now? They’d clearly favor continuing the individual mandate…the requirement that everyone buy their insurance products. They’re opposed to cuts to Medicare Advantage plans, cuts that their ads labeled as “cuts to Medicare.” And they’d like to be free of a planned excise tax on all insurance policies, a tax they’ve labeled a “tax on small business.”
Dylan Matthews, writing for Ezra Klein, notes that Oregon has now joined Vermont and Hawaii as a state to watch for state-level innovations in health care. John Kitzhaber has been declared the victor in his race for Governor. Kitzhaber is a retired Emergency Room physician and a former governor from 1994 to 2002. Under his leadership Oregon covered Medicaid recipients in a novel way, providing fewer services, but services of the highest value covering a much greater share of Oregon’s population than in most states. Note that Oregon’s Senator, Ron Wyden, has already called for waivers of the Affordable Care Act that would let Oregon develop a unique and innovative approach to care.
President Obama has conceded that the Affordable Care Act is “not that different” from Republican proposals including Romney’s bill that became the Massachusetts law.
In 2009, Massachusetts passed a law that denied the right of legal (yes, legal) immigrants to participate in Commonwealth Care. Comm Care, the centerpiece of the 2006 Massachusetts health reform legislation, provides subsidies for low-income Massachusetts residents to purchase private health insurance. Last week, Massachusetts’ highest court, the Supreme Judicial Court, .heard arguments in a class action lawsuit filed on behalf of 40,000 of those legal residents contending they were deprived of equal protection under Massachusetts law. The suit was filed by Health Law Advocates, “the only non-profit law firm in Massachusetts dedicated exclusively to health care access, providing free legal assistance to hundreds of Massachusetts families each year.” From the Health Care for All – Massachusetts blog.
POTTER PUBLISHES- Former Cigna flack Wendell Potter out today with his first book, "Deadly Spin," where PULSE readers should expect to see a lot of familiar names - Karen Ignagni, AHIP and various insurers just about dominate the index. "I think it's going to be somewhat controversial," Potter told PULSE when we caught up with him. "I hope readers get an understanding of what goes on to influence public opinion. Most illuminating bits come from the pre-reform era (Potter left Cigna in May 2008), like the industry's coordinated - and highly guarded - campaign against the Michael Moore movie Sicko, including PowerPoints without "save" or "print" functions and an intra-industry codeword for the movie: "Hollywood." Potter presents at the National Press Club tonight and Politics & Prose tomorrow before hitting the road for a three-month book tour. First stop: University of Tennessee, Potter's alma mater. Yours for $17.16 on Amazon POLITICO Pulse.
Massachusetts is beginning serious efforts to control health care cost. It’s going to be an interesting challenge.
And the process of determining what is to be in the ‘essential benefit package’ offered by every insurance carrier in every policy is also just beginning.
There are abut 120 opportunities for governments or non-profits to apply for funds under the Affordable Care Act. This report details a listing of all available ACA grants, pilot projects and demonstrations and the details necessary for easily navigating their utilization. Such details include eligibility, implementation and application dates and deadlines, data reporting requirements, and links to relevant announcements.
Limbaugh: "Pre-existing condition coverage is not insurance; it's welfare" From Daily KOS
Visit
Thursday, November 11, 2010. Organizational meeting, Health Care for Everyone – Alabama, Conference Room, Emmet O’Neal Library, 50 Oak Street, (Crestline Village), Mountain Brook. 6:30-7:00 business. 7:05-8:00. Dr. Wally Retan will present a test presentation of “The Business Case for Further Health Care Reform”. Afterwards, adjourn to one of Crestline’s restaurants (optional)
Leadership Conference for Guaranteed Health Care meeting, November 12, Philadelphia.
Healthcare-NOW National Strategy Conference. When: Saturday, November 13th and Sunday, November 14th Where: William Way Community Center, 1315 Spruce St., Philadelphia, PA Time: Sat, 4pm to 9pm; Sun, 8am to 4pm Fee: $30 for Healthcare-NOW! Members and $50 for Healthcare-NOW! Non- Members Go to our National Strategy Conference page to register and more information. (10/25 New: Draft Agenda.)
Thursday, November 18, 2010. @5:30 PM. Third Thursday happy hour (social gathering), at 801 Franklin (Huntsville).
Thursday, November 18, 8 PM CDT. PNHP’s monthly activist phone call. Please call me for the phone number and access code.
Saturday, November 20, 9 AM. Pippa Abston’s home. Vision 2011 Workshop to develop roadmap and plan of action for 2011 activities of NAHA, North Alabama Healthcare for All, the north Alabama Chapter of PNHP, Physicians for a National Health Program. (Postponed)
Wednesday, December 1, 2010. Lunch, (social gathering) Panera Bread, Airport Road, Huntsville. Wednesday before each monthly meeting.
Wednesday, December 1, 2010. - B'nai Shalom Temple, Women's Group, anticipates about 30 people. Pippa Abston to present.
Sunday, December 5, 7PM CDT. Healthcare-NOW monthly activist phone call. Please use this Dial-in Number 1-218-862-1300 and Conference Code 441086. To mute and unmute the line, please hit *4.
Monday, December 6, 2010 @ 5:30 PM. North Alabama Healthcare for All Monthly Meeting —Huntsville/Madison County Public Library, 901 Monroe Street (downtown). The meeting is in Room AB, on the first floor. After you enter the library’s front door, turn right towards the auditorium.
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