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newsletter "What's Going On?" July 3, 2010

July 3, 2010

 

The Wonkroom passed along this comment:  “You may have missed an important point in the analysis of the Republican reaction and why they are so adamantly opposed to universal health care. Back when Clinton was trying to get it through, the Republicans realized that if the Democrats got credit for something that would turn out to be as popular as universal health care, then the Republicans were finished as a viable political party. They decided to not just modify Clinton’s proposals but to destroy them.  The same fact holds today. They know that if health care is implemented, that they are finished for the next generation or two, and they are desperately fighting like trapped rats.”

 

The state of Vermont has taken another step toward health care reform that could lead to a state level single-payer system.  This week it appointed Dr. William Hsaio and Dr. Jonathan Gruber to head a team to develop a proposal for the legislature to consider.  Dr Hsaio is the author of the single-payer health care system in Taiwan, and is “is assisting Taiwan, Cyprus, Mexico, Colombia, China, and Sweden in their health systems reforms.”  His competence is unquestioned, and his appointment by the Vermont legislature to carry out the study is the most convincing evidence possible that the state is serious about evaluating all options, choosing the best.  Recall that health care reform didn’t come to Canada all at once.  The province of Saskatchewan went first, and the remaining Canadian provinces joined in when the success of the Saskatchewan initiative was apparent.  

 

The California Assembly Health Committee voted YES for single-payer this week. By a "super majority" vote, the 19 member Health Committee delivered 13 YES votes versus 6 NOs to pass Senator Mark Leno's Senate Bill 810. The landmark health care reform legislation, previously vetoed twice by Governor Schwarzenegger, now proceeds to the Assembly Appropriations Committee for a hearing and vote in July or early August.  For some comments in the debate made in the committee, see here:

 

The Kaiser Daily Health Policy Report:  The U.S. Supreme Court will not review a challenge to San Francisco's health plan brought by city businesses. 

"The justices on Monday denied an appeal from the Golden Gate Restaurant Association of an appeals court ruling upholding the program's requirement that employers help pay the bill or give their workers health coverage," The Associated Press reports. The decision allows the program to maintain its emphasis on sharing the financial responsibility for health care -- a cost borne by the public, employers and employees, said Tangerine Brigham, director of Healthy San Francisco. ... Kevin Westlye, executive director of the restaurant association, said his group has no disagreement with Healthy San Francisco, but questioned whether employers should have to pay for what they consider an overpriced mandate" (Barbassa, 6/28).

 

San Francisco Chronicle: "The plan was approved unanimously by the Board of Supervisors in July 2006 and took effect Jan. 1, 2008. It requires businesses with 20 or more employees to either provide a certain level of health care for their workers or pay a set amount into a city health care pool for every hour that uncovered employee worked. ... Healthy San Francisco now enrolls about 53,000 of the estimated 60,000 uninsured adults in the city. With each participant provided a personal physician, their costly emergency room visits at San Francisco General Hospital dropped 27 percent between the first and second year the program was in operation."

 

The new federal health law could ensure coverage for many of those people, but it "will not include undocumented workers and others covered by the San Francisco program, [so] the city intends to keep operating Healthy San Francisco, forcing businesses to deal with paperwork for two separate health programs" (Wildermuth, 6/29).

 

The Examiner: "'The high court's decision today ensures we can continue providing health care coverage to thousands who would otherwise go without care,' Mayor Gavin Newsom said. Dan Scherotter, owner of Palio d'Asti in downtown San Francisco, said he is disheartened by the Supreme Court's decision. 'The real confusion is going to be in 2014 when the national health care kicks in,' Scherotter said. 'The fact we will have to meet both mandates will be pretty onerous and not good for The City's future of its largest employer -- restaurants'" (Sherbert, 6/29).

 

Firedoglake points out that now the San Francisco plan can serve as a model for other cities in the country.  And the Wonkroom adds that the legal issues chiefly turned about the question of employer mandates that will be echoed in legal challenges to the new national health reform law.

 

Ida Hellander, Executive Director of Physicians for a National Health Program, recently blogged members of PNHP’s google group on state single payer legislation with this reminder: Not to split hairs, but it's important to be clear that Medicare is not a true single payer program because it is only for people over 65 and the disabled.  As a result, it has to operate in a multi-payer environment and lacks some of the most important cost control mechanisms of a single payer (e.g. global budgets for hospitals).

In fact, our message to the Deficit Commission is that single payer is the best way to "save" Medicare for future generations.

This is not only because of the $400 billion in administrative savings possible with a true single payer system in the U.S., but also for the cost control potential of hospital global budgets, negotiated fees and bulk purchasing for the population as a whole, capital budgets and health planning system wide, and identification of outliers and quality improvement through the single payer. 

The future savings from controlling health care costs (or "bending the cost curve") far exceed the $400 billion in annual administrative savings, in fact.

It's true that we generally use a shorthand and refer to Medicare (and the VA) as a "single payer program."  But technically that would only be true if everyone in the U.S. were in it, and that's our goal.

 

In response, Kip Sullivan blogged (shortened): “I urge (we) not to get too preoccupied with defining the perfect single-payer program. We use “single payer” to describe Medicare, and we use it to describe a host of other programs that have defects that we would all agree need to be fixed. Let me offer some examples of questions I suggest we refuse to debate:    (1)    Canada’s system does not cover dental care and does a lousy job of covering prescription drugs. Should we take up time…discussing whether it’s kosher to continue calling Canada’s system a “single payer” system? If so, I would like to propose that we stop calling Canada’s system a single-payer until it covers all services. If (we) can insist that a program must cover 100% of all PEOPLE on a given chunk of land to be a single-payer, I can insist with equal logic that a program cover 100% of all SERVICES in order to be called a single-payer…….”

 

To join the state single payer Google group, : http://groups.google.com/group/state-single-payer/subscribe?hl=en&note=1

 

How Will the Health Care System Change Under Health Reform?  In her most recent blog post, Commonwealth Fund president Karen Davis discussed the ways the new health reform law improves the affordability of insurance for a variety of populations, including the uninsured and the underinsured and older and younger adults. In a new post, Davis explores the lesser-known provisions of the Affordable Care Act that emphasize preventive and primary care and reward health care quality. These key features will ultimately push the health care system to deliver more patient-centered, accessible, and coordinated care—improving our experiences in the doctor's office and hospital.

 

Under the new reforms, patients will be more likely to have:

 

Google News reports: Health overhaul may mean longer ER waits, crowding.  It’s not the uninsured who crowd emergency rooms today.  It’s largely people on Medicaid, and Medicaid will expand under the new law.    From Kaiser Daily Health Policy Reports. 

 

Again, from the Kaiser Daily Health Policy Report: The Oregonian: Sue Sherman of Southwest Portland was diagnosed with pancreatic cancer last year and "joined nearly 2 million disabled Americans -- at least 15,000 in Oregon -- who fall into a twilight with the first monthly Social Security disability payment, for they then must wait two years to become eligible for Medicare." Many of them exhaust their savings "on the care necessary to reach a diagnosis and now cannot get private insurance."

 

"This year, nearly 8 million Americans are receiving Social Security disability income. About a quarter, 1.8 million, are in the 24-month waiting period. For at least the past two sessions of Congress, a proposal has come forward to phase out the waiting period over 10 years. Late last year, a bill got a heavy push from the grass-roots lobby Medicare Rights Center and dozens of patient advocacy groups. Then the Congressional Budget Office, which estimates the cost of legislation to the taxpayer, calculated that eliminating the wait would cost an average of $10 billion a year over 10 years" (Saker, 6/27).

 

POLITICO PULSE EXCLUSIVE, WEDNESDAY: BOEHNER, CANTOR RENEW REPEAL CALL - The top two House Republicans will back efforts to force votes on the House floor to repeal the health care overhaul. They'll announce today their support for two discharge petitions - one from Rep. Steve King to repeal a portion of the law and a forthcoming petition from Rep. Wally Herger to repeal the entire law - and encourage other Republicans to follow suit. “Either course of action would begin to implement the will of the people with respect to ObamaCare,” Boehner and Cantor say in a joint statement. “Accordingly, we will be signing both discharge petitions, and encouraging our colleagues to do the same.” 

REPEAL REALITY CHECK - While more than 20 Republicans signed on to the petition on Tuesday, it brings the total number of signers to King's petition to fewer than 60. Discharge petitions need 218. The petition and an updated list of signers http://bit.ly/9DA4oX .  Club for Growth said this week that it's going to consider signing the petition a “key vote” on the club's annual congressional scorecard. 

NOW V. THEN -The repeal bill introduced by King gathered 90 co-sponsors when it was introduced, shortly after the reform law was passed in late March.

 

On Friday, PULSE reported: THE DELUGE - High risk pools are now online, giving states an early taste of their huge role in implementation. 

Lanny Craft, administrator for Mississippi's already-existing high-risk pool, keeps clearing his phone of messages asking about the federal Pre-Existing Condition Insurance Plan-and it keeps filling up again. 

New Mexico's high-risk pool's voicemail notes that it's “experiencing a large volume of calls” and guides inquiries to the Web site. 

North Carolina received its first request for a high-risk pool application at 3 a.m. Thursday -- leaving the plan's administrator to muse to Pulse that applicant's pre-existing illness might be . . . insomnia.

 

DELUGE, CAPITOL EDITION -- In the two days since HHS opened up its early retiree reinsurance program, 500 companies have turned in applications, 30 of which were delivered by hand to HHS HQ at 200 Independence Ave., S.W.

 

The new government Health Care web site:

 

Politico reported: The new insurance portal HealthCare.gov launched beats its July 1 deadline, launching late last night with approximately 500 pages of content and state-by-state listings of more than 5,500 open health insurance products. 

 

Melinda Gibson, from Healthcare for America Now (not to be confused with our friend, Healthcare-NOW) blogged: For many families and small businesses, finding the right insurance plan has meant spending hours on the phone deciphering confusing insurance company lingo and reading way too much fine print. Today finding health insurance just got easier with the launch of HealthCare.gov. The innovative new website developed by the U.S. Department of Health and Human Services helps you understand all the health insurance options available in your local area for you and your family. After answering just a few basic questions, the website's insurance finder will identify public and private coverage options that might be right for you.   

From HealthCare.gov you can receive updates on the implementation of the new law and, as the website grows, you will be able to research health plan quality ratings, learn about disease prevention, and compare health plan prices all in one place.  

This website is just the beginning of the transparency and peace of mind promised by the new law to check the insurance companies' bad practices and greedy behavior. HealthCare.gov represents an important step in implementation and allows us all to take health care into our own hands. HealthCare.gov represents an important step as we move forward to end the insurance company's stranglehold over the American health care system.  We hope that this resource will move us closer the peace of mind promised by the new law.

 

Firedoglake evaluated the site, tested it as a hypothetical citizen looking for help, gave it a sort of a passing grade.  It’s evaluation concluded: “I don’t know if the real problem people have with the health care system is finding out their options. That may be part of it, and I’m all for efficient websites and clearinghouses of information. In that sense, HealthCare.Gov is a step forward. But my sense was that the real problem concerned actually finding health care coverage that’s affordable and worthwhile and usable. This website can point you in a direction, but there’s no sense that the direction will work for people.”

 

From Politico Pulse: TRAFFIC JAM -- As of late Thursday, HealthCare.Gov was the 10th most popular Google search phrase, according to an administration official.

 

And more Politico: SHORT TERM BUYERS UP MASS. COSTS -- Boston Globe: “The number of people who appear to be gaming the state's health insurance system by purchasing coverage only when they are sick quadrupled from 2006 to 2008, according to a long-awaited report released yesterday from the Massachusetts Division of Insurance.” http://bit.ly/9sCb8t   Ezra Klein isn’t surprised, and isn’t surprised that any complicated system will have bugs appear that require fixing. 

 

Marilyn Werber Serafini of the National Journal asks “Are We Headed For A Two-Tier System?”  on the Health Experts blog. “Is two-tier health care inevitable as a result of the federal overhaul, with some doctors catering to the rich with concierge practices that don't accept Medicare and Medicaid patients while overwhelmed clinics are struggling to serve the less-well-off with government insurance? Is there still a role for physicians who serve all segments of the public?”  Uwe Reinhardt and John Goodman have already posted replies, more are likely to come.

 

Last weekend’s town hall meetings, “America Speaks”, intended to bolster efforts to cut Medicare and Social Security, weren’t greatly successful in achieving their objective.  Single Payer folks showed up.

 

This was a little bit of unexpectedly brilliance.  Matthew Yglesias blogged: “The reason I’m out here in California is for a conference that’s about trying to understand how political advocacy works. Or, rather, about how you would tell whether or not it’s working, which is a difficult task.  This by no means answers the question, but Frank Baumgartner, a political scientist at UNC, offered a provocative analogy that helps explain why it’s so hard. The analogy he drew is between policy change and financial bubbles and panics. Status quo bias is extremely pervasive, and the overwhelming amount of time you can’t change anyone’s ideas. But sometimes a critical amount of mind-changing happens and then suddenly everyone notices that minds are changing and human herding behavior takes over. Consequently, even though shifts are unusual, when they do happen they tend to be rather dramatic — rare, sudden, discontinuous change.  Concretely, this reminds me of a twitter back-and-forth I had yesterday with John Walker and David Dayen where I was saying I didn’t understand the level of paranoia about the deficit commission. The odds against substantial change to Social Security are just so overwhelming. Baumgartner’s research indicates that even though I’m right about that, it’s not necessarily a mistake to worry as much as Walker and Dayen are — when big changes happen they tend to happen rapidly, so one shouldn’t really expect clear “gathering storm clouds” or anything.

 

Kaiser Family Foundation’s tracking poll shows that favorable American public opinion of the new health care reform law has risen seven points in the past month to 48%.  41% hold ‘generally unfavorable’ views of the law, and 10% have yet to make up their minds.   There’s detail within the report if you’re looking for talking points about health care.  There are also PowerPoint slides.

 

Who else would be interested in planning a Birthday Bash for Medicare when it turns 45 this July?  Maybe in the Birmingham area?  Montgomery?  Tuscaloosa?  Mobile?  We ought to be able to get some cake, serve it with candles to some elected officials, local TV and newspapers.  Let me know if you’re interested. 

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Sunday, July 11. Healthcare-NOW! will be hosting it's standing activist conference call at 7pm (CDT). Please use this Dial-in Number: 1-218-862-1300 and Conference Code: 441086.

 

Thursday, July 22.  8 PM Central.  PNHP Conference Call.  Call me for the number and the Conference Code.

 

Friday, July 30.  Medicare Birthday Bash, Huntsville Public Library, 12-1.  Birthday cake, speakers.  Details to follow.

 

Friday, July 30.  Medicare Birthday. Healthcare-NOW is “looking to July 30th this year as a major day of action to protest the cuts and privatization of our hard-won entitlement programs. These cuts are simply, ‘off the table.’  We hope you will consider activating your network on July 30th to demonstrate at your local Congress person's office, your state capitol, a private insurance company, or another target that you think will bring awareness, media attention, and pressure on our elected officials. Healthcare NOW will help to support your efforts with sample press releases, media kits, post cards, petitions, staff support, and email blasts. We need you on the ground to make the noise, and collectively, our work to protect these important programs will build our networks in advocating for what we know can help alleviate so much of the unnecessary suffering in this country: expanded and improved Medicare for All.  Please let Healthcare-NOW staff know if you are interested in planning actions for July 30th at info@healthcare-now.org.”

 

Monday, August 2, 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.  The July meeting is CANCELLED

 

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