In 2009 when the Washington beltway was tied up with the health care reform tussle, Montana Democratic Senator Max Baucus, chairman of the all powerful Senate Finance Committee, said everything was on the table–except for single payer. When doctors, nurses and others rose in his hearing to insist that single payer be included in the debate, Baucus had them arrested. As more stood up, Baucus could be heard on his open microphone saying, “We need more police.”

Yet when Senator Baucus needed a solution to a catastrophic health disaster in Libby, Montana, and surrounding Lincoln County, he turned to the nation’s single payer healthcare system, Medicare, to solve the problem.

Baucus’ problem was caused by a vermiculite mine that had spread deadly airborne asbestos killing hundreds and sickening thousands in Libby and northwest Montana. The W. R. Grace Company that owned the mine denied its connection to the massive levels of mesothelioma and asbestosis and dodged responsibility for this environmental and health disaster. When all law suits and legal avenues failed, Baucus turned to our country’s single payer plan, Medicare.

The single payer plan that Baucus kept off the table is now very much on the table in Libby. Unknown to most of the public, Baucus inserted a section into the health reform bill that covers the suffering people of Libby, Montana, not just the former miners but the whole community—all covered by Medicare.

They don’t have to be 65 years old or more.
They don’t have to wait until 2014 for the state exchanges.
No ten year roll out—it’s immediate.
They don’t have to purchase a plan—this is not a buy-in to Medicare—it’s free.
They don’t have to be disabled for two years before they apply.
They don’t have to go without care for three years until Medicaid expands.
They don’t have to meet income tests.
They don’t have to apply for a subsidy.
They don’t have to pay a fine for failure to buy insurance.
They don’t have to hope that the market will make a plan affordable.
They don’t have to hide their pre-existing conditions.
They don’t have to find a job that provides coverage.

Baucus inserted a clause in the Affordable Care Act to make special arrangements for them in Medicare, and he didn’t wait for any Congressional Budget Office scoring to do it.

Less than two months after the passage of the health reform bill on March 23, 2010, Nancy Berryhill of the Social Security Administration in Denver joined personally in setting up an office in Libby to sign up these newly eligible people. “This is a new thing,” Berryhill told the Missoulian. “No other group like this has ever been selected to receive Medicare.” Berryhill issued a nationwide alert to inform anyone who had lived or stayed in Lincoln County of their eligibility. She opened a storefront in Libby at the old downtown city hall where she signed up 60 people on the first day. She plastered the towns of Whitefish and Eureka with pamphlets explaining the program and added three new staffers to the office in Kalispell.

Berryhill said she did not know how much the care would cost. That kind of analysis was beyond her directive to sign the people up. There have been no reports of competition from the private for-profit Medicare Advantage plans. The sick are not profitable.

No one should begrudge the people of Lincoln County. The mine wastes were used as soil additives, home insulation, and even spread on the running tracks at local schools. Miners brought the carcinogens home on their clothes. The W. R. Grace Company dumped much of the clean up costs onto the federal government. A June 17, 2009, order by the Environmental Protection Agency, the first of its kind, declared Lincoln County a public health disaster. The Libby Medicare provision in the health reform law is based on the area covered by that EPA order.

Baucus gave his reasons to the New York Times for its only story on this unique benefit: “The People of Libby have been poisoned and have been dying for a decade. New residents continue to get sick all the time. Public health tragedies like this could happen in any town in America. We need this type of mechanism to help people when they need it most.”

Health tragedies are happening in every town. Over 51 million have no insurance. Over 45,000 uninsured people die needlessly each year. Employers are cutting coverage and dropping plans. States in economic crisis are slashing both Medicaid and their employees’ plans. Nothing in last year’s reform law will mitigate the skyrocketing costs. Most insurance is threadbare and doesn’t cover. More than 50% of us now go without necessary care. As Baucus said of Medicare, “We need this mechanism to help people when they need it most.” We all need it now.

Bill Clinton recently stated that the U. S. could give coverage to all for one trillion dollars a year less than we now pay if we adopted the system of any other advanced nation. (Unfortunately, he did not say this when it would have mattered most during the 1993 and 2009 health care reform debates.)

Other industrialized countries have found that to cover everyone for less they must remove the profit-making insurance companies. Congressman John Conyers has reintroduced HR 676, the Expanded and Improved Medicare for All Act, which does exactly that. There are 60 cosponsors. It would cover all medically necessary care for everyone including dental and drugs by cutting out the 30% waste and profits caused by the private insurers.

So as the Ryan Republicans try to destroy Medicare and far too many Democrats use the deficit excuse to suggest cuts in its benefits, let us counter with the Libby prescription to clean up the whole mess. Only a single payer, improved Medicare for All, can save and protect Medicare, rein in the costs, and give us universal coverage.

Medicare will celebrate its 46th birthday on July 30, 2011, and all are invited to join in the festivities. Medicare was passed in 1965 and implemented within less than a year. When we pass HR 676, this single payer bill, we can all be enrolled in the twinkling of an eye.

Medica Plan May Be Glimpse of Future
Article by: JACKIE CROSBY, Star Tribune

The insurer’s new option sets aside a certain amount of money for each employee to spend Medica is launching a new plan for businesses that it says will help them gain more control of health care costs, while giving employees more say in designing their insurance plans — even as they’re picking up more of the tab.

The Minnetonka-based insurer’s plan may provide a glimpse into how new health insurance exchanges could work, well ahead of the 2014 federal mandate.
The health care reform law requires states to offer marketplaces where people can shop for plans from different providers. Medica’s program is like a private exchange.
Called “My Plan,” the employer sets aside a specific dollar amount for each employee to use for health care. Employees then go online and decide how they want to spend it by choosing among 20 Medica plans.

The program will be available on July 1 to businesses with at least 51 workers.

“There’s a sweet spot in the small- to mid-range employers that will find this very attractive,” said David Delahanty of the human resources consulting firm Towers Watson in Minneapolis. “For the employee, there’s more choice. If you’re single and you’re healthy or if you’re a young family with children, you can find something within these 20 choices that will appeal to you.”
Medica has partnered with Minneapolis-based Bloom Health, which has developed an online tool that assesses a worker’s financial situation, health care needs and appetite for risk, and helps narrow down the choices that best fit.

The tool is being used by 47 companies to help workers compare health care plans on the individual market. Medica’s program provides employers with a group plan.

This is the first time Bloom Health has adopted its platform for a single insurer in Minnesota, though it has done so for plans in other states.

‘Becoming smarter shoppers’

Bloom Health CEO Abir Sen compares it to Expedia or Travelocity. The online tool sorts through Medica’s 20 options and comes back with two or three options that are best for a particular employee.

Sen said that when workers see how much gets put into their account by their employers and what portion they’ll have to kick in for coverage, they make different choices. Individuals are choosing a $3,000 deductible on average, while the most common family plan at Bloom Health has a deductible of $6,000.

“It goes back to the hypothesis that people spend their own money differently than when they spend other people’s money,” Sen said. “They’re becoming smarter shoppers of care. Anecdotally, some of our employers are saying people are starting to pay more attention to preventive care and those sorts of things because now they’re more on the hook for their own health. It’s early yet, but it’s very encouraging.”

John Naylor, Medica’s vice president of sales and account services, said the new plan moves from a “cost shift” to a “cost share” model.

“Employers are making decisions behind the scenes about the level of benefit and the kind of contribution they’ll make,” he said. “Maybe they’ll lower their benefits or find ways to lower cost, or you as an employee take on more. ‘My Plan’ offers a way for employers to control costs, but to give me as an employee more flexibility and choice.”
Simeon Schindelman, Medica’s senior vice president of commercial markets, said the company spent about a year working on the program, based on feedback from some of its 200 brokers as well as businesses.

First of many innovations

Although companies of various sizes and industries have shown interest, no one has officially signed on.

But Delahanty of Towers Watson predicts it’s the first of many such innovations, as the reform law rolls out and companies think more about health insurance exchanges.

“It’s a great step, but it’s one carrier,” he said. “We are going to see some private exchanges pop up during the next couple of years that offer multiple carriers.
“Medica might be one of the participants, but Blue Cross, HealthPartners, UCare, they might all be competing on these exchanges. And some of the larger employers might have an opportunity to go and put their people in them as well.”

Dr. Margaret Flowers receives an escort

The Census Bureau reports that the number of uninsured in the U.S. jumped 10 percent to 51 million people in 2009. This is the greatest jump since data have been collected. The jump would have been more than 20 percent if not for public programs like BadgerCare.

No other rich nation experiences such high levels of people without access to health care and the resultant suffering and death. For example, a study in the American Journal of Public Health shows that in the United States nearly 45,000 deaths annually can be linked to lack of health insurance. That’s over 120 preventable deaths every day.

Even those who have health insurance are unprotected. A growing number of people have insurance policies that require high co-pays, deductibles and other out-of-pocket expenses. These “cost-sharing” measures are serious obstacles to getting care. The majority of people who go bankrupt from medical bills have insurance when they get sick. Private health insurance is like an umbrella that melts in the rain — it may not be there when you need it most.

Sadly, the new federal health law fails to make the grade. Even the Congressional Budget Office estimates that 23 million people will still lack coverage in 2019 after the health legislation is fully implemented. The Centers for Medicare and Medicaid Services reports that health care costs will rise more quickly under the new law than if there had been no health bill.

A potent example of what to expect occurred when the recent provision preventing health insurers from denying new policies to children with pre-existing conditions kicked in. The day before this protection went into effect, insurers like WellPoint, UnitedHealth Group, Aetna, Cigna and Humana announced that they would no longer offer new policies to individual children.

What can we conclude about the new legislation? It further enriches and empowers the very industries which are at the heart of the problem. As long as private insurers occupy a commanding role in our health system, we will never achieve universal or affordable care. Insurers make money by enrolling the healthy, screening out the sick, denying claims and raising premiums.

There is a solution that receives top marks: a single-payer national health insurance program, commonly referred to as improved Medicare for all. Single-payer means that our health care dollars are pooled in a single public fund that pays for a universal health care system. This is estimated to save $400 billion, which would cover those who need care. Surveys show this approach is supported by two-thirds of the population.

Improved Medicare for all means every person living in the United States would be guaranteed high-quality care from birth to death. Coverage would be comprehensive, including dental care, vision care, mental health services and prescriptions. And the working and middle class would pay less for health care because of the increased efficiency of a single-payer system.

Patients would choose their physician and health facility, and decisions about treatment would be made by patients and their health professionals without interference by insurance company bureaucrats.

While the health care crisis may not be obvious in Madison, the effects are felt in Wisconsin and across the nation. We must work with renewed energy and commitment for a national health program that addresses our fundamental problems. Everybody in, nobody out.

Dr. Margaret Flowers, who spoke recently in Madison, resides in Baltimore and serves as congressional fellow for Physicians for a National Health Program [1]. She is also a board member of Healthcare-Now [2].

Article printed from www.CommonDreams.org

The Republican Party recently told its leaders to call the Obama administration’s new health law “Exhibit A” of a “runaway Washington government.”

But that’s not how longtime GOP health expert Thomas Scully sees it.
“The bill signed by Obama is not a big-government takeover,” Scully told a pro-business audience in Louisville, Ky., last month, adding the new law will result in “an explosive boom for the medical industry.” Scully, a staunch Republican who worked in George H.W. Bush’s White House and was later President George W. Bush’s top administrator for Medicare and Medicaid, said, “The health care reform bill that passed in March is very much like the Bush 1 plan. I know. Richard Darman and I wrote that 1992 plan.”

Scully, who now works in the private sector, was the keynote speaker at a gathering of health industry entrepreneurs sponsored by the Health Enterprises Network, an affiliate of the local Chamber of Commerce, here on May 27. Three of us from Kentuckians for Single Payer Healthcare attended the forum, curious to see what the reform looks like to those who seek financial fortune in the health industry.

For-profit companies win, taxpayers lose
Early in his talk, Scully projected a slide on a large screen with a smiley face over the left seven-eighths of the frame and a frowning face over the right eighth.

Under the smiley face were the “winners” under the health law, including the private health insurance firms, pharmaceutical companies, hospitals, dialysis and hospice companies, and disease management groups. Also listed were the device manufacturers who would pay a special tax but would simply pass it on to others and come out ahead. Home health care would take a hit in the short run but prosper in the long run, he said. On the far right-hand side of the slide, under the frowning face, was the sole “loser”: the taxpayers. (In case you’re wondering, patients didn’t even make the slide.)

While complimenting the bill’s backers for their shrewdness (“The bill is politically smart — the doctors, drug companies and hospitals were bought off early”), he said the new law’s main weakness was its inability to control spending. “In 10 years there will be $1.5 trillion in new spending,” a half-trillion dollars more than the administration has projected, he said. In short, the law is “a fiscal disaster,” and U.S. taxpayers will end up paying for it. “Someone will have to raise the Medicare and Social Security age to 70, and we will have to have tax increases,” he said.

His prediction of devastating changes to these cherished social safety-net programs caused no stir in a room full of people sporting health industry badges. Scully should have some insight into the implications of health reform for taxpayers and businesses. In 2003, when he was administrator for the Centers for Medicare and Medicaid Services (CMS), he withheld from Congress the real costs of the Medicare Modernization Act, which barely passed in an arm-twisting vote.

The bill blocked Medicare from negotiating prices with pharmaceutical companies, something that has since proven wildly lucrative for insurers and drug makers. The Medicare Modernization Act also gave away the store to the privatized Medicare Advantage plans. Along these same lines, Scully told the audience, “We need to turn all of Medicare over to Medicare Advantage.”

Likes Obama plan
Scully said he was a big fan of the Obama plan, but he confessed that it was not his first choice in health reform: “Of course, the Wyden plan is really the best thing to do — it gets rid of Medicare and Medicaid — that is the totally right thing to do.”

The bill offered last year by Sen. Ron Wyden, D-Ore., would have put health care financing entirely in the hands of private insurers, with mandatory individual purchase taking the place of employer-sponsored coverage. Nonetheless, Scully was clearly pleased with the bill passed by the Democrats, which reinforces, not undermines, profit-seeking in health care.

Scully’s last words at the meeting were, “All is driven by money.”

We left even more determined to build the movement for single payer.

Kay Tillow is a native of western Kentucky and is a leader of All Unions Committee for Single Payer Health Care–HR 676.

Jane Hamsher

Where: 6514 Clovernook Road, Middleton
When: Saturday, June 12 from noon til 5 PM
Who: Anyone who realizes that both parties are dominated by corporations and who wants to fight for change!

Dr. Quentin Young

Listen to the Health Writers April 8 broadcast (courtesy of WORT 89.9 FM in Madison WI) by clicking on the player below.

Despite Republican opposition to most of the health insurance reform proposals coming from Congress, the president, in his already infamous compromising style, reaches across the aisle, indicating that he is “still open to Republican ideas.” The attacks by the right-wing on healthcare reform are just one of the factors giving a sense of foot-dragging in Washington. But another factor that has become the president’s legacy is his inability to use his party’s majority in both the House and the Senate to pass meaningful reform. His latest plan he is touting as having “maximum flexibility” in order to get the most support in bi-partisan fashion.

Since they are using reconciliation, a legislative process in the United States Senate intended to allow consideration of a contentious budget bill without the threat of filibuster, then the rhetoric coming out of Washington should be about raising taxes on the wealthiest 1% of Americans in order to budget for reform. President George W. Bush was able to use this process to get his tax cuts pushed through Congress multiple times throughout his presidency. Instead president Obama talks about raising the threshold for taxing “Cadillac plans” to the year 2018 and reducing co-pays in Medicare by the year 2020, essentially “throwing a bone” to labor and seniors. And on top of it all, the plan still includes a mandate to buy into private insurance with absolutely no mention of a legendary public option.

It’s almost as if the administration and the insurance companies are trying to play chess with the American public. Incidentally, as the president sheds light on his “bold” new plan, insurance companies throughout America are being reported as raising premiums by 39% and as much as 56% (MI) in some states! So “tough on Wall Street” president Obama proposes a “Health Insurance Rate Authority” which will effectively add another layer of bureaucracy. This authority would annually review premium increases by the insurance giants and have the power to approve or disprove rate increases. It is pretty clear that Washington is doing whatever it can to appease the health insurance industry and PhRMA in his bold attempt to hold together the backwards healthcare system that the United States boasts itself as the most advanced and efficient in the world. If this authority is anything like the Obama administration’s bank oversight team, the CEOs at the private insurance companies are being sent a message to relax and that their profits will continue to soar to new heights. The American people deserve far better than a corporate windfall disguised as “meaningful reform.”

According to the World Health Organization, the United States is ranked #37 in health care delivery and outcomes. That means that there are 36 other advanced industrialized countries in the world with better health care systems than ours, these countries include: Canada, Greece, Israel, Costa Rica & the United Kingdom. What do all these countries have in common? They all have a single-payer health care system.

In Obama’s latest State of the Union address he said:

“…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.”

Dear President Obama, letting you know that “HR 676 – Expanded and Improved Medicare for All” will meet all your requests.

->Click Here<- to listen to the excerpt from the show.