The new Michael Moore movie, Sicko, a devastating
indictment of our for the profit of the few national health care racket, will
be released June 29th. And the most wonderful aspect of this movie is the
activism of Michael himself in using his documentary as a vehicle for making
real policy change happen.
Under
H.R. 676 [Text
of Bill], Medicare would be extended and improved so that all individuals
residing in the United States would receive high quality and affordable health
care services. They would receive all medically necessary services by the
physicians of their choice, with no restrictions on what providers they could
visit. If implemented, the United States National Health Insurance Act would
cover primary care, dental, mental health, prescription drugs, and long term
care.
The one click form will send your personal message to all
your government representatives selected, with the subject "Pass
H.R. 676." At the same time you can send your personal comments only
as a letter to the editor of your nearest local daily newspaper if you like.
The Colorado Health
Services program represents systemic health care reform designed to ensure
integration of financing, delivery and administration in order to provide
quality health coverage for all in place of our current fragmented, chaotic,
profit-centered multiple-insurance model. CHS is a comprehensive, public-payer
(insurance), private provider (health facilities, providers) system that permits
free choice of providers and hospitals. By eliminating wasteful administrative
spending, the program is designed to provide quality, equitable health care
access at greatly reduced cost by creating a single, statewide risk pool for
all residents. Comprehensive benefits encompass a broader range of coverage
than currently available through any single private insurance plan.
CHS administrative
savings alone are projected at 15-20 percent of health spending. Additional
savings result from elimination of insurance profit-taking, and negotiation
of costs for pharmaceutical and durable medical goods. Providing universal
access to primary, preventive care avoids resort to higher-cost delayed, crisis
emergency room care. The elimination of multiple duplicative insurance paperwork
reduces hospital and providers' costs. Treatment instead of imprisonment of
many suffering substance abuse or mental illness would significantly reduce
prison/jail expenditures. Universal access to continuous health care greatly
reduces costs of malpractice premiums and awards.
Key to any successful
systemic health care reform is a statewide fully integrated Information Technology
network, permitting simultaneous tracking of expenditures, utilization and
outcomes, with assessment of best practices and resource utilization to improve
quality of care and expedite chronic disease management; and to reward hospitals
and providers for excellence. Statewide coordination of public health and
infrastructure prevents duplication of services and administrative waste.
Accountability and transparency of data facilitates informed health care decisions
by all.
Federal, state and
local monies now earmarked for health care would be transferred to the CHS
Trust, insulated from the general state budget. Waivers would be sought for
federal programs (e.g., Medicaid and Medicare). The medical expense portion
of liability, Workers' Compensation and automobile insurance would be folded
into the program, eliminating administrative and adjudication costs for auto
and job-related injuries. Exercising administrative oversight, a governing
board representing five state regions would remain accountable to the people.
CHS would be operated as a publicly-owned not-for-profit insurance company.
Employers and employees
would contribute through payroll deduction or a progressive tax. Health costs
for the vast majority will be substantially reduced below current premium
and out-of-pocket health expenditures (currently averaging $11,000 per family
annually). Divorcing health coverage from employment also frees businesses
to better compete in the global marketplace. All institutions, including public
education and the state, would realize savings when relieved of responsibility
for inflationary health coverage costs. Coloradans will no longer experience
threat of bankruptcy due to high medical bills (the cause of an estimated
50 percent of U.S. personal bankruptcies), or denial of coverage due to "pre-existing"
health conditions.
Equal access to health
care across the state would be facilitated, as providers and hospitals receive
the same reimbursement for the same level of care, negotiated annually. Education
funding for health care providers and incentives for service in high-needs
areas are key features, as is wellness education for the populace and job-retraining
for displaced workers.
Health
decisions made by patient and provider instead of HMOs
Improved
Health Planning
Health
coverage would be portable, not tied to employment.
Eliminates
the high (up to 33 percent) overhead cost of multiple private, for-profit
insurances by including coverage for everyone in a single-risk pool (reducing
administrative costs to 1-5%).
Instead
of hundreds of insurances with differing requirements (requiring increased
office staff), providers would deal with only one form.
The
plan would be financed with a progressive tax, at less per-capita cost.
Companies
would avoid hassles of managing health care, and become more competitive
without annual inflationary health costs.
Consumers
would pay less for goods and services that are inflated by businesses’
high health costs - e.g., currently $1,500 is added to the cost of each U.S.-made
automobile due to health costs.
US
Consumers , who now spend twice as much per capita as consumers in other developed
countries (with poorer outcomes), would save as administrative health costs
are reduced.
Single-risk-pool
coverage would permit negotiation of lower, bulk rates for medications.
Increased
US life expectancy: Similar socioeconomic single-payer European countries
enjoy average two-year longer life expectancies.
The
over-45 million uninsured Americans and 50 million more underinsured would
have access to preventative care, without having to resort to delayed, crisis
Emergency Room care. at 4 to 5 times higher cost.
Lessening
demands on the nation’s emergency rooms for primary care would stem
the tide of closures of overburdened emergency rooms.
Retirees
would not face loss of health coverage by employers.
Eliminates
the profit motive that places priority on stockholders’ profits, and
creates a perverse incentive to deny health coverage to the ill or high-risk.
Citizens
Can Prevail ! Join our Statewide Effort for Single-Payer / Private Provider
National Health Insurance.
With a Single-Payer system the health care delivery system remains private.
As opposed to a national health service, where the government employs doctors,
in a national health insurance system, the government is billed, but doctors
remain in private practice.
Myth - Single-Payer / Private Provider National Health Insurance will be more
expensive
A national health insurance program could save approximately $150 billion on
paperwork alone. Because of the administrative complexities in our current system,
over 25% of every health care dollar goes to marketing, billing, utilization
review, and other forms of waste. A single-payer system could reduce administrative
costs greatly.
Myth - We don't need to fix what's not broken
Financing of health
care drives the delivery system
Lack of cost-effective system
results in medical errors, reduced access to prevention, etc.
Forty-five million
are uninsured; an additional 50 million are underinsured.
Myth - Everybody
has access through the emergency room
Emergency-room care
costs 3-5 times more than primary care.
The financial inability
to cover the needs of the uninsured has been cited as reason for closure
of a number of hospital emergency rooms.
Uninsured have a 10%-15%
higher mortality rate and earn 10-30% less due to poor health
Common
Health Care Myths, summarized from HEALTH CARE MELTDOWN: Confronting
the Myths and Fixing our Failing System by
Robert LeBow M..D., M.P.H.
Myth
#1: Everybody Has Access to Care Through the Emergency Room ERs are the most expensive and inefficient way to deliver primary care.
The uninsured have a 10-15% higher mortality rate and earn 10-30% less due to
poor health.
Myth
#2: We Don't Need to Fix What's Not Broken Major problems of US health care include poor access and lack of a
preventive health care approach. Primarily, a failing system of health care
finance drives the delivery system, which is failing the uninsured (15% of Americans),
including the chronically ill and those with preexisting conditions, who seek
care only when critically ill. An additional 50 million or so underinsured
receive inadequate care.
Myth
#3: "The Market" Is the Solution Profit is a perverse incentive for health care. Rather than quality
of care, US health care competition is based on cost and profits, resulting
in coverage for the healthy and wealthy, and exclusion of the sick and high-risk.
Since the '90s, there has been an increase of uninsured, a decrease in choice
of health care providers, and diversion of resources to administrative costs
(an estimated 25 to 50 percent), marketing and profits, with less left for patient
care. An increasing number of for-profit HMOs has resulted in failure to deal
with less profitable aspects of health care, (e.g., mental and public health).
Myth
#4: Private Is Always Better Than Public The private sector has manipulated regulations to maximize profits,
e.g., the pharmaceutical and energy (Enron) industries. Overhead costs for private
health insurance average 15 percent (global administrative costs 25 percent).
Medicare, with overhead costs of 2 to 3 percent, cannot avoid the poor, the
sick or expensive cases, like the private sector can. The bottom line: Money
spent on administration, overhead, marketing, inflated CEO salaries and corporate
profits is money subtracted from patient care.
Myth
#5: Medicare Is Going Broke Those with a political agenda of privatization or dismantling Medicare,
perpetuate the myth of Medicare "crisis." Despite exploitation by fraudulent
claims, Medicare costs actually decreased in 1999, extending its solvency to
2030. Privatized Medicare, in the form of HMOs, have decreased choices for many.
Myth
#6: We Can't Afford Universal Coverage The US spends almost twice as much per capita on health care as most
industrialized countries, with worse health outcomes. Refundable tax credits,
supplemental insurance for all, or medical savings accounts would add complexity
and administrative wastefulness. Single risk pool coverage would permit over
50 percent administrative savings (an estimated $200 billion in 2002), permitting
coverage of every person in America. Delayed emergency room care for the uninsured
is much costlier. Congressional Budget Office and General Accounting Office
studies consistently show savings for single-payer coverage. The perverse link
between employment and health insurance makes US industry less competitive in
the world market. General Motors spends nearly $3,000 for employee health for
every car made - costs passed on to consumers, and a factor in jobs leaving
the country.
Myth
#7: Americans Don't Want "Rationing" of Health Care "Rationing" is a code word, like "socialized medicine," meant to trigger
negative responses. The US currently has "rationing" or "waiting times," with
some waiting up to 3 to 6 months to see a doctor. Some uninsured have delayed
needed surgery until they are old enough for Medicare coverage.
Myth
#8: We Don't Want Socialized Medicine Like in Canada Canadians don't worry about lacking needed care, or going bankrupt
because of serious illness. The Canadian delivery system is made up overwhelmingly
of private health care providers and hospitals.
Myth
#9: The Insured Pay More To Help Cover the Costs of the Uninsured This
used to be true, but today's practice of cost shifting means that the uninsured
and people with individual insurance now substantially subsidize (paying 4 to
5 times more) the care of those with group insurance plans. The largest subsidy
to the insured occurs as tax-free insurance payments by employers, made up for
by taxes paid by the uninsured (a $140 billion federal subsidy in 2001). The
2000 WHO report ranked the US health care system 54th in the world
in "fairness."
Myth
#10: Universal Coverage Will Overburden Our System After an initial backlog of "catchup work," people would have access
to primary care, resulting in more appropriate use of emergency rooms. Primary
providers freed from administrative tasks would be more efficient. Solutions
include shifting some specialists to primary care; utilization of mid-level
clinicians, e.g., nurse practitioners; and rewards for primary care-givers in
medically under-served areas.
Myth
#11: Costs of "Research and Development" Drive Our Higher Drug Prices Drug companies have the highest profit margin of all American corporations,
with profits as a percent of sales about 19 percent, compared to a median of
about 5 percent for all Fortune 500 companies. Drug companies benefit from taxpayer-funded
drug research, and spend almost three times as much on marketing and administrative
costs as on research and development. US drug prices average 60 percent higher
than in Canada and the U.K. Most U.S.-produced drugs are not innovative, but
varieties of old drugs, developed to extend patent protections. Patent laws
have been manipulated to permit drug monopolies, exorbitant pricing, and to
keep cheaper generic products off the market. The pharmaceutical industry operates
without price controls, unprecedented among developed nations.
Myth
#12: We Can Get to Universal Coverage Through Incremental Changes Like "shoveling sand against the tide," incremental changes over the
past decade resulted in increased uninsured (about 5 million). Recent years
have witnessed annual double-digit health insurance inflation. Even with Children's
Health Insurance Program (CHIP), the number of uninsured children remains at
about nine million. Costly, complex proposals include a mix of refundable tax
credits, federal subsidies, medical savings accounts, vouchers, employer-defined
contributions, supplemental insurance, etc. Complexity raises administrative
costs and enlarges cracks in the system, through which the working poor too
often fall, with only corporate profits insured. Proposals to leave high-risk
people in Medicare, while placing the healthy and wealthy under private sector
insurance, are a huge gift to the insurance industry, and further institutionalize
multi-tiered health care.Myth # 13: Americans Won't Accept Single-
Myth
#13: Americans Won't Accept Single-Payer Universal Coverage Vested interests have attempted to discredit a single-payer approach,
invoking "hated government" and "socialized medicine." The pharmaceutical industry
has fought efforts at group negotiation of bulk rate medicines. Drug and insurance
industries have spent millions to lower people's expectations, and to oppose
the formation of a single risk pool national health insurance. Americans have
expressed overwhelming support for universal coverage. Consumers are enticed
to pay higher costs, and lulled into complacency by phrases like "consumer-directed
care" and "personal health accounts."
Contrasting
Current US Health Care Crisis with Cost-Effective Single-Payer Coverage
Opponents
of Single-Payer Health Coverage Confuse the Issue of Insurance and Health Care. "Socialized Medicine" is a purposefully confusing
term. Insurance by nature is "socialism". Ideally, many pay into a large risk
pool for the assurance of payments for necessary health care.
Canada maintains private providers and hospitals for the most
part. More accurately, single-payer health care like Canada's is "public payer,
private provider."
Tying
Inflationary Health Costs to Employment Reduces US Business Competitiveness
in the World.
In 1994, Jack Smith, former CEO of General Motors, said he
"personally favored the Canadian system" of health coverage. Big-three auto
executives wrote a letter to the Canadian government urging them to keep the
single-payer system so car dealers could hold expenses down. Auto and other
manufacturers are voting for single payer health care by moving plants to Canada
(e.g., Toyota, Ford & General Motors).
In 2005, it was reported that the cost of employee health
care to manufacturers adds $1,500 to the cost of a U.S.-made car ("Critical
Condition," James Steele).
Most foreign competitors are in countries with universal
health care, at 1/3 less cost.
General Motors pays lifetime health costs for a huge group
of retirees, making them less competitive with companies who pay subsistence
wages, and have no health care benefits or costs for retired workers.
Fewer employers are offering health care - of those who do,
benefits are declining - a condition described by Uwe Reinhardt as "unsurance."
Employee copays and expenses are increasing, decreasing take-home pay.
The New York Times reported a 48% rise in health expenses
to workers from 2000-03 (meaning less take-home pay)
Emergency
Room Care is the Most Inefficient Provider of General Health Care. Emergency room care costs 3-5 times more than primary
preventive care, reported by Consumer Health Reports, based on a 6-month investigation
of U.S. Health Care. ("Second Class," CHR, September 2000).
The uninsured are dumped on the public system, forcing overloaded
providers and hospitals to decide how much care to provide without pay. There
is no preventive or follow-up care in ER.
The Hospital Association of Southern California has reported
a "system on the brink of absolute chaos," with six emergency rooms in Los Angeles
forced to close due to increasing financial burdens of treating the uninsured.
The American Hospital Association reports that 80% of Emergency
Rooms are overcrowded, with an average wait of 4 hours. Even those who believe
they have good coverage can be diverted to other hospitals. In busy public hospitals,
ER waits of 4 days have been reported, and some have had to wait weeks for necessary
surgeries. More Problems of U.S. Health Care Annually 18,000 uninsured die prematurely due to
lack of preventive care and early diagnosis, reported a Study by the National
Academy of Sciences (The Denver Post, 5/22/02) An uninsured woman diagnosed
with breast CA is 49% more likely to die than the insured.
Forty percent of personal bankruptcies in the U.S. are due
to medical bills.
Even when they access health care, doctors note that many
patients can’t afford to fill prescriptions.
The uninsured delay care until they require emergency instead
of preventive care.
Families of the working poor make up 80 percent of uninsured.
The American Hospital Association reports that 34% of the
country's 5,000 nonspecialized hospitals, who care for a large percent of the
uninsured, are operating in the red.
The
marketplace is not a cure for health coverage.
For-profit health care is a perverse incentive, leading to
insuring the healthy and wealthy, and decreasing or eliminating benefits to
the sick, in order to maximize shareholders' profits.
Medicine and insurance are not ordinary commodities.
Most private health plans market to consumers least likely
to get sick, and limit the choices of doctors and hospitals.
Tax Credits and Medical Savings Accounts benefit the healthy
and wealthy with tax breaks; most uninsured don't earn enough to pay taxes or
pay into a MSA.
For-profit
insurance is not cost-effective.
HMOs ration health care by limiting tests, drugs, procedures,
denying coverage to higher risk consumers. Inadequate reimbursements drive some
physicians out of business.
The 24 percent of health dollars now going for management,
marketing and profiteering in our fragmented health system could be cut in half
and redirected toward health coverage.
HMOs pay huge amounts for administrative, bureaucratic costs,
advertising, skyrocketing drug costs, and create a blizzard of paperwork.
Doctors are forced to consult dozens of drug lists or formularies
before prescribing medicines, and hire extra office help just to deal with multiple
insurance forms.
A
Single Risk Pool (single payer) is the most cost-effective system of health coverage. The fact is it is more cost-effective to insure
everyone. The more uninsured, the more cost-shifting occurs, with rising health
costs for everyone.
SP is the best way to achieve cost containment - overcoming
problems of the current system, including insecurity, cost-shifting, waste and
profiteering.
Clinical waste is minimized through public health, prevention
and strong primary care.
Access to preventive primary care maximizes health, and reduces
costs and burdens on ERs.
Administrative costs are reduced - single-payer Medicare,
with 2-3% overhead, contrasts with private insurances overhead costs of 9 to
30%.
SP would curtail outsourcing of jobs and reduce administrative
costs (estimated $286 billion annually - enough to cover uninsured, create prescription
drug benefit, retrain laid-off employees & improve preventive care).
Public Support for Single
Payer Health Care A Pew Research Center Survey published 7/24/03
revealed that 72% of Americans agree that government should provide national
health coverage, even if it means repealing most tax cuts passed since George
W. Bush took office.
A 2004 Harvard Medical School survey indicated that 64%
of doctors endorsed a national single-payer system. Frustrated by costs &
cumbersome paperwork, doctors said they would cut fees if it would eliminate
piles of insurance forms.
Physicians'
Proposal for Single Payer Health Care Summary, "Proposal of the Physicians' Working Group for Single-Payer
National Health Insurance," Journal of the American Medical Association,
August 13, 2003
Michael on Bill
Maher
