New Website

We have moved our website to http://www.phillyhealth.org.  We hope you like the new look and updates.  If you are interested, join our listserve at phillyhealth@yahoogroups.com or by donating to us.  You can also come out to one of our general monthly meetings and help us promote the single payer message in Philadelphia.

Health Care Reform: We're Not Done Yet! April 4, 7 PM, Free Library

This past week marked the first anniversary of the landmark health care reform law.  It will profoundly reshape health care in the next decade, but most people do not understand it or understand its implications. I will be explaining the bill:  the good, the bad and the ugly and explain why while the bill is a landmark change, there is much more that needs to be done.  Since this will influence everyone and cost hundreds of billions of dollars, it would be wise for people to learn about this.  Come for a free lecture at the Free Library of Philadelphia.

Health Care Reform:

We’re Not Done Yet!

Monday, April 4, 2011,

7 PM to 8:30 PM

Free Library of Philadelphia, Central Branch

 1901 Vine Street, Philadelphia 19103

Free and Open to Everyone

Walter Tsou, MD, MPH

Physicians for a National Health Program

Whether you agree with, are outraged by,

Feel indifferent to or just wish to be better informed

Please come & voice your opinion on

The Patient Protection and

Affordable Care Act of 2010

(Aka the Healthcare Law of 2010)

Unless we fix health care, we cannot fix our economy.

Sponsored by: Health Care for All Philadelphia;

Health Care for All Pennsylvania; Healthcare-NOW; Physicians for a National Health Program PA.

Contact: 

Labor Donated

March 8 ONLY, Change of Location of HCAP General Meeting

On Tuesday, March 8 ONLY, the HCAP General Meeting will move from Community College of Philadelphia to Temple Univ, Gladfelter Hall, Room 614. This change is necessary because CCP is closed for spring break. Gladfelter Hall is at 1115 West Berks Street on Temple Univ Main campus. Street parking is best along 11th Street between Norris and Montgomery Avenue. Walk to the building with the GH sign in the window. Sign in at guard station and take the elevator to the 6th floor. Walk left and you will find Room 614 down the hall on your left. This is a special meeting to fold envelopes for our fundraising letter.

Corbett hypocricy on Adult Basic

Unless Governor Corbett acts quickly, by March 1^st of this year, 42,000 Pennsylvania residents will loose their health insurance and join the already one million-plus in the state without coverage. Adult Basic, a health insurance program designed for adults who don’t qualify for Medicaid, but earn too little for private-market insurance, is scheduled to be terminated in the state on February 28^th.

The program, initially launched about a decade ago to deal with the still unresolved nationwide health insurance crisis, has largely been funded by Blue Cross/Blue Shield in an agreement related to their tax-exempt status. Now that their obligation to contribute to the program is coming to an end, the Blue’s, despite reaping record profits and continuing to add to its enormous reserves, are refusing to offer further support for the program. Governor Corbett’s staff have told me they “appealed to the federal government” for assistance, but that’s just not good enough.

I’m not sure whether its more shameful that our Governor, who was among the first Attorney Generals in line to challenge President Obama’s health reform package, is now turning to the federal government in a last ditch attempt to preserve insurance for Pennsylvanians, or that the Blue’s, a “charitable organization” that made their billions selling health care, are going to stand by and let thousands of hardworking adults loose their coverage.

Either way its clear that money, as it always has been, is being put before people when it comes to health care. Perhaps the greatest irony of all, is that when these 42,000 begin utilizing hospitals and other medical services without insurance, the costs of their uncompensated care will ultimately be passed on in the form of higher premiums to the rest of us- including those that voted to put the “fiscally responsible” Corbett in office, who is now gambling with the lives of thousands.

Our "Empire" is among "worst of the worst" in life expectancy

The New York Times has an op ed that is worth seeing today, February 19th. It has a table that compares the IMF's "Advanced economy" countries on various measures. The article says "on a whole host of measures we have become the laggards of the industrialized world," and it points out that the newly-submitted Republican budget would makes things far worse.

The criterion seemingly most overtly connected to health care is "Life Expectancy At Birth," where the US received a "worse of the worst" since the age is 78.24 (numbers were close here for many countries). (Other countries were very close in age of life expectancy and yet didn't receive worse of the worse rating.)

The US also did poorly in certain other areas relevant to health. Such measures were "Food Insecurity" (people were asked if there were times in the past 12 months when you did not have enough money to buy food you or your family needed). The percentage answering "yes" in the US (16%) was the highest of the 33 countries considered, with Korea sharing that percentage. No other countries were even close, except for Italy and Israel (15%), and Spain (14%). Countries in which nobody said "yes" to that question were Australia, Norway, Austria, Finland, Belgium, Malta, Iceland, New Zealand, Luxembourg, Czech Republic, Taiwan, and Slovakia. Our score on income inequality was by far the highest except for Singapore and Hong Kong. Our number of prisoners per 100, 000 (related to health in my estimation, especially mental health) was off the chart at 743, with the next highest being France at 365. On unemployment we were only in the "Worst" category at 9% (but we all know our records are fudged, and the real figure is estimated at 15% I have heard), with with Greece, Spain, and Portugal being in the "worst of the worst" category (between 10 and 20%). In a category called Wellbeing Index ("percentage thriving" Huh?), we were in the "Best" category at 57%. Huh? There was no rating of the health care system, but we all know it.

Mark your calendar, April 4, 2011

Dr. Walter Tsou, Health Care for All Philadelphia will be speaking on "Health Care Reform:  We're Not Done Yet!" on Monday, April 4, 7 PM at the Free Library of Philadelphia, Central Branch, Montgomery Auditorium.  The presentation will highlight the new health care reform law including some good, bad and ugly stuff, and then why a single payer health plan is still needed in American in order to bring jobs back to America.

Snow cancellation

Due to the predicted snow on Tuesday, Jan. 11, 2011, the Health Care for All Philadelphia General Meeting will be cancelled.  The next general meeting will be on Tuesday, February 8, 2011 at the Community College of Philadelphia.

Students for single payer organizing meeting

Hello student leaders,

 

As many of you read in my first email below (and others have been referred by people who did), we at Health Care for All Philadelphia are trying to bring together medical and health professional students from all the schools in Philly to advocate for a single payer health care system.

 

We will be meeting at 3PM in the Hamilton Building at Jefferson Medical College TODAY Saturday Dec. 18th to brainstorm and set an agenda for the coming year, including hopefully: an single payer education event at each school in early 2011 and a trip to Vermont to join hundreds of other meds student stating 'single payer is what we want for our future.'

 

Please come if you can and let me know if you are interested in joining (and helping to lead!) this effort, but cannot make this meeting. (I understand this is very last minute notice for many of you, but wanted to include as many people as possible on the notice.)

 

The address for Hamilton is 1001 Locust Street. We will gather in the lobby.  Call me at 203 668 6669 if you need further directions.  Jen

Fiscal Solutions Tour Misses the Obvious Solution

The Fiscal Solutions Tour stopped into Philadelphia on Friday.  Who are these 5 white guys?  Well, they represent the brain trust behind the National Debt Commission and are proposing "solutions" to our $13.6 trillion budget deficit which grows astronomically.

So the tour guides are:
Robert Bixby- Executive Director of the Concord Coalition, a non partisan "grassroots" organization dedicated to fiscal responsibility.
Douglas Holtz-Eakin - former chief economist of President Bush's Council of Economic Advisor, former Director of the CBO, and former Advisor to Sen. McCain's residential campaign.
William Novelli - Professor at Georgetown Business School, former President of AARP, founder of the public relations firm, Porter Novelli
Eugene Steurle - Fellow at the Urban Institute, former President of the National Tax Association
David Walker - founder and CEO of Comeback America Initiative, former CEO of the Pete Peterson Institute and former US Comptroller General

A distinguished but biased group.  Our FY 2010 budget includes $2.14 trillion in revenue and $3.49 trillion in expenses leaving us with a $1.3 trillion dollar deficit.  More than 50% of our deficit is held by foreign countries.  Our major budget expenses are health care and Social Security.  Our deficit, unchecked, will be 235% of our GDP by 2035.  This, of course, is unsustainable.

We agree with the problem, but their solutions - namely severely cutting Medicare, Medicaid and SS are a recipe for disaster.  Interestingly, the budget for defense in the US exceeds the next 14 countries COMBINED (including Russia and China).  This is an obvious area that needs cutting.

In terms of health care, David Walker's slides makes general comments like "reduce the rate of increase in health care costs and target taxpayer subsidies (largely the tax deductibility of insurance premiums)" and "future health care reforms consider cost, quality, coverage and personal responsibility (read high deductible, consumer directed health care)".  Doug Holtz-Eakin is the "health guru" among this group and he clearly let his disdain for single payer come through by saying that government funded health care is not a solution.  During the Q and A I asked why not single payer since every other country in the world has used this as a way of controlling cost?  He answered that he was more concerned about having "a budget than whether it was single payer or not"  There was no opportunity for followup questions since time was running out.

One thing that is clear is that if you had a fixed budget for health care and had the providers and insurers all fighting for the same pool of money, it would quickly become obvious that the insurers served no useful purpose and that the money would go farther if the "budget" directly paid the providers to care for patients.  Hmm . . . sounds eerily like single payer.  So, I believe their ideology precludes them from seeing single payer, but if we use their solution and put everyone under a fixed budget, I think the absurdity of the insurance industry would become obvious.

Health Care Reform: We're Not Done Yet!

Health Care Reform: We're Not Done Yet!
Public Event (free!)

Sunday, October 17 · 3:00pm - 5:00pm

Summit Presbyterian Church
6757 Greene St., corner of Westview and Greene Sts.
Philadelphia, PA

Curious about the new health reform legislation? Come to our free public meeting on the new Health Reform Bill. Hear about economic, moral, and faith-based reasons for continuing to work for health care reform and why there is still more to do.

Rev. Cheryl Pyrch, Pastor Summit Presbyterian Church

Walter Tsou, MD, MPH, Physicians for a National Health Program

Free child care, Light refreshments For more information, call 215 438-2825

Sponsored by Presbyterian Church USA, Health Care for All Philadelphia, Health Care for All Pennsylvania, Healthcare-NOW, PNHP PA, Weavers Way Education Committee, Summit Presbyterian Church,

Labor Donated

America Spoke

On June 26, America Speaks, a non partisan group conducted the largest national town meeting on the budget deficit in 19 cities across the country.  This 6.5 hour marathon consisted of about 3500 people who were meant to be representative of America.   We were given the task of cutting 1.2 trillion dollars from the federal budget by 2025.  

The initial demographics suggested that there were equal numbers of men and women, liberals (44%), moderates (23%), conservatives (33%), a larger number of those older (55+) than the US population, and fewer Latinos.  People were more supportive of government spending (51%) than not adding to the national debt (38%) at this time of recession.  61% felt government should do more to strengthen the economy.  People were equally divided between taking care of the current generation vs. redirecting resources for "future generations" and equally divided between government caring for the most vulnerable and individual responsibility to take care of oneself.  More people felt the rich should pay higher amounts to reduce the deficit.  

It was interesting to hear how people balanced the choices (which were pre chosen by the sponsors) between cuts in spending and raising revenue.  The final report won't be out for several weeks, but my impression was that people were angry about the undue influence of lobbyists and corporate interests over that of ordinary people.  The recent decision not to extend unemployment benefits and FMAP funding for Medicaid is a perfect example of this.

People favored raising taxes over cutting health care or social security.  When people were asked if they would cut Medicare and Medicaid by 5, 10 or 15%, the largest group (38%) said they wanted no cuts.  Many felt that the choices were too limited (in the "options workbook" there is this statement "at the moment, the nation does not seem prepared to consider fundamental reform of the kind suggested in the first two approaches above - premium support or single payer."  Amazingly, when people were asked to comment on their health cuts, there was a huge support for single payer health care - enough to get into the final report.  In Philadelphia, which was the host center for the entire America Speaks program and where I was one of the 450 people who showed up, there was loud clapping for single payer.  Dr. Alice Rivlin was in the Philadelphia conference all day and is one of the members of the debt commission.  I went up to her and pointed to my T shirt which said "It's simple:  Medicare for All".  She most assuredly heard the response to single payer.

There was one area that people definitely wanted cut - defense spending (85%) and raise taxes on corporations to 40% (59%), millionaires (68%), a carbon tax (64%) and stock and bond trading (61%) with the goal of cutting 1.2 trillion by 2025. 

I have to say that the technology was pretty impressive.  There were live camera interviews from all of the sites cross the country.  Everyone of the 3,500 people had keypads which allowed instantaneous polling within 20 seconds of asking a question.  Each of the sites had tables with 6-8 people randomly assigned and a facilitator who discussed all of these issues.  Each table had a laptop and free form comments were invited which allowed other choices besides the ones prescribed by the organizers.  I was surprised at the consensus at my table.  If there were teabaggers, they did not make their presence known in Philadelphia.

AmericaSpeaks says that there is a scheduled meeting next week to discuss these national findings.  They have access to key Congressional staffers and some members.  I, of course, am too cynical to believe that it will make much of a difference since our politicians are totally bought off by the lobbyists.  I remember the town hall meetings in 2006 leading up to the health reform debate which also supported a single payer system.  It was not even a consideration for the politicians.  

But for those of us in the town hall meeting, I think the message was pretty clear - raise taxes on those who have the money, cut defense, don't cut services for main street Americans, and stop listening to special interests and start listening to the American people.

Stop Feeding the Health Insurance Monster and Fix our Deficit!

The only solution to our budget deficit is single payer, national health insurance plan which cuts out the for profit, private insurance industry who literally take hundreds of billions off the top for themselves and forcing 50 million Americans to be without health insurance. America spends 50% more per capita than Canada does on health care. What is the difference? Canada has a balanced budget for the past decade. America’s deficit is $13 trillion dollars. Canada can control health care costs. America’s health care costs are bankrupting our country. Canada has single payer. America does not. Go figure!

You can stand up against this waste of taxpayer dollars by demanding that we stop subsidizing the for-profit, private health insurance industry and institute a single payer system, similar to HR 676. (www.healthcare-now.org).  In Pennsylvania, ask your representatives to support HB 1660 or SB 400, the Family and Business Health Security Act, which would institute a single payer health plan in Pennsylvania. Governor Rendell has stated he would sign the bill if it is passed. (www.healthcare4allpa.org).

Come to our teach-in on July 17, 1-4 PM, ABC Brew Pub, 2nd floor, 50 N. Cameron St, Harrisburg, PA

Kevin Zeese on "health reform" and next steps

an excellent, but long article.


By Kevin Zeese
Prosperity Agenda
A year ago health care was in crisis. Its cost burdened individuals, businesses, and all levels of government. Americans were dying at a rate of 45,000 per year due to lack of access to health care, health care bankruptcies were rising. Change was urgently needed. The crisis was an opportunity to create the best health care system in the world.
Because we have extensive experience with three health systems, we could have had a very informed debate. The U.S. has a market-based system (private insurance-controlled health care); a single payer system (Medicare) and a socialist system (the Veterans Administration). We could have asked which worked best, which covered the most people, which was least expensive, and which produced the best health outcomes. This fact-based discussion could have resulted in putting in place an efficient, effective national health system moving the U.S. into the top tier of health programs from its current dismal ranking of 37th in the world.
But, that debate never happened. Right from the outset President Obama and the Democratic leadership decided to consider only a private insurance, market-based solution. A real debate would have found that the market approach was the least effective and most costly part of American health care. In the end we got the pre-ordained decision; market-based health insurance was further enshrined with all its administrative and bureaucratic costs, its unfairness and inability to provide health care to all.
Over the last year, Democratic and Republican partisans in and out of government have made the debate on health a misleading one. False distractions like 'death panels' and 'government take-over' kept the right wing and Republicans fomenting and angry when neither was occurring. On the left, the public option, always miniscule and never really on the table, was the primary focus of non-profits aligned with the Democratic Party. This non-issue distracted progressives from the real issues and divided Americans who wanted real reform.
Reality is still hard to see through the fog of partisan rhetoric. The Republicans continue to claim socialism and a government takeover of health care, when the law is neither. And, the Democrats have been high-fiving each other and claiming they’ve achieved the equivalent of Social Security, the Civil Rights Acts, and Medicare – none of that is true either.
When the rhetorical fog lifts, we will see the system has not changed much. Health care will still be dominated by profit-driven insurance companies. More public money will go to executive salaries and private industry profits. Tens of millions of people will remain uninsured and costs will continue to increase. The challenge for the future is how to get public dollars to go to the nation’s public health and not to corporations that serve as middlemen that do not provide health care.
The centerpiece of the “reform,” subsidizing the insurance industry, forcing Americans to buy their overpriced product and more deeply embedding insurance market-control of health care, was barely debated. Only after passage of the bill is a debate beginning on whether this is within the constitutional power of government. Of course, the corporate media are saying the mandate is constitutional, not surprisingly since it is in the interests of corporate power. But never before has the federal government required Americans to buy a product. This unprecedented expansion of federal power raises a very real constitutional question that expands the Commerce Clause at a time when the Supreme Court is reining it in. Putting on my lawyer hat, I see this as unconstitutional and in the end it will be decided by a divided court. Click here and here for links to the legal arguments from a progressive and conservative perspective.
We never had a debate about whether it is a good idea to have the federal government force Americans to buy a corporate product. This major, unprecedented approach was lost in the din of death panels and the public option. Where does this precedent lead? Should Americans be forced to buy a retirement plan from JPMorgan or Bank of America to ensure retirement security? The U.S. already gives hundreds of billions annually in corporate welfare through crony capitalism, disguising it with "free market" rhetoric, not even counting the massive bailouts of the last year. This new form of corporate welfare will extend the big business-big government connection in new ways and further the pay-to-play politics of Washington, D.C., with more corporate money polluting politics.
The new law forces Americans to buy a corporate product that is overpriced and flawed. Americans could be required to pay up to 9.5 percent of their income on insurance that only covers an average of 70 percent of their medical expenses. In addition, insurance is allowed to deny care with no court review of that decision. As a result, someone with insurance, paying an expensive premium, could find themselves in bankruptcy as a result of this law. The major cause of bankruptcy before this bill was a health care crisis and a majority of those people had insurance. That will remain true under the new law.
What did we get? There were some attempts to fix insurance abuse, but every fix had a poison pill added by the insurance industry. A good example is insurance no longer being able to deny care for pre-existing illness. The poison pill, which may actually make things worse for more people, is the industry can charge people who do not meet their wellness guidelines double what they charge others. And, if you are older, they can charge triple. So, while you cannot be denied insurance, will you be able to afford it?
We also got expansion of coverage. The largest source of expansion is Medicaid – 16 million more people will be covered. Medicaid is woefully underfunded poverty medicine that pays doctors such poor reimbursement that many refuse Medicaid patients, and it does not cover all health needs. States are already stretched thin trying to pay for Medicaid resulting in more cuts to services and lowered payments to doctors. The federal government provides financial assistance but that ends in 2016. Relying on Medicaid re-enforces a caste system where health care depends on wealth.
The other expansion of coverage depends on people buying insurance. For many the penalty in increased taxes will be more affordable than health insurance. And, businesses will find that it is much cheaper to pay a small fine than to provide insurance. More people will be pushed into the individual insurance market where the cost of insurance is rapidly increasing.
Perhaps the change that will have the most positive impact is one produced by Senator Bernie Sanders; a deal he got for not forcing a vote on single payer in the Senate, the expansion of funding by $12.5 billion for community health centers so that they can double the patients they see. Community health centers are the foundation of primary care for residents of rural areas and inner cities, providing basic services such as blood and dental work for about 20 million U.S. residents.
I’m not going to review every detail of the bill here. Two clear-sighted reviews come from National Nurses United, the largest nurses union, and Physicians for National Health Program. You can see those here and here.
Maybe more important than the specifics, because most of those have insurance company-written poison pills that undermine them, is that for the first time ever in U.S. history, the law codifies the view that all people should have access to health care, regardless of age, income, health or employment status. This bill does not achieve the goal, after fully implemented it leaves 23 million (at best) without health insurance and tens of millions more with inadequate health insurance because they are on Medicaid’s poverty care or their private insurance does not fully cover them.
Now the law states an aspiration. Just as the U.S. is working to become a more perfect union, health care policy needs a lot of work, indeed some important paradigm shifts, before we achieve good quality health care for all.
What should real reform advocates do now?
The first step is to know clearly what we want: Public dollars should only go to health care not to insurance expenses, profits, and bureaucracy. That means a national health program based on expanded and improved Medicare for all so we cost effectively provide health care to everyone in the United States.
Organize a movement to achieve that clear purpose. Build from the base up, organized around congressional districts. The foundation of this movement will be a well educated and unwavering core group that will not compromise on core principles. There are already many strong organizationms working for real reform (see Health Care Now!, Physicians for National Health Program, Single Payer Action, National Nurses United, Progressive Democrats of America, Prosperity Agenda) that did not compromise and no doubt many of the groups that compromised now see that the result was unsatisfactory. And, polls consistently show majority support for a single payer national health program, so we are further along than many realize.
Apply strategies and tactics designed to achieve that end. We need to build a foundation of broad-based education and an understanding that you cannot compromise or effectively regulate the insurance industry. All the traditional tools of advocates have a role in the single payer movement: lobbying, litigation, voter initiatives, state-level reform, protest, civil resistance and elections to achieve our goals. On elections, the single payer movement needs to challenge incumbents in primaries and General Elections. The latter may be where we have more power. The movement must be independent of either political party. One lesson we should learn from this year is we cannot count on any ally in Congress until we build a movement that adds to our power and theirs.
A particular spotlight needs to be kept on the insurance industry. Their behavior will not change with the new law, indeed it will worsen. Single payer advocates need to continue to highlight their abuses, denials of care, excessive executive salaries, rapid increases in premiums and cut backs in coverage. Tools like shareholder actions, boycotts and divestiture need to be used. When abuses occur the movement needs to use tactics like sit-ins at insurance companies to show that people are angry. See www.MobilizeForHealthCare.org.
Those who recognize the need for real reform should not get stuck within the framework of the status quo. Now that the Democrats have further enshrined the insurance industry, some will urge that we work within that framework to improve the law. Tinker with insurance regulation, increase subsidies and increase penalties for not purchasing insurance. The framework of the law is insurance domination of health care. We need to change the framework, not work within it.
There will be a special push for a public option or lowering the age of Medicare. We cannot be fooled by this. These types of programs leave in the place the bureaucratic and expensive profit-driven insurance system. Such approaches only have a marginal positive gain if everyone – those with insurance and those without, whether they get their insurance from work or the individual market – are able to participate. If these programs are limited to those without insurance, as all the proposals considered did, they will do more harm than good because they will become a dumping ground for those who are priced out of the insurance market because of illness or age. It will make the public program fail and add to industry profits. We need to end insurance market-based health care and put in place a national public health system that is publicly funded and covers everyone.
The last year has seen an expansion of activism from those who favor improved Medicare for All. It is critical that the momentum of the movement not be slowed by a law that protects the status quo even if it is called reform. The urgent need for such change remains as tens of thousands will continue to die annually, and hundreds of thousands (mostly with insurance) will go bankrupt. The task of providing health to all as a birth right still remains.
Kevin Zeese is executive director of Prosperity Agenda.

Reflections on the House health bill

Below is the response from Physicians for a National Health Program on yesterday's House vote.  But first, my comments:

Yesterday, the House of Representatives took a huge step in embracing the principle of health care reform.  Much of the language used resembles the rhetoric that would sound like single payer ("universal coverage", "health care is a right", "no longer would people be denied coverage", etc.).  Unfortunately, the promise is better than the reality and the plan fundamentally relies on the for-profit, private insurance industry to rely on providing this coverage.

Given their track record and their demand for shareholder profits, we should be very cautious.  

If you want an idea of how much this will cost and whether you will get a subsidy to fund health care, go to the Kaiser Family Foundation subsidy calculator to get an idea of how much insurance will cost you.  (Look up the reconciliation bill version which is what passed last night).  You may be surprised at the cost.  

Frankly, we will still have the most expensive health care system in the world, by far, (http://blogs.ngm.com/.a/6a00e0098226918833012876a6070f970c-800wi) because we are unwilling to face the reality that the feared "government takeover" of health care is the bitter medicine that we need to control costs.  We would like to believe that a competitive private insurance industry can lower costs, but we have 50 years of evidence that this belief is misguided.  Within that framework, we have asked the insurance industry to stop excluding people with preexisting conditions, no more recissions, no lifetime caps, no medical underwriting, etc.  This is good, but insurers are unlikely to do all this without raising premiums or cutting benefits and AHIP's statement essentially assures they will do just that.

We should note that America's Health Insurance Plans have released a one sentence statement about the reform plan which basically assures us that there will be increases in premiums:

AHIP Statement on Health Care Reform Legislation

   

Washington, D.C. – America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni today released the following statement on health care reform legislation:

“The access expansions are a significant step forward, but this legislation will exacerbate the health care costs crisis facing many working families and small businesses.” 

We will never control costs and preserve access without taking a step toward single payer health care, perhaps by expanding Medicare. This was not our step yesterday.  But in the global economy, we have to start moving this way or employers will find themselves stuck with unaffordable insurance premiums.  I am willing to support candidates who clearly understand this and are willing to support single payer, while still getting people health insurance using our flawed private insurance model right now.  But eventually, we will have to make the really tough decision which we avoided with this legislation.

So today, I rejoice that we made a step toward the idea that we need to fix our health care system, but we have not made the tough choice to move us toward single payer that we have to make to control health care costs and that will position our country to be competitive in a global economy.   For those who don't want to wait until 2014 to see insurance expansion, we have a chance to prove the benefits of single payer in Pennsylvania with the passage of SB 400/HB 1660, the Family and Business Health Security Act.  Walter

______________________________

Physicians for a National Health Program

News release

March 22, 2010

A False Promise of Reform

The following statement was released today by leaders of Physicians for a National Health Program, www.pnhp.org. Their signatures appear below.

As much as we would like to join the celebration of the House's passage of the health bill last night, in good conscience we cannot. We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem - the profit-driven, private health insurance industry - this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers' defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:

* About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.

* Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.

* Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.

* The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.

* People with employer-based coverage will be locked into their plan's limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.

* Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.

* The much-vaunted insurance regulations - e.g. ending denials on the basis of pre-existing conditions - are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.

* Women's reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

It didn't have to be like this. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid - a woefully underfunded program that provides substandard care for the poor - could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers' health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill's passage reflects political considerations, not sound health policy. As physicians, we cannot accept this inversion of priorities. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That's enough to cover all the uninsured and to upgrade everyone else's coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to "wait and see" how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.

Oliver Fein, M.D.

President

Garrett Adams, M.D.

President-elect

Claudia Fegan, M.D.

Past President

     

Margaret Flowers, M.D.

Congressional Fellow

David Himmelstein, M.D.

Co-founder

Steffie Woolhandler, M.D.

Co-founder

     

Quentin Young, M.D.

National Coordinator

Don McCanne, M.D.

Senior Health Policy Fellow

Meeting on March 9 only

The March 9 general meeting from 7-9 PM for Health Care for All Philadelphia will change to the Edmund Bossone Research Center, 3141 Market St, Drexel University in the student lounge area as you walk in the door on Market Street, turn left.  The front door is actually across Market Street from the Soverign Bank parking lot.

Before the meeting, come join us to watch Money Driven Medicine based on a book by Maggie Mahar, who will BE there herself to answer questions in Mitchell Auditorium from 5-7 PM.

Reflections on Arcadia

I was lucky and got tickets in the VIP section in front of the audience literally 10 feet from Obama at Arcadia University. It was a pretty awe inspiring speech with a very supportive and enthusiastic crowd. A few dissenting shouts could be heard and one moment he looked up and people reacted by saying "let the President finish".

The President was introduced by a single woman faced with a doubling of her insurance premiums and saying that something had to be done. The audience had been standing waiting for 3 hours to hear Obama and when he came in, it was a thunderous reception. He began by saying it was good to get out of Washington.

His loudest ovations came when he said that insurance abuses had to end like exclusions for preexisting conditions, that people should be able to buy the same plan as members of Congress and that Republicans had 10 years to do something about health care costs and did nothing and now they are critics of his plan. "If not now, when? If not us, who?".

His message was that Congress needed to pass the bill and that Washington spent more time worrying about the elections and not enough time about the concerns of the people.

At one point he said that, "some people want a government takeoever of health care" to which there was a loud applause including a few of us who shouted, "single payer". He seemed to ignore it, but it was notable and unlikely to be reported by the media.

His final comment was that he wanted us to get Congress to pass his health care bill.  Nothing new that hasn't been said.  

Philadelphia saves under single payer

What's up today?

CITY OF PHILADELPHIA COULD SAVE $381,011,939 PER YEAR ON EMPLOYEE HEALTH CARE COSTS UNDER LEGISLATION NOW PENDING IN HARRISBURG

Philadelphia City Councilman Bill Greenlee (At-Large) will accept a symbolic check made out to Pennsylvania taxpayers by leaders of the healthcare reform group “Healthcare4allPA” at a press conference scheduled for Thursday, February 4, at 9:00 am at City Council’s Caucus Room, Room 401, City Hall, Philadelphia.

According to surveys conducted by the statewide health advocacy group, under provisions of the bills, HR1660 and SB400, Philadelphia could reduce its current spending on health benefits to its workers by more than $381 millions per year.

The bills provide for a flat 10% payroll tax and a 3% individual income tax to cover all health related expenses, including prescriptions, dental, vision, and other – without charging additional costs to consumers.

“We are working to totally revamp the current way of paying for healthcare in Pennsylvania with our initiative,” said Healthecare4allPA chair Cindy Purvis. “One of the surest winners of our proposal will be municipal and local governments and school districts, which will see their health care expenditures shrink. In the end, taxpayers will be double winners: more resources for other vital programs and access to quality affordable healthcare everywhere in the Commonwealth of Pennsylvania,” she added.

Councilman Greenlee was the main author of a resolution supporting the Pennsylvania bills last year. Since Philadelphia, the cities of Pittsburgh, Lancaster and Wilkes-Barre have adopted similar resolutions in support. of the bills, also known as the Family and Business Health Care Security Act.

For more information, and to read the text of the bills, as well as other pertinent information, go towww.healthcare4allpa.org.

Leticia Roa Nixon

Philly 13 arrest and Insurance skit

Our video showing the arrests of the Philly 13 who demanded single payer and a little skit on insurance.

http://www.youtube.com/watch?v=MKZlAYPw3jU

Observations on Senate Banking and Insurance Committee hearing on PA single payer plan

Observations of Dr. Walter Tsou, former Philadelphia Health Commissioner, and Chuck Pennacchio, Executive Director of Healthcare for All Pennsylvania, on yesterday's (12.16.09) Pennsylvania Senate Banking and Insurance Committee hearing on SB 400.

Chuck Pennacchio:

In addition to Walter's more detailed observations and insights below, I'd like to make a few key points intended to translate events and chart a path forward for passage of SB 400/HB 1660 at the earliest possible moment.

First, it was obvious that our SB 400 testifiers -- including Senator Jim Ferlo's tone-setting statement at the top -- were far better prepared, passionate, and on-point than our opponents.  But no need to take our word for it.  The glowing wrap-up comments of Chairman White, his decision to extend the hearing time an additional 50 minutes, his desire to continue the hearings and research and bill-writing process, as well as his personal congratulatory handshake while saying, "your panel did a terrific job," give us real hope that we are within shouting distance of accomplishing what all of us need -- a healthcare system that, in moral and economic terms, puts patient care and dignity first and foremost.

I was also pleased with the preparedness, comments, and questions of Senator Jake Corman, part of the GOP leadership team, Chair of Senate Appropriations, and member of Banking and Insurance.  His grasp of issues, embrace of our "new ideas,"  openness to our fair-share health and wellness tax, and query of SB 400 opponents (exposing their ignorance of Single Payer) are all good signs.  

This leads me to a broader discussion of the significance of what happened yesterday...

I know, I know, you say, we've been here before.  Right?  Politicians raising our hopes and then letting us down.  Actually, so far and past and present experiences inform me, I perceive elements remarkably different and, I believe, promising.  

For starters, it's time to imagine what is unimaginable to many (or most?) citizen activists.  And yet, the "unimaginable" is a course Healthcare for All Pennsylvania has been on since 2006 -- a course that subsequent events have borne out.  

Based on a repeatedly validated assumption that, because of the destructive effects of campaign contributions from health insurance, pharmaceutical, and allied interests to politicians in both major parties, as well as a political culture of "incrementalism," we must be fiercely non-partisan, evidence-based, organizationally sound, forthright and flexible, and mindful of our federalist constitution and political history.  

In other words, we have long held that the winning coalition around the proven Single Payer Solution will be comprised of "conscience Republicans" and "conscience Democrats," beginning with one of our "modeling" fifty states.  And, in the case of Pennsylvania, not only do we have political advantages that others do not, but we have what appears to be a thoughtful and courageous GOP leadership on the joined issues of healthcare delivery, healthcare economics, and healthcare financing.  Put another way, we have legislative leadership in the State Senate that "gets it" -- analysis of problems, openness to policy prescriptions, and a feel for the political choreography needed to bridge policy pieces, key players, and central institutions.   

Finally, and by way of consensus emerging from yesterday's historic Banking and Insurance Committee hearing, our next critical step is to raise the funding to complete our ECONOMIC IMPACT STUDY.  Two months ago, you and other HC4APA supporters provided the $5,000 in seed money to get us to the point where we are today.  Now, with the study prospectus in hand and bidding negotiations finalized, it is on all of us to raise an additional $49,000 to complete our EIS and, provided the learning experiences of other states, "grease the legislative skids."  We truly are that close.  So, obviously, if you can give, do so to the best of your ability.  If you know others who can contribute, please ask them to help as well.  And if you know folks who are serious enough about considering a donation, but need a briefing on SB 400/HB 1660, let us know that as well. 

Dr. Walter Tsou:

"My overall impression was this was an enormously successful and impressive showing for Pennsylvania state single payer.  Yes, I may be biased, but our four panelists did a superb job in explaining the Family and Business Health Security Act.  To explain why I say this, consider the concluding remarks of Senator Don White, Republican Chair of the Senate Banking and Insurance Committee.  First, Senator White offered that "there were those who said I should not have this hearing" -- a clear rebuke of the fearful during this time of healthcare and economic crisis.  Second, whereas in his opening comments he downplayed expectations for the hearing as a "fact-finding session only," by the end, his praise of the Single Payer presenters was so "positive," he declared that this opening act was just the beginning of a series of hearings on this most important topic.

  

 The hearing began with Senator White, a former insurance broker, welcoming everyone and inviting Senator Jim Ferlo, the lead sponsor of SB 400, to present some opening thoughts.  Ferlo explained the need to look at different approaches rather than be tied to the usual failed insurance model.  Among other attributes, he said that the state Single Payer plan would free employers from the onerous burden of skyrocketing health insurance costs by, instead, providing healthcare for everyone at far less cost.

Chuck Pennacchio, Executive Director of Healthcare for all PA spoke next and further explained the particulars of the state-level, Single Payer approach, and how it represents values we can all embrace: freedom, choice, fiscal conservatism, personal responsibility, modeling solutions, constitutional federalism, fair-share taxation, efficiency, transparency, accountability, jobs creation, bureaucratic streamlining, investment and reinvestment, coordinated and comprehensive care, reduced rationing, restored patient-provider relationship, healthy outcomes, tort remedy, end bankruptcy fears, healthcare education, "medical home" data base, and more.

Patricia Eakin, RN from Philadelphia explained that she was a nurse in one of the busiest ERs in Pennsylvania at Temple and that she sees the problems of the lack of insurance on a daily basis.  She gave some examples of the problems faced by people who have lack insurance.  She noted how her hospital was losing money because they had to spend limited resources on billing personnel, and had to absorb, and/or pass along, financial losses on people without insurance or on Medicaid.

Dwight Michaels, MD, a Republican, and family practice doctor from Gettysburg, spoke about how his experience with private insurance bureaucrats had driven him to support the Single Payer Solution.  He said it is increasingly difficult to practice medicine because his five-person practice struggles daily with 20 different insurance plans, all with different rules.  This bureaucratic nightmare makes it impossible to spend quality time with his patients because he is forced to justify more and more of his procedures with the insurance carriers.  Dr. Michaels' testimony was a vivid description of the life of a family doctor in a dysfunctional system.

David Steil, a former Republican state legislator and head of a small manufacturing business was another inspired choice.  Not only did he know all of the Senators but, as a creative-thinking lawmaker, he broke the stereotype that all Single Payer supporters are lefties.  Mr. Steil spoke about how he tries to run a business, but the cost and hassle of health insurance has made his company more vulnerable in an international market where his non-American competitors have far cheaper health costs.

I think this panel worked extremely well.  Not only were they excellent speakers, but they spoke from real world experiences, not as paid lobbyists.  And two were Republicans which was an added bonus.  The committee had many questions, but none were nasty and all seemed genuinely interested in the real world experiences of the panelists.  And the room was packed with 90% supporters of SB 400.  I don't think this was lost on the committee.

The opposing panel were all known lobbyists for their respective interest groups.  They gave the usual refrain of condemning single payer.

NFIB speaker - he simply declared that small businesses don't want Single Payer, but admitted that healthcare costs are the number one concern of businesses.  They want the same outcomes that only Single Payer provides.  But since that involves "government bureaucracy," it cannot possibly work.

PA Medical Society - wants tort reform but not Single Payer because it would be too powerful in controlling reimbursements (and costs).

Capitol Blue Cross - gave a confusing talk about the problems with the Washington federal bill and then simply concluded that SB 400 is just like the Washington bill and should be rejected.  Of course, nothing in the federal bill even resembles Single Payer, which is why it is so unpopular. 

Hospital Association of PA - opposes any government controls generically.  Gave a knee-jerk opposition to Single Payer.

Insurance Federation of PA - same as the hospitals.  They oppose Single Payer as "monopolistic" -- working from the assumption that the 35-cents-on-the-healthcare-dollar insurance "middle man" is indispensable, and that a little more regulation and industry "innovation" will solve cost issues.

There was not much time for questions but, frankly, they were special interest lobbyists and not a very interesting opposing panel.  If this was a debate, the clear winners were the Single Payer SB 400 panel who did a great service in advancing state-level Single Payer today.

Happy Holidays to everyone.  And thanks for all you do.

Chuck and Walter

First ever Republican controlled State Senate has hearing for single payer in PA

On Wed, Dec. 16 at 8:30 AM, an historic meeting will take place.  The nation's first committee hearing by a Republican controlled State Senate will hold hearings on SB 400, the Family and Business Health Security Act which would institute a single payer plan for Pennsylvania.  The pro single payer speakers include Dr. Dwight Michaels from Gettysburg Family Practice who is a conservative Republican doctor who now supports single payer.  The second Republican speaker is Dave Steil, Former State Representative from Bucks County and now a small business owner.  The third speaker is Chuck Pennachio who is the Executive Director of Health Care for All Pennsylvania.  All three are members of the Chamber of Commerce.  The final speaker is Patricia Eakin, RN who is the President of the Pennsylvania Staff Nurses and Allied Professionals.  If you are able get up early, please come to this hearing in Room 8E-A East Wing, Capitol Building.  We need to support this revolutionary bill that will cover all medical, hospital, dental, and long term care services for less money than we now spend.

ACTION ALERT - SENATE HEARING CONFIRMED!

Banking and Insurance Committee to Hold SB400 Hearing What: SB400 hearing before Banking and Insurance Committee When: Wednesday, December 16, 8:30 - 10:00 AM Where: Room 8E-A East Wing, Capitol Building The Banking and Insurance Committee of the Pennsylvania Senate has agreed to hold a hearing on SB400, the Pennsylvania Family and Business Health Security Act. The hearing will take place on December 16, from 8:30-10:00 AM in room 8E-A East Wing, located on the lower level of the Capitol building. Those in support of SB400 will have 45 minutes to present their information and arguments, and those opposed will also have 45 minutes.   This is a vitally important step forward, and one of the only times in history that a state-based single payer bill has been granted a senate committee hearing. We need to make sure that the presence of SB400 (and HB1660) supporters is felt by the members of theBanking and Insurance Committee, the media, and our legislators. Please forward this email to your friends and family. Post it on your Facebook page. Blog about it. Make a Youtube video. Tweet it out. Write it out in holiday lights on your lawn (and send us the pictures!). Do whatever you can to get the word out and, most importantly, attend this critical hearing.   Additional information about presenters will be available at www.healthcare4allpa.orgsoon, so make sure to check back regularly for updates.  For additional information, emailinfo@healthcare4allpa.org, or call 215-828-5055 or 412-421-4242.   To support HealthCare4ALLPA, you can make a donation here, or send a check, made out to HealthCare4ALLPA, to: HealthCare4ALLPA P.O. Box 828 Levittown, PA 19058   Thank you for your support, and for your commitment to making Pennsylvania the first state with truly universal, comprehensive and rational healthcare in the Nation. In Solidarity,   Chuck Pennacchio, Ph.D., Executive Director HealthCare4ALLPA UPDATE! Those testifying on behalf of SB400 will be: Patricia Eakin, R.N. Emergency Room Nurse Temple University Hospital President, PASNAP (PA Assn. of Staff Nurses and Allied Professionals) Philadelphia, PA Dwight Michael, M.D. Gettysburg Family Practice Physician and Co-Owner Gettysburg, PA Chuck Pennacchio, Ph.D. Executive Director Healthcare for All Pennsylvania History Prof., Univ. of the Arts Plumsteadville, PA Dave Steil President Micro Trap Corporation Former PA House Member (HD-31) First-in-the-nation GOP co-sponsor of Single-Payer bill Morrisville, PA

1) If you have social media, i.e. facebook, twitter, myspace, -- start today on your update saying the following:

"Medicare for all type of healthcare reform in PA, SB400, will get its first public hearing this coming wednesday in Harrisburgh, stay tuned. go to www.healthcare4allpa.org for more info."

or

"Washington botched healthcare reform, now we have to keep the fight in the states. SB400, single payer reform in PA will have its first public hearing next wed. in Harrisburg. Go to www.healthcare4allpa.org for more info"

If you use twitter, get creative with 140 characters

Please, please, we have gone this route before and very few of you have followed up on using social media despite having it. Just use your update (what's in your mind today section) and do this once.

2 - A brief call to your local newspaper telling them of the public hearing coming up, and that you expect to read in their pages what happens next wednesday, could be good

3. All of you who are in the healthcare field, two things:

A - The PA Medical Society is opposing the bills -- if you are a member, or know someone who is a member, ask them to call the Harrisburg office and ask why is the Society opposing health reform that will benefit the members, the patients and the state of PA - The contact info is: Phone: (717) 558-7750
Toll free in Pennsylvania only: (800) 228-7823

B -Same if you work at a hospital, call your local hospital and ask to speak to the adminstrator and ask why is the hospital blocking healthcare reform in PA that would certainly benefit them and the community.

4. If you listen to talk radio in PA, call and talk about the public hearing coming up.

5. If you are coming to the public hearing next wed at 8:30 AM

6. Let us know if you do any of these things.

Have fun folks

Pedro & Chuck