Unhealthy America

By Nicholas Kristof for The New York Times

The moment of truth for health care is at hand, and the distortion that perhaps gets the most traction is this:

“We have the greatest health care system in the world. Sure, it has flaws, but it saves lives in ways that other countries can only dream of. Abroad, people sit on waiting lists for months, so why should we squander billions of dollars to mess with a system that is the envy of the world? As Senator Richard Shelby of Alabama puts it, President Obama’s plans amount to “the first step in destroying the best health care system the world has ever known.”

That self-aggrandizing delusion may be the single greatest myth in the health care debate. In fact, America’s health care system is worse than Slov—er, oops, more on that later.

The United States ranks 31st in life expectancy (tied with Kuwait and Chile), according to the latest World Health Organization figures. We rank 37th in infant mortality (partly because of many premature births) and 34th in maternal mortality. A child in the United States is two-and-a-half times as likely to die by age 5 as in Singapore or Sweden, and an American woman is 11 times as likely to die in childbirth as a woman in Ireland.

Canadians live longer than Americans do after kidney transplants and after dialysis, and that may be typical of cross-border differences. One review examined 10 studies of how the American and Canadian systems dealt with various medical issues. The United States did better in two, Canada did better in five and in three they were similar or it was difficult to determine.

Yet another study, cited in a recent report by the Robert Wood Johnson Foundation and the Urban Institute, looked at how well 19 developed countries succeeded in avoiding “preventable deaths,” such as those where a disease could be cured or forestalled. What Senator Shelby called “the best health care system” ranked in last place.

The figures are even worse for members of minority groups. An African-American in New Orleans has a shorter life expectancy than the average person in Vietnam or Honduras.

I regularly receive heartbreaking e-mails from readers simultaneously combating the predations of disease and insurers. One correspondent, Linda, told me how she had been diagnosed earlier this year with abdominal and bladder cancer — leading to battles with her insurance company.

“I will never forget standing outside the chemo treatment room knowing that the medication needed to save my life was only a few feet away, but that because I had private insurance it wasn’t available to me,” Linda wrote. “I read a comment from someone saying that they didn’t want a faceless government bureaucrat deciding if they would or would not get treatment. Well, a faceless bureaucrat from my private insurance made the decision that I wouldn’t get treatment and that I wasn’t worth saving.”

It’s true that Americans have shorter waits to see medical specialists than in most countries, although waits in Germany are shorter than in the United States. But citizens of other countries get longer hospital stays and more medication than Americans do because our insurance companies evict people from hospitals as soon as they can stagger out of bed.

For example, in the United States, 90 percent of hernia surgery is performed on an outpatient basis. In Britain, only 40 percent is, according to a report by the McKinsey Global Institute.

Likewise, Americans take 10 percent fewer drugs than citizens in other countries — but pay 118 percent more per pill that they do take, McKinsey said.

Opponents of reform assert that the wretched statistics in the United States are simply a consequence of unhealthy lifestyles and a diverse population with pockets of poverty. It’s true that America suffers more from obesity than other countries. But McKinsey found that over all, the disease burden in Europe is higher than in the United States, probably because Americans smoke less and because the American population is younger.

Moreover, there is one American health statistic that is strikingly above average: life expectancy for Americans who have already reached the age of 65. At that point, they can expect to live longer than the average in industrialized countries. That’s because Americans above age 65 actually have universal health care coverage: Medicare. Suddenly, a diverse population with pockets of poverty is no longer such a drawback.

That brings me to an apology.

In several columns, I’ve noted indignantly that we have worse health statistics than Slovenia. For example, I noted that an American child is twice as likely to die in its first year as a Slovenian child. The tone — worse than Slovenia! — gravely offended Slovenians. They resent having their fine universal health coverage compared with the notoriously dysfunctional American system.

As far as I can tell, every Slovenian has written to me. Twice. So, to all you Slovenians, I apologize profusely for the invidious comparison of our health systems. Yet I still don’t see anything wrong with us Americans aspiring for health care every bit as good as yours.

Our Last Chance on State Single Payer Option

Letter from Rep. Dennis Kucinich

Dear Friends,

Thank you for all of your efforts on behalf of the Kucinich Amendment for a state single payer option which would protect the right of states to pursue a single payer health care system.

Unfortunately, the House Leadership has rejected the many appeals on behalf of the amendment and will not reverse their decision which removed the amendment from the bill. Therefore, the Kucinich Amendment for a state single payer option will not be included in the Manager’s Amendment and is not in the bill which will come before the House soon.

The Kucinich amendment represents the most powerful challenge to the insurance companies’ control of our health care system. Even the possibility of a state single payer system will make the insurance companies think twice before they raise premiums. The higher the insurance premiums, the more vulnerable companies are to citizens’ efforts to create alternatives such as a single payer system. We should never be locked into higher and higher premiums!

I do not accept the decision to remove the amendment from the bill. Nor should you.

Join the fight for single payer, please contribute.

We will have one more opportunity to offer the American people a true choice regarding health care. Once the health care bill passes the House, and the Senate passes its version, the two bills will go to a Conference Committee. It is at this point that we will have one more chance. We need to insist that the Kucinich Amendment be included in the Conference Committee report, since that is what will ultimately become law.

Why would we be successful in conference when Leadership refused our appeals in the Manager’s Amendment? Very simple. They may need the votes to achieve final passage! We should not quit.

We have come a great distance already. You helped get the Kucinich Amendment through the Education and Labor Committee. Let’s make one more try to get it into the Conference report. Your calls, letters, emails and visits make a difference.

Please contribute to continue the movement for single payer.

Thank you.
Dennis

Take Action: Make Pelosi Keep Her Promise on Single-Payer

On November 3, 12 brave activists were arrested because they entered Nancy Pelosi’s office in California to get some answers.

They wanted to know why she broke her promise to hold votes on two single-payer amendments this fall.

They weren’t leaving until the single-payer amendments were put back on the table.

Pelosi refused to speak to them. They were arrested for disrupting business as usual.

CALL PELOSI NOW! (415) 556-4862 and (202) 225-0100. Ask her to keep her promise on single-payer.

Demand that she keep her promises and put Kucinich Amendment in the bill and allow a Floor vote on the Weiner Amendment!

Remember Medicare for All in the healthcare reform debate

By Kay Tillow for The Hill Blog

We are in danger of losing the opportunity to bring Improved Medicare for All, a single payer plan, before the Congress. Last July Congressman Anthony Weiner and six of his colleagues on the Energy and Commerce Committee attempted to substitute the real public option—HR 676, a single payer plan—for the healthcare reform in the House. Speaker Nancy Pelosi assured them that if they withdrew the amendment in committee they would have an opportunity to bring it to the House floor for a debate and vote. Now Pelosi is threatening to keep the Weiner Single Payer Amendment from seeing the light of day.

If we were able to get this plan really on the table and before the nation in a meaningful way, we could win this hands down. Even Blue Dog Mike Ross, in an unguarded moment, asked why not just have Medicare for All. HR 676, the national single payer legislation introduced by Congressman John Conyers, would cover everyone for all medically necessary care through an Expanded and Improved Medicare for All. The bill and its advocates have been blocked, excluded, and beaten back in the current national healthcare reform debate.

Yet Medicare for All continues to raise its head. When single payer advocates were excluded from the White House kick off meeting for health care reform, doctors’ opened the door to two single payer advocates with a plan to protest at the White House gate. When Senate Finance Chair Baucus ruled single payer off the table, thirteen doctors, nurses, and others rose to protest. Baucus had them arrested. Those gutsy advocates pried open another door and won a round of publicity for single payer. But still not a place at the table.

Yet support for single payer continues to grow. Its simplicity, humanity, and economic efficiency win more supporters each day. The Kentucky House of Representatives, four other state legislative bodies, scores of cities and counties, a half dozen giant religious denominations, NOW, the NAACP, and the National Conference of Mayors have called for passage of HR 676. For unions, it’s the plan of choice. At each contract deadline the double digit rise in health care costs gobbles up the lion’s share of bargaining power. For that reason, 578 unions including 39 state AFL-CIO’s and 134 central labor councils have endorsed HR 676. In September the national AFL-CIO Convention declared unanimous support for single payer as the social insurance plan necessary to achieve social justice.

When Physicians for a National Health Program founder Quentin Young, testified before a House committee last June, Representative Weiner listened and was impressed. Weiner turned HR 676 into an amendment that would transform the House bill into a single payer plan. He popularized it as Medicare for All and catapulted the discussion into the national media with his feisty good humor and popular style.

Now Pelosi wants to renege on her promise to Weiner. We have sent an action alert to over 19,000 unionists asking them to contact Pelosi, and Waxman (who relayed Pelosi’s commitment publicly) and Slaughter (who heads the rules committee) to assure that they allow the Weiner amendment to come to the floor.

The “public option” that remains in both the Senate and the House bills is pitiful and powerless–totally incapable of providing cost control. Those bills, with their forced mandates and fines, their massive transfer of public funds to the insurance industry, and their ban on bulk buying power to rein in the pharmaceutical companies, will fail woefully to cover our people and to make that care affordable.

Pelosi should stick to her promise. We’ll keep up the effort to make her do so. Either now or later Medicare for All will have to come to the table. We’ll keep building the movement to make that happen.

Physicians and supporters arrested at CareFirst health insurance office to call for real health care reform

Dr. Margaret Flowers and Charles Loubert, 81, will stay in jail until CEO of CareFirst meets to discuss redirecting lobbying funds to pay for patients care

Healthcare-NOW!

Baltimore, MD – Two physicians and two supporters were arrested today at a sit-in at a Baltimore CareFirst health insurance office. The sit-in is part of a national groundswell of citizens and health care providers demonstrating for meaningful health care reform at insurance company offices.

Doctor Margaret Flowers, a pediatrician who has testified before Congress on the need for meaningful health care reform, was arrested and intends to stay in jail until the CEO of CareFirst has a public meeting with her. She is joined by Charles Loubert, 81, a Baltimore resident and former teacher who was also arrested, and who was denied health care several years ago by his insurer. Both Flowers and Loubert are refusing to give information to the Baltimore police that would lead to their release until Chet Burrell, the CEO of CareFirst, agrees to meet with them publicly to discuss CareFirst redirecting all funds that go to lobbying, advertising, or political contributions to pay for the care of clients who need it.

Dr. Flowers and Loubert were joined by Dr. Eric Naumberg, also a physician, and Patricia Courtney, also a former teacher. They are part of a national groundswell of civil disobedience at insurance companies to end insurance abuse and win health care for all coordinated by Mobilization for Health Care for All. The mobilization has seen 115 people arrested at health insurance offices in 18 cities so far, with six more actions planned in the coming week. Arrests include several nurses, as well as Matt Hendrickson, MD MPH, who was arrested yesterday in Los Angeles.

Sen. Al Franken humbles Hudson Institute dilettante over healthcare bankruptcies

Sen. Al Franken (D-MN) humbles Hudson Institute dilettante over health care bankruptcies during a senate Judiciary sub-committee hearing on bankruptcies driven by catastrophic medical expenses.

Harrisburg Rotunda Filled By Single-payer Supporters

From PDA via Healthcare-NOW!

“The October 20 ‘Healthcare for All’ rally at the capital rotunda in Harrisburg, Pa., was a huge success,” said Tim Carpenter, PDA National Director. “Anywhere from 700 to 1200 supporters turned out during the course of the event.”

The rally was organized in support of Pennsylvania’s single-payer healthcare legislation and was co-sponsored by many state and national organizations advocating for healthcare system overhaul, including the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP), the California Nurses Association/National Nurses Organizing Committee, Healthcare for All Pennsylvania, Progressive Democrats of America, Healthcare-Now, Physicians for a National Health Program, the Western PA Coalition for Single-Payer Healthcare, and the Pennsylvania AFL-CIO.

Donna Smith, American SiCKO, and Wendell Potter, former CIGNA executive turned whistleblower (pictured above) were among the many speakers at the event and have become “unlikely friends,” according to Smith. During Potter’s tenure, Donna and her husband Larry were bankrupted due to medical crisis even though they carried health insurance coverage, disability insurance and a small healthcare savings account.

Donna told Wendell, “I forgive you.”

Wendell worked as an executive in the private, for-profit insurance industry (for Humana and then CIGNA) until May of 2008 when he finally decided he could not play a part in the suffering that resulted from so many of the practices of the industry.

The crowd of hundreds cheered, as Wendell teared up, embraced Donna and said, “God bless you.”

Keith Martin at the IFA webnews site reported:

Advocates of state or federal sponsored universal health care, including two Pennsylvania state legislators, gathered at the State Capitol in Harrisburg, Pa., to promote their solution to the nation’s coverage crisis.

State Sen. Jim Ferlo (D-Pittsburgh) and State Rep. Kathy Manderino (D- Philadelphia/Montgomery) were among the speakers at a rally Oct. 20 to call for action, including increasing attention paid to two bills they have sponsored to bring a single-payer system to Pennsylvania.

“We need real solutions to solve our current healthcare crisis,” Ferlo said. “The single- payer strategy is the only way to remove the waste in the system and provide universal coverage.”

Ferlo has introduced the Family and Business Healthcare Security Act (SB 400), which would employ a pair of new taxes to pay for universal coverage. A 3% personal income tax for individuals and a 10% payroll tax on businesses would be levied. The new taxes, along with existing Medicaid/Medicare, tobacco settlement funds and other existing health care dollars would pay for the single-payer approach under his proposed legislation.

Ferlo said among the goals in his bill are quality medical, dental and mental health care for every Pennsylvania resident, the establishment of a Health Care Trust owned and controlled by residents as the single payer for health care, eliminating “the existing wasteful and inefficient system of multiple third party payers” and relieving employers from the responsibility of selecting, pricing and administering health insurance.

“We have organized a very diverse group that allows us to demonstrate wide-spread support for the single payer concept,” Ferlo said in a statement. “The last step is to bring our story and solutions to other elected officials so that they can understand and appreciate that a single payer system is the best path to take.”

Manderino’s proposed legislation (HB 1600) would create the Pennsylvania Health Care Plan, a statewide, comprehensive health care system providing comprehensive coverage to all state residents. Like Ferlo’s plan, Manderino’s bill also would create a state health care trust fund, within the state treasury office, and the same individual and business taxes to help fund the new program.

Witnessing the Cigna 7: A Doctor’s Perspective

By Anne Sheetz, M.D. | Chapter News Blogger at PNHP

At 10:10 a.m. on Thursday, October 8, I watched two policemen drag my beloved husband, Jim Rhodes, across a cement plaza in downtown Chicago. His offense: joining 6 other people to sit-in in the lobby of Cigna, refusing to move until Cigna promises to pay all claims for physician-ordered care.

I did not expect him to be hurt. He was not even in handcuffs, and he was not dragged very far. I expected that at worst he would be hungry for awhile, and spend the night in jail. Still, it grieved me to see them treated so coldly, not because they would be hurt, but that they were being brought to jail while people died due to denied claims.

Jim is a veteran of numerous demonstrations, but this was his first act of civil disobedience and his first arrest. He felt it was finally worth arrest for the sake calling attention to the fatal policies of the private insurance industry.

We were there because I am a doctor, and Jim is the manager of my medical practice. We were there because 45,000 people died last year for lack of insurance. In that same time period, 450,000 people who got sick and had health insurance went bankrupt. Jim’s grandchildren have insurance through the state, but their parents are uninsured.

I have witnessed firsthand the workings of the private insurance industry. One of my patients died of upper gastrointestinal bleeding after her insurance plan discontinued coverage for her ulcer medicine. Another patient was refused a procedure while his HMO was bought out. As a result, he developed a life-threatening infection in one of the bones of his neck. Midge Hough was marching outside Cigna for her lost daughter-in-law and grandchild who both died due to lack of insurance.

Despite the tragic state of the private insurance industry, this demonstration was an act of hope. The members of the Chicago Single-Payer Action Network, Mobilization for Health Care, and the arrestees all devoted hours of meticulous planning to ensure a successful demonstration. The marchers outside ensured media coverage and attention to our country’s health care tragedy.
We worked tirelessly on this effort because we know how to create a system that cares for everybody justly and affordably. Over two-thirds of the population shares our desire for this system, we know that Medicare for All is the only solution to our country’s health care tragedy; because we know that we can do it.

Even the police officers who processed our friends’ paperwork voiced their support for health care reform, and released all the arrestees in less than 90 minutes.

Medicare for All is the only health care reform that will give everyone access to care while controlling costs. In the weeks to come, more people will put their bodies on the line in order to bring it about; and many more who do not choose to be arrested will march, chant, talk to their neighbors, write letters, go door to door, stand in the cold on street corners and at bus stops holding signs. We will work until we win. Yes we will.

Everybody in, nobody out. One nation, one health plan. People not profits. Medicare for All.

Dr. Anne Scheetz is a physician in private practice who makes house calls to the elderly who cannot leave home to obtain medical care. She is a long-time member of Physicians for a National Health Program, organizer for Health Care for All Illinois, and the immediate past co-chair of the Chicago chapter of the Illinois Single-Payer Coalition.
For more information on Mobilization for Health Care for All, please visit http://mobilizeforhealthcare.org/.

“Public option” bait-and-switch campaign fools pollsters

By Kip Sullivan, JD | PNHP

The New York Times reported on Saturday, October 17, that Sen. Ron Wyden (D-OR) is warning his constituents that the “public option” is not going to be available to the great majority of Americans. No one who has actually read the Senate health committee’s “reform” bill or the House “reform” bill (HR 3200) disputes this. According to the Congressional Budget Office, the “option” will be available only to about 30 million people, or about one American in ten. As the Times put it (slightly inaccurately), the “option” in the Democrats’ legislation “would be out of bounds to the approximately 160 million people already covered through employers.”

Does the public understand this? According to Wyden, they don’t. Wyden says his constituents are shocked when they are told the “option” will not be available to the vast majority of Americans. When he began informing his constituents about this truth last summer, “They nearly fell out of the bleachers,” he said (“And the public option is….,” New York Times, October 17, 2009, A10).

Democrats and “option” advocates should pay attention to Wyden’s observation. Wyden is saying, in so many words, that “option” advocates, with help from the media and the blogosphere, have fooled the public into thinking everyone will be eligible to buy insurance from the “option,” and when the public finds out this isn’t true, they’re not going to be happy.

I was not surprised by Wyden’s observation. I have written several papers warning the public that they have been the object of a “bait and switch” campaign by the leadership of the “option” movement. The “bait” in this campaign was the original version of the “option” promoted by Jacob Hacker. This version would have created an enormous public program that would have insured half the non-elderly population. Among several provisions of this first version of the “option” that would have ensured large size was one that said the “option” had to be available to all non-elderly Americans. The “switch” occurred when Democrats on the Senate Health, Education, Labor and Pensions (HELP) Committee and three chairmen of House committees drafted legislation that would create a very small and weak “option.” One of the provisions in the Democrats’ legislation that ensured their version of the “option” would be weak was a provision limiting subsidies and eligibility for the “option” to a small fraction of the population, namely, the uninsured and employees of small firms.

After reading Wyden’s warning, I examined over 50 polls to see if any pollsters had bothered to investigate the issue Wyden is raising. It would be interesting, I thought, to see if (a) pollsters had allowed themselves to be fooled by the bait-and-switch campaign for the “option” and (b), to the extent that they hadn’t been fooled, what did they find out about how badly the average American had been fooled?

I discovered that the nation’s best known polling firms have allowed themselves to be fooled. Pollsters are asking the public the wrong question. They are asking the public to comment on Hacker’s original version of the “option” (the “bait”), not the actual “option” proposed in the Senate HELP Committee bill and HR 3200. Not surprisingly, the polls tell us very little about whether the public thinks the “option” will be available to everyone or to just a small minority.

Click here to read the full report.

Call Congress Today!

The House of Representatives will soon be voting on Medicare-for-All!  Call your representative and ask them to:

1. Support Rep. Weiner’s Single-Payer amendment
2. Retain Rep. Kucinich’s State Single-Payer amendment

Westchester is represented by the following members of Congress (to find out which district you are in, click on the congressman’s name to view a map of their district.):

Eliot Engel, 17th C.D. (Currently a cosponsor of HR 676!)
6 Gramatan Avenue; Suite 205
Mt. Vernon, NY 10550
914-699-4100

Nita M. Lowey, 18th C.D.
222 Mamaroneck Ave, Suite 310
White Plains, NY 10605
914-328-1707
Nita.lowey@mail.house.gov

John Hall, 19th C.D.
40 Gleneida Ave, 3rd Floor
Carmel, NY 10512
845-225-3641 ext. 371

Sen. Bernie Sanders (I-VT) will also be introducing two single-payer amendments to the Senate bill, one to create a national single-payer plan, and the other to allow individual states to adopt single-payer systems.

Call Senators Schumer and Gillibrand and urge them to stand up for real health care reform and support Sen. Sanders’ amendments!

Charles E. Schumer
One Park Place, Suite 100
Peekskill, NY 10566
914-734-1532
senator@schumer.senate.gov

Kirsten Gillibrand
780 Third Avenue, Suite 2601
New York, NY 10017
212-688-6262
Kirsten_gillibrand@gillibrand.senate.gov