"Everyone should have health insurance? I say everyone should have health care. I'm not selling insurance."
By Dennis Kucinich
AROUND THE NATION
42% of Texans support single payer
Health care survey yields surprises for the medical community
By Jenny Deam – The Houston Chronicle, April 27, 2015
Not only do the vast majority of Texans think having insurance is important for them and their families, seven in 10 also want health coverage for everyone else.
And they are willing to dig into their pockets to pay for it.
The results of a first-of-its-kind survey measuring attitudes of state residents on health care and insurance coverage elicited surprise and some dismay among the scores of medical professionals gathered Monday at the start of a conference in downtown Houston.
Earlier this year the Texas Medical Center commissioned Nielsen to poll 1,000 Texans over 18 on a variety of topics surrounding the shifting landscape of health care, including how important insurance was to them, whether everyone should have insurance, who should pay for it and what role patients and doctors have in decision making.
Half of those surveyed said having health insurance for themselves and their family was "absolutely essential," and another 33 percent said it was "very important." Only 5 percent said coverage was not important at all.
In addition, 70 percent said they thought it important that the nation have universal health care coverage, with 36 percent calling it "extremely important." Thirteen percent said coverage for all was "not important at all."
But the answer to who should pay for coverage seemed to take the doctors and health care executives in the audience by surprise.
Before Dr. Arthur "Tim" Garson Jr., director of the Health Policy Institute for the Texas Medical Center, presented the finding, he asked the audience to guess the result. Many signaled they assumed people wanted insurance to come from employers or the marketplace.
But in fact, the survey showed that 42 percent of Texans favored a tax-supported single-payer plan, something akin to Medicare for everyone. Twenty-seven percent of those polled thought it should come from employer plans and 12 percent answered it should come from the marketplace.
Still, residents did not expect the government to foot the whole bill, the survey showed. Eighty-one percent, including those who earn the least amount of money, were willing to pay at least something out of pocket to guarantee universal coverage.
That lowest-income group, making less than $25,000 per year, said they would pay an average of $47 a month for universal coverage.
"I think that's a lot," said Garson, adding that he found it significant that those whose budgets are stretched thinnest were still willing to pay to guarantee coverage for others.
Also stumping the audience was a question about whether patients want everything medically possible done for them at the end of their lives. Nearly two in three survey respondents answered yes, much to the surprise of the gathered medical professionals, who assumed otherwise.
The survey also found a majority of Texans think foods that lead to obesity should be more expensive. Fifty-two percent said they would support a "fat tax." They also said people with poor health habits should have to pay more for health insurance.
And, despite the crush of medical information now available to online, doctors remain the top source of information across all age groups, including young adults, the survey found.
The health professionals seemed most concerned by the response that not one person of the 1,000 polled thought quality of care was the most important thing about having health insurance. Instead, coverage came first, followed by a tie between access and cost.
"We are totally missing the boat," lamented Dr. Paul Klotman, CEO and president of Baylor College of Medicine, during a panel discussion after the results were announced.
He said the profession needs to do a better job of not only informing the public what good quality health care is, but also guaranteeing it across facilities.
The second annual Medical World Americas convention runs through Wednesday at the George R. Brown Convention Center in Houston. Last year's convention attracted more than 2,000 medical professionals from 33 countries.
Maine has 1,329,608 reasons for universal health care
Rebecca Pease, artist and painter, Bowdoinham
The ACA was a good place to start, as we all realize. But holy crow: take the exorbitant profit out of a basic human right!
Jennie Pirkl, community organizer, South Portland
“It is unacceptable that people in Maine are suffering because of lack of adequate health care. It is unaccepta-ble that the creation of small businesses is stifled because people cannot afford to leave their employers health plans. It is unacceptable to move backward when there is opportunity to move forward.
I have heard from thousands of Maine people supporting the Affordable Care Act, many of whom stated that the national reform was "a good start" but that we, as Mainers, have a responsibility to take it further. We need to make sure that all Maine people have access to high quality healthcare.
We need a single payer system to ensure that Maine people do not go bankrupt due to illness, that we reduce costs by making preventative care accessible, and that Maine people can start small busi-nesses knowing that if they get sick they are covered. That is the way life should be.”
Excerpt from testimony provided to the Insurance and Financial Services Committee, February 2011
Access to healthcare is a human right.
Alice Bolstridge, retired teacher, Presque Isle
I am a retired teacher with a Maine State Retirement pension. When I signed up for Medicare in 2003, the only additional coverage I could get for which the Maine State Retirement System would pay their 45% share was Aetna, the company providing my health insurance at the time of retirement. I started paying about $350 a month from my own pocket, and the premium went up every year.
At some point I needed surgery and was hospitalized for several days. When the bills started coming in, I dis-covered that I did not have the supplement plan I thought I had, but a catastrophic insurance plan that also covered prescription drugs which I didn’t need. Aetna did not pay any of the co-pay expenses for the surgery and hospital stay. By this time my premium was up to about $450 a month. With the state’s 45% share, my in-surance was costing over $700 a month. Not only was I getting ripped off, the state was, too. As a taxpayer, I was feeling cheated twice to pay for Aetna profits.
The whole experience was a nightmare with trying to figure out if I should blame the insurance company or the providers who kept harassing me with bills. When the collection agency threatened me, I paid the bill to get some peace of mind, but my trust in some of the health care providers involved in that has never recovered. I don’t intend to recover any trust in for-profit insurance.
It is foolish to trust providers who are encouraged by the way they are paid to com-promise quality of care and to waste money for unnecessary procedures. And it is foolish for all of us to trust our health to companies whose only motive is profit.
Testimony to the Insurance and Financial Services Committee, May, 2011
What Can Maine Doctors Do?
Return medicine to its healing roots — help educate and advocate for universal, single-payer health care that covers every Maine resident
- Join Maine AllCare mailing list, and volunteer to help, including supporting financially
- Join PNHP — www.pnhp.org
- Visit our websites regularly — www.maineallcare.org & www.philcaper.net for more information
- Organize and make your voices heard through the Maine Medical Association
- Doctors have lost influence during the past 30 years or so, but we are far from powerless – they don’t have much of a business without us!
- Doctors are still influential – make your views known
- Write op-eds and letters to the Editor of your local paper
- Testify in person and in writing before the relevant legislative committees when legislation affecting health care is being considered. MAC can help organize these efforts
- Organize speaking events directed at professions and lay audiences for Maine AllCare speakers
- Grand rounds
- Local and specialty medical societies
- Community forums, church groups, Rotary Clubs, Lions Clubs, Chambers of Commerce
If you have ideas about how else we might advance the cause of universal health care here in Maine, please write to us at firstname.lastname@example.org and and put "Idea" in the Subject line. Thank you.
Obamacare’s health plan choice benefits are vastly overrated
By Dr. Philip Caper
Special to the BDN
May 14, 2015
It is well documented that many other countries have created health care systems that are more popular than ours, cover everybody, are more effective as measured by better health outcomes, are better able to restrain increases in costs and, therefore, have per-capita costs that are a fraction of ours.
One of the reasons for the popularity of universal health care systems elsewhere in the developed world is that when everybody is in the same system, everybody has an incentive to make that program work. The people of those countries have a sense of ownership and responsibility for their common system.
That contrasts sharply with the situation here in the U.S., where people primarily and often exclusively are concerned with their own little piece of the system, such as Medicare, the Veterans Affairs, their own employment-based or veteran’s insurance, plans purchased on the Obamacare exchanges, Medicaid and so on.
Americans also are confused about who owns the system. Is it the government, their employer or their union? Or, as more Americans are coming to believe, health insurance companies, the pharmaceutical industry or the increasingly consolidated corporate providers of health care such as large hospital systems?
In other words, we lack the solidarity that both is an expression of and created by the existence of a single common way of dealing with the challenges of providing affordable health care coverage for all.
I’m a great fan of the goals of the Affordable Care Act — expanding coverage, restricting the most anti-social practices of health insurance companies and attempting to control overall costs. But I’m not a fan of how it tries to accomplish them.
Obamacare is based on the concept of choice among insurance plans. Such choice is greatly overrated.
In order to provide choice among insurance plans, something most people don’t care much about, we are losing choice among healers, something we care a lot about. We are discovering that choice of insurance plans comes at the cost of losing our choice of doctors and hospitals, as insurance companies vainly attempt to control their premium prices by restricting their networks of “providers.”
The financial price of giving people choice of insurance plans, the very reason for the existence of the problem-plagued health insurance exchanges, is very high. A recent Washington Post article documents the financial struggles of most of the state-run exchanges, struggles that are expected to last indefinitely.
There are other costs, as well. The complex nature of the health insurance “marketplaces” has created unnecessary anxiety and confusion among those using them. That in turn has spawned the creation of armies of consultants, “navigators” and other helpers to assist people in finding their way through the maze of choices created by the health insurance industry and exacerbated by Obamacare. This only adds to our national health care bill and does not buy one doctor visit, lab test, Band-Aid or aspirin.
Complexity is a huge drag on the popularity of our health care system as a whole. I have written before about the barriers to further reform of our health care system — fear, anger, ignorance, ideology, apathy and greed.
Apathy often characterizes people who already are well covered and don’t see any reason to worry about those who aren’t. They include the 55 million beneficiaries of Medicare and roughly 140 million covered by employment-related insurance who like it so much that they are frightened and angered by any program designed to expand coverage for others, fearful that it will reduce their own benefits.
Our obsession with “choice” among health plans not only is misplaced but economically costly and confusing and itself is a huge barrier to political solidarity. The infighting among groups covered by different plans is a powerful ally of those profiting from and wedded to the status quo. It is an important barrier to the one common sense idea most bolstered by evidence of fairness and of effectiveness — improved Medicare for all.
We urgently need fundamental reform of the way we finance health care in the U.S.
Fundamental change is extremely difficult in politics. But as the race to the bottom created by the folly of attempting to interject more choice and competition among insurance plans becomes clearer, the public becomes better informed about the alternatives and frustration grows, and people in Maine and elsewhere will come to demand it.
Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at email@example.com or through his website at philcaper.net.
Obamacare: A deeply flawed system
By Tom Walsh
From The Ellsworth American (Maine), April 2, 2015
The big winners in the Affordable Care Act are not those newly enrolled, but the status quo players in the deeply flawed American health care delivery system: the health insurance industry, Big Pharma drug companies, for-profit hospitals, overpaid doctors and other co-conspirators in an American health care system that, by any objective standard, is a complete failure.
Unfortunately, the emphasis of this federal legislation (translates: Obamacare) is "affordable." To couch it in terms of "health care reform" is a rhetorical joke. The quality of health care in America is not being "reformed" in any way through a program that, bottom line, not only encourages, but now requires, Americans to buy into a health care system that remains deeply flawed. It's an approach that makes health care less expensive and more accessible, but not better in terms of quality of care.
In 2005, Paul and Gretchen Volenik moved from Hancock County to Nova Scotia to take advantage of Canada's common-sense, no-insurance-required approach to health care delivery. Between 1994 and 2002, Paul was a state representative in the Maine Legislature, where he was the point man advocate for a state-funded universal health care system that would provide medical care to every citizen of Maine. When that never happened, the Voleniks moved north.
"It's like a train," Paul says of the so-called health care reform. "The engineer is driving the health care train, and he stops at each stop and picks up a few more people, maybe children, or a group of low-income people. But he fails to notice that the train is on fire and that people are leaping off it in all directions, because the system is ridiculous. Until you get rid of the immense power of the drug companies, until you get rid of the inflated salaries of the hospital administrators, you will never have an effective health care system."
And we don't. In the world of health care statistics, "outcomes" means results. You know, little things like infant mortality and life expectancy. The outcome numbers, as they have for years, undercut the Big Lie that America has the "best health care system in the world." No. It doesn't. Not even close. Not when you look at those pesky outcome numbers.
"The United States health care system is the most expensive in the world," says a June 2014 analysis by the Commonwealth Fund. "The U.S. underperforms relative to other countries on most dimensions. Among the 11 nations studies in this report -- Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States -- the U.S. ranks last, as it did in 2010, 2007, 2006, and 2004. ... Most troubling, the U.S. fails to achieve better health outcomes than the other countries. ... The U.S. is last or near last on dimensions of access, efficiency, and equity. ... The U.S. ranks last overall with poor access scores on all three indicators of health lives -- mortality amenable to medical care, infant mortality, and health life expectancy at age 60."
There it is. Why bore you by drilling down into the stats? Suffice to say the numbers in terms of America's health care efficacy are not close to good. Among the world's industrialized countries, the American health care system, in terms of results, isn't within the top 20.
In 1974, while America's mindset was being distracted by Watergate and Richard Nixon's personal and political meltdown, there was a U.S. senator running around Capitol Hill, loudly preaching the gospel of what he termed "national health insurance." Too loudly, apparently, for the K Street lobbyists for Big Pharma drug companies, the American Medical Association and the American Hospital Association, who took note and collectively circled the wagons, making sure this potential drift away from the extremely lucrative status quo wouldn't come to be. To Sen. Ted Kennedy's dismay, it didn't. Nor has it, 40 years later. In the meantime, an estimated 210,000 Americans die each year from preventable medical errors, making such errors the third leading cause of death in the United States, after heart disease and cancer.
So jump aboard the train. Only now it's not an option, it's required. In the meantime, remember this: The only way to survive the American health care system is to stay out of it.
Good luck with that.
Tom Walsh of Gouldsboro is an award-winning medical and science writer.