"I believe that I saw that much of the business community, which actually may stand to gain the most, doesn’t understand benefits of single payer. They don’t understand what improvements and cost reductions they could get under a system of consolidated payment."
By Donald Berwick, MD, former Administrator of the Center for Medicare and Medicaid Services and candidate for Governor of Massachusetts
Update – LD 384 receives bipartisan support
Augusta - March 31, 2015
LD 384 (as amended) the “Resolve, to Study the Design and Implementation of Options for a Universal Health Care Plan in Maine” passed by a vote of 10 to 1 by the Insurance and Financial Services Committe of the Legislature – only Rep. Wallace voted against it. Sen. Whittemore and Rep. Melaragno were absent.
After revisions to the language, the bill will be going before the full Senate for a hearing in the near future.
Former Rep. Charlie Priest speaks in support of LD 384, the “Study” bill on universal health care options, during the initial public testimonies on March 25th 2015. Only the Governor’s representative testified against the bill.
Large Turnout in Support of Health Care for All
LD 384 "Resolve, To Study the Design and Implementation of Options for a Universal Health Care Plan in Maine"
LD 815 "An Act To Establish a Unified-payor, Universal Health Care System"
If you believe that every person in Maine can and should have access to affordable health care please let your local legislator know and ask for his/her support for these bills. Please join with Maine AllCare in our statewide effort to educate and advocate for universal health care here in Maine.
Senator Geoff Gratwick (District 32 - Bangor) explains objectives of his bill LD 384, "Resolve, To Study the Design and Implementation of Options for a Universal Health Care Plan" to other members of Insurance and Financial Services Committee during a well-attended public hearing on March 25th.
Augusta – March 25, 2015
The legislative hearing room of the Insurance and Financial Services Committee was filled to capacity with supporters of universal health care as committee chair Senator Rodney Whittemore gaveled open the meeting. Sen. Geoff Gratwick (D-Bangor), sponsor of LD 384, a "Resolve to Study the Design Options for a Unified Universal Health Care Plan" introduced his bill before his fellow committee members by making a surprise announcement. He had a creative idea: use "crowd funding" instead of taxpayers' money to pay for the proposed comprehensive study.
"Health care reform is needed in Maine regardless of the outcome of ongoing partisan challenges to the Affordable Care Act. Cost continues to be a major issue," stated the Senator. "The US spends 18% of GNP vs 9-11% for other first world countries, while Maine spend even more, about 22% of our GDP goes toward health care. And the coverage is variable while the quality ranges from superb to poor with the US ranks 17-35th worldwide."
Maine's 2014 overall rank is 20 out of the 50 states and we are plagued with a high percentage of children in poverty, low immunization coverage and limited availability of dentists.
Among the first to testify was Pam Burr Smith of Brunswick. She told a story of her brother, sitting in the waiting room of a large medical practice in Portland, immobile with stomach pain, yet neglected for hours. Apparently the staff believed, incorrectly, that he had no insurance. He died a few weeks later of pancreatic cancer at age 51. Pam concluded her testimony: "As long as some people are considered worthy of care, and others not, abuses of concern will occur. A single-payer system is the only way we can be sure that help is there for all."
Internist Daniel Bryant MD, now retired, shared his experience from a provider's point of view. "Many patients had no health insurance, no personal doctor. In fact, that is why they ended up in the hospital in the first place." Dr. Bryant continued, "Some had private insurance with high deductibles, and behaved like those with no insurance at all. Even when deductible were low, because of the physician panels, formularies, covered illnesses and treatments were unique to their particular plans, I sometimes had to modify my recommendations: not all patients got the treatment I thought was best."
Juliana L'Heureux, a nurse and member of the American Nurses Association (ANA-Maine) stated her organization's support of the Resolve. "Nurses see and understand how people who do not have access to the health care need are disproportionately bearing the burden of experiencing poor health outcomes." Further, "the underserved are at risk for costing the health care system more than if their primary care needs were met."
Testimony in opposition to Sen. Gratwick's LD 384 and LD 815 was submitted by the governor's senior health policy advisor, Holly E. Lusk. She stated that, "Maine taxpayers cannot afford to foot the bill." Her fear: "Adding tens of thousands of new patients to the health care system, without containment strategies firmly in place, could threaten Maine's financial integrity."
In fact, a February 2015 statement from over 100 economists disputes Ms. Lusk's contention. "As economists, we understand that universal, publicly financed health care is not only economically feasible but highly preferable to a fragmented market-based insurance system...Evidence from around the world demonstrates that publicly financed health care systems result in improved health outcomes, lower costs and greater equity." The very purpose of the proposed study is to compare options and associated costs for a state-based healthcare system for Maine.
The more lengthy unified-payor bill, LD 815 was presented by Rep. Heidi Brooks (D-Lewiston). Rep. Brooks spoke about her personal experience with our dysfunctional healthcare system, and about her commitment to bring quality and affordable health care to EVERYONE in Maine.
Numerous other organizations' representatives also spoke in favor of one or both bills including: the Maine Medical Association (MMA), National Association of Social Workers-Maine (NASW-Maine), Maine AFL-CIO, Maine Peoples Alliance (MPA), Maine State Nurses Association (MSNA), Southern Maine Workers Center (SMWC) and Maine AllCare.
Dr. Julie Pease, a psychiatrist and president of Maine AllCare, compared her experience in New Zealand to her practice in Maine. "In New Zealand (a country with universal healthcare) there are minimal copays for primary care doctors visits. Immunizations and preventive programs are free. Dental services are free to all children. Pharmacy benefits are subject to a modest co-pay, based on one's ability to pay. No one goes bankrupt due to medical bills." As for the big picture, "the annual cost per capita for health care in New Zealand is just over $3,000", said Dr. Pease. In Maine the annual healthcare cost per capita is $8,521 (2013 data).
The Insurance and Financial Services Committee has scheduled a work session on LD 384 and LD 815 for Tuesday, March 31 2015 at 1:00PM, Cross Building, Room 220. Visit the legislature.maine.gov websites to view ALL of the excellent testimonies for LD 384 and for LD 815.
Please join with Maine AllCare in our statewide effort to educate and advocate for universal health care here in Maine. To receive periodic updates, please subscribe to our email list at www.maineallcare.org.
'Yes we will..., no we won't' – Political flip-flop in Vermont on universal health care
Editor's Note: This past December Vermont Governor Shumlin declared the state's universal health care law, Act 48, unworkable because it will cost too much. Shumlin received less than 50% of the vote in the November election, therefore, he had to wait until January 2015 for the Legislature to appoint him for a third term. Critics say the governor blinked, politically speaking. (Radio Vermont Group interview). "This is all politics", declared health care economist Gerald Friedman, whose Amherst team wrote the latest economic analysis that concluded quite the opposite. Not only could Vermont afford the new universal system, but would save millions of dollars in the process and cover everyone.
Open letter reply to the Vermont Governor and Legislature from 100 Economists in the U.S.
As economists, we understand that universal, publicly financed health care is not only economically feasible but highly preferable to a fragmented market-‐based insurance system. Health care is not a service that follows standard market rules; it should be provided as a public good. Evidence from around the world demonstrates that publicly financed health care systems result in improved health outcomes, lower costs and greater equity.
Public financing is not a matter of raising new money, but of distributing existing payments more equitably and efficiently. Especially when combined with provider payment reforms, public financing can lower administrative costs, share health care costs much more equitably, and ensure access to comprehensive care for all.
We support publicly and equitably financed health care at federal and state level, and we encourage the government of the state of Vermont to move forward with implementing a public financing plan for the universal health care system envisioned by state law.
Maine has 1,329,608 reasons for universal health care
The ACA is unaffordable
In his new book, “America’s Bitter Pill”, author Steven Brill takes a new and comprehensive look at what the Affordable Care Act does and does not do.
Take 15 minutes and watch his CBS 60 Minutes interview, now on the internet. Here are a few quotes from that interview:
“Good news, we have more people who are going to get healthcare. Bad news: we have no way in the world that we are going to be able to pay for it. It (the ACA) doesn’t do anything about malpractice reform, it doesn’t do anything to control drug prices. It doesn’t do anything to control hospital prices. . . .”
“The hospitals have created in healthcare an alternate universe economy where everyone but the doctors and the nurses makes a ton of money, and nobody is holding them accountable. And Obamacare does ZERO to change any of that. . . .”
“Overall costs are still going up. Although Pres. Obama implies that costs are coming down, healthcare costs are still rising at a rate double the rate of inflation. . . .”
“Obamacare is the OPPOSITE of a government takeover of healthcare. Obamacare is the taxpayers intervening to pay the private sector for the already inflated prices that they charge for healthcare. . . .”
Every day Mainters pay more for health care, and receive less in return.
Tony Zeli, Owner & Publisher, The West End NEWS, Portland
“The problems are well known. Health care costs and the number of uninsured continue to skyrocket. While many aspects of the federal Patient Protection and Affordable Care Act are a step in the right direction, these reforms will not create the quality, affordable, universal health care system that Maine needs.”
Excerpted from testimony before the Insurance and Financial Services Committee of the Maine Legislature, February 9, 2011
Access to healthcare is a human right.
Kathy Day, nurse and patient safety advocate, Bangor
As it stands too many American citizen's rights are being denied. Healthcare has become a commodity that is mostly available to the rich. Everyone needs access. We must not give in to profiteering insurance companies or other naysayers.
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 email@example.com and and put "Idea" in the Subject line. Thank you.
Maine’s delayed kidney donation shows disgrace of U.S. health care
By Dr. Philip Caper
Special to the BDN
April 16, 2015
Getting health care in the U.S. often seems first and foremost to be about money. Our first encounter when seeking health care always seems to be with the billing department, not a caregiver. The problem often is about too little money.
But the latest health care media kerfuffle in Maine is about too much money. It centers around the efforts of a local woman needing a kidney transplant to find a donor. She posted a note on her car’s window asking for somebody to volunteer. A man did volunteer and turned out to be a good match for the patient.
That was the easy part.
Because the U.S. has not created a system to routinely pay the costs of health care, including organ donation, a friend of the donor set up a crowdsourcing fund to cover some of the medical costs, lost income and other expenses he would incur, estimated to be around $6,000.
To everybody’s astonishment, donations came flooding in and soon amounted to about $50,000. Great news and a great success story.
Not so fast. The size of the fund triggered concern on the part of Maine Medical Center, where the transplant was scheduled to be performed, that the donor would be perceived to be selling his kidney. That turns out to be a violation of federal law. Accordingly, the hospital put the transplant on hold, pending resolution of the legal question.
This is just one more example of the ways in which the dysfunctional way we finance health care actually interferes with the provision of care instead of facilitating it. That is true not only for individual cases, but there is evidence the daunting prospect of unpaid bills in the U.S. is deterring potential organ donors to boot.
In many other wealthy democracies that, unlike the U.S., have well-designed health care systems, the donor’s and the recipient’s medical costs and ancillary expenses would be covered, no questions asked. No crowdsourcing, bean suppers or cookie jars in the general store are needed.
“How can they afford to do that?” we might well ask.
The answer is pretty straightforward. Instead of wasting billions of dollars on unnecessary administrative costs related solely to dealing with multiple insurance companies, they have eliminated those costs by simplifying their health care financing into a single system. Savings in the U.S. from eliminating such administrative waste are credibly estimated to reach $190 billion.
By doing that, they free up resources to devote to actual health care and other pressing public needs such as infrastructure, education and public safety. As a result, they are able to cover everybody; get better results than ours; have systems that are simpler and more popular with their public, politicians and doctors; and spend, on average, about half of what we do. If we had such a system, where money is not the dominant issue in determining whether appropriate care is provided, we could join them.
Unfortunately, the top management in many of our nation’s largest medical centers, where much of the care is provided and much of the money is spent, are well known to be hostile to a simplified, single, nonprofit payment system. Instead, they seem to be preoccupied with increasing their “market share” and boosting their bottom line rather than embracing the most efficient system for providing quality care for everybody.
I would love to be proven wrong and see more influential health care leaders advocating for such a transformation. But there is no evidence this will happen anytime soon. It seems that the barriers to reform of our health care system — apathy, fear and anger, ignorance and greed — are alive and well in our medical-industrial complex.
The fundamental problem is that we still treat health care as a privilege instead a right and spend inordinate amounts of money to make sure nobody who doesn’t “deserve” it has to grovel to get it. In the meantime, this patient’s kidneys continue to fail, her transplant continues to be on hold and the patient and donor continue to be subjected to unnecessary anxiety and delay.
This a disgrace. It’s an entirely unnecessary evil. Americans deserve better than this. We all need to push harder for more fundamental reform.
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.