". . . many patients face a growing and unacceptable financial burden for access to treatment. Rather than determining which drug is best for the patient, we find ourselves making treatment decisions based on whether patients can afford drugs."
Dr. Jinoos Yazdany of the University of California, San Francisco, School of Medicine
Maine AllCare at the Common Ground Fair—Please Come and Visit Us at the Social & Political Action Area
For the second year, members of Maine AllCare board of directors and our Speakers Bureau volunteers will be on hand at the Social and Political Action Area of the Common Ground Country Fair in Unity, Maine. Please stop by and say hello, and share your ideas about how best expand access to affordable, quality health care to every Maine resident. Equally important, help us spread the word about Maine AllCare and our work to inform Mainers through local community health care forums. If you are interested in organizing a Maine AllCare sponsored discussion in your hometown, we have speakers and moderators ready to participate. For more information you may always contact us by email.
We know that overly complicated, insurance-based systems waste a lot of money on administration, overhead and profit, none of which provides care to people. Today, tens of thousands of our Maine neighbors still have no health insurance because they simply cannot afford it. By contrast, a simple system, Medicare, includes every senior person over 65 years old. By improving and extending Medicare to cover everyone in Maine is one possible way to lower overall health care costs. We all pay for it and we all benefit.
Please visit with us at the Common Ground Fair this September. It is truly a fun event for the whole family. See you at the Fair.
Maine has 1,329,608* reasons for universal health care.
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* Maine population estimate 2014
The best health care system in the world? Nonsense! Commentary: let's stop buying the party line from insurers and drug companies
By Wendell Potter June 1, 2015 published in publicintegrity.org
Americans spend more per capita on health care than people anywhere else in the world, yet outcomes in every other developed country are better on almost every measure, from infant mortality to life expectancy.
A big reason for that is our collective gullibility. We continue to believe what many politicians tell us, despite evidence to the contrary: that we have the best health care system in the world.
Similarly, we continue to be persuaded by insurance companies that they’re essential to the system and better than any government program could possibly be at controlling health care costs.
And we are still buying the pharmaceutical industry’s argument that if Americans don’t keep paying more for prescriptions than anyone else on the planet, drug companies—which have gargantuan profit margins—won’t be able to keep developing the drugs we need.
To understand how foolish we are, let’s consider the war of words that recently erupted between health insurers and drug companies.
First, though, let’s take a look at a new study that compares how much Americans pay for prescription medication compared to what folks in a few other industrialized countries pay.
The study, released last week by the Kaiser Permanente Institute for Health Policy, showed that pharmaceutical spending in the U.S. per capita had reached $1,010 in 2012. The next highest spender was Germany at $668 per capita. Australia came in at $558.
Am I the only one who finds it more than a little upsetting that the Germans spend 66 percent of what we spend for drugs and the Aussies spend just 55 percent?
As the Kaiser researchers point out, those countries’ citizens get a much better deal on their meds because their federal governments have policies in place to regulate drug prices. And those nations are not alone. Every other country in the developed world has instituted some kind of price control mechanism. Except, of course, the United States.
Kaiser’s numbers are consistent with those from a 2013 analysis by the 34-member Organization for Economic Cooperation and Development (OECD), which showed that Americans spend 40 percent more on drugs than the next highest spender, Canada.
As PBS pointed out last year in a report on drug prices around the world, government agencies in other countries set limits on how much they (and their citizens) will pay drug makers for their various products.
“By contrast,” as PBS further pointed out, “in the U.S., insurers typically accept the price set by the makers for each drug, especially when there is no competition in a therapeutic area, and then cover the cost with high copayments.” (Emphasis mine.)
PBS nailed it. American insurance companies are essentially powerless when it comes to negotiating prices with Big Pharma, just as they are becoming increasingly powerless in controlling the cost of hospital care and physician services. The way insurers continue to make money is not by doing a good job for their customers but by constantly shifting more of the cost of care to those customers.
If we were paying close enough attention to what insurers were saying during the health care reform debate, we would have realized that they are, for all practical purposes, impotent when it comes to holding down costs. All we had to do was read between the lines.
One of the insurers’ consistent talking points was that instead of putting them in the crosshairs, policymakers should instead focus on “the real drivers of health care costs.” Those “real drivers,” according to insurance company executives, are the companies and people who actually provide most of the care we need: hospitals, doctors and pharmaceutical companies.
The industry’s impotence was on display yet again last year when the drugmaker Gilead slapped a $1,000 per-pill price tag on its new hepatitis C medicine.
“Is this ‘whatever you can get away with’ pricing here?” America’s Health Insurance Plans’ then-CEO, Karen Ignagni, asked during a health care conference.
The answer: yes. Drug companies can get away with it because private insurance companies can’t stop them. And, with the exception of the Veteran’s Administration and Medicaid programs, neither can the U.S. government. In fact, the pharmaceutical industry was able to persuade lawmakers to make it illegal for the government to negotiate with drug companies when they enacted the Medicare drug benefit in 2003.
It’s telling that, in response to Ignagni’s rhetorical question, a pharmaceutical industry spokesman said, almost mockingly, that insurers should do more to control health care costs.
As for Big Pharma’s claim that Americans must pay more to keep their R&D departments humming, which we seem to have bought hook, line and sinker, the Kaiser researchers, like many others before them, suggested we’re being duped.
“There is evidence that companies overestimate the amount they actually spend,” they wrote, citing a 2011 analysis that found the median R&D costs for producing a new drug was $43 million, which is just 5 percent of the $802 million figure the industry routinely cites.
Maybe the question we should be asking is, how much longer can we afford to be so gullible?
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.
A Prescription for ALL Americans – Expand and Improve Medicare
Maine AllCare board member Suzanne Roberts, MD, MDiv spoke at the Portland celebration of Medicare's 50th birthday on July 30, 2015
Hello Everyone! My name is Suzanne Roberts and I am a doctor. I practice Primary Care Internal Medicine in Old Orchard Beach Maine. I am the Vice President of MaineAllCare, which is the Maine chapter of a national organization called Physicians for a National Health Program. We are a group of over 19,000 physicians, medical students, and health care professionals who support a national single payer health plan, and we strongly support expanding Medicare to cover everyone.
I graduated from medical school 26 years ago; I have never practiced medicine without Medicare, and I cannot begin to imagine what my practice would look like today without the red, white and blue Medicare card that is so important to all of my patients over the age of 65. But another scene that I cannot imagine is what my practice would look like if everyone HAD Medicare; if all of my patients, from their first breath until their last, had health insurance that was not dependent upon their employment status and not dependent upon the size of their bank account, but health insurance that was theirs: permanent and portable, period. We can all understand that a basic kindergarten through 12th grade education, funded by our taxes, is a good investment in our communities; why can’t we understand that a universal health insurance funded by our taxes, like Medicare, will also make our communities stronger?
Doctors KNOW that our healthcare delivery system is broken, every day we go to work and try to help our patients survive within it. We would love to see ALL of our patients have equal access to quality health care. Just last year a Maine Medical Association poll of doctors found that 66% of us supported universal health care. But we need your help because we cannot successfully advocate for change alone.
So I have a prescription for you, because you didn’t think I was going to let you get away from a visit with the doctor without a prescription, did you? Your prescription is this: TALK ABOUT MEDICARE EXPANSION. Talk about expanding Medicare to EVERYONE in the country. Talk to your doctor about it. Help you doctor to imagine a country where everyone has Medicare from birth to death, where insurance coverage is never an issue, and where your doctor can get back to taking care of patients, not paperwork. Talk to your family and help them to imagine what life would be like if every one of us, kids, grandkids, nieces, nephews--- every one of us had Medicare too. What would it be like if your loved ones never needed to worry about losing health insurance if they lost their job; or if they never had to worry about going bankrupt due to medical bills? Talk to your neighbors, your friends at church or at work, at the gym or on the beach; TALK about our vision of Medicare for all.
Fifty years ago the American Medical Association opposed the creation of Medicare, calling it “socialized medicine”. I am standing here today saying “Thank God!” their fear mongering was ignored and Medicare was born. Now is the time for us to join together in expanding what was started 50 years ago; let’s put a red, white and blue Medicare card in everyone’s wallet! Happy Birthday Medicare!
Maine AllCare members celebrate Medicare's 50th birthday at Monument Square in Portland with art exhibits, music and speeches. (Click to see more)
Medicare at Age 50: Building on Its Success
By Nancy Altman
Medicare -- signed into law fifty years ago, on July 30, 1965 -- was supposed to be just the first step.
For the fifty years before Medicare's enactment, progressives had fought unsuccessfully for universal, government-provided health insurance. In 1912, President Theodore Roosevelt's Progressive Party platform advocated universal, government-sponsored, health insurance, but he was defeated in his quest for another term as president. In 1917, the California legislature approved universal health insurance, and the governor supported it, but a 1918 ballot resolution defeated the measure after a massive, well-financed business and physician-fueled campaign against it. President Franklin Roosevelt seriously considered including national health insurance in his 1935 Social Security legislation, but decided against it out of fear that it would bring down the entire legislative package. President Harry Truman made universal health insurance a top priority, but got nowhere.
The five-decade long history of defeat convinced activists to shift to an incremental approach. They decided to start with a sympathetic group and debated which one that should be. The top candidates were seniors and children. On the one hand, covering children was relatively inexpensive and could lead to a lifetime of better health. On the other hand, seniors were most in need of health insurance and were already used to and supportive of Social Security's government-sponsored wage insurance. And they voted.
So the decision was made to start with them. The expectation was that, after Medicare was enacted, children and others would be quickly added. And, indeed, just seven years later, in 1972, President Richard Nixon signed into law legislation which extended Medicare to people with serious and permanent disabilities.
But then came Watergate, distrust of government, and President Ronald Reagan's famous declaration, "Government is not the solution to our problem; government is the problem." Expansion of Medicare to children or other demographic groups disappeared from the public agenda. But the need for universal high-quality health care, efficiently provided, did not.
Conservatives and centrist Democrats, increasingly in control, looked for alternative approaches. Inclined toward private sector solutions but recognizing that some limited government role was essential, they favored private sector health insurance and savings supported by favorable tax treatment. For those who fell through the cracks and who were deemed worthy, they favored means-tested health insurance provided at the state level, with federal support.
Those are the solutions that have dominated since 1972, despite the obvious advantages of simply expanding Medicare. Means-tested Medicaid, included in the same 1965 legislation that enacted Medicare, was expanded every few years, most recently as part of the Affordable Care Act in 2010. The means-tested State Children's Health Insurance Program (CHIP) was enacted in 1997. And, the Affordable Care Act authorized state exchanges offering private health insurance subsidized with income-tested, government subsidies. During these decades, the tax expenditure on health care insurance grew from the fourth largest tax expenditure in 1986 to the largest today -- at a loss of revenue of over $200 billion a year. And during this same period, conservatives amended Medicare to include private health insurance and means-tested elements.
But these methods of providing health insurance are vastly inferior to universal, government-sponsored health insurance -- essentially, Medicare for All. Universal, government-sponsored insurance is the most effective and efficient way to cover everyone. Insurance is least expensive when it covers the most people; the large size of government-sponsored health insurance provides economies of scale and the greatest ability to negotiate over prices and control costs. Moreover, unlike private health insurance, a government plan has no marketing costs and no high CEO salaries. It can provide health care less expensively and more efficiently for everyone. For these reasons, every other industrialized country provides universal coverage, spends less as a percentage of GDP, and produces better health outcomes.
But we don't have to look to other countries to see the advantages. Medicare covers seniors and people with disabilities, people who, on average, have the worst health and the most expensive medical conditions, requiring the largest numbers of doctor and hospital visits with the concomitant largest number of health care claims. Yet, Medicare's administrative costs are the lowest around. Medicaid, whose administrative costs vary from state to state, is less efficient than Medicare, because its coverage is statewide, not national, and it must impose complicated and expensive means testing, Even with that, both Medicare and Medicaid are significantly more efficient than private health insurance. Compared to Medicare's administrative costs of just 1.4 percent, the administrative costs of private health insurance sponsored by very small firms or purchased by individuals can run as high as 30 percent. Even the administrative costs of health insurance sponsored by large companies typically run around 7 percent. Read More of this story.