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Single-payer system would alleviate misuse of emergency rooms

Baltimoresun.com

4:37 PM EDT, June 1, 2011

 

The headline reads emergency room visits at Howard County General Hospital “might hit a high mark” this year. We know this means that the ER is being misused as a source of primary care. Don’t feel bad, Howard County; in Massachusetts, the model for national health reform, emergency room visits hit a new high last year, and they have under 5 percent with no health insurance, while Maryland has a close to 15 percent uninsured.

The overuse of the ER is a symptom of the lack of primary-care providers in the county. Why the shortage? It is our faith in the markets to make things work. Health Insurers have the upper hand; they decide what primary care is worth. The result is the pay is too low to attract enough primary-care providers.

The reliance on a profit-driven market place to make the medical system work is a problem beyond a shortage of primary care in wealthy county like Howard. The cost of health insurance has more than doubled in the past nine years and the employee share of this expense is rising. Wages have not and cannot keep up with this pace. Before too long most of our salaries will be going to health insurance.

There is a better solution. It is a single-payer health-care system, a program like Medicare that includes everyone but with expanded coverage. The administrative waste in health care is staggering. We spend over 1/3 of our health care dollars on it. Administrative hassles eat up over 10 percent of our doctors’ time that could be put to patient care. A government-run, taxpayer-financed privately delivered system would eliminate much of this waste.

The payment system is streamlined; the middle man (health insurers) is gone. Decisions about doctor pay and distribution of resources can now be made based on medical need first and then profit. With the savings, health-care coverage could be made universal, and expanded to include all needed medical services plus dental and pharmacy. The academic studies to prove this have been done, repeatedly. More importantly, international experience with single-payer systems show the same outcome.

Vermont has passed legislation that will lead to universal health care based on a single-payer system in their state. The Vermont bill starts from the principle that access to health care is a human right. Right now, health care is being treated as a commodity, rationed based on ability to pay. Maryland has similar legislation to Vermont; the Maryland Health Security Act (SB 388). I urge you to find out about it.

Eric Naumburg

Columbia

Eric Naumburg, M.D., is Maryland Health Security Act coordinator for Healthcare-Now of Maryland.

www.baltimoresun.com/explore/howard/opinion-talk/letter-editor/ph-ho-cf-letters-060211-7-20110601,0,818858.story

Contact your State Legislators about the MD Health Security Act Now

Healthcare-Now of Maryland makes it easy for you to ask your state legislators to support the Maryland Health Security Act.

Teams of Healthcare-Now of Maryland members have been in Annapolis the past few weeks meeting with state legislators and asking for their support. Of course, as a constituent, your voice is more powerful than ours. That is why we need your help.

Please visit the new page on our website and take a moment to send a note to your state delegate(s) and senator. It only takes a few minutes. You can use our letter or write your own. You don’t even need to know who your state legislators are. Healthcare-Now will find out for you, based on your address, and will provide you with their names and photos. Just go here.

Thank you for taking the time to support the Maryland Health Security Act.

Contact Your Member of Congress About Funding Domestic Needs

Healthcare-Now of MD is a member of the Fund Our Communities campaign to cut military spending and fund domestic priorities such as universal health care, education and jobs. Forty members of the Maryland state legislature signed on to a letter that was sent to all Maryland members of Congress asking them to decrease military spending and instead use the tax dollars to repair our crumbling social and physical infrastructure. You can read the letter here (.pdf).

We are asking you to take a moment to contact your Maryland senators and representative to offer support for this letter. You can do so by clicking here.

Healthcare-Now of Maryland Represented at the Fund Our Communities Mini-conference

Representatives from Healthcare-Now of Maryland, Ken Sandin, Ray Sullivan and Margaret Flowers, attended the Fund Our Communities mini-conference on March 26th in Bethesda, Over 50 people representing the 37 organizations which have joined the coalition spent the morning listening to speakers and then breaking into smaller groups in order to decide how to move forward to build a strong voice in Maryland that demands that we bring our war dollars home to fund domestic needs. The Fund Our Communities coalition is part of the New Priorities Project, a growing nationwide campaign.

Speakers included Miriam Pemberton of the Institute for Policy Studies who is working with Congressman Barney Frank to cut military spending by 25%; Gino Renne, President of UFCW 1994 MCGEO; Elbridge James of the NAACP; Jeff McManus of Chesapeake Climate Action Network; Dr. Flowers; Lindolfo Carballo of CASA de Maryland; Fred Mason, President of the AFL-CIO of MD and DC and Medea Benjamin of Code Pink.

Points noted about health care in Maryland include:

• There are nearly 800,000 uninsured people in our state.
• The underfunding of developmental disability supports and services has led to placing 3,642 Marylanders on waiting lists to receive state services which they depend on to live a full life.
• Three state facilities and residential centers that serve mentally ill and developmentally disabled individuals have closed since 2007, and capacity at other facilities has been reduced.
• The proposed budget for FY 2012 includes a $5.9 million reduction in addiction funding compared to FY 2009 while there are currently 42,000 untreated people in Baltimore alone.
• Maryland’s Medicaid expansion has been halted.
• The last two phases of a three-phase initiative to address Maryland’s dental crisis have been halted.
• The proposed FY 2012 budget includes a $17 million reduction in provider payments for Medicaid and $15 million in unspecified cuts which means those with Medicaid will face greater difficulties finding care.

The mini-conference was a success. The FOC Coalition now has seed funding, a steering committee and a commitment to plan actions quickly such as resolutions to city and county councils, teach-ins and rallies.

Healthcare-Now of MD looks forward to working with the coalition to bring our war dollars home and fund domestic needs such as a universal single-payer health care system for the state of Maryland. We will keep you informed.

“Single-payer Is Best”

From SoMdNews.com by Carol Paris, MD.

I support a single-payer financing system as in the Maryland Health Security Act, SB388/HB1035. As a solo private practice psychiatrist in a grossly underserved area, I could devote more time to the care of patients if I didn’t have to devote so much time to the bureaucracy that is the reality of our current system.

The insurance lobbyists would have you believe that their industry is more efficient than a publicly funded program. It is not. They would have you believe they can absorb the fluctuations when the economy takes periodic downturns. Of course they can. They do it by increasing premiums and/or decreasing coverage and/or eliminating their risk entirely by morphing into third-party administrators and leaving all the risk with self-insured businesses while also avoiding regulation by the state.

It is true that, should the legislature decide to create a publicly funded financing system for health care for everyone living in the state, we would likely need an amendment to the Maryland Constitution to prevent dedicated health care funds from being redirected to the general fund during times of budget shortfalls. We have such a bill. It is HB926, the Dedicated State Funds Protection Act.

The time for Band-Aids is passed. We need forward-thinking, courageous legislators like the senators from Wisconsin, who are emboldened by their desire to represent their constituents, and not the profiteering interests of corporations. For my part, I will continue to grow the grassroots movement for single-payer health-care reform in Southern Maryland. If you would like to learn more about it, please contact me at www.mdsinglepayer.org.

Dr. Carol Paris, Leonardtown

http://www.somdnews.com/stories/03092011/entelet161510_32335.shtml

Fund Our Communities Coalition

Healthcare-Now of Maryland has joined the Fund Our Communities Coalition in Maryland. The mission of this coalition is to bring groups together to build a large enough grassroots voice to convince our lawmakers to end funding for wars and use the dollars to fund domestic needs such as health care, jobs, education and clean energy. Visit the website to learn more about how you can be involved: www.OurFunds.org. Representatives of Healthcare-Now of Maryland will attend the kick-off summit on March 26th.

Single-payer health care pushed for Maryland

By Larry Carson for The Baltimore Sun –

The idea of a single-payer health care system was lost in the debate over the much amended national health care reform passed by congress last year, but three Howard County delegates are co-sponsors of legislation in this year’s General Assembly that seeks to bring the idea to fruition in the Free State.

The concept involves having everyone in the state get health care through one single insurance pool to which everyone pays premiums. It eliminates the variety of insurance companies that now offer coverage only to those insured through an employer or who can pay.

The Senate version (SB388) of the Maryland Health Security Act is scheduled for a hearing March 9 at 1 p.m. in the Senate Finance Committee in Annapolis, and backers are planning a free event to help boost support March 12 at 1 p.m. at the Central Library in Columbia.

Delegates Guy Guzzone, Frank Turner and Elizabeth Bobo, all Democrats, are all co-sponsors of the House bill (HB1035), and Democratic Del. Shane Pendergrass said she supports a single-payer system in concept, though she is not a co-sponsor because the bill would come before her sub-committee. Sponsors of the three-hour library event are Healthcare-Now! Maryland and Physicians for a National Health Program.

Organizers of the single-payer campaign, Stephen Dunbar and Dr. Eric G. Naumburg say the bill has little chance of passage this year, but they believe that things may change in the future.

“The health system, the way it’s going, cannot survive long-term,” said Dunbar, 68, of Columbia. He’s an entrepreneur with a 43-year old son who was recently laid off from his job. His son, he said, had three open-heart surgeries as a child and needs continuous medical care that he may not be able to afford without employer-provided health insurance.

If the federal plan survives a Republican onslaught, it still leaves millions without coverage, and will be expensive. If Republicans succeed, Dunbar and Naumburg feel, the whole system will collapse, making single-payer the logical alternative.

Naumburg, 63, also of Columbia, is a former pediatrician who said he’s retired from active medical practice to devote his life to promoting a single payer system.

To advocates, the advantages seem naturally appealing. Instead of having multiple insurance companies with a jangle of rules and paperwork, there would be one standard for everyone. That means no need for advertising, huge billing and administrative offices, far less confusion, and medical services dispensed as needed without a cost-driving fee-for-service system.

They are also aware that what they see as a logical solution to the still rising costs of health care is seen as “socialized medicine” to be opposed at all costs by others. “We know we need support from the grassroots,” said Naumburg.

Bobo said she never gives up on what she feels is a good idea, no matter the obstacles. “I think we need to get out there and just keep promoting it.”

State health law waivers: where will they take us?

The president supports state innovation in health care, but vigilance is required to ensure state reforms improve health as we continue to call for national reform

By Margaret Flowers, M.D. for PNHP –

President Obama announced at the National Governors Association on Monday that he supports an amendment to the health law that would allow states some flexibility to innovate with their own models of health reform beginning in 2014, rather than waiting until 2017, as is currently required by law. The president’s concession comes as the current federal health law is deteriorating and states are complaining that the financial burden of complying with the law are too onerous in the face of serious budget deficits.

The president’s endorsement of the Wyden-Brown amendment, known as the “Empowering States to Innovate Act” or S.248, allows states to apply for waivers from the health insurance exchange beginning in 2014 and would give them some federal dollars to experiment with alternative ways of providing health coverage. The federal health bill requires that any state seeking a waiver from the health insurance exchange must at a minimum provide coverage comparable to that specified by the federal bill (Section 1332). It is left to the discretion of the secretary of health and human services to determine if a state meets this requirement.

States that put in place a single-payer health system will surpass the coverage of federal law. A single-payer health system, improved Medicare for all, would be universal and would provide the necessary cost controls and savings that would fund comprehensive coverage, including much-needed mental health, dental and vision care.

States such as Vermont and California, which appear to be closer than any others to enacting a state single-payer health system, welcomed the president’s support for the Wyden-Brown amendment because it would remove one of the many barriers they face. The amendment will still need to be passed by Congress before it arrives at the president’s desk, which may in itself be a formidable feat in the current political climate.

In addition, for states that want to take the path of single payer, even with the amendment, there will still be many hurdles before they can implement such a plan. The amendment only moves up the date when waivers can be applied for. It does not guarantee federal approval of the many waivers a state single-payer system would need, such as being allowed to roll their Medicaid and Medicare populations into their single-payer system.

Of concern is that the president is signaling a greater willingness to allow states to opt out of the health reform bill not because states want to provide better coverage but because governors in some states are opposed to the federal health law altogether. Beginning shortly after passage of the law last year, there has been an effort to undermine it through court challenges to its constitutionality and more recently through efforts to repeal it entirely or in part by the House. Additionally, hundreds of waivers have been issued excusing businesses, union health plans and health insurers from having to comply with parts of the law. The Department of Health and Human Services now has a 24-hour turnaround time on such waivers.

Vigilance will be required to ensure that some states do not use the amendment, if it is passed, to gut important public health programs such as Medicaid and SCHIP and further privatize health care, which would be harmful to patients. According to a White House fact sheet released around the time of the president’s statement, “The law also allows states to submit a single application that includes Medicaid waiver requests which could, for example, seek to give people eligible for Medicaid the choice of enrolling in [health insurance] exchange plans.” A change such as this would undermine Medicaid and shift more people into more expensive and less protective private insurance plans.

Efforts are already underway in Wisconsin to take control of the state’s Medicaid programs away from the state Legislature and end the public’s ability to have a voice in the process and instead give full authority over the program to the governor’s office. Gov. Scott Walker appointed Dennis Smith, a former Heritage Foundation fellow who has written about moving people out of Medicaid and raising co-pays for those still in Medicaid, as his secretary of health.

Wisconsin is not alone in challenging Medicaid. According to the Wall Street Journal, more than half the states want permission to remove hundreds of thousands of people from Medicaid. Other states like New York and Arizona are cutting benefits of health programs that already provide insufficient coverage.

Decades of experience in the United States shows that the market model fails when it comes to financing health care. Health is a necessity, not a commodity. A system based on the purchase of private insurance results in higher costs and poorer outcomes. Patients who cannot afford necessary care get sick, defer treatment and develop preventable complications, sometimes fatal ones. Families experience personal bankruptcy when a serious illness or accident occurs. With increased political pressure and Secretary Sebelius already issuing hundreds of waivers, can further privatization of health care be prevented?

While some welcome the president’s support for the amendment and hope that if it passes a state will be able to demonstrate the benefits of a single-payer system, as happened in Saskatchewan (and which led to Canada’s national Medicare system), it is possible that the actual outcome of such an amendment will be a further attack on our necessary public health programs. For this reason, it is imperative that we continue to push for a national health program, improved Medicare for all in the U.S.

“It would require fewer waivers and be simpler to enact improved Medicare for all at the national level,” says Dr. Garrett Adams, president of Physicians for a National Health Program. “Not only is it simpler, but it would save lives and end personal bankruptcy caused by medical illness. We would like to see a national Medicare-for-all system enacted sooner rather than later. Every day that we wait, hundreds of Americans die of preventable causes.”

Physicians for a National Health Program advocates for a national publicly financed and privately delivered health system: an improved Medicare for All as embodied in H.R. 676, the “Expanded and Improved Medicare for All Act.” Among the benefits of such a program are that it is a simpler system for patients and health professionals, recaptures about $400 billion annually in unnecessary paperwork and bureaucracy and directs that money into care, allows freedom to choose one’s health provider and more control over one’s treatment, is universal and provides comprehensive health benefits while at the same time effectively controlling our soaring health care costs. In this time of fiscal and health crises, national Medicare for all is more important than ever.

Healthcare-Now of Maryland Annual Meeting and Public Forum a great success!

We had a great meeting Tuesday night! Thank you to all who attended. The Peabody Room was packed.

Bekah Mandell and Sandra Schlosser of the Vermont Workers Center “Healthcare is a Human Right Campaign” shared the story of their three year effort to build a strong single payer grassroots in Vermont. They used Truth Hearings, Accountability Sessions and Photo Petitions to educate and grow. The result has brought single payer to the forefront of the discussion in Vermont. You can see their presentation in the video below.

Bekah made the excellent point that during the last national health debate, the model for reform was Massachusetts. It is important that for the next national debate, which we anticipate will occur within five years, that there be a state single payer model. For this reason, it is important that we support the VT efforts.

To learn more about the Vermont Workers Center and to find out how to support them, visit www.workerscenter.org. At present they are in need of donations to support the hiring of organizers. They are also looking for Marylanders to join their May 1st rally in Montpelier.

We would like to thank The Silverbacks for opening the meeting with music. They were fantastic! Many thanks to
Vocalist: Marianna Mujica
Piano: Richard Schroeder
Bass: Kevin Shaner
Percussion: John Kessell
Trombone: Professor Anthony Lehman, MD
Woodwinds: Donn Teubner-Rhodes, MD

Many thanks also to Dr. Dick Humphrey, our emcee, and Rod Ryon of Healthcare-Now of MD. And thanks to Maurice Morales for videotaping the meeting.

Here are links to the videos:
Annapolis Health Care Update
National Update
Sandra Schlosser and Bekah Mandell

Have you gotten PIISD (pissed)?

Dr. Carol Paris the eminent psychiatrist from Southern Maryland has defined a new disorder; Private Insurance Induced Stress Disorder (PIISD) pronounced pissed.  To discover if you are one of the millions who has this disorder go to http://PIISD.org where you will find the diagnostic criteria.  The only known cure is Improved Medicare for All.  PIISD has been featured in the the Psychiatric Times and the Huffington Post.  While at http://piisd.org you can buy a shopping bag or t-shirt that will show your support for single payer.

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