Commonwealth's proposal

Commonwealth Fund's principal researchers and president have authored an article for Health Affairs with Lewin Group modeling that shows a path to dramatically improving U.S. healthcare. It seems far superior to the flawed Wyden plan.

Health Affairs has a firewall, but you can see a synopsis of the plan at Commonwealth Fund or at Medical News Today.

Here are the basics, from Medical News:

• A national entity known as a "connector" that would offer individuals and small businesses a choice of private plans or a Medicare Extra plan.
  
• Requiring that all applicants be given health insurance at standardized rates regardless of their health status.
  
• Tax credits to make sure premiums are affordable. Premium assistance would be available to all to ensure that premiums do not exceed 5 percent of income and 10 percent of income for higher-income tax filers.
  
• Expanding Medicaid and SCHIP to cover all low-income adults and children below 150 percent of the federal poverty level with modest copayments for health care services and no premiums.
  
• Requiring that everyone enroll in a health insurance plan-uninsured individuals who file taxes would be automatically enrolled.
  
• Requiring employers to either provide health insurance or pay 7 percent of payroll up to $1.25 an hour into a pool to help to finance coverage.
  
• Medicare reforms that would extend Medicare Extra benefits to current Medicare beneficiaries, eliminate the two-year waiting period for Medicare for the disabled, and allow adults age 60 or older to buy in to Medicare.

Health Insurance to Africa

Sound familiar?

Private insurance products hardly exist for the rural and urban poor and in cases where they do exist they are not affordable for them. Public Social Insurance Services are mostly insufficient and exclude people working in the informal sector. Nine out of ten people in Sub-Sahara Africa therefore do not have any access to health or accident insurance. They have to pay tremendously high fees for treatment, medical care and hospitalisation out of pocket. Especially those people living below the poverty line (more than 40% in Sub-Saharan Africa) have to take out loans, dissolve their savings or sell essential resources to pay for their treatment. Therefore, many are not in the position to make use of the required services at all. In fact, many people fall into poverty due to illness and treatment costs.

For decades now the World Bank and IMF -- a bit like loan sharks in poor neighborhoods -- have held out fat loans for poor countries. The price for accepting those loans was accepting neoliberal ideology, and privatizing public services.

The loans also weren't usually tracked very carefully, so that they became a corrupting influence for government officials who became fat and retired to Switzerland on them.

So government services were cut, including health care. The money was ineffeciently spent, and then the loans came due -- forcing a further cut in social services. Including health.

And now a German professor has a research project going for how "access to proper insurance for all can be reached successfully" -- through micro-insurance. Same as we have here!

All according to plan.

Nathan Wilkes' Story

Health Care for All Colorado is incredibly lucky to have Nathan Wilkes on its board. In this video from the California Nurses Association he explains how he became involved in the battle to reform health care.

Think about the fact that the health insurance industry skims off one health care dollar out of three -- and then think about Thomas Wilkes.

How can they sleep at night?

Ezra Klein on insurance reform

Ezra Klein is the best. He's got a couple good posts today, one on the malicious side effects of our perverse health insurance industry, and the other on our cutting off our noses to spite our faces in not giving immigrants health care, which is a disaster for public health.

His post on the insurance market is a link to news that it just became impossible in Washington State for many more people -- including people who've had breast cancer -- to buy insurance on the individual market. Ezra writes,

This is the real problem with reform plans that lack a full coverage component (be it a mandate, voucher systems, automatic enrollment in a national market, or whatever). The issue isn't the folks who will be uninsured, but the damage that does to your ability to reform how insurers work. To create a working market you need to create a fair market. And that means setting up the rules such that neither insurers nor individuals can game the system.

It's probably obvious I think people concerned with single-payer should just go to Ezra's site on a daily basis. He's the best.