Baucus says he shouda listened

Well yeah. Politico reports that "Senate Finance Committee Chairman Max Baucus (D-Mont.) told leading advocates of a government-financed health care system that he made a mistake by not giving their proposals more consideration in the reform debate, according to participants in a meeting Wednesday."

Bernie Sanders (I-VT), a single-payer supporter, arranged the meeting with David Himmelstein, MD, and others.

Those involved in the health care negotiations say single payers have been elevated precisely because Baucus excluded them. Baucus has been able keep almost every interest group involved in the process from speaking out against the ideas under consideration. But because they are not involved, single payers have been one of the only vocal constituencies hammering away at Baucus.

The virtual shut-out has emboldened the movement.

After being left off the invite list for the White House health care forum in March, single payer advocates alerted the media and won a seat at the table. They disrupted each of the Finance Committee’s three roundtables on health care in April and May.

CA single-payer urges support for ABX 1 1

Stephen Schear gives a paragraph of his credentials as a single-payer supporter before urging Californians to reconsider and support the Schwartzenegger mandate plan, ABX1 1. (Why the name that sounds like a Reagan era star wars weapon?) His credentials are good. His support of ABX1 1 is unconvincing.

Schear's reasoning is that the Schwartzenegger plan will ease the transition to single-payer.

"Repeated polling, focus groups and experience have demonstrated that fear is the emotion that keeps most voters from supporting proposals for universal health care, including single payer."

Schear thinks that somehow forcing more people into private insurance will make them less afraid of single-payer, and ease the way to its eventual enactment. I read this article wanting to see his point — but it's not congealing. He writes:

"...The mandate for private health insurance is relatively meaningless, especially since ABX1 1 includes a provision that people can be excused from the mandate if buying health insurance would constitute a financial hardship. The government is not going to prosecute individuals for a lack of health insurance. The other “problems” with ABx1 1 are only problems if you compare ABX1 1 with single payer. Although there is not much in the way of cost control in ABX1 1, at least it requires insurers to spend 85% of their premiums on health care, a small advance in limiting private insurance waste. ABX1 1 will not achieve universal coverage, but it expands coverage far more than any legislation since Congress passed Medicaid and Medicare in 1965."

How can a mandate, further strengthening the key malignant element in our system, be meaningless?

HCAC questions report

The Northern Colorado Business Report ran this article on the 208 Commission, which is meeting today to go over their final report to the Colorado Legislature:

DENVER -- A group of health-care professionals who offered one of four proposals selected for review by the Colorado Blue Ribbon Commission for Health Care Reform released a statement Jan. 7 that said it has "deep concerns" about the draft recommendations that appear headed to the state Legislature later this month.

Board members of the Health Care for All Colorado Coalition, which submitted the Colorado Health Services Program proposal to the commission -- sometimes called the 208 Commission -- said the recommendations that are making their way to the Legislature on Jan. 31 won't cover all Coloradans or cut the administrative costs continually increasing health-care premiums.

Board member Michele Swenson said the 208 Commission recommendations fail to address the rising cost of health insurance premiums and would provide taxpayer subsidies to private insurance companies by requiring the purchase of a "minimum-benefit plan."

"They're moving people into minimum-benefit plans and they don't protect families adequately against health and financial risk," Swenson said. "The bottom line is, do we want to increase the bottom line of the insurance industry or increase health-care coverage for all?"

The Health Care for All Colorado proposal was the only single-payer proposal that automatically covered everyone in the state. A financial analysis showed the plan could save about $1.4 billion annually in state health-care spending but would also be the most expensive to implement, costing about $15 billion in new spending to set up.

Maine paper pushes single-payer

This isn't quite an endorsement of single-payer, but it's pretty close. The Bangor Daily News evidently has a readership close enough to Canada that they're not fooled by the propaganda slurring Canada's system. The editorial reads:

Much of American health care is already run quite satisfactorily on a single payer basis: Medicare, Medicaid and the veterans’ health system.

Government run health plans, usually single payer plans, are good enough for Canada, Britain, France, Denmark, Sweden, Germany, Australia, New Zealand and most other developed countries. Why can’t they even be considered and debated by candidates for the U.S. presidency?

208 Commission in the Post

Jim Spencer, news columnist for the Denver Post, wrote a great column today about Colorado's (208) Blue Ribbon Commission for Health Care Reform's task of finding the best three to five of 28 proposals for comprehensive reform that they've received.

None of the proposals assumes people are not entitled to treatment if they cannot pay retail. The hardest question the commission must answer is the private/public mix in the provision of health care. Still, no one argues for the status quo.

Spencer interviewed Service Employees International Union's Colorado point man for health care and Dr. Rocky White, an Alamosa physician, conservative rancher, and Health Care for All Colorado board member. Both SEIU and Health Care for All Colorado submitted proposals to the commission. Rocky was lead author for HCAC's proposal. Spencer described Rocky's proposal as being, "the simplest, most progressive and most controversial of the commission's proposals."

Spencer got right to the heart of the problem when he quoted an advisor to SEIU, who said that what is easiest to administrate — single-payer — may be hardest to approve politically.

This advisor helped Mitt Romney come up with the Massachusetts scheme, which is ticking away — before it even begins — with costs overruns and inadequate plans that people will be forced to buy. "Republicans support the subsidized purchase of private health insurance," he told Spencer.

That is such a mystery to me — but it must be related to what our friend Jack Long says: People are either scared of the wealthy or of the government.

So they'd rather go with inefficiencies that is on course to bankrupt individual families and the government as well, all in the name of free markets. Except if the government is subsidizing private insurance, they're not free markets. Bush's Health and Human Services secretary, Mike Leavitt, recently said that government's role in healthcare should be to "manage markets." If that's the case, why not manage them right, and take private insurance out of the game?

One risk pool needed

Saul Friedman at Newsday has written a great piece on single-payer. He quotes Robert Gumbiner, evidently one of the people behind the managed care movement. Gumbiner writes:

"I am proposing the federal government as the single payer of health care in this country. Only the federal government has the ability to fund one large risk pool through a payroll deduction. As the single payer, the federal government could negotiate hospital and physician payments even more effectively than it does now with Medicare.



"A single pool of funds, collected and administered by the government, would expand Medicare and replace Medicaid, SCHIP (State Children's Health Insurance Program), the VA health-care system, and private health insurance, including the health care aspect of Worker's Compensation. ... Also eliminated would be the tax credit - or subsidy - given to companies for providing health insurance to their employees. In other words, the current, inefficient patchwork of payment systems would disappear, to be replaced by one nationwide program available to every citizen."



Friedman writes he found the piece at the PNHP website.

Friedman invites letters on your ideas on universal care: Saul Friedman, Newsday, 235 Pinelawn Rd., Melville, NY, 11747-4250, or saulfriedman@comcast.net.

Des Moines Register solid

Thanks to Over My Med Body! for this, which I'd missed, being as doped up on pain killers as I was brave enough to be.

(They warn you that the narcotic depresses respiration, and so you might die if you take too much. The advice nurses get pretty exercised about it. Somehow I'm thinking that I was at more risk from the excess tylenol in the four percocets I took in two hours than from the oxycodone, but whatever. I'm on the mend now.)

The Des Moines Register referred to a story they'd evidently told before, of a couple who bought AARP-sanctioned insurance for $700 a month, then found themselves owing $200,000 after one of them came down with cancer. The
Register gets it exactly right:

Private is not better than public when it comes to health insurance.

Private health-insurance companies spend a greater percentage of dollars on administrative costs than government programs such as Medicare. Private companies also use health dollars to pay outrageous CEO salaries. UnitedHealth Group Inc. paid a former CEO $8 million a year. He also had unrealized gains on company stock options totaling nearly $1.6 billion.

Try finding a government worker with a personal jet.

And yet the commenters don't get it — many of them, anyway.

One guy notes that Americans would rather pay their cell phone bills than health insurance. Well — yeah. My cell phone offers a palpable daily benefit — and I know I'm getting a decent deal. For most people most of the time, health insurance offers a theoretical benefit and we know we're getting ripped off. Of course we'd rather pay our cell phone bills. And if we're young, we typically make that calculated choice that we'll be all right, and we forgo the health insurance and buy a cell phone plan instead.

Sure it's stupid. But it's a stupidity engendered not only by human nature but by a system that exacerbates the problem, by rewarding the worst of human nature and giving a shoulder shrug to the best.

Blaming human nature under those circumstances is short-sighted.

Another endorsement

The Minneapolis Star-Tribune has endorsed single-payer healthcare system for the United States. After describing the program in Massachusetts and the proposed program in California as exciting, the editorial board writes that "the closer you look at these ambitious plans, the more you see they are mere patchworks."
They say it's time to think about just making the leap to single-payer.

This radical notion would seem unthinkable, except that every other civilized nation already has thought about it and embraced it -- from conservative societies such as Japan and Australia to nanny states such as Germany and France. Every one of them covers more people, produces better medical outcomes, wastes less revenue on overhead and marketing, and spends less money than the United States.

Endorsing single-payer

How many newspapers have endorsed single-payer healthcare?

This is from today's St. Louis Post-Dispatch's editorial on Bush's state of the union:

"The president showed an admirable willingness to address the nation's growing health insurance crisis. But his diagnosis of what has caused the problem is wrong, thus his prescription to fix it is wrong, too....

"That leveling would be accomplished not by improving coverage for people buying insurance on their own, but by making it more expensive for companies to provide adequate insurance to their workers. That's a step in the wrong direction. The right direction is toward a single-payer national health care plan."