PNHP California

Health care, economy top concerns of Bay Area small business, Bank of America survey says

capa-admin — Fri, 18 May 2012 17:25:37 +0000

By Mark Calvey, San Francisco Business Times

Bay Area small business owners’ greatest concerns center on health care costs, credit availability and a recovery in consumer spending, according to Bank of America’s inaugural survey of small business owners that the bank plans to conduct twice a year.

On an optimistic note, BofA’s (NYSE: BAC) survey found Bay Area small business owners are more confident about prospects for the local economy than their counterparts in other markets surveyed.

In the Bay Area, 52 percent of respondents said the local economy will improve in the next 12 months vs. 42 percent who expressed similar confidence in their local economies elsewhere in the country.

In another striking contrast between the Bay Area and the rest of the nation, only 56 percent of Bay Area respondents said the “effectiveness of U.S. government leaders” was their top concern, the lowest level of all markets surveyed. Nationally, 75 percent listed the effectiveness of U.S. government leaders as their top concern in this presidential election year.

Medical students embrace Medicare for all

capa-admin — Thu, 17 May 2012 16:32:49 +0000

By Ed Weisbart, STLToday

If you ever want to rekindle your hope for American medicine, spend time with medical students. These bright, energetic minds are going into medicine for all the right reasons — to help people, relieve suffering and find new ways to cure illness and eradicate disease.

Their idealism is a pleasure to behold, particularly to a veteran physician like me. Yet I’m painfully aware of how our current health care ‘system” can undermine students’ idealism, especially if they see no alternative.

Fortunately, a better alternative is waiting in the wings: a single-payer, improved Medicare-for-all program. Most Americans, including 59 percent of physicians, want access to an improved Medicare. I’m pleased to report that our physicians-in-training are strong supporters of this truly universal, comprehensive and affordable alternative.

Why? Even before they graduate, today’s medical students learn how our Byzantine, antiquated system of patchwork private insurance undermines medical care. They recognize an imperative to correct social injustice, for both moral and pragmatic reasons.

Medical students learn that as practicing doctors they’ll be dealing with dozens of different insurance schemes, each with its own rules, paperwork and bureaucratic headaches.

As physicians-in-training, they encounter patients who have delayed surgery until they qualified for Medicare at age 65 — often with more difficult and sometimes fatal complications as a result. They meet grandmothers who have had to decide between paying for medications for their hypertension and paying the rent.

They see patients with employer-sponsored health insurance get sick, lose their job, lose their insurance and declare bankruptcy. In fact, medical expenses are the most common cause of bankruptcy.

Like everyone else, medical students are shocked when they see these inequities and inefficiencies. They believe your wealth should not determine your health and that poor health should not be able to destroy your wealth. And, of course, they’re right.

I recently had a chance to discuss these issues with students at both of the major medical schools in town. Just last month the new St. Louis chapter of Physicians for a National Health Program brought in Dr. Garrett Adams, PNHP’s national president, and Dr. Carol Paris, a single-payer advocate from Maryland, to speak with students at those schools.

The sessions were co-sponsored by the American Medical Student Association, a long-standing supporter of a single-payer system that has about 30,000 members nationwide.

It was clear from our local meetings that growing numbers of our medical students reject our dysfunctional, insurance-based system. They want something better. Many understand there is a breathtakingly simple solution: fix the limitations in Medicare and provide it to every American. More than 30 percent of the health care dollar today is wasted on the administrative costs associated with the private health insurance industry; Medicare spent only 1.5 percent on administrative costs during 2011.

A landmark study in the New England Journal of Medicine (2003) showed that by replacing our fragmented, inefficient patchwork of multiple insurers with a single, streamlined, nonprofit agency like Medicare that pays all medical bills, our nation would save about $400 billion annually in reduced administrative costs — enough money to provide comprehensive, high-quality coverage to every American for no more than our nation spends now.

According to Gerald Friedman, professor of economics at the University of Massachusetts-Amherst in the March/April 2012 issue of Dollars and Sense, “a single-payer system would save as much as $570 billion now wasted on administrative overhead and monopoly profits.” Spending would increase by $326 billion from expanding coverage and adjusting Medicaid rates. Americans would net a savings of $244 billion, enjoy universal coverage and eliminate the dreadful scenarios described above. Disposable income would increase for 95 percent of Americans.

Because a single-payer system would possess enormous bargaining clout, it also would be able to rein in costs for pharmaceutical drugs and other medical supplies over the long haul.

I believe that adopting an “improved and expanded Medicare for all” is the best way for students and physicians to return to their mission of caring for our patients, rather than squandering our time navigating administrative barriers erected by insurance companies. And make no mistake — these are barriers to care, with dire consequences.

Although we spend more on health care per capita than any other country in the world, American life expectancy ranks 38th.

My colleagues and I came away from our student meetings confident that the future of medicine is in good hands. The medical students we met didn’t get lost in jaded political quagmires.

They know it’s inevitable. They just want it to happen now.

Me too.

Dr. Ed Weisbart is chairman of Physicians for a National Health Program—St. Louis.

Average annual healthcare cost for a family tops $20,000

capa-admin — Wed, 16 May 2012 21:55:38 +0000

By Chad Terhune, Los Angeles Times

The average cost of healthcare for a family of four this year has increased nearly 7% to $20,728 annually, according to a new study by benefits consultant Milliman, or similar to the cost of a mid-size sedan.

A quick online search turned up a 2012 Hyundai Elantra selling for $20,728 in Michigan sporting “volcanic” red paint. You can nab a 1956 Chevrolet Bel Air in Santa Maria for the same amount or for better mileage a 2010 Toyota Prius with just 36,000 miles in Miami.

Milliman said the 6.9% annual increase was the lowest it has recorded in 12 years of its survey, but the jump in dollars from last year was the largest thus far at $1,335.

Increasingly workers are shouldering more of those medical costs through higher premiums and out-of-pocket expenses. Milliman’s figures reflect the employer and employee costs for a common preferred-provider plan, or PPO.

On average, employees through payroll deductions and cost sharing pay $8,584, or 41%, of the $20,728 for medical care and prescriptions, according to Milliman. Employers pick up the balance.

The average cost in Los Angeles, $20,908, was just slightly above the national figure. Miami was the most expensive of the 14 cities surveyed, at $24,965, Milliman found, and Phoenix was the cheapest, at $18,365.

Read the Article

High uninsured rates can kill you — even if you have coverage

capa-admin — Tue, 15 May 2012 15:56:41 +0000

By Sarah Kliff, Wonk Blog

There are many health policy studies that link uninsurance to worse health outcomes. A forthcoming paper in the Journal of Health Economics adds an important layer to that relationship: It finds that high rates of uninsurance mean worse outcomes even for those with coverage.

Health-care economist N. Meltem Daysal compared outcomes for insured heart attack patients in California over a six-year period, 1999 to 2006, when the state saw a 19 percent reduction in mortality rates for such cases. Across the state, however, there was huge variation in how health outcomes were improving: San Francisco and Los Angeles had decreases between 26 percent and 30 percent, while in Sacramento, the drop was just 13 percent.

Daysal wanted to know what was different about the patients in the three cities. He controlled for basic demographic information, like age and race, as well as a set of preexisting risk factors that were present at admission, like a history of heart failure or hypertension.

What he saw was cities that treated more uninsured patients seeing worse outcomes for those who came in with coverage. Daysal estimates that, if uninsurance were eliminated, there would be 3 to 5 percent fewer deaths among those who already had coverage.

What’s happening here? Daysal describes it as “negative spillover,” where the hospitals that treat more uninsured patients end up footing a higher bill for uncompensated care. That takes away resources they could be spending on hiring better doctors, upgrading medical equipments or making a whole host of investments that could improve health outcomes. Worse care, for all patients treated at the facility, ensues.

On the flip side, increasing insurance coverage could have positive spillover effects, improving quality of care even for the already-insured. “Taken together, my results suggest that policies aimed at addressing the issue of uninsurance may have additional benefits to insured patients residing in the same communities,” Deysal concludes. That means the Affordable Care Act, which is expected to extend coverage to 32 million Americans, could have some fringe benefits for those already covered.

Global push to guarantee health coverage leaves U.S. behind

capa-admin — Mon, 14 May 2012 15:48:18 +0000

By Noam Levey, LA TIMES

Before embarking on its healthcare push, the Mexican government found that 4 million people every year were being driven into bankruptcy by illness. “That was a huge drag on the economy,” Frenk said.

Today, Mexico’s new government insurance plan — known as Seguro Popular — covers more than 50 million people, filling the gap left by the traditional health insurance system funded by payroll taxes.

Such steps don’t eliminate all financial strain on households. Indeed, in many poor nations that are expanding healthcare coverage, such as Vietnam and the Philippines, people still must pay most of their own medical bills, a sign of skimpy coverage.

Governments, too, feel the strain.Colombia’suniversal healthcare system, set up in 1993, has cost more than twice what was expected, said Ramiro Guerrero, a former vice minister of health.

Even so, there is growing evidence that universal coverage is protecting millions worldwide from financial ruin.

Emergency Room Visits on the Rise Due to Low Co-Pay Costs

capa-admin — Fri, 11 May 2012 16:21:28 +0000

Emergency Room Visits on the Rise Due to Low Co-Pay Costs But Some Visits May Not be Necessary, According to 2012 Employee Medical Plan Trends Report

Highroads

Employees and their families are making more trips to the emergency room (ER), urgent care facilities and specialists’ offices as relatively low co-pay costs are narrowing the gap between those and other services – notably primary care physicians. The trends in employee co-pay are among the latest findings in the 2012 Medical Plan Trends Report conducted by HighRoads and Corporate Executive Board (CEB) (NYSE: EXBD).

According to plan data, the average ER visit co-pay is just $76. The relatively low costs may be leading employees to visit the hospital for symptoms that a primary care physician or other provider could easily and more cost-effectively treat. For example, toothaches and sprains are among the 10 most common conditions for which Americans visit hospital emergency rooms. While some ER visits are also likely attributable to patients who lack insurance, the steady increase in visits appears predominantly to be tied to co-pay costs.

The analysis also found the average plan has a relatively minimal price differential between urgent care, in-network co-pay ($32) and primary care physician (PCP) co-pay ($17). As a result, employees may be choosing urgent care facilities simply for convenience since they tend to keep evening and weekend hours and be open holidays.

New York and Missouri Introduce Single Payer Legislation

capa-admin — Thu, 10 May 2012 16:20:06 +0000

Legislation Introduced to Make Health Care a Right in New York State

Healthcare – NOW

Doctors, nurses, patients, senior citizens, anti-poverty advocates, faith leaders and medical administrators joined Assemblymember Richard Gottfried and Senator Thomas Duane in unveiling an updated and revised single payer legislative proposal for New York State. More than 70 state lawmakers are cosponsors.

Assemblymember Gottfried had initially drafted a single payer plan for New York in the early 90s. The revised legislation incorporates changes that have been made in the state’s oversight of health care in the interim, advances in how to provide medical services, and the recent federal changes in the health care system. The legislation builds upon the momentum from last May when Vermont became the first state to enact a universal health care system which the Governor plans to make a single payer system, where on programs pays all bills.

“The current system doesn’t work for patients or health care providers, or for the employers, individuals, and taxpayers who pay for care and coverage today,” said Assembly Health Committee Chair Richard N. Gottfried, author of the bill. “We can get better coverage, get all of us covered, and save billions by having New York provide publicly-sponsored, single-payer health coverage, like Medicare or Child Health Plus but for everyone.”

“Our current health insurance system is driven by uncertainty. Will my family have coverage? Can we afford it?,” said Senator Duane. “Single-payer is about removing that fear from peoples’ lives. It will allow all New Yorkers the same comfort that our seniors get from Medicare, and that our veterans get from TRICARE. It will allow entrepreneurs to worry about product innovation, not health insurance costs. It is time for single-payer in New York.”

Joining Assemblymember Gottfried and Senator Duane at the press conference were Katie Robbins of Health-Care Now!, Vito Grasso, Executive Vice-President of the NYS Academy of Family Physicians, Dr. Asiya Tschannerl of Physicians for a National Health Program, Mark Dunlea of Single Payer NY / Hunger Action Network of NYS, Shaun Flynn of the NYS Nurses Association, and Rev. Bebb Stone.

Assemblymember Gottfried convinced lawmakers four years ago to fund a study of the most cost-effective way to provide health care to all New Yorkers. The answer was single payer, which would reduce overall health care expenditures in New York by $20 billion annually by 2019. The state study said that single payer would be $28 billion cheaper annually by 2019 than the insurance mandate enacted by Congress. In addition to saving money, single payer was the only plan that guaranteed that everyone would have access to health care services.

“The Presbyterian Church U.S.A. has called single payer health care reform ‘a moral imperative’ since 2008. If I want health care coverage for myself ( and I do), how can I not want it equally for my neighbor whom I am commanded to love as myself?” asked Rev. Bebb Stone. “We believe that the value of persons requires that each person have full access to essential services without regard to ability to pay and on terms that enhance the dignity of the individuals” according to the 2008 resolution.

The proposal would provide comprehensive health coverage for all New Yorkers. Every New York resident would be eligible to enroll, regardless of age, income, wealth, employment, or other status. There would be no premium, deductibles, or co-pays. Coverage would be publicly funded. The benefits will include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, laboratory tests, rehabilitative, dental, vision, hearing, etc.

“Even if the recent federal health insurance mandates survives the legal challenges, it fails to provide health care coverage to everyone and is financially unsustainable. Tens of millions of Americans will discover that the insurance they are forced to buy fails to pay for the health services they will need. Everyone knows that there is a better solution – single payer, expanded and improved Medicare for all – and New York should be the first one to put it in place,” said Mark Dunlea, Executive Director of Hunger Action Network.

“The simplest and quickest way to reduce health care costs is to eliminate the money wasted on health insurance, its profits and administrative costs, and the bureaucratic barriers it presents to health providers and consumers. If we got rid of insurance companies nationally, the annual savings would be more than $400 billion,” added Dunlea, chair of the state legislative committee of Single Payer New York, an umbrella organization.

“As a physician working in the Bronx, I see every day the profound limits of medicine when patients must ration their care due to high copays and deductibles,” said Dr. Asiya S. Tschannerl with Physicians for a National Health Program. “And too many patients have told me that they earn just a few dollars too much to qualify for Medicaid, and are now facing the horrible dilemma of – “do I reduce my income? or go without insurance since I couldn’t afford it.” Enough is enough. We need a truly universal healthcare system like every other industrialized nation on this planet. Healthcare is a human right, not a privilege! A Single Payer expanded and improved Medicare for all would guarantee healthcare for all,” added Tschannerl, a member of Doctors for the 99% and Occupy Wall Street.

“We must end funding the waste, greed, and corruption of the health insurance companies, and move these resources to funding and providing actual healthcare. Insured or not, the Affordable Care Act pits people’s needs against profits for corporate-run healthcare. We can reverse this trend and recognize the right to healthcare by implementing the New York Health bill,” stated Katie Robbins of Healthcare-NOW! NYC.

“The Nurses Association firmly supports the establishment of a more equitable coverage system that directs scarce healthcare dollars towards providing universal access to high quality, cost-efficient health care for all New Yorkers – regardless of their age, income, health or employment status,” according to Deborah Elliott, RN, MBA, Deputy Executive Director, New York State Nurses Association.

Under the revised bill, health care would no longer be paid for by insurance companies charging a regressive “tax” – premiums, deductibles and co-pays – imposed regardless of ability to pay. Instead, New York Health would be paid for by assessments based on ability to pay, through a progressively-graduated payroll tax (paid 80% by employers and 20% by employees, and 100% by self-employed) and a surcharge on other taxable income. A specific revenue plan, following guidelines in the bill, would be submitted to the Legislature by the Governor.

Federal funds now received for Medicare, Medicaid, Family Health and Child Health Plus would be combined with the state revenue in a New York Health Trust Fund. New York would seek federal waivers that will allow New York to completely fold those programs into New York Health. The “local share” of Medicaid funding – a major burden on local property taxes – would be ended.

Private insurance that duplicates benefits offered under New York Health could not be offered to New York residents. Assemblymember Gottfried, in his official sponsor memo, noted that “New Yorkers have experienced a rapid rise in the cost of health care and coverage in recent years. This increase has resulted in a large number of people without health coverage. Businesses have also experienced extraordinary increases in the costs of health care benefits for their employees. An unacceptable number of New Yorkers have no health coverage, and many more are severely underinsured.

“Health care providers are also affected by inadequate health coverage in New York State. A large portion of voluntary and public hospitals, health centers and other providers now experience substantial losses due to the provision of care that is uncompensated.”

See more: http://www.healthcare-now.org/legislation-introduced-to-make-health-care-a-right-in-new-york-state/

Missouri Single-Payer Bill Introduced

On May 4, 2012, the Missouri Health Care Policy committee gave a formal hearing to MO HB1405, a bill that would establish a MO state-wide single payer health plan. Two Physicians for a National Health Program physicians testified and one more wrote a strong letter in support. The bill has been consistently advanced thanks to the efforts of Missourians for Single Payer.

The first video below is the introduction of the bill from Rep. Mike Brown of the Kansas City area; the second is the testimonies, running a total of about 15 minutes. A big shout-out of thanks to Rep. Brown and all of our great co-sponsors.

We have to really thank Progress Missouri, a multi-issue progressive advocacy organization, for recording this and so generously sharing it with us all.

Ed Weisbart MD
PNHP-STL, Chair

How single payer can improve the access to cancer care, May 4, 2012

capa-admin — Wed, 09 May 2012 19:53:23 +0000

The call came in the middle of a busy office day; the radiologist had found a suspicious area on the mammogram. I had received similar calls many times in my primary care practice. This time was different; the patient was me.

My first thought “thank God I’m insured.” My second thought was for all those who are not. It was hard enough waiting the week, until further testing could be performed; I can’t imagine the stress of not knowing how or if I would be able to get treatment should I learn I had cancer. For many of our patients that is a real concern. An estimated fifty million Americans do not have health insurance; another twenty five million are underinsured. In the event of a serious diagnosis such as cancer, they face the high cost of out of pocket expenses. For women with breast cancer, the uninsured are more than twice as likely to have their cancer diagnosed in an advanced stage than those with coverage. An estimated fifty thousand deaths a year are attributed to the lack of health insurance.

One in four families impacted by cancer finds themselves in financial straits. A Kaiser Family Foundation and Harvard Public Health study found half of cancer patients use up most or all of their life savings. Studies have found that over half of bankruptcies in the United States resulted from medical bills.

These troubling trends have led the American Cancer Society (ACS) to launch a campaign Access to Care to raise awareness to how the lack of health insurance leads to delays in detection and survival for cancer. John Seffrin, chief executive of ACS, has noted that lack of access could hinder our ability to move forward in the fight against cancer. ACS is calling for a health policy that is adequate, affordable, available and administratively simple.

A single payer system would meet these criteria. Physicians for a National Health Health Program has been working on behalf of a universal health plan that would cover all Americans. A single-payer system would simplify and streamline the process of getting health care.

Under the single-payer model, patients would no longer need to fear the egregious practice of rescission in which insurers drop a patient from their plan when they are diagnosed with a serious condition, such as cancer. The insurers defend the practice as a way to guard against fraud; however for patients it means that failing to mention even a trivial bit of history on the application could mean they are facing cancer with no health insurance. Indeed, a Reuter’s investigation revealed that WellPoint used a computer algorithm to initiate fraud investigation for women newly diagnosed with breast cancer; many of whom last their insurance, just when they needed it most.

A study from the journal Health Affairs found that those enrolled in Medicare, the national single-payer plan, had fewer problems obtaining needed medical care, less financial hardship and higher satisfaction scores than those in private plans. They were less likely to file bankruptcy due to medical expenses. There are also less socioeconomic disparities in health for the population on Medicare. Overall, Medicare patients report greater satisfaction and security than those enrolled in private plans. A single-payer plan could guarantee these benefits to all.

I was lucky to have a quick evaluation and reassuring results. My experience only increased my resolve to work harder on behalf of a single-payer plan so that everyone can receive comprehensive and universal coverage.

Aldebra Schroll is a family physician who resides in Chico, California.

http://www.kevinmd.com/blog/2012/05/single-payer-improve-access-cancer-care.html

Get Ready for Summer Conference 2012!

capa-admin — Wed, 09 May 2012 17:51:19 +0000

Third Annual Summer Conference

Organizing for Healthcare Justice in California
Sponsored by the Campaign for a Healthy California

Where: UCLA Ackerman Union – Grand Ballroom

When: Saturday, July 7th, 9am – 4pm and Sunday, July 8th, 9:30am – 4pm

Saturday: Learn about the Campaign for a Healthy California and the Healthcare Justice Movement in California: Network with other advocates working to guarantee healthcare for all Californians, Develop skills through interactive workshops including Labor & Medicare for All, Building a Coalition of Diverse Communities, Answering FAQs, and more!
Sunday: Gain necessary skills to build a successful movement in California: Strategize with other healthcare advocates from throughout California, Receive in-depth training in key areas of organizing including: Talking to the Media, Legislative Advocacy, Organization & Outreach, Delivering Your Pitch
For More Information:
Email: info@HealthyCaliforniaCampaign.org
Visit: www.HealthyCaliforniaCampaign.org
Call: 800-745-3090
Tickets: $10 (Sliding Scale)

How single payer can improve the access to cancer care

capa-admin — Tue, 08 May 2012 15:48:18 +0000

By Aldebra Schroll, MD – PNHP CALIFORNIA MEMBER

KEVINMD BLOG

Aldebra Schroll is a family physician who resides in Chico, California.

http://www.kevinmd.com/blog/2012/05/single-payer-improve-access-cancer-care.html