Rooster's Advice To cpaptalk Members on Healthcare Debate

Autopapdude wrote:Rooster is full of crap. He's presenting opinion as to what HE thinks about health care, without any facts or substantiation.

Hawthorne wrote: It was just another way for you to get on your soap box about the proposed changes to health care in the US.

Just my opinion.

Muse-Inc wrote:If other countries have figured out how to make it work even with challenges, are we Americans so stupid we can't come up with a reasonable plan?

Kinda like those who claim "healthcare is a right", huh?

PNHP co-founder Dr. Steffie Woolhandler on the passage of House Bill 3962
(Excerpted from an interview with Amy Goodman, Democracy Now, November 11, 2009)
AMY GOODMAN: When the House voted on the bill, 220-to-215, what was your reaction? And can you analyze it for us?
DR. STEFFIE WOOLHANDLER: Well, we think that the Congress needs to start from scratch on this bill. The reform process in Washington has been hijacked by the private health insurance industry. If you look at the Baucus framework, which was the basis of the Senate bill—it’s on the Senate Finance Committee website. Just right-click on that document, and it turns out the author of the document was Elizabeth Fowler, who’s a former vice president of Wellpoint, the nation’s largest private insurance company, covering 35 million people. So the private insurance industry has hijacked the process. What’s come out of the House, what’s likely to come out of the Senate, is a completely inadequate bill that takes about $500 billion in taxpayer money and hands it over to the private health insurance industry.
AMY GOODMAN: I mean, explain exactly that, as people are suffering in the midst of this, you know, tremendous economic downturn, this global economic meltdown. You’re talking once again, not only with the bankers, but with the insurance company, of forcing people to buy health insurance, but to buy it from private insurers. So this is an incredible deal for the private insurers.
DR. STEFFIE WOOLHANDLER: Right. Well, the private insurers are getting millions of mandatory new customers. The taxpayers are going to give subsidies. It’s not going to make healthcare affordable, but it’s going to cost the taxpayers a lot of money to give these subsidies.
Private health insurance is a defective product. We know from our studies of bankruptcy that the majority of Americans who face medical bankruptcy start their illness with private health insurance but are bankrupted anyway by gaps in coverage, like co-payments, deductibles and uncovered services.
And under the House and Senate bills, they’ve done nothing to fix private health insurance. They’ve merely made private health insurance mandatory for middle-income working people and forcing those folks to take lots of money out of their pocket to buy this defective product.
AMY GOODMAN: And, of course, most bankruptcies in this country are caused by medical problems; they are medical bankruptcies.
DR. STEFFIE WOOLHANDLER: Right. In our studies, we found that 62 percent of all bankruptcies in the United States are due at least in part to medical illness or medical bills and that the majority of folks in medical bankruptcy started that illness with private health insurance.
AMY GOODMAN: But what about those who perhaps do even support Medicare for all or single payer who are saying, “Well, at least now you’re talking about tens of millions of people who will be insured, who weren’t otherwise”?
DR. STEFFIE WOOLHANDLER: What’s happened in the past when bills like this have passed in the states is that they run out of money very quickly, healthcare is simply unaffordable, and then you start to see the coverage expansions cut back. The subsidies shrink, the Medicaid shrinks, and then you’re back at square one, where you’ve spent a lot of money and not made any progress. And we’ve seen this over and over in the United States—in Massachusetts in 1988, in Oregon in 1992, in Washington 1993—passed bills virtually identical to what’s being passed in the House right now, and there was no durable improvement in the number of uninsured in those states. Healthcare was not affordable ten years after those bills were passed.
The problem with the House bill is it simply won’t work. And, you know, if we want to expand Medicaid, fine, we should expand Medicaid. If we want more primary care, good, let’s expand primary care. But doing it through $500 billion in subsidies to the private health insurance industry will have the effect of making the health insurance industry more powerful, making the health insurance lobby more powerful. And just as they’ve hijacked this process in Washington, it makes them more able to hijack political processes in the future.
AMY GOODMAN: And the cost of drugs? So it’s not only the mandatory—mandating that people buy health insurance from private companies, but the deal that was worked with the pharmaceutical industry in this country. Explain that.
DR. STEFFIE WOOLHANDLER: OK. Well, the deal with the pharmaceutical industry was minimal. The pharmaceutical industry gave up very little. They said for Medicare recipients who are in the doughnut hole, they would make low[er]-priced [brand-name drugs] available. That’s a very small share of the population. For the rest of us, who may be unable to afford expensive medications, we got nothing out of the pharmaceutical industry.
The pharmaceutical industry, frankly, is thrilled with this bill. And despite all their squawking, the health insurance industry is pretty happy, too. You know, Wall Street has rewarded them by driving up the value of their stocks. And I think any fair and honest reading of this bill would say that it’s a tremendous victory for the health insurance industry. And what we need to do to get to universal healthcare is start from scratch, go for that Medicare-for-all, single-payer approach.
AMY GOODMAN: And the issue of women, reproductive healthcare and abortion?
DR. STEFFIE WOOLHANDLER: Well, that is a horrendous provision in the House bill, which would essentially extend a ban on abortion to private health insurance. In the past, the Hyde Amendment applied only to people who were getting publicly funded care. But in the new bill, any insurance product that’s offered through the exchange has to—
AMY GOODMAN: And explain the exchange.
DR. STEFFIE WOOLHANDLER: Yes. The exchange would be this marketplace where you would go to buy your insurance. If you had subsidized coverage, you would have to buy your insurance through the exchange.
And any insurance plan purchased through the exchange would have to exclude coverage of abortion. So, for the first time, Congress has stepped in and said that even with your own money, with private money, it’s illegal for insurance to cover abortion. It’s a tremendous step backwards for women’s rights.
AMY GOODMAN: And do you think it will make its way through to the final bill?
DR. STEFFIE WOOLHANDLER: Well, I’m not sure about that. Certainly President Obama has weighed in to say, “Well, let’s try to return to what was there before, with just a ban on public funding of abortion,” which is bad enough. It remains unclear what’s going to happen in the Senate, whether the right-to-life folks will step in and get an anti-choice plank in the Senate bill, as well. They certainly were successful in the House. And, of course, that’s one of the many reasons that we think we need to start from scratch on a new health reform bill.
AMY GOODMAN: Steffie Woolhandler, you come from Massachusetts. That’s often held up as the model. I recently saw on CNN your former Governor Weld interviewed about his plan that has been adopted by all of Massachusetts. Explain the Massachusetts plan and then how we, as Americans, fit into the rest of the world when it comes to our healthcare system.
DR. STEFFIE WOOLHANDLER: OK. Well, the Massachusetts plan is considered the model for the national legislation. There’s a mandate that makes it illegal to refuse to purchase private health insurance. The fine is up to $1,068. The good thing with the Massachusetts plan was there was a big Medicaid expansion, but you didn’t need to do the mandates in order to do the Medicaid expansion.
Much of the Massachusetts plan has been wildly expensive. According to the state’s report to its bondholders, it’s cost $1.3 billion this year. The state has opted to pay for that by stealing money from safety net clinics and hospitals, so that safety net providers that care for immigrants, the mentally ill, people with substance abuse, that provide primary care, they’ve seen their funds shrunken, so that money could be handed over to purchase insurance policies. Massachusetts now has the highest healthcare costs in the history of the world.
You have to compare that to what goes on internationally. With the average per capita cost of healthcare about half those in the United States, yet people in Canada and western Europe live about two years longer. They have complete free choice of doctor and hospital. They have lower infant mortality. People in other developed nations use some form of nonprofit national health insurance to get better care for less money. And that’s why our group supports the Medicare-for-all approach.
AMY GOODMAN: So the question is where that fits in today. Finally, former President Clinton met with Senate Democrats yesterday and basically said nothing—said something is better than nothing, pass this now. What do you feel about that?
DR. STEFFIE WOOLHANDLER: Well, I think we know—we now know the outlines of what they’re going to pass. It’s not an abstract something; it’s something real. And it’s quite bad. It’s $500 billion in new subsidies to the private health insurance, millions of mandatory new customers for private health insurance.
The public plan option is incredibly puny. According to the Congressional Budget Office, fewer than 2 percent of Americans will enroll. And the premiums will actually be higher—higher—than premiums in the private sector. So the public plan option will be an expensive, tax-funded subsidy to private health insurance, because the public plan option will take the sickest patients off their hands. It’s not going to be something that’s going to generate coverage or decrease costs.
So, we know what the outlines are of the plan, and there are so many bad and harmful planks to the plan that we do need to start from scratch on health reform.
AMY GOODMAN: Since it doesn’t look like they will, will you not support what is coming out right now? Would you have voted no if you were a congressman—Congress member? Would you vote no in the Senate?
DR. STEFFIE WOOLHANDLER: Well, I’m a, you know, doctor; I’m not a politician. I feel a little bit like we’re debating whether to give aspirin or Tylenol to a patient with breast cancer. The patient needs surgery. And what’s being debated in Washington is really Tylenol or aspirin. And I had said for awhile we’d have to see the final shape of the bill, because, of course, we’d—I’d love to see more Medicaid money. Medicaid is very helpful for very poor people. It’s not perfect, but it’s much better than nothing. But I think there’s so many bad planks in the bill that this bill needs to be scratched, and we need to start over.
AMY GOODMAN: Do think this is a better deal for the health insurance industry, for the private health insurance industry in this country, than we have right now?
DR. STEFFIE WOOLHANDLER: I actually do. Their number one demand was the so-called individual mandate that would make it illegal to not have health insurance. It will become a federal crime to be uninsured. If you have private health insurance through your work, and you hate your private health insurance, tough luck, you have to keep that insurance. The mandate means you have to keep it. You can’t buy the public option. You probably won’t be able to go through the exchange. So they’ve made private health insurance mandatory, giving them hundreds of billions in new—mandatory new customers.
There’s some minimal insurance regulation, and I think more regulation is better than less regulation of insurance, but that’s going to be counterbalanced by the tremendous economic boost that will be given to the private health insurance industry through this bill. And as we know, if you have a lot of money, you can buy a lot of political influence. I think down the line we’re actually likely to be worse off in handing over so much taxpayer money to what is essentially a private health insurance industry bailout.
AMY GOODMAN: Dr. Steffie Woolhandler, I want to thank you very much for being with us, professor of medicine at Harvard University, primary care physician in Cambridge, co-founder of Physicians for a National Health Program. We’ll have a link to their study on our website at democracynow.org.
http://pnhp.org/news/2009/november/pnhp ... -bill-3962

U.S. Needs Health Care, Not Insurance
By Carol Miller
Albuquerque Journal
Sunday, November 15, 2009
A very complex, mandatory private insurance scheme recently passed the U.S. House. The public is being overwhelmed by sound bites on one hand about how great it is, on the other, how terrible. We are hearing few of the details that are actually in the bill. Having read the bill, it is clear now that what started as health reform has emerged from the political process as health "deform," building on the worst, not the best of the current system.
It is still a toss-up as to whether the Senate will pass any bill this year. However, due to intense political pressure, the Senate is likely to pass a bill that will make some House provisions better and others worse. What actually comes out in the final conference-committee bill is anyone's guess at this point — so little time, so many deals still to be made, so many political funders to be appeased.
A careful analysis of the bill shows that it is designed more for political goals than to eliminate financial barriers to health care. For example, the actual coverage doesn't even begin until 2013, opportunistically after the next presidential election, in 2012. Run on having accomplished "historic reform" but before anyone actually experiences how bad it is? How cynical is that?
Yes, there are some good provisions. The best relate to improving existing programs like the Indian Health Service, community health centers, and health professionals education and training; all are important for New Mexico.
But there bad provisions, which comprise most of the 1,990 pages of the bill. Five key reasons this legislation must be stopped:
• If passed, this law will move the U.S. farther from universal health care, making it harder than ever to accomplish health care justice in the future. If Congress does not have the courage to stand up to the private insurance industry now, it will be even more difficult in the future, especially after giving the industry trillions of new dollars through this terrible legislation. Let's call this what it is: another corporate bailout on the backs of working people.
Pay attention to your federal representatives as they carefully talk about "health insurance reform." They aren't talking about health reform any more. Congress could have defended and built up a system based on popular, high-quality government-run health programs like the military and veterans fully socialized health systems or Medicare, a single-payer program. Instead, the president and Congress let the corporations and government-haters take control of the agenda.
• The legislation institutionalizes permanent inequality in health care. Unlike Medicare where all beneficiaries have a single plan, this bill further divides the U.S. system into tiers based on ability to pay. It creates basic, enhanced, premium and premium-plus plans. A basic plan will provide only 70 percent of the coverage of a "reference benefit package," one that includes even fewer services than most insured people have today. The bill doesn't even mention coverage for essential services like vision and adult dental care except in the most costly premium-plus plan.
• Out-of-pocket costs remain sky high. Everyone will be required to pay monthly insurance premiums. Some low-wage workers will receive taxpayer subsidies on a sliding scale. The lowest income people will have full subsidies. But remember, this is not money for care, it is support only to buy insurance.
Almost everyone will have to meet a deductible, capped in the bill at $1,500 a year, higher than most insurance-plan deductibles today. On top of this, insurance companies can charge even more under various "cost sharing" schemes for items like co-pays and co-insurance.
The bill puts a cap on cost sharing, but the total amount is obscene. The cap for an individual is $5,000 a year and for a family it is $10,000 before the plan must cover everything. Well, not exactly everything. Even after paying this huge amount of money, the legislation still allows the corporations to make us pay, billing for non-network providers and, since it is not a comprehensive benefit package, we are still on our own to pay for health care that the plans refuse to cover.
The legislation creates a law to let these corporations increase what they charge people as they get older. In fact, they can be charged up to twice as much as younger people for identical coverage.
• The legislation makes it illegal to not buy health insurance. The penalties are described in a section of the legislation called "Shared Responsibility." This will let the IRS impose a tax of up to 2.5 percent of modified adjusted gross income for not having health insurance. People on the financial edge, people fighting foreclosure to stay in their homes or people who are unemployed all or part of a year will not be able to afford the insurance premiums or the penalties for not having insurance.
• We will all be drowning in paperwork, which will continue to drive up administrative costs. Right now, insurance administrative waste is about 30 percent of every health care dollar— or about $1 billion a day. Adding more people to an insurance-based system will result in even more money going into this bottomless pit.
As if this isn't bad enough, the government will be setting up many new agencies to oversee the whole process including, at the top, the Orwellian Health Choices Administration, headed by the Health Choices Commissioner. This is not an agency to help us make health care choices, but to choose a health insurance company. The IRS will play a very large role in everything from certifying our income for subsidies to monitoring and taxing people who don't buy insurance.
Health Insurance Exchanges will be created across the country with at least one in every state offering both Web sites and telephone assistance. This is where we will go every year to pick our insurance plan in an open enrollment period of at least 30 days between September and November. We can add this unpleasant task to all of our other fall chores.
It is hard to imagine the chaos and wasted resources with the entire country picking insurance plans at the same time, attended by marketing, billboards, advertising and misinformation. We will gamble as we choose a plan, decide which corporation will be the best for us, hoping we pick one that is not dominated by corporate bureaucrats focused on rationing care to maximize their profits. It is not an easy task and if a wrong plan is selected, we are stuck for a year, until the next national open enrollment cycle.
The United States can do better. We can build on a strengthened and well-funded Medicare program. In Medicare, when a person reached the age of eligibility or is determined to qualify because they have a permanent disability, they are in, and there is no re-enrollment.
Imagine real reform, as simple as adding people ages 55 to 65 years old to Medicare in 2010, 35-55 in 2011, and so on until everyone is included by 2013. The bills that promote this kind of reform are under 200 pages, they are simple to implement, cost effective and equitable. Choose a doctor, choose a hospital when needed and let the government pay the bills. Everyone in one system.
That is what real health reform would look like.
Miller is a long-time public health professional and health care advocate. She lives in Ojo Sarco.
Originally published under the title "N.M. Needs Health Care, Not Insurance"
http://www.abqjournal.com/north/opinion ... -15-09.htm
http://pnhp.org/news/2009/november/nm-n ... -insurance

Autopapdude wrote:It is a right, even for people who so virulently oppose it such as yourself.

Autopapdude wrote:If you don't like the "Socialism" that is prevalent in America ( your assertion, not mine),

Autopapdude wrote:Let's see--Medicare--Socialism? Public police and fire protection? Socialism? Public Schools? Socialism? Public Highways? Socialism If we take your simplistic definition {actually from Webster's dictionary}, then we've had "Socialism" for years and years, so why worry?

And yet all your attempts to justify that statement have been ludicrous. Many of the benefits you suggest I forego are things I have EARNED and already paid for. Are you incapable of recognizing the difference?

Hawthorne wrote:LinkC - This Canadian responded here (in spite of the "new" topic title) because I knew it was just a continuation of the thread Rooster started saying he was feeling sorry for his Canadian relatives and friends. I read that because of the title, which did not mention health care reofrm in the US.

This debate still has no place on this forum--- in my opinion.

Autopapdude wrote:No, we all pay FICA so that you can collect your checks in your drooling dotage. You didn't pay for the right to collect Social Security, or Medicare. ALL of us did from payroll taxes, DUFUS.

DS wrote:I'm all for a complete (ahem! socialist) takeover of healthcare insurance (not neccessarily 100% "social healthcare" though). The current "government option" is a farce of a disguise for another corporate industry giveaway of the corporations, by the corporations, and for the corporations.