Alliance for Democracy

MA style Plan and Health IT no solution/updates from PNHP

Posted in Health Care, Sen. Sanders, Single Payer by Alliance for Democracy Portland OR on November 22, 2009

 Senator Sanders will introduce two amendments to allow single payer healthcare in the US.  Contact your Senator and ask for their support. 
Hi AfDers and friends,
 
Sorry for back to back emails but I just received this myself and recommend that each of us action on this. Sen Sanders has announced that he will offer two amendments to the Senate health(insurance) care bill.  If we are to achieve the goals in this healthcare debate that we want  (universal care for all, cost cutting, lessen corporate power, remove the private insurance companies from the system, eliminate co-pays and deductions, no losing coverage because of pre-existing conditions, did I mention universal), then at least one of these must be adopted.
 
The first amendment would create a national single-payer healthcare system (improved Medicare for All).  The second amendment would like states to implement a single-payer system.  The Canadian single payer system developed first in one province and then being so successful was adopted by the whole nation.
 
Action Alert – Ask your senator to support Sanders’ Medicare for All amendments
Sen. Bernie Sanders (I-Vt.) will introduce two single-payer amendments.  One would create a national single-payer plan, similar to S. 703 and H.R. 676.  The other would allow states to adopt single payer.  Urge your senators to vote “yes” on the Sanders single-payer amendments.  The Congressional Switchboard is (202) 224-3121 or you can send an e-mail message through PNHP the web site.

David e. Delk, Alliance for Democracy – Portland Chapter 503 232 5495 www.afd-pdx.org
This email will be posted to the Alliance for Democracy blog at https://afdportland.wordpress.com/ in a few minutes for your comments.



From:
Physicians for a National Health Program

To: lfrarey@rochester.rr.com

Sent: Friday, November 20, 2009 5:49 PM

Subject: MA-style plan and Health IT no solution/updates from PNHP

 

 

November 20, 2009
Dear PNHP members and friends,
We have some good news and some bad news.
 
The good news is that Sen. Bernie Sanders (I-Vt.) will introduce two single-payer amendments in the Senate and PNHPers are speaking out in support of real reform from coast to coast.  From op-eds to articles to TV appearances, PNHP members are making the case that we need to “start from scratch” on health reform and adopt a single-payer, Medicare for All system.

 
The bad news is that the Senate’s version of health reform is, like House version (H.R. 3962) totally inadequate.
 
In brief, it gives $450 billion in taxpayer money to the private insurance industry, along with an individual mandate that shunts them millions of mandatory new customers for their defective product. It doesn’t expand Medicaid or private coverage for another four years, until 2014, and even then would leave over half of the uninsured – 24 million people – without any coverage.  The puny “public option” would only cover 1 percent of Americans (see yesterday’s op-ed “The public option ain’t what it used to be” by Robert Reich). All the key elements of the bill have already been tried and failed to reduce the number of uninsured or health care costs at the state level.  The only durable result is likely to be a strengthening of the power of the insurance and drug companies to hijack the reform process.
 
Action Alert – Ask your senator to support Sanders’ Medicare for All amendments
 
Sen. Bernie Sanders (I-Vt.) will introduce two single-payer amendments.  One would create a national single-payer plan, similar to S. 703 and H.R. 676.  The other would allow states to adopt single payer.  Urge your senators to vote “yes” on the Sanders single-payer amendments.  The Congressional Switchboard is (202) 224-3121 or you can send an e-mail message through PNHP the web site.

Happy Thanksgiving everyone,

Quentin Young, MD
National Coordinator
Ida Hellander, MD
Executive Director

P.S. For talking points and more analysis of the House and Senate legislation and the latest news from Capitol Hill, please see our web site at www.pnhp.org/healthbill 


 

FOR IMMEDIATE RELEASE Contact:
Nov. 17, 2009 Rachel Nardin, M.D.

 

Steffie Woolhandler, M.D., M.P.H.

 

Mark Almberg, Physicians for a National Health Program,
(312) 782-6006, mark@pnhp.org

Massachusetts physicians say reform in their state is no model for the nation
 
Nearly 200 sign ad urging single-payer health care reform
 
In a half-page advertisement appearing in Wednesday’s (tomorrow’s) Boston Globe, 196 Massachusetts physicians and physicians-in-training call the state’s 2006 health reform plan “bad medicine” and warn against adopting the state’s plan nationwide. The health bill recently passed by the U.S. House of Representatives is closely modeled after the Massachusetts reform.
 
According to the U.S. Census Bureau, the Massachusetts reform has left hundreds of thousands uninsured. The doctors’ ad, which takes the form of a letter to their patients, warns that the state’s plan is already failing. Health costs have escalated rapidly since the reform’s implementation. According to the Boston Globe, the state’s largest insurer will hit small businesses with average premium increases of 15 percent to 18 percent as of January 1.
 
As an alternative to Massachusetts-style reform, the letter proposes a single-payer health care plan – Medicare for All. Such reform would cover everyone and control costs through massive savings on bureaucracy as well as improved health planning.
 
“Physician voices have been conspicuously absent from the national debate on health care reform,” said Dr. Rachel Nardin, a neurologist at Harvard Medical School and one of the letter’s lead signers. “This letter is a chance to let our patients know that the current plans for reform will fail to control costs or to give American families real access to the health care they need.”
 
Another lead signer of the letter, Dr. Steffie Woolhandler, a primary care doctor who is a professor of medicine at Harvard, noted, “This reform has left many of my patients worse off than before. Co-payments and deductibles are sky high and premiums are unaffordable. A middle-class woman who’s 56 is forced to lay out at least $4,800 for a policy so skimpy that it pays nothing until she has paid another $2,000 in deductibles.
 
Meanwhile, the state has drained funds from safety net hospitals and clinics to fund the reform, threatening the survival of the institutions that care for the hundreds of thousands who remain uninsured.”
*******
A PDF of the ad with its 196 signers can be found here:
http://pnhp.org/sites/default/files/docs/2009/Mass-Ad-Boston-Globe.pdf
The full text of the original letter can be found here: www.pnhp.org/ma
For detailed price quotes on insurance available under the Massachusetts reform, see http://tinyurl.com/nv9vqb
*******
Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who advocate for single-payer national health insurance. To contact a physician-spokesperson near you, visit www.pnhp.org/stateactions or call (312) 782-6006.


 

EMBARGOED until Contact:
Nov. 20, 2009, 12:01 a.m. EST David Himmelstein, M.D.

 

Steffie Woolhandler, M.D., M.P.H.

 

Mark Almberg, PNHP, (312) 782-6006, mark@pnhp.org


Projections of savings from health IT are baseless, Harvard researchers say
National survey of U.S. hospitals shows information technology has yielded neither administrative efficiencies nor cost savings

The increased computerization in U.S. hospitals hasn’t made them cheaper or more efficient, Harvard researchers say, although it may have modestly improved the quality of care for heart attacks.
 
The findings, published in today’s [Friday’s] online edition of The American Journal of Medicine, contradict claims by President Obama and many lawmakers that health information technology (health IT), including electronic medical records, will save billions and help make reform affordable.
 
“Our study finds that hospital computerization hasn’t saved a dime, nor has it improved administrative efficiency,” said lead author Dr. David Himmelstein, associate professor at Harvard Medical School and former director of clinical computing at Cambridge Hospital in Massachusetts. “Claims that health IT will slash costs and help pay for the reforms being debated in Congress are wishful thinking.”
 
The study uses data from the most extensive survey ever undertaken of hospital computerization. Data from approximately 4,000 hospitals for the years 2003 to 2007, including those on a list of the “100 Most Wired,” were analyzed for evidence of increased quality, cost savings or improvements in administrative efficiency.
 
The data came from the authoritative Healthcare Information and Management Systems Society (HIMSS) Analytics annual survey of hospital computerization; Medicare Cost Reports that virtually all hospitals submit annually to the Centers for Medicare and Medicaid Services (CMS); and the 2008 Dartmouth Health Atlas, which compiles CMS data on costs and quality of care.
 
Although the researchers found that U.S. hospitals increased their computerization between 2003 and 2007, they found no indication that health IT lowered costs or streamlined administration, even in the “most wired” institutions. While U.S. hospital administrative costs increased slightly, from 24.4 percent in 2003 to 24.9 percent in 2007, hospitals that computerized most rapidly actually had the largest increases in administrative costs. (By way of comparison, older studies have estimated administrative costs in Canadian hospitals at 12.9 percent).
 
The study found no evidence of lagged effects, e.g. lower costs in 2007 resulting from information technology introduced in 2003.
 
Modest quality gains were noted in the treatment of heart attacks (acute myocardial infarction) in more-computerized hospitals, but even these small improvements may merely represent better documentation rather than actual gains to patients.
 
Himmelstein said a report from the Congressional Budget Office in 2008 signed by Peter Orszag, now Obama’s budget director, expressed skepticism about claims by the RAND Corp. and others that health IT could generate $80 billion annually in savings.
 
“Part of the CBO’s skepticism was based on the limited information available to the RAND study and similar studies,” Himmelstein said. “But this new, detailed, national survey of diverse hospitals shows such doubts are well-founded. Information technology can’t rescue us from our national health care crisis.”
 
Dr. Steffie Woolhandler, professor of medicine at Harvard and study co-author, said several factors may explain why health IT has failed to reduce administrative costs.
 
“Any savings may have been offset by the costs of purchasing and running new computer systems,” she said. “In addition, most software is designed around the accounting and billing needs of hospitals, not the clinical side.”
 
She noted that a computer success story in recent years has been at the Veterans Administration, where global budgets eliminate most billing and internal cost accounting, allowing physicians to focus instead on delivering care.
 
“The VA system now has our nation’s highest quality and patient approval ratings,” Woolhandler said. “Congress should take note: to get the most benefit from our health care dollars and from health IT, we should adopt a single-payer, Medicare-for-all program. Nothing short of that will allow us to reap the full potential of computerization or to provide comprehensive, quality and affordable care to all.”

******
“Hospital computing and the costs and quality of care: a national study,” David U. Himmelstein, M.D., Adam Wright, Ph.D., and Steffie Woolhandler, M.D., M.P.H., The American Journal of Medicine, Nov. 20, 2009 (online).
 
Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who advocate for single-payer national health insurance. To contact a physician-spokesperson near you, visit www.pnhp.org/stateactions or call (312) 782-6006.


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.

 


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”.

Physicians for a National Health Program
29 E Madison Suite 602, Chicago, IL 60602
Phone (312) 782-6006 | Fax: (312) 782-6007
www.pnhp.org | info@pnhp.org
© PNHP 2009

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