Premium Assistance for Coverage in Exchanges

Kaiser Family Foundation
Health Reform Subsidy Calculator
Premium Assistance for Coverage in Exchanges

An example for a 50 year old with a family of four, with income at 401% of federal poverty level:

$93,934 - Projected income in 2014

$16,858 - Unsubsidized health insurance premium in 2014

N/A - Maximum % of income the family has to pay for the premium

$16,858 - Actual family required premium payment

$0 - Government tax credit

$12,500 - The maximum out-of-pocket costs the person/family will be responsible for in 2014 (not including the premium)

$29,358 - Premium plus out-of-pocket costs

31% - Percent of income for premium plus out-of-pocket costs

http://healthreform.kff.org/SubsidyCalculator.aspx

Comment: This calculator is useful for determining anticipated individual and family costs for insurance premiums plus out-of-pocket expenses for plans obtained through the insurance exchanges, if execution of the program is optimal.

Uncertainties arise since
1) premiums are not guaranteed and could be much higher if private insurers fail to restrain cost increases, and
2) out-of-pocket costs could be much higher based on plan design, limitations of provider networks, and expenses for disallowed services and products. Furthermore, most individuals and families will not even be allowed to purchase plans through the exchanges.

What kind of reform is this? We could have covered everyone without the need to create personal financial
hardship had we adopted a single payer national health program. In fact, we can still do that.

You can read/subscribe to messages like this at http://pnhp.org/news/quote-of-the-day

Summary of H.R. 676, “The United States National Health Care Act,” Or “Expanded & Improved Medicare For All”

Introduced by Rep. John Conyers, Jr.


Brief Summary of Legislation
The United States National Health Care Act (USNHC) establishes a unique American universal health
insurance program with single payer financing. The bill would create a publicly financed, privately
delivered health care system that improves and expands the already existing Medicare program to all
U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all
Americans will have access, guaranteed by law, to the highest quality and most cost effective health care
services regardless of their employment, income or health care status. In short, health care becomes a
human right. With 47 million uninsured Americans, and another 50 million who are underinsured, the
time has come to change our inefficient and costly fragmented non-system of health care.


Who is Eligible
Every person living or visiting in the United States and the U.S. Territories would receive a United
States National Health Insurance Card and ID number once they enroll at the appropriate location. Social
Security numbers may not be used when assigning ID cards.


Health Care Services Covered
This program will cover all medically necessary services, including primary care, inpatient care,
outpatient care, emergency care, prescription drugs, durable medical equipment, hearing services, long
term care, palliative care, podiatric care, mental health services, dentistry, eye care, chiropractic, and
substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and
practices. There no co-pays or deductibles under this act.


Conversion To A Non-Profit Health Care System
Doctors, hospitals, and clinics will continue to operate as privately entities. However, they will be
unable to issue stock. Private health insurers shall be prohibited under this act from selling coverage that
duplicates the benefits of the USNHC program. Exceptions to this rule include coverage for cosmetic
surgery, and other medically unnecessary treatments. Those workers who are displaced as the result of
the transition to a non-profit health care system will be the first to be hired and retrained under this act.
Furthermore, workers would receive their same salary for up to two years, and would then be eligible for
unemployment benefits. The conversion to a not-for- profit health care system will take place as soon as
possible, but not to exceed a 15 year period, through the sale of U.S. treasury bonds.


Cost Containment Provisions/ Reimbursement
The USNHC program will negotiate reimbursement rates annually with physicians, allow for global
budgets (monthly lump sums for operating expenses) for hospitals, and negotiate prices for prescription
drugs, medical supplies and equipment. A “Medicare For All Trust Fund” will be established to ensure a
dedicated stream of funding. An annual Congressional appropriation is also authorized to ensure
optimal levels of funding for the program, in particular, to ensure the requisite number of physicians and
nurses need in the health care delivery system. (over)
H.R. 676 Would Reduce Overall Health Care Costs


Families Will Pay Less
Currently, the average family of four covered under an employee health plan spends a total of $4,225 on
health care annually – $2,713 on premiums and another $1,522 on medical services, drugs and supplies
(Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and
Educational Trust; U.S. Department of Labor, Bureau of Labor Statistics, Consumer Expenditure
Survey.) This figure does not include the additional 1.45% Medicare payroll tax levied on employees.
A study by Dean Baker of the Center for Economic Research and Policy concluded that under H.R. 676,
a family of four making the median family income of $56,200 per year would pay about $2,700 for all
health care costs.


Business Will Pay In 2006, health insurers charged employers an average of $11,500 for a health plan for a family of four.
On average, the employer paid 74% of this premium, or $8,510 per year. This figure does not include
the additional 1.45% payroll tax levied on employers for Medicare. Under H.R. 676, employers would
pay a 4.75% payroll tax for all health care costs. For an employee making the median family income of
$56,200 per year, the employer would pay about $2,700.
The Nation Will Pay About the Same, While Covering All Americans
Savings from reduced administration, bulk purchasing, and coordination among providers will allow
coverage for all Americans while reducing health care inflation in the long term. Annual savings from
enacting H.R. 676 are estimated at $387 billion (Baker).


Proposed Funding For USNHI Program
• Maintain current federal and state funding for existing health care programs
• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
• Establish a 5% health tax on the top 5% of income earners, 10% tax on top 1% of wage earners
• ¼ of 1% stock transaction tax
• Close corporate tax loopholes
• Repeal the Bush tax cuts for the highest income earners

*For more information, contact Joel Segal (joel.segal@mail.house.gov) or Michael Darner
(michael.darner@mail.house.gov) with Rep. John Conyers at 202 225-5126, or contact Olivia Boykins at
313 961-5670.

Tired of being taxed to death?

Let's see if this one gets printed anywhere...

Tired of being taxed to death?

Do you hate levy requests made continually by schools, road, police and fire departments, parks, libraries etc.? Get smart; taxpayers already pay 61% of the nation’s health care bills for public employees.  For taxes to stabilize, we must really reform the out of control health care costs we all pay.  Dumping the insurance companies is the first step toward simplifying paperwork for providers reducing costs. If you are unhappy with the health care reform passed by Congress, you owe it to yourself to learn about HR 676, Medicare for All.  You owe it to family and friends who are unemployed, have a pre-existing condition, has had their insurance coverage terminated, etc.  If you’re worried about “socialized medicine”, you have fallen victim to the medical-industrial complex’s ruthless campaign for obscene profit at your expense.  There is more than enough being spent to care well for everyone; we just aren’t getting the care.  30% is wasted on administration.  You need the facts not myths.  Visit www.pnhp.org and spanohio.org and wndavis.blogspot.com for more links.  Request a speaker for your organization.

MAYBE ANSWERS ARE OVER RAINBOW

MAYBE ANSWERS ARE OVER RAINBOW

BY DR. KATHLENE S. WALLER

FORT COLLINS COLORADOAN, MAY 6, 2010

Dear Auntie Em,

As I was just telling Toto a few days ago we're sure not in Kansas anymore.   We've noticed that things are very strange when it comes to health-care reform here in the land of Oz.

First of all, there is the Tin Man.   He's a Republican, and he sure could use a heart. President Obama extended his hand in a gesture of bipartisanship, but the Tin Man took his little ax and chopped the president's hand right off!

He didn't offer any good ideas himself, just tried to weaken any potential legislation and then voted against it anyway.  He also said that he wants the president to fail.   Can you imagine?   He didn't care about people suffering and dying because they can't afford health care; he just wanted to obstruct everything for the sake of politics.    I hope he is able to find a heart soon.

Then there's the Cowardly Lion.   He's a Democrat, and he could definitely use some courage.   He was so afraid to stand up to the health-care industry that he didn't even consider the best solution to the whole health-care mess: a single-payer financing system.

It doesn't take ruby slippers to understand that a single-payer system is the best way to assure that every person in this country has access to quality health care, while managing costs and saving billions of dollars.   But even while controlling Congress and the White House, he was so cowardly that he took single payer "off the table" at the beginning, starting the discussion with a much weaker public option that was later compromised away.

Most remarkable of all is the Scarecrow, who doesn't have a brain.   He is the loud, ill-informed segment of the American public that is opposed to any government involvement, while ignoring the fact that Medicare is a government-run financing system which has provided health care to the oldest and sickest members of our society for more than 45 years.

He can't seem to understand that having health insurance is not the same as having access to affordable health care, and that for-profit health insurance companies must do everything they can to deny care to sick people in order to maximize profits for shareholders.

Medicare is a single-payer system that could be improved and extended to all Americans from cradle to grave, but unfortunately, any mention of graves makes the poor Scarecrow worry about death panels since those flying monkeys in the right-wing media spread so many lies about health-care reform.   It would sure be helpful if the Scarecrow could find a brain.

I was told to follow the yellow brick road to the Emerald City, and I finally figured out that they were solid-gold bricks, leading to a city the color of greenbacks.   I should have known, since I found the Wizard of Oz behind a curtain of campaign contributions.   And guess what?   The wizard was the health insurance and pharmaceutical companies who wrote the health-care bill and stand to profit greatly from its implementation.

After our long and turbulent journey, the final legislation turned out to be mostly just smoke and mirrors!

Well, we've been through quite a storm.   Unfortunately, I guess real reform still lies somewhere over the rainbow ...

Love,

Dorothy

Class slides

What to Say to Those Who Think Single Payer Advocates Are Wacko

Published on Monday, February 8, 2010 by CommonDreams.org
by Paul Hochfeld
What do we say to our more conservative friends, who genuinely think that the Single Payer solution to our health care crisis would be a disaster?  Try what follows. In the end, you may simply agree to disagree. That’s O.K., but what follows may give them pause to think.
Already, 60% of all our health care dollars come directly or indirectly (because employers insurance premiums are tax deductible) from the taxpayer.  The care of our oldest neighbors are financed by Medicare, i.e. the taxpayers.  The care of our disabled neighbors is financed by Medicaid.  Ditto the care of our poorest neighbors who, because health follows wealth, are also at greater risk of high expense.  Fourteen hundred insurance companies, at significant expense, stratify the rest of the population by “risk”.  Their top-secret formula results in them covering the employed people, small groups, and individuals who can prove that they are at low risk.   What about the others?  When those who can’t afford the premiums get sick, go bankrupt, and can’t pay their bills, “we” all pay for it in higher charges.   Furthermore, employer-paid premiums are tax deductible which means insurance company profits are subsidized by the taxpayer.
As near as I can tell, this is a big taxpayer rip-off.   Additionally, our non-system is fraught with numerous perverse incentives that result in more care, but not necessarily better care.  Physicians must share a significant part of the blame here, but that’s a different, though important, discussion.  Addressing these perversities is problematic because we don’t have a Health Care System we have For-Profit Sick Care Non-System that, to extent that it has any design at all, is designed to serve the for-profit insurance and the pharmaceutical industries.  Perverse incentives work for those who profit from them.  They don’t work for patients or those who pay the bills, i.e., taxpayers.
Single payer means one risk pool.  You’ve heard the slogan.  Everyone in.  Nobody out.  We gather all the money that employers and individuals are currently paying for health care.  It’s not more money.  It’s the same money, already being spent on health care, but by pooling it, we can save 20% right off the top.  Providers won’t have negotiate fee schedules with all the different payers.   Providers will only have to send  bills, electronically, to one place.  Furthermore, substantial savings accrue as the system matures.  When an ER Doctor in Oregon sees a patient passing through town, he will access her electronic medical record in Iowa, resulting in, not just less expensive care, but better care.  None of this is going to be accomplished until we have Public Health Authorities administering a health care system with the goal of health, financed publicly and delivered privately.
This isn’t pie in the sky.  Check out what the other developed countries are doing, but please don’t respond with anecdotes.   We have 45,000 new anecdotes every year that illuminate how real or perceived financial barriers to timely, appropriate care cause unnecessary death.
The real question is whose “system” produces the least number of unnecessary deaths and the least suffering for the dollars being spent?  Yes, other countries are struggling because of limited resources, but they are dealing with the problems maturely, they are making difficult decisions, and, by recognizing that health is a human right, they are getting a healthier population for less cost.
Is access to appropriate health care a human right?  If not, we can agree to disagree.  If so, it is a legitimate function of our government to make sure that nobody falls through the cracks.  Also, doesn’t the government have a fiduciary responsibility to make sure the taxpayer is getting value for its health care dollars?  Insurance company CEO’s have a fiduciary responsibility to maximize profits even if it means investing large sums of money in manipulating public policy… and that’s exactly what they’ve been doing.  It’s unfathomable to me that some people distrust “The United States” more than United Health Care.  That may be where we end up agreeing to disagree.
In any case, the taxpayer is being ripped off, big time.

Just replace PA with OH

http://healthcare4allpa.org/documents/101_reasons.pdf

100 Reasons Balanced Health Care Reform Works for Pennsylvania


Compiled by your friends at HealthCare4AllPA.org, a nonprofit health care reform advocacy group.

1. Protect Pennsylvania jobs - by capping the employer contribution to the Health Trust at 10% of payroll. Those Pennsylvania employers currently paying for employee health insurance coverage will enjoy a substantial savings and will no longer be at a competitive disadvantage to those paying nothing toward the cost of health care coverage. This also completely eliminates the administrative overhead costs associated with employer paid health insurance.

2. Reduce the cost of prescription drugs - by using Pennsylvania’s 12.5 million citizens as a formidable bargaining entity in dealing with drug companies.

3. Eliminate uncompensated care - by assuring that health care providers are paid for all of the services they provide.

4. Assure comprehensive care for all - through a universal health care system. Approximately one million out of our 12 million citizens have no health coverage of any kind.

5. End wasteful “defensive” medicine - which, according to a recent survey, 90% of Pennsylvania physicians admit to. We address this by replacing the fault based malpractice system with a no-fault program that emphasizes broader availability of compensation, quality assurance instead of punishment. Those who believe they are better off retaining their traditional fault based right to sue may opt out of the no-fault system, but the Balanced Plan adopts the no-fault approach as the default position and thus the vast majority of Pennsylvanians will participate in the no-fault program.

6. Address racial disparity - through universal access and a commitment to assuring the availability of quality providers in all communities.

7. Dramatically reduce wasteful administrative costs - through a single payer approach that eliminates the unnecessary and redundant overhead of the existing myriad of public and private payers. Major studies have agreed that approximately 20% of our health care dollars are wasted due to the inefficiencies of the current system.

8. Remove health care as a recurrent union/management issue in collective bargaining - by providing automatic, comprehensive, and universal health care independent of the employment relationship. This legislation does permit unions and employers to opt out of the Commonwealth Plan so long as the benefits included in the collective bargaining agreement are at least as comprehensive as the Commonwealth Plan.

Copyright ©Health Care for All Pennsylvania pg. 1

100 Reasons Balanced Health Care Reform Works for Pennsylvania

9. End health care expenses as the leading cause of personal bankruptcy - thus preserving the dignity and savings of Americans who already face the burdens directly associated with family illness or accident.

10. Preserve the volunteer firefighter and emergency responder base, especially in rural areas of the Commonwealth - through a $1,000 per year state tax rebate to active volunteers we encourage the retention and recruitment of this vital resource.

11. Reduce the cost of workers’ compensation insurance - with universal coverage that meets an injured employee’s health care needs independent of the employer’s workers’ compensation insurance. By eliminating the health care expense and administrative overhead workers compensation premiums will drop dramatically.

12. Eliminate duplication of facilities in over-served communities - by requiring a certification of need communities already adequately served with high tech diagnostics or surgery centers will not see another (which would only threaten the financial viability of both) and instead would-be investors will be encouraged to build in under-served areas.

13. Restore the concept of a true “emergency room” - through universal coverage that assures that all citizens will have ready access to primary care physicians. It would thus end the wasteful and inefficient practice of using hospital emergency rooms as primary care centers.

14. Reduce the cost of automobile insurance for business and consumers - universal health care access eliminates the need to ever file suit to cover past and future medical costs thus removing that risk from the vehicle insurance coverage and leading to dramatically lower premiums.

15. Restore and enhance the traditional physician/patient relationship - by ending the unfortunate and counterproductive environment where every patient is seen as a potential plaintiff.

16. Reduce infant mortality through better pre-natal care - and a universal health access system that assures full and complete pre-natal management thus reducing the number of avoidable low weight and premature deliveries.

17. Preserve the family farm - by eliminating the need for a farm family to seek a “city” job that provides health care benefits and by avoiding financial failures of farm families faced with uninsured or underinsured health care expenses.

18. Retain high-risk specialists in the Commonwealth - by eliminating entirely the burden on providers to fund a dysfunctional medical malpractice system.

19. Support the home care model - where a family is willing to provide a loving environment in a non-institutional setting. A universal health system committed to emotional wellness as well as physical health will provide the training and the specialized services required.

Copyright ©Health Care for All Pennsylvania pg. 2

100 Reasons Balanced Health Care Reform Works for Pennsylvania

20. Provide sufficient substance abuse treatment facilities - by including substance abuse as a covered component of the universal health system we dramatically expand the funding for facilities and trained personnel.

21. Preserve our investment in higher education - by separating health care coverage from employment more economic opportunities are created. When our college graduates are unable to find worthwhile employment in the Commonwealth our investment in their training is wasted and the Commonwealth loses more of its intellectual capital. Additionally, new graduates will not suffer a gap in health coverage while they search for that first job.

22. Encourage early retirement to open opportunities for younger people - by making it possible for a worker to retire before they qualify for Medicare at age 65. If a person is otherwise financially able to retire before age 65, the universal coverage system will make it possible to do so thus opening an employment position for a younger person.

23. Encourage the best and the brightest to enter the health care professions - through the elimination of the specter of financial ruin due to a malpractice action, assured payment for all services, and reduced overhead costs through a simplified and efficient single payer system, the health care professions become more attractive career options.

24. Level the competitive playing field between large and small businesses - through a universal health care system that moots the existing health care insurance premium costs between large and small employers.

25. Reduce the cost of home-owner’s insurance - by assuring that a person injured at your home has automatic health coverage and thus eliminating the need for a homeowner’s insurance policy to insure against the risk of being sued for medical costs. Lower risk equals lower premiums.

26. Permit lawmakers to move on to other critical matters by finally resolving the health care crisis - since every year the General Assembly devotes substantial time to debating, again, the issues surrounding access to health care, Medicaid allowances, coverage for Commonwealth employees, and medical malpractice reform. All of this distracts from other critical issues of the day. A bold move to resolve the health care dilemma through a balanced and fiscally responsible solution opens the legislative agenda for other matters.

27. Allow Pennsylvania manufacturers to compete more fairly against foreign manufacturers - most of whom have a government sponsored health care system independent of the employer and thus manufacturers in those countries do not have the overhead burden of providing health care to their workers. By capping a Pennsylvania employer’s contribution to health care at a fully deductible 10% of payroll, we dramatically reduce the anticompetitive effect of the higher premiums currently being paid by our hard-pressed manufacturers.

Copyright ©Health Care for All Pennsylvania pg. 3

100 Reasons Balanced Health Care Reform Works for Pennsylvania

28. Shift health provider revenues from administrative to clinical work - an estimated 20% of provider revenue is squandered on billing and administrative paperwork required by the existing inefficient and overlapping system of third party reimbursements. Those same resources could be redirected to clinical care.

29. Encourage entrepreneurialism - through a universal health care system that eliminates the risk of being without health access for the aspiring small business person and their family.

30. End the practice of requiring those in need to spend themselves into poverty to qualify for long-term care assistance - by including long term care in the universal health coverage package. This will end the current humiliating practice of forcing an already sick, usually elderly, person to spend themselves into poverty before qualifying for assistance.

31. Accelerate the transition to a paperless “electronic health care record” - through a single payer system it becomes easier to track, document, and access an individual’s health care history. An electronic health care record would be immediately available to any authorized health care provider thus eliminating the delays and errors associated with paper records scattered over a number of offices and ultimately lost over time.

32. Enhance a new culture of health awareness and responsibility - by using part of the trust funds to use the media and school system to teach and encourage better health habits and by creating a sense of social responsibility not to engage in self destructive or unhealthful behaviors that add to the common cost of health care.

33. End the competitive advantage of those businesses which have refused to provide health care insurance - by requiring all employers to pay the same 10% of payroll health care levy as a percentage of payroll. Small employers paying minimum wage would pay just 52 cents an hour more, less net of taxes, toward a universal health care plan.

34. Create a sophisticated health care society - through the creation of an age appropriate K through 12 curriculum with an emphasis on health equal to any other area of study.

35. Establish dedicated funding sources used exclusively for health care - thus assuring that the Trust will be fully funded and not endlessly debated year to year. By establishing dedicated funding sources for health care the interest of health will not have to compete against other government priorities for funding and taxpayers will be less resistant to paying the health specific taxes if confident that all of such revenues will be used exclusively for health care.

36. Reduce drug related crime - by assuring adequate and effective drug treatment services for those supporting their addictions through criminal activity or by becoming drug pushers themselves.

Copyright ©Health Care for All Pennsylvania pg. 4

100 Reasons Balanced Health Care Reform Works for Pennsylvania

37. Assure available specialists in all geographic parts of the Commonwealth - through a single payer system committed to assuring universal availability of quality coverage through-out the Commonwealth. For example, Providers who establish practices or build facilities in underserved areas can be rewarded with bonus reimbursements.

38. Reduce employment discrimination based on age and health - through a universal health care system that ends the concern of employers over the potential increase in group health insurance premiums should they hire an older person or someone with a personal or family illness. This resolves the individual underwriting process now in use which takes the cost savings out of many group plans.

39. End the COBRA irony - through a universal health system that continues regardless of employment status and which ends the absurdity of requiring a newly unemployed or divorced person to pay substantial sums to continue health care for themselves and their families when they are least able to afford it.

40. Preserve patient choice - by permitting the patient to choose their physician among any Participating Provider.

41. Support the ability of charitable organizations to recruit and retain staff - as all employees will automatically be covered under the Plan. Non-profit organizations will no longer lose employees and prospects to private industry solely due to the employee’s need for health care benefits.

42. Free up capital for research and development - by capping the employer contribution to the health care trust at 10% of payroll, thus assuring employers will have cash available for the research and development costs that are at the heart of future growth and competitiveness.

43. Better coordinate epidemiological data - through a single payer system that best captures in one database the occurrence of environmental, viral, or bacteriological illnesses.

44. Reinforce and support primary care - through a reimbursement system that emphasizes wellness and preventative medicine primary care providers will be in greater demand and more appropriately compensated.

45. Accelerate the introduction of new technology to improve diagnostics - by providing a financing means for hospitals and providers to acquire new technology even where the obsolete equipment may not have been fully amortized.

46. Infinite and immediate adjustability of the revenue sources to meet a disaster - with health care taxes adjustable in tenths of a percent as needed, in the event of a natural or man-made disaster the required revenues to meet the urgent medical needs can be instantly and temporarily raised through a simple adjustment in the percentage. Similarly, where Trust surpluses accumulate beyond what is required downward adjustments in the taxes can also be readily and easily made.

Copyright ©Health Care for All Pennsylvania pg. 5

100 Reasons Balanced Health Care Reform Works for Pennsylvania

47. Free the courts from protracted medical negligence litigation - through the introduction of an optional no-fault administrative mechanism to compensate those injured by their care. We thus remove from the court dockets the many and complicated medical malpractice cases that consume a disproportionate share of judicial resources.

48. Reduce state, local and school board expense - through the adoption of a universal health care system whereby governments of all sizes will be relieved of the annual angst of debating, providing, and funding health care benefits.

49. Improve worker productivity - by providing ready access to care for workers and their families. Less time will be lost from work due to untreated conditions that ultimately worsen leading to extended absences.

50. Improve highway safety - by fully funding substance abuse treatment. With a reduction in impaired driving the frequency of motor vehicle accidents will drop and with it the expense related to the care and treatment of those injured.

51. Humanitarian treatment for migrant workers - through the inclusion of critical but under appreciated migrant workers and their families in the health care system. In doing so, we assure the responsible support of those who otherwise would be at the mercy of illness and ultimately burden the emergency facilities of our hospitals.

52. Encourage and support the arts - by assuring that talented individuals pursuing a career in the arts, or as independent performers, are covered through a plan of universal health care.

53. Restore the spirit of joy and service to the health care professions - through the elimination of the specter of malpractice suits and the obsessive concern about whether or not a patient has adequate insurance, health care professionals can again focus on the patient.

54. Reduce abusive access to narcotics - through a unified electronic health record system that immediately identifies situations where a patient is seeking multiple prescriptions from different physicians.

55. Increase self reporting of medical errors - by eliminating the fear of financial ruin. Errors can be more readily reported and thus corrective action taken to limit the harm and to develop protocols to eliminate recurrences.

56. More swiftly identify previously unknown drug side effects or dangerous combinations of drugs - through a single payer system that tracks patients and medications as well as the symptoms that are later reported which may be the clue to adverse chemical reactions.

57. Eliminate the wasted motion of the specialist referral for responsible consumers - by granting all patients the right to self refer to a specialist, and then only limiting that right for those who abuse it, the Plan assures that access to specialists is not delayed by procedural barriers that punish the many for the conduct of the few. Copyright ©Health Care for All Pennsylvania pg. 6

100 Reasons Balanced Health Care Reform Works for Pennsylvania

58. End the “same sex” and “domestic” partner health care debate - by automatically covering everyone under the universal plan.

59. Eliminate suicides related to the cost of health care - through a universal health care system that relieves the chronically ill patient of the guilt associated with potentially bankrupting their family with health care expenses.

60. Reduce the incidence of chronic diseases that could have been avoided or prevented through early intervention - by eliminating the cost of care barrier, individuals with the early symptoms of a disease, such as cancer, will more readily seek care and enjoy an earlier diagnosis and better prognosis.

61. Reward the development of enhanced skills and experience - by adopting a reimbursement structure that adds an incentive bonus to those health care providers who invest in themselves and acquire enhanced skills and experience.

62. End the wasted motion and paperwork associated with point of service deductibles and co-pays - through the elimination of the ritual of collecting and accounting for these charges.

63. Eliminate wasted employer management time - by ending forever the annual dreaded ritual of receiving and analyzing the group health insurance premium increase, shopping around for a lower premium, evaluating how much of the premium cost can be shifted to the employees through premium sharing, a reduction in benefits, an increase in co-payments and the like.

64. End the “food or medicine” choice - through the inclusion of a full prescription drug benefit covering all citizens.

65. Assure full access to mental health treatment - by fully funding mental health therapy and treatment.

66. Maintain the continuity of care - by eliminating constant switching of providers to accommodate different health plans.

67. Guarantee divorced spouses and their children have access to health care - through universal health care marital status is irrelevant to health care access.

68. Improve nurse retention - by reallocating funds from malpractice insurance premiums and administrative overhead. Hospitals will be able to use those resources to assure a rational patient to nurse ratio, eliminate mandatory overtime, and enhance training.

69. Annuitize compensation for persons injured by their medical treatment - by making compensation payments through monthly disbursements, rather than by lump sum. This assures that the money cannot be squandered over a short period of time, which is often the case, and is more consistent with the concept of replacing what was lost rather than granting a lottery type pay-off. Copyright ©Health Care for All Pennsylvania pg. 7

100 Reasons Balanced Health Care Reform Works for Pennsylvania

70. Assured coverage for those working multiple part time jobs - by detaching health care access from employment there is no difference in coverage based upon whether a person is working one full time, or two part-time, jobs.

71. Protection for domestic employees - through universal coverage that assures that housekeepers, cooks, drivers, gardeners and others working as domestic servants enjoy comprehensive access for themselves and their families.

72. More extensive quality assurance review of errors and complications - because every patient claim will be carefully investigated for evidence of correctable mistakes and patterns. By changing the emphasis to care improvement rather than blame all involved can contribute to a more constructive analysis of what went wrong, and what can be done to prevent a reoccurrence.

73. Preserve the free market system while assuring cost containment - with a Plan that does not contemplate public ownership of health care facilities or public employment of health care workers. Rather, the free market system will be allowed to work such that the providers with the best quality of service will attract the most patients.

74. Assured dental coverage - through inclusion of non-cosmetic dental services in the program.

75. Eliminate the health care coverage handcuffs that limit workers’ ability to change jobs - and replace it with the freedom to offer your services to the highest bidder thanks to universal coverage that is independent of the employer.

76. End uncompensated care for providers - and instead assure Participating Providers that they will be paid for 100% of the services rendered to program beneficiaries.

77. Assured vision and optical care - through inclusion of eye health services as an integrated part of the health care package.

78. Eliminate the financial insecurity and fear associated with the aging process - by assuring that gaps in the Medicare program will be filled through the Plan and no Pennsylvanian will suffer needlessly simply based upon their ability to pay.

79. Create tens of thousands of high paying new jobs in health care and health education - required to provide services to the approximately one million currently uninsured Pennsylvanians and to teach a “wellness curriculum” in our schools.

80. Fully protect the catastrophically ill or injured - through a health care system that does not have the usual life time caps that are easily exceeded by those with serious and chronic illnesses or disabilities requiring intensive skilled care.

81. Saving Pennsylvania’s share of the 18,000 who die annually in the United States due to inadequate access to health care - through a universal health care program that assures that every person who needs care will receive it. Copyright ©Health Care for All Pennsylvania pg. 8

100 Reasons Balanced Health Care Reform Works for Pennsylvania

82. Expand the availability of compensation more equitably to those injured by their health care providers - through a no-fault system that does not require a tedious and expensive litigation process committed to finding someone to blame and which allows only a few to recover anything at all. Rather, the optional no-fault program assures expedited claim handling and eligibility with lower attorney fees and other costs of traditional malpractice litigation.

83. Encourage the unemployed to accept entry level positions by removing the fear of losing Medicaid or Adult Blue coverage - with universal care automatic for all, there need no longer be a concern that by accepting a modest paying entry level position a worker will disqualify themselves or their families from access to health care.

84. Assuring that the newly disabled, but under age 65, have access to health care while they wait two years for Medicare eligibility - through a universal coverage approach that does not go away when the disabled lose their jobs.

85. Prompt payment of reimbursements to providers - through electronic billing and electronic fund transfers within one week health care providers have ready access to their money and avoid borrowing costs.

86. End the practice of overcharging the uninsured - which is an ironic and absurd reality in the current system. Many hospitals and doctors charge uninsured patients a higher rate than the reimbursement accepted from private insurers and government programs. As a result the patients least able to pay have been charged the most and often are driven into bankruptcy. Universal coverage through a single payer ends this disparity once and for all.

87. Eliminate the need for outside billing and collection services - thus saving the average physician up to 5% of their gross collections otherwise paid to an outside collector.

88. Pay for Performance incentives - through a reimbursement system that rewards excellence based upon objective performance criteria. Providers who adopt best practices and achieve lower complication and readmission rates will be rewarded and those who do not measure up will be paid less.

89. Create millions of qualified first responders - through enhanced health care education every graduating high school senior can be a certified first responder ready and able to assist a family member, friend, or even a total stranger until help arrives. This can mean the difference between recovery and a lifelong disability or death.

90. Assure that every injured person is rehabilitated to their maximum potential - by incorporating full rehabilitation within the standard program benefits. In addition to being morally right, a commitment to full rehabilitation will reduce the overall cost of care as many more patients will be able to return to the workforce or at least be better able to attend to their own physical needs.

Copyright ©Health Care for All Pennsylvania pg. 9

100 Reasons Balanced Health Care Reform Works for Pennsylvania

91. Keep qualified and experienced physicians on the job - by eliminating the burden of malpractice premiums and by simplifying the billing and collection system.

92. Assure well baby care - with comprehensive post-natal care included in the universal health care program.

93. Reduce the incidence of sexually transmitted diseases - by simplifying access to primary and specialist care. STDs can thus be diagnosed sooner and treatment initiated to reduce the spread of the disease and to assure proper counseling to the affected patients and their partner. Enhanced wellness education also leads to reduced infection transmission.

94. Permit providers to challenge the adequacy of reimbursements - through an administrative process whereby single providers or groups can offer evidence in support of higher reimbursements.

95. Full transparency in the error investigation process - by assuring that a complaining patient is afforded every opportunity to be heard and is kept advised of the investigation and any corrective actions that are ordered in response to an avoidable injury or complication.

96. Implementation of Pennsylvania Cost Containment Council recommendations - through a process whereby all such recommendations are reviewed and where providers are required to implement necessary reforms.

97. Humane end-of-life care - by including hospice care within the comprehensive health care package.

98. All licensed providers can compete - through a universal system that does not try to artificially lower prices by freezing out providers from networks in exchange for lower prices from other providers.

99. Protect early retirees who were promised health care coverage by now defunct employers - through a universal health care system that protects the young retiree from being left out in the cold by a broken promise of retirement health coverage.

100. Prepare Pennsylvania for more cuts in Federal health care support - by preparing our Commonwealth to be more self sufficient and reliant on its own resources and efficiencies as Congress bit by bit reduces grants to states for Medicaid and CHIP programs.

101. No more bake sales to fund health care - instead we embrace health care as a community responsibility and a communal right through a system of universal access.

Copyright ©Health Care for All Pennsylvania pg. 10

There is Still Time For Real Reform, Listen to the American People | Physicians for a National Health Program

There is Still Time For Real Reform, Listen to the American People | Physicians for a National Health Program

A notable comment from Health Justice 1payer.net on Obstructionist Republicans

I received this in November and thought it was time to pass it along...


Republicans: Get out of the way of progress

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
The following comes from a letter to the editor from the North County Times in California. It just shows that Medicare-For-All is the best solution, and reaches all party lines.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
    I am a retired lifelong conservative Republican, planning to change my registration to Independent. Why? Because of obstructionist practices of the Republicans, such as Saturday night's vote in the House. Only one Republican voted for the House Bill 3962. All the rest played strict partisan politics.
    We need change in our broken health insurance system in America. The best change would be a switch to single-payer -- but in the interest of making progress, I implore my Representative, Darrell Issa, to stop playing partisan politics.
    I also implore my senators, Dianne Feinstein and Barbara Boxer, to vote in favor of health care reform in the upcoming Senate votes. Again, single-payer is the best way to go, but any change from the present system will be welcome.
   We have the most expensive health care system in the world, but our health outcomes are well down among developed nations. Why do our politicians not respond to their constituents? Are some in the pockets of the insurance and pharmaceutical companies? Do the wishes of majorities not count with them?

Edgar G.
Oceanside

Response to a friend on insurance companies

    As far as insurance companies go, I don’t believe they are evil. Their behavior is obviously in their own interest, not that of the patient. I don’t go without auto, life or homeowners insurance. I don’t know if any laws changed or when, but the way insurance companies have become able to collect and distill claims data to determine where the profit and loss is in detail, they have been doing whatever they can to drop high risk policyholders and attract low-risk policy holders. If people have an opinion that insurance companies are evil, they brought it on themselves.
    Health insurance, in today’s market is clearly taking more and costing taxpayers and business much more than we can afford or should have to pay. There are just too many sources of fact to support that opinion to ignore. The number of clerical personnel required my providers to deal with insurance companies has become way out of hand. The only way to cut that cost is to eliminate the dozens of companies that providers need to deal with. Single Payer would be more far more efficient.
    I’m sure companies try to do the ‘right’ thing in most cases. The problem is that under the current system, the right thing is out of date! We cannot compete with other countries with our skyrocketing health care costs because we are the only industrialized nation that doesn’t have some sort of national health care plan. We actually have each kind of plan imaginable. The VA is like England’s plan. Medicare is like Canada. We have ‘medigap’ policies for what Medicare won’t cover. We have employer provided insurance with growing contributions required of employees that make it unaffordable. We have high deductible plans that can still leave a person broke if they have a major accident or illness. Overall, the U.S. spends more than twice than any other nation and our results are not as good.
    Your philosophy of people needing to be responsible for their own decisions is based on the false premise that everyone has the same level intelligence with which to digest the myriad choices available in an increasingly complex world. People, in fact, have a broad range of abilities and are unable to make the correct decisions for their best welfare. I’m not saying we should make decisions for everyone, but as Christians, Jesus counts on us to help and protect those who are vulnerable in today’s society. There are clever swindlers that even you could possibly fall prey to under the right circumstances. Just ask the former clients of Bernie Madoff.

What others believe - Lance Armstrong Foundation

While LIVESTRONG has not endorsed any specific reform plan, we stand firmly in favor of comprehensive reform that embraces the following fundamental principles:

• Guaranteed Security and Continuity: All Americans must be able to rely on the continuation of their coverage, regardless of changes in health, family or profession.
• Delivery of Proven Care: Services known to prevent cancer and other diseases and preserve general health must be part of standard coverage.
• Equality: Americans must not be denied coverage for pre-existing health conditions and should have choices appropriate to their own health needs.
• Medical Excellence: Reform must include a continuing effort to promote best medical practices, put the patient first and deliver modern, innovative care.

LIVESTRONG will continue to serve as an honest broker during the health care reform conversation to ensure that these principles are included in a final health reform measure.
www.livestrong.org

A call to action for your brothers and sisters in Christ

“Those who don't know history are destined to repeat it.” - Edmund Burke

First they came for the communists, and I did not speak out—because I was not a communist;
Then they came for the trade unionists, and I did not speak out—because I was not a trade unionist;
Then they came for the Jews, and I did not speak out—because I was not a Jew;
Then they came for me—and there was no one left to speak out.

                                                                        - Martin Niemöller, German pastor and theologian

Now is your time to speak out for people who die for lack of health care or are financially ruined by a catastrophic accident or illness.  Learn about and support Medicare for all.  We can afford it, the medical industry and the conservatives just don't want you to believe it.  What we can't afford is to do nothing or what Congress would foist upon us to benefit their corporate sponsors.

What Would Jesus Do?

Heal the sick, support the weak, comfort the afflicted.

On-the-Demise-of-Comprehensive-Healthcare

Here's a segment I caught on my way home from church this morning. It is food for thought on reform. It doesn't take sides, I hope you will listen.

http://soundmedicine.iu.edu/segment/2336/On-the-Demise-of-Comprehensive-Healthcare

Even ‘responsible’ people devastated by lack of insurance

5:52 PM Friday, December 18, 2009 - Dayton Daily News

To those letter writers, conservative pundits and talk radio “entertainers” who imply that the lack of health insurance is a question of personal responsibility and the government should not interfere, I have a few questions:

• If a person is denied health insurance because of a pre-existing condition, is that due to the person’s lack of responsibility or an irresponsible insurance industry?

• If a person purchases insurance, but then is denied coverage when he or she experience a serious injury or illness, is this irresponsible behavior on the part of the patient or the insurance company?

• If a person loses a job due to downsizing, and, as a result, loses health insurance, is this due to a lack of personal responsibility?

• If a person is driven into bankruptcy or the loss of his or her home due to unforeseen medical expenses or medical expenses insurance won’t cover, is this due to lack of personal responsibility?

It is insulting to imply that people who have been so devastated by the U.S. health care system could have avoided their predicament if they had just been more responsible. It takes a complete lack of compassion not to realize that many of us are just lucky we aren’t in their shoes. 

Daniel E. Fraga

New Carlisle

Testimony of Wendell Potter, Philadelphia, PA Before the U.S. Senate Committee on Commerce, Science and Transportation

June 24, 2009
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Mr. Chairman, thank you for the opportunity to be here this afternoon.
My name is Wendell Potter and for 20 years, I worked as a senior executive at health insurance companies, and I saw how they confuse their customers and dump the sick – all so they can satisfy their Wall Street investors.
I know from personal experience that members of Congress and the public have good reason to question the honesty and trustworthiness of the insurance industry. Insurers make promises they have no intention of keeping, they flout regulations designed to protect consumers, and they make it nearly impossible to understand—or even to obtain—information we need. As you hold hearings and discuss legislative proposals over the coming weeks, I encourage you to look very closely at the role for-profit insurance companies play in making our health care system both the most expensive and one of the most dysfunctional in the world. I hope you get a real sense of what life would be like for most of us if the kind of so-called reform the insurers are lobbying for is enacted.
When I left my job as head of corporate communications for one of the country’s largest insurers, I did not intend to go public as a former insider. However, it recently became abundantly clear to me that the industry’s charm offensive—which is the most visible part of duplicitous and well-financed PR and lobbying campaigns—may well shape reform in a way that benefits Wall Street far more than average Americans.
A few months after I joined the health insurer CIGNA Corp. in 1993, just as the last national health care reform debate was underway, the president of CIGNA’s health care division was one of three industry executives who came here to assure members of Congress that they
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would help lawmakers pass meaningful reform. While they expressed concerns about some of President Clinton’s proposals, they said they enthusiastically supported several specific goals.
Those goals included covering all Americans; eliminating underwriting practices like pre-existing condition exclusions and cherry-picking; the use of community rating; and the creation of a standard benefit plan. Had the industry followed through on its commitment to those goals, I wouldn’t be here today.
Today we are hearing industry executives saying the same things and making the same assurances. This time, though, the industry is bigger, richer and stronger, and it has a much tighter grip on our health care system than ever before. In the 15 years since insurance companies killed the Clinton plan, the industry has consolidated to the point that it is now dominated by a cartel of large for-profit insurers.
The average family doesn’t understand how Wall Street’s dictates determine whether they will be offered coverage, whether they can keep it, and how much they’ll be charged for it. But, in fact, Wall Street plays a powerful role. The top priority of for-profit companies is to drive up the value of their stock. Stocks fluctuate based on companies’ quarterly reports, which are discussed every three months in conference calls with investors and analysts. On these calls, Wall Street looks investors and analysts look for two key figures: earnings per share and the medical-loss ratio, or medical ―benefit‖ ratio, as the industry now terms it. That is the ratio between what the company actually pays out in claims and what it has left over to cover sales, marketing, underwriting and other administrative expenses and, of course, profits.
To win the favor of powerful analysts, for-profit insurers must prove that they made more money during the previous quarter than a year earlier and that the portion of the premium going
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to medical costs is falling. Even very profitable companies can see sharp declines in stock prices moments after admitting they’ve failed to trim medical costs. I have seen an insurer’s stock price fall 20 percent or more in a single day after executives disclosed that the company had to spend a slightly higher percentage of premiums on medical claims during the quarter than it did during a previous period. The smoking gun was the company’s first-quarter medical loss ratio, which had increased from 77.9% to 79.4% a year later.
To help meet Wall Street’s relentless profit expectations, insurers routinely dump policyholders who are less profitable or who get sick. Insurers have several ways to cull the sick from their rolls. One is policy rescission. They look carefully to see if a sick policyholder may have omitted a minor illness, a pre-existing condition, when applying for coverage, and then they use that as justification to cancel the policy, even if the enrollee has never missed a premium payment. Asked directly about this practice just last week in the House Energy and Commerce Committee, executives of three of the nation’s largest health insurers refused to end the practice of cancelling policies for sick enrollees. Why? Because dumping a small number of enrollees can have a big effect on the bottom line. Ten percent of the population accounts for two-thirds of all health care spending.1 The Energy and Commerce Committee’s investigation into three insurers found that they canceled the coverage of roughly 20,000 people in a five-year period, allowing the companies to avoid paying $300 million in claims.
They also dump small businesses whose employees’ medical claims exceed what insurance underwriters expected. All it takes is one illness or accident among employees at a small business to prompt an insurance company to hike the next year’s premiums so high that the employer has to cut benefits, shop for another carrier, or stop offering coverage altogether –
1 Samuel Zuvekas and Joel Cohen, “Prescription Drugs And The Changing Concentration Of Health Care Expenditures,” Health Affairs, 26 (1) (January/February 2007): 249-257.
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leaving workers uninsured. The practice is known in the industry as ―purging.‖ The purging of less profitable accounts through intentionally unrealistic rate increases helps explain why the number of small businesses offering coverage to their employees has fallen from 61 percent to 38 percent since 1993, according to the National Small Business Association. Once an insurer purges a business, there are often no other viable choices in the health insurance market because of rampant industry consolidation.
An account purge so eye-popping that it caught the attention of reporters occurred in October 2006 when CIGNA notified the Entertainment Industry Group Insurance Trust that many of the Trust’s members in California and New Jersey would have to pay more than some of them earned in a year if they wanted to continue their coverage. The rate increase CIGNA planned to implement, according to USA Today, would have meant that some family-plan premiums would exceed $44,000 a year. CIGNA gave the enrollees less than three months to pay the new premiums or go elsewhere.
Purging through pricing games is not limited to letting go of an isolated number of unprofitable accounts. It is endemic in the industry. For instance, between 1996 and 1999, Aetna initiated a series of company acquisitions and became the nation’s largest health insurer with 21 million members. The company spent more than $20 million that it received in fees and premiums from customers to revamp its computer systems, enabling the company to ―identify and dump unprofitable corporate accounts,‖ as The Wall Street Journal reported in 2004.2 Armed with a stockpile of new information on policyholders, new management and a shift in
2 “Behind Aetna’s Turnaround: Small Steps to Pare Cost of Care,” Wall Street Journal, August 13, 2004.
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strategy, in 2000, Aetna sharply raised premiums on less profitable accounts. Within a few years, Aetna lost 8 million covered lives due to strategic and other factors.
While strategically initiating these cost hikes, insurers have professed to be the victims of rising health costs while taking no responsibility for their share of America’s health care affordability crisis. Yet, all the while, health-plan operating margins have increased as sick people are forced to scramble for insurance.
Unless required by state law, insurers often refuse to tell customers how much of their premiums are actually being paid out in claims. A Houston employer could not get that information until the Texas legislature passed a law a few years ago requiring insurers to disclose it. That Houston employer discovered that its insurer was demanding a 22 percent rate increase in 2006 even though it had paid out only 9 percent of the employer’s premium dollars for care the year before.
It’s little wonder that insurers try to hide information like that from its customers. Many people fall victim to these industry tactics, but the Houston employer might have known better – it was the Harris County Medical Society, the county doctors’ association.
A study conducted last year by PricewaterhouseCoopers revealed just how successful the insurers’ expense management and purging actions have been over the last decade in meeting Wall Street’s expectations. The accounting firm found that the collective medical-loss ratios of the seven largest for-profit insurers fell from an average of 85.3 percent in 1998 to 81.6 percent in 2008. That translates into a difference of several billion dollars in favor of insurance company shareholders and executives and at the expense of health care providers and their patients.
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There are many ways insurers keep their customers in the dark and purposely mislead them – especially now that insurers have started to aggressively market health plans that charge relatively low premiums for a new brand of policies that often offer only the illusion of comprehensive coverage.
An estimated 25 million Americans are now underinsured for two principle reasons. First, the high deductible plans many of them have been forced to accept – like I was forced to accept at CIGNA – require them to pay more out of their own pockets for medical care, whether they can afford it or not. The trend toward these high-deductible plans alarms many health care experts and state insurance commissioners. As California Lieutenant Governor John Garamendi told the Associated Press in 2005 when he was serving as the state’s insurance commissioner, the movement toward consumer-driven coverage will eventually result in a ―death spiral‖ for managed care plans. This will happen, he said, as consumer-driven plans ―cherry-pick‖ the youngest, healthiest and richest customers while forcing managed care plans to charge more to cover the sickest patients. The result, he predicted, will be more uninsured people.
In selling consumer-driven plans, insurers often try to persuade employers to go ―full replacement,‖ which means forcing all of their employees out of their current plans and into a consumer-driven plan. At least two of the biggest insurers have done just that, to the dismay of many employees who would have preferred to stay in their HMOs and PPOs. Those options were abruptly taken away from them.
Secondly, the number of uninsured people has increased as more have fallen victim to deceptive marketing practices and bought what essentially is fake insurance. The industry is insistent on being able to retain so-called ―benefit design flexibility‖ so they can continue to
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market these kinds of often worthless policies. The big insurers have spent millions acquiring companies that specialize in what they call ―limited-benefit‖ plans. An example of such a plan is marketed by one of the big insurers under the name of Starbridge Select. Not only are the benefits extremely limited but the underwriting criteria established by the insurer essentially guarantee big profits. Pre-existing conditions are not covered during the first six months, and the employer must have an annual employee turnover rate of 70 percent or more, so most of the workers don’t even stay on the payroll long enough to use their benefits. The average age of employees must not be higher than 40, and no more than 65 percent of the workforce can be female. Employers don’t pay any of the premiums—the employees pay for everything. As Consumer Reports noted in May, many people who buy limited-benefit policies, which often provide little or no hospitalization, are misled by marketing materials and think they are buying more comprehensive care. In many cases it is not until they actually try to use the policies that they find out they will get little help from the insurer in paying the bills.
The lack of candor and transparency is not limited to sales and marketing. Notices that insurers are required to send to policyholders—those explanation-of-benefit documents that are supposed to explain how the insurance company calculated its payments to providers and how much is left for the policyholder to pay—are notoriously incomprehensible. Insurers know that policyholders are so baffled by those notices they usually just ignore them or throw them away. And that’s exactly the point. If they were more understandable, more consumers might realize that they are being ripped off.
Thank you, Mr. Chairman, for beginning this conversation on transparency and for making this such a priority. S. 1050, your legislation to require insurance companies to be more honest and transparent in how they communicate with consumers, is essential. So, too, is S.
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1278, the Consumers Choice Health Plan, which would create a strong public health insurance option as a benchmark in transparency and quality. Americans need and overwhelmingly support the option of obtaining coverage from a public plan. The industry and its backers are using fear tactics, as they did in 1994, to tar a transparent, publicly-accountable health care option as a ―government-run system.‖ But what we have today, Mr. Chairman, is a Wall Street-run system that has proven itself an untrustworthy partner to its customers, to the doctors and hospitals who deliver care, and to the state and federal governments that attempt to regulate it.

Response to letter to editor on "failing government"

To President Obama and all 535 voting members of the Legislature.   It is now official, you are ALL corrupt morons:

Power corrupts and absolute power corrupts absolutely.   People in politics want to be re-elected and therefore gladly accept contributions to their re-election war chests.   The way around this is not to allow political contributions but to make all candidates accept a “fair share” of election money and nothing more.   That should level the playing field.

Obama should have accepted his fair share in his run for President but he didn’t; instead he chose to stick it in the craw of the Powerful Elite - - i.e. the monied interests - - by playing their game.   He was successful because so many little people desperately wanted change.   So far, he has disappointed many little people.

The acceptance of money for re-election war chests does make it appear that our elected officials have been “bought”.   Congressmen and Senators should be made to wear jackets like NASCAR drivers with their big contributors’ logos on them for all to see.   That way the electorate back home could decide if indeed their congressional delegation had been bought and vote them out of office.

The U.S. Post Service was established in 1775. You have had 234 years to get it right and it is broke.

Beyond me why everybody singles out the Post Office and says “UPS makes a profit; why can’t the US Postal Service?’  Two things you should understand:  The USPS serves every nook and cranny of every “Sleepy Hollow” in the country - - while UPS serves only those places where it can make a profit.   Also, the USPS is nothing but a subsidy to American business for distribution of bills, catalogs and sales literature - - to help American businesses stay in business.   Ever hear of “Bulk Rates?”   Who do you think “Bulk Rates” are for?   Certainly not for you and me.   Shouldn’t first class postage apply to catalogs, sales literature – and for that matter, magazines like Time and US News and World Report?   Remember that if it did, their cost of doing business would be more and the prices you and I pay would be higher.

I for one think the USPO does a pretty good job, given the above constraints.

Social Security was established in 1935. You have had 74 years to get it right and it is broke.

Social Security is a great program.   It was established specifically to take care of the elderly and the disabled.   Before Social Security, the elderly were the responsibility of their children or their churches.   That was well and fine while the nation was agrarian.   All an adult child had to do was plant a few more acres and have a few more chickens to take care of his parents.

A funny thing happened around 1890.   The country started shifting from agrarian to industrial.   So what should we have done with the aging parents?   Perhaps we should have lined them up against the wall and shot them.   After all, their children were having a tough enough time taking care of themselves.

Why not let the churches take care of them?   The funny thing is that churches are local.   As a rule, poor churches serve poor sections of town and rich churches serve the more affluent sections of town.   Do you really think that parishioners in the Country Club district would bother with providing for the elderly in the poorer sections of town?   Dream on.

Fannie Mae was established in 1938. You have had 71 years to get it right and it is broke.

Fannie Mae and Freddie Mac are not part of the US Government per se.   Instead, they are what are called government-sponsored enterprises (GSE’s).   GSE’s are a group of financial services created by the US Congress to enhance the flow of credit to targeted economic sectors.

Congress created GSE’s to enhance the availability and reduce the cost of credit to agriculture, home financing and education.   This makes those targeted economic sectors more efficient and transparent.

During the Great Depression, borrowers defaulted on mortgages right and left with the result that banks found themselves strapped for cash.   FDR and Congress created Fannie Mae to buy mortgages from lenders, freeing capital that could go to other borrowers.

Fannie Mae helped usher in a new generation of American home ownership, paving the way for banks to loan money to low- and middle-income buyers who otherwise might not have been considered creditworthy.

During budget difficulties at the time of the Viet Nam war, LBJ requested that Congress take Fannie off the government balance sheet and convert it into a publicly traded company owned by investors.   Two years later, Freddie Mac was launched, primarily to keep Fannie Mae from functioning as a monopoly.

Today, Fannie and Freddie dominate the mortgage markets.   Fannie and Freddie raise cash to buy mortgages from a variety of sources, including pension funds, mutual funds and foreign governments.   Their influence is large enough that the Federal Reserve and the Treasury felt the need to assure that Fannie and Freddie would not be permitted to collapse from reverberations of the sub-prime mortgage debacle under Bush II.

Historically, right wingers have been Fannie’s and Freddie's most vocal critics, arguing that Fannie’s and Freddie’s ties to the U.S. Government give them an unfair advantage over others in the industry.   Whether it does or does not, I can not say for sure.   But I do know that many people would not be home owners if it weren’t for Fannie and Freddie.

Read http://www.investopedia.com/articles/economics/08/fannie-mae-freddie-mac-credit-crisis.asp for better insight.

War on Poverty started in 1964. You have had 45 years to get it right; $1 trillion of our money is confiscated each year and transferred to "the poor" and they only want more.

You don’t want to get me started on this one.   I am getting smarter in this area because of what I am doing to help get campus facilities for the intellectually and developmentally disabled into the Dayton area.

What LBJ did for the really little guy in terms of the “Great Society” was great.   Unfortunately, Ronald Reagan and Dean Stockwell did a hatchet job on the “War on Poverty” and the country still has not recovered.

When Ronnie did his hatchet job, it fell upon the “nonprofit” sector to pick up the slack.   Today, the nonprofit sector stands at a crossroads.   Government budget cuts starting with Reagan have eliminated a significant source of nonprofit revenues and have created a serious fiscal squeeze for many organizations that traditionally help the poor and the disabled.

Although the non profit sector as a whole managed to replace its lost revenue, it did so through increasing fees and charges.   That attracted for-profit businesses into traditional nonprofit fields.   That in turn created a serious economic challenge to the non profit sector.

Questions have been raised about what some see as over professionalization and bureaucratization among the nonprofits.   This has undermined public confidence and prompted questions about the basic legitimacy of the special tax and legal benefits nonprofits enjoy while providing service to the poor and the disabled.

Thank you Ronnie.   You did great.

Medicare and Medicaid were established in 1965.   You have had 44 years to get it right and they are broke.

See the rationale I provided for Social Security.   It also applies here.

Medicare and Medicaid are great programs for the elderly and the disabled.   FDR and HST tried to get Medicare passed but were unable.   LBJ did by twisting arms of Senators and Congressmen who “owed” him.

Thank heaven that he did.   That kept so many decent Americans from having to bankrupt their selves to provide medical care for their parents or their disabled children.

I still remember the TV news the day that LBJ flew to Independence MO to sign the legislation at Harry Truman’s home and to give Truman the first Medicare card.   How happy HST was.   It was a great day for America.

Medicare is so great; I fervently hope that we can get “Medicare for all”.   The country needs it desperately.

The Department of Energy was created in 1977 to lessen our dependence on foreign oil.   It has ballooned to 16,000 employees with a budget of $24 billion a year and we import more oil than ever before.   You had 32 years to get it right and it is an abysmal failure.

I do not know as much about the Department of Energy as I do about other things so I am asking you to extrapolate from the generalities about the need for government that I provide in the next section.   I will say this though: America’s dependence on foreign oil must be reduced.

You have FAILED in every "government service" you have shoved down our throats while overspending our tax dollars.

Government has to be ready to do what private enterprise will not.   At the local level, police, fire, schools, utilities – and especially, the courts are examples of government services.   So is snow removal which is so important from a safety standpoint in a nation which has so many automobiles on the road.

At the national level, Military power is the most important.   Taxation and appropriation follow closely.   And of course, the national court system where the Judiciary is one of the three branches of government.   Ever wonder why?

America is a country of the rule of law.   What good would a contract be if there were no courts to enforce it?   Without laws and the courts to enforce them, there would be absolute chaos.   Is that what you who are so anti government want?   There must be government for the nation to survive.

What do you think the odds would be that private enterprise would build something like the Tennessee Valley Authority dams which were built to jump start economic activity in the South?   Or for that matter, how about all the hydroelectric dams in the Southwestern U.S. which are the main source of fresh water for desert areas.   How many people do you think would live in the Greater LA metropolitan area, Phoenix, Tucson, El Paso Las Vegas or Albuquerque without water from these dams?   Where do you think a good chunk of the electricity for the people that live there come from?

AND YOU WANT AMERICANS TO BELIEVE YOU CAN BE TRUSTED WITH A GOVERNMENT-RUN HEALTH CARE SYSTEMSTEM??

You asked for it.   This is an area I know a little about.

If you want to read “My Daughter’s medical Horror Story” which I was able to get to various Senators and Representatives in Washington, just let me know and I will send it to you electronically.

Caring for the sick is first and foremost, a moral issue.   Supposedly, America is a Christian country.   Ask yourself, “What would Jesus do?”   Would He not heal the sick, support the weak, and comfort the afflicted.   That is exactly what a universal health care system seeks to do.   A “Single Payer” system would be the best choice among universal health care possibilities.

Here are some health care reform myths.   If you believe these myths, then the Medical – Industrial Complex “lobbying” of Congress has done a job on you.

Universal coverage costs too much:   No it doesn’t.    Every other industrialized nation offers universal coverage at a cost much lower than the aggregate we spend in the US, a goodly portion of which goes to insurance and pharmaceutical profits.

Our taxes will go up:   Perhaps, but we are still going to come out ahead when aggregate expenses are considered.   Single Payer “taxes” will cost us less than the premiums, co-pays and medical bill we pay today.   Further, our health coverage will be secure regardless of income or status of employment.

Americans get world class care and we shouldn’t mess with that: in fact, many Americans do not get world class care.   Sure, world class care is available to those that are rich or have good insurance.    However, on almost all measures of health care and mortality, the United States still lags Canada and Europe.   Why is that if we have world class healthcare.

Other countries have much longer waiting times than we do: Actually there are no waiting lists for emergency surgery or urgently needed procedures in universal care countries.   Check www.commonwealthfund.org for studies on wait times.

There is no health care problem; people can get care even if they are uninsured: Yes.   By law, a person cannot he turned down if he presents himself to an Emergency Room.   However, ERs are an expensive place to get treatment.   Further, even with the availability of expensive ERs, more than 60 Americans die daily from lack of care.   See www.cancer.org for more.

And the biggie: “Single Payer” is socialized medicine.   No, single payer is not socialized medicine because government will not own the hospitals and physicians will not be on a government salary.   Single payer will work like today’s Medicare program for the elderly and the disabled where patients see private doctors and use private hospitals.   Clearly, “Single Payer” is not socialized medicine.   Single payer is actually public insurance rather than private insurance.   That is a great big difference.

So you need a job?   This is another biggie the Medical - Industrial Complex doesn’t want the American people to know:

When I was in college, Charlie Wilson said, “What is good for General Motors is good for the country.”   WRONG!!!   GM is now bankrupt.   One of the primary reasons they are is that GM has to buy medical insurance for its employees while their Japanese, German, British and Scandinavian competitors do not.   That is analogous to having the American runner carry a hundred pound weight in a foot race.

A national single-payer system would relieve corporations like GM of the burden of buying and administering health insurance, stabilize costs, and give them the global level playing field they need to compete in world markets.

American business can play a major role in solving the healthcare dilemma by overcoming their blind resistance to a universal care system and insisting instead that a national plan be designed to provide their employees with proper medical coverage without runaway costs.   Universal coverage such as a “Single-Payer” system offers the best hope of achieving these goals.

I would like to ask why the country considers humongous profits for the insurance industry more important than the other economic sectors being on a level playing field with their foreign competitors.

One final thing:   I am on the mailing list for Steny Hoyer’s “Daily Dose”.   From the Daily Dose sent at 5:26 PM Friday, January 8, 2010, I quote:  At the Time This Daily Dose Was Sent, Insured Americans Had Paid a “Hidden Tax” of $44,179,853,891 since January 1, 2009 in Additional Premium Costs to Cover Care for the Uninsured.

Folks, keep this circulating.   It is very well stated.   Maybe it will end up in the e-mails of some of our "duly elected' and their staff (they never read anything) will clue them in on how American's feel.

I will forward this to Congressional and Senate Staffers who have helped me get my daughter’s Medical Horror Story to the proper authorities.

Al Baca

albertbaca@att.net

(937) 236-0782