Howard Dean seals the deal, Single-Payer is Screwed
You may remember last week when discussing Charlie Crist's lousy health care plan that I proclaimed...
as long as this is the kind of crap that Republicans want to push through as "historic legislation", our country is in for tough times. I don't see any Democrat with the guts and political capital to push through true Universal Health Care coverage here in North Carolina, nor in the US Senate, nor in the US House. They'll fold like a house of cards - just like they did over Iraq.
Well, Howard Dean has now sealed the deal. Dr. Dean has always been more moderate or conservative than most Democrats think of him as being, in Vermont he focused on piecemeal programs like Dr. Dynasaur to provide "near-universal" coverage to children and pregnant women. So, it should come as no surprise when he says....
I think while someday we may end up with a single-payer system, it’s clear that we’re not going to do it all at once, so I think both candidates’ health-care plans are a big step forward. Certainly compared to Senator [John] McCain, who represents a big step backward.
Don McCanne over at Physicians for a National Health Program has a cutting take on what we can expect in the next administration from Democrats.
Let’s assume that in 2009 we will have a Democratic president, a solid Democratic majority in the House of Representatives, and sixty filibuster-proof Democrats in the Senate. We also know that, amongst Democrats, there is tremendous support for the single payer model of health care reform. That’s all we need to enact a single payer national health program. Right?
Sorry. The Democrats are already assuming that they will be in control, and the message from them is very clear. “Although single payer may be the best way to finance health care, we can never get there in one step,” is the gospel (small g) as recited by the majority of veteran Democratic legislators (with the notable exception of John Conyers and the supporters of HR 676). The majority of Democrats believe that it would be impossible to skip the next step of first using our existing programs to expand coverage to (almost) everyone.
The consensus is that, above all, we must protect the vested interests if we are to achieve this next “big step forward.” “Vested interests” is not code language; it is the private insurance industry (and to some extent, the pharmaceutical firms, which will not be discussed here).
In health care financing, the private insurers are not the solution to our problem; the private insurers are the problem. (I would apologize to President Reagan, except in his version he got it wrong.)
At least here in North Carolina we have an alternative plan of attack.
HB 2688-HEALTH CARE POLICY COUNCIL-Insko, Holliman; Wainwright; Fisher; CO: Allen; Allred; Barnhart; Bell; Braxton; Brisson; Bryant; Carney; Coleman; Cotham; Current; Dickson; Dockham; Earle; Faison; Farmer-Butterfield; Gibson; Goodwin; J. Harrell; Harrison; Hill; Hughes; Jeffus; Jones; Luebke; Martin; McLawhorn; Michaux; Mobley; Owens; Parmon; Pierce; Ross; Saunders; Spear; Tarleton; Tolson; Underhill; Walend; E. Warren; R. Warren; Weiss; Wilkins; Womble; Wray-AN ACT to establish the Bill Martin and Ruth Easterling Health Care Policy Council.
The bill would set up a council that WOULD plan for providing Universal Health Care in North Carolina. It has 4 primary sponsors, including the House Majority Leader and 45 cosponsors. Rep. Insko's bill has been referred to the House Committee on Health. If you have a minute, please call or email to thank her for getting this bill to the point it is now (919) 733-7208. Also, if you don't see your representative on that list, call them!!!
In addition, great news, Senator Purcell has sponsored the companion bill in the Senate, drop him a line and say thanks! Health Care for All NC is really moving forward this year, but they can't do it without your help!!! Please, stop by their website and join up if you haven't already and if you have them make a donation.
- Robert P.'s blog
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I know this is supposed to be a great time for "Democrats"
but, why do I feel that this must be EXACTLY how the Evangelics felt in 2000?
I don't think it's just the vested interests listed above
Physicians are part of that system as well. Dr. Bratton, who is running against Howard Coble, has said she's not for Universal Health Care or Single Payer "at this time". Her reasons, if I recall, were that people would lose jobs. She was also concerned that a single payer system would not reimburse doctors enough.
I see that as a bad sign.
Be the change you wish to see in the world. --Gandhi
Pointing at Naked Emperors
"single payer system would not reimburse doctors enough"
This is a legitimate concern. Medicare just barely makes it worthwhile for doctors to be in business, but Medicaid and now BCBS pay less (maybe 90-95%) of what Medicare pays. Doctors currently rely on private health care plans to pay more for services to make up this difference. That is why so many providers have turned down the BCBS PPO plan, because it pays @or less than Medicare.
If we want to win this battle, we need physicians on our side. One way to do that is to just come out and say that the savings in paperwork from singlepayer increase their actual earnings to about (making this number up) 110% of current Medicare payments. And, that the singlepayer system would increase payouts so that number would be 120% (again, making this number up).
Who will do the survey of physicians in NC
on this issue?
Can you be more specific?
BTW, I was over at your old stomping grounds last night for the Triangletweetup.
Just asking where physicians really stand on the issue?
Has research been done to know what docs think in NC? If not, who would be the natural organization to do that?
Thanks for the picture
I miss the place.
Natural groups...
A natural group would be someone like PIRG or SEIU (from a national level) or someone like the NC Justice Center here. If we are talking just a simple research survey surely that wouldnt be too hard to fund.
"Keep the Faith"
Dr. Bratton needs to do some research
Uncompensated care is a huge vortex, sucking up labor and materials costs:
The ranks of the uninsured continue to grow, and the likelihood that physicians will be forced to increase the amount of uncompensated care they provide is high. Being compensated for every single patient, even at a slightly lower rate, has got to be more economically beneficial for physicians (in the long run) than a future without Universal Care.
yeah, I think UNC Hospital wrote off over $200 Million
In uncompensated care last year. But, I could be wrong, couldn't google it.
And just think about
how much money they spent just trying to collect from uninsured patients.
And, think about...
how many people they pay to be billing specialists for Medicare, Medicaid, S-CHIP, Veteran's administration, DoD, Indian Affairs Bureau, Blue Cross Blue Shield of North Carolina (group and individual), John Alden (group and individual), American Republic Insurance Company (individual), Wellpath (group), UnitedHealthcare (group), Humana (group), Cigna (group), Aetna, Affordable Alternatives, Alternative Healthcare Options (AHO), Carolina Coverage, D&J Insurance, Hartsfield and Nash Agency, Inc, Health Quotes, Hill Chesson & Associates, LTC Planner, Medical Mutual Group, Partners National Health Plans of North Carolina, Inc, Pharmacy Network National Corporation, Premier Health Systems, Inc, Roper Insurance Agency, Seaway Insurance Agency, Inc, Tar Heel Insurance Agency, and Walker Insurance. (list from here).
AS I understand your post so far, a problem..
would be the income for doctors being enough for their budgets? Not being an expert in this, but having watched many newsclips, the doctors always have that 'high' end to pay for insurance. So here we go again with the insurance companies. You can be sure that if the doctors can afford the premiums now, the insurance companies will find a reason for raising the rates. Again, like the dog chasing his tail. Meantime, some fat bastard CEO of the insurance cos will declare that he needs another few million dollar bonus for his 'good' job. We know what works in other civilized countries, but we have to satisfy the crooks!
Billing Specialists...
are hard working Americans too. Do you expect that decreased costs of doing business will result in a stronger economy, which would create jobs for all these newly unemployed billing specialists? Sounds a lot like supply-side ("trickle down")economics to me! :-)
Are you saying that we should forget about
Universal health care or some kind of single payer system that would benefit All Americans, especially the poor because there is a possibility that billing specialists may become unemployed?
Really?
No matter that patriotism is too often the refuge of scoundrels. Dissent, rebellion, and all-around hell-raising remain the true duty of patriots.
Progressive Discussions
No
That's why I put the smiley at the end.
figured this might be of interest
North Carolina Institute of Medicine Announces:
"Covering the Uninsured and NC Health Care Safety Net Update: Achievements & Challenges" Summit
June 5, 2008
10:00 to 3:30 pm
McKimmon Center, Raleigh, NC
* Keynote Address: Isabel Friedenzohn, Deputy Director, State Coverage Insitiatives, AcademyHealth
* Break-Out Sessions including one on Expanding Coverage for Children featuring Mona Moon from the Division of Medical Assistance, Donna Cohen Ross from the Center on Budget and Policy Priorities, and Tom Vitaglione from Action for Children.
To register, call Thalia Fuller at 919.401.6599, ext. 34 or email thalia_fuller@nciom.org
http://www.ncchild.org
- - - - -
national poll of physicians
There was a poll that came out in May saying more than 50% of physicians nationally, support universal health care. I will search for that and post it.
There are some principles that we can examine to see what the really important beliefs that we share... in what should happen to folks who have bad health, bad genes, bad luck, or bad wealth. Let them eat cake? let them go to the eR? why do some folks get cadillacs and some folks ride in rickshaws? or run under rickshaws?
Yeah, but single-payer is different than universal health care
I'm surprised more doctors don't supposed "universal health care".
Support Health Care for All NC
Go to the website and learn more about what they are doing for NC. This is a major effort to engage legislators and give them a new perspective on what universal health care can mean.
If one believes that employee based health care is simple and easy, and that universal health care is tantamount to the communist menace, then, there is plenty of work to do to open up conversations, provide some facts, present evidence that the current hodge podge of employee based -chaotic rules, ever changing coverage and escalating costs, is a MUST CHANGE FOR THE NC legislators.
but there is a great deal of ---50 years of--- misinformation about universal health care.
So HCFA NC has actively worked to develop a video, gather clear materials for the legislators to read, activate the physician, nurses, health care administrators, health care providers and users, to communicate directly with our legislators.
Support this group.
Here is the link to the article about Physician support for national health insurance, and the actual article
http://www.pnhp.org/news/2008/march/most_doctors_support national health insurance.php
EMBARGOED UNTIL: CONTACTS:
March 31, 2008 Aaron E. Carroll, MD, (317) 278-0552, aaecarro@iupui.edu
5:00 PM EST Ronald T. Ackermann, MD, (317) 278-0906, rtackerm@iupui.edu
Todd Main, PNHP, (312) 782-6006, todd@pnhp.org
Most doctors support national health insurance, new study shows
Reflecting a shift in thinking over the past five years among U.S. physicians, a new study shows a solid majority of doctors - 59 percent - now supports national health insurance.
Such plans typically involve a single, federally administered social insurance fund that that guarantees health care coverage for everyone, much like Medicare currently does for seniors. The plans typically eliminate or substantially reduce the role of private insurance companies in the health care financing system, but still allow patients to go the doctors of their choice.
A study published in today's Annals of Internal Medicine, a leading medical journal, reports that a survey conducted last year of 2,193 physicians across the United States showed 59 percent of them "support government legislation to establish national health insurance," while 32 percent oppose it and 9 percent are neutral.
The findings reflect a leap of 10 percentage points in physician support for national health insurance (NHI) since 2002, when a similar survey was conducted. At that time, 49 percent of all physician respondents said they supported NHI and 40 percent opposed it.
Support among doctors for NHI has increased across almost all medical specialties, said Dr. Ronald T. Ackermann, associate director of the Center for Health Policy and Professionalism Research at Indiana University's School of Medicine and co-author of the study.
"Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy," he said.
Support for NHI is particularly strong among psychiatrists (83 percent), pediatric sub-specialists (71 percent), emergency medicine physicians (69 percent), general pediatricians (65 percent), general internists (64 percent) and family physicians (60 percent). Fifty-five percent of general surgeons support NHI, roughly doubling their level of support since 2002.
Doctors have often expressed concern about lack of patient access to care due to rising costs and patients' insufficient levels of insurance. An estimated 47 million Americans currently lack health insurance coverage and another 50 million are believed to be underinsured. At the same time, health care costs in the United States are rising at the rate of about 7 percent a year, twice the rate of inflation.
The health care issue continues to rank high among voter concerns in the 2008 elections, placing third in a recent poll after the economy and Iraq.
The current study by the Indiana University researchers is the largest survey ever conducted among doctors on the issue of health care financing reform. It is based on a random sampling of names obtained from the American Medical Association's master list of physicians throughout the country.
In addition to measuring attitudes toward NHI, the survey also asked doctors about their views about "more incremental reform," often interpreted as state- or federal-based programs requiring or "mandating" that consumers buy health insurance from private insurance companies, legislative measures providing tax incentives to businesses to provide coverage for their employees, or similar steps.
Fewer physicians (55%) were in support of "incremental" reform. Moreover, virtually all those opposed to national health insurance also opposed incremental reform to improve access to care. In fact, only 14% of physicians overall oppose national health insurance but support more incremental reforms. Ironically, many medical organizations and most politicians have endorsed only incremental changes.
Dr. Aaron E. Carroll, Director of Indiana University's Center for Health Policy and Professionalism Research and lead author of the study, commented: "Many claim to speak for physicians and reflect their views. We asked doctors directly and found that, contrary to conventional wisdom, most doctors support the government creating national health insurance."
Other signs indicate that attitudes among doctors are changing. The nation's largest medical specialty group, the 124,000-member American College of Physicians, endorsed a single-payer national health insurance program for the first time in December.
****
"Support for National Health Insurance among American Physicians: Five Years Later,"
Aaron E. Carroll and Ronald T. Ackermann, Annals of Internal Medicine, April 2008.
Dr. Aaron Carroll is a member of the Board of Directors of PNHP.
Physicians for a National Health Program, a membership organization of over 15,000 physicians, supports a single-payer national health insurance program. PNHP is headquartered in Chicago and has chapters across the United States. To contact a physician-spokesperson in your area, contact info@pnhp.org or call (312) 782-6006.