Category: Single Payer Health Care

Doctors endorse single-payer | Philadelphia Inquirer | 12/04/2007

Doctors endorse single-payer Philadelphia Inquirer 12/04/2007:
“Because much of the growth in expense in the current system is in procedures performed by specialists or in increased use of technology like MRIs, doctors who work in those areas have the most to fear from a single-payer system, Getzen said. Internists, who serve as primary-care doctors for many people, have less to fear.

The ACP also called for better payments for primary-care doctors to help avert a shortage and for the creation of a uniform billing system and greater use of electronic health records to reduce administrative costs.

Dale said that some U.S. doctors and hospitals were better than their counterparts in other nations, but that this country’s health system compares poorly. ‘Part of our call is, ‘Look around, guys, and see how other people are doing,’ ‘ he said, ‘and they’re doing better than us.’ “

Nicely done summary of where most of the tension in advocating for single payer lays.

The ACP position paper is here, and I believe free to anyone.

Cheers,

The McGill Daily – Hyde Park: When universal healthcare isn’t

The McGill Daily:

“But as any medical professional will tell you, this vaunted Canadian universalism is gradually being attenuated. As I recently discovered, universal in Ontario does not always translate to universal in Quebec. Specialized doctors are increasingly compelling their out-of-province patients – a group that includes many university students – to pay out-of-pocket for medical services.

“Specialists are adopting this practice because it relieves them of the cost of processing out-of-province claims and protects them from the occasional loss should a patient turn out to lack provincial health coverage. While out-of-province patients are still entitled to reimbursement from their home provinces, they must seek recovery on their own, a process that can take many weeks. If an out-of-province patient fails to pay, however, the specialist may refuse treatment, a course of action that carries no disciplinary consequences. “

Another caveat. Makes state by state action less appealing. Medicare-for-all looks better as Medicare causes no trouble when traveling to say, Florida for part of the year.

2008 Presidential Candidates Healthcare Proposals Side by Side Comparison

Analysis – health08.org:

“This side-by-side comparison of the candidates positions on health care was prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc. and is based on information appearing on the candidates websites as supplemented by information from candidate speeches, the campaign debates and news reports. The sources of information are identified for each candidates summary (with links to the Internet). The comparison highlights information on the candidates’ positions related to access to health care coverage, cost containment, improving the quality of care and financing. Information will be updated regularly as the campaign unfolds.”

This is an interesting exercise. I suggest you click on Kucinich and anyone else and view them side by side.

House Republicans plan their own health plan – The Crypt’s Blog – Politico.com

House Republicans plan their own health plan – The Crypt’s Blog – Politico.com:

“Under fierce attack by Democrats over the children’s health insurance plan, House Minority Leader John A. Boehner said Sunday Republicans will unveil their own health care plan over the next few months. “Republicans are working on a plan that will provide access to all Americans to high quality health insurance, make sure that we increase the quality of insurance that we have in American, and we want to foster a sprit of innovation,” said Boehner on “Fox News Sunday.” “This is a plan we’ll see over the next coming months where we put the patients in charge of their health care.””

Wow. Another step to the tipping point?

With health deal, UAW’s clout, influence grow

With health deal, UAW’s clout, influence grow:

“‘The size and visibility of this trust fund puts the UAW at the epicenter of the health care debate,’ said Harley Shaiken, a labor expert at the University of California, Berkeley and a longtime adviser to the union. ‘It expands the UAW’s visibility, influence and clout in a major way.’

The UAW has long been an outspoken advocate for nationalized health care. Union leaders already are making it clear that they intend to use their new clout to push for a national solution to rising health care costs. ‘(This) strengthens our commitment to national health care reform,’ said Alan Reuther, the UAW’s chief lobbyist in Washington. ‘This is an issue that has to be addressed by Congress.’

The timing could not be better. ‘National health care could be on the agenda as early as 2009,’ said Mike Whitty, a labor expert at the University of Detroit-Mercy. ‘It will allow the union to take the lead in pushing for a single-payer national health policy.'”

Another push towards the tipping point?

Kolodner says U.S. docs weak on IT adoption, stresses interstate collaboration

Kolodner says U.S. docs weak on IT adoption, stresses interstate collaboration:

“Most patients in the United States receive care in physician practices with one or two providers, yet only four percent of these practices have electronic health records, said Robert Kolodner, MD, here Monday. “

“We’re not getting value for our healthcare dollar in this country,” Kolodner said. “We’re paying more, but we’re ranked much lower than most other developed nations in health outcomes. Health IT is the right thing for our families and communities, but it’s also the right business case.”

In other nations, healthcare IT adoption is subsidized or incentivized more appropriately. Also, there is more uniformity with a single payer or universal system that reduces much uncertainty about purchases and implementation. A practice or hospital does not have to deal with a fragmented sytem on the outside with a myriad of insurers, hospital systems, etc, each with its own unique IT structure (or lack thereof).

NEJM — Health Care for All?

NEJM — Health Care for All?
by M. Gregg Bloche, M.D., J.D.

Just some commments. Dr. Bloche describes the origins of state benefits such as heath care and notes that post war treatment of those who scraficed was an impetus:

In exchange for widespread sacrifice, citizens began looking to the state
to secure their welfare.

I always am taken aback when people view democratic governments as ‘the other’. As Pogo said, “We have met the enemy, and he is us.” I understand with the ridiculously low level of civil participation these days in the us, it seems like us v. them. And especially with the current administration, I definitely feel like I’m a “them” these days. But, “the state” is still us. Our government, our social contract.

The new compact is likely to start with an enhanced sense of individual obligation — to eat sensibly, exercise regularly, avoid smoking, and otherwise care for ourselves. It may include an obligation to buy insurance. Government, in exchange, can offer some protection against the threat of economic and social change that will disrupt people’s coverage by destabilizing employment and family relationships. Not only can the state provide subsidies to enable poorer citizens to buy insurance; it can, at low cost, combine people’s purchasing power and clear away obstacles to competition, empowering markets to extend coverage to tens of millions who now go without it. Government can also fashion incentives to foster evidence-based practice, health promotion, the elimination of racial disparities in care, and the reduction of medical errors.

I absolutely hate this “personal responsibility” and “individual obligtion” crap. The people who are largely harmed by issues typically cited (obese, smokers) usually either a) don’t start draining the system until they are in Medicare or b) save us money by dying young (we get all of their Medicare and Social Security money). The other personal responsibility issues, such as seeing your physician and buying your meds are at least as much economic issues as responsibility issues.

And again with the subsidiesand incentives! Many are so poor that this doesn’t help. And most don’t know how to put their risk into perspective. Why is this so incomprehensible?

What is possible is a new reciprocity of personal and public commitment, tailored to American self-reliance and the uncertainties of a global economy. This arrangement stands a decent chance of delivering near-universal coverage. Success could cement a new understanding of government’s role — not as a guarantor of easy living irrespective of striving but as an insurer of basic decency when self-reliance fails.

Ugh. Reaarange those deck chairs. Again.

David Brooks: European system won’t fix U.S. health care woes

“Some liberals, believing that government should step in as employers withdraw,
support a European-style, single-payer health care system. That would be fine if
we were Europeans. But Americans, who are more individualistic and pluralistic,
will not likely embrace a system that forces them to defer to the central
government when it comes to making fundamental health care choices.”

Yeah, the elderly are practically rioting in the streets to get rid of Medicare, aren’t they? What a self-serving load of hogwash. It’s easy enough to just say you are ideologically against any kind of reform involving a single payer type solution. It’s another thing to blame it on the “American Character”, as if this is some unchanging monolith, or ever was.

“We shouldn’t disrupt the lives of those who are happy with the insurance they
have.”

Mr. Brooks apparently doesn’t realize what a vanishingly small number of people this is these days.In the end, Brooks advocates yet another half-baked idea that tinkers aroun the edges and fails to provide real healthcare security for all Americans.

read more digg story

NEJM — Healing Our Sicko Health Care System

NEJM — Healing Our Sicko Health Care System:

“To get around this catch-22, we will need populist anger but also
political foresight. Moore heads abroad to show us that a single public insurer
is the only hope. But one need not travel to Canada, the United Kingdom, or
France (much less Cuba — Moore’s most dubious destination) to see the virtues of
combining universality with public cost control. Medicare, our country’s most
popular and successful public insurance plan, covers everyone older than 65 and
people with disabilities — groups with great need for coverage and little
ability to obtain it privately. Yet it has controlled expenses better than the
private sector, spends little on administration, and allows patients to seek
care from nearly every doctor and hospital. For some reason, Moore ignores
Medicare. He talks about the post office, the fire department, public education
— but not the one public program that most resembles the ‘free universal health
care’ he extols.

“That’s too bad, because the Medicare model is the not-so-secret
weapon in the campaign for affordable health care for all. Today, many advocates
of national health insurance have wisely started calling for ‘Medicare for All’
rather than their old rallying cry, ‘Single Payer.’ But moving to a national
insurance plan overnight, whatever the label, means threatening the private
coverage on which so many Americans rely and requiring our cash-strapped
government to raise the highly visible taxes necessary to fund a system now
financed largely by the hidden drain on workers’ paychecks. We may be moving
toward the day when we are ready to clear these hurdles in one leap, but we are
not there yet. “

A fairly reasoned discussion in all, but we need leadership of the RFK variety:

“There are those that look at things the way they are, and ask why? I dream of things that never were, and ask why not? “

(Okay, wikiquote says he lifted that from GB Shaw, but, same spirit.)

Best Care Anywhere | The New America Foundation

Best Care Anywhere The New America Foundation:

This is a link to a two hour panel discussion on the VA Healthcare system, our own home-grown single-payer carve out, and it is very informative. It is lead by the author, Phillip Longman of “Best Care Anywhere: Why VA Health Care is Better Than Yours “

Below is a link to an audio only, MP3 version that you can download as well.

MP3 Audio Recording of this Event15.9 MB”