Single-payer health bill introduced in U.S. Senate as fiscal savings measure
Is America ready for a health plan for all? The single-payer health reform bill introduced in the Senate March 25 will be supported by consumer advocates, but it cuts insurance companies out of the equation. Industry is helping to craft other reform plans being developed by the Obama administraton and Senators Baucus and Kennedy.
Senator Bernie Sanders of Vermont introduced a single-payer health reform bill, the American Health Security Act of 2009, S. 703, in the U.S. Senate March 25. A copy of the bill is available here. (PDF) After calling for such national legislation for years, a grassroots movement of citizen coalitions, nurses, unions and progressive medical groups like Physicians for a National Health Program (PNHP) will surely be rallying for the bill. PNHP calls the plan “the most fiscally conservative option for reform” because it eliminates costly administrative and bureaucratic overhead from the delivery of health care. Insurance and associated administrative costs represented one-third of every dollar spent on health care, according to some analysts. PNHP said the $400 billion saved annually can be redirected into clinical care that would cover all 46 million presently uninsured Americans and eliminate the co-pays and deductibles that everyone with insurance current pays. The single-player plan is at odds with the health care reform proposals now getting the most attention. Those plans are being advanced by President Barack Obama and Senators Max Baucus (D-Mont.), chair of the Senate Finance Committee, and Edward Kennedy (D-Mass.). Those plans, still in development, promise to maintain a central role for the insurance industry and likely would involve a public mandate to purchase insurance, and public subsidies to enroll more low-income people in insurance programs. It is unclear who would fund those new enrollments under the plans, how they would contain growing Medicare and Medicaid costs, and how they would reduce the waste in the current system. The White House and Baucus-Kennedy proposals will be a tougher sell to the public today, particularly after disclosures about the billions contributed to members of Congress by financial lobbyists and the unpopular financial bailouts. Members of Congress have been heavily lobbied by the health care industry. Since 2005, the insurance industry has donated $2.2 million and drug companies donated more than $3.3 million to Congress members influential in shaping health care policy, according to Consumer Watchdog, an advocacy group based in California. The financial crisis and resulting foreclosures and job losses have elevated health care reform on the national priority list. Sanders’ bill gives the public an opportunity to rally behind a high profile patient-centered as opposed to profit-centered, health care reform program. “This is excellent news for the nation’s health,” said PNHP national coordinator Quentin Young, a physician and past president of the American Public Health Association. “There is now an affordable cure for our dysfunctional health care system. In the face of our present economic calamity, this is an urgent necessity.”
Rep. Jim McDermott (D-Wash.), has introduced a bill in the House, H.R. 1200, that is similar to the one authored by Sen. Sanders. Rep. John Conyers Jr. (D-Mich.), re-introduced a single-payer bill in the House, H.R. 676, this year. Last year the bill had 93 co-sponsors.
Key aspects American Health Security Act of 2009, S. 703:
*Federally funded, the program will be administered by the states.
*The program would save at least $400 billion annually by eliminating the overhead and profits of the private, investor-owned insurance industry, and the complex paperwork imposed on physicians, hospitals and other providers. Money saved would provide comprehensive care for all.
*The program would fully fund community health centers, giving 60 million Americans now living in rural and underserved areas access to care.
*To address the critical shortage of primary care physicians and dentists, the bill provides resources for the National Health Service Corps to train an additional 24,000 health professionals.
*Comprehensive benefits, including coverage for dental, mental health, and prescription drugs.
*The program would be paid for by combining current sources of government health spending into a single fund. The fund would be supplemented by “modest” new taxes that would be less than what people now pay for insurance premiums and out-of-pocket expenses.



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Bob Marston
If Obama’s health control plan is adopted, one’s level of health care will be determined on how much the bureaucrat ruler’s value one’s worth.
Note that currently 80% of health care expense is attributed to 20% of the patients requiring that care and that 20% is represented by the elderly. What is the worth of your mother, father and grandparents? Permit me to disabuse you of the notion that some faceless bureaucrat would never let your loved ones die to compliment the bottom line. Think again. It’s all about power, control, the bottom line and the expendability of the elderly.
Consider how Congress has managed Medicare, Medicade, Immigration, War on Poverty or drugs. And now we should trust them with the management of 1/5 of the U.S. economy. Get real!
The following is excerpted from the link at the end of this report:
The share of the federal budget devoted to health care (principally though the Medicare and Medicaid programs) is growing rapidly every year, and the entrance of the baby boomers into Medicare will accelerate this trend. Unfunded Medicare and Medicaid liabilities currently run in the tens of trillions of dollars. As with Social Security, there is no real Medicare Trust Fund. The monies raised each year from the Medicare tax are not put into a lockbox for elderly Americans. Rather, they are used to care for Americans today, or to subsidize the current budget.
John Goodman, President of the National Center for Policy Analysis, has outlined the dangers:
A recent forecast by the Congressional Budget Office… shows that Medicare and Medicaid alone (each currently trillions of dollars in debt) are going to crowd out everything else the federal government is doing by mid-century… national defense, energy, education, the whole works. We'll only have health care. If, on the other hand, the government continues with everything else it is doing today and raises taxes to pay for Medicare and Medicaid, the Congressional Budget Office estimates that, by mid-century, a middle-income family will have to pay two-thirds of its income in taxes! [Are you going to silently acquiesce and permit Obama and his minions do this to your children and grand children?]
Comparing Costs:
According to the National Coalition on Health Care, the cost of medical care rose at more than twice the rate of general inflation in the United States in 2008, just as in prior years. In 2007, health care consumed 17 percent of U.S. Gross Domestic Product (GDP), or $2.4 trillion. By the year 2017, healthcare costs are projected to be 20 percent of GDP, or $4.3 trillion, according to a study in the journal Health Affairs.
Other countries, by contrast, have cradle-to-grave insurance systems, which are largely government administered. The systems' providers limit the provision of care to meet annual budget allocations. In other words, the providers ration their health care. They withhold certain types of care, based on cost-benefit analysis, thereby creating lengthy wait lists for non-emergent care. Specifically, they can withhold care if it is deemed too expensive, or unnecessary, such as elective surgeries. Providers in these countries can even limit the use of aggressive treatments for patients with bad prognoses.
One Size Fits All?
The advocates of universal healthcare are most comfortable with a "one size fits all" approach. Inevitably, this would have to mean a resort to a rationing type approach, masked by the euphemism of "best demonstrated practices." President Barack Obama's 2008 stimulus bill provides $1.1 billion for such initiatives.
As Jerome Groopman and Pamela Hartzband argued in the Wall Street Journal, best demonstrated practices are not always best. "In too many cases, the quality measures have hastily been adopted, only to be proven wrong and even potentially dangerous to patients."
Driving Out Private Firms
A new government program could worsen significantly the already daunting federal budget forecasts. The proposed government insurance leviathan could easily under-price its private market competitors, by underpaying providers relative to private insurers, just as it does for Medicare and Medicaid patients. Over time this process would drive many corporations to drop private health insurance, making room for the government program to replace it.
The highly-respected Lewin Group estimates that a new government insurance option could drive up to 130 million Americans currently insured through the private market to the government insurance at a net cost of $2 trillion in federal spending over ten years. Indeed, U.S. taxpayers would essentially subsidize the collapse of the private health insurance market.
Administrative Waste?
Supporters of universal health insurance like to argue that the real problem is the administrative waste and higher costs of the private U.S. health insurance market. They cite numbers to show, for example, that Medicare and Medicaid spend a much smaller percentage of their budgets on administration than private companies. [Yes, and each of these two programs are currently trillions of dollars in debt. Thank Congress for their management oversight and responsibility.]
These numbers are deceiving. For one, private insurance companies have to pay for marketing. After all, these companies need to sell their product. It is also important to note that Medicare and Medicaid pay providers (hospitals, nursing homes, physicians) significantly less than private insurers for nearly all services, often below the actual cost of care. By contrast, providers charge private insurance patients higher prices to compensate. Remember, also, that the uninsured pay little or nothing for their care, often delivered in expensive emergency room settings. Private insurance patients also subsidize this free care or bad debt burden. On top of that, the federal and state health programs set price caps for all providers, but private insurers have to wrangle over prices with individual providers.
The Uninsured
It may come as a surprise that the problem of America's uninsured may not be as grave as advertised. Many of the estimated 45 million uninsured Americans could obtain insurance if they chose to. Sally Pipes, President of the Pacific Research Institute, has summarized the issue:
"About 18 million of the uninsured make more than $50,000 a year—and almost 10 million have yearly incomes over $75,000. More than 10 million aren't U.S. citizens. [read illegal aliens] And as many as 14 million already are eligible for government programs like Medicare, Medicaid and SCHIP—but haven't signed up."
These numbers suggest that the problem of the uninsured does not require a large new government insurance program. Many of America's uninsured would purchase insurance if it was more affordable, and millions are simply unaware that they qualify for an existing government insurance option. Certainly a federal program can create a safety net for those who fall within the gaps.
Alternatives
The Healthy Americans Act, introduced by Senators Ron Wyden (D-OR) and Bob Bennett (R-UT) and endorsed by others from both parties, presents one potential alternative. The legislation proposes a hybrid of public and private coverage, with a regulated private insurance market. The proposal has a smaller federal price tag, and it relies more on company and individual payments for coverage. However, it guarantees a standardized benefit package (similar to that of members of Congress) that ensures higher levels of utilization and cost. [Call your congressman and Senators, and ask them if they and their family will agree to be insured under the Obama Public Option health control plan. If it is not good enough for them, it is not good enough for you. NOTE: ON PAGE 114 OF THE KENNEDY / OBAMA HEALTH CONTROL BILL, CONGRESS IS EXEMPT FROM PARTICIPATING IN THE SAID PLAN. Also, unions are exempt from taxation on their health insurance premiums.]
Regardless of the approach taken with the uninsured, Americans must still address the rapidly escalating cost of both private and government insurance programs. The following six suggestions may provide a point of departure:
1. Allow insurance companies to sell their products nationwide, rather than deal with 50 state bureaucracies. Expanded insurance pools reduce the risk to insurers of high cost patients with chronic diseases, and should result in lower premiums.
2. Reduce the state-regulated mandates for services that must be covered by health insurers. Companies should be allowed to offer a menu of plans, with varying lists of covered services, as well as different deductibles and co-pays. Competition drives down costs in all other areas of the economy, but it is neglected in health care. Without it, costs rise rapidly.
3. Equalize the after-tax treatment of health care benefits for individuals insured through their companies and those who are individually insured. When he ran for president, Senator John McCain (R-AZ) proposed taxing employee health care benefits and offering a tax credit to individuals to purchase insurance. This would provide an incentive to the uninsured to buy insurance, and potentially encourage employees to consider more carefully the costs and benefits of their existing coverage, not to mention their alternatives.
4. Encourage the use of the Health Savings Account (HSA), and other high deductible plans that make health insurance more of a catastrophic benefit, and leave the costs of more routine or day-to-day health care to consumers. While proponents of nationalized health care hate calling patients "consumers," or calling providers and insurers "competitors," HSAs are more affordable than first dollar coverage plans and provide more choices. With consumers more in command of their health care dollars, providers would compete for patients' business on price, service, and convenience. This could set the stage for less costly alternatives to emerge.
5. Provide more significant incentives for greater use of generic drugs and health improving behaviors such as smoking cessation and weight reduction.
6. Address the litigation issue by placing reasonable caps on malpractice awards. In states where such caps exist, physicians pay far lower malpractice premiums, and there are fewer shortages in the high-risk specialty practices, thereby increasing supply and competition. There tend to be greater physician shortages in states that are known to have high malpractice insurance costs resulting both from courts sympathetic to the plaintiffs' bar, and the absence of limits on awards. The problem is most serious in these locations for obstetricians and neurosurgeons.
No Silver Bullet
Reducing national health care spending so that it is closer to the economy's overall growth rate is essential to avoiding fiscal catastrophe. Government health care coverage with rich benefit packages to millions of Americans, many of whom are already insured, may only exacerbate the problem. The government option would provide care to the uninsured, but also to others diverted to this new plan, and significantly increase demand for services, which would drive up costs. The government would then impose price cuts, which would likely drive some physicians and other providers out of the market. Eventually, the government would be forced to ration care to control spending.
This is not the way to improve health care in America. A greater injection of competition, on the other hand, might do more to both improve quality and address the spending levels that are now spiraling out of control.
Richard Baehr is a distinguished fellow at the JPC, and co-founder and political director of The American Thinker, a web-based policy journal. He has worked in the health care industry as a financial and planning consultant for providers for 35 years.
http://www.jewishpolicycenter.org/962/nationalized-health-care-threatens-americas-future
Wakeup America, get your country back and vote most of the Democrats out of office.
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