Showing posts with label Single-payer. Show all posts
Showing posts with label Single-payer. Show all posts

August 26, 2016

Vermont Health Connect: “Current wait times are 90 minutes”

We have had working health insurance coverage for the past couple of years (unlike in 2014), but now we have moved and need to change the billing address.

I go to the Vermont Health Connect web site and click "Report a Life Change" to learn: "These changes should be reported by calling Vermont Health Connect toll-free at 1-855-899-9600 or by logging into your account and reporting your change online." I log in with the result: "An unexpected error occurred. Please contact an administrator." And "Contact Us: Have questions or want to find out more? Tel: (855) 899-9600."

I call. I wait. I give up. I call again a couple days later, wait, give up. I call again and add my number to a queue to be called back "within 3 business days". [Update:  One week later, no callback.]

[Update, Sept. 12:  Two weeks later, no callback. The web site now says that one can report "life changes" on line. So I logged in to my account (trying Opera after receiving the message that "There was some technical error processing your request" in Firefox, and then in Opera being forced to reset the password), got to the irritating terms page, and clicked "Next" — to receive the message that "An unexpected error occurred. Please contact an administrator." Called: "Estimated wait time is greater than 90 minutes." Left another request for callback (an option that is offered only after a couple minutes of waiting).]

[Update, Sept. 23:  They called back! But we were out. That was on Sept. 15. Nothing since. Governor Shumlin defended the whole mess yesterday: "nearly 9 in 10 customers seeking to report a life change 'experience a smooth process,' he said." So I went on line again to report my change of address, and now I couldn't even log in. So I called again (to set up another callback). One of Shumlin's improvements appears to have been to no longer provide an estimated wait time, and after a few minutes there was no longer an option to request a callback. I was planning to wait 5 minutes, and just before that cut-off, someone answered! They have our new address!]

[Update, Oct. 21:  This month's premium notice was sent to our old address. I called VHC (no wait at all!) to confirm that they have the new one, which they do, so maybe it will arrive correctly next month.]

Meanwhile, this month's premium invoice was sent to our old address and instead of being forwarded to us by the Post Office it was returned to Vermont Health Connect who then sent it to our new address with a note about changing the address. We at last received it 1 day before payment was due.

So I called the telephone number provided with the invoice for credit/debit card payment. I should not have been surprised to learn that here, too, "current wait times are 90 minutes".

So I will send the premium payment by mail, trust the assurances from last year that there is a 90-day grace period before coverage is cancelled and current implications that a change of address does not require a complete new application. One also hopes that the address change manages to be made before next month's premium invoice goes out.

Again, before the "Affordable Care Act", so-called Obamacare, Vermont had an excellent functioning state-run health insurance program that through an income-based range of premiums provided near-universal coverage. It wasn't perfect, but it was a system that made living in Vermont very worthwhile. To improve on it, the state had long pursued a true universal single-payer system, electing Peter Shumlin as Governor in 2006 on the promise to implement it. Because of Shumlin's belief, however, that people could not handle the information that they would pay taxes for health insurance instead of paying more in premiums to private insurers whose business is to deny care, the details – and final legislative action – were continually postponed.

Then came Obamacare in 2010, with no provision for states with better systems to keep them. There was no effort by Shumlin or the state's Congressmembers to protect Vermont's system. So money and effort had to be spent to set up the "Obamacare Exchange" (which still doesn't work), and delays and ballooning expenses were justified by the 2-track project of preparing for the coming single-payer system. On May 26, 2011, Shumlin had signed the bill to enact single-payer health insurance.

Finally, Shumlin was re-elected (barely) in 2014 for a third term on the promise that the final plan was to be revealed in December (after the election). Instead, on December 17, he announced that single-payer was dead. It was dead because he was never ready to fight for the payroll taxes to pay for it. He pretended that the need for those taxes was a new discovery, but it was well known from the beginning that such taxes would be the means of funding it. Public advocacy groups had long been explaining to people that the new taxes would be substantially less than current premiums, but the state took no part in that information program. Business owners praised Shumlin, and a few months later he endorsed Hillary Clinton for President and then that he would not seek re-election in 2016.

Shumlin was elected to enact single-payer health insurance in Vermont. Instead, he killed it. Never trust a Democrat.


[Update, Oct. 24: Obama administration announces double-digit premium hikes for Affordable Care Act” (PBS News Hour): ‘Before taxpayer-provided subsidies, premiums for a midlevel benchmark plan will increase an average of 25 percent across the 39 states served by the federally run online market, according to a report from the Department of Health and Human Services. … Moreover, about 1 in 5 consumers will only have plans from a single insurer to pick from, after major national carriers such as UnitedHealth Group, Humana and Aetna scaled back their roles. … While many carriers are offering a choice of plan designs, most use a single prescription formulary and physician network across all their products, explained [Caroline Pearson of the consulting firm Avalere Health]. “So, enrollees may need to change doctors or drugs when they switch insurers,” [s]he said.’ (Our premium is going up 10%. [Update, October 2017: premium for 2018 going up another 10.8%.])]

[Update, Dec. 14:  The first bill for 2017: The amount due has increased by 291%! For no apparent reason, the "advanced premium tax credit" (APTC) was slashed to 38% of what it was throughout 2016, despite the renewal notice dated Dec. 7 stating that it would actually go up. I called and waited 10 minutes and was told that the new amount is what I accepted of the new year's APTC. There was no record of when I did that (because I never did). I arranged to accept quite a bit more of the APTC that we are eligible for, so that the monthly premium will now actually be less that the past year's, but I was also told to go ahead and pay the current bill and hope that the extra will be credited ...]

[Update, Dec. 20:  A second first bill for 2017, dated 8 days after the first one (see previous note) arrived, but now with the amount due increased 18% from last year. It does not reflect the APTC that I arranged to accept (see previous note), so it is only adding to the confusion and one more thing to hope: that ignoring this superfluous bill won't cause trouble.]

[Update, Dec. 21:  A second renewal notice for 2017, dated 12 days after the first one (see two notes above) arrived: nothing different from the first one (though slightly different formatting), just more waste and confusion.]

[Update, Dec. 27:  Notice of partial premium payment. Which in fact was an overpayment (see three notes above). Isn't this fun.]

December 23, 2015

Bernie Sanders: single-payer health care

From the Bernie Sanders campaign:

I want to talk with you about one of the very real differences between Secretary Clinton and me that surfaced during last weekend's debate, and that is our approach to health care in this country.

I was, and all progressives should be, deeply disappointed in some of her attacks on a Medicare-for-all, single-payer health care system. The health insurance lobbyists and big pharmaceutical companies try to make "national health care" sound scary. It is not.

In fact, a large single-payer system already exists in the United States. It's called Medicare and the people enrolled give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over age 65 in a very cost-effective manner.

So I want to go over some facts with you and ask that you take action on this important issue:

Right now, because of the gains made under the Affordable Care Act, 17 million people have health care who did not before the law was passed. This is a good start, and something we should be proud of. But we can do better.

The truth is, it is a national disgrace that the United States is the only major country that does not guarantee health care to all people as a right. Today, 29 million of our sisters and brothers are without care. Not only are deductibles rising, but the cost of prescription drugs is skyrocketing as well. There is a major crisis in primary health care in the United States.

So I start my approach to health care from two very simple premises:

1. Health care must be recognized as a right, not a privilege -- every man, woman and child in our country should be able to access quality care regardless of their income.

2. We must create a national system to provide care for every single American in the most cost-effective way possible.

I expected to take some heat on these fundamental beliefs during a general election, but since it is already happening in the Democratic primary, I want to address some of the critiques made by Secretary Clinton and Rupert Murdoch's Wall Street Journal directly:

Under my plan, we will lower the cost of health care for the average family making $50,000 a year by nearly $5,000 a year. It is unfair to say simply how much more a program will cost without letting people know we are doing away with the cost of private insurance and that the middle class will be paying substantially less for health care under a single-payer system than Hillary Clinton's program. Attacking the cost of the plan without acknowledging the bottom-line savings is the way Republicans have attacked this idea for decades. Taking that approach in a Democratic Primary undermines the hard work of so many who have fought to guarantee health care as a right in this country, and it hurts our prospects for achieving that goal in the near future. I hope that it stops.

Let me also be clear that a Medicare-for-all, single-payer health care system will expand employment by lifting a major financial weight off of the businesses burdened by employee health expenses. And for the millions of Americans who are currently in jobs they don't like but must stay put because of health care access, they would be free to explore more productive opportunities as they desire.

So, what is stopping us from guaranteeing free, quality health care as a basic fundamental right for all Americans? I believe the answer ties into campaign finance reform.

The truth is, the insurance companies and the drug companies are bribing the United States Congress.

Now, I don't go around asking millionaires and billionaires for money. You know that. I don't think I'm going to get a whole lot of contributions from the health care and pharmaceutical industries. I don't like to kick a man when he is down, but when some bad actors have tried to contribute to our campaign, like the pharmaceutical CEO Martin Shkreli who jacked up the price of a life saving drug for AIDS patients, I donated his contribution to an AIDS clinic in Washington, D.C.

Secretary Clinton, on the other hand, has received millions of dollars from the health care and pharmaceutical industries, a number that is sure to rise as time goes on. Since 1998, there are no industries that have spent more money to influence legislators than these two. Billions of dollars! An absolutely obscene amount of money. And in this election cycle alone, Secretary Clinton has raised more money from the health care industry than did the top 3 Republicans -- combined.

Now, and let's not be naive about this, maybe they are dumb and don't know what they are going to get? But I don't think that's the case, and I don't believe you do either.

So, what can we do about it?

Changing the health care laws in this country in such a way that guarantees health care as a right and not a privilege will require nothing short of a political revolution. That's what this campaign is about and it is work we must continue long after I am elected the next President of the United States.

And because of the success we have enjoyed so far, I am more convinced today than ever before that universal quality health care as a right for all Americans will eventually become the law of the land.

It is the only way forward.

BernieSanders.com

October 9, 2014

Sorry, your health care coverage can't actually be used.

=================================

Subject: Important Information About Your Health Coverage
Date: Fri, 6 Dec 2013
From: vthealthconnect@state.vt.us
To: [ ]@[ ].net

Dear [ ],

Hello! We are writing to let you know that you have a new notice regarding your bill for health care benefits from Vermont Health Connect. To view your notice, please click on the link below and log in to your account.

Your notice is: Premium Invoice

www.vermonthealthconnect.gov

After logging into your account, click on ‘My Account’ and select the ‘My Profile’ tab. Once there, click on ‘View Documents’ from the ‘Quick Links’ box. If you have any questions regarding this notice, please call Vermont Health Connect Customer Support toll-free at 1-855-899-9600, Monday-Friday 8am-8pm and Saturdays 8am-1pm (except holidays and holiday weekends).

Thank you,

Vermont Health Connect

=================================

Subject: Re: Important Information About Your Health Coverage
Date: Fri, 06 Dec 2013
From: [ ] <[ ]@[ ].net>
To: vthealthconnect@state.vt.us

There doesn't appear to be a way to log in. There is a "logout" button, which remains "logout" after clicking it. No "login" button or pane.

In fact, because of the consequent inability to check my account and the lack of reply by telephone [since applying on line], I just sent in a paper application today. Which I guess is now unnecessary as far as setting up an account.

I think I would like a paper notice/statement/bill.

Thanks.

=================================

Subject: RE: Important Information About Your Health Coverage
Date: Mon, 9 Dec 2013
From: AHS - VT Health Connect
To: '[ ]' <[ ]@[ ].net>

Dear [ ],

Thank you for writing.

To log in to your account, please go to https://portal.healthconnect.vermont.gov/ and click on “Start Here” found next to where you see “Are you looking for coverage for yourself or your family?” On the next page, please click either on “Login to your Account” or “Apply Now” as either will bring you to the log-in screen. Once you are logged into your account, you will be able to access your invoice using the directions in your original e-mail.

[Makes sense? Even if you have an account, you have to illogically click "Are you looking for coverage for yourself or your family?" to get to it. But perhaps that was an admission of the truth recorded here.]

As you've requested, we'll send a paper invoice to you in the mail. You can expect to receive this invoice within a week.

Please let us know if we can help you with anything else.

Kind regards,
Rebecca

Vermont Health Connect
Customer Support – 855-899-9600

Check out our website for updated information!

Links:
Vermont Health Connect: http://info.healthconnect.vermont.gov/
YouTube Channel: http://www.youtube.com/vthealthconnect

=================================

Subject: Your Vermont Health Connect Invoice
Date: Tue, 17 Dec 2013
From: Vermont Health Connect
To: [ ] <[ ]@[ ].net>

Dear [ ],

Thank you for completing your application for health insurance coverage through Vermont Health Connect. You may have received two invoices this month – one for your new (2014) Vermont Health Connect health plan, which begins January 1, 2014, and one for your former (2013) health plan, which was recently given the option of extending up to March 31, 2104.

You only need to pay the bill for the plan you wish to have effective on January 1. You do not need to pay the other bill. If you want help making the choice of which bill to pay, please call our Customer Support Center toll-free at 1-855-899-9600 and reference the code “VHC1215.” A customer service representative will then talk you through your options. Please note that our call volume is high at this time. We thank you in advance for your patience. If you applied through a Navigator, you could consult him or her as well.

Please note that you do not need to take any additional steps to cancel your former plan. Your 2013 health plan will automatically expire after you pay your premium and your 2014 plan takes effect.

We are open from 8:00 a.m. to 8:00 p.m. Mondays-Fridays and 8:00 a.m. to 1:00 p.m. on Saturdays.

Sincerely,

Vermont Health Connect Customer Service

=================================

Subject: Starting coverage in February
Date: Sat, 11 Jan 2014
From: [ ] <[ ]@[ ].net>
To: vthealthconnect@state.vt.us

I set up my account and selected a plan very early and received an invoice by mail (as requested) in December. However, I had already paid my Catamount Care premium for January, so I did not pay the premium for the new plan.

Now I need to make sure that I will get another invoice (by mail, please) for the new plans, to start coverage in February.

=================================

Subject: RE: Starting coverage in February
Date: Mon, 20 Jan 2014
From: AHS - VT Health Connect
To: '[ ]' <[ ]@[ ].net>

Dear [ ],

Thank you for writing. We're so sorry for the delay in replying to your email.

I've reviewed your account and see that you also called and spoke with someone about this last week. As they told you, it is fine for you to just pay your premium for February. Your account has been marked so that your policy will start in February.

Please let us know if we can help you with anything else.

Kind regards,
Rebecca

Vermont Health Connect

=================================

Subject: Important Information About Your Health Coverage
Date: Wed, 5 Feb 2014
From: vthealthconnect@state.vt.us
To: [ ]@[ ].net

Dear [ ],

Hello! We are writing to let you know that you have a new notice regarding your bill for health care benefits from Vermont Health Connect. To view your notice, please click on the link below and log in to your account.

Your notice is: Premium Invoice

www.vermonthealthconnect.gov

After logging into your account, click on ‘My Account’ and select the ‘My Profile’ tab. Once there, click on ‘View Documents’ from the ‘Quick Links’ box. If you have any questions regarding this notice, please call Vermont Health Connect Customer Support toll-free at 1-855-899-9600, Monday-Friday 8am-8pm and Saturdays 8am-1pm (except holidays and holiday weekends).

[Steps to view invoice:
• Click "Are you looking for coverage for yourself or your family?"
• Click "Log in"
• Click "My Account"
• Click "My Profile"
• Find the "Quick Links" box and Click "View Documents"
• Click the listed documents until you reveal the current invoice]

Thank you,

Vermont Health Connect

=================================

Subject: Re: Starting coverage in February
Date: Mon, 10 Mar 2014
From: [ ] <[ ]@[ ].net>
To: AHS - VT Health Connect

Today I received a "Payment past due/Termination Notice" from BCBS [Blue Cross/Blue Shield]. As noted below, this is because I was assured that it was OK to ignore the January premium and that the new policy was to begin in February. This was necessary because the invoice for January coverage under Catamount Care was due (and paid) before the invoice for the new BCBS policy under VHC was available.

According to the BCBS notice, "Vermont Health Connect has reported that full payment has not been received for your health insurance."

Please resolve this.

=================================

Subject: RE: Starting coverage in February
Date: Thu, 13 Mar 2014
From: AHS - VT Health Connect
To: '[ ]' <[ ]@[ ].net>

Dear [ ],

Thank you for contacting us. We're very sorry that you received the past due notice from BCBS. I see that you have paid each of your invoices well in advance of the due dates, and as you noted, the fault is entirely ours for not yet making that change to your coverage start date. Unfortunately, we don't have that functionality to make the change once your plan is in force, but we are working on it and will correct your account as soon as we are able.

You actually have a 90 day grace period, so there is no danger of your plan being terminated as long as you keep paying your monthly premiums as you have been doing.

Please let us know if we can be of any further assistance.

Kind regards,
Ellen

Vermont Health Connect

=================================

And so I have been paying the monthly premium to Vermont Health Connect, ignoring the monthly "PAST DUE/NOTICE OF TERMINATION" notices from BCBS.

Secure in the knowledge that we do indeed have continuing "affordable health insurance" (which Vermont was already providing for almost everybody, effectively and without major problems: the "Catamount Care" referred to above). Secure, that is, as long as we would never need it, as it turned out.

I had an annual check-up scheduled in early October and was told by the doctor's office that a check of insurance status revealed it to be "pending". For that reason, they would not be able to submit the bill. I learned from a call to BCBS on Oct. 1 that "pending" in this case meant that I was behind in payments, because they still considered my coverage to have begun on Jan. 1 instead of Feb. 1, and therefore still expected an extra month of payment. In other words, despite the reassurance from Vermont Health Connect 8 months before that "we are working on it and will correct your account as soon as we are able", they still had not. Furthermore, the reassurance that "there is no danger of your plan being terminated as long as you keep paying your monthly premiums as you have been doing" turned out to be meaningless, since my regular doctor wouldn't risk billing to a "pending" insurance account. The person I talked with at BCBS helpfully transfered me to Vermont Health Connect, noting that she had heard that they may be "a few months" behind.

Thank goodness we have not been in any emergency situation or in urgent need of a prescription refill.

From Vermont Health Connect I now (!) learned that changing the start date required a new application because it is a "change of status". And so I was transfered to another office to handle that. The woman there, like everyone I have talked with at every step, it should be said, was very helpful and was able to use the original application to make a new one for coverage starting Feb. 1, ie 8 months earlier, to expire Dec. 31, ie in less than 3 months.

Now we were expected to have "new" insurance active in a couple of weeks, a new card in a week after that. Just in time to start the whole charade over again for coverage next year.

We essentially have had no usable insurance coverage since Feb. 1, despite regularly paying monthly premiums for it. What surprises lie in wait for us in the new cycle beginning Jan. 1, 2015, with a promised automatic renewal of coverage? Or in April, when the IRS recalculates everybody's share of their previous year of premiums?

The faster we move to a single payer system the better! Federally, Medicare was supposed to steadily expand in the 1960s to cover everyone, not just the elderly (but then it would have covered draft dodgers and black panthers along with "deserving" citizens like oneself). If the US government can not or will not provide that very basic service to all those who live within its borders, then the states need to go it alone. And I mean not just setting up some mash-up of federal support and state-provided health coverage, although that would be a welcome step despite the likelihood of its being as dysfunctional as the current private-public mash-up — I mean breaking away altogether from the government of Washington. Because health care is just one of its many failures, and war to gain world hegemony seems to be its only goal, war ordnance its only economy, squandering our common wealth as well as our lives, sacrificing them to an end that can only be catastrophic.

[Update:  Two and a half weeks later, we've received no notice about the "new" coverage, but instead a series of premium invoices (up to 4 so far), each one different from the last and none of them reflecting a resolution.]

[Update:  Four weeks later, we haven't received a new insurance card or any notice about the "new" coverage.]

[Update:  A month later, BCBS remains uninformed of the change, which Vermont Health Connect says was "finalized" on Oct. 14 (under a different "service request" no. than the "confirmation no." originally provided).]

[Update:  Five weeks later, the "change of circumstance center" has promised to notify BCBS today, which was supposed to have been done on Oct. 14 but was not. The reason another 2 weeks was required in the first place was because there is a child on S-CHIP, and that "start of coverage" (despite being continually covered under the auspices of the state for some 13 years already) was not supposed to change from January to February, so a new "change of circumstance" (the only change being the system's, not ours) had to be created to disinclude the S-CHIP part — it was done, but then someone neglected to tell BCBS. Oh, and a new "master case" number. Could it be more complicated? More counterproductive (unless, of course, prevention of care is precisely the intention)??]

[Update:  Five-and-a-half weeks later, BCBS remains uninformed of the change, which the Vermont Health Connect "change center" now says was "finalized" on Oct. 29 and confirmed that it was sent to "billing" who would then notify BCBS, which process could take 15 days, likely more as they are busy starting enrollment for next year. Vermont Health Connect customer service confirms the change, that the start date has been changed, billing reconciled, and BCBS informed. However, BCBS finds no change -- and it's not on the latest weekly confirmation list from Vermont Health Connect, waiting to be processed. BCBS suggests checking in another week.]

[Update:  A month and a half later, the "last invoice for 2014" has arrived, showing a "balance forward" of 10 times the new premium amount, presumably representing the charges for February through November of our "new" coverage, ignoring the year of payments for our "old" coverage for those same months. Then, inexplicably, the amount due adds only the SCHIP charge, not the next month's premium. Aieee!]

Further notes from 2015: 

May 13:  "Use this updated form [1095-A] when you complete IRS Form 8962 and file your federal income tax return [last month]."

Premiums due:  January 26: $627.52. February 26: $313.76. March 26: ($2.30). April 26: $311.46. May 26: ($238.36). June 26: $75.40. July 26: $313.76.

June 8:  Notice from Blue Cross–Blue Shield: "Payment Past Due." Go to newly launched Vermont Health Connect web site for any information that might be there: My Health Plans: "No current plans found."

June 25:  "A refund has been issued to you in the amount of $20.00."

July 16:  Notice from IRS: "Our records show that you did not file a 2014 tax return to reconcile advance payments of the Premium Tax Credit. … We received a copy of form 1095-A, Health Insurance Marketplace Statement, issued to you by your Health Insurance Marketplace showing … You are required to file a a 2014 federal tax return with Form 8962, Premium Tax Credit, to reconcile …" So it seems that filing Form 8962 with the correct information from one's own records — because the 1095-A form originally provided was obviously incorrect — instead of the updated 1095-A that came a month after the tax filing deadline (and which was still incorrect) [see May 13, above] is not recognized as a possibility, is as good as failing to file at all, and in fact nullifies the 1040 and everything as if never filed at all!

See a new report from 2016:  Vermont Health Connect: “Current wait times are 90 minutes”

September 18, 2012

The happy truths of single payer

Vermont Leads and Vermont for Single Payer have produced a brochure (click here to download) addressing frequently raised questions:

Green Mountain Care will provide health insurance for all Vermonters in 2017. The State of Vermont is currently researching a proposed benefit package and a plan for paying for Green Mountain Care. We fully expect these details to be public by January 2013 at the latest.

While this new system is being developed, opponents of health care reform have been spreading myths about single payer. Here’s THE STRAIGHT SCOOP:

MYTH: “Single payer will cost us more!”

The taxes for Green Mountain Care (Vermont Single Payer) will REPLACE private health insurance premiums and deductibles. With the increased efficiency of a single payer system, expect to pay less for health care.

MYTH: “Doctors will leave the state!”

Doctors say they will move to Vermont for a single-payer system. The list of doctors is growing.

MYTH: “Our healthcare coverage will get worse!”

Under Green Mountain Care (Vermont Single Payer) benefits will apply equally to every Vermonter. State law requires the benefit package of Green Mountain Care at a minimum to include primary and specialty care, mental health and substance abuse, hospitals and prescription drugs. Under Green Mountain Care everyone will be eligible for these broad benefits.

MYTH: “There will be delays to see our doctor.”

We experience delays now for many reasons: patients put off treatment because of high costs, insurance companies create roadblocks, and sometimes the resources just aren’t there. The efficiency of a single payer system will ensure that the money we have is spent on the care we need, and not on insurance company middlemen.

MYTH: “We won’t have free choice of doctor or hospital.”

Green Mountain Care (Vermont Single Payer) will provide free choice of doctor and hospital, unlike now when private insurers limit choice to suit themselves.

MYTH: “Government bureaucrats will stand between us and our doctors, preventing us from getting necessary care.”

Green Mountain Care (Vermont Single Payer) will remove insurance company bureaucrats now standing between us and our doctor. It is rare for enrollees in Vermont’s existing public health care programs like Dr. Dynasaur to be denied services. We expect this to be the case under Green Mountain Care as well.

MYTH: “Medicare will change.”

Basic Medicare will stay the same. Green Mountain Care (Vermont Single Payer) will add more benefits to Medicare. [Medicare, by the way, is a working example in the U.S. of single payer; it was meant to expand to include all, not just older, citizens. The VA system is a working example in the U.S. of socialized medicine.]

MYTH: “More private insurance companies mean lower costs.”

There is no evidence for this claim. More insurance competition does not result in lower health care costs for everyone. [Health care is not like a consumer commodity, because it is necessary and competition actually drives prices up.]

MYTH: “Under Single Payer care will be rationed!”

Green Mountain Care (Vermont Single Payer) will not be set up to ration care. It will use existing dollars more efficiently to ensure that every Vermonter gets necessary health care.

human rights, Vermont

March 22, 2010

On the big medical insurance bill

Ironic Times House Passes Mild Modification to Health Care System -- After 100-year debate.

Ralph Nader, "A Remnant of Reform": 

The health insurance legislation is a major political symbol wrapped around a shredded substance. It does not provide coverage that is universal, comprehensive or affordable. It is a remnant even of its own initially compromised self — bereft of any public option, any safeguard for states desiring a single payer approach, any adequate antitrust protections, any shift of power toward consumers to defend themselves, any regulation of insurance prices, any authority for Uncle Sam to bargain with drug companies, and any reimportation of lower-priced drugs.

Most of the health insurance coverage mandated by this legislation does not come into effect until 2014, by which time 180,000 Americans will die because they were unable to afford health insurance to cover treatment and diagnosis, according to Harvard Medical School researchers.

The bill’s 2,000 pages afford many opportunities for insurance companies to further their strategy of maximizing profits by denying claims, restricting the benefits of their present customers, and the benefits of the new customers who are mandated to buy their policies, all backed by hundreds of billions of dollars of federal subsidies.

Its main saving grace is that it is so inadequate and so delayed in implementation that the position supported by the majority of people, physicians and nurses –- full Medicare for all –- will have abundant opportunities to build around the country. The spiraling price hikes by the insurance industry are sure to spur the single payer movement to new popularity. (See singlepayeraction.org.)

Chris Hedges

This bill is not about fiscal responsibility or the common good. The bill is about increasing corporate profit at taxpayer expense. It is the health care industry’s version of the Wall Street bailout. It lavishes hundreds of billions in government subsidies on insurance and drug companies. The some 3,000 health care lobbyists in Washington, whose dirty little hands are all over the bill, have once more betrayed the American people for money. The bill is another example of why change will never come from within the Democratic Party. The party is owned and managed by corporations. The five largest private health insurers and their trade group, America’s Health Insurance Plans, spent more than $6 million on lobbying in the first quarter of 2009. Pfizer, the world’s biggest drug maker, spent more than $9 million during the last quarter of 2008 and the first three months of 2009. The Washington Post reported that up to 30 members of Congress from both parties who hold key committee memberships have major investments in health care companies totaling between $11 million and $27 million. President Barack Obama’s director of health care policy, who will not discuss single payer as an option, has served on the boards of several health care corporations. And as salaries for most Americans have stagnated or declined during the past decade, health insurance profits have risen by 480 percent.

Obama and the congressional leadership have consciously shut out advocates of single payer from the debate. The press, including papers such as The New York Times, treats single payer as a fringe movement. The television networks rarely mention it. And yet between 45 and 60 percent of doctors favor single payer. Between 40 and 62 percent of the American people, including 80 percent of registered Democrats, want universal, single-payer not-for-profit health care for all Americans. The ability of the corporations to discredit and silence voices that represent at least half of the population is another sad testament to the power of our corporate state to frame all discussions.

Margaret Flowers, Physicians for a National Health Program, in response to Howard Dean saying "Americans want choice ... Nobody in America likes the government telling them what to do":

The American people want a choice of health care provider and choice of treatment. This bill does neither. Let people choose their doctor and treatment. Under private insurance, the private insurers make the decision. This bill would entrench that system of private insurance. It’s going to continue to leave people out – with the resulting suffering, bankruptcy, foreclosure and preventable death. And that’s not acceptable.

We were excluded from this conversation. This was not a conversation based on data or evidence. It was based on the fact that the industry had their hand in this throughout this legislation and it was written in their favor.

[One might also point out that making it illegal to not have insurance and not providing a nonprofit public alternative to the private insurance market are in fact mockeries of choice. Medicare for All would maximize choice.]

March 15, 2010

Doug Racine sabotages single-payer in Vermont

As reported last week, gubernatorial candidate Senator Doug Racine "unveiled his long-awaited health care reform bill", In fact, his bill is a revision of S.88, an already-introduced bill to establish a single-payer system and universal coverage in Vermont (along with its companion bill in the house, H.100). Racine's version, however, changes it to instead establish a committee to study a few options for a couple of years that might then move us towards universal "access".

This is despicable.

human rights, Vermont

January 15, 2010

Democrats Going Down in Flames

Russell Mokhiber, editor of Single Payer Action, writes in Counterpunch:

Martha Coakley is going down in flames.

So is the Democratic Party.

Why?

We found the answer earlier this week at – of all places – The Cato Institute in Washington, D.C.

Timothy Carney was giving a powerpoint presentation about his new book: Obamanomics: How Barack Obama Is Bankrupting You and Enriching His Wall Street Friends, Corporate Lobbyists, and Union Bosses.

Here’s the book in a nutshell:

“Both parties are the parties of big business,” Carney said. “They both promote corporate socialism.”

I sat there in the front row at Cato, in wonder.

Listening to the talk – as Carney outlined how Obama had cut deals with Billy Tauzin and the pharmaceutical industry.

Thinking to myself – is this why Martha Coakley is having such a hard time in Massachusetts?

She’s just another corporate Dem — just like Obama?

Then, lo and behold, as if I was channeling Carney, he calls up a slide on his powerpoint.

On the big screen at Cato is an invitation to a corporate fundraiser – that night at the Sonoma Restaurant on Capitol Hill – for Coakley.

And I say to myself – wait a second.

Coakley is in the middle of a tight race and she’s flying to DC one week before the election to be with a group of corporate lobbyists?

Yes.

She is.

And then Carney went down the list of 22 members of the host committees – meaning they each raised $10,000 or more for Coakley.

“Seventeen are federally registered lobbyists, 15 of whom have health-care clients,” Carney said.

“You see the names – Gerald Cassidy, David Castagnetti,, Tommy Boggs – those are all lobbyists I’ve highlighted there who have clients who are drug companies, health insurers, hospitals or all three,” Carney said. “AHIP, Phrma, Pfizer, Blue Cross – everybody is covered there. Aetna somehow isn’t. I don’t know how they got left out.”

“These are the special interests,” Carney said. “These are the people trying to elect Martha Coakley to be vote number 60 for health insurance.”

Carney then puts up a slide showing how the Phrma cash went from supporting Republican candidates for President in the past – to supporting Barack Obama in 2008.

“Barack Obama raised $2.1 million from drug companies in 2008,” Carney said. “That’s about equal to what John McCain raised plus what George Bush raised in both of his elections. It’s the most by far any candidate has raised from the drug industry.”

The people of Massachusetts already have tried a corporate reform that forces them to buy junk insurance.

They don’t like it.

They’re waiting for a candidate that will deliver a message they’ve been waiting to hear.

Single payer.

Everybody in.

Nobody out.

Put the private insurance companies out of business.

Drive down the cost of drugs to the levels of say Canada or the UK.

But Obama, Coakley and the Democrats are awash in corporate cash.

They have made their choice.

And they deserve to lose.

Onward to single payer.

November 23, 2009

Healthcare is a Human Right: VT postcard campaign

Healthcare is a Human Right

Click the above link to sign a postcard to be delivered to legislative leaders in Vermont on Jan. 6, the first day of the next session.

human rights, Vermont

November 16, 2009

The enemy of the good

There is an excellent essay at Counterpunch today by Alan Nasser: "Obama's Flawed Case Against Single Payer".

Similar to what he notes about Obama, it seems to be a motto for the sometimes slightly progressive neoliberal politicians in Vermont that "We can't let the perfect be the enemy of the good [so let's not even consider it, or for that matter whether what I'm going along with actually is any good]." It's one big antidemocratic thumbing of their collective nose and most people just nod at this signature wisdom.

And so by dismissing actual good as too "perfect", as irresponsible madness, all that is usually left is quite a bit less than good.

And so we have health insurance reform from our Congress and President: the same lousy system, only more punitive.

human rights, Vermont, anarchism, anarchosyndicalism

August 13, 2009

10 Questions to Ask at ObamaCare Town Hall Meetings

Dave Lindorff, at Counterpunch (click the title of this post):

1. If Canada's single-payer system is so god-awful, why have repeated Conservative governments at the provincial and national level in Canada never touched it? Canada is a democracy. If Canadians don't like their health care system, why haven't they gotten rid of it in 35 years? Since the system there is run by the separate provinces, many of which are very politically conservative, why has not one province ever tried to get rid of single-payer?

2. Why is rationing by income, as we do it here, better than rationing by need, as they do it in Canada?

3. Wouldn't single-payer mean that companies could no longer threaten working people with the loss of their health insurance? Why is this a bad idea?

4. The bigger the insurance pool, the better. So doesn't having a national pool, as with single-payer, make the most sense?

5. Why should we be allowing politicians who are taking money from the medical industry to write the new health care legislation?

6. How can the Congress be developing a health system reform scheme and not even invite experts from Canada down to explain their successful system?

7. If Medicare--a single-payer system here in America--is so popular with the elderly, how come it's no good for the rest of us?

8. Isn't it true that Medicare currently finances the most costly patient group--the elderly and infirm--so that extending it to the rest of the population--most of whom are young and healthy--would be much cheaper, per person?

9. The AMA, the Pharmaceutical Industry, and the Insurance Industry all bitterly opposed Medicare in 1964-5 when it was being debated in Congress and passed into law, with the right, led by Ronald Reagan, calling it creeping socialism. It became a life-saver for the elderly and didn't turn the US into a soviet republic. Why should we give a tinker's damn what those same three industry groups and the Republican right think of expanding single-payer now?

10. The executives of Canadian subsidiaries of US companies all support Canada's single-payer system, and even lobby collectively to have it expanded and better funded. Why does Congress listen to the executives of the parent companies here at home, and not invite those Canadian execs down to explain why they like single-payer?

human rights

August 7, 2009

Two Health Care Systems: One works, the other doesn't

Michael Rachlis writes in the Aug. 3 Los Angeles Times:

Universal health insurance is on the American policy agenda for the fifth time since World War II. In the 1960s, the U.S. chose public coverage for only the elderly and the very poor, while Canada opted for a universal program for hospitals and physicians' services. As a policy analyst, I know there are lessons to be learned from studying the effect of different approaches in similar jurisdictions. But, as a Canadian with lots of American friends and relatives, I am saddened that Americans seem incapable of learning them.

Our countries are joined at the hip. We peacefully share a continent, a British heritage of representative government and now ownership of GM. And, until 50 years ago, we had similar health systems, healthcare costs and vital statistics.

The U.S.' and Canada's different health insurance decisions make up the world's largest health policy experiment. And the results?

On coverage, all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays.

On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.

Lesson No. 1: A single-payer system would eliminate most U.S. coverage problems.

On costs, Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don't need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can't charge as much when they have to deal with a single payer.

Lessons No. 2 and 3: Single-payer systems reduce duplicative administrative costs and can negotiate lower prices.

Because most of the difference in spending is for non-patient care, Canadians actually get more of most services. We see the doctor more often and take more drugs. We even have more lung transplant surgery. We do get less heart surgery, but not so much less that we are any more likely to die of heart attacks. And we now live nearly three years longer, and our infant mortality is 20% lower.

Lesson No. 4: Single-payer plans can deliver the goods because their funding goes to services, not overhead.

The Canadian system does have its problems, and these also provide important lessons. Notwithstanding a few well-publicized and misleading cases, Canadians needing urgent care get immediate treatment. But we do wait too long for much elective care, including appointments with family doctors and specialists and selected surgical procedures. We also do a poor job managing chronic disease.

However, according to the New York-based Commonwealth Fund, both the American and the Canadian systems fare badly in these areas. In fact, an April U.S. Government Accountability Office report noted that U.S. emergency room wait times have increased, and patients who should be seen immediately are now waiting an average of 28 minutes. The GAO has also raised concerns about two- to four-month waiting times for mammograms.

On closer examination, most of these problems have little to do with public insurance or even overall resources. Despite the delays, the GAO said there is enough mammogram capacity.

These problems are largely caused by our shared politico-cultural barriers to quality of care. In 19th century North America, doctors waged a campaign against quacks and snake-oil salesmen and attained a legislative monopoly on medical practice. In return, they promised to set and enforce standards of practice. By and large, it didn't happen. And perverse incentives like fee-for-service make things even worse.

Using techniques like those championed by the Boston-based Institute for Healthcare Improvement, providers can eliminate most delays. In Hamilton, Ontario, 17 psychiatrists have linked up with 100 family doctors and 80 social workers to offer some of the world's best access to mental health services. And in Toronto, simple process improvements mean you can now get your hip assessed in one week and get a new one, if you need it, within a month.

Lesson No. 5: Canadian healthcare delivery problems have nothing to do with our single-payer system and can be fixed by re-engineering for quality.

U.S. health policy would be miles ahead if policymakers could learn these lessons. But they seem less interested in Canada's, or any other nation's, experience than ever. Why?

American democracy runs on money. Pharmaceutical and insurance companies have the fuel. Analysts see hundreds of billions of premiums wasted on overhead that could fund care for the uninsured. But industry executives and shareholders see bonuses and dividends.

Compounding the confusion is traditional American ignorance of what happens north of the border, which makes it easy to mislead people. Boilerplate anti-government rhetoric does the same. The U.S. media, legislators and even presidents have claimed that our "socialized" system doesn't let us choose our own doctors. In fact, Canadians have free choice of physicians. It's Americans these days who are restricted to "in-plan" doctors.

Unfortunately, many Americans won't get to hear the straight goods because vested interests are promoting a caricature of the Canadian experience.

July 24, 2009

Unselling single-payer

Helen Redmond writes at Counterpunch:

... There’s been virtually no stories about labor’s support for HR 676 [Representative John Conyers' single-payer legislation], despite the fact it’s been endorsed by 554 union organizations in 49 states and by 130 Central Labor Councils. But we heard plenty when Andy Stern, the president of the SEIU sat down with Lee Scott, the CEO of Wal-mart to discuss solutions to the nation’s health care crisis. Those two are experts on providing health care to workers? What about the nurses and doctors who support single-payer and got dragged out of, and arrested in Max Baucus’s senate hearings in Washington, DC? If doctors and nurses had been arrested for any other political issue it would have been the lead story in every newspaper and online edition. Doctors and nurses never deliberately get arrested -- that’s news!

The sea change in the public’s attitude toward government financed health care, however, has gotten press. A New York Times poll in June found that 72 percent supported a government-administered insurance plan – like Medicare for everyone under the age of 65. That poll also reported 64 percent believed the federal government should guarantee coverage to the entire population, i.e. health care should be a human right. Another interesting number: 85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt. This is in stark contrast to President Obama’s position of tepid, incremental reform. Obama asserts if he was starting from scratch he might favor SP, but we aren’t so he can’t. He wants to build on the existing system and not “disrupt” the employment-based provision of health care. As if employment-based health coverage isn’t being massively “disrupted” by the economic depression that has laid off millions of workers and forced them down into the ranks of the 50 million uninsured.

But what is truly disgusting is how the “progressive” left has caved so quickly and cravenly, given up the fight for single-payer and support for HR 676. They have become the indignant foot soldiers, apologists and spinmeisters for Obama’s piece of shit legislation. They are betraying what they absolutely know to be true: the private insurance industry must be evicted in order to provide health care to everyone and end the fiscal crisis the multiple-payer system creates.

Even the insurance companies know that, according to revelations by Cigna whistleblower Wendell Potter. He reports the implementation of a single-payer health care system is what keeps the billionaire CEO’s of insurance companies and Karen Ignagni, the high priestess of America’s Health Insurance Plans (AHIP), awake at night cowering in fear and forced to spend 1.4 million dollars a day to make sure it doesn’t happen. They don’t fear a public option despite their protestations; they accept that due to the depth of the crisis, a few token compromises are in order to stay in business. It’s chump change and in exchange for perhaps losing a little market share, they’re going to get a mandate that legally obligates every person to buy their priced-to-make-profits “insurance products” or be financially penalized. If the Obama bill subsidizes the uninsured going into private plans, that’s millions of new customers to extract profits from and a transfer of taxpayer dollars into insurance industry coffers. The Massachusetts mandate madness gone nationwide. ...

human rights, anarchosyndicalism

June 16, 2009

A PETITION TO CONGRESS Supporting Single-Payer Health Care

Whereas:
  • 46 million Americans are currently without health insurance;

  • 60 million Americans, both insured and uninsured, have inadequate access to primary care due to a shortage of physicians and other health service providers in their community;

  • 100 million Americans have no insurance to cover dental needs;

  • 116 million adults, nearly two-thirds of all non-seniors, struggled to pay medical bills, went without needed care because of cost, were uninsured for a time, or were underinsured in the last year;

  • The United States spends $2.3 trillion each year on health care, 16 percent of its Gross Domestic Product;

  • Americans spend $7,129 per person on health care, 50 percent more than other industrialized countries, including those with universal care;

  • The U.S. does not get what it pays for. We rank among the lowest in the health outcome rankings of developed countries, and on several major indices rank below some third-world nations;

  • The number of health insurance industry bureaucrats has grown at 25 times the growth of physicians in the past 30 years;

  • In 2006, the six largest insurance companies made $11 billion in profits even after paying for direct health care costs, administrative costs and marketing costs.

And, whereas:
  • Medicare has administrative costs far lower than any private health insurance plan;

  • The potential savings on health insurance paperwork, more than $350 billion per year, is enough to provide comprehensive coverage to every uninsured American;

  • Only a single-payer Medicare-for-all plan can realize these enormous savings and provide comprehensive and affordable health care to every citizen.

Now, therefore:
  • We, the undersigned, urge the United States Congress to pass a single-payer Medicare-for-all program which will provide quality, comprehensive health care for all Americans.