(Insurance denied because they can’t cherry pick? B-R-O-K-E-N – promoted by blogswarm)

More than a healthcare crisis-this nation has a widespread health insurance crisis.  Just today, the LA Times reports that professional associations are increasingly shut out of the health insurance market because group purchasing doesn’t let insurers cherry pick the healthiest customers.  This comes on the heels of last week’s news that Blue Cross is being fined $1 million for illegally dumping patients off the rolls, a new look at how elderly patients are being fleeced by their mercenary insurers, and complaints from doctors that they spend more time fighting corporate denials of care than tending to their patients.  Given this health insurance crisis that demands a solution, it’s no wonder the Sacramento Bee comes close to endorsing the SinglePayer system, and doing away with these bad actors. 

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

The latest canary in the insurance coal mines are the professional associations that offer their members health insurnace.  As Lisa Girion of the LA Times, who has been on a tear lately, writes:

Health plans offered by professional associations were once havens for millions of people who couldn’t get coverage anywhere else. But as medical costs have soared, groups representing professions as varied as law and golf have been forced to stop offering the benefit or been dropped by insurers.

More than 8,000 people with coverage through the California Assn. of Realtors could be next if Blue Shield of California succeeds with its plan to cancel the group’s health coverage.

“It’s a real stab in the heart,” said Marcy Garber, 62, an Encino real estate agent whose history of breast cancer makes her an almost-certain reject if she seeks similar coverage on her own.

Why are the insurance companies leaving this market?  Because they can’t cherrypick customers:

Insurance carriers began pulling out of association markets about 10 years ago amid mandates requiring the groups – like employers – to offer coverage to all members who wanted to buy it, regardless of preexisting conditions. Unlike employers, however, who typically pick up the much of the premiums for employees, most associations do not share in the costs. Instead, they arrange for their members to purchase coverage at group, rather than individual, rates.

Another real estate agent, Hector Aguirre, 39, of Rancho Cucamonga, also thought the group’s coverage was safe. He pays nearly $1,000 a month for coverage for himself and his family. His wife has lupus and a daughter needs daily shots of an expensive growth hormone.

“I always thought it had more control and more pull because it’s such a huge umbrella under the whole California Assn. of Realtors,” Aguirre said.

Realtor Terry Lucoff, 60, of Malibu, who pays a monthly premium of more than $600, fears that if he loses his coverage he will be unable to obtain new coverage that will allow him to continue seeing his regular doctors because he has been diagnosed with a kidney condition.

“If they can do this to the California Realtors association, they can do it to anybody,” he said.

It is truly, grotesquely surreal that the American medical system is organized around and by huge corporations that only want to serve healthy customers, and that make money by denying the healthcare they are chartered to insure.

Is it any wonder everyone hates them?  But look, there’s more from the car-wreck that is our insurance market.

Girion again: 

Blue Cross of California “routinely” violated state law when it canceled individual health insurance coverage after policyholders got pregnant or sick, making no attempt to determine whether they did anything to merit such “harsh” treatment, according to a state investigation of practices that appear to be industrywide….

As a result of its unprecedented investigation, the Department of Managed Health Care on Thursday said that it had fined Blue Cross $1 million – an amount immediately criticized by canceled policyholders and consumer advocates as too small to matter to an insurer whose parent company, WellPoint Inc., earned $3.1 billion in profit last year on revenue of $57 billion.

Stunningly:

Regulators examined 90 randomly selected cases of policy cancellations – out of about 1,000 a year in California – and found violations in each one.

Insurance companies aren’t just abusing sick people; they’re abusing old people, too:

  Interviews by The New York Times and confidential depositions indicate that some long-term-care insurers have developed procedures that make it difficult – if not impossible – for policyholders to get paid. A review of more than 400 of the thousands of grievances and lawsuits filed in recent years shows elderly policyholders confronting unnecessary delays and overwhelming bureaucracies. In California alone, nearly one in every four long-term-care claims was denied in 2005, according to the state.

And now doctors are reporting that all the time they spend with insurance corporation bureaucrats harms their patients.

So, I ask all the politicians who are supporting insurance mandates: do we really want to force the entire nation to sign up with their heartless corporations?  Do want to increase their influence over the delivery of care in our health system?

The Sacramento Bee doesn’t think so–and kind-of/almost endorse SinglePayer healthcare as the way to deal with our sick health insurance market:

Blue Cross denies wrongdoing. That’s fine. There is a larger lesson here: This health insurance market, the one for individuals or families who don’t automatically get covered through their jobs, is sick. Insurers try to avoid covering people who need care. And many Californians avoid getting insurance until it is in their financial interest to do so. It’s a game, and the game must end somehow. That can only happen by blowing up the individual health insurance market that exists today and replacing it with something that makes more sense. And that can only happen with the California Legislature and Gov. Arnold Schwarzenegger.

There are two basic choices here when it comes to health insurance. One is to get rid of private health insurance altogether and replace it with a program in which the government directly pays doctors and hospitals to provide care. That’s known as single-payer. It is championed by some Democrats, but opposed by the governor. Single-payer isn’t a likely short-term compromise, but the more we look at this mess, single-payer seems to be an increasingly likely long-term solution because of the many ills of the private insurance market.

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Yes, go nurses! : ) – promoted by atdleft)

Roxy Carr is where any of us could be: medically bankrupt.  She’s both the face of our nation’s healthcare crisis, and symptomatic of the most important aspect of that crisis, affordability.  While private insurance companies enjoy record profits, average Americans find they can barely afford medical care, and they are one crisis away from seeing their life savings gone.  Coincidence?  We learn more about just how unaffordable Massachusetts’ healthcare reform plan is for residents, why a Minnesota plan is even worse, and how California’s plan is failing as a result.  Meanwhile, Connecticut unions fight for the kind of SinglePayer insurance that makes care affordable–and the national AFL-CIO endorses a similar proposal.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

Meet Roxy Carr of Twin Falls, ID:

She was making $6.25 an hour working for an employer that didn’t offer health insurance, and she certainly couldn’t afford to purchase her own policy. After paying rent and utility bills and putting gas in the car and food on the table, there was nothing left to pay for the expensive medications she needed to manage her diabetes.

“I juggled bills to afford medications,” Carr said. “I was robbing Peter to pay Paul.”

Carr couldn’t juggle forever. Complications from her diabetes eventually landed her in the hospital, adding yet another bill to the growing stack on her table waiting to be paid. One day, she woke up and discovered she was more than $45,000 in debt. So she did the only thing she believed she could do: She filed medical bankruptcy.

While Roxy had no insurance, many people with insurance have similar problems in the face of deductibles, co-pays, and uncovered costs.  In fact, three-quarters of those bankrupted by illness had insurance, according to a Harvard study. 

So we drive our patients to bankruptcy, and then what happens to them? 

The bankruptcy wasn’t the end of Carr’s story. Still uninsured, she ended up in an emergency room one night when she fell ill. She was diagnosed with shingles – a skin rash caused by the same virus that causes chickenpox. An emergency room doctor examined her, ran some tests and gave her a shot for pain. She was there for three hours, and the bill came to $3,700. Carr could have received the same treatment in a doctor’s office for less than $200.

That’s right we send them into bizarro world where they have to spend even more money on health maintenance.

As Roxy learned, the big problem with our health system is affordability-so many interests are sucking care dollars out of the system that regular, working Americans can’t afford care, especially if they actually get sick. 

Massachusetts has led the way in healthcare reform lately, implementing the dastardly “individual mandates” that require people to buy insurance from private insurers, and impoverish themselves while enriching the insurers.  Who’s hit hardest?  The middle class:

The economic pressure in the state’s new plan falls on those in the middle, the almost poor, several experts told The Standard-Times.
  “For the low-income family earning $36,000 a year before taxes, how do they pay what amounts to 6 to 8 percent of their income for health care, perhaps $2,400 a year?” asked Alan Sager, a professor of health policy and management at the Boston University School of Public Health.

Health costs can be crippling, even to families with health insurance, writes Yale University professor Jacob S. Hacker in his 2006 Oxford University Press book, “The Great Risk Shift.”

In 2003, 82 million Americans were without health insurance at some point, Mr. Hacker reported.
  “And yet, these ordinary Americans at extraordinary risk have for years remained largely unnoticed, an inconvenient blot on the heralded success story of the American economy,” Mr. Hacker wrote.

As people learn about these problems in Massachusetts, copy-cat programs in states like California are starting to run into trouble:

As California lawmakers work out a health insurance overhaul that could contain a similar requirement for individuals, advocacy groups here say the Massachusetts example raises questions about whether it’s possible to come up with affordable health insurance for people to buy on their own.

“Our big concern is that without guarantees that costs will be controlled, we’re certain to stick some patients with health plans that simply aren’t affordable,” said Carmen Balber of the Foundation for Taxpayer and Consumer Rights in Los Angeles, an organization that wants the state to limit how much insurers can charge

It’s even worse than that in a Minnesota proposal.  The plan actually wants to garnish employees wages to pay for their private insurance.  Not only do are you MANDATED to buy insurance, but they will helpfully take it our of your paycheck for you. You won’t be surprised to hear that:

The proposal grew out of a task force of insurers and health care providers from Blue Cross and Blue Shield, HealthPartners, Mayo Clinic and elsewhere.

The opposition is being led by the Minnesota Nurses Association.  Go nurses!

More and more labor unions are supporting the answer to the affordability problem-a SinglePayer system that does away with the bloat of the insurance industry middleman.  Connecticut’s unions are the latest to join the fight.  Nationally, the AFL-CIO recently endorsed Medicare for All, and the California Nurses Association/National Nurses Organizing Committee will affiliate with them.

If the unions don’t succeed, we might see more of the global outsourcing of medicine, a/k/a “medical tourism,” that has devastated other industries in this country. 

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(More reporting from the front lines on what’s happening in health care – promoted by atdleft)

Bonnie Terry had a job, insurance, and a recent diagnosis of cancer.  Her story from there is one more of the millions of tragedies that make up what we call the healthcare crisis.  She lost her job, then her insurance, then her doctor, then her life.  Bonnie Terry was killed as much by her cancer as by a healthcare sector designed to maximize profits for private insurance companies and minimize care for sick people; that’s not healthcare-that’s murder by spreadsheet.  Also, we celebrate the accomplishments of a noted AIDS activist, learn more about the already out-of-control cost of the Massachusetts plan, cheer the medical students aiming to reverse the hateful policies of the American Medical Association, and read about an interfaith group of religious leaders calling for healthcare for all…children.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.
 

Bonnie Terry is the face of America’s healthcare crisis.  As reported by Nicole Foy, Bonnie was a homeless activist and missionary for the Methodist Church who was overwhelmed at age 49 to be diagnosed with breast cancer.  She had insurance through her job, and upon her diagnosis:

The statistics seemed to be in her favor. Over 90 percent of women in her position survive at least five years. About 70 percent make it to the 10-year mark.
{Her physician} suggested neoadjuvant therapy, a way of shrinking the tumor so it’s easier to take out.
That meant chemotherapy first, surgery second, then radiation. Wagner didn’t want to lose any time. She suggested {Dr. Robert Drengler,} an oncologist at South Texas Oncology and Hematology, and urged Bonnie to begin chemotherapy immediately.

Then she lost her job.  The Methodist Board of Global Missionaries chose not to offer her COBRA extensions of her health insurance, so she purchased one of the high-premium, low-cap “junk insurance” plans being pushed by Romney, Schwarzenegger and others in the “mandated insurance” crowd.  What happened?

Bonnie began racking up medical debt and was forced to rely on donations to try and pay for her care.
Accepting financial help was difficult for Bonnie, who always had prided herself on paying bills in full and on time. She wasn’t one to ask for special favors.
Amid chemo and radiation treatments, she sent handwritten thank you notes on floral stationery to her hundreds of supporters.

That’s right-she raised money from hundreds of supporters to pay for her chemo, instead of focusing on her recovery.  Her insurance ran out just as her cancer returned. 

By the spring, when she first felt the swelling again under her arm and returned to Drengler, cancer was roaring through her body. ….
In the chart, Dr. Ronald Drengler described Bonnie’s prognosis as “very guarded.” He called for palliative treatment, care for patients for whom there is no cure.
Then the chart noted Bonnie had lost her health insurance – and, consequently, her status as Drengler’s patient. It read: “Will be seeking enrollment with University group,” meaning CareLink, Bexar County’s public medical program for the poor. …
Bonnie later would tell friends she was hurt but not surprised that Drengler dropped her as a patient because she had no insurance. He has to pay the bills, too, she said. (Drengler did not return calls seeking comment for this article.)
It would be seven weeks after Drengler’s fateful words – back, with a vengeance -until Bonnie received her first chemo treatment to try to stop her aggressive disease.

Dr. Drengler seems to have forgotten his oath to first do no harm.  What happened to Bonnie when she entered a public health system that has been systematically underfunded by politicians on the payroll of the insurance companies and other healthcare corporations?

Once she lost insurance, tests took longer. Doctors rotated. Care wasn’t centralized. There were mountains of bills to pay, forms to fill out, documentation to turn in, public payment programs to apply to.
The stress of it all seemed to zap what little energy Bonnie had left to deal with the cancer spreading stealthily through her body.

Bonnie said:

“I’m on a learning expedition, learning how to access a system that I never had to use before. It is so difficult being poor. I would rather get up and go to work as I have been doing every day of my life than sit in offices begging for services that are so caught up with bureaucracy.”

Here’s why we should all be motivated by Bonnie:

Realizing she couldn’t get in for several weeks to Bexar County’s busy breast cancer clinic for the indigent, Bonnie, then 48, took a trip whose very itinerary spoke to America’s health care crisis.
As cancer cells coursed through her bloodstream, invading her lungs and bones, she flew with Moose and other friends to Washington, D.C., to lobby for increased funding for cancer research and improved access to medical care….
Though many in Bonnie’s circle believe poor access to health care hastened her death, it isn’t clear whether delays in her treatment are directly to blame for her dying when she did. What is clear is that she waged an uphill battle on two fronts: one against an aggressive form of breast cancer and the other against a sluggish and largely impersonal medical system.

Bonnie’s life and death reminds me of the life and death of my friend Bob Hattoy, a legendary AIDS activist who died this weekend.  He took his struggles with sickness and used it as motivation to fight for better healthcare for our country.  In a speech before the 1992 Democratic Convention, Bob, said, 

  “We are part of the American family and, Mr. President, your family has AIDS and we’re dying and you’re doing nothing about it.”

Except it’s not just AIDS-it’s breast cancer, and diabetes, and childhood diseases, and accidents-and murder by spreadsheet committed every day by insurance and healthcare corporations.

So we fight for SinglePayer healthcare so that Bonnie and Bob, and all the members of our family, can concentrate on getting well, not on managing their bankruptcy and begging for care.

In this movement, one of the important struggles is Massachusetts; the new insurance plans that patients are required by the government to buy have come out and here’s the bottom line: if you earn $30,000 per year, you will be required to pay $4,000 in premiums and deductibles before you get one iota of healthcare.  Elsewhere we read that a group of religious leaders got together and agreed that all children deserve healthcare-but they seem to have forgotten about adults like Bonnie and Bob.  But we are all patients, which is the strength of our movement, and we end on a hopeful note, as a group of idealistic medical students is committed to overturning the harmful legacy of the American Medical Association, which is notorious for blocking healthcare reform. 

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(More reporting from the front lines, direct from our own in-house health care advocate – promoted by atdleft)

It’s not just America’s soldiers who are sitting in decrepit rooms begging for healthcare-all of us are in Walter Reed, writes a nurse leader today.  The Bush administration might fire a couple generals, but won’t show the door to the parasitic insurance companies that are hurting the rest of us.  Healthcare is, however, a big issue in the 2008 Presidential race already, writes a Washington Post reporter, but a major study by the American Association of Pediatrics suggests that the most common plans pushed by candidates will end up DECREASING preventive care and sentencing a generation of children to chronic health problems.  Lastly we take a look at anti-patient, right-wing propaganda blaming our true healthcare problem on sick people and Medicare.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

Deborah Burger, RN, is President of the National Nurses Organizing Committee and has worked in hospitals for 30 years.  Over that time she has seen the criminal neglect of the sick and today writes:

The Bush administration’s attitude toward our wounded veterans parallels its behavior toward the rest of our healthcare system – neglect, inadequate funding, and privatization.
It also illustrates a disturbing pattern of misplaced priorities, record spending on a disastrous war while our healthcare security for veterans and millions of other Americans is left behind…

Since President Bush arrived in Washington, the number of uninsured has ballooned by 11%. It’s not much better for the insured. Nearly half say their insurer has refused to pay a medical bill they received, about a third say they have hesitated seeking needed care due to cost. Today half of all bankruptcies, and a third of credit card debt, is directly linked to medical bills.
Concurrently, the number of public hospitals in America has fallen by 30% the past 30 years, a period in which the combined debt of state and local governments has grown by 852% to nearly $200 billion.
It’s affecting huge proportions of our population. New York is preparing to close or merge dozens of hospitals, and Chicago officials just signed off on plans to shut or downsize 19 community and school based clinics….

The U.S. spends more, far more, on health care than any other nation, but much of it is diverted into the pockets of corporate CEOs, gobbled up in record profits for the healthcare industry, and consumed by administrative waste. Just last week the commission that advises Congress on Medicare reported that Medicare has to spend 12% more for care that is administered through private insurers than through traditional Medicare…

While Bush is unlikely to change his attitude, perhaps the next President will.  Christopher Lee in the Washington Post writes today that health is already a focus, with multiple candidates from both parties campaigning on the issue.

The problem?  The trendy policy prescription of “mandated insurance” does literally NOTHING to contain the healthcare costs that are bankrupting Americans.  As such, there is a huge vacuum for whatever candidate will have the guts to take on the private insurance companies that are the cause-not the fix-of those skyrocketing costs.  Such a SinglePayer system has been proven to work in every other developed nation in the world, but the candidates currently fear a backlash from the insurance lobby.  A real leader would take them on and fight to care for the sick and dying in this country who are living their thousands of “Walter Reed” tragedies.  Lee writes:

Although fixing health care is back in vogue, some analysts worry that the prescriptions of the presidential candidates miss the heart of the problem. All the talk about creating universal coverage has obscured the fact that most voters already have insurance, some analysts say, and what they are most concerned about is curbing costs.

“They want some more active government effort to change the way the insurance system works, and to put some more pressure on doctors and pharmaceuticals and hospitals to give a better deal to working people,” said Robert Blendon, a professor and public opinion expert at the Harvard School of Public Health. “The cost issue is a very important driving issue, and politicians haven’t figured out how to touch that nerve yet.”

Taking on costs is more difficult politically because it generally involves challenging powerful interests with a financial stake in the current system, including hospitals, doctors, and drug and insurance companies, said John Rother, policy director for AARP, the seniors lobby.

Even worse, the American Academy of Pediatrics thinks that the “mandated insurance” plans are a health hazard because they discourage parents from taking their kids to receive medical care.  Many of the plans that families will be mandated to buy are just junk insurance, with high deductibles and co-pays, and low caps.  Reuters:

But the American Academy of Pediatrics has joined a chorus of critics that fear high deductibles in the plans will lead patients to skip preventive care, such as immunizations and annual physicals in children. That could lead to costlier treatment down the road, for example, if a patient winds up in an emergency room.
“Faced with difficult choices, families may seek to ‘load up’ on a scheduled visit to save money or delay care until after the deductible is met,” the group wrote in the March issue of the journal, Pediatrics. The group represents 60,000 physicians in the United States specializing in treating children.

Only a SinglePayer system prioritizes care NOT insurance industry profits.  Policy wonks can read the report here.

Finally the anti-healthcare right-wing continues their jihad against America’s patients.  Their propaganda machine today kicks out lies that that the real problem in healthcare is people in this country use too much of it and that Medicare is too expensive.  Kick those patients and seniors out the door and we won’t have a healthcare problem anymore; plus it will be a boon to the mortuary industry. 

I take this as proof that the healthcare industry is worried by the growing national consensus that it’s time for change.

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(As the bumper sticker on my good friend’s car says, “Poverty and health care are moral values.” Now ain’t that the truth! – promoted by atdleft)

That title’s not about some far-off war fought by child soldiers; right here in America, kids without insurance end up being killed off by hospital neglect for the sin of not being attractive customers, according to a new report.  That’s why RNs demand that any healthcare reform guarantee a single standard of care for all patients–something that only a SinglePayer system provides.  And in case you don’t believe that private insurance corporations undermine quality healthcare, Congress just found $65 billion in a budget giveaway that can now be used to actually provide care.  Elsewhere, RNs continue their patient advocacy as Schwarzenegger’s healthcare plan runs into trouble, our public health system is on alert stage red, there’s a die-in in Cook County, and a new nurse-run clinic opens in New Orleans.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

Healthcare isn’t a commodity, it’s a right-and when we forget that, tragedy follows.  We’re reminded of this again in USA Today, which reports that:

WASHINGTON – Hospitalized children who lack health insurance are twice as likely to die from their injuries as those with insurance, a new study reports.
Uninsured children also are less likely to get expensive treatment or rehabilitation and are discharged earlier, says the study by the health care advocacy group Families USA.

Just one example:

Those with traumatic brain injuries were 32% less likely to receive aggressive treatment known as intracranial pressure monitoring. On average, they were discharged after five days, rather than eight days for insured patients.

This is what’s known as a multi-tiered health system.  Some patients can buy care, others can’t.

Please note that all “individual mandate” plans (requiring everyone to buy private insurance) offered by Romney, Schwarzenegger, Edwards, etc won’t change this dynamic at all.  Some kids will have gold-plated insurance; but poor kids will only have high-deductible, low-cap catastrophic insurance.  For-profit hospitals with cash registers where their hearts should be will aggressively treat the kids with good insurance and passively neglect those with bad insurance.  Only a SinglePayer health plan, like “Medicare for All,” guarantees a single standard of care for all Americans.

Responding to the story, the hospital industry gives us the weasel quote of the day:

“I consider the study irresponsible because it is not sufficiently thorough,” said Chip Kahn, president of the Federation of American Hospitals. “I’m worried that this will get people to focus on hospitals, rather than the kids.”

Meanwhile, the Washington Post reports another way healthcare corporations are killing patients: private insurance corporations lobbied Congress to divert 65 billion care dollars away from patients and into their overhead, CEO paychecks, and lobbying budgets. 

A commission that advises Congress told lawmakers that Medicare spends about 12 percent more for care administered through private insurers than when the same care is provided through traditional Medicare.
The commission recommended eliminating that gap, which would save about $65 billion over five years, according to the Congressional Budget Office.
Rep. Frank Pallone, chairman of the House Energy and Commerce subcommittee on health, said the report confirms his belief that the private insurers are overpaid. Pallone, D-N.J., said he wants to steer those overpayments into other health programs.
“The reason they were paid that extra amount is because of their relationship with the Republicans,” Pallone said. “It’s a special-interest advantage that was given to them because of their relationship with the Republican majority. There’s no other rationale for it.”

Stories like this are what motivate Registered Nurses to continue their tradition of taking patient advocacy from the bedside to the statehouse.  Here’s what they’re up to just today: Governor Schwarzenegger is having trouble finding supporters of his incredibly complex health insurance proposal, and is about to be hit with a series of ads from the California Nurses Association (CNA) making clear it makes things much, much worse.  Rose Ann DeMoro, executive director of the CNA, notes that our public health system is on alert stage red, with Schwarzenegger and Bush threatening to make it even worse.  Cook County RNs from the National Nurses Organizing Committee stage a die-in to fight for their patients after the Board of Commissioners proposes slashing the healthcare budget 17%.  And RNs in New Orleans, helped by CNA funding, have opened their own clinic as they fight to get healthcare to those affected by Katrina and its aftermath.

Finally, don’t think America is ready for SinglePayer healthcare?  America disagrees, as nyceve points out.

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Horray for the nurses… And horray for a health care proposal that actually helps real working people! : ) – promoted by atdleft)

State Senator Sheila Kuehl yesterday re-introduced SB 840, her historic bill to move California to a “Medicare for All” health plan.  These kinds of SinglePayer health systems exist in every other developed nation in the world and are the only solution to the problems of access and cost of healthcare-problems caused by the wasteful private insurance bureaucracy.  Schwarzenegger vetoed the bill last year; this year he has promised to bring about healthcare reform and, when SB 840 lands on his desk again, he will have to consider if he is serious about his promise.

The California Nurses Association is the lead sponsor of SB 840, and a strong advocate of H.R.676, the national bill sponsored by Rep. John Conyers.  Nurses are motivated to fight for SinglePayer healthcare because so much of their time is spent fighting insurance corporations on behalf of their patients.  A nurse explains below….

Brought to you by the National Nurses Organizing Committee/California Nurses Association as we organize to make 2007 the Year of SinglePayer Healthcare.

Deborah Burger, RN, President of the California Nurses Association explains why nurses support SinglePayer in her testimony from the SB840 hearing yesterday, and why nurses will continue to fight for it every way they know how, including in a new advertising campaign.  We are at a historic moment in this movement, and California’s progress should provide hope to people across the country that we can cure this healthcare tragedy that is touching so many of us.

Registered Nurses use what’s called the “nursing process” to assess and treat patients.  We are educated to collect objective and subjective data, synthesize that data, and apply our judgment skills to help patients survive both their health problems and the treatment for those problems.  When we ask a patient how they are doing, what their favorite flower is or if they have children, we are not just being pleasant.  We are noting their skin tone, their speech, their pain level, their emotional response and many other indicators of their overall condition.  We are doing a comprehensive assessment of their health, although it may not be apparent to them.

Applying the nursing process to the ailing patient called California, we note symptoms of less access, increasing costs and a less healthy population leading to a diagnosis of healthcare crisis.

The good news is that there is a cure.  It is called SB 840 authored by Senator Sheila Kuehl.

It is probably no accident that the same legislator who fought to protect patients in hospitals and authored California’s historic nurse-to-patient ratios is also the author of SB 840, a SinglePayer, or “Medicare for All” system, where everyone is in, benefits are better, and costs are controlled.  We are very proud, as the principal sponsor of SB 840, to work again with Senator Kuehl.

The California Nurses Association and nurses around the country have  fought insurance companies, HMO’s, patient-care gatekeepers, hospital corporate chains, and everyone else who wants to put us in the position of letting our patients suffer from inadequate care. 

We know one very important fact: a SinglePayer system is the only cure for the current market-based system that has turned our health into a commodity subjected to “insurance products” that cost more and deliver less every year.

Treating these symptoms with more insurance would be like treating a patient with lung cancer or asthma with cigarette smoke.

A SinglePayer plan is the only way to assure genuinely universal care – not universal insurance with a windfall to health plans.

It is the only way to avoid a multi-tiered system, assure better, more comprehensive benefits, and guarantee patient choice of physician and hospital. 

It is the only effective way to adequately control premium and out-of-pocket costs and to end an insurance bureaucracy that wastes 30% of every healthcare dollar because it quite simply takes the insurance middle man out of the middle.

Therefore, CNA RNs are proud to stand with Senator Kuehl, other advocates and other legislators who will fight for the right cure for California’s health crisis.

If you want to join the fight for SinglePayer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Shiela Kuehl is back, this ought to be interesting. – promoted by dday)

While Schwarzenegger’s healthcare plan languishes, California State Senator Sheila Kuehl will re-introduce her historic SinglePayer bill tomorrow.  It landed on Arnold’s desk last year and it will land there again–except this year he has promised to finally deal with the healthcare crisis.  Elsewhere, Republican and Democratic Governors are fighting Washington for their healthcare dollars, indicative of the national consensus for reform, but the Cook County Board of Supervisors drops the ball by fighting for their patronage jobs instead.  Meanwhile bloggers and editorialists check in on the state of healthcare reform in this country.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

The battle for genuine healthcare reform is shifting now to California, where tomorrow Sen. Sheila Kuehl, hero of the SinglePayer movement, will re-introduce SB840, the nation’s signature SinglePayer bill.  It was vetoed by Arnold Schwarzenegger last year even though, as Senator Kuehl remarks, 

“SB 840 represents the gold standard for healthcare reform-the plan that will move California into healthcare solvency and security, not only for ourselves, but for the generations that will follow.”

The time for this bill is now:

Universal health care is possible.  Polls are showing that 60% of Californians now support a publicly funded universal health care system over the current system.  The conversation is steering away from whether we need to enact such a system in favor of how.  SB 840, the California Universal Healthcare Act, is a very important step forward in this because it answers the how.

Here’s how it works:

SB 840 is the only proposal that establishes universal, affordable, comprehensive health insurance for all Californians and that guarantees the right of each patient to choose his or her own doctor.  SB 840 replaces insurance companies with a state-wide trust fund that collects premiums paid by employers and individuals, sharing the responsibility for funding.  This reduces the administrative portion of California’s healthcare costs from nearly 30% to under 10%.  With everyone in one risk pool, no one is denied coverage for a so-called pre-existing condition. Consumers are free to change jobs; start a business; go to school or start a family without losing the doctors they trust.

So what about Arnold?  He has promised to bring universal, affordable coverage to California.  His mask briefly slipped off this weekend, when he made a slightly different promise in reference to the insurance companies:  “You must let everyone make their profits.”

Nonetheless, he hopes to make his legacy with healthcare reform.  His problem is that his plan won’t work.  Legally, he won’t be able to mandate employers provide their workers with health care.  Practically, he won’t be able to mandate individuals to purchase insurance they can’t afford.  And financially, the numbers don’t add up. 

It’s interesting to note that Mitt Romney’s plan in Massachusetts is also facing severe problem; he over-promised and under-delivered.  Unfortunately for Schwarzenegger, RomneyCare was his inspiration.  Here’s one of many articles detailing the Massachusetts mess, in which a conservative activist notes “RomneyCare is in the intensive care unit, soon to be wheeled into hospice.” 

This kind of uncertainly is leading to legislative trouble for Schwrazenegger.  He has yet to find a sponsor for his bill, much of the state is still sitting on the sidelines watch the drama unfold, and it is entirely unclear that his plan will even get out of committee.  Moreover, the California Nurses Association today unveils a wide-ranging media campaign to shape public opinion about the Governor’s plan, and spread the word that it is an insurance industry giveaway barely pretending to address the problems of cost and access of healthcare.  The San Francisco Chronicle writes:

The ads are strong and striking in a political arena that so far has treated the governor’s health care plan with kid gloves.
Although a lot of interest groups have expressed doubts about parts of the governor’s plan, there’s been little public criticism. Many groups, like the Service Employees International Union and the California Chamber of Commerce, have said that they are withholding judgment until the legislative process takes it course and at least, so far, are willing to work with the administration. The nurses do not appear interested in being part of that effort.
“We will never be a part of any plan that benefits only the big insurance companies,” said Chuck Idelson, association spokesman.

Schwarzenegger will have to choose between affordable, universal coverage under the SinglePayer system proposed by Senator Kuehl or breaking his promise of healthcare reform.  The movement for SinglePayer healthcare runs through the California legislature for the next few months.

Around the country, despite the strong public mood for an increase in healthcare, much of our public health system is in deep peril.  A bi-partisan coalition of Governors is raising a red flag about underfunding of the State Children’s Health Insurance Program, a stop-gap program which helps millions of families.

The program in question, the State Children’s Health Insurance Program, covers more than six million children in families that have too much income to qualify for Medicaid but not enough to buy private insurance.

Karen A. Smigielski, a spokeswoman for the Minnesota Department of Human Services, said her state had a federal allocation of $48.6 million this year, would run out of money in July and would need $15 million to continue the program as it is.

In a separate letter to Congress, the National Governors Association criticized a Bush administration proposal to cut federal Medicaid payments to public hospitals and nursing homes. The White House says the changes are needed to ensure the “fiscal integrity” of Medicaid and to curb “excessive payments.”

It is extraordinary that Republican governors are forcing a confrontation with a Republican President over a healthcare issue.  Are we seeing healthcare emerge as the new third rail of American politics-the issue that no candidate dares to fail on?

If so, Cook County Board President Todd Stroger in Chicago hasn’t gotten the message.  Many of Cook County’s 5.2 million residents rely on their public health system, which is among the best in the nation.  Not for long, if Stroger has his way-his new budget would cut nearly 10% of the system’s nurses and close half the clinics, while maintaing 400 high-paid patronage jobs doled out by the politicians.

The County’s RNs, represented by the National Nurses Organizing Committee, promises a furious fight-back.  Watch this one.

Finally, the Agonist notes why market-based health insurance simply CANNOT work,  USA Today notes that we are approaching a choice: change the employer-based system of healthcare or junk it, and an insurance corporation executive argues that it’s not his bloated industry driving costs in our healthcare system-it’s those darn, sick patients!

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

( – promoted by Brian Leubitz)

John Edwards looked a “Medicare for All” health system in the eye, and he blinked.  The tragedy is that there are strong political arguments to be made that a SinglePayer or Medicare for All plan is the smartest politically and will have the most appeal among the public.  Today’s SinglePayer Update will review those arguments, and knock down the claim that SinglePayer healthcare is a political non-starter.  In fact, it seems much more realistic than the incredibly complicated mix-and-match plans that have now been offered by Hillary Clinton, John Edwards, Arnold Schwarzenegger, and Mitt Romney.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of SinglePayer Healthcare.

To the data:

1. The public is ready for a significant healthcare reform
Much of my data comes from the Center for American Progress, including this article that suggests that 89% of Americans are looking for fundamental change to the healthcare system.  In this context, the plans we have seen fail woefully.  Edwards, for instance, joins Schwarzenegger in demanding an “employer” mandate and joins Romney in demanding an “individual” mandate.  This is not a fundamental change to our healthcare system–this is much, much more of the same.

2. There is broad public support for significantly expanding Medicare
There is a bunch of date to support this.  The same Center for American Progress article cites an October, 2006 Kaiser Family Foundation/ABC News/USA Today poll finding that, by a 56% to 40% majority, Americans want to replace the current, employer-based system with a universal, governmet-run healthcare plan “like Medicare,” for instance.  It seems that the public is far ahead of our leaders on this-and that the first Presidential candidate, Democratic or Republican, to realize this will have the wind at their backs.

3. People hate the health insurance companies-they will make a wonderful target in explaining a SinglePayer or Medicare for All system.
Much of the evidence I have on this is anecdotal and comes from my bosses, California’s Registered Nurses, telling me about conversation they have with patients and their families in care settings.  I have never heard anyone say anything good  about insurance companies.  Edwards, and Clinton/Romney/Schwrazenegger, all do their darnedest to carve out a role for and protect the profits of private insurance companies, thereby limiting their ability to attack them.  We saw how well this worked for Clinton back in ’93; she couldn’t attack the big insurers, but they attacked her with their Harry & Louise ads.

4. SinglePayer or Medicare for All is the only solution that will work
Look-the U.S. spends the most money of any nation on healthcare, but our healthcare system is only the 37th best in the world.  Every other developed nation uses a system based on SinglePayer, and it has been proven to work time and time again.  You can’t really argue this point, at least not with facts.  For more background, why don’t you check out Physicians for a National Health Program?  Specifically, I don’t think that Edwards’ idea of “regional health markets,” where Medicare would be sold alongside private insurance plans will work, and I turn to Jonathan Cohn:

Still, such an evolution is hardly guaranteed. One big concern is the possibility of adverse selection–the idea that the public program would continually attract sicker beneficiaries, thereby tilting its beneficiary pool in a way that forces it to jack up premiums, thereby scaring away healthier people, further driving up the premiums. If that sort of cycle begins, the public program would eventually lose most of its beneficiaries–not because it was deficient but because, in effect, it was too good. Edwards’s plan theoretically has protections against this: Regulation of private insurers would, supposedly, keep them from selecting out the best risks. But that’s easier said than done and it’s an open question whether the protections would work

5. It is in the interest of businesses to support a move to a SinglePayer system
The healthcare mess is decimating our manufacturing sector and is a major competitive disadvantage for America.  Only a few business leaders are now on the record in favor of SinglePayer, but that will change, as it is in their interest to get themselves OUT of the business of arranging healthcare for their employees.  By contrast, check out this quote on the Edwards plan from a spokeswoman for a small business lobbying group: “Health care mandates are a nonstarter for our members.”

6. Half-hearted reforms hurt progress 
Edwards and his supporters argued that his plan might ultimately pave the way to single-payer by allowing people with his proposals that people “buy in” to Medicare.  I think it is just as likely that the American people will become convinced that our healthcare systems are un-reformable, because his plan won’t work, and we will have missed an opportunity for reform.

7. Rhetorically-which plan will have more effect with voters?

a. “I support an employer mandate, individual mandate, regional health markets with Medicare buy-in, buttressed by tax code changes and tighter insurance regulations.”
b. “It is time to modernize Medicare and extend it to ALL Americans.”

We’re still waiting from Giuliani, Clark, Obama and others-who will be the first Presidential candidate to support SinglePayer?

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

Arnold and Bush are going to war over healthcare.  Arnold wants the feds to give him almost $4 billion more to subsidize his insurance industry; Bush wants to cut the money he spends on healthcare.  Any true healthcare reform will have to deal with the cost problem caused by unnecessary private insurance companies.  The other big news in the healthcare cauldron also comes from California, where the state’s top HMO regulator is threatening to investigate insurance thugs who toss sick people off their rolls without cause.  Elsewhere, Massachusetts’ half-hearted reform attempts will force consumers who already have health insurance to buy more plans, New Jersey and New York are coming up with new proposals, New Orleans finally figures out how to get some healthcare, and single-payer activists around the country make their case.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of Single-Payer Healthcare.

The Los Angeles Times carries the story of the coming war between Schwarzenegger and Bush over healthcare dollars.  Remember that each is committed to protecting the profits of the private health insurers-and each needs to find more healthcare dollars for their own political purposes.  In Arnold’s case, he’s looking for about $4 billion a year to subsidize the state’s insurance industry.  Not gonna happen:

“That’s a big number on an annual basis,” said Sen. Judd Gregg of New Hampshire, the ranking Republican on the Senate Budget Committee. “California hasn’t yet passed a law [implementing the governor’s plan], but when they do, I would think people are going to take a deep breath.”

The cost of helping states fund their health plans has already attracted the attention of budget cutters because it is complicating President Bush’s stated goal of balancing the federal budget in five years. In his new budget, scheduled to go to Congress on Monday, Bush is expected to call for a substantial slowdown in federal healthcare spending. Some of the cuts Bush proposes could affect programs Schwarzenegger is counting on to help pay for his plan, such as Medicaid.

Yep, this healthcare reform is stuck between Iraq and a hard place.  Remember that a main benefit of single-payer health systems is that they allow for genuine cost savings by rooting out the 34% waste committed by private insurers.

Those private insurers must feel extraordinarily vulnerable right now.  A growing public outcry has targeted, in addition to their profits, their “recissions.”  Recission is industry-speak for revoking the insurance of sick people.  Is California about to crack down on them?

The state’s top HMO regulator said Monday that health plans should be required to get outside review before dropping a policyholder, a dramatic step up in oversight that probably would face stiff challenges from the industry.

Cindy Ehnes, director of the Department of Managed Health Care, said she hadn’t yet developed details on how such a requirement would work. But she said any external input – possibly by the department or some independent panel – could significantly enhance policyholders’ safeguards against the loss of coverage.

“It is clear to me that we have to have some independent oversight,” Ehnes said.

Chris Ohman, president of the California Assn. of Health Plans, contended that regulations to limit rescissions would not be necessary if the governor’s plan were adopted and insurers had to sell to everyone.

“We see pursuing new regulation of rescission as a contradiction of the governor’s overall policy direction,” he said.

Elsewhere, Massachusetts’ plan mandating individuals purchase private insurance is forcing patients to sign up for all sorts of supplemental policies-much to the evil glee of the companies selling the product.

More than 200,000 people with health insurance would have to buy additional coverage to meet proposed minimum standards under the state’s new health insurance law, according to a count completed by insurers yesterday.
Most of the individuals do not have coverage for prescription drugs or have drug coverage that is more restrictive than the minimum proposed by the state board implementing the law. The Commonwealth Health Insurance Connector board is scheduled to vote on the standards in March. Individuals would face a fine of about $200 next year and more in future years, if they do not have insurance that meets the standards.
“It’s very troubling,” said Richard Lord, president of Associated Industries of Massachusetts and a member of the Connector board. “The new law was about expanding access for people without any health insurance. I don’t think we should be forcing people who do have some coverage to spend more.”

Iin California, the state GOP demonstrates that it doesn’t have any idea what to do about health access problems, while New Orleans has figured out that if we can’t have a healthcare system, perhaps we can have a healthcare fair. 

I’m not sure what New York Governor Eliot Spitzer is up to; he says he’ll cut Medicaid to pay for more health insurance.  Sounds like he’s re-shuffling around healthcare dollars.  In New Jersey, the individual mandate-aka, the “forced market” for insurance companies-is coming down the turnpike, at least until everyone realize it doesn’t work. 

Meanwhile, Congressman Pete Stark makes clear that Bush’s healthcare proposals will only make the situation much worse and have no political future, Congresswoman Tammy Baldwin pushes a bill to allow states to use federal money to experiment with single-payer health systems, Connecticut could save $1 billion if it tried a single-payer system, and blogger Terri Emerick at My Left Wing gives us an overview of HR 676, the “Medicare for All” single-payer bill that was recently re-introduced.

( – promoted by Brian Leubitz)

Sadly, we’re reminded again today by Newsweek why we need to fight for single-payer healthcare.  They tell of the struggle of Nathan Wilkes and his very ill son to get medical coverage through his insurer.  Hint: the insurance industry didn’t do the right thing.  But the Wilkes are not alone-today we also learn how Insurance Corporation Gangsters practice unfair, retroactive cancellation of coverage for sick people, and their latest scam for elderly Medicare supplemental insurance patients. Nationally, experts dismiss the Bush plan as a giveaway to insurers, Hillary Clinton tells us why she SHOULD support single-payer, Schwarzencare is running into problems, and more voices around the country call for genuine healthcare reform.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of Single-Payer Healthcare.

If you aren’t committed to putting these sociopath insurance corporations out of business and replacing them with the kind of single-payer health plan that works in every other industrialized nation, read this Newsweek profile:

But it wasn’t just folks in Washington who were upset. Nathan J. Wilkes of Greenwood Village, Colo., was so worried about the possible effects of Bush’s proposal on his ability to provide coverage for his chronically ill son that he decided to travel to the capital to make some noise. A computer network security expert who earns over $100,000, Wilkes works for a private firm outside of Denver which fits into the large-group insurance category and is allowed to shop around for different providers each year. But when his son Thomas, born with severe hemophilia, developed a resistance to treatment at age 1, Wilkes’s claims soared; his company’s insurance provider, Wilkes says, soon began hiking premiums 40 to 55 percent each year, and introduced a lifetime cap of $1 million for all employees and their families-including Thomas. Soon, Wilkes says, no other insurance companies would offer to cover the company.

His father will soon have no choice but to go bankrupt.  He had health insurance-and it worked so long as nobody got sick.

A USA Today story suggests that he’s lucky he got what care he did.  The new trend for insurance corporations is to comb the applications of their sick customers and try to retroactively deny them care for mistakes. 

Their stories illustrate a little-recognized fact about insurance purchased by individuals: Even after being approved, policyholders can see their coverage amended to exclude certain medical conditions or revoked entirely, sometimes long after the policies are issued.
“Insurers love to market the promise, ‘We’ll take care of you. Just sign here,’ ” says Karen Pollitz of the Institute for Health Care Research and Policy at Georgetown University. “Then there is all this opportunity for the insurer not to keep the promise, and you don’t find out until it’s too late.”…
Attorney William Shernoff, who represents Wheeler, Seals and some other patients involved in the California legal disputes, says the forms are designed to be unclear, giving insurers cover to cancel almost any policy.
“I would venture to say that anyone who fills one out would make a mistake,” Shernoff says. “They have compound questions, confusing questions, ambiguous questions. There’s no place to answer ‘I don’t remember’ or ‘I don’t know.’ ”

And the San Francisco Chronicle reports one more health insurance abuse-bullying or deceiving elderly customers into buying Medicare supplemental insurance that’s a total rip-off.

So are we any closer to getting rid of them?  The Washington Post tells us that Bush’s plan will only make things work by allowing corporations selling junk insurance to get their hooks deeper into America:

But experts said yesterday that (Bush’s plan) would tilt that field toward a kind of health insurance that Bush has long favored — a high-deductible plan paired with a special tax-exempt health savings account, or HSA.

This is ideological warfare on the everyday consumer.  Patients, like Mr. Wilkes, would have high out-of-pocket expenses and caps that would quickly burn through their HSA’s.  Insurance companies would get more customers, and would find it easier to get rid of those pesky sick ones.  More risk for individuals and more profits for insurers.

Elsewhere, Hillary Clinton tells us why she SHOULD support single-payer healthcare, in an unusual speech making clear that it’s affordable and her supporters like it.

Let’s pick up story.  Campaigning in Iowa, Hillary says she favors universal healthcare, but on the plan:

“I’m not ready to be specific until I hear from people,” she said

Oooookay.  Then:

… Clinton asked at one point for a show of hands from the audience to see how many would prefer employer-based health insurance, how many would prefer a system in which individuals purchased insurance, with help from the government if necessary, and how many would prefer a system modeled on Medicare.
The audience overwhelmingly favored moving toward a Medicare-like system for all Americans. But Clinton, recalling the famous “Harry and Louise” ads run by opponents of her early-’90s health-care plan, warned that until there is greater political consensus, the same kind of attacks could sink any new efforts to provide universal coverage.

Jill Lawrence from USA Today continues the story:

“That really makes a lot of sense, because you could get the costs down,” Clinton said. But she said such a plan, like her 1994 proposal, is vulnerable to attacks that it is “government-run health care.” Clinton said she will work this year to cover all uninsured children and seek input from voters before proposing larger changes. “This time we’re going to build the consensus first,” she said.

So she used to oppose Medicare for All before she supported it?  Or is it the other way around?

Meanwhile, in California, Schwarzenegger’s ineffective, complicated plan is running into political problems and it looks the state will face a referendum of one kind or another in 2008. 

The Minneapolis Star-Tribune has some advice for him: the patchwork plans are too complicated to pass and will never work: 

Yet the closer you look at these ambitious plans, the more you see they are mere patchworks. In Massachusetts, which will require most residents to buy private insurance, policies are coming on the market with higher prices and less coverage than experts hoped. Economist and columnist Paul Krugman points out that the Schwarzenegger plan will require big new state bureaucracies to regulate insurance companies and police individual behavior. As for the president’s plan, even the White House admits it will cover only 5 million of the nation’s 46 million uninsured; that’s because it relies on tax deductions, which aren’t much use to low-income families who represent the bulk of the uninsured population

The biggest argument against a single-payer system is it’s “politically unrealistic” in a free-market society like the United States. We think that gives too little credit to the impatience and common sense of American voters. But then we won’t know until a leader has the courage to find out.

Elsewhere, columnists in New York and California call for single-payer healthcare, Blogger Over My Med Body reminds us it will be cheaper, and the Smirking Chimp asks who’s afraid of SinglePayer.