IF YOU ARE SHOUTING AT CONGRESS AND OBAMA TO SAVE MEDICARE AND MEDICAID......THEY ARE ALREADY PRIVATIZING IT AND SENDING IT TO THE STATES GUTTED OF FUNDING AND CREATING TIERED ACCESS FOR GOODNESS SAKE.
Medicare Advantage was a George Bush attempt to privatize as much of Medicare as possible and as this article states it has pulled 1/4 of seniors off the public program simply by boosting coverage for popular health access issues that Medicare does not offer like dental and vision....or giving a good price on heavily used health item while loading costs on others. So, Expanded and Improved Medicare for All would not want these private plans drawing from the Trust funds.....it would want Medicare to cover all of those health issues for everyone. This article is good in two respects.....it shows that the Affordable Care Act is having a negative impact on these private Medicare Advantage plans but it shows as well why.......the Affordable Care Act deliberately seeks to create a tiered funding of Medicare just as with these state systems. As I have said, the plan is to throw Medicare, Medicaid, and public sector health plans into these systems and it will come out as Medicare looking more like Medicaid for most people. Again, it will be 80% of people unable to access the quality care of Medicare that has always been available to all seniors. The lower-income seniors are the more costly and they are the ones targeted to be pushed from the system. THAT IS HOW OBAMA PLANS TO CUT COSTS OF MEDICARE. Obama is a tiered kind of guy......a perfect republican!!!!
NEO-LIBERALS RUN AS PROGRESSIVE DEMOCRATS AND THEN SERVE LIKE RIGHT WING REPUBLICANS
Pharma & Healthcare | 1/06/2014
More Cuts In Store For Medicare Plans -- Here Are The Options That Will Shrink Most For Seniors
Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)
The privately run Medicare plans known as “Medicare Advantage” have been in the political crosshairs of the Obama White House. Even after facing steep cuts under Obamacare, the Advantage plans are now slated to take a brand new round of reductions in 2015. These new cuts will cause the private Medicare option to shrink further in the next few years, and pressure the insurance companies that offer them.
The latest cuts are the consequence of a slowdown in the overall growth of Medicare spending — some of it owing to reduced utilization of medical services as a result of the slack economy. The Medicare program recently told the private plans that, since per capita costs are trending lower than prior estimates, the feds are now assuming that Medicare Advantage will take another cut in 2015, on top of existing reductions.
This means that in 2015, the rates that the feds pay these plans is slated to go from an earlier 1.7 percent increase to a new, -2.0 percent decrease. This is on top of other cuts that have already been announced or implemented. Combined with these other cuts mandated by Obamacare, the Medicare Advantage plans are looking at significant reductions when they had been expecting small increases.
The slower rate of growth in overall Medicare spending will come as welcome news. Yet basing Medicare Advantage rates off this metric was always flawed. The translation between Medicare’s per-capita costs and beneficiary costs in the Medicare Advantage program was never precise. They don’t track each other well, as the Advantage plans often implement reforms and realize savings in ways that are detached from trends underway in the broader medical marketplace.
These 2015 rate adjustments will affect the investment decisions that the advantage plans make. Now that anticipated increases are turning into cuts, more health plans are likely to skinny down the options that they offer.
Hardest hit are going to be the health plans that have made the biggest investments in Medicare Advantage. At the top of this list is Humana.
Humana has about 2.5 million Medicare Advantage members and 3.3 million participants in Medicare Part D drug plans. The company’s Medicare business accounts for 70 percent of its revenue. So watch the plan as a bellwether for the impacts of these policy trends.
Humana has been making aggressive investments in the way it delivers care to seniors and integrates their medical services. It’s part of a broader effort to improve medical outcomes, and save money on medical costs. But these are long term investments that might not pay off in time to offset the near term cuts. That’s the problem with the way Washington budgets around healthcare. The year-to-year budget adjustments don’t provide enough opportunity for insurers to realize the savings from making longer-term investments in healthcare. If Humana’s Medicare business starts to shrink, or benefits get trimmed in noticeable ways, it will be a reflection of the recent cuts.
All of this begs the question why the private Medicare plans remain a target?
The original gripe that the Obama team had was that the MA plans were being paid more for each beneficiary that they covered than what the government spent on an average senior enrolled in traditional fee-for-service Medicare.
The math on this costs per-beneficiary estimate was always fuzzy. It baked in a lot of fungible assumptions. Nonetheless, Obamacare sanded away any perceived discrepancy, cutting more than $150 billion from these plans.
The net effect of all of these cuts is already expected to shrink the program. The Obama Administration is disproportionately shifting these cuts onto so-called Medicare “special needs” plans. These are Medicare Advantage plans that are specifically designed to enroll patients with certain serious and costly chronic illnesses like diabetes and heart disease. Many of these patients are low income, and dually eligible for both Medicare and Medicaid.
These SNP plans are paid more to effectively siphon these less healthy patients away from other Medicare schemes like Medicare’s fee-for-service program. The idea is that these specialized Medicare Advantage plans will be able to more closely manage these patients, reducing morbidity associated with chronic ailments, and in turn lowering costs to the Medicare program. There is evidence that this kind of focused health plan works to improve clinical outcomes, and reduce costs.
More than 1.5 million seniors were covered by about 500 of these plans in 2013. Avalere Health, a Washington-based health policy firm estimates that at least 13% of these plans will be eliminated as a result of the cuts.
The targeting of SNPs is illustrative of the incongruous nature of the President’s policies when it comes to Medicare Advantage. The White House has been using a “demonstration” project authorized under Obamacare to forcibly turn many of these same patients over to state-run healthcare programs. The states, in turn, are typically enrolling these seniors into the HMOs used by their Medicaid programs. It’s going to be hard to argue that low-income seniors with chronic medical problems will be better off in state-run Medicaid HMOs (getting the equivalent of a Medicaid benefit) than they were in the private Medicare SNPs.
The Obama demonstration program aims to improve the medical management of these seniors. But the SNPs were already doing the same thing that the states are now trying to figure out. And the SNPs are using managed care plans tailored to seniors, and not designed to serve state Medicaid programs. The effort to turn these seniors over to the states always looked like it was more about politics than sound healthcare — a backdoor scheme to cross subsidize state Medicaid programs with money from Medicare.
It can’t help but seem like the real aim of the successive cuts is to shrink the advantage program. Yet more than a quarter of Medicare beneficiaries enroll in the private Medicare Advantage plans. Many of these are low-income seniors who choose these options because they can’t afford the Medigap policies that richer seniors use to plug the increasing gaps in traditional, fee-for-service Medicare. The private Medicare Advantage plans typically have fewer out-of-pockets costs than traditional Medicare, eliminating the need to buy a costly, supplemental health plan.
The Obama team has made a warm embrace of managed care options when it comes to Obamacare and Medicaid. But for Medicare, they want to deny low-income seniors these options. All of the administration’s old arguments on why they resisted these private Medicare plans have been largely mooted, or never materialized. Only one possible reason remains prominent. It’s a Bush era program that sought to privatize aspects of this public program. And it will continue to be opposed largely on those grounds.
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For those not knowing that the Affordable Care Act is about huge cuts in health access for most people in order to make the health industry more profitable, the roll-out is showing people what they are losing. Medicare is being taken to the same tiered level of care you see on these state health exchanges and as we can see, Medicare and Medicaid will end as Federal programs and simply become part of these state systems of tiered access. Seniors needing care the most will now not be able to access important care if they cannot pay for the right health plan.
Obama Administration Issues New Rounds Of Cancer Care Cuts Amidst Healthcare Reform Chaos
Community Oncology Alliance gravely concerned over severe cuts to cancer care
Community Oncology Alliance December 18, 2013 12:29 PM
The Centers for Medicare & Medicaid Services (CMS) recently announced Medicare fees for 2014, which include severe cuts to essential cancer care services. CMS will arbitrarily cut by 7.4% chemotherapy services payments to physician-run community cancer clinics — where close to 70% of the nation's cancer patients are treated — without any cost-based justification. At the same time, CMS will increase payment to hospitals by 29.9%. This is in direct opposition to the Medicare Payment Advisory Commission's recommendation in their June 2013 Report to Congress that CMS should be achieving payment parity for identical services, regardless of where those services are delivered.
"Our government has consistently and increasingly jeopardized this country's cancer care delivery system," said Dr. Mark Thompson, COA president and an oncologist at the Mark H. Zangmeister Center in Columbus, Ohio. "These latest payment cuts are bad medicine for cancer patients and taxpayers. They will further consolidate cancer care into large corporate medical systems and, in the process, inhibit patient access while increasing costs to patients and taxpayers."
RECENT REPORTS:
"The sequester cut to cancer drugs is a wrecking ball to our cancer care delivery system," said Ted Okon, COA executive director. "To make matters worse, oncologists are being hit by insurers who are cutting them out of Obamacare exchange and Medicare Advantage networks, which recently happened en masse to 170 cancer care providers in Florida. In the midst of this chaos, CMS will reduce cancer care payments even further, with no rationale justification, and is simply driving up costs for Medicare and seniors. It doesn't make sense."
COA's official comment letter to CMS on the agency's 2014 fee schedule for cancer care services can be obtained here: http://www.communityoncology.org/COA-Comment-Letter.pdf
About Community Oncology Alliance (COA)
Community Oncology Alliance (COA) is a non-profit organization dedicated solely to community cancer care, where four out of five Americans with cancer are treated. Since its formation over a decade ago, COA has helped community cancer clinics navigate an increasingly turbulent environment by working together to become more efficient, advocating for their patients, and proactively providing solutions to Congress and policy makers. COA members have testified before both chambers of Congress, authored cancer care demonstration projects, and been instrumental in the passage of oral cancer drug parity legislation, among many other initiatives.
COA also leads a multi-stakeholder group that is developing and implementing an Oncology Medical Home (OMH) cancer care model and is advancing payment reform for cancer care. More information can be found at www.CommunityOncology.org.
The COA Patient Advocacy Network (CPAN) was created in 2010 to advocate for access to local affordable care for all cancer patients. More information can be found at www.COAadvocacy.org.
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WE ALL HEARD THAT THE ONLY PEOPLE THAT WENT TO JAIL FOR THE MASSIVE SUBPRIME MORTGAGE FRAUD WERE THE SMALL FRIES AT THE BOTTOM OF THIS SCAM......WELL, THIS PRIVATE CONTRACTING CORPORATIONS WILL DO THE SAME WITH ENTITLEMENT FRAUD....
We all want fraud and waste in the health care system be addressed as we have lost 1/2 of entitlement spending to fraud over a few decades.....trillions of dollars needing to come back. What Obama is doing is outsourcing Medicare now....private firms are creating these websites, below you see private contractors looking for fraud, and as Obama places Medicare on tiered levels of access, these ACOs will be in control of how Medicare funds are spent. No standard payment for all. This will of course create the same disparities as with any corporate operation and consumer service. The search for fraud for example will focus on individuals/mafia types of fraud and completely ignore the hundreds of billions being stolen by health institutions. I read an article on Medicaid fraud that had one of these private contractors saying they do not see much fraud when we know it is rampant. No doubt what these agencies will do is monitor doctors adherence to restricted levels of health care to deter any hippocratic oath caretakers.
ALL OF THIS IS REALLY , REALLY, REALLY BAD. REMEMBER, ALL THESE STRUCTURES BEING BUILT ARE ABOUT CONTAINING COSTS TO MAXIMIZE PROFITS. THEY ARE NOT ABOUT SAVING MEDICARE TRUSTS FROM BEING RAIDED BY CORPORATE FRAUD.
Sat, Jan 11, 2014, 11:31AM EST -
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Tommy G. Thompson, Former U.S. Secretary of Health and Human Services, Appointed Chairman of HealthcarePays, Inc. Board of Directors Thompson: Time is Now to Tackle Healthcare Fraud, Inefficiency, and Improve Transparency
HealthcarePays, Inc.
December 18, 2013 12:04 PM
HCP employs an industry-owned network for healthcare payment authorization and processing that is proprietary, standardized and compliant with the Affordable Care Act (ACA) and all state and federal laws. Employers, providers and insurance companies are joining HCP to combat waste and fraud, create efficiencies of healthcare payment processing and access industry-wide data cube analytics.
Thompson says he's joining HealthcarePays to combat the lack of cost transparency and rampant waste and fraud that are draining the U.S. healthcare system of hundreds of billions each year.
"There is little doubt that the future financial well-being of both the federal and state governments depends in, large part, on controlling healthcare payment inefficiencies," said Thompson. "It makes little sense that the U.S. has no overarching healthcare industry payment network to check for fraud and authorize payments by examining all the payments in the system, similar to what is in place in our financial services sector. I'm joining HealthcarePays to establish the first industry-owned network of this kind. The leaders in the areas of employers, health plans and governments are encouraged to join us in this unique opportunity to create healthcare accountability through payment automation."
Key healthcare accountability challenges include:
HCP interacts with all existing healthcare industry organizations including employers, hospital systems, physician groups, insurance companies, government payers such as Medicaid and Medicare, intermediaries, clearinghouses and banks.
As Secretary of Health and Human Services and Governor of Wisconsin, Thompson became a champion for welfare and Medicare reform, and had a reputation for fighting for the federal funding needed to improve public health.
"Tommy is a visionary and has a long track record of accomplishments in health services," said HealthcarePays Chief Executive Officer Dave Adams. "He's been advocating for healthcare reform throughout his impressive career in public and private service. We are fortunate to have him as a leader and an evangelist for our cause to reduce healthcare costs in the U.S."
About Tommy G. Thompson
Tommy G. Thompson was the 42nd and longest serving Governor of the State of Wisconsin from 1987 to 2001. Thompson also served from 2001 to 2005 as the United States Secretary of Health and Human Services (HHS). Thompson has held numerous important posts including as Chairman of AMTRAK, Independent Chairman of the Deloitte Center for Health Solutions and served on the boards of various other publicly and privately held entities. Thompson has been called a "pioneer" for two landmark initiatives, the Wisconsin Works welfare reform and school voucher programs. During his time as HHS Secretary, Thompson provided key leadership in the post 9-11 environment, reorganizing HHS, increasing funding to the National Institutes of Health, increased the responsiveness of the Centers of Medicare and Medicaid and working through the backlog of waiver requests thereby providing health insurance to 1.8 million low income Americans.
About HealthcarePays
HealthcarePays (HCP) is an industry-owned "payment network" designed to cut healthcare costs. HCP, headquartered in Richmond, Virginia, with its technology group based in Carlsbad, California, provides a fast, secure, electronic network that simplifies and improves the healthcare payment system. HCP streamlines the movement of healthcare payments and filters such payments among providers, health plans, self-insured employers, government payers, intermediaries, clearinghouses and banks in the U.S. The secure network is highly efficient, cost effective and fully compliant with the Affordable Care Act and other state and federal laws.
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Headlines in all media says 'Good news, health costs going down'. Now, the public was led to believe that the ACA was about controlling health costs for the public, but as we are seeing controlling costs means limiting access to most people so health institutions are more profitable. Below we see the biggest winners Health Insurance Corporations and Big PHARMA. People now pay for insurance and then are kept from using it with co-pays and deductibles.
Insurance has no where to go but up as with all health care institutions because the ACA is about consolidation into global health systems and as we know when consumers come from all over the world.....only the affluent of the world will be able to afford most private insurance. While 80% of US citizens will be on Medicaid and Bronze plans both allowing mostly preventative care, when these insurance corporations expand overseas.....and that will happen fast.....the percentage not accessing much of health care will go to 90%. So, Affordable means that almost all Americans will be getting preventative care that is the cheapest health care to be had!
This is why Obama and neo-liberals put the policy of buying out of purchasing insurance so low initially and tying that penalty to the lowest cost of Bronze level insurance soon after....IT WILL TAKE ALL THE DISPOSABLE INCOME MOST PEOPLE HAVE JUST TO BUY THIS INSURANCE!
SCORE WALL STREET!!!!
Wall Street wouldn't be able to do all this without your neo-liberal incumbent!
Pharma & Healthcare
New Survey of Health Insurance Brokers: Private Health Plan Premiums Are Spiking. Now, Even The Fed Is Watching These Trends Get ready for even higher healthcare costs.
A new survey of health insurance brokers shows that commercial insurance rates are going to rise “significantly” in 2014.
The research team at investment bank Morgan Stanley surveyed 131 brokers, finding that December 2013 rates are rising in excess of 6% in the small group market, and 9% in the individual market.
The spike in the quarterly-reported rates for annual premiums on new or renewing contracts is being attributed to the continued implementation of Obamacare rules, as well as new Obamacare taxes and fees that are being assessed on plans this year.
The December 2013 rate hikes are the largest reported since Morgan Stanley’s research team first started conducting the quarterly surveys of brokers in 2010. In prior quarters, the average quarterly reported rate increases never rose above 3% over the preceding period.
On top of this, health plans are also predicting higher cost trends in 2014, after years of stabilization (much of it attributable to the economic downturn, which reduced medical utilization rates). These higher cost trends were also among the reasons health plans cited for their December rate increases.
According to the survey, Aetna and United are increasing insurance rates in excess of 10%. Commercial carriers such as United are already on record attributing the bulk of their increased healthcare costs to new, Obamacare-related provisions.
Among the states seeing the highest annualized rate hikes (for the full 2013 year) in the individual market are Connecticut, which is averaging a 37% increase; Florida (42%); Illinois (33%); Michigan (39%); and Minnesota (35%).
Among the states with the biggest annualized spike in the small group rates are Delaware, which is averaging a 35% increase; Michigan (30%); and Minnesota (50%).
These rate increases have broad implications. Federal Reserve Board Member Jeffrey Lacker said today that the Fed has its eye on these costs.
Lacker said that he expects a “lot of turmoil” in the healthcare industry, and that the Fed will be watching how Obamacare unfolds.
In a speech to the Greater Raleigh Chamber of Commerce this afternoon he said “I think the Affordable Care Act is something that we are watching very closely because it’s something that could well have a substantial economic impact.”
In other words: You can’t tap the average family by $2,000 or $3,000 in additional healthcare costs and not expect some macro impacts.
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Those people backing this reform often are the ones who are afraid that the coming baby boomer boom will implode the Medicare Trust and so think limiting access of low-income is a good idea. You had better look at how extreme these reforms will be in removing regulations and protections and handing all control to Wall Street in how health care is dished out. EVEN THOSE UPPER MIDDLE CLASS SHOULD BE OUTRAGED.
PUSH FOR EXPANDED AND IMPROVED MEDICARE FOR ALL AT NATIONAL AND STATE LEVEL!!!
While Obamacare Enrollment Continues to Lag, Labor Builds Support for Expanded and Improved Medicare for All
Posted: 12/30/2013 10:25 am
The 113th Congress will likely be remembered as the most unproductive in our history, and with an overall approval rating of 9 perent, it is safe to say that most Americans do not consider this bunch to be a noble group of public servants engaged in good works for the people of this country. It is rare that any member of Congress is honored on any level these days, but one truly worthy exception is Rep. John Conyers (D-MI), who early in December was honored with a breakfast celebration attended by some 40 union representatives at a restaurant on East 29th Street in New York City.
Those present included leaders from Actors Equity, The International Alliance of Theatrical Stage Employees (IATSE) and the New York City Central Labor Council (NYCCLC), whose President, Vincent Alvarez, declared his support for Mr. Conyers' bill HR 676, The Expanded and Improved Medicare for All Act, and promised to deliver their 1.3 million members to back this cause. This is a very significant development, as the 300 unions under the umbrella of the NYCCLC are made up of truck drivers, teachers, nurses, operating engineers, construction workers, janitors, train operators, electricians, fire fighters, retail workers and many more hardworking Americans who, along with everyone else in our nation, would benefit greatly from this revolutionary healthcare plan. They are the face of American labor today, and Mr. Alvarez spoke of the need for labor and the general public to unite and work together for this imperative cause: providing affordable, quality healthcare to all Americans.
We might recall that it was labor that gave us the middle class during the post World War II years as they worked to indeed lift all boats in that time of unprecedented prosperity. Can they lead our nation once again in this time of unprecedented need? They have been taking quite a beating, and have been decimated in several states by the lackeys of the 1 percent. But their values are America's values, and it is critical that they remain a vibrant force for change in this country.
Mr. Conyers was introduced by his longtime friend, TV talk show host Phil Donahue, and other speakers that morning included Robert Score, Recording-Corresponding Secretary of Local 1 of IATSE, and Stephen Shaff, speaking on behalf of Progressive Democrats of America. Mr. Conyers himself noted that it took him 15 years to move Congress to declare a national holiday for Dr. Martin Luther King, so he is prepared for a long haul to achieve Medicare For All. He has reintroduced HR 676 in every Congress since 2003, and has now garnered support from 54 other House members, along with an impressive 609 union organizations, including 146 Central Labor Councils/Area Federations and 44 State AFL/CIO's. Obamacare's failure to address the Taft Hartley Plans and the operating procedures under which they work could create even more union support for the Single Payer movement. The president must address this issue.
Meanwhile, support from the public also continues to build, as the warts on the ACA become more apparent and the questions about its viability grow louder on almost a daily basis. This will undoubtedly drag into the 2014 election and continue to send shock waves throughout the political world into the 2016 race for the White House, as the Conservatives will remain active in their attacks and continuing efforts to end Obamacare.
Following the breakfast, Mr. Conyers and his policy director Mike Darner met with 15 of his core Single Payer activist leaders from organizations like Physicians For A National Health Program and Healthcare-Now! -- as well as some doctors -- to discuss strategy and continue building the movement. This group is definitely in it for the long haul, too, as they have supported Mr. Conyers and his bill for years. This is a bill that would deliver all necessary health services at less than half the cost we pay now, eliminating co-pays, deductibles and co-insurance while providing long-term care -- including all of those expensive dental specialties. The estimated savings would be in the range of $592 billion a year. Better healthcare at lower costs -- what's not to like? And if you like your doctor, you actually could keep him or her -- did you hear that, Mr. President? You can also pick any doctor you like -- no more provider networks. These healthcare professionals would be able to become doctors once again, instead of a "provider" or "vendor," and we could become patients again, ending our dehumanizing role as a "consumer" or "customer."
Of late, we have been reading about Medicare For All from such luminaries as Robert Reich, Ralph Nader and William Greider in The Nation, among others. Even Bill Clinton mentioned it during President Obama's second campaign. If Hillary were to acknowledge that Medicare For All is the next logical step after Obamacare, she would gain tremendous support and a second opportunity to get the right healthcare plan in place for her presumed 2016 run for president. Unfortunately, Hillary has proven herself to be far from progressive on many issues in the past, so we will have to wait and hear from her what her healthcare plan actually is if she decides to run.
Meanwhile, in the past few weeks Vermont Senator Bernie Sanders and Rep. James McDermott (D-WA) -- who is also a doctor -- have both introduced Single Payer bills. Bernie's bill is a Medicare-for-All proposal known as the American Health Security Act of 2013 (S.1782), which would be administered by the states and transferable between states. The McDermott bill also moves the initiative outside of D.C., leaving it up to the states to develop their own plans based on their diversity and individual needs. As Massachusetts was the template for the ACA, it makes sense to finally introduce Single Payer on a state-by-state level.
Vermont has approval in both of its houses for a Single Payer plan, but it needs a waiver from the ACA to implement it in 2017. Can't the federal government speed up that process? There are also plans at the ready in New York and in Rep. McDermott's home state of Washington. And what of California, which has come so close in the past? One state can lead the country toward this monumental goal, the way Massachusetts did with the ACA. We just need to find the will.
In the Greider article in this month's The Nation, entitled "Reviving The Fight For Single Payer," he raises the question many of us ask: Can Obamacare deliver what it promised? One of the major problems he notes is that "...the reformed system will also still rely on the market competition of profit-making enterprises, including insurance companies." Rep. McDermott was interviewed for this article, and he pointed out another major flaw in the ACA: "In the long arc of healthcare reform, I think [the ACA] will ultimately fail, because we are trying to put business-model methods into the healthcare system. We're not making refrigerators. We're dealing with human beings, who are way more complicated than refrigerators on an assembly line."
Rep. McDermott - an advocate for Single Payer for decades - further wondered if hospitals will become "too big to fail" as they continue to merge and buy up private practices, and continue hiring younger doctors as salaried employees. Mr. Greider also made the following revelation: "An AMA survey in 2012 found the majority of doctors under 40 are salaried employees." Rep. McDermott sees the troubling direction of this trend, noting that many new doctors "...will simply be serfs working for the system," and Mr. Greider referred to another key point in the AMA research, noting that "...hospitals focus on employing primary-care physicians in order to maintain a strong referral base for high-margin specialty service lines." Mr. Greider added further insight from Rep. McDermott: "Big hospitals need a feeder system of salaried doctors, McDermott explained, to keep sending them patients in need of surgery or other expensive procedures." Even so, Rep. McDermott remains optimistic that stronger health care systems resembling Single Payer will spring up moving forward.
The New York Daily News offered a scathing editorial on December 24th entitled "Can This Patient Be Saved?" in which we were given a blow-by-blow analysis of the devastatingly mishandled rollout of the Obamacare exchanges and the problems millions of Americans have been having signing up for them. The situation was so bad that the deadline was extended until Christmas Eve for those to sign up who wanted their insurance to kick in on January 1, 2014. The CBO projects seven million will sign up in 2014, in addition to the about 1.1 million this year -- well below the Administration's projections. Meanwhile, millions will be losing their current plans due to the mandate. The question of more people losing their insurance than gaining it as a result of the president remaking the "healthcare economy" was also raised in this Op Ed piece.
Key provisions of the bill have already been waived in the past three years since its passage, and an additional postponement of the requirement for companies with fifty or more employees to offer health insurance or pay a tax penalty has now been postponed until 2015.
The individual mandate requiring most Americans to find coverage by April is also waiving penalties for those who had insurance and lost it this year. Most glaring in this critical article is the fact that there is "little reliable" information on who is getting what as far as coverage is concerned, and at what cost. The even larger question is, will those younger and healthier people opt in at all? If not, financially this boondoggle will sink. Obamacare is counting on them.
As the tinkering continues on the ACA, a major architect of this mess has just been rewarded by the president with an ambassadorship offer to China. Senator Baucus, do you not know the meaning of the word "retire?"
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This says it simply. National Physicians tries to be diplomatic with ACA by stating a few helpful issues addressed, but if you look closely they are not even really addressed. Shout out to your national pols and your local ones.....ALL OF MARYLAND POLS VOTED FOR THIS PRIVATIZED NIGHTMARE. Maryland has some Expanded and Improved Medicare for All groups to join!
Medicare for All
We Demand: Medicare for All. Pass H.R. 676, the Expanded and Improved Medicare for All Act.
Whether healthcare is a “right” is a meaningless abstraction. It is an urgent necessity, for lack of which many Americans suffer and die needlessly. Public health insurance must be expanded and made available to all Americans, regardless of age, income or health.
The debate over “Obamacare” (The Affordable Care Act) has been misrepresented on both sides. Supporters claim it makes coverage universal, failing to mention its failures to contain costs or protect Medicare. Critics call it “rationed care,” failing to justify the more egregious rationing by private insurers.
Obamacare does contain several components which are highly valuable to the American people – including the mandate to insure without prejudice those with pre-existing conditions, and the new insurance exchanges. Wall Street and the GOP are eager to destroy the act on this basis alone. Anything that is good for the American people is bad for Wall Street.
However, Obamacare represents a continued bailout of the private insurance industry. Rather than expanding public programs, it offers public subsidy for private insurance, forces uninsured individuals to buy private insurance, and fails to control costs or defend Medicare, America's only truly public insurance program.
What we demand is not mere “universal coverage,” but a system that is affordable and available to all, without regard for the profit motive of the private insurance industry. The only system that fits the bill is to expand and improve Medicare for all Americans.
Quick facts*
Our Demand
Medicare Advantage was a George Bush attempt to privatize as much of Medicare as possible and as this article states it has pulled 1/4 of seniors off the public program simply by boosting coverage for popular health access issues that Medicare does not offer like dental and vision....or giving a good price on heavily used health item while loading costs on others. So, Expanded and Improved Medicare for All would not want these private plans drawing from the Trust funds.....it would want Medicare to cover all of those health issues for everyone. This article is good in two respects.....it shows that the Affordable Care Act is having a negative impact on these private Medicare Advantage plans but it shows as well why.......the Affordable Care Act deliberately seeks to create a tiered funding of Medicare just as with these state systems. As I have said, the plan is to throw Medicare, Medicaid, and public sector health plans into these systems and it will come out as Medicare looking more like Medicaid for most people. Again, it will be 80% of people unable to access the quality care of Medicare that has always been available to all seniors. The lower-income seniors are the more costly and they are the ones targeted to be pushed from the system. THAT IS HOW OBAMA PLANS TO CUT COSTS OF MEDICARE. Obama is a tiered kind of guy......a perfect republican!!!!
NEO-LIBERALS RUN AS PROGRESSIVE DEMOCRATS AND THEN SERVE LIKE RIGHT WING REPUBLICANS
Pharma & Healthcare | 1/06/2014
More Cuts In Store For Medicare Plans -- Here Are The Options That Will Shrink Most For Seniors
Barack Obama signing the Patient Protection and Affordable Care Act at the White House (Photo credit: Wikipedia)
The privately run Medicare plans known as “Medicare Advantage” have been in the political crosshairs of the Obama White House. Even after facing steep cuts under Obamacare, the Advantage plans are now slated to take a brand new round of reductions in 2015. These new cuts will cause the private Medicare option to shrink further in the next few years, and pressure the insurance companies that offer them.
The latest cuts are the consequence of a slowdown in the overall growth of Medicare spending — some of it owing to reduced utilization of medical services as a result of the slack economy. The Medicare program recently told the private plans that, since per capita costs are trending lower than prior estimates, the feds are now assuming that Medicare Advantage will take another cut in 2015, on top of existing reductions.
This means that in 2015, the rates that the feds pay these plans is slated to go from an earlier 1.7 percent increase to a new, -2.0 percent decrease. This is on top of other cuts that have already been announced or implemented. Combined with these other cuts mandated by Obamacare, the Medicare Advantage plans are looking at significant reductions when they had been expecting small increases.
The slower rate of growth in overall Medicare spending will come as welcome news. Yet basing Medicare Advantage rates off this metric was always flawed. The translation between Medicare’s per-capita costs and beneficiary costs in the Medicare Advantage program was never precise. They don’t track each other well, as the Advantage plans often implement reforms and realize savings in ways that are detached from trends underway in the broader medical marketplace.
These 2015 rate adjustments will affect the investment decisions that the advantage plans make. Now that anticipated increases are turning into cuts, more health plans are likely to skinny down the options that they offer.
Hardest hit are going to be the health plans that have made the biggest investments in Medicare Advantage. At the top of this list is Humana.
Humana has about 2.5 million Medicare Advantage members and 3.3 million participants in Medicare Part D drug plans. The company’s Medicare business accounts for 70 percent of its revenue. So watch the plan as a bellwether for the impacts of these policy trends.
Humana has been making aggressive investments in the way it delivers care to seniors and integrates their medical services. It’s part of a broader effort to improve medical outcomes, and save money on medical costs. But these are long term investments that might not pay off in time to offset the near term cuts. That’s the problem with the way Washington budgets around healthcare. The year-to-year budget adjustments don’t provide enough opportunity for insurers to realize the savings from making longer-term investments in healthcare. If Humana’s Medicare business starts to shrink, or benefits get trimmed in noticeable ways, it will be a reflection of the recent cuts.
All of this begs the question why the private Medicare plans remain a target?
The original gripe that the Obama team had was that the MA plans were being paid more for each beneficiary that they covered than what the government spent on an average senior enrolled in traditional fee-for-service Medicare.
The math on this costs per-beneficiary estimate was always fuzzy. It baked in a lot of fungible assumptions. Nonetheless, Obamacare sanded away any perceived discrepancy, cutting more than $150 billion from these plans.
The net effect of all of these cuts is already expected to shrink the program. The Obama Administration is disproportionately shifting these cuts onto so-called Medicare “special needs” plans. These are Medicare Advantage plans that are specifically designed to enroll patients with certain serious and costly chronic illnesses like diabetes and heart disease. Many of these patients are low income, and dually eligible for both Medicare and Medicaid.
These SNP plans are paid more to effectively siphon these less healthy patients away from other Medicare schemes like Medicare’s fee-for-service program. The idea is that these specialized Medicare Advantage plans will be able to more closely manage these patients, reducing morbidity associated with chronic ailments, and in turn lowering costs to the Medicare program. There is evidence that this kind of focused health plan works to improve clinical outcomes, and reduce costs.
More than 1.5 million seniors were covered by about 500 of these plans in 2013. Avalere Health, a Washington-based health policy firm estimates that at least 13% of these plans will be eliminated as a result of the cuts.
The targeting of SNPs is illustrative of the incongruous nature of the President’s policies when it comes to Medicare Advantage. The White House has been using a “demonstration” project authorized under Obamacare to forcibly turn many of these same patients over to state-run healthcare programs. The states, in turn, are typically enrolling these seniors into the HMOs used by their Medicaid programs. It’s going to be hard to argue that low-income seniors with chronic medical problems will be better off in state-run Medicaid HMOs (getting the equivalent of a Medicaid benefit) than they were in the private Medicare SNPs.
The Obama demonstration program aims to improve the medical management of these seniors. But the SNPs were already doing the same thing that the states are now trying to figure out. And the SNPs are using managed care plans tailored to seniors, and not designed to serve state Medicaid programs. The effort to turn these seniors over to the states always looked like it was more about politics than sound healthcare — a backdoor scheme to cross subsidize state Medicaid programs with money from Medicare.
It can’t help but seem like the real aim of the successive cuts is to shrink the advantage program. Yet more than a quarter of Medicare beneficiaries enroll in the private Medicare Advantage plans. Many of these are low-income seniors who choose these options because they can’t afford the Medigap policies that richer seniors use to plug the increasing gaps in traditional, fee-for-service Medicare. The private Medicare Advantage plans typically have fewer out-of-pockets costs than traditional Medicare, eliminating the need to buy a costly, supplemental health plan.
The Obama team has made a warm embrace of managed care options when it comes to Obamacare and Medicaid. But for Medicare, they want to deny low-income seniors these options. All of the administration’s old arguments on why they resisted these private Medicare plans have been largely mooted, or never materialized. Only one possible reason remains prominent. It’s a Bush era program that sought to privatize aspects of this public program. And it will continue to be opposed largely on those grounds.
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For those not knowing that the Affordable Care Act is about huge cuts in health access for most people in order to make the health industry more profitable, the roll-out is showing people what they are losing. Medicare is being taken to the same tiered level of care you see on these state health exchanges and as we can see, Medicare and Medicaid will end as Federal programs and simply become part of these state systems of tiered access. Seniors needing care the most will now not be able to access important care if they cannot pay for the right health plan.
Obama Administration Issues New Rounds Of Cancer Care Cuts Amidst Healthcare Reform Chaos
Community Oncology Alliance gravely concerned over severe cuts to cancer care
Community Oncology Alliance December 18, 2013 12:29 PM
- WASHINGTON, Dec. 18, 2013 /PRNewswire/ --
- The Community Oncology Alliance (COA) issued a plea today to Congress to immediately stop the latest round of payment cuts the Obama Administration will make effective January 2014 to providing chemotherapy and other life-saving drugs to seniors with cancer. Additionally, COA called on Congress to stop the sequester cut to cancer drugs by passing the Cancer Patient Protection Act (H.R. 1416), a bill authored by Rep. Renee Ellmers (R-N.C.) and cosponsored by 109 representatives
The Centers for Medicare & Medicaid Services (CMS) recently announced Medicare fees for 2014, which include severe cuts to essential cancer care services. CMS will arbitrarily cut by 7.4% chemotherapy services payments to physician-run community cancer clinics — where close to 70% of the nation's cancer patients are treated — without any cost-based justification. At the same time, CMS will increase payment to hospitals by 29.9%. This is in direct opposition to the Medicare Payment Advisory Commission's recommendation in their June 2013 Report to Congress that CMS should be achieving payment parity for identical services, regardless of where those services are delivered.
"Our government has consistently and increasingly jeopardized this country's cancer care delivery system," said Dr. Mark Thompson, COA president and an oncologist at the Mark H. Zangmeister Center in Columbus, Ohio. "These latest payment cuts are bad medicine for cancer patients and taxpayers. They will further consolidate cancer care into large corporate medical systems and, in the process, inhibit patient access while increasing costs to patients and taxpayers."
RECENT REPORTS:
- A study by the actuarial firm Milliman found that Medicare pays $6,500 more per beneficiary annualized when chemotherapy is given in outpatient hospital facilities versus community cancer clinics, and each senior patient pays $650 more in out-of-pocket costs.
- A recent study by The Moran Company reveals that Medicare cancer patients receive more chemotherapy treatments with more expensive chemotherapy drugs in hospitals compared to community oncology clinics, resulting in chemotherapy costs that are as much as 47% higher.
- COA reported earlier this year that 469 community cancer clinics had merged into or affiliated with hospital systems and 288 cancer treatment facilities had actually closed over the past 6 years, especially in rural areas. This creates access problems when patients, particularly seniors, have to travel for cancer care.
"The sequester cut to cancer drugs is a wrecking ball to our cancer care delivery system," said Ted Okon, COA executive director. "To make matters worse, oncologists are being hit by insurers who are cutting them out of Obamacare exchange and Medicare Advantage networks, which recently happened en masse to 170 cancer care providers in Florida. In the midst of this chaos, CMS will reduce cancer care payments even further, with no rationale justification, and is simply driving up costs for Medicare and seniors. It doesn't make sense."
COA's official comment letter to CMS on the agency's 2014 fee schedule for cancer care services can be obtained here: http://www.communityoncology.org/COA-Comment-Letter.pdf
About Community Oncology Alliance (COA)
Community Oncology Alliance (COA) is a non-profit organization dedicated solely to community cancer care, where four out of five Americans with cancer are treated. Since its formation over a decade ago, COA has helped community cancer clinics navigate an increasingly turbulent environment by working together to become more efficient, advocating for their patients, and proactively providing solutions to Congress and policy makers. COA members have testified before both chambers of Congress, authored cancer care demonstration projects, and been instrumental in the passage of oral cancer drug parity legislation, among many other initiatives.
COA also leads a multi-stakeholder group that is developing and implementing an Oncology Medical Home (OMH) cancer care model and is advancing payment reform for cancer care. More information can be found at www.CommunityOncology.org.
The COA Patient Advocacy Network (CPAN) was created in 2010 to advocate for access to local affordable care for all cancer patients. More information can be found at www.COAadvocacy.org.
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WE ALL HEARD THAT THE ONLY PEOPLE THAT WENT TO JAIL FOR THE MASSIVE SUBPRIME MORTGAGE FRAUD WERE THE SMALL FRIES AT THE BOTTOM OF THIS SCAM......WELL, THIS PRIVATE CONTRACTING CORPORATIONS WILL DO THE SAME WITH ENTITLEMENT FRAUD....
We all want fraud and waste in the health care system be addressed as we have lost 1/2 of entitlement spending to fraud over a few decades.....trillions of dollars needing to come back. What Obama is doing is outsourcing Medicare now....private firms are creating these websites, below you see private contractors looking for fraud, and as Obama places Medicare on tiered levels of access, these ACOs will be in control of how Medicare funds are spent. No standard payment for all. This will of course create the same disparities as with any corporate operation and consumer service. The search for fraud for example will focus on individuals/mafia types of fraud and completely ignore the hundreds of billions being stolen by health institutions. I read an article on Medicaid fraud that had one of these private contractors saying they do not see much fraud when we know it is rampant. No doubt what these agencies will do is monitor doctors adherence to restricted levels of health care to deter any hippocratic oath caretakers.
ALL OF THIS IS REALLY , REALLY, REALLY BAD. REMEMBER, ALL THESE STRUCTURES BEING BUILT ARE ABOUT CONTAINING COSTS TO MAXIMIZE PROFITS. THEY ARE NOT ABOUT SAVING MEDICARE TRUSTS FROM BEING RAIDED BY CORPORATE FRAUD.
Sat, Jan 11, 2014, 11:31AM EST -
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Tommy G. Thompson, Former U.S. Secretary of Health and Human Services, Appointed Chairman of HealthcarePays, Inc. Board of Directors Thompson: Time is Now to Tackle Healthcare Fraud, Inefficiency, and Improve Transparency
HealthcarePays, Inc.
December 18, 2013 12:04 PM
- RICHMOND, Va., Dec. 18, 2013 /PRNewswire/ -- HealthcarePays (HCP) (@HealthcarePays), an industry-owned "payment network" designed to cut healthcare costs by effectively reducing waste and fraud, announces Tommy G. Thompson as a member of its board and its chairman.
HCP employs an industry-owned network for healthcare payment authorization and processing that is proprietary, standardized and compliant with the Affordable Care Act (ACA) and all state and federal laws. Employers, providers and insurance companies are joining HCP to combat waste and fraud, create efficiencies of healthcare payment processing and access industry-wide data cube analytics.
Thompson says he's joining HealthcarePays to combat the lack of cost transparency and rampant waste and fraud that are draining the U.S. healthcare system of hundreds of billions each year.
"There is little doubt that the future financial well-being of both the federal and state governments depends in, large part, on controlling healthcare payment inefficiencies," said Thompson. "It makes little sense that the U.S. has no overarching healthcare industry payment network to check for fraud and authorize payments by examining all the payments in the system, similar to what is in place in our financial services sector. I'm joining HealthcarePays to establish the first industry-owned network of this kind. The leaders in the areas of employers, health plans and governments are encouraged to join us in this unique opportunity to create healthcare accountability through payment automation."
Key healthcare accountability challenges include:
- The National Healthcare Anti-Fraud Association (NHCAA), a watchdog group, cites information from the FBI that anywhere between $70 billion and $234 billion is lost annually to healthcare fraud. (Source: Reuters/Huff Post Health News http://www.huffingtonpost.com/2011/04/13/health-care-fraud_n_848691.html)
- PricewaterhouseCoopers research found that wasteful spending in the health system has been calculated at more than half of all health spending. (Source: PricewaterhouseCoopers http://www.pwc.com/us/en/healthcare/publications/the-price-of-excess.jhtml)
- Only 10 percent of all healthcare claim payments are made electronically, in an industry that represents more than $2.7 trillion in annual healthcare spend, or 17.9 percent of the Gross Domestic Product (GDP). (Source: http://www.ushealthcareindex.org/resources/USHEINationalProgressReport.pdf and Source: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html)
HCP interacts with all existing healthcare industry organizations including employers, hospital systems, physician groups, insurance companies, government payers such as Medicaid and Medicare, intermediaries, clearinghouses and banks.
As Secretary of Health and Human Services and Governor of Wisconsin, Thompson became a champion for welfare and Medicare reform, and had a reputation for fighting for the federal funding needed to improve public health.
"Tommy is a visionary and has a long track record of accomplishments in health services," said HealthcarePays Chief Executive Officer Dave Adams. "He's been advocating for healthcare reform throughout his impressive career in public and private service. We are fortunate to have him as a leader and an evangelist for our cause to reduce healthcare costs in the U.S."
About Tommy G. Thompson
Tommy G. Thompson was the 42nd and longest serving Governor of the State of Wisconsin from 1987 to 2001. Thompson also served from 2001 to 2005 as the United States Secretary of Health and Human Services (HHS). Thompson has held numerous important posts including as Chairman of AMTRAK, Independent Chairman of the Deloitte Center for Health Solutions and served on the boards of various other publicly and privately held entities. Thompson has been called a "pioneer" for two landmark initiatives, the Wisconsin Works welfare reform and school voucher programs. During his time as HHS Secretary, Thompson provided key leadership in the post 9-11 environment, reorganizing HHS, increasing funding to the National Institutes of Health, increased the responsiveness of the Centers of Medicare and Medicaid and working through the backlog of waiver requests thereby providing health insurance to 1.8 million low income Americans.
About HealthcarePays
HealthcarePays (HCP) is an industry-owned "payment network" designed to cut healthcare costs. HCP, headquartered in Richmond, Virginia, with its technology group based in Carlsbad, California, provides a fast, secure, electronic network that simplifies and improves the healthcare payment system. HCP streamlines the movement of healthcare payments and filters such payments among providers, health plans, self-insured employers, government payers, intermediaries, clearinghouses and banks in the U.S. The secure network is highly efficient, cost effective and fully compliant with the Affordable Care Act and other state and federal laws.
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Headlines in all media says 'Good news, health costs going down'. Now, the public was led to believe that the ACA was about controlling health costs for the public, but as we are seeing controlling costs means limiting access to most people so health institutions are more profitable. Below we see the biggest winners Health Insurance Corporations and Big PHARMA. People now pay for insurance and then are kept from using it with co-pays and deductibles.
Insurance has no where to go but up as with all health care institutions because the ACA is about consolidation into global health systems and as we know when consumers come from all over the world.....only the affluent of the world will be able to afford most private insurance. While 80% of US citizens will be on Medicaid and Bronze plans both allowing mostly preventative care, when these insurance corporations expand overseas.....and that will happen fast.....the percentage not accessing much of health care will go to 90%. So, Affordable means that almost all Americans will be getting preventative care that is the cheapest health care to be had!
This is why Obama and neo-liberals put the policy of buying out of purchasing insurance so low initially and tying that penalty to the lowest cost of Bronze level insurance soon after....IT WILL TAKE ALL THE DISPOSABLE INCOME MOST PEOPLE HAVE JUST TO BUY THIS INSURANCE!
SCORE WALL STREET!!!!
Wall Street wouldn't be able to do all this without your neo-liberal incumbent!
Pharma & Healthcare
New Survey of Health Insurance Brokers: Private Health Plan Premiums Are Spiking. Now, Even The Fed Is Watching These Trends Get ready for even higher healthcare costs.
A new survey of health insurance brokers shows that commercial insurance rates are going to rise “significantly” in 2014.
The research team at investment bank Morgan Stanley surveyed 131 brokers, finding that December 2013 rates are rising in excess of 6% in the small group market, and 9% in the individual market.
The spike in the quarterly-reported rates for annual premiums on new or renewing contracts is being attributed to the continued implementation of Obamacare rules, as well as new Obamacare taxes and fees that are being assessed on plans this year.
The December 2013 rate hikes are the largest reported since Morgan Stanley’s research team first started conducting the quarterly surveys of brokers in 2010. In prior quarters, the average quarterly reported rate increases never rose above 3% over the preceding period.
On top of this, health plans are also predicting higher cost trends in 2014, after years of stabilization (much of it attributable to the economic downturn, which reduced medical utilization rates). These higher cost trends were also among the reasons health plans cited for their December rate increases.
According to the survey, Aetna and United are increasing insurance rates in excess of 10%. Commercial carriers such as United are already on record attributing the bulk of their increased healthcare costs to new, Obamacare-related provisions.
Among the states seeing the highest annualized rate hikes (for the full 2013 year) in the individual market are Connecticut, which is averaging a 37% increase; Florida (42%); Illinois (33%); Michigan (39%); and Minnesota (35%).
Among the states with the biggest annualized spike in the small group rates are Delaware, which is averaging a 35% increase; Michigan (30%); and Minnesota (50%).
These rate increases have broad implications. Federal Reserve Board Member Jeffrey Lacker said today that the Fed has its eye on these costs.
Lacker said that he expects a “lot of turmoil” in the healthcare industry, and that the Fed will be watching how Obamacare unfolds.
In a speech to the Greater Raleigh Chamber of Commerce this afternoon he said “I think the Affordable Care Act is something that we are watching very closely because it’s something that could well have a substantial economic impact.”
In other words: You can’t tap the average family by $2,000 or $3,000 in additional healthcare costs and not expect some macro impacts.
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Those people backing this reform often are the ones who are afraid that the coming baby boomer boom will implode the Medicare Trust and so think limiting access of low-income is a good idea. You had better look at how extreme these reforms will be in removing regulations and protections and handing all control to Wall Street in how health care is dished out. EVEN THOSE UPPER MIDDLE CLASS SHOULD BE OUTRAGED.
PUSH FOR EXPANDED AND IMPROVED MEDICARE FOR ALL AT NATIONAL AND STATE LEVEL!!!
While Obamacare Enrollment Continues to Lag, Labor Builds Support for Expanded and Improved Medicare for All
Posted: 12/30/2013 10:25 am
The 113th Congress will likely be remembered as the most unproductive in our history, and with an overall approval rating of 9 perent, it is safe to say that most Americans do not consider this bunch to be a noble group of public servants engaged in good works for the people of this country. It is rare that any member of Congress is honored on any level these days, but one truly worthy exception is Rep. John Conyers (D-MI), who early in December was honored with a breakfast celebration attended by some 40 union representatives at a restaurant on East 29th Street in New York City.
Those present included leaders from Actors Equity, The International Alliance of Theatrical Stage Employees (IATSE) and the New York City Central Labor Council (NYCCLC), whose President, Vincent Alvarez, declared his support for Mr. Conyers' bill HR 676, The Expanded and Improved Medicare for All Act, and promised to deliver their 1.3 million members to back this cause. This is a very significant development, as the 300 unions under the umbrella of the NYCCLC are made up of truck drivers, teachers, nurses, operating engineers, construction workers, janitors, train operators, electricians, fire fighters, retail workers and many more hardworking Americans who, along with everyone else in our nation, would benefit greatly from this revolutionary healthcare plan. They are the face of American labor today, and Mr. Alvarez spoke of the need for labor and the general public to unite and work together for this imperative cause: providing affordable, quality healthcare to all Americans.
We might recall that it was labor that gave us the middle class during the post World War II years as they worked to indeed lift all boats in that time of unprecedented prosperity. Can they lead our nation once again in this time of unprecedented need? They have been taking quite a beating, and have been decimated in several states by the lackeys of the 1 percent. But their values are America's values, and it is critical that they remain a vibrant force for change in this country.
Mr. Conyers was introduced by his longtime friend, TV talk show host Phil Donahue, and other speakers that morning included Robert Score, Recording-Corresponding Secretary of Local 1 of IATSE, and Stephen Shaff, speaking on behalf of Progressive Democrats of America. Mr. Conyers himself noted that it took him 15 years to move Congress to declare a national holiday for Dr. Martin Luther King, so he is prepared for a long haul to achieve Medicare For All. He has reintroduced HR 676 in every Congress since 2003, and has now garnered support from 54 other House members, along with an impressive 609 union organizations, including 146 Central Labor Councils/Area Federations and 44 State AFL/CIO's. Obamacare's failure to address the Taft Hartley Plans and the operating procedures under which they work could create even more union support for the Single Payer movement. The president must address this issue.
Meanwhile, support from the public also continues to build, as the warts on the ACA become more apparent and the questions about its viability grow louder on almost a daily basis. This will undoubtedly drag into the 2014 election and continue to send shock waves throughout the political world into the 2016 race for the White House, as the Conservatives will remain active in their attacks and continuing efforts to end Obamacare.
Following the breakfast, Mr. Conyers and his policy director Mike Darner met with 15 of his core Single Payer activist leaders from organizations like Physicians For A National Health Program and Healthcare-Now! -- as well as some doctors -- to discuss strategy and continue building the movement. This group is definitely in it for the long haul, too, as they have supported Mr. Conyers and his bill for years. This is a bill that would deliver all necessary health services at less than half the cost we pay now, eliminating co-pays, deductibles and co-insurance while providing long-term care -- including all of those expensive dental specialties. The estimated savings would be in the range of $592 billion a year. Better healthcare at lower costs -- what's not to like? And if you like your doctor, you actually could keep him or her -- did you hear that, Mr. President? You can also pick any doctor you like -- no more provider networks. These healthcare professionals would be able to become doctors once again, instead of a "provider" or "vendor," and we could become patients again, ending our dehumanizing role as a "consumer" or "customer."
Of late, we have been reading about Medicare For All from such luminaries as Robert Reich, Ralph Nader and William Greider in The Nation, among others. Even Bill Clinton mentioned it during President Obama's second campaign. If Hillary were to acknowledge that Medicare For All is the next logical step after Obamacare, she would gain tremendous support and a second opportunity to get the right healthcare plan in place for her presumed 2016 run for president. Unfortunately, Hillary has proven herself to be far from progressive on many issues in the past, so we will have to wait and hear from her what her healthcare plan actually is if she decides to run.
Meanwhile, in the past few weeks Vermont Senator Bernie Sanders and Rep. James McDermott (D-WA) -- who is also a doctor -- have both introduced Single Payer bills. Bernie's bill is a Medicare-for-All proposal known as the American Health Security Act of 2013 (S.1782), which would be administered by the states and transferable between states. The McDermott bill also moves the initiative outside of D.C., leaving it up to the states to develop their own plans based on their diversity and individual needs. As Massachusetts was the template for the ACA, it makes sense to finally introduce Single Payer on a state-by-state level.
Vermont has approval in both of its houses for a Single Payer plan, but it needs a waiver from the ACA to implement it in 2017. Can't the federal government speed up that process? There are also plans at the ready in New York and in Rep. McDermott's home state of Washington. And what of California, which has come so close in the past? One state can lead the country toward this monumental goal, the way Massachusetts did with the ACA. We just need to find the will.
In the Greider article in this month's The Nation, entitled "Reviving The Fight For Single Payer," he raises the question many of us ask: Can Obamacare deliver what it promised? One of the major problems he notes is that "...the reformed system will also still rely on the market competition of profit-making enterprises, including insurance companies." Rep. McDermott was interviewed for this article, and he pointed out another major flaw in the ACA: "In the long arc of healthcare reform, I think [the ACA] will ultimately fail, because we are trying to put business-model methods into the healthcare system. We're not making refrigerators. We're dealing with human beings, who are way more complicated than refrigerators on an assembly line."
Rep. McDermott - an advocate for Single Payer for decades - further wondered if hospitals will become "too big to fail" as they continue to merge and buy up private practices, and continue hiring younger doctors as salaried employees. Mr. Greider also made the following revelation: "An AMA survey in 2012 found the majority of doctors under 40 are salaried employees." Rep. McDermott sees the troubling direction of this trend, noting that many new doctors "...will simply be serfs working for the system," and Mr. Greider referred to another key point in the AMA research, noting that "...hospitals focus on employing primary-care physicians in order to maintain a strong referral base for high-margin specialty service lines." Mr. Greider added further insight from Rep. McDermott: "Big hospitals need a feeder system of salaried doctors, McDermott explained, to keep sending them patients in need of surgery or other expensive procedures." Even so, Rep. McDermott remains optimistic that stronger health care systems resembling Single Payer will spring up moving forward.
The New York Daily News offered a scathing editorial on December 24th entitled "Can This Patient Be Saved?" in which we were given a blow-by-blow analysis of the devastatingly mishandled rollout of the Obamacare exchanges and the problems millions of Americans have been having signing up for them. The situation was so bad that the deadline was extended until Christmas Eve for those to sign up who wanted their insurance to kick in on January 1, 2014. The CBO projects seven million will sign up in 2014, in addition to the about 1.1 million this year -- well below the Administration's projections. Meanwhile, millions will be losing their current plans due to the mandate. The question of more people losing their insurance than gaining it as a result of the president remaking the "healthcare economy" was also raised in this Op Ed piece.
Key provisions of the bill have already been waived in the past three years since its passage, and an additional postponement of the requirement for companies with fifty or more employees to offer health insurance or pay a tax penalty has now been postponed until 2015.
The individual mandate requiring most Americans to find coverage by April is also waiving penalties for those who had insurance and lost it this year. Most glaring in this critical article is the fact that there is "little reliable" information on who is getting what as far as coverage is concerned, and at what cost. The even larger question is, will those younger and healthier people opt in at all? If not, financially this boondoggle will sink. Obamacare is counting on them.
As the tinkering continues on the ACA, a major architect of this mess has just been rewarded by the president with an ambassadorship offer to China. Senator Baucus, do you not know the meaning of the word "retire?"
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This says it simply. National Physicians tries to be diplomatic with ACA by stating a few helpful issues addressed, but if you look closely they are not even really addressed. Shout out to your national pols and your local ones.....ALL OF MARYLAND POLS VOTED FOR THIS PRIVATIZED NIGHTMARE. Maryland has some Expanded and Improved Medicare for All groups to join!
Medicare for All
We Demand: Medicare for All. Pass H.R. 676, the Expanded and Improved Medicare for All Act.
Whether healthcare is a “right” is a meaningless abstraction. It is an urgent necessity, for lack of which many Americans suffer and die needlessly. Public health insurance must be expanded and made available to all Americans, regardless of age, income or health.
The debate over “Obamacare” (The Affordable Care Act) has been misrepresented on both sides. Supporters claim it makes coverage universal, failing to mention its failures to contain costs or protect Medicare. Critics call it “rationed care,” failing to justify the more egregious rationing by private insurers.
Obamacare does contain several components which are highly valuable to the American people – including the mandate to insure without prejudice those with pre-existing conditions, and the new insurance exchanges. Wall Street and the GOP are eager to destroy the act on this basis alone. Anything that is good for the American people is bad for Wall Street.
However, Obamacare represents a continued bailout of the private insurance industry. Rather than expanding public programs, it offers public subsidy for private insurance, forces uninsured individuals to buy private insurance, and fails to control costs or defend Medicare, America's only truly public insurance program.
What we demand is not mere “universal coverage,” but a system that is affordable and available to all, without regard for the profit motive of the private insurance industry. The only system that fits the bill is to expand and improve Medicare for all Americans.
Quick facts*
- Administrative costs – including underwriting, advertising and executive/shareholder compensation – consume 31% of US health spending.
- Simply eliminating these costs (over $350 billion annually) would create enough revenue to cover all uninsured Americans.
- “Single-payer” systems like that in Canada operate at far lower costs per capita, and provide better access to health care and better health outcomes than in the US.
- Taxes already pay for over 60% of US health spending, with business paying less than 20%.
Our Demand
- Medicare for All. Pass H.R. 676, the Expanded and Improved Medicare for All Act.
- Universal, comprehensive coverage
- A single national insurance plan with regional administration
- Free choice of providers
- No out-of-pocket payments
- Funding will come from a modest, progressive payroll tax, supplemented by revenue from a 1% Wall Street Sales Tax
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