Nobel Prize Winner "Terrified" of McCain's Health Plan
Annie Birdsong
of McCain's Health Plan
"McCain's plan would do for health care what deregulation
has done for banking. And I'm terrified," said Paul Krugman,
winner of the 2008 Nobel Prize in Economics, in a New
York Times editorial.
Here are selected quotes from the New York Times article:
"Conservative Republicans still hate Medicare, and would kill it
if they could - in fact, they tried to gut it during the Clinton
years (that's what the 1995 shutdown of the government was
all about). But so far they haven't been able to pull that off.
"So John McCain wants to destroy the health insurance of
nonelderly Americans instead.
"Most Americans under 65 currently get health insurance
through their employers. That's largely because the tax code
favors such insurance: your employer's contribution to
insurance premiums isn't considered taxable income, as
long as the employer's health plan follows certain rules. In
particular, the same plan has to be available to all employees,
regardless of the size of their paycheck or the state of their health.
"This system does a fairly effective job of protecting those
it reaches, but it leaves many Americans out in the cold.
Workers whose employers don't offer coverage are forced
to seek individual health insurance, often in vain. For one
thing, insurance companies offering "nongroup" coverage
generally refuse to cover anyone with a pre-existing medical
condition. And individual insurance is very expensive,
because insurers spend large sums weeding out "high-risk"
applicants - that is, anyone who seems likely to actually
need the insurance. ... Mr. McCain ... wants to blow up
the current system, by eliminating the tax break for
employer-provided insurance. And he doesn't offer a
workable alternative.
"Without the tax break, many employers would drop their
current health plans. Several recent nonpartisan studies
estimate that under the McCain plan around 20 million
Americans currently covered by their employers would
lose their health insurance."
!!!!PLEASE EMAIL THIS TO PEOPLE IN YOUR CHURCH
AND OFFICE!!!
Read the entire article in the New York Times:
Health Care Destruction
Oct.6, 2008
http://www.nytimes.com/2008/10/06/opinion/06krugman.html
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From the Associated Press:
GENEVA -- "Nobel Prize-winning economist Paul Krugman
believes universal health care may soon become an accepted
feature of American life.
"In an interview with the Bulletin of the World Health Organization,
the Princeton University professor says the U.S. has retirement
and social security systems that are ''in some ways more comprehensive''
than many European countries.
"He says Americans would find universal health care inconceivable
to live without once they see the benefits of a good plan."
----------------------------------------------------------------------------
Senator Edward Kennedy, D-Mass., the great lion of the Senate who
is undergoing treatments for a malignant brain tumor, is working
on a universal health insurance program for the country that he plans
to introduce in January when the new Congress meets.
He wants to entend Medicare to all citizens. As chairman of the Senate
Health, Education, Labor and Pensions Committee, he recently held
a hearing with 10 speakers on how to make health insurance more affordable.
Senator Barack Obama, who was endorsed by Kennedy, wants to offer
American citizens the option of purchasing the same public plan enjoyed
by the Senate, which is nonprofit insurance.
Send democrats and we may fix our health insurance problems!
-----------------------------------------------------------------------
Below is a congressional testimony on the need for a single-payer
health insurance (single-payer) by the former editor of the New England
Journal of Medicine, Dr. Marcia Angell:
--------------------------
This is the summary. The United States spends more
than twice as much on health care as the average of
other developed nations, all of which boast universal
coverage. Yet, over 42 million Americans have no health
insurance whatsoever and most others are underinsured
in the sense that they lack adequate coverage for all
contingencies; for example, long-term care or prescription
drug benefits. Why is the United States so different?
The short answer is that we alone treat health care as
a commodity, distributed according to the ability to
pay, rather than as a social service to be distributed
according to medical need.
In our market-driven system, investor owned firms compete,
not so much by increasing quality or lowering costs, but
by avoiding unprofitable patients and shifting costs back
to patients or to other payers. This creates the paradox
of a health care system based on avoiding the sick. It
generates huge administrative costs which, along with
profits, divert resources from clinical care to the
demands of business.
In addition, burgeoning satellite businesses, such as
consulting firms and marketing companies, consume an
increasing fraction of the health care dollar. We endorse
a fundamental change in America's health care. The
creation of a comprehensive national health insurance
program, or NHI. Such a program which, in essence,
would be an expanded and improved version of Medicare,
would cover every American for all necessary medical
care. Most hospitals and clinics would remain privately
owned and operated, receiving a budget from the NHI to
cover all operating costs. Investor owned facilities
would be converted to not-for-profit status and
their former owners compensated for past investments.
Physicians could continue to practice on a fee-for-service
basis or receive salaries from group practices, hospitals
or clinics.
A national health insurance program would save at
least $150 billion annually by eliminating the high
overhead and profits of the private investor owned
insurance industry, and reducing spending for marketing
and other satellite services. Doctors and hospitals would
be freed from the concomitant burdens and expenses of
paperwork created by having to deal with multiple
insurers with different rules, often rules designed to
avoid payment.
During the transition to an NHI, the savings on
administration and profits would fully offset the
costs of expanded and improved coverage. NHI would
make it possible to set and enforce overall spending
limits for the health care system, slowing cost growth
over the long run.
A national health insurance program is the only
affordable option for universal, comprehensive
coverage. Under the current system, expanding
access to health care inevitably means increasing
costs, and reducing costs inevitably means limiting
access. But an NHI could both expand access and
reduce costs. It would squeeze out bureaucratic
waste and eliminate the perverse incentives that
threaten the quality of care and the ethical
foundations of medicine.
Now I'd like to take a few minutes to expand on
some of the points in the summary I just read and, in
particular, to respond to some of the arguments often
made against a national health insurance program.
As stated in the summary, Americans have the most
expensive health care system in the world. We
spend on average twice as much per person as other
developed nations, and that gap is growing. That's
not because we're sicker or more demanding. Canadians,
for example, see their doctors more often than we
do and spend more time in the hospital. And it's not
because we get better results. By the usual measures
of health, life expectancy, infant mortality,
immunization rates, we do worse than most
other developed countries.
Furthermore, we're the only developed nation that
does not provide comprehensive health care to all
its citizens. Over 42 million Americans are uninsured
disproportionately, the sick, the poor and minorities.
And most of the rest of us are underinsured, even
while we sometimes receive far more of certain kinds
of health care than we need.
In sum, our health care system is outrageously
expensive, yet inadequate and inequitable. Why?
The only plausible explanation is that there's something
about our system, about the way we finance and
deliver health care, that's enormously inefficient.
We simply don't get our moneys worth. In my view, and
that of many other critics of our system, the underlying
problem is that we treat health care like a market
commodity instead of a social service.
UNIDENTIFIED MAN: There you go.
DR. ANGELL: Health care is targeted, not to
medical need, but to the ability to pay. Now markets
are good for many things, but they're not a
good way to distribute health care. Let's look for a
moment at how the health care market really works.
Most Americans receive tax free health benefits from
the employers who pay insurers a portion of the premiums,
but not all employers offer benefits. It's strictly
voluntary. And when they do, the benefits may not
be comprehensive. Higher salaried workers are more
likely to be covered and the coverage is better. About
one in five workers, mainly those with low salaries,
turn down health benefits because they can't afford to pay
their share of the premiums.
The insurance companies with whom employers do business
are mostly investor-owned, for profit businesses,
that first appeared on the scene 10 to 20 years ago
when the managed care market opened up. They tried to
keep premiums down and profits up by stinting on medical
services. In fact, the best way for insurers to
compete is by not insuring high risk patients at all;
limiting the coverage of those they do insure, for
example, by excluding expensive services such as
heart transplantation, and by passing costs back to
patients by denying their claims, or its deductibles
and co-payments.
We are the only nation in the world with a health
care system based on dodging sick people. These
practices are collectively called cost shifting
and they add enormously to overhead costs because
they require a great deal of paperwork. They also
require creative marketing to attract the
affluent and healthy, and avoid the poor and sick.
Not surprisingly, the United States has by far the
highest overhead costs in the developed world.
It's instructive to follow the health care dollar
as it wends its way from employers toward the
doctors and nurses and hospitals that actually
provide the medical services.
First, private insurers regularly skim off the top
a substantial fraction of the premiums, anywhere
from 10 to 30 percent, for their administrative
costs, marketing and profits. The remainder of
the health care dollar is then passed along a
veritable gauntlet of satellite businesses that have
sprung up around the health care industry. These
include brokers to cut deals, disease management
and utilization review companies, drug management
companies, legal services, marketing consultants,
billing agencies, information management firms, and
so on and so on. They, too, skim off a portion of
what they get for administrative costs, marketing and
profits.
It's been estimated, no one knows for use, but it's
been estimated that no more than 50 cents of the
health care dollar actually reaches the providers,
who themselves have high overhead costs to deal with
the requirements of multiple insurers, often bent
on avoiding payment.
One final comment on the inappropriateness of the
market for delivering health care and controlling
costs. Markets are meant to expand, not to contract.
When the seller of a consumer good, like VCRs,
lowers prices, it's only with the intention of
increasing volume. And yet, we say we want the
health care market to contract. That's simply not what
successful markets do.
Now compare all that with the national program
we're advocating today. This program is the very
sole of simplicity and efficiency compared with our
private health care system. In many ways, it
would be tantamount to extending Medicare to
the entire population. Medicare is the most efficient
part of our health care system. Many people don't
know that, but it's the most efficient part of our
health care system, with overhead costs of less
than 3 percent. It covers virtually everyone over
the age of 65, not just some of them. Medicare
is not perfect, but it's by far the most
popular part of the U.S. health care system, as
evidenced by the resistance of Medicare
beneficiaries to any changes.
Not what are the usual objections to the sort
of program we're calling for today? They are
mostly based on a number of myths, which I'll review
briefly. Myth number one is that we can't afford
a national health care system. My answer is that
we can't afford not to have one. Our costs are
exorbitant, premiums are once again rising at double
digit rates, and the number of uninsured will
undoubtedly swell with the softening of the economy.
We're headed for a crisis in health care. Professor
Norris (?) is correct on that.
A single payer system would be far more cost effective,
since it would eliminate excess administrative costs,
profits, cost shifting and unnecessary duplication.
Furthermore, it would be permit the establishment of
an overall budget and the fair and rational distribution
of resources. We should remember also that we now pay
for health care in multiple ways: through our
paychecks, the prices of goods and services,
taxes at all levels of government, and out-of-pocket.
It makes more sense to pay just once. The most
progressive way is to an earmarked health
care tax on income.
According to myth number two, innovative technologies
would be scarce under a single payer system. We would
have long waiting lists and maybe rationing. This
misconception is based on the fact that there are
indeed waits for elective procedures in some countries
with national health systems, such as the UK and Canada.
But that's because they spend far less than we do
on health care. The UK, for example, spends about a
third of what we do per person. If they were to put
the same amount of money as we do into their systems,
there would be no waits and all their citizens
would have immediate access to all the care they need.
For them, the problem is not the system, it's the
money. For us, it's not the money, it's the system.
There's plenty of money already there.
Myth number three is that a single payer system
amounts to socialized medicine, which would
subject doctors and other providers to onerous
bureaucratic regulations. But, in fact, although
a national program would be publicly funded, providers
would not work for the government. That's currently the
case with Medicare, which is publicly funded but
privately delivered. As for onerous regulations,
nothing could be more onerous, both to patients and
providers, than the multiple intrusive regulations, the
micro-management imposed on them by the private
insurance agencies-companies. Indeed, many doctors,
and you see many of us here, who once opposed a
single payer system are now coming to see it as a far
preferable option.
Myth number four says that the government can't do
anything right. Some Americans like to believe
that, or say it, without thinking of all the ways in
which government functions very well indeed, and
without considering the alternatives. I had a
very conservative uncle who once asked me,
rhetorically, to name three things the government
does well. I said the NIH, the National Park
Service and the IRS, at least in that era. I might
also have added Medicare which, as I've said, is
far better at funding health care than the private
sector.
We should remember too, that the government is elected
by the public and is accountable to the public. An
investor owned insurance company, in contrast, reports
to its owners, not to the public.
A fifth and final myth is that a single payer system
is a good idea, but politically unrealistic. Now
that is a self-fulfilling prophesy. In my opinion,
the medical profession and the public would be
enthusiastic about a single payer system if the
facts were known and the myths dispelled. Yes,
there would be powerful special interests opposing
it, and I don't underestimate them, but with
courageous leadership and the support of the medical
profession and the public, I believe there's nothing
unrealistic about a national health insurance program.
There's no question in my mind that a national
program is the only way to provide universal,
comprehensive care, while providing a mechanism to
control costs. If we were to put the money we now
spend into such a system, Americans would have
the very best health care in the world. I want
to mention one final and very important reason
for enacting a national health program. We live
in a country that tolerates enormous disparities
in income, material possessions, and social
privilege. That may be an inevitable consequence
of a free market economy. But those disparities
should not extend to denying some of our citizens
certain essential services because of their income
or social status.
One of those services is health care. Others are
education, clean water and air, equal justice,
and protection from crime. All of which we already
acknowledge are public responsibilities. We need
to acknowledge the same thing for health care.
Providing these essential services to all
Americans, regardless of who they are, helps
insure that we remain a decent, cohesive and
optimistic country. It says that when it comes
to vital needs we are one community, not 280
million individuals competing with one another.
And seeking to ensure adequate health care for
all our citizens, we have an opportunity today to
reassert that we are indeed a single nation.
Thank you.
REP. KUCINICH: Congressman Conyers just said
that's the best summary that he's ever heard
in his life and I think that many of us would agree.
Thank you, thank you, thank you. I would ask that
the Gentlelady, and all of those who have testified,
provide this panel with copies of your remarks.
One of the things we can do is to make sure that
it's inserted in the Congressional Record and we
will do that.
"Annie Birdsong" <an...@anniebirdsong.com> wrote in message
news:zYidnbfn1YFswJHU...@cavtel.net...
> "McCain's plan would do for health care what deregulation
> has done for banking. And I'm terrified," said Paul Krugman,
> winner of the 2008 Nobel Prize in Economics, in a New York Times
> editorial.
> Here are selected quotes from the New York Times article:
>
> "Conservative Republicans still hate Medicare, and would kill it
> if they could - in fact, they tried to gut it during the Clinton
> years (that's what the 1995 shutdown of the government was
> all about). But so far they haven't been able to pull that off.
>
> "So John McCain wants to destroy the health insurance of
> nonelderly Americans instead.
>
> "Most Americans under 65 currently get health insurance
> through their employers. That's largely because the tax code
> favors such insurance: your employer's contribution to
> insurance premiums isn't considered taxable income, as
> long as the employer's health plan follows certain rules. In
> particular, the same plan has to be available to all employees,
> regardless of the size of their paycheck or the state of their health.
>
> "This system does a fairly effective job of protecting those
> it reaches, but it leaves many Americans out in the cold.
> Workers whose employers don't offer coverage are forced
> to seek individual health insurance, often in vain. For one
> thing, insurance companies offering "nongroup" coverage
> generally refuse to cover anyone with a pre-existing medical
> condition. And individual insurance is very expensive,
> because insurers spend large sums weeding out "high-risk"
> applicants - that is, anyone who seems likely to actually
> need the insurance. ... Mr. McCain ... wants to blow up
> the current system, by eliminating the tax break for
> employer-provided insurance. And he doesn't offer a
> workable alternative.
>
> "Without the tax break, many employers would drop their
> current health plans. Several recent nonpartisan studies
> estimate that under the McCain plan around 20 million
> Americans currently covered by their employers would
> lose their health insurance."
>
>
> Read the entire article in the New York Times:
> Health Care Destruction
> Oct.6, 2008
> http://www.nytimes.com/2008/10/06/opinion/06krugman.html
>