IN RESPONSE TO:
Should Obama's Health Care Be Opposed?: An Exchange from the June 7, 2012 issue
To the Editors:
In Marcia Angell’s critique of Ronald Dworkin’s article about the Affordable Care Act’s mandate to buy health insurance, she advocates for replacing the ACA with a single-payer system [“Should Obama’s Health Care Be Opposed?,” NYR, June 7]. In his rebuttal to her letter, Dworkin states that “even Senator Edward Kennedy, who was among the most powerful advocates of a single-payer system, long ago abandoned all hope of achieving it.” That is not quite correct.
I was the first physician Senator Kennedy hired as an adviser on health care. I served on his staff between 1971 and 1976 and continued to advise him on matters of health policy until his death in 2009. Although Senator Kennedy was acutely (and painfully) aware of the political obstacles that stood in the way of passing legislation expanding Medicare to eventually cover the entire American population, he nonetheless continued to believe it would be the best policy. On April 25, 2007, and over the objections of some on his staff at the time, he (together with Congressman John Dingell) introduced a bill that would do just that.
To the end, Senator Kennedy believed in going for the best.
Philip Caper, MD
Brooklin, Maine
Brooklin, Maine
Jeff Madrick, whom Ronald Dworkin cited as a source, replies:
As Dr. Caper writes, Senator Kennedy always believed that a single-payer system was the best way to achieve adequate health care for all Americans. Not only did he sign onto the Dingell bill, he also reiterated his support of Medicare for all in his book, America Back on Track, which I helped write.
MONDAY, AUGUST 20, 2012
The Romney-Ryan Medicare Plan Compared to the Obama Medicare Plan—Who’s Telling the Truth on Medicare?
They both are and they both aren’t.
I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare.
As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for the press to try to make sense of it.
This blog post is quite long because the subject matter is complicated. If you want to cut to the chase, see my conclusion and summary at the end of this post.
Allow me to list a few of the questions people are asking and give you my take on it.
I’ve never seen a week in health care policy like last week. The media reports have to be in the thousands, all trying to make sense of the furious debate between Obama and Romney over Medicare.
As someone who has studied this issue for more than 20 years, it has also been more than exasperating for me to watch each side trade claims and for the press to try to make sense of it.
This blog post is quite long because the subject matter is complicated. If you want to cut to the chase, see my conclusion and summary at the end of this post.
Allow me to list a few of the questions people are asking and give you my take on it.
MaineCare to warn recipients it plans to cut their benefits
Posted Aug. 20, 2012, at 7:30 p.m.
AUGUSTA, Maine — The Department of Health and Human Services is preparing to notify some Mainers who are expected to lose their health insurance coverage under Medicaid soon.
Come Oct. 1, thousands of Mainers are slated to lose benefits under MaineCare, the state’s Medicaid program, through controversial cuts aimed at balancing the budget that have fiercely divided lawmakers this year.
Democrats and Republicans agreed on one cut, however, that tightens income limits for about 12,000 parents who are on MaineCare. Lawmakers voted earlier this year to change the threshold at which residents qualify for MaineCare from 200 percent of the poverty level to 133 percent. For a family of four, that’s a change from a threshold of $46,100 in income a year to $30,657 a year.
“We will be shortly sending out a notice to consumers who are affected by the eligibility change from 200 percent to 133 percent for the parents,” DHHS Commissioner Mary Mayhew told members of the Legislature’s Appropriations Committee on Monday. “It is all subject to federal approval, so the notice will continue to reference that.”
Medicaid is run jointly by the state and federal governments.
Rep. John Martin, D-Eagle Lake, said he worried that recipients due to lose coverage will be confused unless the letter makes clear that the cut won’t take effect without a green light from the feds.
“We might as well get ready for the phone calls when they get the letters because people will not understand,” he said.
Mayhew said DHHS will carefully draft the letter to avoid confusion and make staff available to answer any questions.
“We are equally concerned about the sensitivity to how that letter is interpreted,” she said. “We are also concerned about not providing adequate notice.”
Sen. Richard Rosen, R-Bucksport, the committee’s co-chairman, pointed out that the panel unanimously approved the cut earlier this year.
Any changes the state makes to the MaineCare program must pass federal muster and comply with President Barack Obama’s federal health reform law.
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