Health Care Reform Articles - March 10, 2014

Maine Medical Association survey shows 64 percent support single payer

Membership survey shows strong support for a Medicare for All, single-payer approach to reform

By Maine Medicine Weekly Update editors
Maine Medicine Weekly Update, March 10, 2014
A recent survey of Maine Medical Association (MMA) members showed an increase in the percentage of members supporting a single payer approach to health system reform. The survey, completed by more than 450 respondents included the following question:
"When considering the topic of health care reform, would you prefer to make improvements to the current public/private system or a single-payer system such as a 'Medicare for all' approach?"
Sixty-four and three tenths percent (64.3%) of respondents indicated that they preferred the single-payer option compared to the alternative "Improvements to the current public/private system" which garnered support from 35.7% of those respondents who answered the question.  The nearly two-thirds who indicated the single-payer preference represents an increase from the previous membership survey in 2008 in which just over half (52.3%) indicated preference for the single-payer option while 47.7% preferred improvements to the current system.
The question presented was worded precisely the same in each of the surveys.
In the recent survey, conducted in January, there was little to no difference in response to the question based upon age, geographic location, or MMA membership status. There was, however, a significant difference based upon specialty with primary care physicians and psychiatrists tending to more heavily favor the single-payer option than physicians in other medical specialties. Respondents from practices that were owned by the physicians themselves were less likely to prefer the single-payer option and more likely to prefer improving the current system.
The survey had a total of 462 respondents of whom 85% were physicians and 15% were medical students. 87% of the respondents were MMA members. The respondents make up approximately 13% of MMA members. The survey was conducted by Crescendo Consulting Group in Portland on behalf of MMA as part of the Payment Reform grant awarded by the Maine Health Access Foundation. The survey was also requested by a group of members who presented a Resolution at the 2013 Annual Meeting asking for the survey to be updated from 2008.
More details of the survey will be placed on the Association's website at www.mainemed.com by the end of this week.
While the survey demonstrates strong support for a single-payer system by those members who responded to the survey, MMA's formal policy position on health system reform, developed originally in 2003 and updated in 2010, is in support of universal coverage for all Mainers to be achieved through a combination of public and private health plans.

http://www.pnhp.org/print/news/2014/march/maine-medical-association-survey-shows-64-percent-support-single-payer

Little-Known Health Act Fact: Prison Inmates Are Signing Up

By ERICA GOODEMARCH 9, 2014

In a little-noticed outcome of President Obama’s Affordable Care Act, jails and prisons around the country are beginning to sign up inmates for health insurance under the law, taking advantage of the expansion of Medicaid that allows states to extend coverage to single and childless adults — a major part of the prison population.

State and counties are enrolling inmates for two main reasons. Although Medicaid does not cover standard health care for inmates, it can pay for their hospital stays beyond 24 hours — meaning states can transfer millions of dollars of obligations to the federal government.

But the most important benefit of the program, corrections officials say, is that inmates who are enrolled in Medicaid while in jail or prison can have coverage after they get out. People coming out of jail or prison have disproportionately high rates of chronic diseases, especially mental illness and addictive disorders. Few, however, have insurance, and many would qualify for Medicaid under the income test for the program — 138 percent of the poverty line — in the 25 states that have elected to expand their programs.

Health care experts estimate that up to 35 percent of those newly eligible for Medicaid under Mr. Obama’s health care law are people with histories of criminal justice system involvement, including jail and prison inmates and those on parole or probation.

“For those newly covered, it will open up treatment doors for them” and potentially save money in the long run by reducing recidivism, said Dr. Fred Osher, director of health systems and services policy for the Council of State Governments Justice Center.

He added that a 2009 study in Washington State found that low-income adults who received treatment for addiction had significantly fewer arrests than those who were untreated.

In Chicago, inmates at the Cook County Jail are being enrolled in Medicaid under the health care law as part of the intake process after they are arrested; the county has submitted more than 4,000 applications for inmates since Jan. 1.

http://specialprojects.pressherald.com/aging/part-3-larry-roy-the-long-goodbye/

Liberty, Equality, Efficiency

MARCH 9, 2014

Most people, if pressed on the subject, would probably agree that extreme income inequality is a bad thing, although a fair number of conservatives believe that the whole subject of income distribution should be banned from public discourse. (Rick Santorum, the former senator and presidential candidate, wants to ban the term “middle class,” which he says is “class-envy, leftist language.” Who knew?) But what can be done about it?

The standard answer in American politics is, “Not much.” Almost 40 years ago Arthur Okun, chief economic adviser to President Lyndon Johnson, published a classic book titled “Equality and Efficiency: The Big Tradeoff,” arguing that redistributing income from the rich to the poor takes a toll on economic growth. Okun’s book set the terms for almost all the debate that followed: liberals might argue that the efficiency costs of redistribution were small, while conservatives argued that they were large, but everybody knew that doing anything to reduce inequality would have at least some negative impact on G.D.P.

But it appears that what everyone knew isn’t true. Taking action to reduce the extreme inequality of 21st-century America would probably increase, not reduce, economic growth.

Let’s start with the evidence.

http://www.nytimes.com/2014/03/10/opinion/krugman-liberty-equality-efficiency.html?hp&rref=opinion

Compromise moves New Hampshire closer to Medicaid expansion

By Reid Wilson, The Washington Post

Posted March 09, 2014, at 11:26 a.m.

After months of negotiations, the New Hampshire Senate voted last week to expand Medicaid to cover as many as 50,000 low-income residents, using tens of millions of dollars in federal aid.

About 12,000 residents who would qualify for coverage would be given subsidies to pay for insurance through their employers. Thousands more would receive subsidies to buy private insurance through the state’s health care exchange.

If the bill becomes law, the state would seek a waiver from the U.S. Department of Health and Human Services to implement the modified program. HHS has granted preliminary permission to several other states that sought to implement similar programs rather than expand Medicaid to cover those who earn less than 138 percent of the federal poverty level.

The proposed legislation expanding Medicaid expires at the end of 2016, when the amount of federal money covering the state’s costs decreases from 100 percent to 90 percent. Senate President Chuck Morse, a Republican, told the Concord Monitor he was unwilling to allow New Hampshire to cover the remaining 10 percent because he didn’t think the state could afford the cost.

In a recent interview, Gov. Maggie Hassan, a Democrat, said the political cover that the compromise affords to Republicans was key to getting a deal done.

“What was important to conservatives was that we not permanently expand Medicaid,” Hassan said. “Our goal was to get people covered as quickly as possible.”

Seven Republicans voted with 11 Democrats on Thursday to pass the compromise, 18-5. The measure will be sent back to the state House of Representatives, which is controlled by Democrats. The House passed a straight expansion of Medicaid last year and is likely to rubber-stamp the Senate compromise.

http://bangordailynews.com/2014/03/09/politics/compromise-moves-new-hampshire-closer-to-medicaid-expansion/print/

Letter to the editor: Every person has a right to health care

Health care is a human right. This means that simply by being born human – and nothing more – all of us are entitled to resources so we can sustain our health and achieve a humane quality of life.

Part of what makes health care as a human right such a powerful notion is that it does not produce one definition of what “health” means and it applies uniformly to everyone.

Instead, this belief embraces the diversity of all bodies and minds, with their unique possibilities and challenges. It rejects the notion that any human being is disposable.

The question of whether or not our state will accept federal funds for MaineCare expansion simultaneously poses a bigger question: Do we believe that every person’s life possesses value and everyone’s health ought to be protected?

The Southern Maine Workers’ Center, a coalition member of the statewide Health Care is a Human Right campaign, answers: Yes – whether we are holding down two or three part-time jobs that do not offer health benefits, or we are no longer physically able to work due to an injury or illness, or we are doing the crucial work of child-rearing and nursing our loved ones, or we are struggling to meet basic needs while living below the poverty line.

MaineCare expansion will not solve all the problems of our profit-driven health system. Only a truly universal, publicly funded system can do that.

However, by seizing this crucial opportunity to secure access to care for some of our most vulnerable neighbors, we progress toward being a state that respects the value of every Mainer’s life.

Cait Vaughan

member, Health Care is a Human Right Committee, Southern Maine Workers’ Center

Portland

http://www.pressherald.com/opinion/letters/Letter_to_the_editor__Every_person_has_a_right_to_health_care.html?searchterm=letters+to+the+editor