Single-payer health plan in Maine would benefit everyone
By William D. Clark, M.D.
Portland (Maine) Press Herald, Letters, Sept. 30, 2014
Portland (Maine) Press Herald, Letters, Sept. 30, 2014
Steve Mistler’s Sept. 17 article “Number of Mainers without health insurance rose 9 percent in 2013″ notes Maine is one of two states with “a rise in the number of people without health insurance from 2012 to 2013.” Thus, Maine’s uninsured comprise “147,000, or 11.2 percent of the state’s population.”
Mistler reports tactical comments from gubernatorial candidates. No one mentions covering every Maine person with a fair and economical single-payer plan. Can Maine accomplish single-payer, and who would benefit?
- People benefit. Everyone is covered from birth to death – period. No premiums, no searching for the “right” coverage. No bankruptcy when hit by a car or cancer. Health outcomes improve.
- Employers benefit. They escape from the tension between insurer negotiations and worker benefits versus salaries, and create more Maine jobs.
- Health care providers benefit. Physicians reclaim their mission of healing. Hospitals and all providers get simple billing, prompt payment and fewer “authorization” hassles. Dramatic discrepancies in physician salaries disappear, but all make a decent living.
- Maine benefits. Maine creates a patient care-oriented system, and more clinicians choose primary care. No Medicaid hassles, and no “hidden tax” to cover the uninsured. First-year savings of $1 billion (as estimated by health care policy expert Dr. William Hsiao, who testified before the Legislature in 2010) bolsters Maine’s economy.
Maine could accomplish this. The Affordable Care Act allows states to insure their people if they provide coverage at least as comprehensive as ACA benefits, beginning in 2017. Everyone pays Maine a tax on income – when well, not when sick.
Decades of tweaking our profit-oriented system have failed, and our recent tweak drives people crazy and sends billions to insurance companies. They return useless paperwork while maximizing profits. Trying to reward competition excluded 147,000 Mainers and made the ACA prohibitively expensive and dauntingly complex.
Dr. William D. Clark resides in Woolwich.
Obamacare 2.0
by Senator Bernie Sanders
The Affordable Care Act has made modest improvements in American health care since it took effect. Twenty million Americans have gained insurance under the law, including young people who can stay on their parents’ policies and others who may no longer be denied insurance because of pre-existing conditions. The law also has expanded access to primary care to some 4 million more Americans through community health centers that also provide dental care, low-cost prescription drugs and mental health counseling.
But the United States remains, shamefully, the only major country on Earth that does not guarantee health care to all its people as a right. And because of the profiteering of the pharmaceutical industry and private insurance companies, the United States spends almost twice as much per capita on health care as any other nation, while our infant mortality and preventable deaths are higher than most other countries. If our goal is to provide high-quality health care for all Americans in a cost-effective way, we must move toward a single-payer system.
The health insurance lobby and other opponents of single-payer care make it sound scary. It’s not. In fact, a large, single-payer system already exists in the United States: It’s called Medicare. People enrolled in the system give it high marks. More importantly, it has succeeded in providing near-universal coverage to Americans over age 65.
I am very proud that my home state of Vermont is now moving forward on a plan to establish a single-payer health care system to provide coverage for every man, woman and child in our state. I believe we can be a model for the rest of the country. A single-payer system guaranteeing health care for all will not only be a source of great security to the American people; it will also be good for our economy. Entrepreneurs and small businesses will be free to develop their business plans without worrying about the cost and complexity of providing health care for themselves and their employees. Millions of Americans won’t have to stay in jobs they don’t like because their family needs health care.
The goal of real health-care reform must be high-quality, universal coverage in a cost-effective way—with an emphasis on disease prevention. We must ensure, to as great a degree as possible, that the money we put into health coverage goes to the delivery of health care, not to paper-pushing, astronomical profits and lining CEOs’ pockets.
Sen. Bernie Sanders, (Ind.-Vermont), is chair of the Primary Health and Aging Subcommittee of the Health, Education, Labor and Pensions Committee.
Obamacare’s Surprises
As a practicing ear, nose and throat specialist in Ahoskie, N.C., Dr. Raghuvir B. Gelot says that little has frustrated him more than the digital record system he installed a few years ago.
The problem: His system, made by one company, cannot share patient records with the local medical center, which uses a program made by another company.
The two companies are quick to deny responsibility, each blaming the other.
Regardless of who is at fault, doctors and hospital executives across the country say they are distressed that the expensive electronic health record systems they installed in the hopes of reducing costs and improving the coordination of patient care — a major goal of the Affordable Care Act — simply do not share information with competing systems.
The issue is especially critical now as many hospitals and doctors scramble to install the latest versions of their digital record systems to demonstrate to regulators starting Wednesday that they can share some patient data. Those who cannot will face reductions in Medicare reimbursements down the road.
What you should know about the new doctor payment data
Posted Oct. 01, 2014, at 8:46 a.m.
Planning to look up payments drug and medical device companies made to your doctor? Be aware of the information’s shortcomings first.
The data’s missing a lot of payments. It covers payments made over only for five months, from August to December 2013. If your doctor received compensation in say, February of last year, that won’t show up. The federal government says future data will be more complete, with information for all 12 months of this year expected next summer.
The federal Centers for Medicare and Medicaid Services also said that a third of the payment records companies submitted wouldn’t be released immediately, after concerns about the data’s integrity arose. In investigating one doctor’s complaint, CMS discovered many physicians were assigned erroneous identification numbers. The problems forced the agency to delay the database’s publication.
Some payments were intentionally excluded. Physicians, dentists, podiatrists, chiropractors and optometrists are covered. But drug and medical technology companies don’t have to report payments to other health professionals under the law, such as nurse practitioners.
Companies can also hold off on publicly releasing payments related to research for new products until after gaining FDA approval or four years after the payment was made, whichever comes first, according to a report by ProPublica.
A wide variety of compensation is included. The database includes everything from fees for speaking at events to research grants and entertainment and meals. As ProPublica pointed out, different types of payments indicate varying levels of involvement with a company.
The database has errors. This marks the first time CMS has released this data, so some problems are expected. Drug and medical device manufacturers may make mistakes in submitting the data, and the American Medical Association has said the 45-day window physicians were given to review and dispute payments before Tuesday’s release was insufficient and confusing. Of the nearly 550,000 physicians affected by mandate, only 26,000 were able to register to review their data and pursue corrections for any inaccuracies.
Other sources of information are available. Also check out ProPublica’s Dollars for Docs tool, which has tracked similar information since 2009.
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