Doctors group welcomes national debate on ‘Medicare for All’
Doctors group welcomes national debate on ‘Medicare for All’
Nonpartisan physicians group calls single-payer reform ‘the only effective remedy’ for nation’s continuing health care woes and urges focus on facts, not rhetoric
FOR IMMEDIATE RELEASE, January 22, 2016
Contact: Mark Almberg, PNHP communications director, (312) 782-6006, mark@pnhp.org
Physicians for a National Health Program, a nonprofit, nonpartisan organization of 20,000 doctors who support single-payer national health insurance, released the following statement today by its president, Dr. Robert Zarr, a Washington, D.C., pediatrician.
The national debate on single-payer health reform, or "Medicare for All," that has emerged in the course of the presidential primaries is a welcome development. But unfortunately a number of misrepresentations about single-payer national health insurance – and the prospects for its attainment – have crept into the dialogue and are potentially misleading the public.
Most of these misrepresentations, or myths, have been decisively refuted by peer-reviewed research. They include the following:
Myth: A single-payer system would impose an unacceptable financial burden on U.S. households. Reality: Single payer is the only health reform that pays for itself. By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up to guarantee coverage to all of the 30 million people who are currently uninsured and to upgrade the coverage of everyone else, including the tens of millions who are underinsured. Co-pays and deductibles, which have been rapidly rising under the Affordable Care Act, would be eliminated. Further, the single-payer system’s bargaining clout would rein in rising costs for drugs and medical supplies. Lump-sum budgets for hospitals and capital planning would control costs even more.
A recent study shows 95 percent of U.S. households would come out financially ahead under an improved version of Medicare for all. The graduated, progressively structured tax burden would be based on ability to pay, and the heavy cost to average U.S. households of private insurance premiums, co-pays, deductibles, and many currently uncovered services would be eliminated. Patients could go to the doctor or hospital of their choice, and would no longer be restricted to proprietary networks. Multiple studies over a period of several decades, including by the General Accountability Office and the Congressional Budget Office, show that a single-payer system would provide universal coverage at a much lower cost, per capita, than we are spending now. International experience confirms it. Even our traditional Medicare program, which falls short of a true single-payer system, has much lower overhead than private insurance, and shows that publicly financed programs can deliver affordable, reliable care.
A single-payer system would also greatly diminish the administrative burden on our nation’s physicians and hospitals, freeing up physicians, in particular, to concentrate on doing what they know best: caring for patients.
Covering everyone for all medically necessary care is affordable; keeping the current private-insurance-based system intact is not.
Myth: The U.S. has a privately financed health care system. Reality: About 64 percent of U.S. health spending is currently financed by taxpayers. (Estimates that are lower than this exclude two large sources of taxpayer-funded care: health insurance for government employees and tax subsidies to employers and individuals for purchasing private health plans.) On a per capita basis, the amount of government-funded health care in the U.S. exceeds the health spending of nations with universal health systems, e.g. Canada. We are paying for a national health program, but not getting it.
Myth: A single-payer system would overturn the gains won under the Affordable Care Act and provide inferior coverage to what people have today. Reality: A single-payer system would go far beyond the modest improvements that the ACA made around the edges of our current private-insurance-based system and ensure truly universal care, affordability and health security. For example, H.R. 676, the Expanded and Improved Medicare for All Act,would guarantee coverage for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care and correction, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, podiatric care, and long-term care. It would eliminate financial barriers to care like co-pays and deductibles and eliminate restrictive networks. It would end the steady erosion of job-based coverage under our current arrangements and disconnect insurance coverage from employment. H.R. 676 currently has 61 sponsors.
Myth: The American people don’t support single payer. Reality: Surveys have repeatedly shown that an improved Medicare for All is the remedy preferred by about two-thirds of the population. A recent Kaiser Family Foundation survey yielded similar results, showing 58 percent of Americans support Medicare for All. A solid majority of the medical profession favors such an approach, as well, as do more than 600 labor organizations, and many civic and faith-based groups.
Myth: The goal of establishing a single-payer system in the U.S. is unrealistic, or “politically infeasible.” Reality: It’s true that single-payer health reform faces formidable opposition, especially from the private insurance industry, Big Pharma, and other for-profit interests in health care, along with their allies in government. This prompts some people to conclude that single payer is out of reach and therefore not worth fighting for. While such moneyed opposition should not be underestimated, there is no reason why a well-informed and organized public, including the medical profession, cannot prevail over these vested interests. We should not sell the American people short. At earlier points in U.S. history, the abolition of slavery and the attainment of women’s suffrage were considered unrealistic, and yet the movements to achieve these goals were ultimately victorious and we now wonder how those injustices were allowed to stand for so long.
What is truly “unrealistic” is believing that we can provide universal and affordable health care, and control costs, in a system dominated by private insurers and Big Pharma.
We call upon our nation’s lawmakers and the political leaders of all political parties to heed public opinion and to do the right thing by acting swiftly to bring about the only equitable, financially responsible and humane cure for our health care ills: single-payer national health insurance, an expanded and improved Medicare for all.
America the Unfair?
FOR IMMEDIATE RELEASE, January 22, 2016
Contact: Mark Almberg, PNHP communications director, (312) 782-6006, mark@pnhp.org
Physicians for a National Health Program, a nonprofit, nonpartisan organization of 20,000 doctors who support single-payer national health insurance, released the following statement today by its president, Dr. Robert Zarr, a Washington, D.C., pediatrician.
The national debate on single-payer health reform, or "Medicare for All," that has emerged in the course of the presidential primaries is a welcome development. But unfortunately a number of misrepresentations about single-payer national health insurance – and the prospects for its attainment – have crept into the dialogue and are potentially misleading the public.
Contact: Mark Almberg, PNHP communications director, (312) 782-6006, mark@pnhp.org
Physicians for a National Health Program, a nonprofit, nonpartisan organization of 20,000 doctors who support single-payer national health insurance, released the following statement today by its president, Dr. Robert Zarr, a Washington, D.C., pediatrician.
The national debate on single-payer health reform, or "Medicare for All," that has emerged in the course of the presidential primaries is a welcome development. But unfortunately a number of misrepresentations about single-payer national health insurance – and the prospects for its attainment – have crept into the dialogue and are potentially misleading the public.
Most of these misrepresentations, or myths, have been decisively refuted by peer-reviewed research. They include the following:
Myth: A single-payer system would impose an unacceptable financial burden on U.S. households. Reality: Single payer is the only health reform that pays for itself. By replacing hundreds of insurers and thousands of different private health plans, each with their own marketing, enrollment, billing, utilization review, actuary and other departments, with a single, streamlined, tax-financed nonprofit program, more than $400 billion in health spending would be freed up to guarantee coverage to all of the 30 million people who are currently uninsured and to upgrade the coverage of everyone else, including the tens of millions who are underinsured. Co-pays and deductibles, which have been rapidly rising under the Affordable Care Act, would be eliminated. Further, the single-payer system’s bargaining clout would rein in rising costs for drugs and medical supplies. Lump-sum budgets for hospitals and capital planning would control costs even more.
A recent study shows 95 percent of U.S. households would come out financially ahead under an improved version of Medicare for all. The graduated, progressively structured tax burden would be based on ability to pay, and the heavy cost to average U.S. households of private insurance premiums, co-pays, deductibles, and many currently uncovered services would be eliminated. Patients could go to the doctor or hospital of their choice, and would no longer be restricted to proprietary networks. Multiple studies over a period of several decades, including by the General Accountability Office and the Congressional Budget Office, show that a single-payer system would provide universal coverage at a much lower cost, per capita, than we are spending now. International experience confirms it. Even our traditional Medicare program, which falls short of a true single-payer system, has much lower overhead than private insurance, and shows that publicly financed programs can deliver affordable, reliable care.
A single-payer system would also greatly diminish the administrative burden on our nation’s physicians and hospitals, freeing up physicians, in particular, to concentrate on doing what they know best: caring for patients.
Covering everyone for all medically necessary care is affordable; keeping the current private-insurance-based system intact is not.
Myth: The U.S. has a privately financed health care system. Reality: About 64 percent of U.S. health spending is currently financed by taxpayers. (Estimates that are lower than this exclude two large sources of taxpayer-funded care: health insurance for government employees and tax subsidies to employers and individuals for purchasing private health plans.) On a per capita basis, the amount of government-funded health care in the U.S. exceeds the health spending of nations with universal health systems, e.g. Canada. We are paying for a national health program, but not getting it.
Myth: A single-payer system would overturn the gains won under the Affordable Care Act and provide inferior coverage to what people have today. Reality: A single-payer system would go far beyond the modest improvements that the ACA made around the edges of our current private-insurance-based system and ensure truly universal care, affordability and health security. For example, H.R. 676, the Expanded and Improved Medicare for All Act,would guarantee coverage for all necessary medical care, including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care and correction, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, podiatric care, and long-term care. It would eliminate financial barriers to care like co-pays and deductibles and eliminate restrictive networks. It would end the steady erosion of job-based coverage under our current arrangements and disconnect insurance coverage from employment. H.R. 676 currently has 61 sponsors.
Myth: The American people don’t support single payer. Reality: Surveys have repeatedly shown that an improved Medicare for All is the remedy preferred by about two-thirds of the population. A recent Kaiser Family Foundation survey yielded similar results, showing 58 percent of Americans support Medicare for All. A solid majority of the medical profession favors such an approach, as well, as do more than 600 labor organizations, and many civic and faith-based groups.
Myth: The goal of establishing a single-payer system in the U.S. is unrealistic, or “politically infeasible.” Reality: It’s true that single-payer health reform faces formidable opposition, especially from the private insurance industry, Big Pharma, and other for-profit interests in health care, along with their allies in government. This prompts some people to conclude that single payer is out of reach and therefore not worth fighting for. While such moneyed opposition should not be underestimated, there is no reason why a well-informed and organized public, including the medical profession, cannot prevail over these vested interests. We should not sell the American people short. At earlier points in U.S. history, the abolition of slavery and the attainment of women’s suffrage were considered unrealistic, and yet the movements to achieve these goals were ultimately victorious and we now wonder how those injustices were allowed to stand for so long.
What is truly “unrealistic” is believing that we can provide universal and affordable health care, and control costs, in a system dominated by private insurers and Big Pharma.
We call upon our nation’s lawmakers and the political leaders of all political parties to heed public opinion and to do the right thing by acting swiftly to bring about the only equitable, financially responsible and humane cure for our health care ills: single-payer national health insurance, an expanded and improved Medicare for all.
America the Unfair?
by Nicholas Kristof
Donald Trump and Bernie Sanders don’t agree on much. Nor do the Black Lives Matter movement, the Occupy Wall Street protests and the armed ranchers who seized public lands in Oregon. But in the insurgent presidential campaigns and in social activism across the spectrum, a common thread is people angry at the way this country is no longer working for many ordinary citizens.
And they’re right: The system is often fundamentally unfair, and ordinary voices are often unheard.
It’s easy (and appropriate!) to roll one’s eyes at Trump, for a demagogic tycoon is not the natural leader of a revolution of the disenfranchised. But the populist frustration is understandable. One of the most remarkable political science studies in recent years upended everything rosy we learned in civics classes.
Martin Gilens of Princeton University and Benjamin I. Page of Northwestern University found that in policy-making, views of ordinary citizens essentially don’t matter. They examined 1,779 policy issues and found that attitudes of wealthy people and of business groups mattered a great deal to the final outcome — but that preferences of average citizens were almost irrelevant.
“In the United States, our findings indicate, the majority does not rule,” they concluded. “Majorities of the American public actually have little influence over the policies our government adopts.”
One reason is that our political system is increasingly driven by money: Tycoons can’t quite buy politicians, but they can lease them. Elected officials are hamsters on a wheel, always desperately raising money for the next election. And the donors who matter most are a small group; just 158 families and the companies they control donated almost half the money for the early stages of the presidential campaign.
That in turn is why the tax code is full of loopholes that benefit the wealthy. This is why you get accelerated depreciation for buying a private plane. It’s why the wealthiest 400 American taxpayers (all with income of more than $100 million) ended up paying an average federal tax rate of less than 23 percent for 2013, and less than 17 percent the year before.
Conversely, it’s why the mostly black children in Flint, Mich., have been poisoned by lead coming out of the tap: As Hillary Clinton noted Sunday in the Democratic debate, this wouldn’t have happened in an affluent white suburb. Lead poisoning permanently impairs brain development, but it’s not confined to Flint. Some 535,000 children across the country suffer lead poisoning, according to the Centers for Disease Control and Prevention.
Those kids never have a chance — not just because of the lead, but also because they don’t matter to the American political system. American politicians are too busy chasing campaign donors to help them.
The Many Problems With Bernie Sanders’s Health-Care Plan
BY JAMES SUROWIECKI
Bernie Sanders’s health-care plan, which he released hours before Sunday night’s Democratic Presidential debate, under the rubric “Medicare for All,” is a remarkably ambitious effort, proposing as it does to replace the current mix of private and government insurance with a single-payer system. Yet the accompanying document devoted to explaining how the plan would work, and what it would mean for patients and providers, consists of just a couple of pages. Considering that Sanders wishes to bring about nothing less than a complete transformation of the U.S. health-care system, that seems a tad skimpy.
Of course, the document’s purpose is primarily political, so you could argue that it’s more important for Sanders to lay out his broad vision there than to get into specifics. The problem is that, when you’re talking about the health-care system, God (or the devil, depending on your perspective) is very much in the details. Moving to the kind of single-payer model that Sanders envisions would require a host of difficult choices. It would demand dramatic changes in the way that health-care providers of all kinds do business, and in the way patients get care.
Take the question of cost. Although the plan is called Medicare-for-All, in fact it’s much more generous than Medicare. It would give all Americans dental, vision, hearing, mental-health, and long-term care, massively expanding both the number of people who have insurance and the range of treatment they can get. It would also eliminate co-pays and deductibles. “As a patient, all you need to do is go to the doctor and show your insurance card,” the plan says. All things being equal, these changes would significantly increase the amount that Americans spend on health care (currently around three trillion dollars a year). Yet the plan also calls for trillions of dollars less to be spent on health care over the next ten years. In other words, Sanders is promising more coverage and more treatment, for a dramatically lower cost. How would he pull this off?
The answer in the document is vague: “Reforming our health care system, simplifying our payment structure and incentivizing new ways to make sure patients are actually getting better health care will generate massive savings.” The general idea seems to be that moving to the single-payer model will lead to a huge drop in administrative costs, and will also allow the government to use its leverage to drive down the prices of drugs and medical devices. According to an analysis that the campaign released by Gerald Friedman, a professor of economics at the University of Massachusetts at Amherst, costs in the new system would also rise much more slowly than they do today. Sanders claims that, all told, his plan will save ten trillion dollars across ten years.
Neither the plan nor Friedman explains where those ten trillion dollars would come from. “The pleasure of being an academic is I can just spell things out and leave the details to others,” Friedman told the Times. “The details very quickly get very messy.” A study he published in 2013 of a single-payer plan that was introduced in the House by Representative John Conyers, of Michigan, suggests that Friedman is assuming a single-payer system would save almost five hundred billion dollars in administrative costs, by eliminating the huge bureaucracy now devoted to billing- and insurance-related issues. Cutting prescription-drug spending would save another hundred and twenty billion or so. But even if you accept these estimates as realistic (plenty of observers would not), where are the rest of the savings, approximately four hundred billion dollars a year, going to come from? The best the campaign can offer is a vague reference, in Friedman’s analysis, to “a slowdown in the growth of spending.”
The truth is that if you want to save a trillion dollars a year in health-care spending, you can’t do it solely by cutting administrative costs and drug prices. You have to be willing to spend far less on medical procedures and services, and to be far more rigorous about expenditures for new medical technology. That would probably mean a drop in income for some doctors, particularly high-priced specialists, as well as for many hospitals. Providers would also have to relinquish a great deal of control over their facilities and equipment.
Indeed, a proposal for a single-payer system made by Physicians for a National Health Plan, the organization that has done perhaps the best work studying how to make such a model cost-effective, calls for the complete abolition of for-profit hospitals, and places the responsibility for managing “health facilities and expensive equipment purchases” in the hands of regional planning boards. Sanders’s initiative would almost certainly require something similar, but he says nothing about what will happen to hospitals. In fact, the word “hospital” doesn’t even appear in his plan. This might be politically sensible, since talk of government planning boards deciding whether or not your hospital gets a new MRI machine would undoubtedly make some people nervous. But it’s not exactly forthright.
The Sanders plan also makes it sound as though Americans would never again have to worry about not having coverage for some treatments, or about not being able to see their preferred doctors. “Patients will be able to choose a health-care provider without worrying about whether that provider is in-network and will be able to get the care they need without having to read any fine print or trying to figure out how they can afford the out-of-pocket costs,” it says. If a single-payer plan is to hold down costs, though, the government will have to make choices about paying for some things and not for others, which necessarily means that some treatments people really want won’t be covered. Indeed, a footnote in Friedman’s analysis acknowledges that his figures assume that twenty per cent of people’s projected out-of-pocket costs would be for things found to be “not medically necessary.” Similarly, a single-payer plan, if it is to keep costs down, would have to limit how much it would pay doctors, which would likely mean excluding from the system those who won’t accept lower fees. In that event, some patients would no longer be able to see the doctors they wanted. (The plan generally fails to discuss the thorny question of whether people will be able to get health care outside of the single-payer system, either by purchasing supplementary insurance or paying doctors directly, as they do now with physicians who don’t accept their insurance.)
The point isn’t that a single-payer system is a bad idea, per se, nor even that it’s wholly unrealistic from a political perspective. Rather, it’s that Sanders needs to be more forthright and detailed about what his plan would entail, and specifically about the fact that it would require major and often unwelcome changes not just for businesses that many people dislike, such as insurance and drug companies, but also for doctors and hospitals, which are generally popular. And he should acknowledge that the single-payer model would, in some cases, mean big and potentially controversial changes for patients, too. Moving to a single-payer system would be a tumultuous experience, and it’s a proposal worthy of a great deal of open debate. Sanders can certainly make a case that such a transition would be beneficial, given the enormous amount of waste and inefficiency in our current system. But he needs to stop pretending that it would be easy.
http://www.newyorker.com/business/currency/what-bernie-sanderss-health-care-plan-leaves-out?mbid=nl_012016_Daily&CNDID=22403094&spMailingID=8454694&spUserID=MTA5MjQwMDk1NDk4S0&spJobID=842221165&spReportId=ODQyMjIxMTY1S0
Clinton changes tone on Sanders
Allies acknowledge her sharper attacks of last week have backfired.
Sanders Makes a Rare Pitch: More Taxes for More Government
by Josh Barrow
Senator Bernie Sanders’s health care plan is advancing a notion that has long been out of fashion in American politics: that the federal government should provide a new, expensive service to most Americans, and that it should levy significantly higher taxes on most Americans to provide that service.
He is proposing a health care plan that would require over a trillion dollars a year in new, broad-based taxes applying to nearly all Americans who work. His main opponent, Hillary Clinton, has reiterated President Barack Obama’s pledge not to raise taxes even on many affluent families, setting her cutoff for tax increases at $250,000.
His campaign estimates that his plan to cover all Americans with a zero-deductible, zero-co-pay health plan will add $1.38 trillion a year to government spending. There are reasons to think that estimate is optimistically low, but even if it’s correct it’s still a lot of money: Paying for it would require increasing federal tax receipts by about a third, and Mr. Sanders has a plan to do so.
According to revenue estimates provided by the campaign, $238 billion of his new revenues would come from taxes focused specifically on people making more than $250,000 a year or inheriting estates larger than $3.5 million.
Income tax rates would get progressively higher at the top, maxing out at 52 percent for people making over $10 million per year. (Currently, the maximum federal income tax rate is 39.6 percent.) Mr. Sanders would eliminate tax preferences for capital gains for people making over $250,000, and also limit the value of tax deductions they could take.
That would be a large tax increase on the wealthy, similar in size to the tax increase high earners faced in 2013. That’s when portions of the Bush tax cuts expired and taxes in the Affordable Care Act came into effect, causing the effective tax rates for the top 400 taxpayers to rise by seven percentage points.
Still, this wouldn’t be the main source of financing for his plan. Most of the new revenue, about $1.15 trillion a year, would come from broad-based taxes: $630 billion from a 6.2 percent employer-paid tax on payrolls; $210 billion from a 2.2 percent income tax, applied to the existing taxable income base; and $310 billion from the elimination of existing tax preferences for health benefits.
The third item is a somewhat complicated idea: Currently, health insurance benefits are exempt from both income and payroll taxes. If employers didn’t need to pay for health insurance, economists generally believe that, in the long run, their spending on health insurance would shift into taxable wages and salaries. That is, eliminating employer-based health insurance would cause wages and salaries to go up.
Under Mr. Sanders’s plan, employers would need to use some of the money they were spending on health insurance to pay the new 6.2 percent payroll tax, but this would be less than what they’re spending on health insurance now. If the difference went into higher wages, that would mean $310 billion a year in new income and payroll taxes, on average over the next 10 years.
Nurses Applaud New Sanders Plan for Healthcare for All
‘Protecting Our Most Precious Gift – Our Health’
WASHINGTON - National Nurses United today enthusiastically welcomed Sen. Bernie Sanders’ new plan for achieving the dream of countless Americans for nearly a century – healthcare coverage for everyone.
Sanders’ plan also aligns with the official position of the AFL-CIO, which has endorsed single payer health care, Medicare for all – most recently again last July when the AFL-CIO specifically endorsed single payer as part of its national Raising Wages campaign, noted NNU Executive Director RoseAnn DeMoro, a national vice president of the AFL-CIO.
“Finally, a real plan from a leading Presidential candidate that will guarantee healthcare for every American, just as every other major nation has done,” DeMoro said.
“This is a plan that will end the long nightmare facing the nation’s uninsured, and those having to choose between getting the care they need or putting food on the table for their families. And it protects our most precious gift, our health,” DeMoro said.
“By eradicating the crisis of the 29 million who are still uninsured, and the tens of millions more facing medical debt, even with the gains made under the Affordable Care Act, this plan would cut health care costs, put money back in consumers’ pockets, create jobs, and address a major cause of income inequality, un-payable medical bills.”
“Instead of being held hostage to a corporate system based on profits and price gouging, with Sanders’ Medicare for all plan we can finally have a system based on patient need, with a single standard of quality care for all, regardless of ability to pay, race, gender, age, or where you live. That’s a beautiful thing,” DeMoro said.
Sanders’ plan also aligns with the official position of the AFL-CIO, which has endorsed single payer health care, Medicare for all – most recently again last July when the AFL-CIO specifically endorsed single payer as part of its national Raising Wages campaign, noted NNU Executive Director RoseAnn DeMoro, a national vice president of the AFL-CIO.
“Finally, a real plan from a leading Presidential candidate that will guarantee healthcare for every American, just as every other major nation has done,” DeMoro said.
“This is a plan that will end the long nightmare facing the nation’s uninsured, and those having to choose between getting the care they need or putting food on the table for their families. And it protects our most precious gift, our health,” DeMoro said.
“By eradicating the crisis of the 29 million who are still uninsured, and the tens of millions more facing medical debt, even with the gains made under the Affordable Care Act, this plan would cut health care costs, put money back in consumers’ pockets, create jobs, and address a major cause of income inequality, un-payable medical bills.”
“Instead of being held hostage to a corporate system based on profits and price gouging, with Sanders’ Medicare for all plan we can finally have a system based on patient need, with a single standard of quality care for all, regardless of ability to pay, race, gender, age, or where you live. That’s a beautiful thing,” DeMoro said.
As Sanders notes, DeMoro continued, “his plan includes a pledge to provide comprehensive coverage, inpatient and outpatient, emergency care, dental care, vision, long term care, prescription drugs, medical supplies, and other basic needs. One medical card, no networks that limit patient choice of doctor or other provider, no fighting with insurance companies over needed care they refuse to pay for.”
“And, contrary to those in the Clinton camp who have claimed that Sen. Sanders wants to turn our healthcare over to state governors, many of whom have refused to expand Medicaid under the ACA, the Sanders plan would be federally administrated, with national standards and national reimbursements.”
Ultimately, any single payer plan is a financing mechanism. All final details would remain to be ironed out in the legislative process, as occurred with the ACA as well.
“Bernie Sanders has certainly emphasized the power of the healthcare industry lobby in Congress, and that it will take the power of a grassroots political movement that he talks about to enact this plan. Nurses will be in the forefront of that effort,” DeMoro noted.
In his announcement, Sanders said that “the typical family earning $50,000 a year would save nearly $6,000 annually in health care costs.”
That, DeMoro continued, means, as NNU has long noted, improved Medicare for all will raise real wages for American workers and income will go up for nearly everyone. And, as NNU and other health economists have pointed out, that will give consumers more resources to spend, creating a huge multiplier effect for the economy.
An NNU study in 2009, on the eve of debate over the ACA, predicted that single payer would create some 2.6 million new jobs alone, plus substantial increases in federal and state revenues.
A recent New York Times/Kaiser Family Foundation survey found that 20 percent of people under 65 who have health insurance continue to face significant problems with medical bills, despite the ACA.
The Times report found that 63 percent of those burdened by medical bills said they had “used up all or most of their savings,” 42 percent had to take on another job or work more hours, 11 percent had to move or take in roommates, and 11 percent had to turn to charity due to those bills.
“Those days will come to an end when we pass the Sanders proposal.”
“Now we have the framework for a plan that will save lives, achieve the dreams of Americans for nearly a century for guaranteed health care, help the fight to create jobs and reduce income inequality. Sen. Sanders deserves our thanks, and nurses will fight to make the dream come true,” DeMoro concluded.
“And, contrary to those in the Clinton camp who have claimed that Sen. Sanders wants to turn our healthcare over to state governors, many of whom have refused to expand Medicaid under the ACA, the Sanders plan would be federally administrated, with national standards and national reimbursements.”
Ultimately, any single payer plan is a financing mechanism. All final details would remain to be ironed out in the legislative process, as occurred with the ACA as well.
“Bernie Sanders has certainly emphasized the power of the healthcare industry lobby in Congress, and that it will take the power of a grassroots political movement that he talks about to enact this plan. Nurses will be in the forefront of that effort,” DeMoro noted.
In his announcement, Sanders said that “the typical family earning $50,000 a year would save nearly $6,000 annually in health care costs.”
That, DeMoro continued, means, as NNU has long noted, improved Medicare for all will raise real wages for American workers and income will go up for nearly everyone. And, as NNU and other health economists have pointed out, that will give consumers more resources to spend, creating a huge multiplier effect for the economy.
An NNU study in 2009, on the eve of debate over the ACA, predicted that single payer would create some 2.6 million new jobs alone, plus substantial increases in federal and state revenues.
A recent New York Times/Kaiser Family Foundation survey found that 20 percent of people under 65 who have health insurance continue to face significant problems with medical bills, despite the ACA.
The Times report found that 63 percent of those burdened by medical bills said they had “used up all or most of their savings,” 42 percent had to take on another job or work more hours, 11 percent had to move or take in roommates, and 11 percent had to turn to charity due to those bills.
“Those days will come to an end when we pass the Sanders proposal.”
“Now we have the framework for a plan that will save lives, achieve the dreams of Americans for nearly a century for guaranteed health care, help the fight to create jobs and reduce income inequality. Sen. Sanders deserves our thanks, and nurses will fight to make the dream come true,” DeMoro concluded.
Debunking the Case Against Bernie
January 20, 2016
Argumentum ad nauseam refers to the logical fallacy that an argument is correct by virtue of it constantly being repeated. Argumentum ad hominem is the fallacy that a point is wrong because of personal critiques of the person making it.
A new logical fallacy should be added to the list: Argumentum ad centrum, or the flawed claim that an assertion is accurate because it is from the ideological center.
The argumentum ad centrum is increasingly popular in politics today, as working-class people all around the world become more and more frustrated with the status quo. The rapid rise of left-wing alternatives to an increasingly right-wing political modus operandi — with Bernie Sanders in the U.S., Jeremy Corbyn in the U.K.,Podemos in Spain, Syriza in Greece and more — has apologists for power on the ropes, desperately clutching for any argument that can beat back the dissent and discontent.
Nowhere is this more evident than in the incessant liberal attacks on Sen. Bernie Sanders, whose unexpected presidential campaign has, in mere months, taken U.S. politics by storm.
Columnist Jonathan Chait lobbed a series of argumenta ad centrum at the Vermont senator in “The Case Against Bernie Sanders.” The article, published this week in New York magazine, went viral with tens of thousands of shares.
The crux of Chait’s argument is that Sanders is too extreme of a candidate, and that U.S. politics is too far to the right, for him to get anything done. It is not until the final paragraph of his piece that Chait, an unabashed Clinton aficionado, makes it clear that he does not endorse “Sanders’s policy vision.” Perhaps unsurprisingly, then, his points perilously teeter-totter back and forth between vapid political tea-leaf reading and baseless condemnation.
“What the next president won’t accomplish is to increase taxes, expand social programs, or do anything to reduce inequality, given the House Republicans’ fanatically pro-inequality positions across the board,” Chait argues. “The next Democratic presidential term will be mostly defensive, a bulwark against the enactment of the radical Ryan plan. What little progress liberals can expect will be concentrated in the non-Sanders realm.”
In other words, Chait is essentially telling the American left to simply give up, because the cards are stacked in the interest of power. His entire article is a defense of fatalism and political resignation, covered with a thin veneer of liberal analysis.
“It seems bizarre for Democrats to risk losing the presidency by embracing a politically radical doctrine that stands zero chance of enactment even if they win,” Chait adds.
One could imagine similar pieces written in the early 19th century, with respectable pundits haughtily chiding abolitionists for being too extreme and unrealistic, insisting that slavery is reforming and getting progressively less brutal; or in the late 19th century, with popular columnists chastising suffragists for taking such clearly outlandish and utopian positions.
Chait further confirmed these suspicions in a tweet, writing, “Even if you agree with Sanders’ ideas, which I don’t, they’re badly mismatched with the powers he would have.”
The New York magazine columnist’s piece is, in essence, an extended argument from the center. In painting Sanders’ candidacy as a dangerous and extreme political gamble, Chait tries to graft a superficially attractive sheen onto the asinine axiom that the truth necessarily lies somewhere in the middle.
by Paul Krugman
There are still quite a few pundits determined to pretend that America’s two great parties are symmetric — equally unwilling to face reality, equally pushed into extreme positions by special interests and rabid partisans. It’s nonsense, of course. Planned Parenthood isn’t the same thing as the Koch brothers, nor is Bernie Sanders the moral equivalent of Ted Cruz. And there’s no Democratic counterpart whatsoever to Donald Trump.
Moreover, when self-proclaimed centrist pundits get concrete about the policies they want, they have to tie themselves in knots to avoid admitting that what they’re describing are basically the positions of a guy named Barack Obama.
Still, there are some currents in our political life that do run through both parties. And one of them is the persistent delusion that a hidden majority of American voters either supports or can be persuaded to support radical policies, if only the right person were to make the case with sufficient fervor.
You see this on the right among hard-line conservatives, who insist that only the cowardice of Republican leaders has prevented the rollback of every progressive program instituted in the past couple of generations. Actually, you also see a version of this tendency among genteel, country-club-type Republicans, who continue to imagine that they represent the party’s mainstream even as polls show that almost two-thirds of likely primary voters support Mr. Trump, Mr. Cruz or Ben Carson.
Meanwhile, on the left there is always a contingent of idealistic voters eager to believe that a sufficiently high-minded leader can conjure up the better angels of America’s nature and persuade the broad public to support a radical overhaul of our institutions. In 2008 that contingent rallied behind Mr. Obama; now they’re backing Mr. Sanders, who has adopted such a purist stance that the other day he dismissed Planned Parenthood (which has endorsed Hillary Clinton) as part of the “establishment.”
But as Mr. Obama himself found out as soon as he took office, transformational rhetoric isn’t how change happens. That’s not to say that he’s a failure. On the contrary, he’s been an extremely consequential president, doing more to advance the progressive agenda than anyone since L.B.J.
Yet his achievements have depended at every stage on accepting half loaves as being better than none: health reform that leaves the system largely private, financial reform that seriously restricts Wall Street’s abuses without fully breaking its power, higher taxes on the rich but no full-scale assault on inequality.
There’s a sort of mini-dispute among Democrats over who can claim to be Mr. Obama’s true heir — Mr. Sanders or Mrs. Clinton? But the answer is obvious: Mr. Sanders is the heir to candidate Obama, but Mrs. Clinton is the heir to President Obama. (In fact, the health reform we got was basically her proposal, not his.)
Could Mr. Obama have been more transformational? Maybe he could have done more at the margins. But the truth is that he was elected under the most favorable circumstances possible, a financial crisis that utterly discredited his predecessor — and still faced scorched-earth opposition from Day 1.
And the question Sanders supporters should ask is, When has their theory of change ever worked? Even F.D.R., who rode the depths of the Great Depression to a huge majority, had to be politically pragmatic, working not just with special interest groups but also with Southern racists.
Remember, too, that the institutions F.D.R. created were add-ons, not replacements: Social Security didn’t replace private pensions, unlike the Sanders proposal to replace private health insurance with single-payer. Oh, and Social Security originally covered only half the work force, and as a result largely excluded African-Americans.
Just to be clear: I’m not saying that someone like Mr. Sanders is unelectable, although Republican operatives would evidently rather face him than Mrs. Clinton — they know that his current polling is meaningless, because he has never yet faced their attack machine. But even if he was to become president, he would end up facing the same harsh realities that constrained Mr. Obama.
The point is that while idealism is fine and essential — you have to dream of a better world — it’s not a virtue unless it goes along with hardheaded realism about the means that might achieve your ends. That’s true even when, like F.D.R., you ride a political tidal wave into office. It’s even more true for a modern Democrat, who will be lucky if his or her party controls even one house of Congress at any point this decade.
Sorry, but there’s nothing noble about seeing your values defeated because you preferred happy dreams to hard thinking about means and ends. Don’t let idealism veer into destructive self-indulgence.
State gets warning on health price disparities
By Priyanka Dayal McCluskey GLOBE STAFF
A state watchdog agency issued a stern warning Wednesday on the wide variation in prices of medical services, saying the state must take action to curb disparities that are pushing health care costs even higher.
Some Massachusetts hospitals and doctors groups receive higher payments than their lower-priced competitors for essentially the same medical care, the Health Policy Commission said in a new report.
Such disparities drive overall health costs higher because the most expensive providers, including Partners HealthCare of Boston, also treat the most patients.
The findings echoed a 2015 report from Attorney General Maura Healey ; earlier studies by her predecessor, former attorney general Martha Coakley; and an investigation by The Boston Globe, which drew the same basic conclusion: Some health care providers are paid more than others not because they give better care, but because they have more market power.
“Work by multiple state agencies over the last six years has documented significant variation in provider prices that is not tied to measurable differences in quality, complexity, or other common measures of value,” the Health Policy Commission’s report said.
The commission identified Partners as the operator of the state’s highest-paid hospitals. Partners owns 10 hospitals, including Brigham and Women’s and Massachusetts General, and is the state’s largest health care system.
The report called physicians at Partners, Boston Children’s Hospital, and Newton-based Atrius Health the highest-priced doctors networks.
Partners spokesman Rich Copp noted that the agency’s previous reports have acknowledged Partners is a high-quality provider — even though the commission said Wednesday that price variations are generally not linked to quality of care.
“Any perceived market power that Partners has comes from the public’s knowledge of our hospitals’ quality, and the willingness of the public to recommend and return to our institutions,” Copp said in a statement.
Dr. Steven Strongwater, chief executive of Atrius, which includes Harvard Vanguard Medical Associates and other physicians, said Atrius’s prices reflect “a very complete package of care for our patients.” Atrius has worked to reduce overall costs over the past few years, he added in a statement.
Children’s Hospital had no immediate comment.
The Health Policy Commission’s report adds weight to efforts to close the price gap among providers.
The Service Employees International Union, a large labor union that represents hospital workers, is pushing legislation and a statewide ballot question that would level payments by taking money from Partners and redistributing it among several lower-paid hospitals.
The Health Policy Commission stopped short of endorsing any particular measure to tackle price variation Wednesday, but said it will hold meetings in the coming weeks to discuss specific recommendations
Lynn Nicholas , president of the Massachusetts Hospital Association, said the trade group opposes any legislation that would regulate payments, but said hospitals agree that price disparities should be addressed.
“Something other than the status quo is probably warranted,” she said. “ Most [hospitals] are hopeful we can have a market-driven approach, not a regulatory approach.’’
It’s unclear whether lawmakers will tackle health care price disparities. State Representative Jeffrey Sanchez, Democrat of Jamaica Plain, the House chairman of the Joint Committee on Health Care Financing, said he and his colleagues are still trying to determine whether legislation would be appropriate.
“It’s an extremely complex subject area,” Sanchez said. “The question is: what is there to do, if anything, on the legislative side? Right now, we’re just deliberating.”
Governor Charlie Baker is exploring ways to increase transparency in health care pricing, said a spokeswoman, Lizzy Guyton.
This includes stronger enforcement of a 2012 health care cost control law that required insurers and providers to make pricing information more readily available.
Ted Cruz flubs his family's health insurance and (naturally) blames Obamacare
by Michael Hiltzik
S. Sen. Ted Cruz (R-Texas), a candidate for the GOP presidential nomination, has revealed on the campaign trail that his family no longer is covered by health insurance.
Naturally, he blames the Affordable Care Act: "I’ll tell you, you know who one of those millions of Americans is who’s lost their healthcare because of Obamacare? That would be me," he told an audience in Manchester, N.H., according to Politico. "I don’t have healthcare right now."
If you pay attention, however, you'll discover that Cruz’s quandary is entirely his own fault. His, and his Republican colleagues in the Senate.
Essentially, Cruz’s coverage lapsed because his 2015 carrier, BlueCross BlueShield of Texas, ended its individual PPO plans for 2016, including the family plan that covered the Cruz family. The carrier decided to move entirely to HMO plans for the individual market. And Cruz didn’t manage to sign up for a new 2016 plan by Dec. 31. That happened even though the insurer announced its decision to close PPO plans way back on July 23. Five months is normally enough for an educated adult to arrange health insurance.
Cruz still has until Jan. 31 to sign up for coverage beginning March 1, and he said he’d be doing that. "We’re in the process of finding another policy," he said. "I hope by the end of the month we’ll have a policy for our family."
In other words, Cruz’s problem has nothing to do with Obamacare and everything to do with his own sloth — unless the explanation is more sinister, as insurance expert Richard Mayhew of balloon-juice.com speculates: "The Cruz family is currently uninsured to guarantee their father a cheap laugh line."
What’s more certain is that Cruz’s characterization of his issue is layered with dishonesty. He claims that the new plans he has examined carry premium increases of 50% — "That’s happening all over the country," he said. "That’s happening in New Hampshire."
Well, no. Cruz wasn’t especially forthcoming with details about his old plan or the new ones he’s examining, but average rate increases in the individual market in Texas aren’t anywhere near 50%. No single carrier is getting a rate increase that high; the largest is 34%, for a very tiny carrier. At some companies, including BlueCross BlueShield, some rates actually decreased.
In New Hampshire, the biggest plans had increases in the single digits. At Anthem, the largest individual insurer, some rates decreased.
It’s proper to examine why Cruz is looking for insurance on the individual exchange in the first place. Until last year, the Cruz family got its coverage from his wife’s employer, Goldman Sachs. But after she took an unpaid leave of absence from her job to help him run for president, they had to find coverage from his employer — the federal government.
Normally, Cruz would be eligible for the standard government health insurance plan enjoyed by all government employees. But thanks to a deliberate monkey wrench forged by Sen. Charles Grassley (R-Iowa) during the drafting of the Affordable Care Act, members of Congress and their staffs are required to get their insurance through the exchanges — a biting-your-nose-off-to-spite-your-face stunt that increased the complexity of health coverage for them all, since the ACA wasn't designed to substitute for employer insurance.
Cruz is still eligible for the government’s employer subsidy of up to 75% of his health insurance premium. He has said he wouldn’t accept the employer share, which makes his complaint about his cost of insurance just a teeny bit more dishonest because he’s the one driving up his own premium.
Cruz’s lament is sadly typical of congressional critics of Obamacare, including former Speaker John Boehner, who made the claim in 2013 that his insurance rates had "spiked" because of Obamacare. It was just as bogus as Cruz’s complaint, as we demonstrated here. Former Sen. Tom Coburn (R-Okla.) claimed in 2014 that Obamacare had cost him his cancer doctor. Typically, his office refused to provide any details, including why the 65-year-old Coburn was using an ACA plan instead of Medicare.
That’s the state of Obamacare criticism on the GOP side of the aisle. They insist they want to "repeal and replace" Obamacare. Because they can’t offer any legitimate reasons to do so, they’re stuck with making them up.
Naturally, he blames the Affordable Care Act: "I’ll tell you, you know who one of those millions of Americans is who’s lost their healthcare because of Obamacare? That would be me," he told an audience in Manchester, N.H., according to Politico. "I don’t have healthcare right now."
If you pay attention, however, you'll discover that Cruz’s quandary is entirely his own fault. His, and his Republican colleagues in the Senate.
Essentially, Cruz’s coverage lapsed because his 2015 carrier, BlueCross BlueShield of Texas, ended its individual PPO plans for 2016, including the family plan that covered the Cruz family. The carrier decided to move entirely to HMO plans for the individual market. And Cruz didn’t manage to sign up for a new 2016 plan by Dec. 31. That happened even though the insurer announced its decision to close PPO plans way back on July 23. Five months is normally enough for an educated adult to arrange health insurance.
Cruz still has until Jan. 31 to sign up for coverage beginning March 1, and he said he’d be doing that. "We’re in the process of finding another policy," he said. "I hope by the end of the month we’ll have a policy for our family."
In other words, Cruz’s problem has nothing to do with Obamacare and everything to do with his own sloth — unless the explanation is more sinister, as insurance expert Richard Mayhew of balloon-juice.com speculates: "The Cruz family is currently uninsured to guarantee their father a cheap laugh line."
What’s more certain is that Cruz’s characterization of his issue is layered with dishonesty. He claims that the new plans he has examined carry premium increases of 50% — "That’s happening all over the country," he said. "That’s happening in New Hampshire."
Well, no. Cruz wasn’t especially forthcoming with details about his old plan or the new ones he’s examining, but average rate increases in the individual market in Texas aren’t anywhere near 50%. No single carrier is getting a rate increase that high; the largest is 34%, for a very tiny carrier. At some companies, including BlueCross BlueShield, some rates actually decreased.
In New Hampshire, the biggest plans had increases in the single digits. At Anthem, the largest individual insurer, some rates decreased.
It’s proper to examine why Cruz is looking for insurance on the individual exchange in the first place. Until last year, the Cruz family got its coverage from his wife’s employer, Goldman Sachs. But after she took an unpaid leave of absence from her job to help him run for president, they had to find coverage from his employer — the federal government.
Normally, Cruz would be eligible for the standard government health insurance plan enjoyed by all government employees. But thanks to a deliberate monkey wrench forged by Sen. Charles Grassley (R-Iowa) during the drafting of the Affordable Care Act, members of Congress and their staffs are required to get their insurance through the exchanges — a biting-your-nose-off-to-spite-your-face stunt that increased the complexity of health coverage for them all, since the ACA wasn't designed to substitute for employer insurance.
Cruz is still eligible for the government’s employer subsidy of up to 75% of his health insurance premium. He has said he wouldn’t accept the employer share, which makes his complaint about his cost of insurance just a teeny bit more dishonest because he’s the one driving up his own premium.
Cruz’s lament is sadly typical of congressional critics of Obamacare, including former Speaker John Boehner, who made the claim in 2013 that his insurance rates had "spiked" because of Obamacare. It was just as bogus as Cruz’s complaint, as we demonstrated here. Former Sen. Tom Coburn (R-Okla.) claimed in 2014 that Obamacare had cost him his cancer doctor. Typically, his office refused to provide any details, including why the 65-year-old Coburn was using an ACA plan instead of Medicare.
That’s the state of Obamacare criticism on the GOP side of the aisle. They insist they want to "repeal and replace" Obamacare. Because they can’t offer any legitimate reasons to do so, they’re stuck with making them up.
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