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.
Physicians for a National Health Program (www.pnhp.org) has been advocating for single-payer national health insurance for three decades. It neither supports nor opposes any candidates for public office.
How to make both parties happy through the Affordable Care Act
FOR IMMEDIATE RELEASE, January 22, 2016
Contact: Mark Almberg, PNHP communications director, (312) 782-6006, mark@pnhp.org
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.
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.
Physicians for a National Health Program (www.pnhp.org) has been advocating for single-payer national health insurance for three decades. It neither supports nor opposes any candidates for public office.
Obamacare Pummels Blue Cross Blue Shield Of NC--What Can We Learn From This?
by Chris Conover - Forbes
Blue Cross and Blue Shield of NC is expecting to lose more than $400 million on its first two years of Obamacare business. According to this morning’s News and Observer, “The dramatic deterioration in Blue Cross’ ACA business is causing increasing alarm among agents and public health officials.” In response to its bleak experience with the Obamacare exchange, the company has decided to eliminate sales commissions for agents, terminate advertising of Obamacare policies, and stop accepting applications on-line through a web link that provides insurance price quotes–all moves calculated to limited Obamacare enrollment.
What can we learn from North Carolina’s experience?
Obamacare Losses Made the Entire Company Unprofitable in 2014
First, these are not nickel and dime losses. BCBSNC reported an operating loss of $50.6 million in 2014–the first such loss in 15 years. Why? Because its Obamacare policies lost $123 million despite $343 million in various insurer bailouts (the so-called “Three R’s“–risk adjustment, reinsurance, and risk corridors).
What makes this shocking is that BCBSNC is the state’s dominant insurer, covering 72% of the large group market. If a deep-pocketed insurer such as this cannot make a go of Obamacare, that does not bode well for many smaller carriers who do not have large profits on other lines of business with which to absorb whatever losses are generated by policies sold on the Obamacare exchanges. Indeed, part of the explanation for why over half of the Obamacare co-ops have already failed is that they lacked the deep pockets of the largest and most experienced insurers in the business.
The fact that one of the nation’s largest insurers, UnitedHealthcare also has raised doubts about its ability to carry plans on the healthcare law’s exchanges beyond 2016 makes clear that this problem is not unique to North Carolina.
The Problem is Getting Worse, Not Better
A large carrier such as BCBSNC can afford to absorb a temporary hit to its profits. But the evidence in NC is that Obamacare losses are growing over time rather than shrinking–a clearly unsustainable business model. It may just be a matter of time before BCBSNC too abandons its Obamacare policies as a line of business.
Obamacare losses were $123 million in 2014. Year-end final figures for 2015 may not be announced until late February. But the most recent news suggests they will be at least double the losses experienced in 2014 [1]. This mirrors the experience of UnitedHealth, which recently announced it expects to lose more than $500 million on the Obamacare exchanges in 2016 — after already losing $475 million in 2015.
Because of its enormous losses, BCBSNC was able to convince the state’s insurance commissioner to allow a 32.5% average increase in its rates for the 2016 Obamacare policies now being sold. It remains to be seen how effective this is in forestalling future losses. However, as shown below, it should be obvious that higher premiums is going to limit the willingness of at least some Obamacare plan members to secure or maintain their coverage.
How a huge insurance company screwed up on Obamacare
by Michael Hiltzik - LA Times
UnitedHealth Group is the nation's biggest private health insurer, so
when its executives started whining last year about how it was losing
millions on Affordable Care Act exchange plans and threatened to leave the ACA market as early as 2017, people took notice.
Even Obamacare devotees wondered whether United's experience signaled deeper problems with the ACA exchanges generally. Obamacare's critics gorged on United's words and still do: As recently as last week, the Wall Street Journal's editorial writers lamented that "the ObamaCare money-pit sunk [United's] year-over-year profit margin to 3.7% from 4.3%." They blamed, among other things, the ACA's "bureaucratic nuisance."
We were skeptical of United's complaint about the ACA, arguing that it "may say a lot more about the company than the law." Now there's more evidence for that. Analysts at the Urban Institute's Health Policy Center have taken a close look at the pricing and design of United's Obamacare policies and concluded that the company shot itself in the foot.
In addition, they concluded that United is such a marginal player in the individual exchange market that its departure won't matter very much.
The Urban Institute critique coincides with a broadside fired at the company by Peter Lee, executive director of Covered California, the state's ACA exchange and a distinct Obamacare success story.
"Instead of saying, 'We screwed up,' they said, 'Obamacare is the problem and we may not play anymore,'" Lee told Chad Terhune of California Healthline. "It was giving an excuse to Wall Street and throwing the Affordable Care Act under the bus." The company's words, he added, have "fed this political frenzy that Obamacare doesn't work. It's total spin and unanchored in reality."
United, which specializes in large-group employer health plans, came into the individual exchange market reluctantly — and, as Urban Institute analysts imply, ineptly. The company seldom offered the lowest or second-lowest prices in the markets it did enter, but did offer "a broader-than-average provider network." These two features discouraged enrollment by customers who were younger or in relatively good health, for whom price is the chief concern. But it attracted sicker customers, for whom the widest choice of doctors is paramount.
It's an article of faith among ACA critics that the narrow networks of exchange plans can be a burden on consumers. But the truth is that they're an accepted method of keeping costs under control in the employer-sponsored insurance market as well as the exchanges. That was true long before the ACA was enacted.
In any event, United didn't offer wider networks for some public-spirited reason; they did so because they were incompetent at designing health plans for the individual market. They're blaming the market for their own mistakes, which is a bit like a football team blaming the scoreboard for showing that it's losing 52-0.
http://www.latimes.com/business/hiltzik/la-fi-mh-insurance-company-screwed-up-on-obamacare-20160203-column.html
Even Obamacare devotees wondered whether United's experience signaled deeper problems with the ACA exchanges generally. Obamacare's critics gorged on United's words and still do: As recently as last week, the Wall Street Journal's editorial writers lamented that "the ObamaCare money-pit sunk [United's] year-over-year profit margin to 3.7% from 4.3%." They blamed, among other things, the ACA's "bureaucratic nuisance."
We were skeptical of United's complaint about the ACA, arguing that it "may say a lot more about the company than the law." Now there's more evidence for that. Analysts at the Urban Institute's Health Policy Center have taken a close look at the pricing and design of United's Obamacare policies and concluded that the company shot itself in the foot.
In addition, they concluded that United is such a marginal player in the individual exchange market that its departure won't matter very much.
The Urban Institute critique coincides with a broadside fired at the company by Peter Lee, executive director of Covered California, the state's ACA exchange and a distinct Obamacare success story.
"Instead of saying, 'We screwed up,' they said, 'Obamacare is the problem and we may not play anymore,'" Lee told Chad Terhune of California Healthline. "It was giving an excuse to Wall Street and throwing the Affordable Care Act under the bus." The company's words, he added, have "fed this political frenzy that Obamacare doesn't work. It's total spin and unanchored in reality."
United, which specializes in large-group employer health plans, came into the individual exchange market reluctantly — and, as Urban Institute analysts imply, ineptly. The company seldom offered the lowest or second-lowest prices in the markets it did enter, but did offer "a broader-than-average provider network." These two features discouraged enrollment by customers who were younger or in relatively good health, for whom price is the chief concern. But it attracted sicker customers, for whom the widest choice of doctors is paramount.
It's an article of faith among ACA critics that the narrow networks of exchange plans can be a burden on consumers. But the truth is that they're an accepted method of keeping costs under control in the employer-sponsored insurance market as well as the exchanges. That was true long before the ACA was enacted.
In any event, United didn't offer wider networks for some public-spirited reason; they did so because they were incompetent at designing health plans for the individual market. They're blaming the market for their own mistakes, which is a bit like a football team blaming the scoreboard for showing that it's losing 52-0.
http://www.latimes.com/business/hiltzik/la-fi-mh-insurance-company-screwed-up-on-obamacare-20160203-column.html
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