Baucus backs single-payer health system
by Gail Schontzler - Bozeman Daily Chronicle - September 8, 2017
It’s time for America to consider seriously a single-payer, government-run health system, says Max Baucus, Montana’s longest serving U.S. senator, former ambassador to China and one of the chief architects of Obamacare.
“My personal view is we’ve got to start looking at single-payer,” Baucus said Thursday night at Montana State University. “I think we should have hearings…. We’re getting there. It’s going to happen.”
It was a startling turnaround for Baucus, who eight years ago was chairman of the powerful Senate Finance Committee and a key Democratic leader in the political battles that ultimately passed the Affordable Care Act.
Back then, Baucus said, he felt adamantly that Congress wouldn’t pass a government-run system like Canada’s. So it was the one alternative he refused to put “on the table” for consideration.
But you can see the difference, Baucus said, when you visit hospitals on either side of the border. In Montana, half a rural hospital will be dedicated to processing medical insurance claims. In Canada, he said, just one small room is needed to verify that patients are residents.
And Americans pay much higher drug prices, he said, because the government can’t negotiate better prices with the drug industry, so U.S. patients end up subsidizing drug prices for the rest of the world.
Now President Donald Trump’s administration and Republicans in Congress are trying to undermine Obamacare so it will collapse, he said. “I think it’s tragic.”
Baucus, 75, who now lives in the Bozeman-area with his wife Melodee Hanes, spoke in the Strand Union Building to a crowd of about 300 students, faculty and community members. Sponsored by the Burton K. Wheeler Center, the event was billed as “celebrating a career in public service.”
In a discussion led by Nicol Rae, a political scientist and dean of MSU’s College of Letters and Science, Baucus answered questions for 90 minutes about his public career of more than 40 years. The crowd twice stood and applauded him.
Baucus served as ambassador to China for three years. He said he tried to talk to Chinese officials about North Korea, but it was often “like talking to a brick wall.” He said Obama’s discussions with the Chinese sometimes seemed like just checking off boxes.
Trump now is sending different messages, “hot and cold,” Baucus said. The solution to conflict with North Korea, he said, depends on working with China, and doing so with respect, carrots as well as sticks.
“There could be a deal,” he said, if handled well. He dismissed the president’s recent threats about cutting off trade with countries that deal with North Korea. “There’s not going to be a trade war – that’s stupid.”
Baucus decried several changes in Congress over the last 40 years. No longer do senators get together for bourbon, or lunch in a private dining hall. Instead every lunch is dedicated to party strategizing about how to defeat the terrible people down the hall, he said. No longer can you win an election with less than $1 million, he said. Now it can cost $24 million.
Baucus also lamented the end of earmarks, which the press criticized as political “pork” for the folks back home and as “bridges to nowhere.” He spoke proudly of getting farm bills, rural hospital money, conserving open space and landing highway money for Montana that built Bozeman’s North 19th Avenue freeway interchange and interchanges in Belgrade and Billings. Ninety percent of earmarks were good, he said, and they were “the glue” that held politics together. “We got bamboozled by the press,” he said.
Asked about the seven presidents he served under, Baucus shared several anecdotes. Ronald Reagan was a great storyteller, he said. Once in the White House, Baucus started talking about Montana. “’Montana!’” Reagan said. “’My favorite film was ‘Cattle Queen of Montana.’” And he told a funny story about getting his horse to cross a stream.
George W. Bush liked sports and was impressed that Baucus ran marathons. “’What’s your best time?’” Bush asked. “We bonded as jocks,” Baucus said. “He always called me Maxie after that.”
Baucus grew up in the Helena area and on the Sieben family ranch, and earned a law degree at Stanford University. He said during a hitchhiking trip around the world, he was in the Congo when he had an epiphany, that the world is getting smaller and resources scarcer. “That planted the seed of public service,” he said.
He returned to Montana and in 1971 served as executive director for the state’s Constitutional Convention. He won election to the Montana House, then the U.S. House. He gained recognition by walking some 630 miles across Montana, from Gardiner to the Yaak Valley. In 1978 he won election to the U.S. Senate, filling the seat long held by Lee Metcalf. There he served for nearly 36 years.
In the Senate, Baucus was considered a moderate, often infuriating the left wing of his party. In 2013, Obama chose Baucus as ambassador to China, a post he held for three years until President Trump took office and fired sitting ambassadors.
Asked if he would recommend public service to students, Baucus said “absolutely.”
“The most noble human endeavor is service,” he said. “I loved it. …Running for public office – it is fun.”
This story was corrected Sept. 8 to show that Baucus now lives in the Bozeman area and that he won the Senate seat long held by Lee Metcalf (and filled about one year by Paul Hatfield), not Mike Mansfield’s seat.
The Republican assault on the Affordable Care Act is not over
by Lee Webb - Bangor Daily News - September 6, 2017
It seems like forever since it fell to three Republican senators — including Maine’s Susan Collins — to join with Democrats to stop efforts to take health care away from millions of Americans.
But it was just a month ago that efforts to repeal the Affordable Care Act stalled.
And I say stalled because they have not ended.
Medicaid, which provides health insurance coverage to more than 260,000 Mainers, remains in the crosshairs, and some Republicans in Congress are doing their best to revive the move to undo the Affordable Care Act.
Early this summer, voters in Maine and across the country found their voice on health care. They spoke loudly and often. They wrote letters to their members of Congress, went to town hall meetings, called their offices, protested, picketed, cajoled, yelled and begged politicians to listen to them.
Their message, confirmed by polls and hundreds of displays large and small, was that they want more people to have insurance, not fewer.
And their efforts worked — for a while.
Unfortunately, U.S. Sens. Bill Cassidy and Lindsay Graham are reportedly working with the White House on a new version of a bill that would kill the Affordable Care Act.
It’s dressed up differently, but the results likely would be the same: Millions of people around the country and thousands in Maine would lose their health care coverage.
The bill would institute a per capita cap on Medicaid funds distributed to states, costing Maine $180 million by 2026, according to the Center on Budget and Policy Priorities in Washington, D.C. After 2026, it would get even worse.
The repeal effort also would eliminate Medicaid expansion, which has helped 31 states and the District of Columbia provide quality, affordable health care to millions of people.
It would discontinue the tax credits that help Mainers to buy health insurance on the private market.
And it is expected to weaken protections for people with pre-existing conditions, re-impose lifetime limits, and raise deductibles and out-of-pocket expenses.
This proposal would put at risk older Mainers in nursing homes, people with disabilities, and about six in 10 newborns who rely upon Medicaid for a healthy start on life.
It also threatens the quality, affordability and access to care for all of us by destabilizing the insurance marketplace and scraping important consumer protections.
Most people agree that our health care system needs improvement. Even with the good that has come from the Affordable Care Act, including fewer people who must go without health care, we know that costs still can be too high.
There’s a need for real reform. But we can’t get to reform in a process marred by closed-door meetings, backroom deals and arm-twisting.
As Collins has said, we need an open, transparent and bipartisan approach to health care reform, which listens to experts, doctors and patients. The goal should be to expand the number of people with health care coverage, not take it away.
That’s not what we’ve had so far, and it’s not what we’re getting with this new Cassidy-Graham scheme.
Like its predecessors, this latest attack on Medicaid and the Affordable Care Act isn’t motivated by a desire for good health care policy. Instead, the goal is to take health coverage away from people to fund tax cuts for the wealthiest in our country.
Maine people have rejected this trade. They’re anxious for reform, but they won’t be fooled by a tax cut pretending to be about making health care better.
There are ways to make health care more accessible and affordable, but we can’t get there unless we have an honest and open discussion that’s built on facts.
Health care accounts for one-sixth of our country’s economy. But more than that, it is desperately important to the mother with a sick child, an adult caring for aging parents, or our neighbors who have a disability. To them, it’s more than numbers on a spreadsheet. It’s peace of mind or maybe even life and death.
That’s too important to leave to partisan politics and secret negotiations.
Lee Webb is chair of the board of directors of the Maine Center for Economic Policy.
Congress has a second chance to make our health care system better
by Steve Butterfield - Bangor Daily News - September 7, 2017
Call it redemption or just call it a second chance. After spending the entire year debating one idea after another to dismantle our health care system — an effort that finally hit a wall just a few short weeks ago — Congress will have the opportunity to find common ground to stabilize and actually improve our nation’s health insurance markets.
Maine Sen. Susan Collins deserves credit for this opportunity for showing the courage to speak up and point out that the Senate had lost its way and was about to do more harm than good.
At Consumers for Affordable Health Care, we know what’s at stake. Every year, we help thousands of Mainers navigate our health system. We know all too well that, while so many Maine families have benefited, it is not a perfect system. But we also know there are actions Congress can take right away to limit, and even begin to repair, the damage that they have already done.
First, Congress must move quickly to approve funding for cost-sharing reductions. These are federal reimbursements to insurance companies to minimize out-of-pocket costs, such as deductibles and copayments, for many lower-income consumers who get their insurance through the Affordable Care Act marketplaces. This includes more than half of marketplace consumers in Maine. Without these payments, insurance rates will skyrocket next year as insurers are forced to cover those costs with higher premiums.
Cost-sharing reductions are a classic “pay now or pay a lot more later” decision for Congress because those same premium increases will ultimately be paid by the federal government in the form of tax credits. The Congressional Budget Office estimates that if Congress doesn’t fund the cost-sharing reductions, it will leave the federal government on the hook to spend an extra $4 billion next year alone, in part from use of tax credits to offset higher premiums. This seems like an easy one: Congress should do the right thing, fund the cost-sharing reductions, and save the government $4 billion.
Second, the Trump administration seems eager to sabotage the Affordable Care Act. Last week, for instance, they slashed outreach advertising by 90 percent and pulled the rug out from under community groups across the country that help consumers with impartial enrollment help, cutting funding for “health insurance navigators” by more than 40 percent. This certainly does not help consumers, who count on getting expert advice when they’re making decisions about their health and finances. Congress should put a stop to this interference by funding and enforcing marketplace education and promotion, so all Americans know what their options are.
Third, Congress should consider extending some of the Affordable Care Act’s “premium stabilization programs,” such as reinsurance. Reinsurance is a way of keeping premiums down by protecting health markets against extremely high claims costs. Reinsurance programs in other states have helped keep premiums down — even those who may not qualify for tax credits or subsidies. Congress should look at ways to make sure every state can benefit.
Fourth, Congress must fully abandon any remaining effort to cut funding for Medicaid. Medicaid and Medicare are the foundation of our health care system. Here in Maine, Medicaid is the insurer that pays for about 4 out of 10 births. Medicaid provides health insurance for half the kids in our state. Medicaid is Maine’s biggest insurer of long-term care costs. Jeopardizing the safety of our kids, older Mainers and our most vulnerable by playing a shell game with Medicaid funding should be a red flag for anybody who wants to keep Maine healthy.
Finally, let’s not forget that it was only a few short years ago that you could be denied coverage for a pre-existing condition, charged more if you were sick or have your benefits cut off if you hit an annual or lifetime cap. Nobody comes out ahead when insurance companies are allowed to cut and run as soon as they need to hold up their end of the bargain. Congress must protect these essential benefits and fair rules from here on out.
Margaret Chase Smith, in her famous Declaration of Conscience, said “too much harm has already been done with irresponsible words of bitterness and selfish political opportunism.” We see that same dynamic at play today, but Congress has a second chance. They can join the work Collins and Sen. Angus King have already been doing for months and seek ways to stabilize the markets and make the system work better for everyone — consumers, doctors, hospitals and insurance companies. We hope Congress is ready to do the right thing and move America forward.
Effort Launches to Expand Medicaid in Maine Through Ballot Initiative
by Patty Wight - Maine Public - September 6, 2017
Mainers for Health Care officially launched their campaign to expand Medicaid though a ballot initiative this November.
Dr. Elizabeth Rothe, a family medicine physician at Central Maine Medical Center, says expanding the insurance program will not only help an estimated 70,000 Mainers, it will also help hospitals.
"Caring for patients who cannot pay their bills puts hospital budgets in the red," Rothe says. "It jeopardizes jobs, departments, and even entire hospitals. Maine needs to expand Medicaid."
Under the Affordable Care Act, states that expand Medicaid receive extra federal dollars. Maine lawmakers have approved expansion five times, but Governor LePage has vetoed the legislation.
F.D.A. Accuses EpiPen Maker of Failing to Investigate Malfunctions
by Katie Thomas - NYT - September 7, 2017
The Food and Drug Administration this week accused the drugmaker Pfizer of failing to properly investigate reports of malfunctioning EpiPens, including incidents when patients died or became severely ill after the device failed to work. Pfizer manufactures the EpiPen, which treats allergic reactions, for the drugmaker Mylan.
In a warning letter issued Tuesday, the agency said Meridian Medical Technologies, which is a unit of Pfizer, did not adequately look into problems with a crucial component of the EpiPen — the mechanism on the device that insures that it fires and delivers the proper dose of epinephrine, which stops an allergic reaction.
The F.D.A. said the company failed to conduct a proper investigation even though it received numerous complaints about problems with activating the device. “Our own data show that you received hundreds of complaints that your EpiPen products failed to operate during life-threatening emergencies, including some situations in which patients subsequently died,” the agency said in the letter.
A spokeswoman for Pfizer, Kim Bencker, said in a statement that the company was “very confident in the safety and efficacy of EpiPen products being produced at the site” and noted that it has shipped more than 30 million EpiPens since 2015. “It’s not unusual to receive product complaints, especially when the product is frequently administered by non-medically trained individuals.”
She added, “We currently have no information to indicate that there was any causal connection between these product complaints and any patient deaths.”
Theresa Eisenman, a spokeswoman for the F.D.A., did not provide details about the number of patient deaths reported, saying only that the agency had received “adverse event” reports that claimed the device failed to activate. She said “an adverse event report does not establish a causal relationship between an adverse event and device failure, and reports do not always contain enough detail to properly evaluate an event.”
In its letter, the F.D.A. noted that Pfizer and Mylan recalled 13 lots of the EpiPen earlier this year for products sold in the United States and overseas markets because of the problem, but said that the companies did so only after the F.D.A. inspected the manufacturing facility and “after multiple discussions with F.D.A.”
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