Editor's Note:

Here is a link to the Jayapal press event announcing the introduction of her Medicare-for-All bill.

https://www.facebook.com/doctorsforsinglepayer/videos/1371063689712251/?eType=EmailBlastContent&eId=8b84317a-b0f0-4418-a1ea-c0ef59ecd965

And here is a link to the informative segment about Medicare for All on the February 28 PBS Newshour:

https://www.pbs.org/newshour/show/why-these-house-democrats-say-medicare-for-all-is-americans-best-health-option

-SPC

Why these House Democrats think Medicare for All is the best path for U.S. health care

by Judy Woodruff - PBS Newshour - February 28, 2019

n the U.S., health care costs continue to rise, insurance is more difficult to obtain and millions lack access to care entirely. As a result, some House Democrats want to implement a single-payer, universal coverage system in which all costs are paid by the federal government. Rep. Pramila Jayapal, D-Wash., talks to Amna Nawaz about the benefits of expanding Medicare for all Americans.

Judy Woodruff:
Speaking of the Democratic Party's agenda, health care is a big part of it, and specifically a push to expand health care coverage and to lower costs.
But there are many different ideas within the party on how to do that and just how far to go. Many have been loosely referred to as Medicare for all.
Even so, there's a new bill in the House that is considered the most comprehensive version of Medicare for all.
Amna Nawaz explores what it might do and how it could affect the political conversation.
Amna Nawaz:
Well, Judy, you might remember Medicare for all from the 2016 platform of Senator Bernie Sanders.
But there's an even more ambitious plan now in the House. It would move the U.S. to a single-payer, government-run health care system. Every American would be able to go to the doctor, or the hospital, or get prescriptions without paying anything out of pocket. Hospitals would be paid lump sums to manage, not paid by patient visits or procedures.
Even long-term care for people with disabilities or home health services would be covered. And the plan for this total health care overhaul would take effect in just two years.
There's no price tag yet, but some estimate a cost of trillions or tens of trillions over 10 years.
Congresswoman Pramila Jayapal of Washington state is the lead co-sponsor of the bill, and she joins me now.
Congresswoman, welcome back to the "NewsHour."
Let's start about with what Americans think of your plan. Broadly speaking, there's a lot of support. Over 70 percent say they like the idea. When you drill into details, you ask people about delays in care or higher taxes, that support drops off significantly, down to 25 and 37 percent.
So what is your message to the people who like the idea, but don't like the details or the impact?
Rep. Pramila Jayapal, D-Wash.:
Well, here's the thing that is so important about this.
It is not a government-run system, number one, because we use the same existing system of doctors and hospitals that is already there. And I think sometimes people confuse what is in our plan. All we're saying is, you can see the doctor and the hospital of your choice, in fact, more choice than you have right now, with insurance plans that — private insurance plans that continue to limit that.
The only thing we are changing is who pays for that. So instead of having five insurance plans, instead of having to argue with the insurance company about what's covered or not covered, which facility is in or out of that network, you can go see anyone you want and get comprehensive care.
Now, the second thing is, Medicare is a very popular system. And it already exists today for our seniors. And what we have done is, we have expanded and improved upon that Medicare system. So, instead of having to buy an additional Medicare Advantage plan for vision, hearing and dental, we cover that for everybody, same thing with mental health and substance abuse.
And then we say, instead of just applying to seniors, it applies to everyone, so expanded and improved Medicare.
And then, in terms of the transition, I would remind people two years seems so hard to imagine, but, in fact, Social Security was implemented within one year, and there were no computers, nothing existed there to actually be able to do that.
So this plan is about making sure that every American gets guaranteed universal health care, and that is something that every major peer country of ours already has, and it is affecting our people. People are dying. They're having to choose…
Amna Nawaz:
Congresswoman, let me ask you about what some of those people are saying, though.
In their concern about the plan, they do say they don't want to have to pay higher taxes for it. You haven't proposed in your plan how this would be paid for. So how would you pay for it?
Rep. Pramila Jayapal, D-Wash.:
Yes, thanks for the question.
So, we already cover about two-thirds of people through Medicaid and Medicare. So, two-thirds of the costs are already taken care of. The other third, we have a number of different ways in which you could pay for it, including that employers are already paying enormous premiums to insurance companies. They could pay just a fraction of that into this plan and create some of that money that we need.
And then we can have a tax on millionaires and billionaires. We can roll back tax loopholes. We have never had really a conversation about why it's so important to keep the costs of our health care system down, right now, 19 percent of GDP, that's double what any other industrialized country in the world pays already.
Amna Nawaz:
One of the criticisms, I should point out, is that your plan doesn't include any efforts to bring down the cost of health care before the government would essentially take over the system.
So are you worried about that? I mean, there are people who will say, look, it already costs so much, why not work to do that first?
Rep. Pramila Jayapal, D-Wash.:
No, actually, that's the beauty of our plan, is it has cost containment built into it through using something called global budgets, which is a really important tool for building in cost containment.
And it allows, on pharmaceutical drugs, dramatically brings down the price, probably to 50 percent of what pharmaceutical drugs now cost. And we do that through required negotiation of drug prices, which we already have in the VA, but we don't have in the Medicare system.
Amna Nawaz:
There is the situation of having to transfer — transition, rather, over 150 million Americans who are currently privately insured to this single-payer system.
I want to run by you something the health and human services secretary, Alex Azar, said today when he was asked about a Medicare for all plan. He first attacked it as a government takeover of health care.
But then he said this. He said: "The best doctors are going to jump out of the program. They will be paid under market rates. To get quality care, you will end up going outside the system if you have got the money the do so."
So, my question is, is that a concern, that you end up making a two-tier system, where people who can afford to go out of it do?
Rep. Pramila Jayapal, D-Wash.:
Actually, it's the opposite.
Because we would be covering everybody and we wouldn't allow duplicative care, which is how we operate with Medicare right now, we believe that the majority of doctors will actually get paid either the same or a little bit more. Some specialty doctors might have to earn a little bit less, but everyone will get the same care.
You don't have to be rich, you don't have to be poor, but you get quality health care. That's actually one of the huge benefits of the system we have proposed, vs. the system that we have now, 30 million people uninsured, 40 million people underinsured, two-thirds of all bankruptcies in this country because of medical costs.
That's wrong. And we need to end that.
Amna Nawaz:
Finally, Congresswoman, it's fair to say you have an uphill legislative battle, not just against the Republicans who control the Senate, but some of your own party members don't really love this plan.
Is the idea here, by pushing to a very, very ambitious — there's nothing incremental about this plan — is the idea that you change the conversation so that more incremental steps are maybe more palatable?
Rep. Pramila Jayapal, D-Wash.:
No.
We really are all about passing this plan. It sounds ambitious, only because health care in this country is so broken. But the reality is, every industrialized country in the world provides this. Why is it that the United States, the richest country in the world, cannot guarantee health care for every single person in this country?
Right now, we spend double what other countries spend, and we have more mothers dying in childbirth, we have more babies who are dying in terms of our infant mortality rates, and our life expectancy is the lowest of all our peer countries.
Again, this is not a particularly ambitious plan, in the sense that so many others have done it. The United States should be leading on this issue. And I think this is the plan that gets us there.
Amna Nawaz:
Just a few seconds left here, Congresswoman.
I want to ask you about the idea of something being medically necessary, right? Those are the things that would be covered as part of this plan. Wouldn't that change based on who's in charge, what people deem necessary and not?
Rep. Pramila Jayapal, D-Wash.:
No.
We actually specify very clearly what is actually in it, what is covered. So, dental vision, comprehensive care, reproductive care, substance abuse, all of those things are detailed in our bill. It's a very comprehensive bill. It's over 150 pages.
We put a lot of thoughts into it. And it really is a real transformation of our health care system, so that everybody in the United States doesn't have to go to bed worrying about where they get their care.
Amna Nawaz:
Congresswoman Pramila Jayapal, thank you very much for your time.
Rep. Pramila Jayapal, D-Wash.:
Thank you.
https://www.pbs.org/newshour/show/why-these-house-democrats-say-medicare-for-all-is-americans-best-health-option

The Medicare for All bill is a winner

by Jeffrey Sachs - CNN News - March 1, 2019

(CNN)Rep. Pramila Jayapal introduced a sweeping Medicare for All (MFA) bill on Wednesday (H.R. 1384), and the national debate on healthcare is bound to intensify through the 2020 election. Voters rank healthcare costs as their second most important priority, just after the economy. The political fate of MFA will likely depend on one key question: Will it reduce healthcare costs while preserving the freedom to choose health providers?
If properly structured, MFA can do that: cut costs while improving choice.
Medicare for All has come a long way since Sen. Bernie Sanders launched his 2016 presidential campaign on that theme, while fellow Democrats ran from the label. Sanders also faced the wrath of mainstream pundits like Paul Krugman, who described Sanders' healthcare plan as "smoke and mirrors." Now, every major Democratic Party candidate endorses the label, (though they will certainly differ on the details) and Sanders could well become president in 2021 on the basis of his clear and persistent MFA advocacy.
No doubt the debate will become heated, even shrill. We are talking about serious money, and the largest single sector of the American economy. Healthcare outlays in the United States account for nearly 18% of the country's gross domestic product. Profits are soaring in the private healthcare and pharmaceutical industries, both of which will fight fiercely against MFA. President Donald Trump has weighed in, declaring that Democrats are "radical socialists who want to model America's economy after Venezuela."
While former President Barack Obama spoke out in favor of a single-payer plan, he avoided the battle back in 2009 with the Affordable Care Act. And by making health insurance available to millions more Americans, the Affordable Care Act allowed private industry to raise prices given the increase in demand. The result is that Obamacare expanded overall coverage, and provided hugely popular guaranteed coverage for pre-existing conditions, while avoiding any decisive steps on cost containment.
MFA picks up at that point. Real cost containment will be the critical issue that either makes or breaks each MFA proposal.
Americans currently pay around $10,000 per person per year in health outlays, compared with roughly half that amount in other high-income countries such as Canada, Japan, the Netherlands, or Sweden. The reasons have been debated and studied in detail. Do Americans use more and better healthcare and therefore also pay more? Alas, no. Americans use roughly the same or less healthcare, but pay far more for health services including drugs, hospital stays, and medical procedures such as an MRI.

The Canada comparison

A comparison of healthcare costs between the US and 10 other high-income countries allows a detailed comparison of the US and Canada, the most relevant peer country. According to the comparative data, the US spends 17.8% of GDP compared with Canada's 10.3%, amounting to $9,403 per person in the US compared with Canada's $4,641.
All Canadians are covered by the healthcare system, while 10% of Americans lack public or private insurance coverage. Total pharmaceutical spending per person per year averages a whopping $1,443 in the US, compared with $613 in Canada.
For example, the cholesterol drug Crestor is $86 per month in the US, and $32 in Canada; the arthritis drug Humira is $2,505 in the US, compared with $1,164 in Canada. Yet despite the much higher health spending per person, life expectancy in the US is 78.8 years, while in Canada it is 81.7 years.
The article reaches the following conclusion: "The United States spent approximately twice as much as other high-income countries on medical care, yet utilization rates in the United States were largely similar to those in other nations. Prices of labor and goods, including pharmaceuticals, and administrative costs appeared to be the major drivers of the difference in overall cost between the United States and other high-income countries."

Huge private costs in the US

US private health insurance costs are out of sight. A typical US family of four covered by employer-based health insurance pays, in total, around $28,000 per year, taking into account the insurance premium paid for by the employer out of the worker's total compensation, the premium paid directly by the household, and all of the extra costs, including deductibles, co-payments, and out-of-network payments. The cost of healthcare is crippling working-class families, which may explain why it is at the top of the political agenda.
What is the reason for these extraordinary costs in the US? Astronomical administrative costs, for one, are the result of countless and conflicting payments systems facing almost any patient who visits the doctor's office or hospital. One study in 2014 suggested that America's extraordinarily complicated multi-payer system leads to administrative costs for billing and insurance that are five times the costs of a simplified payment system such as Canada's.
The second is the soaring monopoly profits and sky-high salaries along the entire private supply chain, from drug manufacturers to hospitals. The drug companies use their extraordinary monopoly power, whether due to patents or FDA approvals on out-of-patent drugs, to overcharge Americans with markups that are sometimes hundreds of times the production cost of the medicines. And private providers are a highly concentrated industry in most metropolitan areas.
With the mergers and closures of hospitals during the past 20 years, driven by for-profit medicine, this market power has soared, and so too have monopoly profits and healthcare costs facing consumers.
Check out the CEO compensation of the big systems providers -- $59 million for Aetna, and $44 million for Cigna in 2017 -- or the salaries of the executives of the "not-for-profit" hospitals in your area, often running several million dollars per year.
For these reasons, healthcare costs in the US could be brought down by cutting three main areas: administrative costs, drug prices, and monopoly profits of private insurers, which in turn could be achieved by much lower reimbursement rates for medical services and more effective contracting. Recent studies (here and here) have shown prospective savings on national health expenditures resulting from Medicare for All would save trillions of dollars over 10 years.

Smart cost control

The Jayapal bill is smart on cost control. It would have Medicare negotiate with pharmaceutical companies to drive drug prices down, with the threat of removing the monopoly rights of patents if the drug company doesn't reach a reasonable agreement on prices. (Technically, the government would issue a compulsory license to competitors). It would have Medicare set an annual budget with hospital providers. This annual budget would focus on healthcare provision rather than wasted time and expenses on billing. It would not permit astronomical management salaries and super-profits.
By wringing massive administrative costs, monopoly profits, and sky-high salaries out of the healthcare system, costs would be slashed, with the savings passed on to households. Remember, if the US paid the same share of income as our peer countries like Canada, the total saving would be on the order of 6% of GDP (from 18% today to around 10-12% as in the peer countries). With a GDP of around $62,000 per person in the US, 6% of GDP saving comes to a cost saving of around $3,700 per person, or around $14,800 for a family of four.
Such savings wouldn't be achieved in full, or even in the early years. The pushback from industry against cost-cutting will be fierce. Moreover, the sheer inertia of existing costs, prices, budgets, and administrative systems cannot be doubted. But what can be said with confidence is that a well-designed MFA system would put the US on a path toward the reasonably priced healthcare systems of other comparable countries.
Moreover, MFA would allow us to rethink healthcare delivery to take into account perhaps the biggest feasible benefit in health outcomes. America's current disease burdens often reflect unhealthy life circumstances -- great stress, obesity-inducing diets, lack of exercise, drug dependence, and others. These are social ills turning into medical ills.
A fairer, more balanced, health system based on good health rather than maximum profits would turn its attention to helping Americans live healthier lives.
Getting MFA through the political process won't be easy. The drug industry is one of America's top lobbies and campaign contributors, befitting a massive economic sector rolling in profits. Lobbying outlays in 2018 across the health sector are estimated at around $549 million and campaign funding in the 2018 election cycle at $255 million. The industry will be ready to fight an MFA plan with guns blazing, and trot out the usual arguments: stop socialized medicine, save personal choice, don't put yourself into the hands of government bureaucrats, don't let American become Venezuela -- you name it.
Yet Sanders and Jayapal and their many colleagues who have come on board now (including 106 co-sponsors) have the best chance to prevail in our modern history. Americans know that the healthcare system is rigged, and they will support a new system that convincingly shows the way to fair and reasonable healthcare costs.
https://www.cnn.com/2019/03/01/opinions/medicare-for-all-is-a-winner-opinion-sachs/index.html

Golden unveils health care roadmap with ‘Medicare for All as the destination’

by Dan Neumann - The Beacon - February 27, 2019

Congressman Jared Golden has joined U.S. Rep. Chellie Pingree, along with over 100 House Democrats, in co-sponsoring federal “Medicare for All” legislation, which lead sponsor Rep. Pramila Jayapal (D-Wash.) unveiled on Wednesday.
While Medicare for All is his stated goal, Maine’s Second Congressional District representative said he is also backing a series of what he describes as pragmatic measures that would expand access to the existing Medicare program, reduce drug costs and protect pre-existing conditions.
“I won’t mislead people about the road ahead — it’s unlikely to happen overnight. But pushing for universal health coverage is the right thing to do, and it’s the right direction for America,” Golden said in a statement Tuesday outlining his own “health care roadmap” to get to universal health coverage.
Jayapal’s bill is the most detailed plan released by House Democrats to date on how they would transform the country’s health care system to a single-payer program with guaranteed coverage for every American. In the Senate, Sen. Bernie Sanders (I-Vt.) has 16 Democrats co-sponsoring his own Medicare for All bill.
“Something that would have seemed impossible just a few years ago is becoming reality as more people are stepping up and claiming their right to quality healthcare,” said Connie Huynh of People’s Action, a group that has been working with Jayapal to improve and build support for the proposed legislation.
“Pharmaceutical companies make billions in profits while working Americans use kickstarters to pay for health care. It’s time we put people over profit. That’s why I’m proud to join Rep. Jayapal and over 100 of our colleagues as a co-sponsor of the Medicare for All Act!” said Pingree on Twitter as the bill was unveiled.
Golden’s staff acknowledges the demand for Medicare for All among Mainers, but added that push must move in tandem with passing legislation which can make immediate impacts. “Golden recognizes Medicare for All as the destination of his healthcare roadmap, and he will work to enact the more immediately feasible parts of his plan in the short term so that Maine people aren’t forced to wait for relief from the skyrocketing cost of care,” his team said in a statement.
A first step towards that goal, Golden says, is through expanding access to the existing Medicare program. He supports the House “Medicare Buy-in and Healthcare Stabilization Act,” which would allow Americans age 50-64 to be eligible for Medicare.
“Our 50+ Medicare buy-in lowers costs and provides economic security for more than 145,000 people in our state, while steadily pushing the country closer to universal coverage,” Golden said.
Golden’s roadmap also includes passing his own legislation, “The Forcing Limits on Abusive and Tumultuous (FLAT) Drug Prices Act.” The freshman congressman’s law seeks to protect against unfair price hikes for prescription drugs by penalizing pharmaceutical companies that gouge their customers with sudden, exorbitant price increases.
Pingree and four House Democrats have co-sponsored Golden’s FLAT Prices Act. Illinois Senator Dick Durbin has introduced companion legislation to Golden’s bill in the Senate.
Golden is also supporting a measure to safeguard the Affordable Care Act’s protections for people with pre-existing conditions, which is under threat after a Texas federal district court ruled the entire ACA unconstitutional, a decision currently under review in the conservative Fifth Circuit of the U.S. Court of Appeals.
New Hampshire Representative Annie Kuster has introduced legislation to limit the ability of states to obtain waivers from the ACA’s patient protections.
Golden’s roadmap also includes backing proposals such as “The Safe and Affordable Drugs from Canada Act” and “The Incentivizing Medicaid Expansion Act.”
http://mainebeacon.com/golden-unveils-health-care-roadmap-with-medicare-for-all-as-the-destination/

Vowing to Fight 'Until We Win,' Advocates Plan Nationwide Mobilization to Pass Medicare for All

by Julia Conley - Common Dreams - February 27, 2019

With Rep. Pramila Jayapal (D-Wash.) and more than 100 other House Democrats standing behind sweeping new Medicare for All legislation, advocates on Wednesday immediately mobilized to pressure lawmakers to pass the bill.
On Capitol Hill, leaders of National Nurses United unveiled their plan to initiate more than 1,500 local canvassing operations across the country to continue building grassroots momentum—tapping into the growing demand for Medicare for All among the public.
"We will continue building our Medicare for All movement. Neighbor by neighbor. Conversation by conversation, as this bill moves forward," said NNU executive director Bonnie Castillo. "And in honor of those who paid the price in an unfixable, immoral system we will win Medicare for All."
The Medicare for All advocacy blitz will include canvassing and phone banking campaigns, and follow more than 150 barnstorms organized by NNU earlier this month. Organizing efforts are currently scheduled throughout throughout the month of March and into April.
"The launch of today's bill is a monumental achievement in its own right," wrote NNU in an email to supporters. "Just a few years ago, Medicare for All was viewed as little more than a far-away dream. Virtually zero legislators supported it, and even fewer had the courage to add their name to any bills publicly."
"This is a milestone in the fight for universal healthcare and an equitable society, where working people make the decisions that determine our destiny. Now our task is to build a mass organization of working people that will not give up until we win." —Michael Lighty"But that didn't deter us. We've rallied and fought tirelessly—fueled by the belief that healthcare is a right, not a privilege—and now Medicare for All is supported by the majority of voters, the majority of Congressional Democrats, and the majority of 2020 presidential candidates," the group continued. "That's proof that our work is paying off. And this bill is our next big test."
Recent polls have shown that support for Medicare for All has grown rapidly in recent years. Seventy-one percent of Americans approved of the proposal according to a survey by Reuters last year, compared with a 2009 CBS/New York Times poll which found that only 59 percent of the public backed the idea.
Support has climbed as reports on the effects of the for-profit insurance system on American families have become more and more prevalent. NPR reported Tuesday on a recent study that showed 42 percent of Americans who were diagnosed with cancer between 2000 and 2012 drained their life savings within two years, as astronomical bills for tests and treatments piled up.
Leaders of National Nurses United, which has been fighting for Medicare for All since the group's inception more than a decade ago, gathered with the bill's sponsors on Capitol Hill as they announced the proposal.
"Here's the thing, if we can end slavery, if we can give women the right to vote, if we can send a man to the moon then God, we can do universal healthcare for every American!" said Jayapal.
The Democratic Socialists of America (DSA) also offered its endorsement of the proposal on Wednesday and announced its own nationwide mobilization to enure the bill advances through Congress.
On Thursday, DSA will kick off a tour featuring longtime Medicare for All advocate and expert Michael Lighty, who will discuss "the urgency of the moment" with supporters.
"This is a milestone in the fight for universal healthcare and an equitable society, where working people make the decisions that determine our destiny," said Lighty. "Now our task is to build a mass organization of working people that will not give up until we win."
The groups' mobilization comes as the for-profit health insurance industry—and its defenders in Congress—are preparing to launch their own fight to maintain the status quo, instead of transforming the U.S. medical system into one resembling those of other developed countries where healthcare is considered a right.
"Don't forget, when we established Social Security, Medicare, and unemployment insurance, our opponents said it was too hard, they said it was too difficult. today is not going to be any different. You're going to see probably hundreds of millions of dollars flowing in to try to kill this bill, trying to pit us against each other, telling us that it is too expensive or that you're going to give something up," Jayapal said.
"But we are ready. We can do this as long as every single person across America stands with us to organize, to fight, and to demand healthcare as a human right," she added.
https://www.commondreams.org/news/2019/02/27/vowing-fight-until-we-win-advocates-plan-nationwide-mobilization-pass-medicare-all?

Insurance Stocks Plunge as Medicare for All Bill Unveiled With Major Democratic Support

"Sorry not sorry," Rep. Pramila Jayapal, the legislation's lead sponsor, tweeted in response to the news.
by Jake Johnson - Common Dreams - February 28, 2019

Support for Medicare for All is rapidly gaining momentum in Congress—and insurance investors are starting to get nervous.
Health insurance stocks tanked on Wednesday as Rep. Pramila Jayapal (D-Wash.) introduced comprehensive Medicare for All legislation with the backing of more than 100 House Democrats and major progressive organizations, including America's largest nurses' union and national consumer advocacy groups.
"The S&P 500 Managed Health Care Index plunged as much as 4.9 percent, the most since Dec. 6, led by UnitedHealth Group Inc., Humana Inc., and WellCare Health Plans Inc.," Bloomberg reported after Jayapal unveiled her bill during an event on Capitol Hill. "Insurers UnitedHealth and Cigna Corp, which also own the country's largest pharmacy benefit managers, were both down about four percent."

Jayapal quickly made clear that she has no sympathy for the insurance industry, tweeting in response to the news, "Sorry not sorry."
Under Jayapal's plan, the U.S. would transition to a Medicare for All system over a period of two years, and private insurance would be nearly eliminated.
Dr. Adam Gaffney, president of Physicians for a National Health Program (PNHP), said in a statement on Wednesday that the "only way to achieve universal and comprehensive coverage is to eliminate the profits and waste of the private insurance industry, which drains hundreds of billions of dollars from our healthcare system each year."
With their profits under threat, the insurance and pharmaceutical industries are mounting a full-fledged and aggressive campaign to stop Medicare for All in its tracks. The Partnership for America's Health Care Future, a coalition formed by major pharmaceutical and insurance interests, is reportedly planning a "big nationwide effort" to undermine single payer's momentum and preserve the for-profit status quo.
To overcome the opposition of the deep-pocketed insurance industry, National Nurses United (NNU) and other grassroots organizations are planning a nationwide mobilization of their own in the coming weeks in an effort to defeat corporate power with a mass movement of ordinary Americans.
"This is a milestone in the fight for universal healthcare and an equitable society, where working people make the decisions that determine our destiny," Sanders Institute fellow Michael Lighty said of Jayapal's bill. "Now our task is to build a mass organization of working people that will not give up until we win."
https://www.blogger.com/blogger.g?blogID=3936036848977011940#editor/target=post;postID=2240081449970928304

Less than 4 years after its own merger, Brunswick health care group considers joining MaineHealth

by Darcie Moore - BrunswickTimes Record - February 28, 2019

BRUNSWICK — Brunswick-based Mid Coast-Parkview Health is considering joining MaineHealth, a health care group with more than a dozen hospitals and medical offices stretching from Biddeford to Belfast and into northern New Hampshire.
Mid Coast-Parkview Health’s 25-member board voted unanimously Feb. 19 to establish a committee to spend the next four to six months exploring whether to join the MaineHealth system.
Should it merge with MaineHealth, it will be the second major change in the southern midcoast’s health care network in recent years. In 2015, Mid Coast Hospital merged with rival Parkview Adventist Medical Center as part of a nearly $8 million sale agreement, forming Mid Coast-Parkview Health.
The changing health care landscape would be a major consideration for the merger, Mid Coast CEO Lois Skillings said. Factors include increases in regulation and governmental policies, declining health care reimbursements and increases in patient care for which Mid Coast isn’t compensated.
“Last year we provided $24.6 million in free and uncompensated care,” Skillings said.
Mid Coast, an independent health care network, also is facing pressure from competitors. That includes a new diagnostic imaging center that recently opened at Brunswick Landing, a cancer treatment facility that opened at the Topsham Fair Mall in Topsham and a new urgent care facility that is under construction on Bath Road in Brunswick – none of which is affiliated with Mid Coast or MaineHealth.
“It’s also clear that the rise of this for-profit competition locally is chipping away at our ability to be as facile and quick in responding to things because we’re looking at things like, we have to stand up a service 24 hours a day seven days a week and the others provide a great service, but they may not be here 24/7,” Skillings said.
Mid Coast-Parkview Health employs 2,000 people with more than 200 active medical staff and serves a population of 75,000. The 93-bed Mid Coast Hospital admitted 5,454 people in 2018, had 438,331 outpatient visits through Mid Coast Medical Group. The system also encompasses CHANS Home Health and Hospice and Mid Coast Senior Health.
Comparatively, MaineHealth, the state’s largest employer, has 19,000 employees and 11 community hospitals in a dozen counties in Maine and New Hampshire.
Skillings said Mid Coast has had a formal relationship with MaineHealth for 25 years. It was Mid Coast-Parkview Health that approached MaineHealth, which includes Portland’s Maine Medical Center, the state’s largest hospital.
“We could have an advantage of being on the same electronic health records, so that our patients’ information flows back and forth freely, where we can use things such as telehealth technology,” she said, “and these kinds of things that take an organization with big scope and scale that Mid Coast, as strong as we are financially and clinically, will not have the scope and depth of scale to be able to stand up these big technological advances that we think could potentially advantage our patients.”
Bill Caron, MaineHealth CEO, is confident Mid Coast would find a financial advantage.
“We haven’t gone through the exercise of calculating the financial benefits, but there are a number of financial benefits for the Mid Coast-Parkview system in that because of our size, there are economies of scale ranging from group purchasing to some back office supports that we provide – so there will be a financial benefit to them,” he said.
Since its inception in 1998, MaineHealth has had several organizations join its system, some of them struggling financially. However, Mid Coast-Parkview is financially strong, making it an ideal time to consider joining MaineHealth, Caron said.
“This is an important decision, not only for Mid Coast but for the Mid Coast community,” Caron said. “There’s no better team at having that dialogue in their community because these are transparent folks and they will say it like it is.”
Skillings said the regulatory process could take six to 12 months if the Mid Coast-Parkview board votes to proceed with integration with MaineHealth.
“We value excellence over independence,” Skillings said, adding that health care is not a business but a complex integrated delivery system that could be aided by harnessing the power of a larger health system. Most important is that patients have the care they need now and in the future.
Mid Coast is holding local focus groups and public forums through March and possibly into April to speak to community members about why the health organization is looking at this option, “and to listen to them about any questions or feedback they have,” she said.
Mid Coast also is reaching out to employees, medical staff, volunteers and other stakeholders as the exploratory committee works to learn more about what it means to be part of a larger system and what changes may be in store for patients, staff and the community. Mid Coast doesn’t anticipate any downsizing or relocation of services.
“This is just the beginning of a conversation,” Skillings said. “I know it’s the right conversation and the right time to have it.”
https://www.pressherald.com/19/02/28/brunswick-hospital-considers-joining-mainehealth/

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Saturday, March 2, 2019

Health Care Reform Articles - March 2, 2019