The Independent Reviewer #5
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May
4, 2009
The Independent Reviewer was last published 9/1/08.
Health Care Reform is going to get its day in the sun after health care
in the United States has reached unsustainable levels. This unsustainable
state is now very close. We asked you in the last reviewer to vote for
Senator Obama for President as he had the best chance of obtaining health
care reform and meeting our goal of universal health care. This would
fulfill the axiom that all of us believe in at the Coalition for a Health
Secure America. Health care is a right not a privilege.
The current state of affairs:
1. 42 million are without health care as of a year ago.
Without any firm
statistics we see millions more dropping their policies as $1500 per month
unemployment does not allow you to pay a $1500 per month health insurance
bill.
2. Insurance companies are agreeing with the need for health care reform as their policy base continues to drop like a rock secondary to one.
3. The SCHIP (State Children’s Health Insurance Program) for more child coverage and state plans like Badger Care Plus in Wisconsin which placed 100,000 more people on Medicaid in WI is stressing the system by cost shifting even more.
In California these numbers are astronomical approaching the million numbers. This has caused health care providers to raise their rates to cover for the very low pay they receive from Medicaid which is the fee schedule used for re-imbursement. (Example in Wisconsin: “A Sore Throat” office visit (code 99213) for an established patient payment by Medicaid $30.30, Medicare $66.04, and Usual and Customary charges for people not on a government program but with health insurance or no health insurance $119.00) The Medicare price is more than enough if all people would have the insurance equal to Medicare. Anthem Insurance is expecting to raise rates in California 20-25%. Remember this looks like a $1500 per month health insurance premium going to $2000. This is quite a problem when unemployment insurance is about $1500 per month.
4. Hospital administrators are very disturbed as with the above scenarios occurring people simply are not using their services and many who do cannot pay.
I have a recent quote from a community hospital administrator that lays it out very succinctly. “Health Care Reform is messy but it is only a matter of time before the system implodes. It cannot go on like this. I am writing off $250,000 per month in bad debt expense because people have no insurance or are underinsured. The Governor wants to further reduce my revenues by $3 million per year over the next biennium. I plan to freeze salaries for all employees including my own. We have cut back capital spending and nobody leaves the state for education.” The list goes on. The current health care system is unsustainable.
5. People with deductible insurances are not seeing their doctor early
enough and are much sicker than they should be.
All of the above has been happening with a moderate progressive march but beginning in October 2008 everything began racing to the bottom with the huge unemployment numbers. This is forcing action. The government is printing money, bailing out the banks and large corporations. The economy still has not seen the bottom and may well not for some time if you watch any of the financial gurus. With our financial system in deep trouble the health care crisis has reached proportions pushing health care reform front and center in the Congress with bills expected to be advanced within months.
The above is a summary of events to this date and all agree health reform is needed. Not only insurance companies, hospitals, patients, large clinics or individual providers, but virtually every special interest in the health field is lining up his assets to be sure his “Ox is not gored”.
Part of the purpose of this writing is to make people aware of what to look for and keep in mind when you are trying to influence your Congressmen, your neighbor or simply trying to evaluate your representative’s political actions. Do I want this person to be re-elected to his legislative post with the positions I hear him give on health care reform when he and his family is well covered but I am not?
The former Senator Obama made it very clear his idea on reform in the campaign and he has very much stuck with this as President. The most crucial point- offering a government insurance program to Americans who do not qualify for Medicaid or SCHIP or have access to health insurance through an employer or through small businesses that cannot afford to offer health insurance to their employees. Until only recently all this was somewhat unclear.
A government run health care plan which we in the coalition have favored-Medicare for all- may be a bit far for the Congress to go even though this is the only solution that will work allowing the big cost savings with electronic records, set fee schedules, a history of success and most of all is now functioning. Medicare for all could easily cut our costs in half. As a physician, and one of the 62% who want universal care Medicare for all would be the best idea with the singe payer concept presently functioning. The insurance companies are going to be on the losing end of this plan but rather than forcing them out of the health care business all on the same day, making Medicare for all voluntary, could be the public plan that President Obama promised in his campaign. Medicare for all on a voluntary basis is being suggested by Senator Max Baucus (D), MT., a very significant health care reform leader in the Senate, and Senator Grassley (R); IA represents the opposition to this. The Democrats have organized a new method of vote in the Senate (a fast track method) that would require only 51 votes to get this done. It is suggested that since this plan would be cheaper than private insurance this is what the public will take and indeed the day of private health insurance may be over. Sanity may well return to the health care industry allowing common sense to govern health care with all Americans being covered. I expect health care reform to happen before the summer is out.
In expressing confidence that perhaps we will have a start to a sane health
system in the US I must caution you when I realize the following: (If
it looks incorrect to you it probably is)
1. Drug companies have spent 47 billion dollars in the last couple of years on marketing and are not about to go willingly into a public system of health care. (How many ads have you seen for Plavix in the last three months on prime time TV and try and estimate the cost)
2. Drug companies have been paying off the generic drug companies not to produce some successful recently off patent drugs. This is legal and a great burden that has to be corrected. Work is started on legislation to put an end to this!
3. President Obama was successful in passing with the stimulus package the funding of an agency to test treatments to see which work and which don’t. At the same time Sen. Feingold, (D) WI along with Sen. Kyle, (R) of AZ entered an amendment that stated the results of these tests could not be used to deny a person treatment. The amendment lost but this clause was still entered into the final form of the legislation which means: If a form of treatment has been proven to not work this will be presented to physicians and patients but if the patient and physician wish to use the ineffective treatment it cannot be denied by insurance. WOW!! This is incomprehensible to me when our health care costs are twice other countries and we live five years less and most of all we have millions that can’t afford insurance. Since I send this to Sen. Feingold I hope he will reconsider his thinking on this when this comes up again. It will come up again as we cannot afford it. I have not received a satisfactory explanation from Sen. Feingold other than we cannot limit choice. You will have to decide if his reasoning is correct or not and vote your conscience.
4. We have had comments and a book written by Sen. Daschle stating that universal health insurance will not fly in this country as it is Socialism. In Socialistic Universal health care the provider gets his salary from the government. This is not the case in any plan I have seen put forward in the US. Physicians and other providers will still be allowed to compete for patients by the service they offer. The private insurers such as United Health Care do not want a public system and until Sen. Daschle’s activities were identified during his confirmation process for Sec. of HSS we thought he was all for helping health reform in this country with only the citizens in mind but this would be hard with the money he has received as an “unregistered lobbyist”. I had sent him congratulations on his appointment by Sen. Obama only to be crushed when his activities and tax problems were made public.
To all of you who are watching and fighting for health care reform go
back to the basics and if it looks like a special interest is hurting
citizens in favor of itself please fight back. To outline again and have
in front of you I urge you to re-read the sections in my book where these
items are outlined. This begins on page 50. It will not take you long
to read. The book can be downloaded free at the below website.
If health care reform matters to you contact you congressmen or state legislator via their website email when you agree with or disagree with their thinking. It will probably be your last chance to fight for health care reform in this administration. Health reform has to be done right and you have to help make it so. If you have any questions I might help you with please do not hesitate to call me at 715-237-2597. All of us who consider ourselves activists cannot do this alone. All citizens will have to help. Let’s go for it!
Thank you,
Fred Bannister, M.D.
Chairman
Board of Directors
Coalition for a Health-Secure America
fredb@healthsecurityamerica.com
Dr. Bannister is the author of the book Health Security America: Fixing the Health Care Crisis, a citizens’ guide to reforming our health care system. This is available as well as other archived health care dissertations by Dr. Bannister at
http://www.healthsecurityamerica.com
The book Health Security America is available free on the Net at:
http://www.healthsecurityamerica.com/ehsa.pdf
Please allow time for it to download.
Health Security America is the remedy.
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by Four Leaf Clover.