Rick Rigney, President of USW Local 155, reports that his union has endorsed HR 676, national single payer health care legislation sponsored by Congressman John Conyers.

“We just believe that every American ought to be afforded the right to have health care,” said Rigney, “but there are a lot of Americans who have to choose between food or their medicine.”

Local 155 represents approximately 450 members who work at Reynolds Aluminum and Eckert America in Louisville, Kentucky, and at Ryerson in nearby Shelbyville.

In other news, with the addition of Congressman Paul Tonko, Democrat from the 20th District in New York, there are now 43 co-sponsors on HR 676 Tonko, who represents the communities of Albany, Schenectady, Troy, Saratoga Springs and Amsterdam, signed on to HR 676 on June 3, 2013.

After spending 25 years in the health care field, most of it related to making hospitals more efficient and effective, I have become skeptical of many of Washington’s reform efforts, especially by my party, the GOP.

One of the biggest problems with health care is escalating, uncontrolled expenditures, taking a larger and larger proportion of our GNP. However, what Rep. Paul Ryan and the GOP want to talk about is the federal budget and cost-shifting via Medicare and Medicaid.

Experts in health care economics differ on many things. But one thing they all agree on is that raising the age for Medicare will do virtually nothing to reduce the overall cost of health care in this nation.

Under the Affordable Care Act, everyone must have insurance or be taxed. Medicare has a 3 percent administrative overhead while the private sector has run 28 percent, coming down to 20 percent as required by the ACA. Raising the Medicare age simply shifts the insurer from the government to less efficient private providers. This dumps the extra cost into the lap of the senior, who at 65 is probably unemployed and unemployable. There are no overall cost savings via efficiencies with Ryan’s Medicare “voucher” proposal.

Dr. Gerald Friedman, professor of economics at the University of Massachusetts, was in Charlotte recently for the launching of a physician advocacy group, Health Care Justice. Friedman indicated that U.S. per capita health care cost is $7,920. That compares with $3,323 in Sweden, $2,984 in Finland and only $2,686 in Italy. He points out that people in these countries are healthier than in our country and things are getting worse here. In 2001 among the non-elderly, 14 percent did not see a doctor for needed medical care. The figure rose to 26 percent in less than a decade.

Friedman pointed out that the most basic financial problem with U.S. health care is the for-profit insurance system. Insurance company profits have increased 250 percent in the last decade, Friedman said. The head of Cigna made a whopping $29 million in 2009 while health care premiums and increased deductibles are eating up more and more of workers’ wages.

He further pointed out that the administrative cost of health care insurance is one of the major drivers of escalating health care costs from 1980 to 2005. According to Friedman, the administrative cost of private insurance will be $200 billion in 2013. In the U.S. billing costs run $83,975 per doctor per year versus only $22,205 in Ontario.

This is waste, pure and simple. Although the Affordable Care Act pushed through by the Democrats does not do enough to solve the issue, the current GOP proposals totally ignore it.

A related area is prescription drugs. We pay 60 percent more than other countries. Our nation is in effect providing a subsidy to all the others. Why should we pay more to develop drugs that are used elsewhere, not just here?

What is the best course of action to provide better health care and reduce the growth of national health care expenditures? Dr. Friedman’s cure is to move to single payer.

Single payer would drive down costs because Medicare (or a utility-like private single payer insurer) would have leverage to keep costs down. With no other game in town, providers would be forced to operate more efficiently. Drug companies would be pressured to give Americans the same drug pricing that is found elsewhere.

Friedman pointed out that in multiple state studies (independently done by several groups), single payer turns out to save money. In his own studies, he has shown savings of around 20 percent for North Carolina, Pennsylvania and Massachusetts, and even more in Colorado and Maryland.

According to Friedman, a national single payer system would produce enormous savings, $18.7 billion per year. Surely, at a time when wage earners are being faced with ever increasing premiums and higher deductibles, we should at least consider Medicare for all or a similar single payer system.

The real question is whether either party is willing to stand up to the drug and insurance lobbies and do what is best for America.

Jack Bernard is a retired health care executive, former Jasper County, Ga., commission chairman and former chairman of the Jasper County Republican Party.

Come to the National Strategy Conference to discuss the latest single-payer strategies and organizing as we pool our resources and experience. As the Affordable Care Act begins implementation and austerity politics lead to attacks on all of our public programs, it is more important than ever for advocates of healthcare justice to organize strategically and effectively.

You can register and find more information here.

When: Saturday, October 5th and Sunday, October 6th, 2013

Time:
Saturday, 2pm – 9pm – Strategy Conference
Sunday, 9am – 4pm – Strategy Conference continues

Where: Scarritt-Bennett Center, 1008 19th Ave. South, Nashville, TN 37212

The full conference agenda will be released in the coming weeks.

A study released today on the Health Affairs blog finds that between 29.8 million and 31.0 million people will remain uninsured after the implementation of the Affordable Care Act in 2016 and breaks down those figures by state.

The research team from Harvard Medical School and the City University of New York School of Public Health projects that the demographic composition of today’s uninsured population will change little under Obamacare.

The share of the uninsured who are U.S. citizens will rise slightly from 80 percent to 81 percent. White persons (of all ethnicities) will continue to constitute 74 percent of all uninsured Americans. About 59 percent of the uninsured will have incomes between 100 percent and 399 percent of poverty, while 27 percent will have incomes below poverty.

The researchers also estimated uninsured figures for each state (see table below).

The study analyzed Census Bureau data on current patterns of uninsurance, and used a coverage prediction model based on the model used by the Congressional Budget Office.

The researchers projected two coverage scenarios for each state. One assumed that the state turns down a Medicaid expansion and the other assumed that the state implements Medicaid expansion despite the Supreme Court ruling that such expansion is optional. The national estimates use the Advisory Board Company’s latest summary of which states are likely to participate in the Medicaid expansion.

Study co-author Dr. Steffie Woolhandler, a professor at CUNY and visiting professor of medicine at Harvard, said: “Many people believe that Obamacare will cover everyone. But the reform is so deeply flawed that 30 million or more will still be uninsured after it’s fully implemented. Even if the Supreme Court hadn’t let states of the hook for Medicaid expansion, 26 million would have been uninsured. We need to replace Obamacare with a simple single-payer system that would cover everyone.”

Lead author Dr. Rachel Nardin, chief of neurology at Cambridge Health Alliance and assistant professor of neurology at Harvard, commented: “Even in Massachusetts, where a reform like Obamacare has been in place since 2006, too many patients still can’t get the care they need. Hundreds of thousands are still uninsured, and many more have such skimpy coverage that they face unaffordable co-payments.”

“The Uninsured After Implementation of the Affordable Care Act: A Demographic and Geographic Analysis,” Rachel Nardin, M.D., Leah Zallman, M.D., M.P.H., Danny McCormick, M.D., M.P.H., Steffie Woolhandler, M.D., M.P.H., David Himmelstein, M.D. Health Affairs blog, June 6, 2013.

Medicare has reduced poverty among the elderly by two-thirds since it was introduced and it remains extremely popular — 58 percent of people want NO cuts to Medicare or Social Security.

Actions organized in July come at a crucial period as Congress proposes cuts to Medicare and Social Security to reach a “grand bargain” to replace automatic cuts already underway through a process of sequestration. We can’t allow that to happen. The solution we all know is improved and expanded Medicare-for-all.

Can you donate to Healthcare-NOW! today to help make this year’s actions a success?

It’s up to us to use Medicare’s anniversary, and the implementation of Obamacare, to educate our communities on single-payer and motivate our friends and neighbors to take action.

The wonderful folks at Single Payer Now in California are willing to match every dollar you donate up to $1,000, and they will match monthly recurring donations at $10 for every $1 per month you donate (a $20 recurring donation will trigger a $200 match!).

Help us meet this goal.

Donate $20 and we’ll send you a Healthcare-NOW! bumper sticker and pin. Donate $40 and we’ll send you a copy of Dr. John Geyman’s book Health Care Wars.

All donors receive a discounted registration for our National Strategy Conference this October in Nashville, TN–we’ll send out more information about that soon!

You can donate online, send a check to Healthcare-NOW!, 1315 Spruce Street, Philadelphia, PA 19107, or call 800-453-1305.

Thank you so much for your support.

Sincerely,
Ben, Zoraida, and Jeff
Healthcare-NOW! National Staff

Four central labor councils have passed an identical resolution calling upon the September AFL-CIO convention to organize an offensive campaign for expanding Social Security financing and passing improved “Medicare For All” legislation.

The resolution, which was initiated by the Troy Area Labor Council, has also been passed by the Greater Louisville Central Labor Council, the Greater Green Bay Central Labor Council and the Capital District Area Labor Federation in Albany, NY.

The resolution calls upon the AFL-CIO to organize a Solidarity Day march on Washington and on the West Coast “to demand an expansion of Medicare to cover everyone and to defend Social Security by removing the cap on income and tax all income in a similar fashion.”

The resolution calls for taxing all income for the purpose of Social Security including dividends, interest, capital gains, and rental income as well as removing the cap on wages and salaries now set at $113,700. Currently, those who earn up to $113,700 pay 6.2% in Social Security taxes on every dollar. Those who earn over that amount do not pay taxes on their earnings above that level even if they make millions. Currently the income of the wealthy in dividends, interest, capital gains, etc. is not taxed at all for Social Security.

On Medicare the resolution calls for “implementing a single Payer Medicare for All system as outlined in HR 676,” Congressman John Conyers’ single payer legislation which has 42 House co-sponsors. The legislation would cover everyone for all medically necessary care without co-pays, deductibles or premiums. The removal of the private health insurance industry would bring costs under control while expanding care.

In Minnesota, the Machinists’ State Retirees’ Council (IAM) is sending the resolution to all central labor councils in that state. In Pittsburgh, the president of a steelworkers local (USW) is submitting it to the Allegheny County Labor Council.

The AFL-CIO convention opens September 8th in Los Angeles, CA. Central Labor Councils, Area Labor Federations, and State AFL-CIO Federations as well as international unions may submit resolutions. Resolutions can be sent to Elizabeth Shuler, Sec.-Treas. AFL-CIO, 815 16th St. NW, Washington, DC 20006.

The resolutions can be found here.

Text of resolution:

Resolution for Action in Defense of Social Security and Medicare

Whereas: Both Social Security and Medicare are hard fought fundamental gains for all working people.

And Whereas: Cutting Social Security and Medicare benefits would mean destitution for millions of workers and their families.

And Whereas: The social insurance Social Security and Medicare provide is now under sustained attack by Wall Street interests which seek to direct these funds into private hands for private profit.

And Whereas: Removing the cap on income taxed for Social Security would both solve any financial issues the fund might have and end the unfair advantage of those making over the current capped level.

And Whereas: Implementing a Single Payer Medicare for All system as outlined in HR 676 would both cover everyone and save billions of dollars over the current private health insurance industry.

Therefore: The Troy Area Labor Council AFL-CIO urges that the AFL-CIO, within this calendar year, organize a Solidarity Day of Action in Washington and on the West Coast which calls all affiliates and labor allies to mobilize their members to demand an expansion of Medicare to cover everyone and to defend Social Security by removing the cap on income and tax all income in a similar fashion.

As Congress mulls changing America’s border and naturalization rules, a study finds that immigrant workers are helping buttress Medicare’s finances, because they contribute tens of billions a year more than immigrant retirees use in medical services.

“Immigrants, particularly noncitizens, heavily subsidize Medicare,” the researchers wrote in the journal Health Affairs. “Policies that reduce immigration would almost certainly weaken Medicare’s financial health, while an increasing flow of immigrants might bolster its sustainability.”

The Hospital Insurance Trust Fund, which pays for Medicare’s Part A inpatient hospital care, skilled nursing facilities, home health and hospice for the aged and disabled, had assets of $244 billion at the start of 2012 but is projected to run out of money in 2024 as the population ages, according to estimates of the Medicare trustees. It is financed by payroll and self-employment taxes.

The study examined the impact of 29 million immigrants counted in the Census on the financing of the Medicare program. It included those who had become U.S. citizens as well as those who hadn’t, but, the authors noted, probably excludes many [undocumented] immigrants who dodged the survey.

The study found that in 2009, immigrants contributed $33 billion to the trust fund, nearly 15 percent of total contributions. They received $19 billion of expenditures, about 8 percent, giving the trust fund a surplus of $14 billion. People born in the United States, on the other hand, contributed $192 billion and received $223 billion, decreasing the trust fund by $31 billion, according to the paper’s lead author, Leah Zallman, a scientist at Cambridge Health Alliance in Massachusetts,

Between 2002 and 2009, immigrants generated a cumulative surplus of $115 billion for the trust fund, the study found. Most of the surplus contribution came from noncitizens. The immigrants created a net gain primarily because of demographics: There are 6.5 immigrants of working age for every one elderly immigrant, but only 4.7 working-age native citizens for every one retiree. Although that ratio could change in the future, the report notes that the Census Bureau projects that the share of immigrants in the United States will increase for the next 18 years.

Continue reading.

Yesterday, the New York Times reported that the Affordable Care Act’s “Cadillac Tax” will accelerate the erosion of quality health insurance as employers demand higher copays and deductibles from their workers to keep their premiums low enough to avoid the tax.

While the Times is correct about the dangers of the tax, they are perpetuating inaccuracies about who will face the tax and how employers are trying to avoid it.

The Times inaccurately states that the tax “penalizes companies that offer high-end healthcare plans to their employees.” The tax, starting in 2018, actually penalizes plans with premium costs above $10,200 for individuals or $27,500 for families.

However, your premium costs have almost nothing to do with how good your coverage is, or whether you have a “high-end” plan or not. A 2009 Health Affairs study found that the quality of insurance coverage explains only 3.7% of the variation in premiums.

This means the tax will not be hitting those with good health coverage, but rather older patients (who can be charged up to three times what younger patients are for the same coverage), and those living in states with expensive hospital care. The term “Cadillac Tax” itself is inaccurate and misleading, and the Times should not be perpetuating this myth.

A major theme of the Times’s article is that employers will try to keep their premiums down by keeping their employees healthy, through “wellness” programs that create financial incentives for healthy behavior (such as smoking cessation, weight loss, etc). A number of recent studies show that these programs are not effective at reducing healthcare costs, and in reality they are a way for employers to shift costs onto workers with chronic illnesses or disabilities by charging them higher premiums or withholding benefits.

Join me in writing a letter to the editor of the New York Times asking them to stop perpetuating the myths of the “Cadillac Tax” and “wellness programs,” and reminding them that a single-payer health plan would take the burden of healthcare costs off of employers and give all workers access to comprehensive coverage – with no cost sharing – while reducing our healthcare costs. Painful tradeoffs like those that will be created by the Affordable Care Act’s tax on high-premium plans are unnecessary and immoral with a proven alternative like single payer reform.

You can submit a letter to the Times by emailing letters@nytimes.com. Letters can be no longer than 150 words, must refer to an article that has appeared within the last seven days, and must include your address and phone numbers. No attachments.

For inspiration, here’s what I submitted to the Times:

Dear Editor:

In its May 27 article (“High-End Health Plans Scale Back to Avoid ‘Cadillac Tax’”), the Times perpetuates the myth that the Affordable Care Act, starting in 2018, will tax “high-end health care plans.” In reality it will tax plans with high premiums, which are not those with the best coverage but rather those offered to older people (who can be charged three times the premium of younger patients for the same coverage) and those living in high-cost states. A 2009 Health Affairs study found that only 3.7% of differences among premiums could be explained by how good their coverage was. The term “cadillac tax” is misleading and should be abandoned by the Times. The tragic consequences outlined by the Times – rising deductibles and copays – are all too real, though, and unnecessary given that single payer health reform could extend comprehensive care to all residents while reducing our spending.

For a better chance of being published, please don’t copy this letter word for word.

“On Saturday, May 4th the New Hampshire AFL-CIO unanimously passed a resolution supporting HR 676 and the adoption of a national single payer health care system that covers all Americans for all necessary medical care including prescription drugs and dental,” reported President Mark MacKenzie.

New Hampshire is the 42nd State AFL-CIO Federation to endorse HR 676, Expanded and Improved Medicare for All, sponsored by Congressman John Conyers (D-MI).

“HR 676 will save hundreds of billions of dollars by eliminating the private health insurance industry with its high overhead and profits,” said MacKenzie.

“As President of the New Hampshire AFL-CIO I am proud to have our members actively participate in the movement to win passage of HR 676 and to make health care a human right.”

On May 21, 2013, HR 676 gained another co-sponsor in Congress with the addition of Danny Davis (IL-7). HR 676 now has 42 co-sponsors.

North Carolina could save as much as $18.7 billion next year on health-care costs if it changed the way it finances health care.

The catch? That change would require a switch to a single-payer system in which one entity collects all health-care fees and pay related costs, says Gerald Friedman, a professor of economics at the University of Massachusetts at Amherst.

“We have a system that was broken 10 years ago, and it’s getting worse,” he says. “You can’t fix it unless you change its fundamental basis.”

Friedman spoke Thursday night in Charlotte at the Health Care Justice meeting. That organization wants everyone in the community to have access to health care. It is a chapter of the Physicians for a National Health Program, which supports single-payer national health insurance.

Friedman has drafted financing plans for single-payer health systems for Maryland, Massachusetts and the United States. If adopted, he estimates such a payment model could result in $2 trillion in savings nationwide over the next decade mainly by cutting administrative costs and controlling prescription drug prices.

On Thursday night at the Midwood International and Cultural Center, he touted the need for universal-comprehensive coverage, in which everyone would have access to care. Individuals, businesses and the government stand to benefit, Friedman said.

Universal coverage would minimize billing expenses, avoid wasteful competition among insurers and eliminate adverse selection against people who are sickest, he said.

Friedman estimates that nationwide there is $1.5 trillion in waste annually when it comes to health-care spending. Such spending now accounts for roughly 18 percent of the gross domestic product. And it is expected to rise to 22 percent of the GDP within five years.

In North Carolina, health-care spending has risen more than 400 percent in North Carolina since 1990, Friedman said.

At the same time, per capita income has barely doubled, which puts increased pressure on a family’s income. In 1960, health-care spending accounted for just 7 percent of a family’s take home pay. That rose to 39 percent in 2010.

“More and more money is going to health care,” he said.

The current health-care payment system is unsustainable because it is focused on making profits, Friedman said. That results in waste, fragmented care delivery and significant administrative costs and monopolistic pricing, he added.

For example, he said drug prices are 60 percent higher in the U.S. than elsewhere.

Health insurers will spend nearly $200 billion on administrative costs in 2013, he noted.

Friedman expects the current payment system will collapse. He notes expanded access through federal health-care reform will fall short of providing universal coverage and does not do enough to stem rising health-care costs.

That means health insurance premiums will continue to rise, making it unaffordable for more individuals.

“Right now health-care is a lump-sum tax on individuals, especially sick individuals,” he said.