Michele Swenson's Blog
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Michele S (Denver, CO)

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Advocate, Single-Payer (Public Payer, Private Provider) Health Care

The "right-to-life" movement that elevates embryonic life above women's lives is more accurately termed "right-to-prenatal-life." One of the most extreme 2008 anti-abortion, anti-contraceptive ballot measures is the so-called Colorado "Personhood" amendment - number 48 - defining fertilized eggs as "persons" with Fourteenth Amendment rights to "life, liberty and due process of law." Simultaneously, rightists have opposed the same rights for women as "reading feminism into the Constitution."

Both Amendment 48 and a rule change proposed by the Bush administration Department of Health and Human Services would re-define pregnancy as the point of conception, disregarding the medical definition of pregnancy - "the implantation of a fertilized egg." They would effectively categorize as abortion any contraception (e.g., the pill, IUD, emergency contraception, contraceptive patch) that interferes with the implantation of a fertilized egg, thus outlawing most contraception - the primary means to reduce the need for abortion.

In a slippery slope to 19th century status for women, rightists have promoted "conscience clauses" permitting pharmacists' and others' refusal to fill prescriptions or provide health care for women. The HHS proposal states, "[T]he conscience of the individual or institution should be paramount in determining what constitutes abortion..." - holding women's health hostage to anyone's professed religious/ideological beliefs.

It is time to recognize that abortion serves as surrogate for a spectrum of unspoken issues related to female personhood and male entitlement. The anti-abortion political litmus test was introduced by Paul Weyrich, who dictated that women step aside and "make way for new life." It serves dual purposes - the marginalization of women and the lightning rod around which to mobilize political coalitions, notably, Evangelicals and Catholics. The elevation of fetal life over women's lives, coupled with conservative strategist Howard Phillips' euphemistically described goal of return to "one-family-one-vote," is calculated to marginalize and disenfranchise women, consistent with the ultraright tenet that ultimately, only select white Christian males should retain the right to vote or hold office.

Rickie Solinger concluded from her historical research of women's health care that women's rights have often been held hostage by politicians and others with "political agendas hostile to female autonomy and racial equality" (Wake Up Little Susie: Single Pregnancy and Race Before Roe v. Wade, 1992). The criminalization of contraception and abortion, and the widespread U.S. adoption black market that assigned value to babies and punishment to women based on race, were some effects of pre-Roe efforts to control women's reproduction.

At core, Weyrich's anti-abortion, anti-contraceptive and abstinence-only ideology serves as cornerstone of an anticipated male supremacist theocracy. It is the platform upon which the majority of Republican candidates continue to run in 2008. The greatest conceit - that pregnancy is not a health issue and women's lives are expendable - underlies the dual standards of Republican Party pronatalist policy demanding female submission to males who presume the right to hold women hostage to personal beliefs.


On August 29, the Friday before the Republican Convention, members of the Council for National Policy convened in Minneapolis to grant their imprimatur to the vice presidential candidacy of Sarah Palin. Focus on the Family's Tom Minnery described the group's reaction in a Focus on the Family Action video, which has since been removed from their website: "There could not be more excitement based on the little we know about Palin so far," enthused Minnery. Given general longstanding opposition to women in positions of power among CNP members, Minnery was asked whether James Dobson could possibly support a woman for the office. He quoted Dobson: "If it's the right woman, we are ready to vote for her." Dobson has been hoping for some time to find a "Margaret Thatcher" type, noted Minnery.
Outside the obvious, i.e., her anti-gun control and anti-abortion positions, Minnery recited Palin's positives as a conservative candidate: a hocky mom in an intact marriage who "has not rejected her feminine side"; because she and her husband are union members, it was speculated that blue collar voters in important swing states would be attracted; and (improbably) because she is a woman, that she would appeal to Hillary Clinton supporters.

The Council for National Policy (CNP) has remained largely below the radar since its 1981 founding as an umbrella group uniting a network of over 500 members from Congress, the business community and hard-right evangelicals. The press are excluded from their secretive invitation-only strategy meetings, held three times annually.

The group is strongly influenced by the teachings of the late Rousas Rushdoony, a CNP member and patriarch of the reactionary Christian Reconstructionist (Dominionist) movement that has infused the doctrine of conservative churches since the '60s, and seeks Christian dominion over all aspects of society and the world.

   Read More »

When Democrat Mark Udall debated Republican Bob Schaffer in July, he made no effort to refute Schaffer’s distortions surrounding health care reform. In fact, he essentially short-circuited meaningful debate by adopting the nebulous right-wing description of single-payer health care as “government health care,” thus capitulating to Republican framing of the issue.

Just what is government health care? Is it the more than 60 percent of all health care costs that are paid by taxpayers, including subsidies for inflated costs of private insurances? Private insurers skim the cream and game the system for profit, and count on government (taxpayers) to pick up the health care costs of all whose coverage they reject. Does government health care include the 70 percent of our legislators’ health coverage that is funded by taxpayers?

Democrats who facilely echo GOP talking points grossly misrepresent single-payer health care. In fact, contrary to assertions by the right-wing “free market” chorus, only single-risk-pool insurance provides true free choice of private providers, the same as traditional Medicare before Republicans moved to privatize Medicare (at 12 percent higher cost). Private insurance plans limit choice to “in plan” doctors, often requiring change of providers when plans are changed. Only single payer is capable of providing comprehensive, continuous health care benefits and protection against medical bankruptcy.

Our leaders should vigorously protest the abomination of Medicare prescription drug reform that was written by insurance and pharmaceutical lobbies with billions of dollars of taxpayer subsidies and inflated profits to benefit their bottom lines, while prohibiting negotiation of bulk drug prices.

Instead of privatizing Medicare-for-profit, why not improve and expand its coverage for everyone? Traditional Medicare has lower overhead costs – less than 4 percent – whereas private insurances divert 25 percent or more to profits, lobbying, marketing, exhorbitant CEO salaries and wasteful administrative costs. Profit is a perverse incentive for health insurance, which protects its bottom line by reducing benefits and shifting ever-greater costs to consumers.

The insulated political class in Washington, dependent upon corporate money and privy to 70 percent taxpayer-subsidized health coverage, seem out of touch with the U.S. people. Polls by Pew and others have revealed that increasing numbers – 54 to 65 percent – support a national single-payer health care plan. A recent study reported in the Annals of Internal Medicine (3-31-08) that 59 percent of U.S. physicians “support government legislation to establish national health insurance,” an increase of 10 percent since 2002.

Notably, more than 20 federal and state studies since 1990, including the 2007 Lewin Group evaluation in Colorado, have demonstrated that single-payer health insurance is the only reform model that can both save money and provide comprehensive health care benefits for all. The Colorado single-payer proposal and Rep. John Conyers’ national health care bill, HR 676, both deserve serious further study.

We have everything to gain from an honest dialogue about quality-, saftey-centered universal single payer health care, in place of profiteering health insurance gatekeepers.

Progressive Democrats of America with The Nation magazine are setting up headquarters at Central Presbyterian Church (1660 Sherman St.), where they have scheduled issues forums over 5 days of the Democratic National Convention.

Free daily panels moderated by The Nation's John Nichols at 11 AM, are followed by additional panels covering Health Care on Monday, August 25, followed the rest of the week with forums on Media and Election Reform, Economic Justice, Global Warming and Constitutional Law.

Participants include Reps. John Conyers, Barbara Lee, Robert Wexler, Keith Ellison and Lynn Woolsey; Tom Hayden, Jim Hightower and authors David Sirota and Vincent Bugliosi; various writers and publisher of The Nation; journalist and radio host Laura Flanders; Jeff Cohen, author and founder of FAIR; and many others.

For schedule and more info, check Web site http://pdamerica.org, click on "Progressive Central" in green bar at page top. Watch for posting of PDF event flyer.

Also, check link to HCAC page for Democratic Convention Actions around Health Care.

A study published in Health Affairs (6-10-08) documents a sharp (60%) increase in numbers of underinsured between 2003-2007. Underinsurance rates nearly tripled among those with incomes above 200% of poverty. Consequently, 42 percent of U.S. adults were under- or uninsured in 2007, reporting high levels of access problems and financial stress.

Even among those with incomes over 400% of poverty, 15% are underinsured. The study indicates that the move toward greater consumer cost-sharing for minimum benefit insurance policies in recent years is pushing millions of insured non-elderly adults toward spending large shares of their incomes on health care. The clear impact is to increase the share of families at risk for medical debt and loss of savings for retirement, college, or other long-term needs.

Our current insurance system is working well only for the wealthy, who can afford high costs. Politicians' promises that "you can keep the insurance you have" also apply to the wealthy.  Read the Report


Following is a 650-word piece I wrote about the failure of profit-centered health care that has been picked up by several newspapers around the state.


                              Failure of U.S. profit-centered health insurance

Spending almost twice as much, the U.S. has worse health outcomes than other industrialized nations. Uniquely, U.S. health care is dependent on over 1200 for-profit health insurances, functioning as gatekeepers. Underwriting – the art of risk evaluation and avoidance – insures profits by covering the healthy and rejecting everyone else as a "pre-existing condition."

Profit is a perverse incentive for quality health care: imagine for-profit fire or police protection. "Market-driven" health care treats health as a commodity, to be negotiated like a car or a house. The free market has also spawned "designer hospitals," offering only the most profitable specialties, e.g., cardiac procedures, and eliminating less profitable services, e.g., emergency and mental health.

No reform proposal by current presidential candidates addresses the failure of the private health insurance industry, characterized principally by decreasing benefits and greater costs and risks shifted to consumers. In turn, more are subjected to underinsurance and unpaid medical bills – now the leading cause of personal bankruptcies. Premium increases of 87 percent over 6 years have outpaced both cost-of-living and median family income increases.

Incremental reform proposals demonstrate lack of political will – the same failure to confront corporate profit-taking by insurance and pharmaceutical industries that wrote Medicare prescription drug reform with billions of dollars of taxpayer subsidies and inflated profits to benefit their bottom lines.

Commercial health insurance is the 800-pound gorilla, responsible for over 25% of health care dollars siphoned to excessive administrative costs, lobbying, marketing, CEO salaries and profit-taking: $30 billion annual health insurance profits; $32 billion insurance underwriting and marketing costs (McKinsey Group, 2007).

Gaming the system for profit has given rise to the annual $20 billion business of "denial managment" – health insurance middlemen who search claims for excuses to delay, deny or renege on reimbursements.

Responding to double-digit premium increases, more employers are opting to move employees into underinsurance – high-deductible catastrophic plans. Simultaneously, the American Hospital Association reports that both family out-of-pocket health expenses and unpaid medical bills have risen approximately 60% over a decade – still more costs ultimately shifted to taxpayers and consumers.

Notably, more than 20 federal and state studies since 1990, including the 2007 Lewin Group evaluation in Colorado, have demonstrated that single-payer health insurance is the only reform model that can both save money and provide comprehensive health care benefits for all. Indeed, the single payer model is the only truly efficient, equitable, and sustainable financing system, enabling universal coverage by spreading risk across the entire population.

Contrary to assertions by the "free market" choir, only single payer insurance permits true choice of pubic and private providers; private insurance is limited to "in plan" doctors. Only single payer provides comprehensive benefits and protection against medical bankruptcy.

Rather than comprehensive health care reform, most current proposals revert to a Massachusetts-style nostrum, preserving insurance profits and requiring an individual mandate to purchase minimum-benefit insurance, subsidized by taxpayers as needed. It is a formula for continued inflationary consumer health costs and decreasing benefits.

National single payer bill, HR676, calls for a progressive 3 to 4 percent employer and employee payroll tax to replace all health deductibles and premiums. Full-coverage costs for a family of four earning $40,000 annually would drop to $110 a month, from recent levels of $273/month for employer-sponsored coverage, or $489/month for an individually-insured family (Kaiser Family Foundation, 2007).

A political class dependent on corporate money (and privy to 70 percent-taxpayer-subsidized health coverage) sidesteps meaningful reform. Nevertheless, polls by Pew and others have revealed increasing numbers – 54 to 65 percent of people – support a national single-payer health care plan. A recent survey reports that 59 percent of U.S. physicians now support national health care, up 10 percent from 2002.

A grassroots movement and political reforms, including publicly-financed campaigns, may be necessary to instill the political will for meaningful reform. We have everything to gain from quality-, saftey-centered universal single payer health care to replace U.S. dependence on profiteering health care gatekeepers.

CheneyCare -- We taxpayers pay 70% of guaranteed coverage for VP Dick Cheney and 2 million federal legislators and employees. 
Link: Bill Moyers' Journal 5/9/08 -- California Nurses' campaign for "CheneyCare" for all.  Read transcript or view program: http://www.pbs.org/moyers/journal/05092008/transcript1.html


Video "Who the Health Cares?" gets straight to the point: Presidential candidates will not determine health care reform -- the ball is in the court of Congress. http://www.moblogic.tv/video/2008/04/30/who-the-health-cares/


For-Profit Health Insurance and Pharmaceutical Industries
-- scary statistics

1) Melody Peterson's book "Our Daily Meds" reveals that the benefit of medicines marketed by pharmaceutical companies "has become secondary to how much it will bring shareholders in profit"...due to constant pressure by Wall Street for drug companies to exceed profits made the year before; Big Pharma employs 2 lobbyists for every Congress member.

2) Tests show that placebos often work as well as the drugs being marketed to the public.

3) 100,000 Americans die annually from taking prescribed drugs as prescribed (FDA reports).

4) U.S. experiences 75,000-100,000 preventable deaths annually, ranking 19 out of 19 nations. (Recent study, Ellen Nolte & Martin McKee, London School of Hygiene & Tropical Medicine) 

Please join Be the Change-USA & Health Care for All Colorado
for an exciting, engaging and fun event May 31

Are We All Really Covered? Closing the Gaps in Health Care

12 noon - 7:30 PM, Sat., May 31, 2008

First Plymouth Congregational Church
3501 S. Colorado Blvd. (Hampden and Colorado Blvd)
Englewood, CO

Registration: Full program: $35; Dinner & evening speakers: $25; Evening speakers only: $10. Discount for Seniors, students, veterans, BTC and HCAC members: $5

Special program features:
1-3 PM Providers and Patients Panel: "How did we get into this mess, and how can we get out?"

3-5 PM Presentations by CO elected officials and candidates: "Will Colorado begin to close the gap?"

5 PM Dinner "Legislative Grill" -- Members of Congress and candidates and representatives of Presidential campaigns: "Will Congress or our next President begin to close the gap?"

6 PM Evening Keynote speaker: Elizabeth Kucinich

More info: www.BTC-USA.org or www.healthcareforallcolorado.org or call Dick Barkey, 303-808-8504, or Eliza Carney, 970-416-0636
To register online: www.BTC-USA.org  

The U.S. spends on average twice as much on health care as other industrialized nations, and has overall worse outcomes. Paul Krugman’s & Robin Wells’ commentary ("The Health Care Crisis and What to Do About It," The New York Review of Books, 3/23/06) attributes the U.S. health care crisis to high dependence on fragmented, for–profit private insurances, hospitals and numerous middlemen that add health costs without adding value. Noting "the strange persistence, in the teeth of all available evidence, of the belief that the private sector can provide health insurance more efficiently than the government," Krugman and Wells remark that free-market ideology is "wholly inappropriate to health care issues." As many observe, health is not a commodity, like a car or house.


Factors of declining U.S. health care:

  •      -Washington and the Bush administration are in thrall to insurance and drug industry lobbyists.
  •      -The privatization-for-profit increases the fragmentation of U.S. health care, swelling the ranks of the uninsured.
  •      -Commercial insurance has abandoned the principle of shared risk, shifting more risk to consumers, and has adopted the principle of adverse selection to guarantee profits for shareholders.
  •      -Private insurances continue to skim over 20 percent of costs for profit and CEO salaries.

Employer-provided health coverage is unraveling, as U.S. health costs rise twice as high as inflation and 4 times faster than wages, prompting more employers to reduce/eliminate health coverage.


Medicaid rolls grow, as Medicaid picks up the slack from the unraveling system of employer-based insurance.

  •      -Medicaid is particularly vulnerable as a means-tested program – its consituency is not politically powerful.
  •      -Authors: "Funding for Medicaid depends on politicians' sense of decency, always a fragile foundation for policy."
  •      -States fund an average 40 percent of Medicaid – unable to operate at a deficit, states are squeezed by growing Medicaid costs.
  •      -Attempts to privatize Medicaid for profit – states like South Carolina are seeking federal waivers to offer recipients vouchers for purchase of private insurance – certain to be inadequate for many.


So-called ‘consumer-directed’ health plans requiring higher out-of-pocket medical expenses are not a cure.

  •      -Health Savings Accounts (HSAs) serve as a tax break for the rich, but do nothing for the lower income.
  •      -HSAs undermine employment-based health care, encouraging adverse selection – HSAs are attractive to healthier individuals, tempting them to opt out of company plans, leaving them less healthy individuals.


The authors cite a large body of evidence indicating that public insurance of the kind in many European countries achieves equal or better results at much lower cost.

Unfortunately, political will is lacking. Krugman and Wells call it "politically smarter" and "economically superior" to educate voters about the huge advantages of a single payer system, than to merely attempt to coopt the drug and insurance lobbies by writing them into compromise plans that they will likely oppose anyway. Alternatively, say the authors,"things will have to get much worse before reality can break through the combination of powerful interest groups and free-market ideology."

Everything speaks to the need to grow a grassroots movement in order to overcome the powerful insurance and pharmaceutical lobbies that write policy, as they did Medicare prescription drug reform, with billions of dollars of subsidies and inflated profits to enhance their bottom lines.

The reporting in the media around candidate health care reform proposals perpetuates a false premise: the notion that health care reform revolves  around the question of whether or not to enforce a mandate to purchase private insurance. Growing numbers of under-insured will testify that insurance does not equal health care. At best, mandates move people from uninsurance to undersinsurance, leaving families at health and financial risk.

However, the insurance industry promotes mandates and taxpayer subsidies to private insurances because they enhance their bottom line, while failing to address cost and quality controls for health coverage.

Following is information forwarded from Rep. Morgan Carroll about the money spent by insurance, pharmaceutical and related lobbies. The insurance and pharmaceutical have recouped many billions of dollars in profits in return for  their lobbying investment.

From 1998 - 2007 here''s how much the following industries spent on lobbying  activities nationally:
Insurance Industry spent $1,008,474,967 on Lobbying
Pharmaceutical Industry spent $1,316,714,703 on Lobbying
Hospital / Nursing Home Industry spent $563,926,474 on Lobbying
Health Professionals spent $531,096,203 on Lobbying
*SOURCE: Open Secrets.org

Imagine how much cheaper your premiums might be if YOU weren't paying $3.95 BILLION for their lobbying activities since 1998? ($3,951,308,550 to be precise). That would have been enough to pay for an entire year of insurance premiums for 1,069,655 individuals at the average of $3,695 per year for individual coverage.
*SOURCE: Kaiser Family Foundation

The consumer is ultimately footing a big bill for lobbying activities that are not always in their best interests.

Throughout the process of the Colorado Blue Ribbon Commission for Health Care Reform, the two large Denver newspapers have consistently failed to present factual information about the Colorado Health Services Single Payer Proposal -- the one that was most favorably evaluated by the Lewin Group.

Since March of 2007 both The Denver Post and the Rocky Mountain News have each printed a number of commentaries by 'free-market' health care advocates Brian T. Schwartz and Paul Hsieh, as well as commentaries by Sen. Andy McElhany and ex-Senator Mark Hillman. Only Rep. Claire Levy was granted a commentary in the Post that dissented from the predominant 'free market' view.

At least five commentaries since the Spring of 2007 have been submitted by myself and others about the advantages of the Single Payer proposal, as well as the broken system of third-party multi-payer commercial health insurances. The information has been ignored by the Post and the News. Only out-state papers like the Pueblo Chieftain and some northern Colorado papers, including the Fort Collins Coloradoan and the Northern Colorado Business Report, have consistently printed different perspectives of health care reform, including the Single Payer perspective.

In May 2007 Todd Engdahl, a Post editorial page editor, notified me that he planned to print a commentary/overview that I had written about the Colorado Health Services Single Payer health care reform proposal then being evaluated by the Lewin Group for the 208 Commission for Health Care Reform. Subsequently, Engdahl was one of eight or so reporters and editors 'retired' by the Post. I followed up with Post assistant editorial page editor, Barbara Ellis, who repeatedly assured me the paper would print a piece about the single payer health care proposal. Each time we have sent something to the Post, Ms. Ellis has responded to the effect, "Thank you, we are considering how to present health care reform, and we will be in touch."

In January, before the 208 Commission for Health Care Reform presented their final recommendations to the legislature, a piece was sent to the Post signed by the board president and vice president of Health Care for All Colorado, critiquing the draft recommendations by the 208 Commission, based on a Massachusetts-style mandate for private insurance, and elaborating on advantages of Single Payer insurance. When I followed up with Ms. Ellis in early February, inquiring why no commentary presenting the Single Payer health care proposal has been printed in the past year, I received the following email from her:

"With the governor and his staff about to propose their own health care reform plan, publishing anything by the individual groups involved in submitting proposals to the 208 Commission is taking the story backward instead of forward."

"However, if you or anyone else should have anything to write in response to that plan once it is detailed, feel free to send it to us. I'm sure you can understand that the 208 Commission's report may be rendered moot by the governor's plan, so we're trying to take the story forward. Should the single payer plan still be part of the discussion, we'd value your input."

On February 2, 2008, the Post printed an editorial wrongly stating that, of the five reform proposals, Single Payer universal health care is the 'costliest option,' costing an 'additional $15 billion a year.'

The lack of understanding of the Single Payer proposal by the Post editorial board alone is disturbing, and it is quite understandable why Coloradans who have been so poorly served by local media totally lack understanding about what the 208 Commission has done, and what the proposals would accomplish (or not), let alone the results of the Lewin Group evaluation of the proposals.

Only one proposal evaluated by the Lewin Group, the Colorado Health Services Single Payer Plan, demonstrated the capability of providing comprehensive health coverage for all, and of reducing health care costs. Reported annual health cost savings to the state were $1.4 billion. More than $4 billion additional costs savings were reported for Colorado businesses, families, providers and hospitals. See Lewin Report Single Payer Cost Savings. The $15 billion public funding for Single Payer represents a shift from the current higher rate of private out-of-pocket health care costs (premiums, copays and deductibles, etc) that we all currently pay. In place of these high out-of-pocket private health costs, everyone would pay a progressive tax (the individual and employer tax is the source of $15 billion public funding) that for all except those making over $100,000 a year, would be less than their current out-of-pocket health care expenses.

The Rocky Mountain News exercised their own version of news blackout on the issue of health reform, early on writing an editorial titled "Single Payer Baloney" advising that Single Payer reform be dismissed as unreasonable and unworkable. 

After saying he wanted to present another perspective and repeatedly failing to do so, Rocky Business editor Rob Reuteman informed me in a phone conversation that he was "not going to confuse the readers by printing" my commentary about single payer, calling it "pie in the sky," and insisting that he could not understand where the funding would come from.

Is it any wonder that so many are still in the dark about health care reform in Colorado? We still have not had a honest and open exchange of information surrounding health care reform – when are we going to hear the broader perspective? If the local news media refuse to provide a forum, then who will? It is no wonder that the multi-billion-dollar insurance and pharmaceutical industries continue to write health care policy, as they did with Medicare prescription drug reform, granting themselves billions of dollars of taxpayer subsidies and inflated profits to enhance their bottom lines. Simultaneously, commercial insurances game the system to increase their profits by delaying, denying and reneging on claims they should be covering.

One can only assume that the corporations that own the media set the standards of news coverage – selectively influencing what information is and is not made available to readers.

The Colorado Blue Ribbon Commission for Health Care Reform based its recommendations to the legislature on its own 5th Proposal, modeled after Massachusetts reform, with a mandate to purchase private insurance, no controls of insurance costs, and taxpayer subsidies to private insurances.

A cornerstone of the Massachusetts plan as adopted by the 208 Commission is an individual mandate that compels everyone to purchase private health insurance, or suffer tax penalties.

Comprehensive health plans in Massachusetts total $6,000 annually for an individual or $14,000 for a family - prohibitive costs for many. 'Affordable' coverage is often a bare-bones, stripped-down 'minimum benefit' insurance averaging $660/month for a family, and $330 for an individual - still unaffordable to many working families. Stripped-down policies, with high copays and deductibles, do not provide adequate protection against serious health or financial risk.

A 2005 Harvard Medical and Law Schools study estimated that 76 percent of those bankrupted by medical bills had insurance at the onset of the illness that bankrupted them. As noted previously, high-deductible or catastrophic insurances have contributed to a 59 percent rise in consumer out-of-pocket health expenses and a 60 percent rise in uncompensated hospital care over a decade (reported by the American Hospital Association).

The Massachusetts plan does nothing to control insurance costs or eliminate the high overhead costs, including exorbitant CEO salaries and profits, of multi-payer insurances. Therefore, Massachusetts continues to experience annual double-digit premium increases, shifting more people into taxpayer-subsidized private insurances or public programs. It is a recipe for the downward spiral that renders more people under- and uninsured, and shifts increasing costs to taxpayers.

Read 2-3-08 Denver Post article about the Massachusetts mandate - the Massachusetts 'Health Care for All' mentioned in the story co-authored Massachusetts reform, and is actually a group funded by commercial insurance companies.

A continuous rise in multi-payer health care premiums (12% annual increases for University of California retirees) has prompted California to look at cutting government retiree health benefits. Until inflationary health insurance costs are controlled, retirees' health benefits everywhere will continue to be on the line. As long as multi-payer insurances continue to protect their bottom line by increasing premiums, copays and deductibles, and denying claims, everybody will be vulnerable to health and financial risk.

Watch candidate YouTube video for single payer health insurance illustrating how "exposed" multipayer health insurance leaves most of us.

Our congressional delegation should be encouraged to support single payer insurance, as written in HR676. At the very least, we can encourage our federal legislators to support Russ Feingold and Lindsay Graham's S1169 and Rep. Tammy Baldwin's HR 506, federal bills intended to free States to create health care reform solutions, by addressing issues like ERISA requirements and Medicaid waivers that now hamstring the states. There is bipartisan support for these measures to permit states greater leeway in writing reform, e.g., Reps DeGette and Musgrave both co-sponsor HR 506.

Even with the freak Wednesday snowstorm that tangled traffic and kept people home on Thursday January 31, 300 people rallied at the Capitol for Single Payer Health Care, some traveling from Montrose, Pueblo, Fort Collins and the eastern plains, on the same day that the Blue Ribbon Commission for Health Care presented their recommendations to the legislature for a Massachusetts-style mandate to purchase private insurance.

There was great press coverage, including Colorado Public Radio's report on the large turnout for the rally for Single Payer. Endorsing groups that provided speakers included the Colorado Education Association, the League of Women Voters, the Colorado Nurses Association and the Alliance for Retired Americans. A number of physicians from the Fort Collins area attended, including Dr. Cory Carroll, who spoke about lack of health care choices and obtacles to patient care under the multi-payer insurance system.

Betty Lehman of the Autism Society spoke movingly about how insurance companies game the system by denying needed care. In later comment before the Senate-House HHS Committees, Lehman remarked that it is immoral to require taxpayers to subsidize private insurances that profit by denying care. A number of speakers noted experiencing high out-of-pocket costs, even while paying annual family insurance premiums of $10,000 to $18,000. Also noted -- multi-million dollar annual CEO salaries and $1.6 billion stock options for UnitedHealth's retiring CEO.

Sen. Ken Gordon and Reps. John Kefalas, Jerry Frangas and Claire Levy also addressed the crowd. Larimer County Commissioner Eubanks also attended. Health Care for All Colorado board vice president Barry Keene said the group is working on legislation to keep the issue in front of the legislature, and to prevent passage of an individual mandate to purchase private insurance that will replace masses of uninsured with the underinsured.

It was emphasized that now is the time to contact our legislators, instilling in them the political will to work toward meaningful health care reform, rather than subsidizing private insurances and mandating their purchase without controlling insurance costs, as has been done Massachusetts, and was rejected in California last week. To identify one's legislators, visit www.vote-smart.org or call 1-888-VOTE-SMART.

There was also much support for Single Payer insurance during the comment period before the joint HHS Committees the afternoon of January 31. Dr. Irene Aguilar of the 208 Commission's Vulnerable Populations Task Force urged legislators to "do what is right for all Coloradans," taking into consideration the Lewin Group evaluation of savings and comprehensive coverage for all only with the CHS Single Payer proposal. The Vulnerable Populations Task Force has requested and been granted a hearing in the House HHS Committee this week.

Commissioner Mark Simon, who voted against endorsing the 208 Commission Final Report, commented on elements of his Minority Report, in which he endorses Single Payer as the only comprehensive reform capable of covering all.

The market place is clearly not a solution for improving health care access. Most businesses increase profits by providing more services of higher quality; multi-payer insurances expand profits by denying services.

Please join us on Thursday, January 31 at the Captitol. On that day, the Colorado 208 Blue Ribbon Commission for Health Care Reform will present its recommendations to Colorado legislators. The 208 Commission chose 4 diverse health care reform proposals for evaluation, and wrote one of their own in 2007. Only one proposal - the Colorado Health Services Single Payer Health Plan - demonstrated cost-savings for the state ($1.4 billion) and comprehensive health coverage for all. Nevertheless, the 208 Commission has chosen in its Final Report to the Colorado General Assembly to recommend the elements of its own 5th Proposal, modeled on a Massachusetts-style individual mandate for purchase of private insurance, as well as taxpayer subsidies to private insurances, without any cost or quality controls on private insurances.

Some problems with the Commission's recommendations:

  • The 208 Commission seeks to solve the problem of the uninsured by mandating that people purchase products of underinsurance (minimum benefit plans), a cause of increasing unpaid medical bills - yet another form of cost-shifting to taxpayers and consumers.
  • The Commission creates many new categories of coverage, means testing, and the added layer of insurance known as the 'Connector,' further expanding the insurance administrative bureaucracy.
  • The Commission calls for increased taxpayer subsidies to multi-payer private insurances, without addressing the bureaucratic administrative waste and profit-taking that funnels 31 percent of every health care dollar to overhead costs. Read Full 2-page Overview of 208 Commission's Recommendations 

View a 1-page contrast Single Payer vs. Massachusetts Mandated multi-payer

View a half-page Lewin Savings with CHS Single Payer Plan 

The Final Recommendations to the Legislature by the 208 Commission widely miss the mark.

The one hope that Colorado has for true health care reform is through grassroots appeal to our legislators. Join us on the west steps of the Capitol at noon, Thursday Jan. 31 to carry a message to legislators that we cannot afford to squander the opportunity for health care reform. We cannot afford to permit the insurance industry to write health care policy to benefit their bottom line, as they did with Medicare prescription drug reform, and Massachusetts reform that creates a captive market for commercial insurance without any cost or quality controls on multi-payer insurances. Read 1-page Physicians' Assessment of Massachusetts Reform

  • January 31 actions - do what you can:

    10 a.m. - Meet at Central Presbyterian Church (1660 Sherman, a block north of the Capitol)
    11:30 a.m. - March to the Capitol (Colfax and Sherman in Denver)
    Noon - Rally at the West Steps -- Hear supportive legislators, providers and groups endorse Single Payer Health Care
    1:30 - 4 p.m. - The Colorado Blue Ribbon Commission for Health Care Reform presents its recommendations to Colorado State Legislators in the old Supreme Court Chambers. Open to the public.
    After the rally, drop in on your legislators.

January 31 Information Flyer

Meaningful health care reform in the face of big-money lobbies requires activation of a large grassroots movement! Let's urge our legislators to consider the facts about the crisis nature of health care in Colorado and the U.S., and then act in the best interest of their constituents, not to serve the bottom line of multi-payer insurances.

Lastly, take a Resolution for Single Payer Health Care to your Precinct Caucus on February 5.

Thank you for whatever you can do!

NPR reported on January 15 about a study released in the Journal of Health Affairs the same day, describing increasing waits in U.S. Emergency Rooms, even for the very sick. This on the heels of the Institutes of Medicine recent report that ERs are at a breaking point.

Dr. Arthur Kellerman, professor of emergency medicine at Emory U., noted that though it is popular to point to Canada and the UK for their long wait times for elective procedures, the waits in U.S. emergency rooms are "the waits that matter" -- heart attack victims and other true emergencies are receiving delayed care. Waits for heart attack victims doubled between 1997 and 2004.

U.S. Emergency Rooms bear the brunt of the burden of crisis health care access -- those who cannot access primary preventive care resort to emergency rooms for basic health care or delayed crisis care.

Kellerman pointed out that it doesn't matter whether one is insured or uninsured, all are affected by these delays. The report ended with the news that the federal government is planning to cut funding to hospitals with the biggest problems - in inner cities, etc. Listen to the report (approximately 3-1/2 minutes)

The delaying and denial of claims takes a heavy toll on providers and hospitals. The following account by a New York doctor in 2007 relates the nature of delay tactics practiced by multipayer insurances (http://www.ama-assn.org/...).

As stated on the AMA Web site, "Prompt pay laws have been established since the late 1990s by states to relieve problems of delayed payments by most private health care plans to providers." However, just as they have bypassed statutes requiring insurances to be not-for-profit in Minnesota, so, too, do insurances often bypass this requirement.

Says one doctor:
"In New York, where I live,the law requires that clean claims must be paid in 45 days. But, as you might imagine, the insurance industry has found legal loopholes, and payment delays are the norm for doctors around the country.

"I guess things are so bad for the nation's doctors, that the AMA has an on-line booklet appropriately entitled '15 Steps to Protect Your Practice from Abusive Payment Tactics.' Like most complicated issues in life, there are myriad complexities to the crisis involving third party payments to doctors. But I'll give you a sense of what my friends who are doctors tell me.

"They say that getting paid is more often than not a take-no-prisoners battle. An insurer will reject a claim for the smallest reason. If a claim is submitted with every T crossed and every I dotted, as sure as night follows day, the insurer will require reams of additional information on the patient and the procedure. Almost nothing gets paid without a fight. Some describe the fight as a smoke and mirrors Kafkaesque nightmare.

"Imagine this sort of scenerio playing out in doctor's offices and hospitals across the nation. Imagine the costs associated with an army of claims specialists who are employed simply to pry payments out of the hands of the for-profit insurers. Physicians charge that one of the most common practices leading to long lag times is insurers' refusal to pay claims they say aren't 'clean.' They also ask patients to send unnecessary information before they'll pay, doctors alleged."

One doctor reported that an insurance company denied a claim for procedures performed on both of a patient's knees during one office visit, arguing that the claims were duplicative. Insurers also have asked his patients to provide accident information, even though it's already provided on a claim form, or information about pre-existing conditions. Health plans often won't send a copy of the request, so the doctor's staff can't help patients get the information. One claim for hand surgery included the surgeon's name and license number, but the insurer denied payment because the claim didn't state the doctor's degree.

"Most of it is really ridiculous -- standard form letters in their system that they shoot off and hope the provider doesn't address," explained an office administrator. "A lot of these claims get paid down the road, but they hold the funds 30 to 90 days longer than if it went through with a 'clean' claim," she said.