CSU-Pueblo Students for Progress
CSU Pueblo Students for Progress!

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  

I have started receiving somewhat threatening anonymous phone messages from "toto", the person who posted this Reply

"Re: Impeachment/ Pardoning oneself

Reply By Toto Yesterday at 2:20 pm MDT

Neither Democrats nor Thom Hartmann (nor any of the sites to which impeachco links) can be made to notice the fact that Traitor-in-chief Bush has twice inadvertently made loose-lips-sink-ships statements implicating himself in 9/11 (whatever it was...):

IOW, Bush repeatedly, voluntarily(!) told us that what he knew and when he know it, and how he knew it: Link = 911blimp.net/aud_BushImplicate sBush.shtml"

To this blog posting of mine Link

If I cannot get help identifying this person I will go to Qwest, then to the authorities. Given that the caller references websites he apparently owns that are hosted out of state I will if necessary get the FBI involved. Server records at PNA and the website hosting service (and Qwest phone records) can be gotten by subpeona. I would like to settle this quietly and quickly if possible.

I would appreciate everyone's help in identifying this person. The messages on our voice mail were a carbon copy of his reply message on ProgressNowAction.org I think he may be a 9/11 Truther who is frustrated that Cheney and Bush may be allowed to get away with their crimes without accountability. I sympathize, but this is not the way.

The ownership of 911blimp.net which apparently is his website, is also anonymous, but I suspect it is related to the other websites he references...
911u.org and fawcett911.us
( both of which are listed as being owned by someone in Colorado Springs) The owner's listed Verison phone number of 719-555-000 is not working and was I suspect phoney when submitted.

All three of these websites are hosted by advancednetworkhosting.com in Glen Ellyn, Illinois, leading me to suspect that all are owned by the person who is making the anonymous phone calls to me.

PLEASE: Anyone having some knowledge of who this please email me, John Kennedy at "protestinthestreet@yahoo.com"

Thank you.

PS: to the perpetrator. I will end my investigation if you email me an apology complete with your full name, address, and phone number, and a promise never to do it again.

Just so the perp understands: I do op/eds at author at OpEdNews.com.

A few days ago a fellow commented on one of my articles by suggesting the assassination of Congressmen. I immediately reported the guy to the FBI and the Secret Service. It turned out to be under the jurisdiction of the Secret Service which is currently investigating. I have recordings of your voice messages and I am not bluffing.

An emailed apology done Very Soon will end it, otherwise?

..

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.

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.

Over 20 federal and state studies since the ‘90s have reported enough administrative savings with Single Payer insurance to cover the uninsured and upgrade coverage of the underinsured. Thanks to the greater administrative efficiency of single payer, other industrialized nations experience better health care outcomes while spending on average half as much as the U.S. – where the medical-industrial complex now eats up one-sixth of our Gross Domestic Product.

One of the greatest conceits of health care reform debates is the notion that ‘free-market competition’ of multi-payer for-profit private insurance companies will lower health costs or improve quality of care. Rather than a free market, the insurance industry is increasingly a profit-centered monopoly market, dominated by four behemoths – United Health, Wellpoint, Aetna and Cigna. Instead of reduced costs, premium rates have increased 82 percent in Colorado over six years, consistently outpacing the rate of inflation or workers’ wages.

Just as we wouldn’t expect ‘free-market’ for-profit police or fire protection, health care should not be treated as a commodity, like a car or a house, to be negotiated at the door of a hospital.

Having abandoned the insurance principle of shared risk, multi-payer health insurance has created a two-trillion dollar industry by gaming the system. Shareholder profits are maximized by selectively insuring the healthy, and rejecting everyone else as a ‘pre-existing condition.’ Commercial insurances direct 20 percent or more of health care dollars into high administrative costs, multi-million-dollar CEO salaries, and expanding shareholder profits.

Insurance middlemen in Denial Management – a $20 billion annual industry – scan claims for excuses to delay, deny or renig on provider reimbursements. Some insurers demand money back; more are reported to simply deduct it from future claim payments, forcing providers to appeal claims a second or third time. Reports The Wall Street Journal (2/14/07), 30 percent of provider claims are denied the first time – adding to the administrative nightmare of providers who are forced to deal with different forms and requirements, resubmitted claims and changing formularies, as well as the annual ritual of provider re-credentialing by each insurer. Provider and hospital costs for extra staff to deal with insurance claims alone is estimated to absorb an additional 12-15 percent of all health care dollars.

Private insurers continue to line up for a gravy train of taxpayer subsidies, even as they purposely deny health care access to many. As growth in the employer-sponsored and individual markets has slowed, commercial insurers have pushed to privatize public programs, like Medicaid and Medicare. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) was influenced by the insurance and pharmaceutical industries to enhance their bottom lines with billions of dollars of subsidies and inflated profits. Taxpayers also subidize private Medicare Advantage plans at 12 percent higher cost than traditional Medicare (with a 2 percent overhead cost).

Welcome to health insurance hell: more family dollars poured into the insurance black hole in return for declining health care access.

Some state legislators, as well as the 208 Commission for Health Care Reform, ascribe the problem of health care cost-shifting primarily to the uninsured. The reasoning goes, that if you can just get everyone insured by enforcing Massachusetts-style 'Individual Mandate' to buy commercial health insurance, the cost-shift will end (the Commission's recommended penalty equals the cost of one year's insurance premiums). However, the recommended cure may be worse than the disease.

'Affordable' private insurance -- known as 'Minimum Benefit Plans' -- are not really affordable to many working families. They come with high deductibles (often $5,000 per individual, $10,000 per family annually) and low caps that leave people vulnerable to health and financial risk. In part due to such plans, out-of-pocket health costs have risen about 60 percent over a decade; simultaneously, unpaid medical bills have also increased 60 percent. Consequently, some hospitals reportedly now ask those arriving at their doors with underinsurance policies, for up-front payment.

The Families USA report,  "Too Great a Burden: Colorado's Families At Risk" (12-13-07) reveals that 1,054,000 people under the age of 65 in Colorado are in families that will spend more than 10% of their family income on health care costs in 2008 before accounting for taxes. Out of these people, the vast majority, 82.6%, have insurance. Out of these Coloradans, 299,000 live in families that will spend more than 25% of their pre-tax income on health care costs in 2008.

In short, Families USA reports that the numbers of underinsured people have increased since previous studies in 2000, and as a result, put thousands of families at risk due to a growing health care burden.   Full Report - Families USA: Colorado's Families At Risk

Only one of five Colorado health care reform proposals evaluated by the Lewin Group has demonstrated any cost savings - $1.4 billion. The Colorado Health Services Single Payer Insurance proposal is also the only one shown capable of providing comprehensive health care for all.

Single payer -- or single-risk-pool - insurance would eliminate wasteful administrative spending.

Currently over 30 percent of U.S. health care dollars go to inefficient administration costs, CEO salaries and profits of over 1200 U.S. commercial insurances. Providers and hospitals are forced to hire extra staff just to deal with administrative costs of multiple insurance authorization procedures and drug formularies, and requirements for claims, billing and provider re-credentialing - excess costs ultimately passed on to taxpayers and consumers.

U.S. commercial health insurance no longer performs the function for which it was developed in the 1930s and '40s - to spread health care risk and cost.

Assertions that the 'free market' will lower health costs are belied by the fact that commercial health premiums have risen 78% since 2001, and that increasingly we pay more for less coverage. U.S. health insurance is best described as a monopoly market, now dominated by three behemoths - UnitedHealth, Wellpoint and Aetna. Annual premium increases continue to exceed both the rate of inflation and increases in workers' earnings.

In response to rising premium costs, more and more employers move employees into catastrophic insurance policies with high out-of-pocket costs that place individuals and families at greater health and financial risk.

Individual out-of-pocket health costs rose 59% over the decade preceding 2005; simultaneously, unpaid medical bills increased 60%, relates the American Hospital Association. Not coincidentally, large medical bills contribute to over 50 percent of U.S. personal bankruptcies.

Commercial health insurances game the system to increase profits, by covering the healthy and rejecting as a 'pre-existing condition' anyone who might require health care.

Gaming the system is the role of the 'Denial Management' industry -- insurance middlemen who scan claims for excuses to delay, deny or renig on reimbursements, at an additional cost of $20 billion annually, reports The Wall Street Journal 2-14-07 .

Privatizing public programs is also very costly. Medicare prescription drug reform of 2003 was exploited as opportunity to move more seniors into higher-cost, heavily tax-subsidized private insurance plans. Insurance and pharmaceutical lobbies co-wrote reform to enhance their bottom lines with billions of dollars of subsidies and inflated profits.

Because commercial health insurances shift more risks and costs to individuals, many hesitate to share personal information with their physicians for fear it will be used as an excuse to deny them coverage. In no other industrialized nation do people fear loss of health care benefits with change of jobs; nor do families agonize about losing everything due to huge medical bills, as U.S. families do.   Read More »

To All, Notice of Opportunity to Inform Blue Ribbon Commission for Health Care Reform's Report to Legislature Four proposals for health care reform in Colorado have been evaluated by the Lewin Group, and the 208 Commission is writing a 5th proposal that includes an individual mandate to purchase private insurance. Read a draft summary of the Commissions 5th proposal (yet to be evaluated by the Lewin Group). Read a 1-page summary of Lewin's evaluation of four proposals, and a 1-page summary of savings with the single payer proposal. Let the Commission know of your priorities for reform. Read an ongoing discussion of health care reform in the state at www.thebell.org/blog/208 .

The Blue Ribbon Commission for Health Care Reform was created by the legislature to identify ways to make health coverage more affordable, accessible and cost-effective for all Coloradans. The following meetings in each congressional district provide an opportunity for public input to the Commission. Please note that due to lack of adequate facility, the Brighton meeting has been cancelled, and a meeting in Golden added instead. Note a few changes in times, dates and locations. Check Commission website for updates www.colorado.gov/208commission. In response to public demand, we have changed a few meeting sites to accommodate larger groups. UPDATED 09/28/07

 

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The 208 Blue Ribbon Commission for Health Care Reform is scheduled to make its final recommendations to the legislature by the end of January. The Lewin Group just completed its evaluation of four diverse proposals selected by the 208 Commission. Now the Commission is working on its own 5th Proposal.

 

There is one more opportunity for the public to weigh in on health care reform - see the schedule of October congressional district meetings below, and mark your calendars. Below the schedule are suggested topics the Commission is requesting comment on.

 

View a 1-page summary of the Lewin Group report of administrative savings with the Colorado Health Services Single Payer propos