From don at mccanne.org Thu Dec 1 16:24:48 2011 From: don at mccanne.org (Don McCanne) Date: Thu, 1 Dec 2011 13:24:48 -0800 Subject: [Health Care Action] qotd: Does ACA's "Basic Health Program" stabilize coverage? Message-ID: The New England Journal of Medicine November 30, 2011 Balancing Coverage Affordability and Continuity under a Basic Health Program Option By John A. Graves, Ph.D., Rick Curtis, M.P.P., and Jonathan Gruber, Ph.D. According to the Congressional Budget Office, the Affordable Care Act (ACA) will bring health insurance coverage to an estimated 32 million currently uninsured people. It does so through various mechanisms, including an expansion of Medicaid to Americans with incomes up to 138% of the federal poverty level (133% plus a 5% "income disregard"), premium and cost-sharing subsidies for coverage purchased through a new insurance exchange, small-employer tax credits, and an individual mandate to obtain health insurance. The ACA's incremental approach to near-universal coverage has raised concerns that changes in income, employment, and family composition will shift people into and out of different coverage arrangements over time - a phenomenon referred to as "churning." Avoiding disruptions in coverage is an important goal because it can reduce unnecessary administrative costs and improve health plans' incentives to invest in achieving longer-term health outcomes. Continuity of coverage can also help maintain clinician?patient relationships, especially in places where there are substantial differences between the clinicians participating in Medicaid and those participating only in private plans. To address concerns about churning, some states are considering adopting a Basic Health Program (BHP) - an ACA-created option modeled after Washington State's Basic Health Plan. Under this option, a state would receive an annual lump-sum payment equal to 95% of the projected cost of the subsidies for coverage through an insurance exchange for households with incomes between 139 and 200% of the federal poverty level. The state would then assume responsibility for financing a BHP for adults in that income range that met or exceeded the generosity and scope of benefits available in the exchange. A number of states are considering this option, including California, where BHP legislation has already passed the senate and final consideration is planned for 2012. The eligibility range for a BHP is narrow - and there's no guarantee that there will be continuity of access for people moving from Medicaid to a BHP, or vice versa. A BHP could theoretically extend access to the same plans and providers as Medicaid does, but in practice, states may find that providers willing to accept reimbursement that is often below their costs for their most indigent patients will be unable or unwilling to do so for an additional population. Moreover, introducing a BHP may create a new point of disruption: although patients might retain their coverage when moving above or below 138% of the poverty level ($30,843 for a family of four in 2011), they would be more likely to have coverage disruptions when moving above or below 200% of the poverty level ($44,700 for a family of four). Such disruptions could occur if the mainstream plans and providers used by people with incomes above 200% of the poverty level do not participate in the BHP. Finally, introducing a BHP would reduce the subsidized population in the insurance exchange by about half, which could compromise its efficiency and market role and reduce the proportion of uninsured people who gain access to mainstream coverage. To investigate BHPs' potential for reducing churning between Medicaid and an exchange by acting as a bridge between them, we used data from a dynamic income microsimulation model of the ACA. Since we follow an initially eligible cohort over a 2-year period, we can more easily model relative changes in churning in varied policy environments. For our analysis, we used a national sample of adults 18 to 61 years of age who were initially uninsured or enrolled in nongroup coverage and who were eligible for subsidized coverage (had an income below 400% of the poverty level). We then simulated eligibility for Medicaid, a BHP, and an exchange in three policy environments: the baseline ACA structure, under which people with incomes up to 138% of the poverty level are eligible for Medicaid and those with higher incomes are eligible for the exchange; an integrated BHP, under which Medicaid and the BHP are run as a single program, with identical plans and providers; and three separate programs, with Medicaid, the BHP, and the exchange all operating independently, with different reimbursement rates, cost-sharing structures, and provider networks. Both Washington State's original BHP and California's pending BHP legislation would fit in the third category. Our main findings are summarized in the Kaplan?Meier curves (see graph, available at link below), which show the overall proportion of subsidized adults who would remain continuously eligible for their initial program over a 24-month period. As the graph shows, operating separate BHP, Medicaid, and exchange programs substantially increases churning. Under that policy, just 44% of adults remain eligible for their initial program after 1 year and less than one third remain so after 2 years; under the baseline ACA structure, the proportions are 63% and 49%, respectively. Given the dynamic nature of the wages and incomes of adults with moderate incomes, this finding is not entirely surprising: a separate BHP coverage category based on a narrow income range increases the likelihood of eligibility shifts between programs. Perhaps more striking, however, is our finding that a BHP operating within Medicaid would result in slightly more eligibility losses than would the baseline ACA structure. Although we find that a BHP would reduce churning (i.e., increase retention) at the 138%-of-poverty threshold, there would be a more-than-offsetting increase in churning between the exchange and the Medicaid?BHP at 200% of the poverty level. The net result would be slightly more overall churning than with the baseline ACA structure. Moreover, these program-eligibility shifts would now happen around a "notch" created at 200% of the poverty level, where there are much larger implications for enrollees, in terms of premiums and cost sharing, of moving from Medicaid?BHP to private coverage. For example, a family moving from a Medicaid-like BHP program to the exchange tax-credit structure at 200% of the poverty level could suddenly see the value of its benefits fall by as much as 25% (depending on state decisions about patient cost sharing under the BHP). The ACA's sliding-scale subsidies were designed to avoid such notches, which create major inequities between people with marginally different incomes and penalize them for additional work and earnings. Ensuring access to stable and affordable coverage is an important ACA goal. Whether by design or through attrition of willing plans and providers, however, operating a BHP with provider networks different from those of both Medicaid and the exchange could further stratify the low-income and moderate-income population into three separate classes of coverage. As our modeling shows, such stratification would exacerbate the concerns about churning that BHPs were designed to address. Moreover, even a BHP integrated with Medicaid would slightly increase churning overall, with the increased churning around the 200%-of-poverty point more than offsetting the reduced churning around the 138%-of-poverty point. Although various policy considerations should enter into decisions about adopting a BHP, the need to achieve coverage and provider stability is an argument against doing so. http://www.nejm.org/doi/full/10.1056/NEJMp1111863 Comment: Section 1331 of the Patient Protection and Affordable Care Act (ACA) authorizes states to establish "basic health programs" to cover individuals with incomes between 133% and 200% of the federal poverty level, who are not otherwise eligible for Medicaid. The primary thrust of ACA is to cover many of the currently uninsured by expanding Medicaid and by establishing new state health exchanges offering private health plans. This NEJM article evaluates whether adding a third option - a basic health program - would improve stability and continuity of coverage for this low-income sector. This is an important question since setting up an additional program adds considerable administrative costs and complexity to our health care financing system. The brief answer is "no." After two years with three separate programs, less than one-third would still be in the programs in which they were originally enrolled. Suppose the states decided against establishing basic health programs, what would happen under the baseline ACA structure with just Medicaid and the private exchange plans? Half of individuals would no longer be in their initial programs. This is only over a period of two years. Because of continual fluctuations in eligibility (changing income levels, etc.), stability over a decade or two would be virtually nonexistent. This instability can be quite disruptive. Between Medicaid, basic health programs, and private exchange plans, there may be little or no overlap in provider networks. A change in coverage could also have a major impact on out-of-pocket expenses required of the insured individuals. One intent of the basic health programs would be to save the government money by paying providers at levels close to those of Medicaid. Many physicians already reject Medicaid because of these low rates. Adding many more new patients to the Medicaid program, plus introducing an entirely new, under-funded, basic health program, would surely cause providers to flee both Medicaid and the basic health programs. The patients might have a basic health ticket, but nowhere to use it. The entire ACA infrastructure is irreparably fragmented and dysfunctional. It needs to be replaced with... yes, an improved Medicare for all. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From jon at wmjwj.org Thu Dec 1 16:33:35 2011 From: jon at wmjwj.org (Jon Weissman) Date: Thu, 1 Dec 2011 16:33:35 -0500 Subject: [Health Care Action] SUSTAINING WESTERN MASS JOBS WITH JUSTICE Message-ID: <003601ccb070$e2d83e30$a888ba90$@org> Dear Activists and Allies, Thank you for Being There in the struggle for workers' rights. I hope you had a happy Thanksgiving. Jon Stewart and other comedians are giving thanks for the current crop of Presidential candidates. All kinds of social movements are giving thanks for Occupy Wall Street. And Western Mass. Jobs with Justice gives thanks to you for your activism and support for workers' rights. Founded in 1987, Jobs with Justice is a national network that organizes solidarity among labor, community, student, and faith-based groups to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger movement for economic and social justice. We do so by organizing local coalitions. The Western Mass Coalition was founded in 1993. I am honored and thankful to be able to work for Western Mass. Jobs with Justice, a coalition of 66 organizations. If you appreciate this work, please make a donation to keep it going. Your dues and donations are used primarily for operational expenses related to employing me as a full-time coordinator/organizer (see current program attached and here ) and now Patrick Burke as Student-Labor Action Project Organizer. Local activists and unions donate many other costs in-kind. We started Patrick at only 30 hours a month. We need to increase Patrick's hours, and with your generous donations, we will! Dues are Donations for Membership; Members have decision-making rights at the annual Membership Meeting, quarterly Steering Committee meetings, and in committees, projects, and alliances. Will you sponsor Western Mass. Jobs with Justice? Our goal is to recruit 100 individual donors who give $100 each year. They will be listed (if they choose) as Sponsors of the Annual Conference. Will you donate what you can afford? Will you apply your donation to membership and Be There ? Donations are to the Jobs with Justice Fund of the Warren J. Plaut Charitable Trust and are tax-deductible. You may make your check out to WJPCT JwJ Fund. Send it to Jobs with Justice, PO Box 296, Granby MA 01033. Attached (and here ) is a form you can use to show how you want your donation categorized and acknowledged. It includes an easy electronic funds transfer (EFT) option. Thank you for all your support and hard work! In solidarity, Jon ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Current Program.pdf Type: application/pdf Size: 194643 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: Donation & Dues Form.pdf Type: application/pdf Size: 239632 bytes Desc: not available URL: From don at mccanne.org Fri Dec 2 18:16:21 2011 From: don at mccanne.org (Don McCanne) Date: Fri, 2 Dec 2011 15:16:21 -0800 Subject: [Health Care Action] qotd: The PROMETHEUS Bundled Payment Experiment Message-ID: Health Affairs November 2011 The PROMETHEUS Bundled Payment Experiment: Slow Start Shows Problems In Implementing New Payment Models By Peter S. Hussey, M. Susan Ridgely and Meredith B. Rosenthal As mandated by the Affordable Care Act of 2010, the Centers for Medicare and Medicaid Services recently announced a national Medicare bundled payment initiative. There is strong support for bundled payment on conceptual grounds. However, there is only limited empirical evidence to support the use of bundled payment, and concerns have been raised about the feasibility of its implementation. This paper presents findings from an evaluation of the initial "road test" of PROMETHEUS Payment. PROMETHEUS (an acronym for Provider Payment Reform for Outcomes, Margins, Evidence, Transparency, Hassle Reduction, Excellence, Understandability, and Sustainability) is a bundled payment model managed and implemented by the Health Care Incentives Improvement Institute, a nonprofit organization. After three years of implementing systems and processes to support a bundled payment model, pilot participants have yet to make bundled payments or execute new payment contracts. PROMETHEUS was designed to pay for all of the care required to treat a defined clinical episode, particularly those services recommended by clinical guidelines or experts. The multiple services that are anticipated to be required under a particular episode of care are referred to as "bundles." PROMETHEUS has defined twenty-one bundles that include chronic medical conditions such as diabetes, acute medical conditions such as acute myocardial infarction, and procedures such as hip replacement. Our data collection occurred over the years 2009?11. Progress of the pilots As of May 2011, none of the pilot sites had achieved the goal of using PROMETHEUS as a payment method or had executed bundled payment contracts between payers and providers. The participants expressed disappointment at the slow progress, which for some lagged months or years behind their planned milestones. Bundled payment is complex and must build on existing complex health care systems. As implemented, PROMETHEUS builds on fee-for-service claims infrastructure and thus adds to the complexity of existing payment systems. Services that are part of a clinical episode, and thus subject to bundled payment, are identified using the information about the patient's diagnoses and services that providers report on fee-for-service insurance claims. The same information is also used to classify each service as either typical care or a potentially avoidable complication. The decision rules that determine whether specific services are part of a bundle and, if so, whether they constitute typical care or potentially avoidable complications are complex and depend on the quality of the information that providers include on claims, which are not designed with the needs of a bundled payment system in mind. Identifying bundles during claims processing is important not only so that payments can be processed appropriately by insurers, but also so that providers can rapidly receive information on their patients who had initiated clinical episodes subject to bundled payment. No site succeeded in modifying its claims processing methods to identify bundled services using the PROMETHEUS Engine or an alternative. Executing contracts is difficult because of the number and complexity of considerations involved, including the market power - or lack thereof - of individual payers and providers in their own health care markets. Shared savings has turned out to be more difficult to implement than expected. Interviewees at two sites reported that neither payers nor providers were eager to set aside funds from which to make the bonus payments. In addition, some payers did not accept the idea that they should share any savings. All three sites are using electronic health records as a crucial component of their strategies for care redesign. However, the sites have found that their record systems lack key capabilities that would enable more effective care redesign. Providers in all three sites have begun planning and implementing care delivery before payment methods actually change. However, they recognize that without new payment incentives in place, these efforts will be limited because they may decrease provider revenues. We found that the PROMETHEUS road test encountered major challenges, and none of the pilot sites had made bundled payments as of May 2011. The pilot has taken longer than expected to implement primarily because of the complexity of the model and the fact that it builds on existing complex health care systems. Despite efforts by the institute and the pilot sites, some of the most prominent issues that have been raised with respect to bundled payment remained obstacles to implementation. The debate we observed about how payers and providers should share risk around episodes of care mirrors the current debate about the final form of accountable care organization risk-sharing regulations. http://content.healthaffairs.org/content/30/11/2116.abstract Comment: The PROMETHEUS Bundled Payment Experiment held the promise of improving the quality of care while controlling costs simply by bundling together services of multiple health care providers into a single package covering a specific acute or chronic disorder. After three years of implementation, the payers and providers have not been able to make bundled payments or execute new payment contracts. The experiment is an abject failure. The authors of this report suggest that the experiment has been of value because the participants have learned lessons, and they understand the complex obstacles to implementation, even if they were unable to surmount them. They conclude, "Payment and delivery reform models may yet yield desired improvements in health care quality and spending, but notable gains may not come quickly or easily." It is so clear that the health reform efforts to date have been a fiasco, and yet what do we do? We diddle around playing the PROMETHEUS board game, trying to get past "Go" so we can collect $200, but without going to jail (though perhaps some players should). It is long past time to get serious about reform. We have more than enough money to finance a premier health care delivery system for everyone. We simply need to start spending our health care dollars more wisely, by enacting a financing system that places patients first - a single payer national health program (Improved Medicare for All). -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Mon Dec 5 14:50:00 2011 From: don at mccanne.org (Don McCanne) Date: Mon, 5 Dec 2011 11:50:00 -0800 Subject: [Health Care Action] =?windows-1252?q?qotd=3A_Michael_Dukakis_on_?= =?windows-1252?q?ACOs=3A_=22We_tried_that=2C_folks=2E_It_didn=92t_?= =?windows-1252?q?work=2E=22?= Message-ID: The Boston Globe November 28, 2011 Michael Dukakis on ACOs: "We tried that, folks. It didn?t work." By Chelsea Conaboy The creation of accountable care organizations or a global payment structure won't fix the health care system in Massachusetts and make it more affordable, former governor Michael Dukakis told an audience at Harvard last week. Speaking during the Harvard School of Public Health Voices from the Field series, Dukakis said urging the health care market to fix itself is "a colossal waste of time." Here's an excerpt from the event: "If we paid a little attention, it might be a good idea, to the experience of other countries around the world who are doing this and who, for some reason, seem to be able to provide rather good health care to their people at half the cost we do -- whatever the siltstone, whether it's Australian medicare or a multi-payer system in Germany or an essentially privatized system in Switzerland -- every one of them regulates cost, without exception. "What do we do? Come up with this ACO, global payment thing... We?ve done it. ACOs and global payments. What did we used to call them? HMOs and capitation. We tried that, folks. It didn?t work. Why are we doing it again? "Now don't get me wrong. Nobody loves having to regulate. We had something called the rate-setting commission when I was governor... We treated hospitals as public utilities. They couldn't raise their rates a nickel unless they went to the rate-setting commission. We certainly didn?t have these huge disparities between what Partners gets and what the BI gets. Wouldn't allow it. So, we?ve got to get on with the business of regulating costs. And I think the least bureaucratic way to do it, rather than getting into setting elaborate fee schedules and so forth, is essentially to use the authority we have in this state under the state insurance statutes to regulate the rate of increase and the cost of premiums... You've got to involve the key players - providers, consumers, legislators, and so forth - in the process of developing how we're going to regulate and then carefully monitoring it so that, in point of fact, it works and works effectively and at the same time make sure that we provide people with excellent health care, which we do in this state. "What I'm worried about is that we're futzing around with new institutional arrangements, accountable care organizations." http://www.bostonglobe.com/lifestyle/health-wellness/2011/11/28/michael-dukakis-acos-tried-that-folks-didn-work/i6WTqNZOg8OB3fL170Y54I/story.html Comment: Michael Dukakis certainly recognizes accountable care organizations as being merely a new variant of HMOs with capitation. He worries about us "futzing around" with ACOS, but we need to go him one better. Let's quit "futzing around" with private insurers and establish an improved Medicare for everyone. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From calendar at wmjwj.org Mon Dec 5 21:58:55 2011 From: calendar at wmjwj.org (=?US-ASCII?Q?Workers'_Rights_Calendar?=) Date: Mon, 5 Dec 2011 21:58:55 -0500 Subject: [Health Care Action] Verizon Solidarity Calendar this week Message-ID: <045f01ccb3c2$fea2ef20$fbe8cd60$@org> Verizon workers are still trying to get a labor contract that keeps 45,000 good jobs in the US. The bargaining is going slowly. Verizon still wants give backs despite huge profits and tax breaks. Check out http://www.jwj.org/verizon/vz_fact_sheet.pdf. During this busy buying season, we'll be putting extra pressure nationwide on Verizon to settle. Please sign up for a leafleting shift - if not this week, then December 14, 17, 21, 24, 28, 31. Or suggest another shift. You can also join community delegations going into stores to deliver our message and weekly workplace stand-outs. Reply to wmjwj at wmjwj.org to volunteer. Wednesday December 7 (Every Wednesday) SUPPORT WORKERS AGAINST VERIGREEDY Noon to 2pm, leaflet customers at the door of the Verizon Wireless store at 360 Russell St, Hadley . Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). Friday December 9 (Every Friday) VERIZON STREET HEAT COMMITTEE meets with PIONEER VALLEY STREET HEAT on Second Friday: Friday December 9 (Second Friday) PIONEER VALLEY STREET HEAT - THE AFL-CIO MOBILIZATION COMMITTEE 9:30-11am, AFL-CIO Hall, 640 Page Blvd, near corner of Osborne Ter, across the street from the old Westinghouse, Springfield. Get directions here . On the agenda: Verizon; Jobs Crisis; Green Jobs; Mass Mutual Center workers; Safe Hospital staffing; Immigration Reform; Your Organizing! Community and labor activists are urged to attend. Info, send agenda items to: Jon Weissman, 732-7970, street_heat at pvaflcio.org. Saturday December 10 (Every Saturday) SUPPORT WORKERS AGAINST VERIGREEDY We leaflet customers every Saturday at the doors of the four Verizon Wireless stores in Western Mass: 360 Russell St, Hadley ~ Noon to 2pm ~ please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. 1123 Riverdale St, West Springfield ~ Noon to 2pm ~ please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. 1420 Boston Rd, Springfield ~ Noon to 2pm ~ please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. 555 Hubbard Ave, Pittsfield . ~ 11am to 1pm ~ please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Tue Dec 6 09:43:23 2011 From: don at mccanne.org (Don McCanne) Date: Tue, 6 Dec 2011 06:43:23 -0800 Subject: [Health Care Action] qotd: Shocking growth of premiums - in a single interactive visualization Message-ID: The Commonwealth Fund November 17, 2011 State Trends in Premiums and Deductibles, 2003?2010: The Need for Action to Address Rising Costs By Cathy Schoen, M.S., Ashley-Kay Fryer, Sara R. Collins, Ph.D., and David C. Radley, Ph.D., M.P.H. INCREASE IN PREMIUMS Click on this link: http://www.commonwealthfund.org/usr_doc/site_docs/slideshows/PremiumTrends2011/PremiumTrends2011.html You will see an interactive map of "Employer Premiums as Percentage of Median Household Income for Under-65 Population, 2003 and 2010" Near the top of the page, slowly drag the slider from 2003 to 2010. In dark blue you now see the states in which employer health insurance premiums average over 20% of median household income. Over 20%! In 2010, 62% of the population lived in states where total premiums amounted to 20% or more of middle incomes! A static slide of this change, showing the U.S. side by side in 2003 and 2010, can be downloaded at this link (slide number 2): http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Nov/State%20Trends/PDF_Schoen_state_trends_premiums_deductibles_2003_2010_exhibits.pdf INCREASE IN DEDUCTIBLES In slide 4 at the same link, you will see that, in 2010, average deductibles for employer sponsored plans are $1,025 for a single-person plan and $1,975 for a family plan, nearly double that of 2003. For the full Commonwealth Fund report, "State Trends in Premiums and Deductibles, 2003?2010: The Need for Action to Address Rising Costs": http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2011/Nov/State%20Trends/1561_Schoen_state_trends_premiums_deductibles_2003_2010.pdf Comment: More people receive their health insurance through their work than from any other source. The costs of employer-sponsored plans have been skyrocketing, as demonstrated by the increase in premiums. The coverage has eroded, as demonstrated by the increase in deductibles. The Office of the Actuary has predicted that "private insurance spending per person will increase faster than public programs over the next decade." Yet the Affordable Care Act failed to provide measures which would have any significant impact on these trends in employer-sponsored plans. Let's restart the reform process, but this time let's do it right. Let's have only single payer at the table. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From acswift at comcast.net Tue Dec 6 12:47:59 2011 From: acswift at comcast.net (Alice Swift) Date: Tue, 6 Dec 2011 12:47:59 -0500 Subject: [Health Care Action] Fwd: Single Payer Hearings Scheduled for NEXT THURSDAY! In-Reply-To: <1195470708.557454.1323192909013.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> References: <1195470708.557454.1323192909013.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> Message-ID: I just received this!! ---------- Forwarded message ---------- From: Mass-Care Date: Tue, Dec 6, 2011 at 12:35 PM Subject: Single Payer Hearings Scheduled for NEXT THURSDAY! To: Alice ** Mass-Care's single payer bill will have a hearing at the State House next Thursday, December 15 - time to organize testimony! Is this email not displaying correctly? View it in your browser. *Hello Mass-Care Coalition Members,* Mass-Care's single payer bills (in the House and the Senate) and the bills to introduce a public option will have a hearing before the Joint Committee on Health Care Finance next *Thursday, December 15 at 11AM in Hearing Room B1*! Click herefor the hearing's posting on the General Court web-site. This was announced just this morning, so we need to mobilize testimony rapidly. For the first time in my memory, we will also not be competing with hearings for other health care bills - this hearing will host only the single payer and public option legislation. *Tomorrow, Wednesday, December 7, Mass-Care has a stuffing party to get our newsletter out* - please join us if you can, and we will also start planning testimony while we work! We can continue the planning at our Saturday statewide coalition meeting, but we will need to get invitations out quickly. Benjamin Day Executive Director, Mass-Care forward to a friend | friend on Facebook | follow on Twitter *Copyright ? 2011 Mass-Care, All rights reserved.* You are receiving this email because you wish to receive updates about Mass-Care's Board meetings. *Our mailing address is:* Mass-Care 33 Harrison Ave - 5th Floor Boston, MA 02111 Add us to your address book [image: Email Marketing Powered by MailChimp] unsubscribe from this list| update subscription preferences -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From acswift at comcast.net Tue Dec 6 15:38:05 2011 From: acswift at comcast.net (Alice Swift) Date: Tue, 6 Dec 2011 15:38:05 -0500 Subject: [Health Care Action] Single payer public hearing 12/15 Statehouse Message-ID: *Public hearing* on Mass-Care's *single payer bills* (S.501, H.338) and the bills to introduce a public option (S.500, H.1228) will be held before the Joint Committee on Health Care Financing next *Thursday, December 15 at 11AM in Hearing Room B1, State House, Boston*. The hearing will only cover those bills; no others will compete for time. We hope to have a good contingent from Western Mass. at the hearing to show our support! It?s late notice at a busy time of year, but please try to get there. There will be carpooling from the Amherst, Northampton, Greenfield, Springfield area somehow. I suggest you contact people in any group you?re associated with ? LWV of Amherst or Northampton, F/H HCC, WMJwJ, MSAC, etc. or Jackie Wolf (lwvahealthcare at yahoo.com), Jon Weissman ( wmspn at wmjwj.org), Alice Swift (acswift at comcast.net). We?re all going. Please consider preparing written comments, either to say (don?t plan to read a written statement) at the hearing or to hand in or send. I personally think short statements are better than long ones. There will probably be a limit on oral testimony, perhaps three minutes. Joint Committee on Health Care Financing hearing - House Facilitator: Rep. Steven Walsh, Senate Facilitator: Sen. Richard Moore* * *Alice* -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Wed Dec 7 09:26:48 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 7 Dec 2011 09:26:48 -0500 Subject: [Health Care Action] Verizon leafleting Message-ID: <017d01ccb4ec$44f4fed0$cedefc70$@org> Weather.com predicts rain at noon in Hadley today, so no leafleting. See you Saturday? Dear Workers' Rights Activists, Please let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! See schedule below. If you tell us in advance that you're coming, we'll contact you if anything changes (tell us how to contact you; we can send an email to your cell phone as a text message if you send your phone number and name of carrier to wmjwj at wmjwj.org). And please sign the online Message of Solidarity . We leaflet regularly at the door and stand out with the VeriGreedy banner at the street at 360 Russell St, Hadley , 1123 Riverdale St, West Springfield , 1420 Boston Rd, Springfield , & 555 Hubbard Ave, Pittsfield . This week's schedule: Saturday, Noon to 2pm, at the Hadley store: Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store: Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store: Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store: Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off by 9am and let you know by email. If we know you are coming, we can send the email to your cell phone as a text message if you send your phone number and name of carrier to wmjwj at wmjwj.org. You can call the Store Captains listed above to be sure, but it's better if you tell us in advance that you're coming and we'll call you. When we call off a planned leafleting shift due to weather, the captains will be there at the beginning to tell anyone who did not get the message, but we'll only wait 15 minutes. If this email was forwarded or copied to you, be sure to keep up-to-date on workers' rights campaigns by subscribing to the Workers' Rights List. To subscribe, send a blank email to workersrights-subscribe at lists.prometheuslabor.com or go to http://lists.wmjwj.org/mailman/listinfo/workersrights. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Wed Dec 7 14:38:44 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 7 Dec 2011 14:38:44 -0500 Subject: [Health Care Action] CDH rhetoric incites nurses, scares public Message-ID: <027101ccb517$e107c5c0$a3175140$@org> CDH rhetoric incites nurses, scares public Daily Hampshire Gazette 12/7/11 To the editor: I was appalled at the Dec. 1 headline in the Gazette "CDH makes backup plans for nurses' strike." I have been at Cooley Dickinson Hospital for nine years and I have been a union steward for at least the last five. I have been sitting at the negotiation table since day one. There has not ever been one word of the Massachusetts Nurses Association holding a strike or even a vote to authorize a strike. There are proposals on the table that still have plenty of potential movement. While the progress has been painfully slow, there is still progress. The rhetoric that the management of CDH has been putting out is only inciting the registered nurses and scaring the public. The CDH nurses work very hard making sure their patients are getting all their needs met, despite the high patient load they carry. CDH has had four layoffs over the last four years, decreasing the amount of nurses and ancillary staff to care for patients and assist their families. On top of the responsibilities the nurses have in caring for ill patients, they are also now responsible for handing out food trays, feeding patients, answering the telephones and walking patients to the bathroom. These tasks now delay the nurse in assessing a patient's medical condition or giving out pain medication. What are the RN's asking for? Staffing guidelines with the inclusion of ancillary staffing to hold the hospital accountable for safe patient care. The nurses are already accountable for safe patient care with the state-issued licenses we carry. It is time for the hospital to be accountable too. We are also asking for status quo on our vacation time and pension. We continually put our responsibilities at CDH over our families, coming in because it is short-staffed or staying late to help that last patient get their needs met. We miss our children's events, we miss dates with our spouses, miss our home life. Why? Because we are nurses that care for our hospital and our patients. Kathryn Wilkins-Carmody Northampton Kathryn Wilkins-Carmody is a union steward at Cooley Dickinson Hospital. -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Wed Dec 7 16:48:18 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 7 Dec 2011 13:48:18 -0800 Subject: [Health Care Action] qotd: Defined contributions future for health care Message-ID: Bloomberg December 6, 2011 Orszag: Defined Contributions Define Health-Care Future By Peter Orszag Over the next decade, we are likely to see a shift in health insurance in the U.S.: So-called defined-contribution plans will gradually take over the market, shifting the residual risk of incurring high health-care costs from employers to workers. The market today is dominated by "defined-benefit" plans, under which companies determine a set of health-insurance benefits that are provided for employees. These will gradually be replaced by defined-contribution plans, under which companies pay a fixed amount, and employees use the money to buy or help pay for insurance they choose themselves. The fundamental driver of this shift is the effort by American businesses to reduce their exposure to health-care costs. But the recent health-care-reform law may accelerate the shift. The change in health insurance is already well under way in coverage for retirees. In the early 1990s, in response to accounting changes and rising costs, companies began to re- evaluate retiree health plans, and some capped the amount they were willing to pay at a multiple of existing costs. Over time, as those limits were reached, most companies declined to raise them, thereby effectively creating defined-contribution retiree health-insurance plans, with the company's contribution set by the cap. Exchanges have been created to allow retirees to use these employer contributions to purchase their own health insurance. For current workers, the precursor to a defined- contribution approach is the "consumer-driven" health plan. This typically has higher deductibles and co-payments than a traditional plan has, and it is often tied to a health savings account. It typically still provides generous insurance for catastrophic cases. Some insurers are already anticipating the shift. Bloom Health Corp. will begin offering defined-contribution exchanges in 2012. Bloom, based in Minneapolis describes itself as "a leader in the defined-contribution health benefits marketplace," and says it is "committed to assisting employers of all sizes move toward an employer-sponsored system that has effective cost predictability for employers and increased choice and personalization for employees." In September, the company announced that Health Care Service Corp., Blue Cross Blue Shield of Michigan and WellPoint (WLP) Inc. had purchased a majority of its equity. The inevitable transition to defined-contribution health insurance may get a little push from the new health-care-reform law. Indeed, the legislation may have a larger impact on the type of health-insurance plan that employers offer than on their decision about whether to drop health-care benefits altogether. If most employers do retain their health plans, the state insurance exchanges created under the new federal health-care law will make the basic idea of a defined-contribution health plan more prevalent, and thus may speed its adoption. The regulations written to carry out the new law will determine how things play out. If defined-contribution plans that are sufficiently generous count as employer-based coverage - as is generally expected - the trend toward such plans will probably accelerate. In any case, the bottom line is that a shift toward defined-contribution plans seems likely. I?d be willing to bet $1 that most large U.S. employer health-care offerings in 2020 will be defined-contribution plans. Any takers? (Peter Orszag is vice chairman of global banking at Citigroup Inc. and a former director of the Office of Management and Budget in the Obama administration. The opinions expressed are his own.) http://www.bloomberg.com/news/2011-12-07/defined-contributions-define-health-care-ahead-commentary-by-peter-orszag.html Comment: One of the more important tools to enable the transfer wealth up the income ladder is to shift from defined benefit programs to defined contributions. With a defined contribution, a set dollar amount is contributed to the program regardless of what the future benefits may cost, whereas with a defined benefit program, the projected costs of the program must be fully funded so the benefits will always be there when needed. In the case of pension plans, a defined contribution allows the employer to shift the risk of wage inflation and the risk of living longer from the employer to the employee. The latter is particularly a problem since many individuals will outlive the funds accumulated in their defined contribution pension plan. It is true that they could use those funds to buy an annuity, but fewer funds would be available because it is not a defined benefit plan, and converting to an annuity burns up even more of the retirement funds to pay for sales and administrative costs plus the costs of insuring against the risk of living longer. How does this move wealth up the income ladder? Defined benefit pension plans were considered to be a standard part of the well-earned employee benefit package. These defined benefit plans were actually paid for by foregone wage increases. In the last couple of decades, contributions to the pension plans were limited by changing to defined contribution, yet wages remained flat. The foregone wages never came back. Workers suffered a net loss, while employer/owners kept the difference, thus an upward transfer of wealth. Now we are seeing this same inequitable concept being applied to employer-sponsored health plans. Traditional health plans provided generous benefits and often had an actuarial value of 90 percent (the plan paid 90 percent of health care costs and the worker paid 10 percent). We are now seeing a decline in actuarial value. The most obvious contributing factor is the relatively abrupt increase in the adoption of high-deductibles for employer-sponsored plans, but also benefits covered are diminishing, often through less transparent, innovative changes to the plans. Once again, benefits are being reduced but without a commensurate return of forgone wages. Particularly alarming in Peter Orszag's article is the investment of WellPoint and Blue Cross Blue Shield of Michigan in Bloom Health Corporation. Bloom Health is "a leader in the defined-contribution health benefits marketplace." They are committed to a system that has "effective cost predictability for employers," but exposes employees to the ever higher costs and risks of health care. This ongoing shift to defined contribution in health care is not limited to businesses. In a recent message, we reported that the Institute of Medicine is recommending that the essential health benefits for the state insurance exchanges under the Affordable Care Act "should be defined as a package that will fall under a predefined cost target rather than building a package and then finding out what it would cost." "Predefined cost target" is a defined contribution. Even Medicare is vulnerable. The New York Times, in a recent editorial, stated that for Medicare, "serious analysis and testing of premium support are clearly worth pursuing." Premium support is a defined contribution that would be used to purchase a private Medicare plan. Medicare beneficiaries would be responsible for paying for the balance of the premium for whatever coverage they could get. Further, with tight control of the defined contribution, an increasing percentage of health care costs would be shifted to Medicare patients in the form of higher out-of-pocket spending. What do all of these have in common? They are all methods of perpetuating the private insurance industry, while shifting risks from the insurers to the insured individuals. They reduce the financial commitment of employers and the government, but increase the financial burden for workers, their families, and retirees - most of us. However, it is a jobs program - for personal bankruptcy attorneys, as if our health care system didn't give them enough work already. Defined contribution is a nefarious conspiracy directed at the masses to benefit the well off. We can counter by demanding an end to a system dominated by private insurers and replacing it with a single, publicly-financed and publicly-administered national health program - an improved Medicare for everyone. (After we fix Medicare, we may want to think about greatly reinforcing our publicly-financed, publicly-administered, defined benefit Social Security program so we wouldn't have to put up with the abuses of our private, defined contribution pension plans. Really.) -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From acswift at comcast.net Thu Dec 8 13:17:40 2011 From: acswift at comcast.net (Alice Swift) Date: Thu, 8 Dec 2011 13:17:40 -0500 Subject: [Health Care Action] Fwd: Single Payer Hearing NEXT THURSDAY! In-Reply-To: <877988622.636396.1323359396811.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> References: <877988622.636396.1323359396811.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> Message-ID: We need bodies at the hearing. You don't need to testify. Please come. Alice ---------- Forwarded message ---------- From: Mass-Care Announce Date: Thu, Dec 8, 2011 at 10:49 AM Subject: Single Payer Hearing NEXT THURSDAY! To: Mass-Care Announce Hello Single Payer Supporters - the public hearing for our state's single payer bill, called the 'Massachusetts Medicare for All' legislation (S.501/H. 338), has been scheduled for next *Thursday, December 15, at 11AM*! It will be held in *Hearing Room B1 at the State House*, and we need your testimony to support making health care a right for all residents of the state. If you can offer testimony speaking as a patient, as a provider, as an employer, a worker, or as an expert, please contact us at info at masscare.org - your written testimony will prove extremely important, and if you are available to speak next Thursday, we will be assembling panels of speakers. We also need to pack that hearing room, so come to support this life-changing bill regardless of whether you wish to speak or not! *If you give one day of your time for single payer over the next year, this is your best opportunity to have an impact!* This hearing will also solicit feedback on a public option bill for Massachusetts (S.500/H.1228), if you wish to speak in support of a public option plan! Written testimony is typically limited to one page, and speakers will have no more than 2 minutes, sometimes only 1 minute, so be as succinct as possible, and speak to the issue only from the perspective you have personal experience with or expertise in - you do not need to make a full argument for single payer reform, as we will have many speakers. Thank you for your support, Benjamin Day Executive Director, Mass-Care _______________________________________________ Mass-Care: The Massachusetts Campaign for Single Payer Health Care 33 Harrison Ave - 5th floor Boston, MA 02111 Ph: 617-723-7001 Fx: 617-723-7002 Em: info at masscare.org -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Thu Dec 8 15:58:07 2011 From: don at mccanne.org (Don McCanne) Date: Thu, 8 Dec 2011 12:58:07 -0800 Subject: [Health Care Action] qotd: Don McCanne on "unaffordable under-insurance" Message-ID: In These Times December 7, 2011 Health Reform Devolves Into 'Unaffordable Under-Insurance' By Roger Bybee Healthcare reform in the shape of the 2010 Affordable Care Act (aka "Obamacare") was supposed to relieve working Americans of the burdens of rising healthcare costs as they struggle to survive the jobless recovery. Instead, working Americans are being confronted with the emergence of a new stage in America?s downward slide on healthcare. "'Unaffordable under-insurance' is rapidly becoming the new standard in the United States," Dr. Don McCanne, senior health policy fellow for Physicians for a National Health Program (PNHP), told In These Times. For McCanne and fellow health professionals in PNHP, the downward spiral in healthcare will finally end only with the United States installing a Canadian-style "Medicare for all" single-payer system that puts a halt to the machinations of for-profit insurers. http://inthesetimes.com/working/entry/12348/health_reform_runs_into_unaffordable_under-insurance Comment: This brief article from In These Times, available at the link above, explains how the Affordable Care Act is bringing us a new national standard of "unaffordable under-insurance." It's not simply that we can do better, we have to do better. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Fri Dec 9 07:42:31 2011 From: don at mccanne.org (Don McCanne) Date: Fri, 9 Dec 2011 04:42:31 -0800 Subject: [Health Care Action] qotd: Uwe Reinhardt on social insurance and individual freedom Message-ID: The New York Times December 9, 2011 Social Insurance and Individual Freedom By Uwe E. Reinhardt The continuing debate over the Affordable Care Act and the commentary on this blog have convinced me that nothing can ever unite Americans on their vision of an ideal health system. We need different health insurance systems for different Americans. I mean by this not Americans who differ by age or ability to pay but Americans with different notions of a just society. Closing the Door to Statutory Insurance By law, every German must have coverage for a prescribed benefit package. German employees and pensioners earning less than 49,500 euros ($66,350) per year (in 2011) are compulsorily insured under the statutory system. Employees and pensioners above that threshold are free to opt out of the statutory system and purchase private, commercial coverage, but if they do, they cannot ever return to the statutory system unless they are paupers. The intent is to minimize gaming of the insurance system by individuals. It is this feature that intrigues me, as it has my colleague Paul Starr, in his proposed alternative to an individual mandate to be insured. What if Americans at, say, age 26 (beyond which they can no longer be included on their parents? insurance policy) or even as late as age 30 were offered the choice of: 1. joining the community-rated health insurance offered through the insurance exchanges called for in the Affordable Care Act; 2. remaining in a private insurance system that is free to charge in any year ?actuarially fair? premiums, that is, premiums that reflect the applicant?s projected health status and spending for that year and is free to refuse issuing a policy altogether; 3. simply self-insuring, by remaining uninsured? For want of better terms, we might call the exchange system the ?social insurance track? (because it leans heavily toward social insurance) and the second and third options the ?rugged individualist tracks,? because they cater to Americans with individualist preferences. For people choosing the rugged individualist tracks, Professor Starr proposes to shut the door to the social insurance track for only five years. I believe his stricture is too weak and propose instead to follow the German example by shutting the door permanently to social insurance to any individual who chose one of the two rugged individualist tracks, unless such individuals were truly pauperized. A return then would have to be allowed, because, for better or for worse, our civic sentiments preclude letting anyone ? even a myopic rugged individualist ? die for want of critically needed health care. Admittedly, this approach would confront young Americans with a serious life-cycle choice. But life-cycle choices are made all the time, and choices do have consequences that people in their mid-20s should be mature enough to think about. Adults must realize that individual freedom has its price. The American health insurance system now is structured as a paradise for clever adolescents, inviting gaming of many sorts that makes sensible health policy almost impossible. It is time to move away from such a system. http://economix.blogs.nytimes.com/2011/12/09/social-insurance-and-individual-freedom/ Published comment: Don McCanne, San Juan Capistrano, CA Those of us who have great admiration for Paul Starr were disappointed by his recommendation to require anyone who opted out of coverage to be prohibited from having coverage for the next five years. Under this policy, many of these very healthy young people will decide to take the chance that they will not need expensive care, and most will win that bet. There are two problems with this. Some will have major trauma, some will develop serious disorders such as cancer, and some will develop severe chronic problems such as type I diabetes. These people should receive the care that they need regardless of the fact that they made the unwise decision to decline insurance. Who pays for that care? The other problem is that we do need the many who are healthy to pay into the risk pools to cover the fewer with greater health care needs. Otherwise those pools end up with a death spiral of ever higher premiums. Just as our nation does not allow me, a pacifist, to not pay through my taxes the costs of our ill-considered wars, our nation should also prohibit the rugged individualists from not paying their share of our collective national health expenditures. The nation will continue to disagree on this, which is precisely Professor Reinhardt's point. But that won't stop some of us from continuing to advocate for what is right. http://economix.blogs.nytimes.com/2011/12/09/social-insurance-and-individual-freedom/?comments#permid=1 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Fri Dec 9 13:09:33 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Fri, 9 Dec 2011 13:09:33 -0500 Subject: [Health Care Action] Verizon Workers Community Support Letter Message-ID: <019801ccb69d$b5699ce0$203cd6a0$@org> Dear Western Mass. Jobs with Justice Workers Rights Board and Community Members, I attach a community sign-on letter to the Verizon CEO. Would you be willing to sign it? It is an updated version of the one we circulated in October and if you have signed onto that one, you do not need to sign onto this one. It will be presented to him as a list, so you may "sign" by simply replying to this email with your approval, Name, Title, Organization/Congregation, and understanding that the letter will be used publicly and may be published with that information for identification only. Your contact information will not be used publicly. The deadline for signing is Monday December 12 at noon. In addition, there is an online Message of Solidarity to Verizon workers, which I hope you already signed. Thank you for any help you can give! In solidarity, Jon ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: vzcommunityletter.2.doc Type: application/msword Size: 22528 bytes Desc: not available URL: From don at mccanne.org Mon Dec 12 09:28:13 2011 From: don at mccanne.org (Don McCanne) Date: Mon, 12 Dec 2011 06:28:13 -0800 Subject: [Health Care Action] qotd: PNHP response to Rick Ungar's "Obamacare Bomb" Message-ID: Forbes December 2, 2011 The Bomb Buried In Obamacare Explodes Today-Hallelujah! By Rick Ungar I have long argued that the impact of the Affordable Care Act is not nearly as big of a deal as opponents would have you believe. At the end of the day, the law is - in the main - little more than a successful effort to put an end to some of the more egregious health insurer abuses while creating an environment that should bring more Americans into programs that will give them at least some of the health care coverage they need. There is, however, one notable exception - and it?s one that should have a long lasting and powerful impact on the future of health care in our country. That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers? premium dollars they collect - 85% for large group insurers - on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care. This is the true ?bomb? contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we?ve seen in quite some time. Indeed, it is this aspect of the law that represents the true ?death panel? found in Obamacare - but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry. Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most. Today, that bomb goes off. Today, the Department of Health & Human Services issues the rules of what insurer expenditures will - and will not - qualify as a medical expense for purposes of meeting the requirement. As it turns out, HHS isn?t screwing around. They actually mean to see to it that the insurance companies spend what they should taking care of their customers. Here?s an example: For months, health insurance brokers and salespeople have been lobbying to have the commissions they earn for selling an insurer?s program to consumers be included as a ?medical expense? for purposes of the rules. HHS has, today, given them the official thumbs down, as well they should have. Selling me a health insurance policy is simply not the same as providing me with the medical care I am entitled to under the policy. Sales is clearly an overhead cost in any business and had HHS included this as a medical cost, it would have signaled that they are not at all serious about enforcing the concept of the medical loss ratio. So, can private health insurance companies manage to make a profit when they actually have to spend premium receipts taking care of their customers? health needs as promised? Not a chance - and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know - we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it. http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/ Ungar responds to criticism of this article: http://www.forbes.com/sites/rickungar/2011/12/05/the-obamacare-bomb-is-very-real-even-if-washington-post-doesnt-quite-get-it/ **** PNHP co-founders David Himmelstein and Steffie Woolhandler respond to Rick Ungar's "The Bomb Buried in Obamacare...": "Limiting overhead to 15%-20% is far from the stringent regulation that Ungar implies. Private insurers' overhead currently averages about 14% nationwide, and they will probably be able to reclassify some items currently classified as overhead into the patient care expense category (despite regulations that attempt to stop this). Moreover, some current sales expenses will be offloaded to the insurance exchanges, which are likely to have overhead of 3-4%, and the exchanges' expenses will not count as part of insurers' overhead. Finally, ACOs will take over many of insurers' administrative tasks and expenses, but these ACO overhead expenditures will not count toward the 15%-20% overhead limit. In sum, total insurance overhead (and profit) is likely to grow, not fall in the years ahead." Comment by Don McCanne, MD: Never have we received as many requests to comment on an article as we have on Rick Ungar's "The Bomb Buried in Obamacare..." He is to be highly commended for his enthusiastic support of single payer, but his analysis that the insurers' requirement to comply with the statutory medical loss ratios is an Obamacare bomb that will cause so much damage that we'll be on an inescapable path to single payer might represent... well, perhaps a touch of hyperbole, intended or not. In the response above, David Himmelstein and Steffie Woolhandler explain how the medical loss ratio will have very little impact on reducing total insurance overhead and profit, although some recategorization will likely take place. Thus it isn't quite the bomb that will relieve us of their excesses and intrusions, nor relieve the health care providers of the administrative burdens that are placed upon them by the insurers and by the general complexity of our fragmented, dysfunctional health care financing system. That said, it is political season. We can thank Rick Ungar for providing us with well-meaning hyperbole that that is appropriately provocative and makes people want to look once again at single payer as an answer to our health care mess. As Ungar says, "we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it," even if the medical loss ratio bomb won't really budge us in that direction. Although PNHP will remain meticulous with the facts, upholding our reputation as a highly credible resource on single payer reform, it would be great if Rick Ungar and many others would continue with passionate pro-single payer advocacy, though perhaps fine tuning the hyperbole in order to ensure credibility. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From acswift at comcast.net Mon Dec 12 15:09:05 2011 From: acswift at comcast.net (Alice Swift) Date: Mon, 12 Dec 2011 15:09:05 -0500 Subject: [Health Care Action] Fwd: CHANGE OF TIME/ROOM for Single Payer Hearing Thursday! In-Reply-To: <1079762557.770631.1323720334801.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> References: <1079762557.770631.1323720334801.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> Message-ID: ---------- Forwarded message ---------- From: Mass-Care Announce Date: Mon, Dec 12, 2011 at 3:05 PM Subject: CHANGE OF TIME/ROOM for Single Payer Hearing Thursday! To: Mass-Care Announce Hello Single Payer Supporters - The public hearing for the state single payer bill has been moved to *1PM this Thursday, December 15, in the Gardner Auditorium at the State House. Please note the new time and room location*! We need all the support we can get, so please volunteer to attend, or submit testimony in support of single payer health reform, as well as the public option bill if you are interested! Email info at masscare.org to get plugged in. See you all on Thursday! _______________________________________________ Mass-Care: The Massachusetts Campaign for Single Payer Health Care 33 Harrison Ave - 5th floor Boston, MA 02111 Ph: 617-723-7001 Fx: 617-723-7002 Em: info at masscare.org -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Tue Dec 13 08:49:49 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 13 Dec 2011 08:49:49 -0500 Subject: [Health Care Action] Verizon leafleting this week Message-ID: <067301ccb99e$20503340$60f099c0$@org> If this email was forwarded or copied to you, be sure to keep up-to-date on workers' rights campaigns by subscribing to the Workers' Rights List. To subscribe, send a blank email to workersrights-subscribe at lists.prometheuslabor.com or go to http://lists.wmjwj.org/mailman/listinfo/workersrights. Dear Workers' Rights Supporters, Please let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! See schedule below. We leaflet regularly at the door and stand out with the VeriGreedy banner at the street at 360 Russell St, Hadley , 1123 Riverdale St, West Springfield , 1420 Boston Rd, Springfield , & 555 Hubbard Ave, Pittsfield . This week's schedule: Wednesday, Noon to 2pm, at the Hadley store: Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Saturday, Noon to 2pm, at the Hadley store: Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store: Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store: Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store: Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Tue Dec 13 10:54:58 2011 From: don at mccanne.org (Don McCanne) Date: Tue, 13 Dec 2011 07:54:58 -0800 Subject: [Health Care Action] qotd: Insurers: Trust us on risk adjustment Message-ID: Center on Budget and Policy Priorities December 12, 2011 Allowing Insurers to Withhold Data on Enrollees' Health Status Could Undermine Key Part of Health Reform By Edwin Park Risk adjustment is one of the critical elements of health reform (i.e., the Affordable Care Act, or ACA) that's designed to encourage insurers to compete based on price and quality - not on attracting the healthiest enrollees and deterring those in poorer health, as they typically do today in the individual and small-group insurance markets. Under the ACA's risk adjustment provision, insurers in the individual and small-group markets with sicker-than-average overall enrollment will receive payments to compensate them for their resulting higher costs. The payments will come from plans that enroll healthier-than-average people who do not cost as much to cover. By compensating insurers that enroll people in poorer health, risk adjustment reduces the incentive for insurers to "cherry pick" the healthy and avoid enrolling people with chronic illnesses and other serious health conditions. To implement this "risk adjustment" provision, the federal government proposes that the entities administering risk adjustment - states or the U.S. Department of Health and Human Services (HHS) - determine the health status of plan enrollees based on data that insurers submit to them, which is similar to how risk adjustment in Medicare works today. But some insurance companies, as well as some House Republicans, are urging the federal government to allow insurers to measure the health status of their enrollees themselves without submitting any data. Some insurance companies are mounting strong opposition to the HHS proposal on risk adjustment data submission. Instead, they are pushing HHS to adopt a "distributed" approach to the collection of risk adjustment data. Under a distributed approach, insurers would standardize their data (according to federal and state specifications), themselves apply the risk adjustment methodology and calculate their own risk scores and then simply submit those scores to the entity administering risk adjustment. Insurance companies would not provide the risk adjustment entity with any of the underlying claims and encounter data needed to determine whether the data are reliable and valid and whether the risk scores have been accurately calculated. (Insurers would be expected to make a sample of that data available after the fact for retrospective audits.) Risk adjustment is an essential element of the Affordable Care Act. Letting insurers calculate their own risk scores without having to submit the underlying data needed to make sure those calculations are accurate would place the health reform law's risk adjustment system at substantial risk of error, upcoding, and fraud, threatening the long-term success of the exchanges and the major health insurance market reforms scheduled to take effect in 2014. http://www.cbpp.org/cms/index.cfm?fa=view&id=3640&emailView=1 And... BlueCross BlueShield Association October 31, 2011 Letter to Centers for Medicare & Medicaid Services Re: Proposed Rule for Standards Related to Reinsurance, Risk Corridors and Risk Adjustment (CMS-9975-P) We strongly recommend that HHS use a distributed model for accessing risk adjustment data. Our recommended model: 1) alleviates members' privacy concerns since States will not be collecting confidential, individually identifiable health information; 2) retains issuers' control of proprietary data that has strategic importance; and 3) allows States/HHS to maintain the same control over the process while alleviating the burden of creating, securing, maintaining and updating a large costly centralized multi-payer database. http://www.regulations.gov/#!documentDetail;D=HHS-OS-2011-0022-0543 And... National Bureau of Economic Research report on risk adjustment in the Medicare Advantage Program: Thus the authors conclude that the Medicare Advantage program both increased total Medicare spending and transferred Medicare resources from the relatively sick to the relatively healthy, and that risk-adjustment was not able to address either of these problems. http://pnhp.org/blog/2011/10/03/private-medicare-plans-shockingly-game-risk-adjustment/ Comment: Insurers that corner the market of healthy individuals have an unfair advantage over insurers that cover a greater number of high cost, sicker patients. To protect those insurers with high costs from failing in the markets, risk adjustment corrects for the market distortions by taking funds from the insurers with low cost patients and transferring them to the insurers with high cost patients. Risk adjustment may be a great theory, but in practice it doesn't work very well. As an example, even though prohibited from selectively enrolling healthier patients, Medicare Advantage plans have been very successful at selectively marketing to the healthy. Insurers end up with significantly lower costs, even though they are paid higher amounts than are paid for patients in the traditional Medicare program. In 2004, Medicare began to adjust for risk, but the Medicare Advantage insurers gamed the system, as was demonstrated in an NBER report (link above), further increasing the unfair differential to about $3000 per patient. The Medicare-supervised risk adjustment was ineffective, not due to the incompetence of Medicare, but rather due to the deviousness of the Medicare Advantage plans in coding patients with just a touch of illness, making them appear as being more seriously ill than they were. Now the insurers want to do their own "distributed model" of risk adjustment, preventing federal or state bureaucrats from looking over their shoulders as they do their dirty deeds. This applies not only to Medicare Advantage plans but to all plans in and out of the exchanges, except for grandfathered plans. They claim that this secrecy is necessary to maintain patient privacy and to protect the insurers' proprietary data, but risk adjustment of the Medicare Advantage program has demonstrated that these are not valid concerns. Risk adjustment does not work, as the insurers will always game the system. The insurers' solution is to allow them to do it in greater secrecy, with a "trust us" attitude that certainly has not been earned based on their previous behavior. A solution that would benefit all of us would be to totally eliminate the need for risk adjustment. How do you do that? You simply eliminate multiple risk pools by eliminating the private insurer middlemen, and then establish a single, universal risk pool - an improved Medicare for all. There would never be a need for Medicare to risk adjust itself. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Tue Dec 13 14:27:38 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 13 Dec 2011 14:27:38 -0500 Subject: [Health Care Action] "B2B" for Verizon Workers 12/17 Message-ID: <014d01ccb9cd$4663ed90$d32bc8b0$@org> It isn't just other workers who know the value of standing up for good jobs protected by contracts like the CWA and IBEW contracts at Verizon - contracts that a very greedy Verizon wants to gut. Smart business folks know this too. And are saying so. A delegation from American Income Life Insurance Co. will deliver a letter of support for Verizon workers on Saturday December 17 at noon at the Boston Road Verizon Wireless store. Please let us know (wmjwj at wmjwj.org) if you can join them (if you can't, please sign the online Message of Solidarity ). This will be a peaceful action inside the store just to deliver the letter to the manager. This will be during our weekly leafleting and stand-out. So, please also let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! See schedule below. Wednesday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Saturday, Noon to 2pm, at the Hadley store: Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store, 555 Hubbard Ave, Pittsfield : Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store, 1420 Boston Rd, Springfield : Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store, 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). -------------- next part -------------- An HTML attachment was scrubbed... URL: From calendar at wmjwj.org Wed Dec 14 11:35:12 2011 From: calendar at wmjwj.org (=?us-ascii?Q?Workers'_Rights_Calendar?=) Date: Wed, 14 Dec 2011 11:35:12 -0500 Subject: [Health Care Action] GREENFIELD! SATURDAY! Message-ID: <010601ccba7e$5ac3d190$104b74b0$@org> Saturday December 17 RALLY FOR FAIR CONTRACT AT SERVICENET 9:30-11am, Greenfield Town Common, corner of Main & Federal Sts. MARCH ON BANK OF AMERICA 11am, from Town Common and back. BoA is at 208 Federal St. More below <> . RALLY FOR FAIR CONTRACT AT SERVICENET 9:30-11am, Greenfield Town Common, corner of Main & Federal Sts. We ask that ServiceNet bargain a fair contract for its employees without further delay. After 8 months of negotiations, ServiceNet says it wants a contract, but here's what it's been doing: Wages - Since 2008, Counselor pay has started at $11.30/hour, not a living wage. ServiceNet offers a 1% raise followed by a 3 year wage freeze ($250 yearly bonuses). Unequal Sacrifice - ServiceNet's managers pay 50% less than most of low-paid counselors for health insurance. Top executives got pay raises averaging 13%/year from 2006-2009. The highest salary at ServiceNet is now over $160,000/year. ServiceNet refuses to say if they will share the sacrifice being demanded of its counselors. Obstructing Our Right to Join the Union - ServiceNet objected to the decision by home health nurses to join the UAW, forcing the nurses to sit through "captive audience" anti-union meetings.. An election is scheduled for December 16. Labor law violations - ServiceNet refuses to provide information about pay for executives and other non-union employees, forcing UAW to file a complaint with the National Labor Relations Board. Bad Faith Negotiations - ServiceNet continues to demand that counselors give up their right to bargain over future changes to their health insurance and insist on the right to pay some new employees below Union scale. BACKGROUND - ServiceNet is a non-profit agency operating in Franklin, Hampshire, Hampden, Berkshire, and Worcester counties. ServiceNet receives upwards of $30 million/year, mainly from the state, to provide housing and community support to adults with developmental disabilities, mental illness and the homeless. UAW-2322 represents over 300 direct care staff, counselors and nurses, who help ServiceNet clients live safely in the community. Our members administer medication, assess clients, assist them in finding jobs and housing, ensure their health and safety and more. We have been bargaining with ServiceNet for 8 months and have been without a contract since July. MARCH ON BANK OF AMERICA 11am, from Town Common and back. BoA is at 208 Federal St. This is a national day of action for the Occupy movement. Besides being a symbol of the excesses of corporate America, Bank of America was one of the key players in the housing crisis. In Massachusetts, BoA along with four other banks are being sued by the State for fraudulent activities regarding mortgages and foreclosures. See http://www.mass.gov/ago/news-and-updates/press-releases/2011/five-national-b anks-sued-by-ag-coakley.html. The next Occupy Franklin County General Assembly will be Wednesday January 4, 7 to 9pm at the Second Congregational Church, Court Square, Greenfield. -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Wed Dec 14 14:27:10 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 14 Dec 2011 11:27:10 -0800 Subject: [Health Care Action] qotd: Critique of the Fraser Institute report on wait times Message-ID: Fraser Institute December 2011 Waiting Your Turn: Wait Times for Health Care in Canada - 2011 Report by Bacchus Barua, Mark Rovere and Brett J. Skinner This edition of Waiting Your Turn indicates that waiting times for elective medical treatment have increased since last year. Specialist physicians surveyed across 12 specialties and 10 Canadian provinces report a total waiting time of 19.0 weeks between referral from a general practitioner and receipt of elective treatment. http://www.fraserinstitute.org/uploadedFiles/fraser-ca/Content/research-news/research/publications/waiting-your-turn-2011.pdf And... Canadian Institute for Health Information (CIHI) Wait Times in Canada?A Comparison by Province, 2011 At least 8 out of 10 Canadian patients are receiving priority area procedures, such as hip replacements, cataract surgery and cancer radiation treatment, within medically recommended wait times, according to a new study from the Canadian Institute for Health Information (CIHI). The study provides the first comprehensive national picture of how long Canadians wait for care in priority areas as compared with evidence-based benchmarks of acceptable waits. http://www.cihi.ca/cihi-ext-portal/internet/en/document/health+system+performance/access+and+wait+times/release_21mar11 Comment: The Fraser Institute has released its 21st annual report on wait times for health care in Canada. This report is used widely to condemn Canada's reliance on their single payer medicare program for the financing of health care. It helps to fulfill the Fraser Institute's libertarian agenda of advocating for privatization of their health care system. Today's comment takes a critical look at this report. The findings in the report are based on the solicited opinions of Canadian physicians. Questionnaires were sent to 10,737 of the 68,000 active Canadian physicians. Of these, 1,696 physicians responded (15.8% response rate). Distributing these responses amongst the 12 specialties and ten provinces results in single digit tallies for 63 percent of the categories, and often only one physician falling into a given category. For instance, only one specialist in internal medicine represented the views of all internists in the province of Prince Edward. Besides questioning whether these numbers are adequate to represent the views of all Canadian physicians, there are two other factors that may have skewed the results. As an enticement to return the questionnaires the physicians were given the chance to win $2000. Physicians with an entrepreneurial mentality - those who more likely favor privatization of health care - might be more favorably inclined to try for this reward. More altruistic physicians who really care about the problem of queues might be insulted by this attempt to buy responses with a prize. A great many Canadian physicians strongly support their medicare program and oppose the current efforts to privatize both the delivery system and the health insurance system. These physicians are acutely aware of the agenda of the Fraser Institute and would be much less likely to cooperate in their biased studies. Thus it is unlikely that the sampling truly represents the views of mainstream Canadian physicians. Another important consideration is that this study was heavily weighted toward elective surgeries. Emergency conditions were not included. Patients in Canada have excellent access when a true emergency exists. So this study is not looking at acute, urgent conditions. Instead, this study was looking more at patients with chronic conditions which are usually managed over a long period of time, sometimes for a lifetime. Yet the authors imply that the disorders for which they are treated began at a single point in time in the generalist's office. In reality, when the physician and patient decide that it is time to consider more options for managing a chronic problem, often a decision is made to obtain a specialist's consultation. These are not emergencies so a routine appointment is scheduled. Except for a few specialties, most of these appointments are within a reasonable time interval. Once the patient sees the specialist, more time is consumed for appropriate comprehensive evaluation of the problem before a decision is made on definitive management. Again, these time intervals are mostly reasonable. Once the decision is made to schedule the elective surgery or other procedure, then excessive waiting times can be more objectionable. But how long are these waiting times? The specialists were asked what a reasonable waiting time was for their given procedures, and how long their patients had to wait. With the exception of plastic surgery and orthopedics, most waiting times were very close to those that the specialists considered to be reasonable. (Internal medicine was also an outlier for endoscopy and non-urgent angiography.) The Fraser report is very deceptive because they add to the time between scheduling a procedure and completing a procedure the time for the routine request by a generalist for a consultation, and the time for the specialist to complete the full evaluation before deciding on the specific management. If you separate these out, most of the intervals are quite reasonable. The 19 week wait reported by Fraser has little meaning, since it does not represent the time between scheduling a procedure and completing it. The much more credible study from the Canadian Institute for Health Information confirms that Canada is doing quite well in delivering care within medically recommended wait times. This does not mean that there are no problems. There is a very major problem, and it is political. Conservative politicians who currently control much of the government would like to privatize the health care system. Their approach is to abandon their role as stewards of the health care system, deliberately allowing longer queues to develop. Then the public is told that the only way to fix these outrageous delays that are killing people is to turn to the private health care markets in order to bypass the queues. As this view gains traction there is greater support for what amounts to a two-tiered system - the best of care for the relatively wealthy, and an under-funded public program for the masses. Sound familiar? Only we're far ahead of them in fragmenting our system. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Thu Dec 15 11:25:54 2011 From: don at mccanne.org (Don McCanne) Date: Thu, 15 Dec 2011 08:25:54 -0800 Subject: [Health Care Action] qotd: Why is Wyden supporting Ryan's Medicare voucher proposal? Message-ID: The Wall Street Journal December 15, 2011 A Bipartisan Way Forward on Medicare By Ron Wyden and Paul Ryan Our plan would strengthen traditional Medicare by permanently maintaining it as a guaranteed and viable option for all of our nation's retirees. At the same time, our plan would expand choice for seniors by allowing the private sector to compete with Medicare in an effort to offer seniors better-quality and more affordable health-care choices. Under our plan, Americans currently over the age of 55 would see no changes to the Medicare system. For future retirees, starting in 2022, our plan would introduce a "premium support" system that would empower Medicare beneficiaries to choose either a traditional Medicare plan or a Medicare-approved private plan. Unlike Medicare Advantage, these private plans would compete head-to-head with traditional, fee-for-service Medicare on a federally regulated Medicare exchange. Low-income seniors who qualify for both Medicare and Medicaid would continue to have Medicaid pay for their out-of-pocket expenses. Other lower-income seniors would receive fully funded savings accounts to help offset any increased out-of-pocket costs, while wealthier seniors would receive less help. In the event that these efforts did not stem the rising tide of Medicare spending, there would be a cap on the program's rate of growth. But unlike other proposals, spending that exceeds the cap would neither be addressed through bureaucratic cuts nor passed on to seniors by default as higher premiums. Instead, Congress would be required to do its job: Determine why the costs exceeded the cap and - when the evidence merits - reduce payments to providers, drug companies, or others who may be responsible for escalating costs. Our plan would also expand health-care options for working Americans by giving smaller businesses the opportunity to empower their employees to make their own health-care choices. Under this "free choice option," employees take the amount that their employer was contributing toward their employer-provided health coverage and use it to purchase their own health insurance instead. The cost to the employer - and the tax-free benefit to the worker - would remain the same. Yes, these are ambitious reforms, and while we are hopeful for the future, we are under no illusions that they will pass tomorrow. Nevertheless, we offer this plan as proof that Democrats and Republicans don't have to spend next year making Medicare reform more difficult. Instead, our parties can work together on bipartisan reforms to save and strengthen Medicare. (Mr. Wyden, a Democrat, is a U.S. senator from Oregon. Mr. Ryan, a Republican, is a U.S. representative from Wisconsin.) http://online.wsj.com/article/SB10001424052970203893404577098681919780636.html Press release: http://wyden.senate.gov/newsroom/press/release/?id=02334291-9c60-4020-9a8d-e2b9d0f37422 White paper (13 pages): http://budget.house.gov/UploadedFiles/WydenRyan.pdf Comment: Although Sen. Ron Wyden (D-Oregon) and Rep. Paul Ryan (R-Wisconsin) have released their white paper on a proposal for reforming Medicare, there is no intent on their part to follow it up with legislation during this session of Congress. Their stated intent is to initiate a bipartisan discussion on Medicare reform, but it appears instead that other political considerations prompted this proposal. Paul Ryan was stung by the response to his original proposal to end the traditional Medicare program and replace it with a premium support (voucher) program of private health plans. The Congressional Budget Office reported that his plan would cause a major shift of costs from the government to Medicare beneficiaries, and his own constituents beat up on him back home. Also, the Republicans in the House of Representatives are now on record as having voted for the Ryan premium support plan, and the Democrats have made it clear that they will make this a major issue in the coming elections. This white paper gives the Republicans an out. They can now claim that this is better than the original Ryan proposal because it protects Medicare by leaving it as an option while providing more choices of competing private plans. Obviously this takes away the sting of the Democrats' attack. Why would Ron Wyden cooperate with Paul Ryan in this effort to defuse the Democrats' strategy of using the premium support vote against the Republicans? It is because he is more supportive of his own previous proposal for health care reform than he is for the Democrats to prevail in the next election. His Healthy Americans Act that he pushed throughout the reform process called for an individual mandate to purchase private plans, shifting the tax benefit from employers to individuals (a concept included in this white paper). He has said that Democrats want universal coverage, Republicans want choice, and his plan, and now the Ryan-Wyden proposal, would enable both. The problem for single payer supporters is that this is a digression that shoves the concept of an improved Medicare for all further into the background. The substance of the debate will be over converting the Medicare Advantage plan into a voucherized program competing on price. Single payer supporters will not be welcome participants in that debate, nor should we. We shouldn't waste our resources on countering premium support. That's the wrong debate. We need to continue with a very strong message on countering private, corporate control of health care, while promoting a publicly-financed and publicly-administered Medicare for everyone. That's the message that America needs to hear. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Fri Dec 16 16:02:33 2011 From: don at mccanne.org (Don McCanne) Date: Fri, 16 Dec 2011 13:02:33 -0800 Subject: [Health Care Action] qotd: HHS punts the essential benefits decision to the private insurers! Message-ID: U.S. Department of Health & Human Services December 16, 2011 Essential Health Benefits: HHS Informational Bulletin On December 16, 2011, the Department of Health and Human Services issued a bulletin outlining proposed policies that will give States more flexibility and freedom to implement the Affordable Care Act. Intended Approach: Comprehensive and Flexible HHS intends to propose that essential health benefits are defined using a benchmark approach. Under the Department?s intended approach announced today, states would have the flexibility to select a benchmark plan that reflects the scope of services offered by a ?typical employer plan.? This approach would give states the flexibility to select a plan that would best meet the needs of their citizens. States would choose one of the following benchmark health insurance plans: * One of the three largest small group plans in the state by enrollment; * One of the three largest state employee health plans by enrollment; * One of the three largest federal employee health plan options by enrollment; * The largest HMO plan offered in the state?s commercial market by enrollment. If states choose not to select a benchmark, HHS intends to propose that the default benchmark will be the small group plan with the largest enrollment in the state. The benefits and services included in the benchmark health insurance plan selected by the state would be the essential health benefits package. Plans could modify coverage within a benefit category so long as they do not reduce the value of coverage. To prevent federal dollars going to state benefit mandates, the health reform law requires states to defray the cost of benefits required by state law in excess of essential health benefits for individuals enrolled in any plan offered through an Exchange. These benchmarks are generally regulated by the state and would be subject to state mandates applicable to the small group market. Thus, those mandates would be included in the state essential health benefits package if the state elected one of the three largest small group plans in that state as its benchmark. This approach would provide maximum flexibility to states, employers and issuers while providing quality, comprehensive, coverage for consumers. Coverage Essential health benefits must include coverage of services and items in all 10 statutory categories. Based on our research, we believe that these benchmarks will cover most of the essential health benefits outlined by the Affordable Care Act. These categories include preventive care, emergency services, maternity care, hospital and physician services, and prescription drugs. Allowing Plans Flexibility to Innovate and Consumers Greater Choice To meet the EHB coverage standard, HHS intends to require that a health plan offer benefits that are ?substantially equal? to the benchmark plan selected by the state and modified as necessary to reflect the 10 coverage categories. Health plans also would have flexibility to adjust benefits, including both the specific services covered and any quantitative limits, provided they continue to offer coverage for all 10 statutory EHB categories and the coverage has the same value. Permitting flexibility will provide greater choice to consumers, promoting plan innovation through coverage and design options, while ensuring that plans providing EHBs offer a certain level of benefits. Fact sheet: http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html Essential Health Benefits Bulletin (15 pages): http://cciio.cms.gov/resources/files/Files2/12162011/essential_health_benefits_bulletin.pdf Comment: It looks like Health and Human Services has decided that the new standard for health insurance to be offered under the Affordable Care Act will be the cheapest of the three largest small group plans offered in any given state. There will be no national standard. Although they would allow states more generous options other than the skimpy small group plans, with today's concerns over high health care costs, the cheapest option certainly will be selected by the state stewards. There is a requirement that 10 categories of health benefits must be included, but the specific services covered within each category will be determined by the insurers. The insurers will retain the flexibility to adjust both the specific services and the amount of those services (quantitative limits). HHS claims that this benefits us by providing greater choice for consumers and by providing insurers with the opportunity to innovate. Why they should deem that to be beneficial is astonishing when considering that insurer innovation means having to choose between various plans that take away, to varying degrees, choices of providers, benefits, and amount of financial security. The essential health benefits do not define the cost sharing features of the plans such as deductibles, copayments and coinsurance. Guidance on that will be forthcoming, but we already know that the least expensive plan will be the bronze plan with an actuarial value of 60 percent (the plan pays 60 percent of only the covered health care services). Again, because of our high insurance premiums, most people will select the cheapest actuarial-value plan. Can you think of anything worse than having cash-starved states selecting the cheapest private plans with the most spartan selection of benefits allowable - benefits selected by the private insurance industry - and offering those plans to struggling middle-income Americans who will be mandated to purchase these plans when many of them will not be able to afford even the bottom bronze plans in spite of the subsidies? And don't even think about how they're going to pay the high out-of-pocket expenses when they actually need health care. Dissecting out each individual policy perhaps can make them easier to understand, but when you patch them together, just try to explain the resulting health care financing infrastructure to the average individual who just wants health care when needed. Most individuals may not be able to understand the complexities of health policy, but once they've been exposed to the new standard, they certainly will understand what is meant by UNAFFORDABLE UNDER-INSURANCE. Try this thought experiment. Since the common defect in these Quote of the Day policy messages seems to be the dominance of the private insurers, try constructing a health care financing system without the private insurers being included. Wow! That was easy! All we need now is to elect leaders who are willing to dismiss the insurers so that we can get on with building a system that works for all of us. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Sun Dec 18 20:25:09 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sun, 18 Dec 2011 20:25:09 -0500 Subject: [Health Care Action] Congratulate local candidate for national Scrooge of the Year Message-ID: <022a01ccbded$0d93ca70$28bb5f50$@org> As the press release below notes, Eddie Hull has the notoriety of being the first Western Massachusetts nominee for the national Scrooge of the Year Award. We want to make sure to congratulate him for such a distinction. You can send him (and all his superiors!) a brief email message from the UAW 2322 website in order to help support workers and students at UMass Amherst. Voting for the Scrooge of the Year Award began on December 15 and will conclude on December 21 with the announcement of the winner. More information about the nominees and how to vote can be found at Scrooge of the Year Award. Please take a moment to vote, and make sure to send Eddie and his bosses a note of congratulations! UMass Director of Housing and Residential Life Nominated for National Scrooge of the Year Award Eddie Hull, UMass-Amherst Director of Housing & Residential Life, has been nominated Scrooge of the Year Award by the national workers' rights organization, Jobs with Justice. Mr. Hull earned the nomination by firing 73 undergraduate employees at UMass-Amherst prior to the December holidays and radically reconfiguring Housing & Residential Life to include more over-paid administrative positions. Mr. Hull chose to announce this two weeks before the end of the fall semester. When asked why no student workers had been involved in the decision to restructure these positions, Mr. Hull stated that there was more than one way to hear student concerns and "sometimes, students don't need to be at the table to do this." Mr. Hull has the notoriety of being the first Western Massachusetts nominee for this national award. Mr. Hull is in fine company with the other 2011 nominees: Rob Walton, the Chairman of the Board of Walmart, who slashed health care coverage for hundreds of thousands of Walmart employees and their families right before the holidays; the American Legislative Exchange Council (ALEC), an organization that has worked widely to suppress voter participation by students and communities of color in the U.S.; and Publix, a U.S.-based supermarket chain that has refused to work with the Coalition of Immokalee Workers (CIW) to improve the wages & working conditions for the farmworkers who pick their tomatoes. Previous Scrooge of the Year Award winners have included Republican Senator Mitch McConnell for his effort to aggressively block all legislation in the Senate, especially laws that would help working and middle class families and the U.S. Chamber of Commerce for their narrow, radical agenda advocating anti-worker, profit-focused solutions to the broken health care, labor, and environmental systems. Voting for the Scrooge of the Year Award began on December 15 and will conclude on December 21 with the announcement of the winner. More information about the nominees and how to vote can be found at Scrooge of the Year Award. Founded in 1987, Jobs with Justice 's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass. JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. ### Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 -------------- next part -------------- An HTML attachment was scrubbed... URL: From acswift at comcast.net Mon Dec 19 10:37:19 2011 From: acswift at comcast.net (Alice Swift) Date: Mon, 19 Dec 2011 10:37:19 -0500 Subject: [Health Care Action] Fwd: URGENT ACTION: Submit Letters to the Boston Herald! In-Reply-To: <868051413.988698.1324308403580.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> References: <868051413.988698.1324308403580.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> Message-ID: ---------- Forwarded message ---------- From: Mass-Care Announce Date: Mon, Dec 19, 2011 at 10:26 AM Subject: URGENT ACTION: Submit Letters to the Boston Herald! To: Mass-Care Announce Hello Single Payer Supporters - The Boston Herald this morning published an editorial opposing single-payer health reform, which we include at the bottom of this email. The editorial is filled with strange inaccuracies about what the Massachusetts single payer bill would do. Please submit brief (under 250 word) letters to the editor today at letterstoeditor at bostonherald.**com , or feel free to post comments on their web page: http://www.bostonherald.com/**news/opinion/editorials/view.** bg?articleid=1389505 The editorial is responding to the public hearing last week of the 'Medicare for All Massachusetts' bill. The Herald did not attend or cover the hearing: and it shows! The Herald editorial claims that "the proposal could require enormous new investments of federal dollars." This is certainly a bizarre claim: the single payer bill requires no new federal dollars at all. The Herald's editors say that the bill's 7.5% employer payroll tax and 2.5% employee payroll tax would be a danger to the economy. They neglect to mention that these taxes would REPLACE health premium costs, which are currently much higher than 7.5% for employers and higher then 2.5% for employees. The City of Boston, for example, pays more than 20% of its payroll towards just its share of health care premiums. Replacing these premium costs with a 7.5% payroll tax would cut its health care costs by more than half, and most employers would see the same savings. Finally, it might be worth telling the Herald that the belief in single payer reform reducing costs and maintaining access to high-quality care is not 'irrational': all we have to do is compare the United States with countries who have single payer systems to see that this is true. I hope everyone has a wonderful holidays, and please cc info at masscare.orgwith your letters to the editor! ------------------------------**------------------------------**-------- Single payer a no-go By Boston Herald Editorial Staff Monday, December 19, 2011 For some Massachusetts policy-makers, too much is never enough. That ought to explain the latest push for Bay State taxpayers to assume even more of the burden of providing health insurance coverage to state residents ? as in, the entire burden. A bill calling for a government-controlled, single-payer health insurance system had a hearing at the State House last week, and from what we can gather it amounted to the usual harangue against private insurers and an insistence that government can do a better job of administering health coverage. With passage of the 2006 health care reform law, Massachusetts has managed to ensure that 98 percent of state residents have health insurance. That achievement has come at a huge cost, yes, in part because of a major expansion of state-subsidized coverage. And as we speak state policy-makers are considering further reforms to help rein in the exploding cost of care. That isn?t enough for advocates of a single-payer system, who maintain an irrational faith that a Medicare-like system for residents under 65, with all of its bureaucratic requirements, will both save money and continue to ensure access to high-quality care. But in addition to the flaws generally associated with a single-payer system, there are particular flaws with the pending proposal in Massachusetts, as the Pioneer Institute pointed out in testimony presented to the Joint Committee on Health Care. To help make up for the loss of privately-subsidized care, the proposal could require enormous new investments of federal dollars. That sure feels like a long shot, doesn?t it? Meanwhile, more than half of covered employees in Massachusetts work for companies that are self-insured and as such are regulated under federal, not state, law. So unless 100 percent of those employers opt in to a single-payer system, the state would be essentially running a costly, parallel insurance program. There are a slew of other concerns, not least of which is the impact of a 7.5 percent payroll tax on employers, 2.5 percent on individuals and 12.5 percent tax on unearned income (to be paid by ?the rich,? of course) on the state?s economy. Yes, Massachusetts has work to do to bring down the cost of care, and by extension, the cost of coverage. But this bill isn?t a solution ? it?s a political nightmare. Article URL: http://www.bostonherald.com/**news/opinion/editorials/view.** bg?articleid=1389505 ______________________________**_________________ Mass-Care: The Massachusetts Campaign for Single Payer Health Care 33 Harrison Ave - 5th floor Boston, MA 02111 Ph: 617-723-7001 Fx: 617-723-7002 Em: info at masscare.org -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Mon Dec 19 14:42:23 2011 From: don at mccanne.org (Don McCanne) Date: Mon, 19 Dec 2011 11:42:23 -0800 Subject: [Health Care Action] qotd: Is expensive health care a social determinant of health? Message-ID: BMJ Quality & Safety March 29, 2011 Health and social services expenditures: associations with health outcomes By Elizabeth H Bradley, Benjamin R Elkins, Jeph Herrin, Brian Elbel Abstract Objective To examine variations in health service expenditures and social services expenditures across Organisation for Economic Co-operation and Development (OECD) countries and assess their association with five population-level health outcomes. Design A pooled, cross-sectional analysis using data from the 2009 release of the OECD Health Data 2009 Statistics and Indicators and OECD Social Expenditure Database. Setting OECD countries (n=30) from 1995 to 2005. Main outcomes Life expectancy at birth, infant mortality, low birth weight, maternal mortality and potential years of life lost. Results Health services expenditures adjusted for gross domestic product (GDP) per capita were significantly associated with better health outcomes in only two of five health indicators; social services expenditures adjusted for GDP were significantly associated with better health outcomes in three of five indicators. The ratio of social expenditures to health expenditures was significantly associated with better outcomes in infant mortality, life expectancy and increased potential life years lost, after adjusting for the level of health expenditures and GDP. Conclusion Attention to broader domains of social policy may be helpful in accomplishing improvements in health envisioned by advocates of healthcare reform. http://qualitysafety.bmj.com/content/20/10/826.abstract And... The New York Times December 8, 2011 To Fix Health, Help the Poor By Elizabeth H. Bradley and Lauren Taylor IT?S common knowledge that the United States spends more than any other country on health care but still ranks in the bottom half of industrialized countries in outcomes like life expectancy and infant mortality. Why are these other countries beating us if we spend so much more? The truth is that we may not be spending more - it all depends on what you count. In our comparative study of 30 industrialized countries, published earlier this year in the journal BMJ Quality and Safety, we broadened the scope of traditional health care industry analyses to include spending on social services, like rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life. We studied 10 years? worth of data and found that if you counted the combined investment in health care and social services, the United States no longer spent the most money - far from it. In 2005, for example, the United States devoted only 29 percent of gross domestic product to health and social services combined, while countries like Sweden, France, the Netherlands, Belgium and Denmark dedicated 33 percent to 38 percent of their G.D.P. to the combination. We came in 10th. What?s more, America is one of only three industrialized countries to spend the majority of its health and social services budget on health care itself. For every dollar we spend on health care, we spend an additional 90 cents on social services. In our peer countries, for every dollar spent on health care, an additional $2 is spent on social services. So not only are we spending less, we?re allocating our resources disproportionately on health care. Unfortunately, instead of learning from countries like Sweden and France, we prefer the frantic scramble to recover money from one part of the health care system only to reallocate it toward retreads of previously failed reforms. We pretend that the fresh schemes are innovative, but they are usually long on promises, short on details and often marked with an annoying acronym: H.M.O., F.S.A., A.C.O. and so forth. It?s time to think more broadly about where to find leverage for achieving a healthier society. One way would be to invest more heavily in social services. This may be difficult for many Americans to swallow as it suggests a potentially expanded role for government. (Elizabeth H. Bradley is professor of public health at Yale and faculty director of its Global Health Leadership Institute, where Lauren Taylor is a program manager.) http://www.nytimes.com/2011/12/09/opinion/to-fix-health-care-help-the-poor.html And... The New York Times December 18, 2011 Letters To the Editor: Re "To Fix Health, Help the Poor" (Op-Ed, Dec. 9): Although Elizabeth H. Bradley and Lauren Taylor never use the words "social determinants of health," they are illustrating the profound truth that it is the circumstances in which people live and work that determine the health status of any population, in any nation. Along with that come some counterintuitive truths. First, that health care, while crucial to individual survival, makes at best a modest contribution to population health. Second, that most social and economic policies are in effect health policies because of their impact on those social determinants. Even a perfect American health care system (let alone what we have now) cannot by itself fix our abysmal maldistribution of health. When my colleagues and I worked at the nation's first community health center in the Mississippi Delta in the 1960s, our doctors saved many lives and eased much suffering. We repaired collapsing plantation shacks. We built sanitary privies. In the face of devastating poverty, unemployment and malnutrition, we organized a cooperative farm where residents grew tons of vegetables, and we found pathways to jobs and education. Those interventions did far more to save lives, ease suffering and improve our target population?s health than our medical care did. H. JACK GEIGER Brooklyn, Dec. 9, 2011 (The writer is professor emeritus of community medicine at the City University of New York Medical School.) http://www.nytimes.com/2011/12/19/opinion/the-road-from-poverty-to-health.html?ref=opinion Comment: Opponents of health care reform frequently object to the use of statistics such as our lower life expectancy and greater infant mortality, arguing that these represent socioeconomic factors and therefore are not due to deficiencies in our health care system. There are two problems with their position. One is that this allows them to gloss over the severe deficiencies in our overly expensive but inadequate health care system. The other is that they offer no remedies that might improve the social determinants of health, implying that misery and poverty are a simply matter of personal choice. As this report shows, "The ratio of social expenditures to health expenditures was significantly associated with better outcomes in infant mortality, life expectancy and increased potential life years lost, after adjusting for the level of health expenditures and GDP." The United States has distorted this ratio by spending so much on health care (much misdirected) while spending so little on social services. We need to spend more money, but not on health care. We are already paying the health care delivery system enough, but we need to have a far more efficient financing system that improves the allocation of those payments. Where we need to spend more money is on public social services, in the broadest sense of the term. The comment by Jack Geiger shows that it is not so much a matter of money as it is a matter of personal and societal dedication, supported by strong public policy. We can make America a far better place for the least of us and for the rest of us as well. To accomplish that, we're going to have to do better in promulgating the virtues of egalitarianism. We certainly could use more help from the One Percenters. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Tue Dec 20 11:13:31 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 20 Dec 2011 11:13:31 -0500 Subject: [Health Care Action] Verizon action this week Message-ID: <007e01ccbf32$52e5e590$f8b1b0b0$@org> If this email was forwarded or copied to you, be sure to keep up-to-date on workers' rights campaigns by subscribing to the Workers' Rights List. To subscribe, send a blank email to workersrights-subscribe at lists.prometheuslabor.com or go to http://lists.wmjwj.org/mailman/listinfo/workersrights. Dear Workers' Rights Supporters, Please let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! Schedule below. Note that we have added before-work stand-outs with Verizon workers on Thursdays. And have you signed the online Message of Solidarity ? We are also organizing community delegations to deliver letters in support of Verizon workers to store managers. On Dec. 17, a delegation from American Income Life Insurance Co. delivered a letter from AIL General Agent Philip Prata, quoting AIL CEO Roger Smith. Please let us know (wmjwj at wmjwj.org) if you can form or want to join such a delegation. If you are interested in participating in Verizon Holiday Caroling, please contact Patrick Burke, Western Mass. Student Labor Action Project Organizer, patrick at wmjwj.org. And our Verizon Street Heat committee meets Friday December 23, 9:30-10:30am, at IBEW Local 2324, 281 Cottage St, Springfield . This week's schedule: Wednesday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Thursday, 6:45-7:30am, Verizon garages at 95 Brookdale Dr, Springfield and 111 North Hatfield Road, Hatfield : Just stop by! Saturday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store, 555 Hubbard Ave, Pittsfield : Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store, 1420 Boston Rd, Springfield : Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store, 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Tue Dec 20 12:09:52 2011 From: don at mccanne.org (Don McCanne) Date: Tue, 20 Dec 2011 09:09:52 -0800 Subject: [Health Care Action] qotd: Theresa BrownGold: Painter of the under-insured Message-ID: In These Times December 7, 2011 Health Reform Devolves Into ?Unaffordable Under-Insurance? By Roger Bybee This article on unaffordable under-insurance was covered in a previous Quote of the Day (Dec. 8), but a new response posted on the In These Times website follows: Response by "Art As Social Inquiry" 19 Dec 2011 Thank you for this piece. I draw similar conclusions from my informal research. I am looking at how we access healthcare in the US by painting portraits and telling the stories of those who are using the system. More recently, the portraits are of people who actually HAVE insurance but because they are under-insured, they are suffering great financial and physical hardships. The great secret in the US is that millions of us are under-insured and don?t know it unless we suffer a medical catastrophe. This secret will be exposed if the essential benefits package of the ACA is too skimpy. People will get sick, think they are insured and find that even with insurance medical bills will eat up their savings. And they will be very angry. I don?t know?this next difficult phase may be the crucial first step toward a single-payer system? The ACA will help many millions, but is it enough? The question will always be "Can a for-profit system for delivering medical care really see to the needs of a country?s greatest asset - it?s people?" http://inthesetimes.com/working/entry/12348/health_reform_runs_into_unaffordable_under-insurance "Art As Social Inquiry" is actually portrait painter Theresa BrownGold. >From her website: Art As Social Inquiry Health Care in the United States This is a series of what will be 100-plus paintings depicting a cross-section of Americans. The titles of the paintings designate the kind of health insurance coverage or lack of coverage the sitters have. The goal is to paint a picture of the American health care system in the faces of our country's citizens from the very best health coverage to the most horrific of circumstances resulting from a person's lack of coverage. Who are we when it comes to health care? Let's not be afraid to look at real people and be touched by their experiences - from the best to the worst - as we navigate this very big issue. There is no agenda but to ask, "What's your experience? What are your thoughts on the subject?" http://artassocialinquiry.org/projects/healthcare/ Comment: We have long heard tragic stories of the uninsured, but now the under-insured are joining them with their sad tales. Theresa BrownGold's series of portraits on Health Care in the United States tells us stories of a cross section of Americans, while relating them to their insurance status. You might take a moment to look at two extremes in her series. First click on the third portrait in the eighth row - painted in a style that indicates that the person is no longer with us. Those of us who have been in the trenches certainly recognize the description as being all too typical of when the U.S. health care system fails us miserably. The other portrait to click on is the politician in the seventh row on the left, with blue eyes and wearing a blue sweater pulled over an open-collar white shirt. Again, many of us will recognize his description as being one of those power players who seem to be oblivious to the plight of those not well served by our health care system. Everyone has a story, whether good or bad. We can thank Theresa BrownGold for giving us so many pictures, each worth a thousand words and more, motivating us to continue to do our best to see that all stories become good ones. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Wed Dec 21 09:16:57 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 21 Dec 2011 09:16:57 -0500 Subject: [Health Care Action] Verizon action this week Message-ID: <00da01ccbfeb$39523390$abf69ab0$@org> Weather.com predicts rain at noon in Hadley today, so no leafleting. See you Saturday? Please let a Store Captain know. Thanks! From: WMass Jobs with Justice [mailto:wmjwj at wmjwj.org] Sent: Tuesday, December 20, 2011 11:14 AM To: 'WMJwJ Members List'; Workers' Rights List; 'WMass SLAP List'; 'Street Heat List' Cc: 'Health Care Action List'; Arise Action List; Interfaith Coalition List; Pride at Work List; Progressive Dems In Western Mass List; SAGE List; FOCNW List (focnw-list at lists.afscwm.org) Subject: Verizon action this week If this email was forwarded or copied to you, be sure to keep up-to-date on workers' rights campaigns by subscribing to the Workers' Rights List. To subscribe, send a blank email to workersrights-subscribe at lists.prometheuslabor.com or go to http://lists.wmjwj.org/mailman/listinfo/workersrights. Dear Workers' Rights Supporters, Please let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! Schedule below. Note that we have added before-work stand-outs with Verizon workers on Thursdays. And have you signed the online Message of Solidarity ? We are also organizing community delegations to deliver letters in support of Verizon workers to store managers. On Dec. 17, a delegation from American Income Life Insurance Co. delivered a letter from AIL General Agent Philip Prata, quoting AIL CEO Roger Smith. Please let us know (wmjwj at wmjwj.org) if you can form or want to join such a delegation. If you are interested in participating in Verizon Holiday Caroling, please contact Patrick Burke, Western Mass. Student Labor Action Project Organizer, patrick at wmjwj.org. And our Verizon Street Heat committee meets Friday December 23, 9:30-10:30am, at IBEW Local 2324, 281 Cottage St, Springfield . This week's schedule: Wednesday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Thursday, 6:45-7:30am, Verizon garages at 95 Brookdale Dr, Springfield and 111 North Hatfield Road, Hatfield : Just stop by! Saturday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store, 555 Hubbard Ave, Pittsfield : Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store, 1420 Boston Rd, Springfield : Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store, 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 7218 bytes Desc: not available URL: From wmjwj at wmjwj.org Wed Dec 21 09:23:21 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 21 Dec 2011 09:23:21 -0500 Subject: [Health Care Action] FW: Healthy Environment/Healthy Springfield CARES Message-ID: <00ec01ccbfec$18d6f730$4a84e590$@org> From: Live Well Springfield laura.hurley at bhs.org Healthy Environment/Health Springfield CARES Community Action for a Renewed Environment in Springfield We need you input! Meeting Dates DATES:Tuesday, January 10th and Tuesday January 24th (*Snow dates - January 17 & 31) TIME:6-8 PM LOCATION: Springfield Technical Community College One Armory Square, Springfield MA Scibelli Hall, 7th Floor RSVP: Laura Hurley at Laura.Hurley at baystatehealth.org by January 6th, 2012 * Meetings will be rescheduled if schools are closed and/off-street parking ban is in effect, due to weather Our First Stakeholder Meeting- January 10th- will examine the federal designation of Springfield as an Environmental Justice (EJ) Community. Hosted by Arise for Social Justice, this meeting will consider why Springfield is an EJ community; examine Springfield's environmental issues; their consequence for human health and alternatives to the current state of affairs. Our Second Stakeholder Meeting- January 24th - will present issues for community deliberation and prioritization. Hosted by Live Well Springfield: Eat Smart.Stay Fit. initiative, decisions made and votes taken at this meeting will drive the Action Plan for HEHS CARE and its partner organizations and set the path for addressing issues going forward. Partners for a Healthier Community, Inc. 280 Chestnut Street Springfield, Massachusetts 01101-4895 413.794.1454 www.partnersforahealthiercommunity.org Forward email Partners for a Healthier Community, Inc. | 280 Chestnut Street | P.O. Box 4895 | Springfield | MA | 01101-4895 -------------- next part -------------- An HTML attachment was scrubbed... URL: From acswift at comcast.net Wed Dec 21 11:38:26 2011 From: acswift at comcast.net (Alice Swift) Date: Wed, 21 Dec 2011 11:38:26 -0500 Subject: [Health Care Action] Fwd: Please Give to Mass-Care/UHCEF This Year In-Reply-To: <955510899.1065054.1324485378652.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> References: <955510899.1065054.1324485378652.JavaMail.root@sz0009a.westchester.pa.mail.comcast.net> Message-ID: ---------- Forwarded message ---------- From: Mass-Care Date: Wed, Dec 21, 2011 at 11:36 AM Subject: Please Give to Mass-Care/UHCEF This Year To: acswift at comcast.net ** Please consider giving to Mass-Care and UHCEF this year! Is this email not displaying correctly? View it in your browser. *Hello Single Payer Supporters*, This year please consider making a donation to Mass-Care, or our tax-deductible arm, the Universal Health Care Education Fund (UHCEF). Your donation will support making health care a right for all residents of the state, eliminating disparities in health insurance coverage, and controlling the runaway costs that are crippling household, municipal, and state budgets. Mass-Care does not take donations from the health care industry, and virtually all of our funding comes from individual Massachusetts residents whose lives or work have been affected by our dysfunctional health care system, as well as community and labor organizations. Click here to go to Mass-Care's web-site, and click 'Donate' in the upper right hand corner to make an online donation to UHCEF. Or you can send a check to Mass-Care or UHCEF at 33 Harrison Ave - 5th floor, Boston, MA 02111. Thank you all for your continued support, and have a wonderful holidays! *Benjamin Day* Executive Director, Mass-Care ------------------------------ Website *Massachusetts Health Reform in Practice :* Mass-Care and Massachusetts PNHP have released a comprehensive new report on the first five years of the Massachusetts health reform, and the future of national health reform. Click hereto download a copy or to read the Executive Summary. Mass-Care In The News *Advocates Push for Single Payer Health Care :* Single payer supporters testified on behalf of the state's single payer legislation at the bill's public hearing this past Thursday, December 15. Click hereto read the State House News Service's coverage of submitted testimony. Events *Sat, December 31:* Last day to make a tax-deductible donation to UHCEFfor calendar year 2011! *Mon, January 16:* Martin Luther King day. *Late March/early April:* Mass-Care & UHCEF's annual Single Payer Gala at the Ryle's Jazz Club. Date TBA! forward to a friend | friend on Facebook | follow on Twitter *Copyright ? 2011, Mass-Care, All rights reserved.* You are receiving this email because you have expressed an interest in receiving updates on the campaign for single payer health reform in Massachusetts. *Our mailing address is:* Mass-Care 33 Harrison Ave - 5th Floor Boston, MA 02111 Add us to your address book [image: Email Marketing Powered by MailChimp] unsubscribe from this list| update subscription preferences -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Wed Dec 21 14:19:34 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 21 Dec 2011 11:19:34 -0800 Subject: [Health Care Action] qotd: PolitiFact's 2011 Lie of the Year Message-ID: Politico December 20, 2011 Dems' 'Mediscare' a dubious winner By Angie Drobnic Holan and Bill Adair Republicans muscled a budget through the House of Representatives in April that they said would take an important step toward reducing the federal deficit. Introduced by Rep. Paul Ryan of Wisconsin, the plan kept Medicare intact for people 55 or older, but dramatically changed the program for everyone else by privatizing it and providing government subsidies. Democrats pounced. ? Just four days after the party-line vote, the Democratic Congressional Campaign Committee released a Web ad, saying seniors will have to pay $12,500 more for health care "because Republicans voted to end Medicare." ? Rep. Steve Israel of New York, chairman of the DCCC, appeared on cable news shows and declared that Republicans voted to "terminate Medicare." ? A Web video from the Agenda Project, a liberal group, said the Ryan plan would leave the country "without Medicare" and showed a Ryan look-alike pushing an old woman in a wheelchair off a cliff. ? And just last month, House Minority Leader Nancy Pelosi sent a fundraising appeal that read, "House Republicans' vote to end Medicare is a shameful act of betrayal." PolitiFact debunked the Medicare charge in nine separate fact-checks rated False or Pants on Fire, most often in attacks leveled against Republican House members. Now, PolitiFact has chosen the Democrats' claim as the 2011 Lie of the Year. At times, Democrats and liberal groups were careful to characterize the Republican plan more accurately. Another claim in the ad from the Agenda Project said the plan would "privatize" Medicare, which received a Mostly True rating from PolitiFact. President Barack Obama also was more precise with his words, saying the Medicare proposal "would voucherize the program, and you potentially have senior citizens paying $6,000 more." With a few small tweaks to their attack lines, Democrats could have been factually correct, said Norman Ornstein, a resident scholar at the American Enterprise Institute, a conservative think tank. "I actually think there is no need to cut out the qualifiers and exaggerate," he said. http://www.politico.com/news/stories/1211/70705.html And... Congressional Budget Office April 5, 2011 Long-Term Analysis of a Budget Proposal by Chairman Ryan Among other changes, the proposal would convert the current Medicare program to a system under which beneficiaries received premium support payments - payments that would be used to help pay the premiums for a private health insurance policy and would grow over time with overall consumer prices. The change would apply to people turning 65 beginning in 2022; beneficiaries who turn 65 before then would remain in the traditional Medicare program, with the option of converting to the new system. Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system. For a typical 65-year-old with average health spending enrolled in a plan with benefits similar to those currently provided by Medicare, CBO estimated the beneficiary?s spending on premiums and out-of-pocket expenditures as a share of a benchmark: what total health care spending would be if a private insurer covered the beneficiary. By 2030, the beneficiary's spending would be 68 percent of that benchmark under the proposal. http://www.cbo.gov/ftpdocs/121xx/doc12128/04-05-ryan_letter.pdf Comment: PolitiFact has chosen the Democrats' claim that "Republicans voted to end Medicare" as 2011 Lie of the Year. The facts that led the Democrats to attack the Ryan Medicare plan that the House Republicans passed are not in dispute. PolitiFact's lie accusation stemmed simply from the imprecision of the Democrats' political rhetoric, and not from a dispute about the actual facts that Democrats were attempting to publicize through simple sound bites. Under the Republican-approved proposal, the traditional Medicare program would be phased out totally and replaced with private insurance plans. Much of the financing responsibility would gradually shift to the Medicare beneficiaries. According to the Congressional Budget Office, by 2030 two-thirds of the costs would be paid by the beneficiary, and only one-third paid by the government. In almost no way does this resemble the Medicare program that we know. Nevertheless this almost entirely new program would still carry the Medicare label. Thus PolitiFact can argue that, technically, Republicans did not vote to end Medicare. But substantively, the infrastructure of the traditional Medicare program would be ended with not much more than the label surviving. Norman Ornstein makes the important point that the Democrats would have been factually correct had they made a few small tweaks to their attack lines (e.g., "end Medicare as we know it," which was used effectively). That is a lesson that we all should learn. Unfortunately, PolitiFact did knock its credibility down a notch on this one. Poorly crafted sounds bites are worthy of a demerit, but the shocking truth behind the crucial message that the Democrats were trying to convey certainly did not warrant the "Pants on Fire" 2011 Lie of the Year award. That award should have been bestowed instead upon the Republicans who claimed that they voted to save Medicare. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Wed Dec 21 14:25:41 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 21 Dec 2011 11:25:41 -0800 Subject: [Health Care Action] qotd: PolitiFact's 2011 Lie of the Year Message-ID: Politico December 20, 2011 Dems' 'Mediscare' a dubious winner By Angie Drobnic Holan and Bill Adair Republicans muscled a budget through the House of Representatives in April that they said would take an important step toward reducing the federal deficit. Introduced by Rep. Paul Ryan of Wisconsin, the plan kept Medicare intact for people 55 or older, but dramatically changed the program for everyone else by privatizing it and providing government subsidies. Democrats pounced. ? Just four days after the party-line vote, the Democratic Congressional Campaign Committee released a Web ad, saying seniors will have to pay $12,500 more for health care "because Republicans voted to end Medicare." ? Rep. Steve Israel of New York, chairman of the DCCC, appeared on cable news shows and declared that Republicans voted to "terminate Medicare." ? A Web video from the Agenda Project, a liberal group, said the Ryan plan would leave the country "without Medicare" and showed a Ryan look-alike pushing an old woman in a wheelchair off a cliff. ? And just last month, House Minority Leader Nancy Pelosi sent a fundraising appeal that read, "House Republicans' vote to end Medicare is a shameful act of betrayal." PolitiFact debunked the Medicare charge in nine separate fact-checks rated False or Pants on Fire, most often in attacks leveled against Republican House members. Now, PolitiFact has chosen the Democrats' claim as the 2011 Lie of the Year. At times, Democrats and liberal groups were careful to characterize the Republican plan more accurately. Another claim in the ad from the Agenda Project said the plan would "privatize" Medicare, which received a Mostly True rating from PolitiFact. President Barack Obama also was more precise with his words, saying the Medicare proposal "would voucherize the program, and you potentially have senior citizens paying $6,000 more." With a few small tweaks to their attack lines, Democrats could have been factually correct, said Norman Ornstein, a resident scholar at the American Enterprise Institute, a conservative think tank. "I actually think there is no need to cut out the qualifiers and exaggerate," he said. http://www.politico.com/news/stories/1211/70705.html And... Congressional Budget Office April 5, 2011 Long-Term Analysis of a Budget Proposal by Chairman Ryan Among other changes, the proposal would convert the current Medicare program to a system under which beneficiaries received premium support payments - payments that would be used to help pay the premiums for a private health insurance policy and would grow over time with overall consumer prices. The change would apply to people turning 65 beginning in 2022; beneficiaries who turn 65 before then would remain in the traditional Medicare program, with the option of converting to the new system. Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system. For a typical 65-year-old with average health spending enrolled in a plan with benefits similar to those currently provided by Medicare, CBO estimated the beneficiary?s spending on premiums and out-of-pocket expenditures as a share of a benchmark: what total health care spending would be if a private insurer covered the beneficiary. By 2030, the beneficiary's spending would be 68 percent of that benchmark under the proposal. http://www.cbo.gov/ftpdocs/121xx/doc12128/04-05-ryan_letter.pdf Comment: PolitiFact has chosen the Democrats' claim that "Republicans voted to end Medicare" as 2011 Lie of the Year. The facts that led the Democrats to attack the Ryan Medicare plan that the House Republicans passed are not in dispute. PolitiFact's lie accusation stemmed simply from the imprecision of the Democrats' political rhetoric, and not from a dispute about the actual facts that Democrats were attempting to publicize through simple sound bites. Under the Republican-approved proposal, the traditional Medicare program would be phased out totally and replaced with private insurance plans. Much of the financing responsibility would gradually shift to the Medicare beneficiaries. According to the Congressional Budget Office, by 2030 two-thirds of the costs would be paid by the beneficiary, and only one-third paid by the government. In almost no way does this resemble the Medicare program that we know. Nevertheless this almost entirely new program would still carry the Medicare label. Thus PolitiFact can argue that, technically, Republicans did not vote to end Medicare. But substantively, the infrastructure of the traditional Medicare program would be ended with not much more than the label surviving. Norman Ornstein makes the important point that the Democrats would have been factually correct had they made a few small tweaks to their attack lines (e.g., "end Medicare as we know it," which was used effectively). That is a lesson that we all should learn. Unfortunately, PolitiFact did knock its credibility down a notch on this one. Poorly crafted sounds bites are worthy of a demerit, but the shocking truth behind the crucial message that the Democrats were trying to convey certainly did not warrant the "Pants on Fire" 2011 Lie of the Year award. That award should have been bestowed instead upon the Republicans who claimed that they voted to save Medicare. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Wed Dec 21 14:29:30 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 21 Dec 2011 11:29:30 -0800 Subject: [Health Care Action] qotd: Please excuse the duplicate messages. Message-ID: Sorry. Don -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From calendar at wmjwj.org Wed Dec 21 16:16:29 2011 From: calendar at wmjwj.org (=?us-ascii?Q?Workers'_Rights_Calendar?=) Date: Wed, 21 Dec 2011 16:16:29 -0500 Subject: [Health Care Action] MSAC Dec. 29 celebration Message-ID: <010e01ccc025$ce8271c0$6b875540$@org> From: Linda Stone lstone at masssenioraction.org Mass. Senior Action Members & Friends! Celebrate the Season and our 2011 accomplishments ! Thursday, Dec. 29, 1:30 p.m. Springfield Hobby Club 309 Chestnut St. (behind the YMCA) Special guests: Verne McArthur, Musician Extraordinaire with songs of the season and music for activists AND Jon Weissman, WMass Jobs with Justice Coordinator with updates on local actions Great refreshments & raffle prizes Call 543-2334 if you need a ride or directions. Linda Stone Western MA Organizer Massachusetts Senior Action Council 413-543-2334 www.masssenioraction.org -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Wed Dec 21 20:20:58 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 21 Dec 2011 20:20:58 -0500 Subject: [Health Care Action] And the winner is... Message-ID: <01c601ccc047$f7dc9060$e795b120$@org> From: Jobs with Justice National jwjnational at jwj.org Jobs with Justice This year?s Scrooge of the Year is Rob Walton! The vote was close and went up until the last minute, but across the nation people made their voices heard - and Rob Walton is the biggest Scrooge of them all! A quick reminder of why Rob Walton was given this nomination: Deemed a ?billionaire bully? by Brave New Films, Rob Walton is the Chair of Walmart?s board of directors. His estimated net worth is around $21 billion. As a family, the Waltons control 49% of Walmart stock, and are predicted to gain a controlling share in the next 12 months. The Waltons are the richest family in the United States, with a combined net worth is $93 billion. The Walton Family has as much wealth as the bottom 30% of American families combined ? more than 35 million families. Waltons make up 4 of the 11 wealthiest people in the United States according to Forbes Magazine, and they could give more than $4,700 to every resident of New York and still have $1 billion left over. With the economy as it is, that would make a huge difference! The family?s dividends from their Walmart stock alone are more than $2 billion/year. Just using their dividends, they could ensure that a million Walmart employees make at least $12/hour. Instead, they are growing richer by the year. Even with all of this money, Walmart only pays an average of $8.81/hour to store associates. And the company has yet to meet with and address the concerns of those who work for them such as scheduling (especially during the holiday season). Just last month Walmart, under Rob?s leadership, slashed health care coverage for hundreds of thousands of Walmart employees and their families?right before the holidays! What a scrooge! Over the course of the next year, Rob Walton will be hearing from all of us in the Jobs with Justice network about how to make amends. Thanks for voting for Scrooge of the Year and happy holidays! CONNECT twitter facebook flickr youtube -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Thu Dec 22 11:50:33 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Thu, 22 Dec 2011 11:50:33 -0500 Subject: [Health Care Action] REMINDER: Verizon Street Heat tomorrow Message-ID: <008f01ccc0c9$d440ae70$7cc20b50$@org> Verizon Street Heat committee meets Friday December 23, 9:30-10:30am, at IBEW Local 2324, 281 Cottage St, Springfield . & Leafleting Saturday: Saturday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store, 555 Hubbard Ave, Pittsfield : Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store, 1420 Boston Rd, Springfield : Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store, 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Thu Dec 22 15:36:54 2011 From: don at mccanne.org (Don McCanne) Date: Thu, 22 Dec 2011 12:36:54 -0800 Subject: [Health Care Action] qotd: Drug sales reps now pushing hospitals Message-ID: Kaiser Health News December 13, 2011 Hospitals Adopt Drug Industry Sales Strategy By Phil Galewitz The University of Chicago Medical Center is one of a growing number of hospitals nationwide hiring former drug and device sales representatives to visit doctors' offices to persuade them to use their services over competing facilities. In visits that can last five to 20 minutes, the reps may try to win doctors' loyalty by helping them get better times on operating room schedules or easier patient referrals to hospital-based specialists. The sales reps can also carry messages back to the hospital, like a doctor?s request for a new medical device to be available in surgery. While hospitals have always tried to woo doctors to refer patients to them, the institutions are growing more direct in their efforts. The hospitals mine data to see which doctors have the most profitable, well-insured patients, and then they assign those doctors to a sales rep. HCA Inc., the nation's largest for-profit hospital chain, has at least 150 employees who make physician visits - or about one per hospital, said spokesman Ed Fishbough. Convinced the sales-call strategy is fueling higher admissions, Tenet Healthcare Corp., the nation's third largest for-profit hospital chain, has doubled its sales force in the past two years. The company now has 152 "physician liaisons" at its 49 hospitals, most of which are in California, Texas and Florida. About two-thirds of Tenet's liaisons are former drug and device sales reps, and they can make tens of thousands of dollars in bonuses if doctors increase their referrals to the hospitals. "These people are really good and really assertive and very sophisticated," said Stephen Newman, Tenet's chief operating officer. http://www.kaiserhealthnews.org/stories/2011/december/14/hospitals-adopt-drug-industry-sales-strategy.aspx?referrer=search Comment: The for-profit hospital chains - HCA and Tenet - both infamous for prior ethical lapses, have instituted tarnished sales programs that are now being adopted by others, including the not-for-profit University of Chicago Medical Center. They are using "assertive" former pharmaceutical and medical device sales reps to siphon off the most profitable and best insured patients, by convincing physicians to change their hospital referral patterns. This is not about making the best use of a region's health care resources. This is about hospitals cherry picking the most lucrative physicians and their patients, while making other competing hospitals, which are often safety-net institutions, the victims of adverse selection. We are already witnessing the closure of some of these institutions because of the inability to meet their costs. This strategy is working. Sales calls are fueling higher admissions. What does this say about the physicians who are complicit in this activity? Can we really expect them to support altruistic policies in support of more equitable health care in the community at large, when they are being offered lucrative opportunities to practice in a more physician-friendly environment? Under a well designed single payer system, capital improvements would be based on regional planning and budgeted separately, providing the facilities and equipment appropriate for the needs of the community. Hospitals would be placed on global budgets, providing enough financial resources to fulfill their mission of health care. Passive investors would be removed by eliminating for-profit ownership of hospitals. This would change the hospitals' primary mission of making the greatest profit that the market will bear, to one of simply serving the health care needs of the community. A comment from a recent Quote of the Day on the social consequences of segregation of the affluent (Nov. 25) seems to be very appropriate here. I wrote, "As the more affluent members of our society continue to concentrate themselves in their upscale neighborhoods, they take our resources with them, including some of the best of our health care services. Not only do they leave behind fewer resources for low- and moderate-income families, they also leave behind the political will to do something about it." -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Fri Dec 23 08:29:17 2011 From: don at mccanne.org (Don McCanne) Date: Fri, 23 Dec 2011 05:29:17 -0800 Subject: [Health Care Action] qotd: Patient complicity through insurer kickbacks Message-ID: The Boston Globe December 20, 2011 Insurer to reward patients for finding cheaper care By Robert Weisman Told they need a routine medical test, such as a colonoscopy or a mammogram, most patients go wherever the doctor recommends. But under a program being rolled out next month by Harvard Pilgrim Health Care, they could be paid to seek care somewhere else. The health insurer plans to introduce a rewards program through which its Massachusetts members who have been given referrals will be asked to call a "clinical concierge" service that can direct them to hospitals or medical facilities that charge less for the same tests. In return, they will receive a check from Harvard Pilgrim, ranging from $10 to $75. The program, called SaveOn, is intended to help patients make smarter health care choices, according to Harvard Pilgrim, and to rein in the runaway prices of imaging tests and other procedures that have contributed to steadily rising premiums. On the customer side, health insurers have been selling employer groups limited-network plans, which restrict which providers patients can see, and tiered-network plans, which require them to pay more to visit higher-priced physicians or medical centers. But SaveOn, which has already been introduced as a pilot on a limited scale in New Hampshire, will be the first in Massachusetts structured as a rewards program, similar to those offered by online retailers for shopping at their stores. The role of employers in educating their workers will be key to the adoption of SaveOn because employers typically pick up the largest share of health insurance costs. But if the program succeeds in moderating reimbursements for everything from MRIs and CT scans to ultrasounds and sleep studies, employers will probably want their own financial reward. Harvard Pilgrim's (chief executive Eric H.) Schultz said he hopes SaveOn will help the insurer sell products and gain market share while driving down health care costs, one procedure at a time. "This becomes a conversation at the watering hole - 'I just got a check for $75,'" he said. http://bostonglobe.com/business/2011/12/20/insurer-reward-patients-for-finding-cheaper-care/a6ajBBBu2hpHZ1IyiRPmLP/story.html Comment: Harvard Pilgrim Health Care will be offering cash rewards to patients who ignore their physicians' recommendations and instead consult with the insurer's "clinical concierge service" on where to obtain their imaging tests and other procedures. When there has been a big push to further integrate health care services, is it wise to establish a policy that disrupts usual referral patterns that have at least some minimal semblance of integration? Harvard Pilgrim's chief executive visualizes the conversation at the watering hole wherein one worker tells his fellow worker that he just got a $75 kickback from the insurance company. What is the fellow worker to think? "Since I don't need care, I don't get a kickback. Yet I have to pay a higher insurance premium so this jerk can get a cash reward using my premium dollars?" This is yet another scheme to make patients informed shoppers in the health care market by making them sensitive to the costs - or cash rewards! - for the health care they choose. It doesn't seem to matter that this may be an illegal kickback, especially if Medicare or Medicaid funds are involved. The cash rewards are inevitably passed onto whomever is paying the bills. Instead of making patients complicit participants in this devious scheme, wouldn't it be better to establish policies that gets the prices right in the first place, so that there is no extra $75 available to use as a cash reward? We do know how to do that. Government administered pricing, such as with the Medicare program, does a much better job than the private insurers at setting prices at appropriate levels. This is not merely an opinion, but has been confirmed through extensive policy research. In our current fragmented system of financing health care, some may disagree that Medicare pricing is appropriate, but if Medicare were the only payer, pricing decisions would be even more precise and appropriate. The public administrators have to pay enough to maintain the financial viability of the health care delivery system, yet not so much that those paying into the system are not receiving a fair value. Addendum: PNHP co-founder, David Himmelstein, M.D., provided this response: I'm a Harvard Pilgrim enrollee (as a Harvard retiree). This week my long-time physician at Beth Israel hospital in Boston referred me for a test and dolefully informed me that I would be charged extra if I chose to have it done at Beth Israel rather than at a no-name place with which he has no association, and no established lines of communication. I declined to go brand X for the test. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Sat Dec 24 16:21:00 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sat, 24 Dec 2011 16:21:00 -0500 Subject: [Health Care Action] FW: Funny holiday video (not) from Verizon or Verizon Wireless Message-ID: <00c501ccc281$efcdbf70$cf693e50$@org> Below is an e-newsletter from the campaign for a fair Verizon contract. Be sure to watch the video mocking the one Verizon sent to union members. Happy holidays! From: Unity at Verizon unityatverizon at cwa-union.org Unity at Verizon | Communications Workers of America Dear Jon, The holiday season has sparked lots of creativity in our fight for a fair contract at Verizon, from caroling for members of the Board of Directors to the funny video you can watch here . The company is trying to wear us down, but we'll keep mobilizing and fighting into the new year! Everyone needs to do their part and volunteer 4 hours a week to mobilize to win the contract we deserve. Sign up for mobilization activities after you watch the video or contact your local. In the meantime, enjoy the video and enjoy your holidays. _____ Here's the most recent bargaining report: Verizon Bargaining: Report #54 Dec 14, 2011 For the past several weeks, the CWA District 1/IBEW Local 2213 and IBEW New England Regional Committees and the CWA District 2-13/ IBEW Mid Atlantic Regional Committees have been meeting at the RyeTown Hilton in Rye, NY. The meetings have been ?off the record? discussions in Sub Committees focusing on several major areas of our collective bargaining agreements. The Company continues to undermine the bargaining process by not providing information on its partnership with Comcast, Time Warner and Bright House Cable Companies. Your committees demanded that full disclosure of of the Company?s planned partnership be shared with CWA/IBEW to determine the effect on our members. The Company has agreed to provide this information at a meeting of Union and Company leadership tentatively scheduled for next week. The sub-committee process of the last several weeks has not had the desired outcome. So no further sub-committee meetings are scheduled. After your CWA/IBEW Regional teams receive and evaluate the cable partnership information, formal bargaining sessions will be scheduled. In all likelihood no sessions will be scheduled until after January 1, 2012. It is more important than ever that our members continue to mobilize and that EVERY member commit to spending 4 hours per week participating in mobilization activities. Please contact your local for instructions. Your bargaining teams thank you for all your support and wish all CWA/IBEW brothers and sisters a joyous holiday season and a happy and healthy New Year. Remember to wear RED!!! Now more than ever we need to mobilize! Mobilize! ? Mobilize! ? Mobilize! Communications Workers of America, AFL-CIO, CLC. All Rights Reserved. 501 Third Street, NW Washington, DC 20001 Find CWA on Facebook -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Tue Dec 27 06:42:14 2011 From: don at mccanne.org (Don McCanne) Date: Tue, 27 Dec 2011 03:42:14 -0800 Subject: [Health Care Action] qotd: Insurer Highmark becoming a health care provider Message-ID: amednews.com December 26, 2011 Highmark looks to expand hospital and physician ownership By Emily Berry Faced with a future where its home region's largest health system could be outside of its network, Pittsburgh-based Highmark plans to buy and affiliate with more hospitals and physician practices. Highmark's June announcement that it would purchase West Penn Allegheny Health System established its first large-scale foray in the clinical side of the health care business. It also contributed to the deterioration of contract negotiations with the University of Pittsburgh Medical Center, which sees West Penn as a competitor. Highmark's new direction is similar to what other insurers are trying to do. Insurers, hospitals and physicians are merging, affiliating and contracting in new ways as they seek alternatives to fee-for-service payment arrangements and look ahead to a post-reform health system, said Kevin Ryan, a Chicago-based attorney. During a conference call with reporters Dec. 8, Highmark Executive Vice President David O'Brien said the West Penn deal "is only a small part of our strategy going forward." "We are in discussions with physicians and hospitals," O'Brien said. "We're looking to expand our footprint in the provider world. We think the future for us strategically is being able to work closely with providers, to be in the provider space." UPMC sees Highmark's strategy as aimed primarily at undercutting UPMC's standing in the market so that Highmark can drive members of its health plan to cheaper care settings, UPMC spokesman Paul Wood said. "What Highmark is doing is essentially transforming from a neutral insurer where every subscriber could go to any hospital, to a competing integrated delivery and financing system. That puts them in direct competition with UPMC," he said. UPMC and Highmark are fighting in federal court over issues arising during contentious contract negotiations. UPMC's contract with Highmark expires on June 30, 2012. http://www.ama-assn.org/amednews/2011/12/26/bisb1226.htm Comment: Highmark, a Blue Cross Blue Shield licensee in Pennsylvania and West Virginia, is "transforming from a neutral insurer where every subscriber could go to any hospital, to a competing integrated delivery and financing system," according to spokesman Paul Wood of the University of Pittsburgh Medical Center (UPMC). Or as Highmark's David O'Brien says, they are moving into "the provider space." This is yet one more example of the insurers trying to take over the health care delivery system. Besides providing a management that places it own business interests before all else, it also locks in the exorbitantly high administrative costs characteristic of these organizations. Even worse, patients already had lost provider choice when plans such as Blue Cross and Blue Shield switched from indemnity plans to preferred provider organizations with their restrictive provider networks, but now, by now becoming the actual providers, the plans will no doubt establish severe penalties (zero coverage?) for obtaining care outside of their own intrinsic health care delivery systems. How does that benefit patients? Many do recognize that the private insurance model is no longer sustainable, and that it is only a matter of time before the switch to a single payer system becomes inevitable. The question is, what will we do with the private insurers once they are the health care delivery system? Scary thought. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From wmjwj at wmjwj.org Tue Dec 27 09:08:25 2011 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 27 Dec 2011 09:08:25 -0500 Subject: [Health Care Action] Verizon action this week Message-ID: <027d01ccc4a1$04323600$0c96a200$@org> Please let the Store Captains listed below know you are coming to leaflet about Verizon and corporate greed this week! Schedule below. Note that we have added before-work stand-outs with Verizon workers on Thursdays. And our Verizon Street Heat committee meets Friday December 30, 9:30-10:30am, at IBEW Local 2324, 281 Cottage St, Springfield . This week's schedule: Wednesday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Ryan Quinn know you are coming: rep at geouaw.org, 413-545-0705. Graduate Employees Organization/UAW 2324 has adopted this shift. Thursday, 6:45-7:30am, Verizon garages at 95 Brookdale Dr, Springfield and 111 North Hatfield Road, Hatfield : Just stop by! Saturday, Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-827-0301. Saturday, 11am to 1pm, at the Pittsfield store, 555 Hubbard Ave, Pittsfield : Please let Brian Morrison know you are coming: brian.morrison at state.ma.us, 413-281-3223. Berkshire Central Labor Council has adopted this shift. Saturday, Noon to 2pm,, at the Springfield store, 1420 Boston Rd, Springfield : Please let Kathy Collins know you are coming: kathy7157 at hotmail.com, 413-734-0863. Saturday, Noon to 2pm, at the West Springfield store, 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. Join us! Please wear your organization's apparel and/or a red shirt/jacket, as the strikers did. If it looks like rain or snow, we will make the decision to call it off around 9am and let you know by email. If we know you are coming, we can let you know by phone, text, or the email sent to your cell phone as a text message (if you've sent your phone number and name of carrier to wmjwj at wmjwj.org). If this email was forwarded or copied to you, be sure to keep up-to-date on workers' rights campaigns by subscribing to the Workers' Rights List. To subscribe, send a blank email to workersrights-subscribe at lists.prometheuslabor.com or go to http://lists.wmjwj.org/mailman/listinfo/workersrights. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Jon Weissman, Coordinator Western Mass Jobs with Justice 640 Page Blvd #101 Springfield MA 01104 (413) 827-0301 Founded in 1987, Jobs with Justice's mission is to improve working people's standard of living, fight for job security, and protect workers' right to organize. We believe workers' rights are human rights and to be successful, we have to be part of a larger campaign for economic and social justice. To that end, "J with J" has created a national coalition and a network of local coalitions that connect labor, community, student, and faith-based organizations and activists on workplace and community social justice campaigns. Western Mass JwJ - founded June 5, 1993 - is now a coalition of almost 70 organizations. Let's keep in touch - please check out our mailing lists at http://wmjwj.org/our-lists. cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: not available Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Wed Dec 28 12:33:36 2011 From: don at mccanne.org (Don McCanne) Date: Wed, 28 Dec 2011 09:33:36 -0800 Subject: [Health Care Action] qotd: New York's Local 6 gets it right Message-ID: The American Prospect November 7, 2011 A Model of Health By Robert Kuttner The New York hotel workers' plan provides comprehensive coverage at its own health centers, including full dental and optical care, with no deductibles or co-pays and a core philosophy that emphasizes primary care, wellness, and prevention. In the office of Dr. Robert Greenspan, who has headed the plan for 12 years, hangs the official charter signed by New York Governor Thomas E. Dewey in 1949 authorizing Local 6 to operate the nation's first medical practice run by a union. The plan may well be the best in the nation at providing so much coverage while effectively constraining costs. All doctors are salaried, with general practitioners being paid slightly more than specialists, in order to reward primary care. >From a small clinic on Manhattan's West Side, the plan has grown into five comprehensive health centers, serving approximately 88,000 hotel workers, their family members, and union retirees. Even those who've been laid off keep their health coverage. The plan boasts New York's highest rate of patient satisfaction. The plan's sole out-of-pocket charge is for drugs. While ordinary prescriptions require a modest co-pay of $5 or $15 for non-generics, the charge is eliminated for patients on long-term treatments, such as for high blood pressure. "Bob [Greenspan] experimented with free drugs for patients who are chronically ill," says union president Peter Ward. "He found that this dramatically reduced visits to the ER; there were fewer catastrophic events. So now, we waive all co-pays for patients on long-term drug therapy." "The difference isn't just financial - it's philosophical," Greenspan says. "We want you to come in. We want unlimited access to primary care. It pays off over the long term. All of the co-pays and deductibles do the opposite of what is claimed. They don?t assure that scarce medical resources are used as efficiently as possible or deter excessive use. They are simply barriers to care. People say, 'Maybe it will clear up by itself, so I won't see the doctor,' or 'I'll stretch out the medicine supply by taking less than the prescribed dose.' All you are doing is inducing people not to be compliant with the medical program. Then you wonder why costs keep going up - it's because people get sicker, and their eventual treatment is more expensive. We do just the opposite." Last year, the hotel workers' health plan cost $411.24 a month for an individual and $1,027.56 for an average family. By comparison, Healthfirst, the cheapest HMO in New York City, cost roughly three times as much - $1,116 a month for an individual and $3,316 for a family - while it excluded many services offered by the union such as dental and optical care and piled on deductibles and co-pays. Factoring in benefits not provided by other plans, the typical commercial insurance package costs about four times as much as the hotel workers' plan. So why is the plan virtually unknown in the health-policy debate? For one thing, the union has emphasized publicizing the plan among New York hotel workers, and Greenspan has focused on improving care for members, not crusading for national reform. Except for single-payer advocates, reformers have pursued cost-effective care within the context of an insurance-dominated system - something of a fool's errand - whereas the hotel workers' plan begins by dispensing with third-party insurers. To review all the ways that the hotel workers' plan delivers better care more cost-effectively is to appreciate the vast inefficiency in the rest of America's health system - and to see that cost-containment gurus are mostly looking in the wrong places for efficiencies. For starters, by dispensing with insurance-company middlemen, the plan eliminates a whole layer of costs. A doctor treats the patient according to his or her best medical judgment. There is no army of staffers dealing with patient billing, claims, and insurance reimbursement; no arguing with insurance-company case reviewers. Second, doctors are all on salary. So there is no incentive to undertreat or overtreat. Further, the plan's core principle is unlimited access to primary care, with all of the prevention and early-detection benefits that approach brings. In most systems, specialists drive costs. "We don't waste specialists on routine cases," Greenspan says. "We do want specialists to see appropriate cases, which is both more cost effective and more professionally challenging to the physician." The union, which knows something about negotiating, engages in hard bargaining with all of its vendors, from drug manufacturers to hospitals, and is relentless about eliminating middlemen. Most conventional health plans use "pharmacy benefit managers" who negotiate with drug companies on the plan's behalf and, of course, take a cut for themselves. The union negotiates directly. It also dispenses with cadres of consultants, from human-resource departments to utilization reviewers and behavioral-health companies, all of which add costs under the guise of shaving costs. In New York, some medical specialists in high demand have market power to raise prices. "Have you heard the term, RAPER?" Greenspan asks. "It stands for Radiologists, Anesthesiologists, Pathologists, and ER doctors." Most New York hospitals now contract out these services to specialists' groups who charge whatever the market will bear. In recent bargaining with one of its hospitals over a proposed rate increase, the hotel workers were told that the increase partly reflected higher charges billed by anesthesiologists. Greenspan requested the hospital to push back. Not our problem, the hospital contended; we don?t control these costs. "We told them, OK, next week our members stop using your hospital," Greenspan says. The costs came down. At some point, the public must realize that the choice is drastic reform or drastic cuts. More than any other in America, the hotel workers' plan points the way to an efficient and humane system of health care. http://prospect.org/article/model-health Comment: New York's Local 6 has achieved many of the goals of single payer reform by working from the bottom up. They are providing very comprehensive health care services at only about one-third of the costs of other New York plans, and with the highest patient satisfaction ratings. The key is that they have been able to to create a health care delivery infrastructure dedicated to optimal patient care that is removed from our current dysfunctional system dominated by insurer middlemen. This was all about patients, not insurers. One important example of the difference is that they recognized that co-pays and deductibles were barriers to care. As Dr. Greenspan says, "They do the opposite of what is claimed." People should have unlimited access to primary care. To show how wrong the policy community is in their support of cost sharing, Dr. Greenspan's group has eliminated these barriers, yet their costs are far less than New York's least expensive HMO. You do not need deductibles and co-pays to control health care spending. Although this was a bottom up success, it is improbable that it could be used as an insurance model for the rest of the nation. Their success was dependent on the unique efforts of a local union. Also their members have no coverage outside of their system. Our health care delivery systems and our health care financing systems are too fragmented to permit the creation of a nation of Local 6-type institutions, especially when the solidarity characteristic of unions is lacking in most other environments. Although a top down approach contrasts sharply with what Local 6 has done, nevertheless, a well designed single payer model can accomplish the same results, with the added benefit of ensuring patient choice of their health care professionals and institutions. But we'll have to get the private insurers out of the way. They would never accept a system with so little money in it. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Thu Dec 29 09:25:26 2011 From: don at mccanne.org (Don McCanne) Date: Thu, 29 Dec 2011 06:25:26 -0800 Subject: [Health Care Action] qotd: Medical bill problems will persist Message-ID: Center for Studying Health System Change December 2011 Medical Bill Problems Steady for U.S. Families, 2007-2010 By Anna Sommers, Peter J. Cunningham While problems paying medical bills stabilized in recent years, the proportion of Americans in families with medical bill problems remained significantly higher in 2010 compared with 2003 - 20.9 percent vs. 15.1 percent. And, in 2010, many people in families with problems paying medical bills continued to experience severe financial consequences, with about two-thirds reporting problems paying for other necessities and a quarter considering bankruptcy. Underscoring uninsured people?s lack of financial protection from health care expenses, uninsured children and working-age adults in 2010 were more likely to have medical bill problems (31.5%) than their insured counterparts (20.2%). http://www.hschange.org/CONTENT/1268/ Comment: Although the uninsured would be expected to have problems paying medical bills, we should be very concerned that one-fifth of insured individuals under age 65 also face significant medical debt. Most of these individuals are insured through their work. Since the state insurance exchange subsidies for purchase of insurance and for out-of-pocket expenses will not apply to employer-sponsored plans, it can be anticipated that the Affordable Care Act will not reduce medical bill problems for a majority of our workforce. When we know that the Affordable Care Act will fall far short of what we need to ensure financial security in the face of medical need, why aren't we as a nation busy with efforts to enact a program that actually would work? -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day From don at mccanne.org Fri Dec 30 08:41:11 2011 From: don at mccanne.org (Don McCanne) Date: Fri, 30 Dec 2011 05:41:11 -0800 Subject: [Health Care Action] qotd: A future with high deductibles for everyone Message-ID: The Tennessean December 27, 2011 High-deductible health plans on rise By Tom Wilemon Corporate employers, small businesses and nonprofit organizations are increasingly requiring their workers to spend between $1,200 and $5,000 before filing a health insurance claim. Nearly three in four employers will offer at least one of these plans next year, according to a survey by the National Business Group on Health, a nonprofit association that represents large employers. Helen Darling, its president, predicts that by 2016 the majority of all health plans will have high deductibles. http://www.tennessean.com/article/20111227/NEWS07/312270017/High-deductible-health-plans-rise Comment: The National Business Group on Health (NBGH) is composed of the nation's largest employers, predominantly Fortune 500 companies. They provide health coverage for over 50 million workers, retirees and their families. When NBGH's president, Helen Darling, says that three years from now the majority of all plans will have high deductibles, you can bank on it. Although this development is independent of the measures in the Affordable Care Act (ACA), it has greater consequences than any other feature of ACA, merely based on the number of people who will be impacted - not just the Fortune 500 company employees, but virtually everyone else as well. Most workers and their families obtain their health care coverage through their employment. With large employers leading the way, high deductible plans will become the national standard. For median-income households, the deductible is large enough to create a financial hardship should a family member have significant health care needs. Thus, under-insurance is becoming the new norm, not only for employer-sponsored plans, but also for the low actuarial value plans to be offered through the state insurance exchanges. The rationale usually given for high deductibles is to make patients more sensitive to the costs of health care so that they will use less of it. This has been shown not only to decrease the use of beneficial health care services, but it also potentially exposes people to financial hardship when they develop problems for which health care is absolutely essential. So the question is, does this really save enough money to warrant these adverse consequences? Let's look at the RAND HIE and also the experiences of other nations. The RAND Health Insurance Experiment demonstrated that health care use was reduced by 30 percent in patients with cost sharing as compared to first dollar coverage, supposedly without resulting in harm (though low-income people were harmed). But that study was limited to healthy workers and their young healthy families during a few healthy years of their lives. It does not apply to the relatively unhealthy 20 percent of people who use 80 percent of our health care dollars - care that is not influenced by deductibles. Reducing spending by 30 percent on healthy people who use very little care - perhaps an office visit or two - is not going to reduce our national health expenditures significantly. Many other nations have first dollar coverage with no deductibles, yet spend far less than we do, and with no evidence of significant overuse of medical services. There are far more effective and much more patient-friendly methods of controlling spending than the use of deductibles and other cost sharing, as these nations have demonstrated. The Affordable Care Act is not providing us the framework that would ensure affordable care for everyone. Trying to modify the Act to make it work better won't help because the financing infrastructure is so fundamentally flawed that legislative tweaking cannot repair it. Though getting rid of deductibles would be an improvement, it wouldn't reduce our high costs, but would merely shift them, making insurance premiums even less affordable. For this new year, we really have our work cut out for us. The public at large needs to understand the irreparable flaws in the ACA model of reform. People need to know that we can control spending while making health care accessible and affordable for everyone. We can do this by enacting a far better way to finance health care - a single payer national health program: an improved Medicare for all. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- _______________________________________________ Quote-of-the-day mailing list Quote-of-the-day at mccanne.org http://two.pairlist.net/mailman/listinfo/quote-of-the-day