From don at mccanne.org Wed Feb 1 16:00:58 2012 From: don at mccanne.org (Don McCanne) Date: Wed, 1 Feb 2012 13:00:58 -0800 Subject: [Health Care Action] qotd: Beware the Essential Health Benefits Coalition Message-ID: Essential Health Benefits Coalition January 31, 2012 Letter To: HHS Secretary Kathleen Sebelius From: Neil Trautwein, National Retail Federation Re: Request for Information on the Essential Health Benefits Bulletin The Essential Health Benefits Coalition ("EHBC") appreciates the opportunity to provide comments in response to the "Essential Health Benefits Bulletin" as issued by Department of Health and Human Services' (HHS's) Center for Consumer Information and Insurance Oversight (CCIIO) on December 16, 2011. As you finalize the definition of the Essential Health Benefits (EHB) package, we want to emphasize our concerns regarding the affordability of coverage for small employers and individuals under the Affordable Care Act (ACA). HHS seeks to give states flexibility to structure their own EHB package using private market coverage options in use today to serve as benchmarks. Yet these benchmark options are subject to the same state mandates that today keep coverage unaffordable and out of reach for many small employers and individuals. We urge HHS to consider an approach that balances reasonably comprehensive benefits with affordability for employers and individuals. A definition that does otherwise will make health coverage more expensive for employers and individuals to purchase and make jobs more difficult for employers to create. Excerpt from recommendations: Specifically, we urge the Department to reiterate that the Bulletin reflects the statutory requirements that: * The EHB package does not dictate cost sharing requirements. * Use of benefit limits included within benchmark plans is not barred. * Future state mandates will not be added to the benchmark plan. * Use the benchmark plan only to define the 10 categories of EHBs required by the ACA, and not any additional benefits that the benchmark may cover. Members of the Essential Health Benefits Coalition Steering Committee: American Osteopathic Association America's Health Insurance Plans Blue Cross Blue Shield Association Express Scripts Inc. National Association of Health Underwriters National Association of Manufacturers National Association of Wholesaler-Distributors National Federation of Independent Business National Retail Federation Pharmaceutical Care Management Association Prime Therapeutics Retail Industry Leaders Association U.S. Chamber of Commerce http://ehbcoalition.org/wp-content/uploads/2012/02/EHBC-Comments.pdf Comment: HHS has proposed that "essential health benefits" for plans under the Affordable Care Act need meet only the minimal standard of state regulated plans in the small group market. Now a coalition of the usual suspects which push self-serving reforms is proposing to further weaken the "essential health benefits" standard. The details of their recommendations are not nearly as important as the fact that this maneuver represents what has been wrong with the reform process all along. The vested interests have been in the front seat while the guileless patients have had to accept their work product - a mandate to purchase unaffordable under-insurance, amongst many other flawed policies. Instead of fighting over the definition of minimal essential benefits in a highly flawed health financing program, we should be joining with the nation's patients in demanding that our elected leaders quit listening to these self-serving interests and instead enact a program that puts patients in the front seat - an improved Medicare for all. Addendum: Members of the American Osteopathic Association (AOA) may want to advise their leadership that, as a patient-oriented organization, AOA should immediately withdraw from this dastardly coalition. -------------- 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 Feb 1 23:04:58 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 1 Feb 2012 23:04:58 -0500 Subject: [Health Care Action] Verizon Action This Week Message-ID: <011c01cce15f$d9d85d40$8d8917c0$@org> Fighting Corporate Greed this week is as easy as (1) (2) (3) (4) (1) STAND WITH VERIZON WORKERS: Thursday February 2, 6:45-7:30am, Verizon garages at 95 Brookdale Dr, Springfield and 111 North Hatfield Road, Hatfield : Just stop by! (2) MARCH WITH OCCUPY WESTERN MASS: Thursday February 2, 4pm, from Pulaski Park, Main St, next to Academy of Music, Northampton. (3) LEAFLET & STAND-OUT AT VERIZON WIRELESS STORES: Pick a Saturday ~ Feb. 4, 11, 18, 25 Pick an ?Hour of Power? between Noon & 2pm (11am & 1pm in Pittsfield) Pick a VzW Store: Hadley / Pittsfield / Springfield / West Springfield And click here . Or let the Store Captains know you are coming this 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. Noon to 2pm, at the Hadley store, 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-250-5267. at the Springfield store, 1420 Boston Rd, Springfield : Please let Marty Feid know you are coming: martinfeid at gmail.com, (413) 530-8888. 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). (4) DO IT YOURSELF DELEGATIONS TO VERIZON WIRELESS STORES: We have a letter from community leaders across the nation, including Western Mass., asking Verizon to respect workers rights. Will you deliver it to a local store manager? Here?s how you do it! ? Talk to a couple of friends, neighbors, relatives, coworkers, or members to see who?s in. Any size delegation is fine. ? Pick any time and store that your delegation wants to visit. See the Western Mass. list below. ? Go to http://www.massjwj.net/news/help-show-community-support-verizon-workers to download the letter and directions. Or get them by email from wmjwj at wmjwj.org. ? Read the directions. ? There?s room on the letter to add your names if you want. ? Visit the store and ask to speak with the manager. Deliver the letter, explaining that you are part of a national movement of people who want respect for Verizon workers. ? After you do your delegation, tell Jon at WMass Jobs with Justice (jon at wmjwj.org) how it went. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 jon at wmjwj.org Thu Feb 2 13:55:27 2012 From: jon at wmjwj.org (Jon Weissman) Date: Thu, 2 Feb 2012 13:55:27 -0500 Subject: [Health Care Action] WMJwJ Conference March 3 Message-ID: <028d01cce1dc$3becef60$b3c6ce20$@org> Occupy Jobs with Justice! The Western Massachusetts Jobs with Justice Educational, Organizing, & Membership Conference Saturday, March 3, 2012, 10am to 5:15pm (includes lunch) Holyoke Community College ~ Kittredge Center 303 Homestead Avenue, Holyoke (easy off I-91) The conference is in partnership with the Kittredge Center for Business and Workforce Development at Holyoke Community College. Registration is required at http://www.hcc.edu/community-and-business/conference-registration. When you register, please use the dropdown to tell us if you want a meat or vegetarian lunch. Then click Add to Cart and Proceed to Checkout. Use the comment box at the bottom of the registration form to let us know if you need simultaneous interpretation in Spanish, by writing the word "Spanish" in the box. Ignore any payment requests. There is no cost to attend this conference. It is fully underwritten by the grants and donations of generous supporters. You are invited to add your donation to theirs, now or at the conference. Please visit http://wmjwj.org/sustaining-western-mass-jobs-justice for more information on donations. Keynote Speaker: Stephanie Luce community/labor educator and activist Associate Professor of Labor Studies, Murphy Institute for Worker Education and Labor Studies, City University of New York Tabling Opportunity for Progressive Organizations (send request to wmjwj at wmjwj.org) Organizing Workshops: Good Green Jobs ~ owned by union members? Health Care Justice ~ Massachusetts Medicare for All Student Labor Action Project Tax the Rich! So Called "Non-Profits" Plenaries: Workshop Report-Backs What is National Jobs with Justice? Labor Organizing + Community Organizing = Jobs with Justice Organizing Economic Literacy For more information: Western Mass. Jobs with Justice 640 Page Boulevard #101, Springfield MA 01104 v (413) 827-0301 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 Thu Feb 2 15:44:44 2012 From: don at mccanne.org (Don McCanne) Date: Thu, 2 Feb 2012 12:44:44 -0800 Subject: [Health Care Action] qotd: More bad news about "essential health benefits" Message-ID: Kaiser Health News February 2, 2012 HHS Essential Benefits 'Bulletin' Draws Tide Of Comments As the official window of time allowed for groups to react to the Department of Health and Human Services essential benefits proposal closed, a variety of objections, concerns and common themes became clear. CQ HealthBeat: State 'Flexibility' For Essential Benefits Gets Cool Reception A tide of objections and worries rolled in just before Tuesday's deadline for health groups to react to a Department of Health and Human Services proposal on essential health benefits. Input from health interests and consumers on the benefits "bulletin" is not being made public by the Obama administration, which asked that comments be sent to an email address rather than posted on a government website as would be the practice with a proposed regulation (Norman, 2/1). Politico Pro: EHB Comments Show Some Common Themes Believe it or not, businesses, insurers and consumers do see eye to eye on essential health benefits ? well, on some parts, anyway. They're at odds on some of the bigger issues, which doesn't exactly come as a surprise. The comments submitted to HHS on its essential health benefits approach shows a wide divide between consumers ... and businesses and insurers, who don't see enough safeguards to keep the essential health benefits package affordable (Millman, 2/2). http://www.kaiserhealthnews.org/Daily-Reports/2012/February/02/essential-benefits.aspx Comment: Yesterday we reported that some of the most politically powerful organizations in the nation have joined together in a coalition to try to weaken the package of "essential health benefits" that will be required of health plans under the Affordable Care Act. Excerpts from two new articles covered in the Kaiser Daily Health Policy Report should have us even more concerned. In Politico Pro, it is reported that businesses and insurers "don't see enough safeguards to keep the essential health benefits package affordable." The proposal already has reduced the required benefits down to the relatively austere level of small group plans offered in the various states. These plans leave patients facing financial hardship when they must access health care. Yet the powerful businesses and insurers want an even lower standard of benefits in order to keep the health benefits package affordable. The insurers want to protect their markets by keeping the insurance premiums affordable, and businesses also want the lowest premiums they can negotiate. Low premiums equate with higher out-of-pocket expenses for those with medical needs. In trying to make the health insurance plans more affordable, actual health care for the patients will be even less affordable. As we have seen, the process has always been about powerful interests, with only a passive concern for patients. In CQ HealthBeat, we see that comments on the proposal are being "sent to an email address rather than posted on a government website as would be the practice with a proposed regulation," and are "not being made public by the Obama administration." The White House gave these special interests carte blanche with secretive access during the reform process. Secrecy continues. Should we be surprised when the final rule on "essential health benefits" pleases business and insurance interests, at a cost of exposing those with health care needs to greater financial hardship? No, not surprised. Outraged is more like 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 Feb 3 08:11:53 2012 From: don at mccanne.org (Don McCanne) Date: Fri, 3 Feb 2012 05:11:53 -0800 Subject: [Health Care Action] qotd: A word about the Susan G. Komen Foundation Message-ID: The New York Times February 2, 2012 Editorial A Painful Betrayal With its roster of corporate sponsors and the pink ribbons that lend a halo to almost any kind of product you can think of, the Susan G. Komen for the Cure foundation has a longstanding reputation as a staunch protector of women?s health. That reputation suffered a grievous, perhaps mortal, wound this week from the news that Komen, the world?s largest breast cancer organization, decided to betray that mission. It threw itself into the middle of one of America?s nastiest political battles, on the side of hard-right forces working to demonize Planned Parenthood and undermine women?s health and freedom. The Associated Press reported on Tuesday that the foundation is cutting off its financing of breast cancer screening and education programs run by Planned Parenthood affiliates. That means nearly $700,000 less for Planned Parenthood, which performed 750,000 such screenings last year, many thousands of them with money from the Komen foundation. http://www.nytimes.com/2012/02/03/opinion/a-painful-betrayal.html?ref=opinion And... The Susan G. Komen Breast Cancer Foundation, Inc. Consolidated Statements of Functional Expenses Year Ended March 31, 2011 Public support and revenue $471,750,158 Program services Research $75,301,537 Public health education $181,092,283 Health Screening Services $54,089,036 Treatment services $23,251,563 Total program services $333,734,419 http://ww5.komen.org/uploadedFiles/Content/AboutUs/Financial/2011%20Komen%20Financial%20Statements%20FINAL(3).pdf Comment: Nothing further needs to be said about how unwise it was for the Susan G. Komen Foundation to cut off funds for breast cancer services at Planned Parenthood facilities. Having made an error so grievous that some suggest could result in the demise of this public service organization dedicated to fighting breast cancer, we should ask if we can afford to lose their contributions to this effort. We need to take a look at their program services. The $75 million that they spend on research could easily be incorporated into the budget of the National Institutes of Health, the world's largest medical research institute. The $181 million spent on public education has reached all of us through their pink ribbon campaign. Although it certainly is important for the public to know about screening mammography, isn't it likely that this will still be common knowledge, even without the pink ribbons? The $54 million for screening and the $23 million for treatment actually are already being paid for by taxpayers. If you consider that the marginal tax rate for Komen donors likely averages about 30 percent, then tax subsidies for the $471 million in public support amount to about $141 million, far more than the $77 million being spent on screening and treatment. In fact, the balance of our tax subsidies would pay for most of the research that they fund. A more fundamental question is why aren't all women guaranteed appropriate screening and necessary treatment for breast cancer? They would be if we had a single payer national health program - an improved Medicare for all. If so, the loss of the Komen Foundation would not be all that tragic, though it is still painful to say that. -------------- 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 Feb 3 17:01:39 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Fri, 3 Feb 2012 17:01:39 -0500 Subject: [Health Care Action] Greg Speeter 10/12/1943-2/2/2012 Message-ID: <007201cce2bf$69d8d270$3d8a7750$@org> From: Jo Comerford, National Priorities Project, jo at nationalpriorities.org It is with great sadness that I share the news that NPP's founder, Greg Speeter, passed away last night just before 9:00 pm, surrounded by family. I join you in mourning the loss of our mentor, dear friend, and extraordinary visionary -- and in celebrating his exquisite life. Greg's passing leaves a tremendous chasm. We are comforted to know that his dreams live on with all of us, working together to fulfill his legacy. We don't yet have details about his memorial, but we'll be in touch as we receive information. Peace, Jo National Priorities Project | 243 King Street | Suite 109 | Northampton | MA | 01060 -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Mon Feb 6 12:27:41 2012 From: don at mccanne.org (Don McCanne) Date: Mon, 6 Feb 2012 09:27:41 -0800 Subject: [Health Care Action] qotd: Uwe Reinhardt describes single payer, and we respond Message-ID: The New York Times February 3, 2012 Health Care Payers Push Back Against Costs By Uwe E. Reinhardt In a paper, ?Divide et Impera: Protecting the Growth of Health Care Incomes (Costs),? published this month in the British journal Health Economics, I summarize themes touched on here and there in several earlier posts on this blog. My argument in the paper is that what is often called overuse of health care by what are often described as excessively insured Americans ? especially their use of high-cost, high-tech procedures ? is at best a partial explanation for the high cost of American health care. Yet cost-containment initiatives like high deductibles and co-insurance have taken use of health care as their chief target. These efforts will be only partly successful in controlling national health spending. Equally important contributors to our high health spending, and probably more so, have been two other factors. The first is the much higher administrative overhead costs loaded onto the American health system. David Cutler and Dan Ly, both of Harvard University, illuminate this proposition in their recent paper, ?The (Paper) Work of Medicine: Understanding International Medical Costs,? in which they compare health spending in Canada and the United States. Earlier, in a 2003 paper, ?Costs of Health Care Administration in the United States and Canada,? Dr. Steffie Woolhandler, Terry Campbell and Dr. David Himmelstein estimated that in 1999 total administrative costs of health insurers and all other parties in health care, save patients, accounted for 31 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. A second major factor accounting for high health spending per capita in the United States is the significantly higher prices Americans pay for virtually all health care services and products. My thesis on this issue ? expressed in the title of my paper ? is that these much higher prices are the product of a deliberate strategy, hashed out in our political bazaars between the supply side of health care and state and federal legislators, always to keep the payment side of our health system fragmented and relatively weak vis ? vis the supply side of health care. http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/ Comments (published on the NYT blog): Don McCanne San Juan Capistrano, CA In his paper, "Divide et Impera," Professor Reinhardt discusses three approaches to controlling health spending: single payer, all-payer, and rationing by prices. The last, of course, is what we now have and is rejected by most of us who wish to see a more humane method of financing care. It is still supported by those who believe the health care consumer should use their own funds to shop for care, even though these supporters are reluctant to call it what is is - rationing by ability to pay. In his article, single payer is dismissed based on lack of political feasibility, a view widely held in the United States. In contrast, Dr, Reinhardt discusses an all-payer system in which prices are standardized and budgeted by associations - a great improvement over our current system (which Dr. Reinhardt discussed in a previous blog). However, he states, "Admittedly, a transition from the current to an all-payer system for all providers of health care in all states would be challenging, both analytically and politically." Politically challenging. Isn't that like questioning political feasibility? Is the political hurdle for an equitable and efficient single payer system really that much greater than the hurdle for a less efficient, less equitable and more fragmented all-payer system? If we're going to have to break down political barriers, why don't we go for the best? http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/?comments#permid=1 Nathan Punwani Cambridge, MA If we're really interested in cost control, do we really need a public option? What about an all-payer system? What are the advantages and disadvantages of an all-payer system relative to a single-payer system (besides private insurers don't like single payer)? Nathan Punwani MPH Candidate - Harvard School of Public Health http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/?comments#permid=24 Uwe Reinhardt Princeton, NJ The advantages of a single-payer system are: 1. They are simple and easily understood by all concerned. 2. They foster egalitarian health care delivery, because they usually are financed on the ability-to-pay principle. and providers are paid the same fee regardless of the socio-economic status of the patient. 3. They are ideal platforms for the smart application of electronic health information systems. 4. They have relatively low administrative overhead costs. 5. They give the insurer (the single-payer) a financial incentive to invest in preventive care and behavioral health care, because patients have automatic life cycle insurance under these systems so that the insurer reaps the savings in acute care treatment costs over the longer run. 6. Cost control is easy with these systems. The disadvantages are: 1. Prospective insured do not have a choice among different insurers and different benefit packages. 2. Government, which usually operates these systems, may underfund them relative to what the people actually want and would be willing to pay for, although one should think that in a properly functioning democracy that could not go on for very long. 3. Mistakes at the center in coverage or payment matters quickly diffuse to all corners of the system. 4. Some people, notably Americans, just oppose all forms of centralized power, however efficient it may be. http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/?comments#permid=24:15 Don McCanne San Juan Capistrano, CA Some of the other effective tools of the single payer model, as supported by Physicians for a National Health Program, include the following: * Administratively efficient global budgeting of hospitals, as with police and fire departments * Negotiation of fair rates with physicians * Bulk purchasing of pharmaceuticals, like the VA * Reducing diversion of patient care funds by eliminating for-profit corporations and their passive investors * Planning and separate budgeting of capital improvements to prevent wasteful excess capacity, while ensuring adequate capacity in under-served areas * Replacing choice of restrictive, wasteful, expensive private insurers with the choice we want - choice of our health care professionals and institutions The greatest problem with single payer systems is that conservative governments strive to privatize and underfund the programs, such as the current efforts in England and Canada, and also here with the conservative attack on our Medicare program. Such anti-egalitarian approaches tend to shift burdensome costs to patients who are already suffering from ill health. The efficient and equitable policies of the single payer model which would provide us with much greater value in our health care purchasing are precisely what we need. It's the politics that we need to change, something that we should be able to do with a "properly functioning democracy." http://economix.blogs.nytimes.com/2012/02/03/health-care-payers-push-back-against-costs/?comments#permid=24:17 _______________________________________________ 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 Tue Feb 7 15:40:20 2012 From: don at mccanne.org (Don McCanne) Date: Tue, 7 Feb 2012 12:40:20 -0800 Subject: [Health Care Action] qotd: California's health insurance lessons for the U.S. Message-ID: UCLA Center for Health Policy Research February 2012 The State of Health Insurance in California: Findings from the 2009 California Health Interview Survey By Shana Alex Lavarreda, PhD, MPP, Livier Cabezas, MPAff, Ken Jacobs, Dylan H. Roby, PhD, Nadereh Pourat, PhD, Gerald F. Kominski, PhD Excerpts (These paragraphs are not contiguous in the report.) Medi-Cal, Healthy Families, and Medicare provided insurance coverage to 9.3 million people in California for all or part of 2009. Despite the presence of these state and federally run public programs, there are still many low-income, uninsured Californians who do not qualify for coverage. Additionally, there are children and their parents, people with disabilities or medical needs, and elderly Californians who are eligible for public insurance programs but who are not enrolled. Only three-fourths of uninsured Latinos will be able to gain coverage under ACA. A slightly higher percentage (43.1%) will be eligible for the Medi-Cal expansion, but far fewer will participate in the Exchange, either with subsidies (21%) or without (9.2%). The rest will be ineligible to participate in the coverage expansions due to their citizenship status (26.8%). The exclusions embedded in ACA will likely increase the health insurance disparities between U.S. citizens and non-citizens over time. If these issues remain unaddressed, California runs the risk of increasing racial/ethnic inequities in health care access and outcomes. Medicare beneficiaries without Medi-Cal or a supplemental source of coverage were more likely to report delays in obtaining medical care or necessary prescription drugs. Not all types of health insurance are equal in their impact on access. Significant variations in premiums, cost sharing, and benefits exist between employment-based and individually purchased insurance, further complicated by the high-deductible plans that exist in both markets. Medi-Cal and Healthy Families coverage have very low or no premiums and cost sharing, but funding shortfalls often threaten eligibility, benefits, and provider participation in these programs. The uninsured were also more likely than the insured to forgo or delay needed medical care due to costs or lack of insurance; 5.7% of those with employment-based insurance reported such barriers, compared to 19.5% of the uninsured. The existing racial and ethnic disparities in health insurance coverage and resulting access to the health care system will be exacerbated as health care reform is implemented, with the very serious possibility that more than one million California residents (including non-citizen children) will be left to rely on safety net providers who may not receive enough money to care for the residual uninsured. According to the 2009 California Health Interview Survey, approximately 92.7% of all children who were eligible for Medi-Cal actually signed up in 2009, and a lower percentage of adults ages 19 to 64 who were eligible actually enrolled (85.0%). That represents more than 215,000 children who could have had health insurance through a low-cost, public program but who did not enroll. In addition, another 331,000 adults were estimated to be eligible for Medi-Cal but remained uninsured. Although Healthy Families does not enroll adults, a smaller number of uninsured children are eligible for the program. Approximately 189,000 of uninsured children are estimated to be eligible for Healthy Families but are not enrolled ? 22.2% of the eligible population. Variations in health care use, as well as reports of forgoing needed care or delaying it due to costs and presence of medical debt by type of insurance, are likely due to differences in deductible levels and cost sharing and benefits. These variations indicate that health insurance does not fully address the financial barriers to access. Among the publicly insured, the presence of access barriers and financial debt illustrate the challenges the Medi-Cal and Healthy Families programs have to overcome despite the perennial funding shortfalls that threaten eligibility, benefits, and provider participation in these programs. The continuing increase in premiums is likely to increase the number of high-deductible plans not accompanied by savings accounts, increase cost sharing and lead to more medical debt, increase the ranks of those who forgo or delay needed medical care, and potentially reduce timely doctor visits and increase emergency room visits. In October 2010, California became the first state in the nation to pass legislation establishing the California Health Benefit Exchange, a fundamental component of the infrastructure of ACA. The Board faces numerous challenges over the next two years, including how to coordinate eligibility determination and enrollment processes with state and county agencies, whether to standardize co-payments and deductibles within each of the four tiers of health plans to be offered in the Exchange as a means of facilitating comparison shopping by consumers, and providing seamless transitions for individuals between Medi-Cal and the Exchange resulting from changing income, to name just a few. Based on considerable evidence from previous expansion of public programs, including experience with individual mandates and penalties for remaining uninsured in Massachusetts, ACA will not result in 100% enrollment rates among those who are eligible for Medi-Cal or Exchange subsidies. Furthermore, we estimate that as of 2009, 1.2 million California residents will not be eligible under ACA due to their citizenship status. As a result, despite the significant reductions in the number of uninsured that are anticipated in 2014, those who remain uninsured are likely to strain the capacity of safety net providers in certain areas of the state. Our findings suggest that ACA could have a devastating effect on counties such as Los Angeles, where 20.7% of the currently uninsured, or nearly 450,000 individuals, will not be eligible for insurance under ACA. The net effect of ACA of reducing subsidies to hospitals for uncompensated care, reducing the number of uninsured, and increasing subsidies for community health centers could leave counties such as Los Angeles more vulnerable than they are now in meeting the demand for indigent care. This geographic disparity in the distribution of uninsured Californians may temper some of the considerable overall benefits anticipated under ACA. The State of Health Insurance in California (114 pages): http://www.healthpolicy.ucla.edu/pubs/files/shic2009report.pdf Comment: This highly informative UCLA policy report on the status of health insurance in California confirms that coverage and access have grown more dire, made even worse by the recession. Although the report explains how some of the benefits of the Affordable Care Act will provide limited improvements, it is also clear that we will fall far short of meeting all of our health care needs. Although the report is silent on the wisdom of the financing infrastructure of the Affordable Care Act, we already know that the model is irreparably defective. The multitude of corrective patches that might be proposed would still leave us with unaffordable underinsurance as the new standard in America, along with a chronically underfunded public program for the poor. We need to replace the ACA model with a program that works - a single payer national health program. _______________________________________________ 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 Feb 8 10:08:32 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 8 Feb 2012 10:08:32 -0500 Subject: [Health Care Action] FW: Score One for the Bad Guys Message-ID: <00b801cce673$86174040$9245c0c0$@org> From: Labor for Single-Payer [mailto:organizers at laborforsinglepayer.org] Labor Campaign National Advisory Board Don Berry, President Maine AFL-CIO Jeff Crosby, President Northshore Labor Council (MA) Rose Ann DeMoro, Executive Director National Nurses United Donna Dewitt, President South Carolina State AFL-CIO Maria Elena Durazo, Exec. Secty-Treasurer Los Angeles Federation of Labor Pat Eiding, President Philadelphia CLC Fernando Gapasin West Central Oregon CLC Ben Johnson, President Vermont State AFL-CIO Jeff Johnson, President Washington State Labor Council Greg Junemann, President International Federation of Professional and Technical Engineers Bruce Klipple, President United Electrical Workers, UE Fred Mason, President Maryland/DC AFL-CIO Hugh McVey, President Missouri State AFL-CIO David Newby, President Emeritus Wisconsin State AFL-CIO Henry Nicholas, President AFSCME 1199 Tim Paulson, Executive Director San Francisco CLC Clyde Rivers, Representing California School Employees Association Jos Williams, President DC Metro CLC Nancy Wohlforth, Representing California State AFL-CIO On January 31, the California Universal Health Act (SB 810) fell two votes short of passage in the State Senate. SB 810 would have created a single public health insurance program for all Californians, much like an improved Medicare-for-All plan that has been proposed at the federal level. Similar Bills had passed twice in earlier legislative sessions only to be vetoed by then-Governor Schwarzenegger. The 2010 election of Governor Jerry Brown had raised expectations that a new single-payer Bill could be passed and signed into law this session. Despite extensive grassroots lobbying of the Democratic Caucus, two Democratic State Senators voted against the Bill and four abstained. Supporters of the Bill were undeterred. "Nurses will not give up on winning guaranteed universal healthcare, like SB 810" stated DeAnn McEwen, RN, Co-President of the California Nurses Association, "because we will not abandon our patients who need this vital reform." "Healthcare is a human right," Progressive Democrats of America's California State Coordinator and Emergency Physician Dr Bill Honigman stated, "It is immoral for businesses to profit from the illness of others, just as we would not expect them to profit from other public services such as police, fire, or education." The fight to pass the Bill in this session led to the founding of the Campaign for a Healthy California as a powerful and growing coalition of community, labor and advocacy groups. Prominent labor endorsers include the California Nurses Association, the California School Employees Association and the Communications Workers of America District 9. "We will continue to build on the momentum we have created through our recent actions and statewide activism, and build an even broader and more powerful grass roots movement to ensure we win universal healthcare in California," said Pilar Schiavo, the CHC Campaign Coordinator. Meanwhile, the healthcare crisis continues unabated. In Ravenswood, West Virginia, retirees in their 60's, 70's and 80's have been occupying a narrow median strip in front of Century Aluminum after the Company cut health benefits for 540 retirees . Fifty million Americans live without health coverage and even those with insurance are frequently forced into medical bankruptcy . Despite the passage of the Affordable Care Act, this crisis will continue until healthcare is a right for everyone in America. The defeat of SB 810 is a reminder of the massive influence that the for-profit health insurance industry has over the political process. Former insurance executive Wendell Potter has written extensively about how that industry will stop at nothing to preserve its flawed business model which profits through the denial of healthcare. It will take a mighty grassroots movement to prevail over this concentrated corporate power and win healthcare for all. Activists in California have vowed to come back with a bigger, stronger movement and leaders in other states are beginning to understand what it will take to win this fight. Last week, delegates from 28 unions, non-profits and grassroots organizations met in Portland to launch a new coalition to win universal healthcare in Oregon . Rather than starting off with a developed piece of legislation that would rely on the good will of the Democratic legislative caucus to advance, they have determined to focus first on grassroots community organizing and outreach. Labor must lead the fight to win healthcare for all and the Labor Campaign for Single Payer works to organize all levels of the labor movement to support this historic mission. The AFL-CIO has gone on record in support of single-payer but more needs to be done. As in Vermont, the next time single-payer is on the agenda in California, labor needs to support it with one voice and be prepared to mobilize every union member in every community of the state. The fight for healthcare justice goes on. Please work to ensure that your union is part of the fight and that it joins and contributes to the Labor Campaign for Single Payer . In Solidarity, Mark Dudzic National Coordinator LCS-P National Steering Committee Larry Barragan, President Los Angeles Ports Council Paul Bigman IATSE Local 15 Michael Bilbrey 1st Vice-President CSEA Andrew Coates, MD NY State Public Employees Federation Al Cholger USW Staff Representative - Detroit Jeff Crosby, President Northshore MA CLC Donna Dewitt, President South Carolina State AFL-CIO Jed Dodd, General Chair PA Federation BMWED/IBT Mark Dudzic USW & Labor Party Sandy Eaton MA Nurses Assoc. Jon Flanders, Moderator NY Labor for Single-Payer Bill Gibbons USW Regional Dir (Ret) Don Giljum, Business Manager IUOE Local 148 Bill Henning, Vice-Pres. CWA Local 1180 Winifred Z. Kennedy, President NY State Nurses Assoc. Peter Knowlton, President New England, UE Martha Kuhl, Treasurer National Nurses United (CA) Paul Kumar, Political Director NUHW Tom Leedham, Secty-Treasurer IBT Local 206 Traven Leyshon, Sec. Treas. VT State AFL-CIO Martha Livingston United Univ. Professions , AFT Lo 2190 Lew Moye, President St. Louis CBTU David Newby, President Emeritus Wisconsin State AFL-CIO John Ocampo, Coord. Restaurant Opportunities Center, Miami Rodney Orr, Political Director CWA 9119 Josh Pechthalt, Vice-President UTLA-Los Angeles Lenny Potash Labor United for Universal Healthcare Rose Roach Calif. School Emp. Assoc. Jean Ross, Co-President National Nurses United (MN) Jim Savage, President USW Local 10-1 Robert Score, Rec-Secty IATSE Local 1 Jerry Tucker former UAW Exec-Board Member & CLR John Walsh Massachusetts JwJ Jos Williams, President DC Metro CLC Nancy Wohlforth California State AFL-CIO Tony Zeli Maine Labor Group on Health The Labor Campaign for Single-Payer survives on the generosity of our supporters. Please consider making a donation. www.LaborForSinglePayer.org | organizers at laborforsinglepayer.org empowered by Salsa -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Wed Feb 8 12:31:09 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 8 Feb 2012 12:31:09 -0500 Subject: [Health Care Action] Score One for the Bad Guys In-Reply-To: References: <00b801cce673$86174040$9245c0c0$@org> Message-ID: <017c01cce687$725861b0$57092510$@org> From: Michael Meeropol [mailto:mameerop at gmail.com] ONE IMPORTANT POINT -- If we had universal single-payer health care (Medicare for all), the current debate about whether to force specific employers to give universal coverage (of reproductive health services) to their employees would be moot. NO EMPLOYERS would be giving health coverage -- everyone would have portable health insurance from the single-payer .... Very few people are making this point -- but it would be a way to avoid the "religious freedom" fight that the Obama Administration finds itself in. Mike Meeropol (retired but not retiring economist) On Wed, Feb 8, 2012 at 10:08 AM, WMass Jobs with Justice wrote: From: Labor for Single-Payer [mailto:organizers at laborforsinglepayer.org] Labor Campaign National Advisory Board Don Berry, President Maine AFL-CIO Jeff Crosby, President Northshore Labor Council (MA) Rose Ann DeMoro, Executive Director National Nurses United Donna Dewitt, President South Carolina State AFL-CIO Maria Elena Durazo, Exec. Secty-Treasurer Los Angeles Federation of Labor Pat Eiding, President Philadelphia CLC Fernando Gapasin West Central Oregon CLC Ben Johnson, President Vermont State AFL-CIO Jeff Johnson, President Washington State Labor Council Greg Junemann, President International Federation of Professional and Technical Engineers Bruce Klipple, President United Electrical Workers, UE Fred Mason, President Maryland/DC AFL-CIO Hugh McVey, President Missouri State AFL-CIO David Newby, President Emeritus Wisconsin State AFL-CIO Henry Nicholas, President AFSCME 1199 Tim Paulson, Executive Director San Francisco CLC Clyde Rivers, Representing California School Employees Association Jos Williams, President DC Metro CLC Nancy Wohlforth, Representing California State AFL-CIO On January 31, the California Universal Health Act (SB 810) fell two votes short of passage in the State Senate. SB 810 would have created a single public health insurance program for all Californians, much like an improved Medicare-for-All plan that has been proposed at the federal level. Similar Bills had passed twice in earlier legislative sessions only to be vetoed by then-Governor Schwarzenegger. The 2010 election of Governor Jerry Brown had raised expectations that a new single-payer Bill could be passed and signed into law this session. Despite extensive grassroots lobbying of the Democratic Caucus, two Democratic State Senators voted against the Bill and four abstained. Supporters of the Bill were undeterred. "Nurses will not give up on winning guaranteed universal healthcare, like SB 810" stated DeAnn McEwen, RN, Co-President of the California Nurses Association, "because we will not abandon our patients who need this vital reform." "Healthcare is a human right," Progressive Democrats of America's California State Coordinator and Emergency Physician Dr Bill Honigman stated, "It is immoral for businesses to profit from the illness of others, just as we would not expect them to profit from other public services such as police, fire, or education." The fight to pass the Bill in this session led to the founding of the Campaign for a Healthy California as a powerful and growing coalition of community, labor and advocacy groups. Prominent labor endorsers include the California Nurses Association, the California School Employees Association and the Communications Workers of America District 9. "We will continue to build on the momentum we have created through our recent actions and statewide activism, and build an even broader and more powerful grass roots movement to ensure we win universal healthcare in California," said Pilar Schiavo, the CHC Campaign Coordinator. Meanwhile, the healthcare crisis continues unabated. In Ravenswood, West Virginia, retirees in their 60's, 70's and 80's have been occupying a narrow median strip in front of Century Aluminum after the Company cut health benefits for 540 retirees . Fifty million Americans live without health coverage and even those with insurance are frequently forced into medical bankruptcy . Despite the passage of the Affordable Care Act, this crisis will continue until healthcare is a right for everyone in America. The defeat of SB 810 is a reminder of the massive influence that the for-profit health insurance industry has over the political process. Former insurance executive Wendell Potter has written extensively about how that industry will stop at nothing to preserve its flawed business model which profits through the denial of healthcare. It will take a mighty grassroots movement to prevail over this concentrated corporate power and win healthcare for all. Activists in California have vowed to come back with a bigger, stronger movement and leaders in other states are beginning to understand what it will take to win this fight. Last week, delegates from 28 unions, non-profits and grassroots organizations met in Portland to launch a new coalition to win universal healthcare in Oregon . Rather than starting off with a developed piece of legislation that would rely on the good will of the Democratic legislative caucus to advance, they have determined to focus first on grassroots community organizing and outreach. Labor must lead the fight to win healthcare for all and the Labor Campaign for Single Payer works to organize all levels of the labor movement to support this historic mission. The AFL-CIO has gone on record in support of single-payer but more needs to be done. As in Vermont, the next time single-payer is on the agenda in California, labor needs to support it with one voice and be prepared to mobilize every union member in every community of the state. The fight for healthcare justice goes on. Please work to ensure that your union is part of the fight and that it joins and contributes to the Labor Campaign for Single Payer . In Solidarity, Mark Dudzic National Coordinator LCS-P National Steering Committee Larry Barragan, President Los Angeles Ports Council Paul Bigman IATSE Local 15 Michael Bilbrey 1st Vice-President CSEA Andrew Coates, MD NY State Public Employees Federation Al Cholger USW Staff Representative - Detroit Jeff Crosby, President Northshore MA CLC Donna Dewitt, President South Carolina State AFL-CIO Jed Dodd, General Chair PA Federation BMWED/IBT Mark Dudzic USW & Labor Party Sandy Eaton MA Nurses Assoc. Jon Flanders, Moderator NY Labor for Single-Payer Bill Gibbons USW Regional Dir (Ret) Don Giljum, Business Manager IUOE Local 148 Bill Henning, Vice-Pres. CWA Local 1180 Winifred Z. Kennedy, President NY State Nurses Assoc. Peter Knowlton, President New England, UE Martha Kuhl, Treasurer National Nurses United (CA) Paul Kumar, Political Director NUHW Tom Leedham, Secty-Treasurer IBT Local 206 Traven Leyshon, Sec. Treas. VT State AFL-CIO Martha Livingston United Univ. Professions , AFT Lo 2190 Lew Moye, President St. Louis CBTU David Newby, President Emeritus Wisconsin State AFL-CIO John Ocampo, Coord. Restaurant Opportunities Center, Miami Rodney Orr, Political Director CWA 9119 Josh Pechthalt, Vice-President UTLA-Los Angeles Lenny Potash Labor United for Universal Healthcare Rose Roach Calif. School Emp. Assoc. Jean Ross, Co-President National Nurses United (MN) Jim Savage, President USW Local 10-1 Robert Score, Rec-Secty IATSE Local 1 Jerry Tucker former UAW Exec-Board Member & CLR John Walsh Massachusetts JwJ Jos Williams, President DC Metro CLC Nancy Wohlforth California State AFL-CIO Tony Zeli Maine Labor Group on Health The Labor Campaign for Single-Payer survives on the generosity of our supporters. Please consider making a donation. www.LaborForSinglePayer.org | organizers at laborforsinglepayer.org empowered by Salsa _______________________________________________ You are subscribed to the WMJwJ mailing list. To manage your subscription settings or unsubscribe, please visit http://lists.wmjwj.org/mailman/listinfo/wmjwj. -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Wed Feb 8 13:33:05 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Wed, 8 Feb 2012 13:33:05 -0500 Subject: [Health Care Action] Verizon Action This Week & Next Message-ID: <01f901cce690$1e3c2900$5ab47b00$@org> Fighting Corporate Greed is as easy as (1) (2) (3) (4) (5) <> (1) STAND WITH VERIZON WORKERS: Thursday February 9, 6:45-7:30am, Verizon garages at 95 Brookdale Dr, Springfield and 111 North Hatfield Road, Hatfield : Just stop by! (2) LEAFLET & STAND-OUT AT VERIZON WIRELESS STORES: Pick a Saturday ~ February 11 and/or 18 Pick an ?Hour of Power? between Noon & 2pm (11am & 1pm in Pittsfield) Pick a VzW Store: Hadley / Pittsfield / Springfield / West Springfield And click here . Or let the Store Captains know you are coming Saturday: 11am to 1pm: 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. Noon to 2pm: 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-250-5267. 1420 Boston Rd, Springfield : Please let Marty Feid know you are coming: martinfeid at gmail.com, (413) 530-8888. 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). (3) DO IT YOURSELF DELEGATIONS TO VERIZON WIRELESS STORES: We have a letter from community leaders across the nation, including Western Mass., asking Verizon to respect workers? rights. Will you deliver it to a local store manager? Here?s how you do it! ? Talk to a couple of friends, neighbors, relatives, coworkers, or members to see who?s in. Any size delegation is fine. ? Pick any time and store that your delegation wants to visit. See the Western Mass. list above. ? Go to http://www.massjwj.net/news/help-show-community-support-verizon-workers to download the letter and directions. Or get them by email from wmjwj at wmjwj.org. ? Read the directions. ? There?s room on the letter to add your names if you want. ? Visit the store and ask to speak with the manager. Deliver the letter, explaining that you are part of a national movement of people who want respect for Verizon workers. ? Afterward, tell Jon at WMass Jobs with Justice (jon at wmjwj.org) how it went. (4) VALENTINE?S WEEK DO IT YOURSELF DELEGATIONS TO VERIZON WIRELESS STORES: We have an alternative letter for next week! See the attached. Instructions are the same as above. (5) Thursday February 16! Rally For a Fair Verizon Contract ~ Save 45,000 Good Jobs! 5pm ~ Teamsters Local 404, 115 Progress Avenue, Springfield ~ John Rowley, IBEW Local 2324 Business Manager will report from the bargaining table. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: -------------- next part -------------- A non-text attachment was scrubbed... Name: Verizon Wireless Valentine's Day.pdf Type: application/pdf Size: 197758 bytes Desc: not available URL: From don at mccanne.org Wed Feb 8 14:37:51 2012 From: don at mccanne.org (Don McCanne) Date: Wed, 8 Feb 2012 11:37:51 -0800 Subject: [Health Care Action] qotd: Circuit Court: Individuals cannot disclaim entitlement to Medicare Part A Message-ID: United States Court of Appeals For the District of Columbia Circuit Decided February 7, 2012 BRIAN HALL, ET AL., APPELLANTS v. KATHLEEN SEBELIUS, SECRETARY OF THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN SERVICES, AND MARK J. ASTRUE, COMMISSIONER OF THE SOCIAL SECURITY ADMINISTRATION, APPELLEES KAVANAUGH, Circuit Judge: This is not your typical lawsuit against the Government. Plaintiffs here have sued because they don?t want government benefits. They seek to disclaim their legal entitlement to Medicare Part A benefits for hospitalization costs. Plaintiffs want to disclaim their legal entitlement to Medicare Part A benefits because their private insurers limit coverage for patients who are entitled to Medicare Part A benefits. And plaintiffs would prefer to receive coverage from their private insurers rather than from the Government. Plaintiffs? lawsuit faces an insurmountable problem: Citizens who receive Social Security benefits and are 65 or older are automatically entitled under federal law to Medicare Part A benefits. To be sure, no one has to take the Medicare Part A benefits. But the benefits are available if you want them. There is no statutory avenue for those who are 65 or older and receiving Social Security benefits to disclaim their legal entitlement to Medicare Part A benefits. For that reason, the District Court granted summary judgment for the Government. We understand plaintiffs? frustration with their insurance situation and appreciate their desire for better private insurance coverage. But based on the law, we affirm the judgment of the District Court. http://www.cadc.uscourts.gov/internet/opinions.nsf/0/890596479218E0818525799D00548389/$file/11-5076-1356903.pdf Comment: Although the government requirement that an individual be required to purchase an unwanted private health plan is being challenged before the Supreme Court, it is reassuring that Medicare is so well established within our laws that an individual over 65 who is receiving Social Security cannot disclaim their legal entitlement to Medicare Part A benefits, even though they can refuse to receive those benefits. It is unfortunate that Congress chose a model of reform that depends on an unpopular and possibly illegal mandate to purchase private health insurance, with a financial penalty for those who fail to comply. Medicare, one of the nation's most popular programs and one for which there is no legitimate legal challenge, should have been selected instead. An improved Medicare for all would have been much more effective and less expensive, and would not have had to face legal challenges. All of us can have Medicare, if we, as the people, demand it. _______________________________________________ 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 Feb 9 11:44:03 2012 From: don at mccanne.org (Don McCanne) Date: Thu, 9 Feb 2012 08:44:03 -0800 Subject: [Health Care Action] qotd: Help make Lawrence O'Donnell on SINGLE PAYER go viral! Message-ID: MSNBC The Last Word with Lawrence O'Donnell February 8, 2012 How America got into birth control mess In this seven minute video, Lawrence O'Donnell uses the current controversy over coverage of contraception as a platform to launch his message on why single payer is the imperative. http://www.msnbc.msn.com/id/45755883/vp/46320398#46321122 We often ask what we can do to advance the single payer cause. Besides the "be there and do it" rule, a very simple, immediate step is to help this video go viral by sharing it with your friends, colleagues, social websites, email lists, and anywhere else that people may want to hear the message that there is real HOPE for the future of health care in America. And... It is important to understand that the rationale of the single payer model is not only in the purview of progressives like Lawrence O'Donnell. Here is a statement from Michael Brendan Dougherty of Business Insider and The American Conservative (Democracy Now!, Feb. 8, 2012): Michael Brendan Dougherty: And most of the people who want to enforce this rule (employer-sponsored coverage of contraception) would prefer a single-payer system of healthcare anyway, where you?re not actually forcing employers to violate their conscience in buying this. Amy Goodman: So you?re saying a single-payer system would solve the problem. Michael Brendan Dougherty: Well, I?m saying it would solve this particular problem of conscience, as it has in Europe. http://www.democracynow.org/2012/2/8/as_contraceptives_rule_enters_gop_race CALL FOR ACTION: Share the O'Donnell video NOW! GO VIRAL! _______________________________________________ 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 Feb 9 20:47:58 2012 From: acswift at comcast.net (Alice Swift) Date: Thu, 9 Feb 2012 20:47:58 -0500 Subject: [Health Care Action] Fwd: Last night Lawrence O' Donnell on Single Payer Message-ID: Lawrence O'Donnell on Single Payer Health Care! http://pnhpcalifornia.org/2012/02/the-last-word-with-lawrence-odonnell-on-single-payer/ The problem will be solved when we have Medicare for All. Excellent! Kathleen -- acswift at comcast.net Alice C. Swift Amherst, MA 01002 -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Fri Feb 10 08:41:16 2012 From: don at mccanne.org (Don McCanne) Date: Fri, 10 Feb 2012 05:41:16 -0800 Subject: [Health Care Action] qotd: Insurers shift more out-of-network costs to patients Message-ID: Kaiser Health News February 8, 2012 Consumers Hit By Higher Out-of-Network Medical Costs By Julie Appleby Consumers have long complained about the cost of going outside their health plan's network, but ... Now, instead of paying a percentage of the "usual and customary" charges from physicians and other providers, insurers are basing reimbursements on a percentage of what Medicare pays, which can be much less. "Every carrier is moving to this," says Ken Sperling, global health care practice leader at the benefit consulting firm Aon Hewitt. Many employers welcome the change as a way to slow rising premium increases, but some ?employees are going to get stuck shouldering a significant portion of the bill because they don't understand how it?s done," Sperling says. Consumers are responsible for the difference between what the out-of-network doctor charges and what their insurer pays. But few understand the basis on which plans reimburse, let alone the widely varying prices doctors and hospitals charge. As a result, they may be blindsided by big bills, says Lynn Quincy, senior health policy analyst at Consumers Union. Insurer networks are designed to slow rising health care costs, in part by getting doctors and hospitals who join to agree to negotiated rates, which are generally lower than their usual fees. Because out-of-network hospitals and doctors are not held to negotiated rates, they can set their own fees and "balance bill" patients for the portion insurers don't cover. "One of the most expensive decisions that a customer could make is going out of network," says Alan Muney, chief medical officer at Cigna. Medicare strictly limits how much patients can be balance billed by doctors who don't participate in the program. Benefit consultants, insurers, patient advocates and actuaries say the shift to Medicare rates began after a national database tracking usual and customary charges -- run by UnitedHealthcare subsidiary Ingenix -- was shuttered in 2009 following an investigation by the New York Attorney General, who questioned whether the data were skewed in favor of insurers. While the closure was touted as a consumer win, "unfortunately, it's worse now," says Jennifer Jaff, executive director of Advocacy for Patients with Chronic Illness, a Connecticut-based group that helps file insurance appeals for consumers. "Once New York said you can?t use those (Ingenix figures) anymore, the insurers looked at it as an opportunity to pay even less." http://www.kaiserhealthnews.org/Stories/2012/February/09/consumers-hit-by-higher-out-of-network-medical-costs.aspx Comment: The most effective cost containment tool introduced during the managed care revolution was the ability of insurers to contract for set rates with networks of health care providers, eliminating arbitrarily high rates by those providers, rates that seemed to have no end in sight. Although health plan purchasers benefited by the slowing of the rate of premium increases, the trade-off was that care obtained outside of the networks either required larger out-of-pocket costs, or was not covered at all. A universal single payer system would apply rate controls to all health care no matter where is was obtained. The obvious advantage would be that patients would then have their choice of any and all health care providers. With the current provider networks established by the private insurers, care outside of the networks may not be available because of prohibitive out-of-pocket costs. Networks may not include centers of excellence, specialists with greater expertise of complex problems, an adequate network of primary care physicians, care that is provided by non-network physicians called in during a hospitalization, or care that is accessible within reasonable geographic boundaries. There are many reasons, not always under the control of the patient, as to why care is obtained out of the network. Although the insurer may not provide any coverage for out-of-network care, it is more common to provide coverage that will cost the insurer no more or even less that would be paid to in-network providers. The patient could bear the brunt of the costs when the amount of the allowed charges not covered is higher, but the greater risk is that the patient is responsible for the full amount of charges over the allowed amount since the providers' charges are not bound by a network contract. Those supporting the private insurance industry tout the application of insurer innovations as being one of the great advantages of market solutions. But these are not social institutions that serve the public good. These are private businesses that serve their own interests. The innovations are designed to leverage markets in their favor. This latest innovation is particularly repulsive because it is a new deception that was designed to replace the fraudulent rate-setting perpetrated by Ingenix, a UnitedHealthcare subsidiary. Ingenix and the insurers using them were caught cheating patients by manipulating downward the usual fees charged by out-of-network providers so that they would pay less out-of-network, while the patients had to take up the slack. The insurance industry paid hundreds of millions of dollars in legal settlements and shut down the Ingenix program. Not to be outdone, without fanfare, they replaced the phony usual fee determination for out-of-network care with an allowable fee based on a percentage of Medicare fees. In most cases, this shifts even more of the costs away from the insurers and onto the patients receiving care. So these Ingenix-driven scam artists have shifted to a worse-than-Ingenix system of manipulating prices, but one that will pass legal muster since it's in the fine print of the insurance contract (as an example, on page 108 of the 126 page booklet of the Oxford/UnitedHealthcare plan mentioned in the article). Another newer innovation that compounds the injustice of this scheme is that insurers are increasing the number of limited network plans - smaller networks which increase the probability that patients will be stuck with the much higher costs of out-of-network providers. Also compounding this problem is that the high-deductible plans that flooded the individual market are now being adopted wholesale by employers. Insurers benefit because they can keep their premiums more competitive, even if still outrageous. Employers have complicity with these strategies because they want the lower premiums made possible by protecting the insurers from the costs that are shifted to the patients. Under the Affordable Care Act, we'll continue to see more of these abuses. Employers will continue to shift more payment responsibilities to their employees. Insurers will continue to innovate to bring them the highest return possible using this sick financing system. And the patients will be exposed to ever greater financial hardship. Most employers would prefer not to introduce these innovations that stiff their employees, but the very high cost of private plans almost force them to do so. We should relieve employers of the obligation to sponsor their employees' health plans. Above all, we need to eliminate the industry that uses health care payment innovations to enrich themselves at a great cost to patients. For those who have not yet watched Lawrence O'Donnell's video on employer-sponsored plans and single payer, do it now, and then share it with others: http://www.msnbc.msn.com/id/45755883/vp/46320398#46321122 _______________________________________________ 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 Fri Feb 10 11:45:57 2012 From: calendar at wmjwj.org (=?us-ascii?Q?Workers'_Rights_Calendar?=) Date: Fri, 10 Feb 2012 11:45:57 -0500 Subject: [Health Care Action] Occupy Franklin County events Message-ID: <009501cce813$7984a2e0$6c8de8a0$@org> 1) Tomorrow, on Saturday Feb. 11, at 11:00 am, Occupy Franklin County will conduct a march from Greenfield Commons to the Courthouse to call for the overturning of the Supreme Court decision that removed all restraints on corporate donations to election campaigns. Info: David Cohen, davidjc at comcast.net. 2) "Corporate Personhood vs. Democracy", a talk and dialogue sponsored by Occupy Franklin County, will be held on Monday, February 20, 7pm, at the Greenfield Community College downtown campus, 270 Main Street, Greenfield. John Bonifaz, Co-Director of Free Speech for People , will lead the discussion on what we can do to overturn corporate personhood. Info: David Cohen, davidjc at comcast.net. 3) The Massachusetts Nurses Association at Baystate Franklin Medical Center and at Baystate Visiting Nurses/Hospice are engaged in struggle with Baystate Health to get decent contracts. On Tuesday, Feb. 28 at 10:00 AM, in Springfield, the nurses will stage a protest against Baystate at the grand opening of Baystate's new "Hospital of the Future". There will be a bus going from Greenfield to the demonstration. Info: Charlotte Gordon, chuckagordon at hotmail.com. 4) The next General Assembly will be on Wednesday March 7 (First Wednesday), at 7:00pm at the Second Congregational Church, Court Sq. in Greenfield. Several proposals will be discussed. They are available from David Cohen at davidjc at comcast.net. -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Sat Feb 11 09:06:14 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sat, 11 Feb 2012 09:06:14 -0500 Subject: [Health Care Action] Verizon Leafleting Today Message-ID: <006001cce8c6$55ab2570$01017050$@org> Weather.com predicts no snow or rain during our leafleting hours today, so . see you there? Please let the Store Captains know you are coming: 11am to 1pm: 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. Noon to 2pm: 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-250-5267. 1420 Boston Rd, Springfield : Please let Marty Feid know you are coming: martinfeid at gmail.com, (413) 530-8888. 1123 Riverdale St, West Springfield : Please let Patrick Burke know you are coming: patrick at wmjwj.org, 413-454-5692. And see you Thursday? Thursday February 16! Rally For a Fair Verizon Contract ~ Save 45,000 Good Jobs! 5pm ~ Teamsters Local 404, 115 Progress Avenue, Springfield ~ John Rowley, IBEW Local 2324 Business Manager will report from the bargaining table. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 wmspn at wmjwj.org Sat Feb 11 16:43:15 2012 From: wmspn at wmjwj.org (WMass Single Payer Network) Date: Sat, 11 Feb 2012 16:43:15 -0500 Subject: [Health Care Action] WMSPN 2/25 Message-ID: <019201cce906$2a041d10$7e0c5730$@org> Saturday February 25 (rescheduled from normal Third Saturday in January) WESTERN MASS SINGLE PAYER NETWORK MEETING 9:30-11:30am, Lathrop Village Community Room, 1 Shallowbrook Ln, off Bridge Rd, Northampton. WMSPN is a nonpartisan, nonprofit coalition of organizations and individuals committed to achieving a universal single payer health care system. . Please send agenda items to wmspn at wmjwj.org. . Please email wmspn at wmjwj.org if you are definitely coming or your organization will definitely be represented. Top of the agenda: Winning Massachusetts Medicare for All. Please visit http://masscare.org/ma-single-payer-bill/. Info: (413) 827-0301 x1, wmspn at wmjwj.org. -------------- next part -------------- An HTML attachment was scrubbed... URL: From wmjwj at wmjwj.org Sat Feb 11 18:26:48 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sat, 11 Feb 2012 18:26:48 -0500 Subject: [Health Care Action] Greg Speeter Memorial 3/3; WMJwJ Conference 4/14 Message-ID: <003101cce914$a26b71f0$e74255d0$@org> As you know, Greg Speeter, National Priorities Project founder, died Feb. 2 . Greg was a long-time member, mentor, and good friend of Western Mass. Jobs with Justice and National JwJ. His family has decided to do a memorial at Haydenville Congregational Church at 11am on March 3, with a reception, possibly at the Garden House in Look Park in Northampton. We have decided to change the date for the Western Mass. Jobs with Justice Conference. For various reasons, the next available date is April 14 and the rest of April is not available. Unhappily, that is also the CLPP conference weekend. I talked with the key organizer there and she understands our situation. Thank you for your understanding. Jon Occupy Jobs with Justice! The Western Massachusetts Jobs with Justice Educational, Organizing, & Membership Conference Saturday, April 14, 2012, 10am to 5:15pm (includes lunch) Holyoke Community College ~ Kittredge Center 303 Homestead Avenue, Holyoke (easy off I-91) The conference is in partnership with the Kittredge Center for Business and Workforce Development at Holyoke Community College. Online Registration is required. Go here and follow these steps, ignoring any payment requests: 1. Click the Select One drop down menu. Make a meal choice. 2. Click Add to Cart. 3. Click Proceed to Checkout. 4. Fill in form, including Password (your choice) at Create New Account. 5. Answer Additional Questions (starred ones are required). 6. Fill in Comments if any - if you need simultaneous interpretation in Spanish, write "Spanish". 7. Click Check out. There is no cost to attend this conference. It is fully underwritten by the grants and donations of generous supporters. You are invited to add your donation to theirs, now or at the conference. Please visit http://wmjwj.org/sustaining-western-mass-jobs-justice for more information on donations. Keynote Speaker: Stephanie Luce community/labor educator and activist Associate Professor of Labor Studies, Murphy Institute for Worker Education and Labor Studies, City University of New York Tabling Opportunity for Progressive Organizations (send request to wmjwj at wmjwj.org) Organizing Workshops: Good Green Jobs ~ owned by union members? Health Care Justice ~ Massachusetts Medicare for All Student Labor Action Project Tax the Rich! So Called "Non-Profits" Plenaries: Workshop Report-Backs What is National Jobs with Justice? Labor Organizing + Community Organizing = Jobs with Justice Organizing Economic Literacy For more information: Western Mass. Jobs with Justice 640 Page Boulevard #101, Springfield MA 01104 v (413) 827-0301 wmjwj at wmjwj.org ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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 Mon Feb 13 10:16:15 2012 From: don at mccanne.org (Don McCanne) Date: Mon, 13 Feb 2012 07:16:15 -0800 Subject: [Health Care Action] qotd: Hospitals' charity obligations Message-ID: The New York Times February 12, 2012 Hospitals Flout Charity Aid Law By Nina Bernstein New York?s charity care system, partly financed by an 8.95 percent surcharge on hospital bills, is one of the most complicated in the nation, but many states have wrestled with aggressive debt collection by hospitals in recent years. Like New York, several passed laws curbing hospitals? pursuit of unpaid bills, including Illinois, California and Minnesota. But a new study of New York hospitals? practices and state records finds that most medical centers are violating the rules without consequences, even as the state government ignores glaring problems in the hospitals? own reports. Hospitals are not legally barred from seeking judgments or liens, but must first offer an aid application, help the patient complete it, and wait while it is pending. Instead, many hospitals turn to collection agencies, and sue when that fails. The unpaid bills ? typically reflecting much higher rates than what insurers pay ? are then treated as the equivalent of charity care. Change is now urgent, health care experts agree, because the state pool stands to lose hundreds of millions of federal dollars in 2014, when provisions of the health care overhaul will no longer treat so-called bad debt, based on uncollected bills, as if it were charity care. http://www.nytimes.com/2012/02/13/nyregion/study-finds-new-york-hospitals-flout-charity-rules.html?_r=1&emc=eta1&pagewanted=all Comment: How much charity care should hospitals be expected to provide? Contrary to the prevailing view, the answer should be, "None." Let me explain. With our fragmented, dysfunctional system of financing health care it is inevitable that some individuals will receive essential health care services in hospitals, often on an urgent or emergency basis, even though they lack both the funds and insurance coverage to pay for those services. Charity always has been expected of hospitals, so much so that some even have included "Charity" in their names. The issue became more acute with a differentiation between nonprofit and for-profit hospitals. Nonprofit hospitals were relieved of tax obligations on retained revenues exceeding their costs in exchange for fulfilling their obligation to provide charity care. These retained excesses could then be used for capital improvements, or for charity care. For-profit hospitals, as entrepreneurial entities, are taxed on these retained revenues as profits. As such, they usually are not expected to provide free care as part of their mission to profitably serve the health care needs of the community. Members of Congress have expressed concerns over the fact that many nonprofit hospitals seem to be shirking their responsibilities to provide charitable services. They have been acting more like the for-profit hospitals in that much of their uncompensated care is not for prearranged charitable services but rather represents charges that patients were unable to pay. They then write this off as their charitable obligation, but usually only after vigorous attempts to collect the bills - efforts which often leave those patients in financial ruin forever. It seems ironic that members of Congress pursue an investigation of the charity practices of nonprofit hospitals while paying their respects to market principles by exempting the for-profit hospitals from such an investigation, though it is understandable when you realize that Congress allows tax policy to trump health policy. The fundamental flaw in all of this is our dysfunctional health care financing system. Everyone should have comprehensive health care coverage that pays all appropriate costs. There should never be a situation in which a person would require charity care. This is a fundamental principle common to most other wealthier nations in that their systems are designed to see that everyone receives appropriate care without the necessity of negotiating financial barriers. Services outside of the system, such as vanity cosmetic surgery, would be available based on the ability to pay, but would never require a need for charity. Once again, it's clear that we need to move forward with enacting an efficient, comprehensive, equitable single payer national health program. Why do we keep putting it off when the need is so clear? _______________________________________________ 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 Tue Feb 14 16:17:54 2012 From: don at mccanne.org (Don McCanne) Date: Tue, 14 Feb 2012 13:17:54 -0800 Subject: [Health Care Action] qotd: Vermont adds bronze plan Message-ID: cbsnews.com February 6, 2012 Vt. would allow 'bronze plan' to encourage health Vermont Gov. Peter Shumlin and legislative leaders said Monday they wanted to make it possible for more of the state's small businesses to offer lower premium health insurance plans sometimes known as "bronze plans" until the state can implement its single payer health care system. Speaking Monday in Montpelier, Shumlin and leaders from the House and Senate, all Democrats, said they would also allow businesses with more than 50 employees to remain outside the federally-mandated health care exchange until 2016. "This was a hard decision, a very hard decision because there are people who will not have the opportunity to get into that market and they'll have to wait two years and their employees will have to wait two years as well," (House Speaker Shap Smith) said. http://www.cbsnews.com/8301-505245_162-57372163/vt-would-allow-bronze-plan-to-encourage-health/ Comment: Vermont is providing us with very important lessons on just how difficult it is to set up a single payer program on a state level. The legislation that passed - hailed as the first single payer system in the United States - is primarily an enactment of a state health insurance exchange as called for in the Affordable Care Act, along with future proposals that are not much more than a wish list at this point. When they enacted the insurance exchange, they deliberately eliminated the bronze plan since it has an actuarial value of only 60 percent, which would leave 40 percent of covered health care costs to be paid by the patient out-of-pocket, minus income-related subsidies which are inadequate to prevent financial hardship for many of those with health care needs. They wanted better coverage than that. The problem they faced was that the premiums for the silver and gold plans (70 and 80 percent actuarial values) would be too expensive for many individuals and small businesses in Vermont, thus the trade off of lower premiums for spartan plans. What doesn't appear in this article is that these high-deductible bronze plans are very profitable for insurers, and they certainly would want to maintain and grow this sector of their market. It is likely that the insurers' message to the governor and the legislature was that they couldn't provide silver and gold plans at the level of premium that many businesses could afford, and the insurers likely didn't need to resort to threats of withdrawing from markets. (BlueCross BlueShield of Vermont is the dominant insurer and can write its own ticket, and, though a nonprofit, it still depends on profits.) The governor and the legislature are to be commended for doing their very best to try to bring a single payer system to Vermont, though they are finding many of the barriers to be insurmountable. While they are patching together what they can, they should join our growing movement demanding that Congress enact a national single payer program. That would solve the health care financing problems for all states. _______________________________________________ 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 Feb 14 17:02:14 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 14 Feb 2012 17:02:14 -0500 Subject: [Health Care Action] Verizon Contract Rally 2/16 Message-ID: <021401cceb64$4fe9a170$efbce450$@org> (more info at http://www.jwj.org/verizon/vz_fact_sheet.pdf.) Rally For a Fair Verizon Contract Save 45,000 Good Jobs! Thursday February 16! Rally Thursday February 16! 5:00pm Teamsters Local 404 115 Progress Avenue, Springfield JOHN ROWLEY, IBEW Local 2324 Business Manager will report from the bargaining table. Find out how you can help pressure the company to settle. Verizon, a $100-billion-dollar-a-year company, is making record profits, paying no federal income taxes (getting rebates instead), and trying to ship jobs overseas. Verizon's top 5 executives are in the top one tenth of the 1%. They each make more than 99.9% of american families! Yet Verizon is demanding that its workers, who create its wealth, add to those profits from their own pockets by accepting slashed wages and benefits. When 45,000 Verizon workers struck for two weeks in August, people across the nation joined them. We were all on strike against corporate greed. They're back in bargaining now, but we all need to keep the pressure on the company if we want to keep good quality jobs in America. Info: Verizon Street Heat Committee: Western Mass. Jobs with Justice, (413) 827-0301, wmjwj at wmjwj.org International Brotherhood of Electrical Workers 2324, (413) 734-0863, ibew2324 at verizon.net -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.jpg Type: image/jpeg Size: 11077 bytes Desc: not available URL: From don at mccanne.org Wed Feb 15 14:27:55 2012 From: don at mccanne.org (Don McCanne) Date: Wed, 15 Feb 2012 11:27:55 -0800 Subject: [Health Care Action] qotd: Explaining regional variation in private health care spending Message-ID: National Institute for Health Care Reform February 15, 2012 Health Status and Hospital Prices Key to Regional Variation in Private Spending Research Brief by Chapin White Differences in health status explain much of the regional variation in spending for privately insured people, but differences in provider prices ? especially for hospital care ? also play a key role, according to a new study by the Center for Studying Health System Change (HSC) for the nonpartisan, nonprofit National Institute for Health Care Reform (NIHCR). Based on claims data for 218,000 active and retired nonelderly unionized autoworkers and their dependents, the study found that health spending per enrollee in 2009 varied widely across 19 communities with large concentrations of autoworkers, from a low of $4,500 in Buffalo, N.Y., to a high of $9,000 in Lake County, Ill. The autoworkers? health benefits are essentially uniform nationally, so spending differences do not reflect benefit differences. Differences in service quantities accounted for two-thirds of the overall spending variation, while differences in prices accounted for one-third, according to the study. On the quantity side, differences in health status and other demographic factors explained most, but not all, of the variation in quantity. About 18 percent of the total variation in spending was a result of unexplained differences in service quantities. On the price side, the cost of doing business explained very little of the price differences, with almost all of the differences in prices unexplained, the study found. http://www.nihcr.org/news_Spending_Variation.html >From the Research Brief: Sources of health care spending variation across autoworker communities, 2009 Differences in spending due to quantities 37% - Differences in health status 10% - Differences in age and sex 18% - Differences in quantities (excess) Differences in spending due to prices 2% - Differences in providers' cost of doing business 33% - Differences in prices (excess) Comparing Private Prices to Medicare Physician office visits. The prices paid by the autoworker plan for physician office visits, on average, are only 3 percent higher than what Medicare would have paid for the same services. Hospital inpatient care. The prices for inpatient hospital care paid by the autoworker plan are, on average, 55 percent higher than what Medicare would pay, and the price gap varies widely across communities. Hospital emergency department care. The prices paid by the autoworker plan for hospital emergency department care are, on average, more than double the Medicare price, and the price gap varies even more widely across communities than for inpatient care. Research Brief http://www.nihcr.org/Spending_Variation.html PDF version http://www.nihcr.org/Spending_Variation.pdf Comment: Policy wonks likely will download this Research Brief since it will prove to be a landmark study explaining the wide variation in spending amongst privately insured patients - very useful information when designing policies to improve our health care financing. We already have several landmark studies demonstrating the wide variations in quantity of services and in pricing of those services - both factors in determining the variations in health care spending. What has not been so clear is whether the quantities vary based on the health status of the patients or based simply on variations in intensity amongst populations of comparable health (i.e., providing excess services to drive up revenues, though deficient services when system capacity is inadequate is an important but separate concern). What also has not been so clear is whether price differences are primarily due to differences in costs of health system resources, or simply due to charging higher prices where private insurer market control is weaker. This study provides very convincing data to explain the differences. Look at the percentage differences listed above. Health status (37%) and age and sex (10%) explain almost half (47%) of the differences in spending. These are entirely appropriate differences and do not require policy intervention. The 18% that is not otherwise explained may well be excess quantity of services that perhaps could be moderated by judicious application of health policy. But let's not kid ourselves. Those who suggest that, based on the Dartmouth studies, close to 100% of the difference in quantity of services is excessive tend to support policies that would come as close as possible to eliminating the differences. Since this study shows that the excess quantity is only about 18% of the difference in spending (only slightly over one-fourth of the increased quantity in higher spending areas), it would be very difficult to design policies that would tease out this modest amount while leaving in place the other services that are clearly beneficial. That doesn't mean that efforts shouldn't be made to do so, but it does mean that great care must be taken to be certain that people still receive the services that they should have - a much more important priority than budget trimming. Excessive prices (33%) appear to account for most of the differences in prices for services since differences in the providers' costs of doing business account for a mere 2% of spending differences. Most of this excess pricing is found in hospitals and in their emergency departments. This finding screams out for a better method of controlling prices. All other wealthier nations use some form of government pricing to eliminate these excesses. We should too. Uwe Reinhardt has provided convincing evidence that an all-payer system, such as the hospital price-setting system in Maryland, would capture much of this excess in pricing. That is true, though it would be more difficult for an all-payer system to address the problem of excess quantity. Our objection to all-payer systems is that they address only this one issue and leave out the many other advantages of a single payer national health program. When we have a solution that would fix so many problems at once let's go with that. -------------- 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 Thu Feb 16 08:53:02 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Thu, 16 Feb 2012 08:53:02 -0500 Subject: [Health Care Action] Verizon Action This Week & Next Message-ID: <004401ccecb2$4d830df0$e88929d0$@org> Fighting Corporate Greed is as easy as (1) (2) (3) (1) Today February 16! Rally For a Fair Verizon Contract ~ Save 45,000 Good Jobs! 5pm ~ Teamsters Local 404, 115 Progress Avenue, Springfield ~ John Rowley, IBEW Local 2324 Business Manager will report from the bargaining table. Please park in the lot just south of the building (keep going to the driveway). (2) LEAFLET & STAND-OUT AT VERIZON WIRELESS STORES: Pick a Saturday ~ February 18 and/or 25 Pick an ?Hour of Power? between Noon & 2pm (11am & 1pm in Pittsfield) Pick a VzW Store: Hadley / Pittsfield / Springfield / West Springfield And click here . Or let the Store Captains know you are coming Saturday: 11am to 1pm: 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. Noon to 2pm: 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-250-5267. 1420 Boston Rd, Springfield : Please let Marty Feid know you are coming: martinfeid at gmail.com, (413) 530-8888. 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). (3) DO IT YOURSELF DELEGATIONS TO VERIZON WIRELESS STORES: We have a letter from community leaders across the nation, including Western Mass., asking Verizon to respect workers? rights. Will you deliver it to a local store manager? Here?s how you do it! ? Talk to a couple of friends, neighbors, relatives, coworkers, or members to see who?s in. Any size delegation is fine. ? Pick any time and store that your delegation wants to visit. See the Western Mass. list above. ? Go to http://www.massjwj.net/news/help-show-community-support-verizon-workers to download the letter and directions. Or get them by email from wmjwj at wmjwj.org. ? Read the directions. ? There?s room on the letter to add your names if you want. ? Visit the store and ask to speak with the manager. Deliver the letter, explaining that you are part of a national movement of people who want respect for Verizon workers. ? Afterward, tell Jon at WMass Jobs with Justice (jon at wmjwj.org) how it went. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: image001.png Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Thu Feb 16 12:56:46 2012 From: don at mccanne.org (Don McCanne) Date: Thu, 16 Feb 2012 09:56:46 -0800 Subject: [Health Care Action] qotd: Archer and Marmor on Medicare versus commercial insurance Message-ID: Health Affairs Blog February 15, 2012 Medicare And Commercial Health Insurance: The Fundamental Difference By Diane Archer and Theodore Marmor As the debate over Medicare continues in connection to America?s fiscal problems, it is critical to understand how Medicare differs from commercial health insurance for working people. There is a fundamental difference between these two types of health insurance plans, one social and one commercial. The basic difference between Medicare and commercial insurance is that Medicare is designed to absorb risk, serving individuals who have or may have costly and complex medical needs as well as the relatively healthy, whereas commercial insurance is required to protect its business interests by avoiding those most likely to use medical care. **** But nothing can change the underlying reality that programs like Medicare are designed to absorb and broadly distribute risk, protecting everyone, while commercial insurers are designed to select and protect individuals with the fewest needs. The belief that competition among private health insurance firms can produce cost savings or higher quality care represents the victory of illusion over evidence. We need to let the existing Medicare system do what it already does effectively: insulate Americans from risk, rather than shift risk to the most vulnerable citizens. http://healthaffairs.org/blog/2012/02/15/medicare-and-commercial-health-insurance-the-fundamental-difference/comment-page-1/#comment-165108 Comment: The fundamental difference between Medicare and commercial health insurance is very basic and easy to understand. Medicare is "designed to absorb and broadly distribute risk, protecting everyone, while commercial insurers are designed to select and protect individuals with the fewest needs." The explanation of this difference in this Health Affairs Blog entry by Diane Archer and Theodore Marmor should make us question once again why Congress and President Obama chose commercial insurers as the foundation for the Affordable Care Act when what we clearly needed was a universal public program based on improved version of Medicare. You should read their fairly brief blog entry and then read the replies posted first by Vince Kuraitis and then by Don McCanne. They exemplify the differences between the commercial approach to insurance and the social function of Medicare. It's really an easy concept to grasp: Commercial - "Of or relating to commerce, having profit as a chief aim" Social - "Of, relating to, or occupied with matters affecting human welfare" Addendum: Since the reply submitted by Don McCanne has not yet been posted on the blog website, both the Kuraitis reply and McCanne reply are reproduced here. Vince Kuraitis says: You (Archer and Marmor) make a sweeping statement: No matter what regulations are instituted in an attempt to guarantee their good behavior, commercial insurers will still have an incentive to avoid risk, and they will do so insofar as it is possible. An equally sweeping rebuttal: this problem is entirely fixable by risk adjusting ? paying higher premiums for members that are less healthy. Medicare has already started doing this with Medicare Advantage plans. Of course, the devil is in the details?and in a debate we?d probably come out in the middle somewhere. Risk adjustment is easier to conceptualize than to do accurately. ?but I think your broad, blunt assertion needs to be challenged. Don McCanne says: Vince Kuraitis writes that the authors' statement on incentives for commercial insurers needs to be challenged. It is Mr. Kuraitis' challenge that needs to be challenged since the authors' statement is quite correct. Commercial insurers do have incentives to avoid risk, and, if subjected to risk adjustment, they have incentives to game the system. This is not suggesting illegal activity. It merely represents "appropriate" commercial activity - activities that are rewarded on Wall Street. Risk adjustment already takes place in the Medicare Advantage program. An NBER study (Working Paper No. 16977, April 2011) revealed that the Medicare Advantage plans were able to further increase their own advantage and transfer more resources from the relatively sick in the traditional program to the relatively healthy within their plans. Quoting from the NBER report, "With social insurance programs, however, imperfect pricing can induce private firms to cream-skim, exacerbating the utility consequences of the underlying inequality the program was initially intended to mitigate. At least in the case of Medicare, we find little evidence that risk adjustment has solved this problem." And from the NBER Digest, "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." Archer and Marmor are precisely correct: "No matter what regulations are instituted in an attempt to guarantee their good behavior, commercial insurers will still have an incentive to avoid risk, and they will do so insofar as it is possible." That is the nature of the commercial approach to insurance, which is in sharp contrast to the social function of the traditional Medicare program. -------------- 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 Feb 17 15:42:27 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Fri, 17 Feb 2012 15:42:27 -0500 Subject: [Health Care Action] Say NO to Baystate Health's Union Busting 2/20 & 28 Message-ID: <00cd01ccedb4$a9d97a00$fd8c6e00$@org> From: Leo Maley LMaley at mnarn.org Say NO to Baystate Health's Union Busting on Presidents? Day . . . and again on Feb. 28. The Massachusetts Nurses Association/National Nurses United (MNA/NNU), a union of 23,000 Registered Nurses and health care professionals, represents the Registered Nurses at two Baystate Health System facilities ? the nurses at the Baystate Visiting Nurse Association & Hospice (BVNAH) in Springfield and at the Baystate Franklin Medical Center in Greenfield. Both groups of nurses are currently in contract negotiations with Baystate for new labor contracts. Baystate has hired the notorious union-busting law firm of Jackson Lewis in the form of Howard Bloom in an attempt to bust the nurses? unions. At the BVNAH negotiations, Baystate management has taken the position of basically denying any collective bargaining rights for health insurance and attendance policy, among other serious concessions. This is an outright attempt to destroy the union at BVNAH which has been there for decades. This week BVNAH management declared ?impasse? and unilaterally implemented their last offer! The MNA will be filing an Unfair Labor Practice charge with the National Labor Relations Board and is pursuing other more public avenues to defend the basic human right of collective bargaining and to insure that union nurses are treated with the respect they deserve. The most immediate response to this attack on labor involves an action plan with the following events ? to which YOU are invited. First: On Presidents? Day, Monday, February 20, the MNA will be leafleting multiple Balise Auto locations. Steven M. Mitus is Executive Vice President and Chief Financial Officer of Balise Motor Sales. He has also a member of the Baystate Health Board of Trustees since 2008. We will not be engaging in a secondary boycott, but just advising the public of his role in these negotiations. We will be leafleting on Monday, February 20 at 10:00 AM. If you would like to join us, we will be meeting at 9:45 AM at the IHOP at 640 Riverdale St, West Springfield MA. What better way to celebrate Presidents Day! (Other Trustee events will follow.) ?If any man tells you he loves America, yet hates labor, he is a liar. If any man tells you he trusts America, yet fears labor, he is a fool.? ? Abraham Lincoln Second: On Tuesday, February 28 at 10:00 AM Baystate will be dedicating their new $252 million ?Hospital of the Future? on Springfield St. in Springfield. The MNA will be picketing that event. The MNA applauds the fact that the hospital was built in part with Union Labor through Project Labor Agreements. However, Baystate is seeking to destroy the Unions representing the nurses that work in its facilities. We ask all of the Massachusetts labor community to join the nurses on Feb. 28 in defending their contract. The theme is "Occupy Baystate - Respect Union Nurses!" ?We want the community to understand that we are very serious about retaining our union rights, as those rights are key to providing nurses the ability to advocate for better working conditions and safer patient care. We are not out to embarrass Baystate, but we plan to be very creative in getting the message across that Baystate made $61 million in the last fiscal year and is spending hundreds of millions of dollars on bricks and mortar while attacking the caregivers who have the greatest impact on your health and safety when you are most vulnerable, whether it?s in the hospital or in your home.? -- Donna Stern, RN, Baystate Franklin Medical Center MNA Co-Chair For more information about Baystate?s anti-union labor practices, call Joe Twarog at 781-571-9959. To reserve a place on a bus from Greenfield or Northampton for the February 28 Springfield action, contact Leo Maley at LMaley at mnarn.org or 781-520-1483. -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Fri Feb 17 17:03:29 2012 From: don at mccanne.org (Don McCanne) Date: Fri, 17 Feb 2012 14:03:29 -0800 Subject: [Health Care Action] qotd: ACA Sec. 1104 - Administrative Simplification Message-ID: Deloitte Administrative Simplification >From compliance to competitive advantage Administrative Simplification, part of the Patient Protection and Affordable Care Act of 2010 (ACA) signed into law on March 23, 2010, has an overarching goal of streamlining administrative interactions between health plans and providers to improve the patient experience and reduce costs throughout the health care system. Administrative Simplification provisions build on the electronic standards first defined in 1996 with HIPAA 4010 and accelerated in 2009 with passage of HIPAA 5010. While HIPAA addresses the technical structure of transactions, Administrative Simplification addresses how they are used. Goals: ? Standardized business and operating rules to eliminate variability in transaction implementation, moving the industry toward commoditization of ?back-end? transaction processing ? Standardized benefit coverage information to drive consistency of eligibility content, enabling providers to better understand financial liability ? Provision of patient financial liability at or before the point of care, enabling providers to improve the collections process ? Real-time electronic auto-adjudication and claims status, providing for automated reconciliation ? Automation of health plan utilization management and care management decision processes required to support real-time referrals and pre-authorizations Key dates and scope: ? Wave 1 (January 1, 2013): Automation of point-of-care eligibility and claims status ? Wave 2 (January 1, 2014): Automation of claims payment remittance advice and electronic funds transfer ? Wave 3 (January 1, 2016): Automation of claims and encounters, enrollment/disenrollment, referral authorization, premium payments, and claim attachments Deloitte - Administrative Simplification: http://www.deloitte.com/assets/Dcom-UnitedStates/Local%20Assets/Documents/us_lshc_AdministrativeSimplification_021612.pdf CMS - Administrative Simplification Provisions in the Patient Protection and Affordable Care Act of 2010 (ACA) (6 page pdf): https://www.cms.gov/Affordable-Care-Act/Downloads/Summary%20of%20ACA%20provisions%20for%20Administrative%20Simplification.pdf Comment: It has long been recognized that profound administrative waste is a unique feature of the U.S. health care system - waste that contributes to our unparalleled, sky-high health care spending. During the reform process, the subject of administrative waste was brought up repeatedly. In response, Congress included in the Affordable Care Act "Sec. 1104 Administrative Simplification." What is that? You can read either Sec. 1104 in ACA, or, better, you can read the six page summary by CMS (link above). However, easiest would be to read the excerpts above from the Deloitte report on Administrative Simplification. There is enough there to let you know what it is. It will not take long for people who understand the administrative advantages of the single payer model to realize that Sec. 1104 has nothing to do with the administrative waste that is a result of our highly fragmented, dysfunctional health care financing infrastructure. Sec. 1104 is primarily revising the information technology systems of the insurers and then requiring the providers to become compliant. An idea of what Sec. 1104 is really about can be gleaned from Deloitte's discussion of a revolutionary scenario for administrative simplification: "This scenario assumes that all stakeholders adopt real-time, end-to-end transaction processing, and that product standardization emerges. Implementation costs would be significant for both health plans and providers. Commercial health plans, in particular, would face a new strategic reality as claims transactions become a commodity, and health plan differentiation shifts to other areas, such as provider network and member experience. Such revolutionary change is possible if existing industry players and/or new entrants look for innovative ways to capitalize on market opportunities to affect health care cost and quality and make meaningful improvements to our health care system." Do not be misled when ACA supporters talk about "administrative simplification." That's their code language for "commoditization" and "innovative ways to capitalize on market opportunities." "Administrative simplification" is another term that they have stolen from the single payer community, and then bastardized it. Don't let them get away with it. That's our policy science. -------------- 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 Feb 21 14:37:46 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 21 Feb 2012 14:37:46 -0500 Subject: [Health Care Action] Baystate vs. Nurses' bargaining rights - picket! 2/28 Message-ID: <07b801ccf0d0$4d6bb570$e8432050$@org> Will You Stand Up Against the Baystate Bully & For the Right to Collective Bargaining? Baystate Health is dedicating its new $251 million "Hospital of the Future" on Springfield Street, Springfield on Tuesday, February 28. The Massachusetts Nurses Association/National Nurses United (AFL-CIO) and allies will picket this high-profile event beginning at 9:00 AM. See the background below. There's a bus from Greenfield and Northampton for the action. To reserve a seat, contact Leo Maley at LMaley at mnarn.org or 781-520-1483. The 58 nurses at Baystate Visiting Nurse Association & Hospice (BVNAH) in Springfield have been negotiating for a new labor contract for over a year. The 210 nurses at Baystate Franklin Medical Center (BFMC) in Greenfield are also in the midst of bargaining. One of the largest health systems in New England, Baystate Health is a mix of "non-profit" and for-profit operations that include an academic medical center, a children's hospital, two community hospitals, visiting nurses and home care agencies, medical practices, a health insurance company (Health New England), an ambulance company, and a "captive insurance company" in the Cayman Islands! Baystate employs about 10,000 (the largest private employer in this region), takes in about $1.5 billion, and paid CEO Mark Tolosky (the second highest paid health care CEO in New England) $1.9 million in 2010. This corporate behemoth is an octopus with tentacles into all aspects of our society. It must think that bullying workers is ok behavior. Baystate has hired the notorious union-busting law firm of Jackson Lewis in the form of Howard Bloom in an attempt to bust the two groups of union nurses they bargain with. Its Director of Employee Relations, Jo-Ann Davis, is also a lawyer affiliated with another well-known union-buster, Skoler, Abbott & Presser (SAP) in downtown Springfield. More information about law firms like JL and SAP is here . Video here . At BVNAH, Baystate has put proposals on the bargaining table to take away collective bargaining rights on health insurance and attendance policy (it just recently backed down on a similar proposal on wages). Unions are guaranteed collective bargaining by the National Labor Relations Act. The Baystate nurses, members of the Massachusetts Nurses Association/National Nurses United (AFL-CIO), will not give up collective bargaining on any aspect of wages, hours, and working conditions. So on February 16, Baystate declared "impasse." Declaring impasse says, "We're done bargaining!" It is a declaration of war in the workplace. It is unacceptable behavior in a Union City like Springfield. Springfield City Council was one of the first to endorse the Union Cities Program in 1995 (see also http://prospect.org/article/union-cities) and has regularly reaffirmed its support for workers' rights, including collective bargaining. As a legal term, impasse means the parties have reached a point at which further bargaining would be futile. The National Labor Relations Board is empowered to determine if that is true, if the impasse is real. One question is, Did Baystate really negotiate in good faith, demonstrating a real desire to reach agreement? The union has filed charges that it did not. Certainly, demanding that the union give up future bargaining over health insurance and attendance policy does not demonstrate a real desire to reach agreement. If an impasse is legal, federal law allows "implementation", that is, the employer may implement some or all of its contract proposals. This is one of many aspects of federal law that stack the deck against workers, based on the premise that the employer has the right to squeeze profit out of its employees. At this point, the law ignores the role of the employer in creating the impasse. The law does not maintain the previous contract which both parties previously agreed upon. The employer is allowed to pick and chose what it wants to implement and can even ignore those proposals that both parties agreed on during bargaining sessions. In other words, "implementation" gives the employer more favorable terms than does collective bargaining. We are waiting to see what Baystate will implement. In October 2007, Baystate completely shut down the Greenfield office of Baystate VNA and Hospice rather than continue to bargain a first contract with the Nurses. It has generally behaved as an anti-union corporate bully towards its employees (see http://wmjwj.org/sites/wmjwj.org/files/BFMC%20WRB.pdf). For more information about Baystate's anti-union labor practices, call Joe Twarog at 781-571-9959. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: image002.png Type: image/png Size: 7218 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image003.jpg Type: image/jpeg Size: 19500 bytes Desc: not available URL: From don at mccanne.org Tue Feb 21 14:29:37 2012 From: don at mccanne.org (Don McCanne) Date: Tue, 21 Feb 2012 11:29:37 -0800 Subject: [Health Care Action] qotd: Timothy Jost - Update on essential health benefits Message-ID: Health Affairs Blog February 18, 2012 Implementing Health Reform: Essential Health Benefits And Medical Loss Ratios By Timothy Jost On December 16, 2011, the Department of Health and Human Services issued a bulletin describing the approach that it intended to take to defining the essential health benefits (EHB) that individual (nongroup) and small group plans must cover under the Affordable Care Act. The EHB bulletin raised a host of questions as to how this approach would work. On February 17, 2012, HHS issued guidance in the form of an FAQ (frequently asked questions) addressing some of these questions. This post will discuss this FAQ. Summing up: The FAQ do go some distance toward clarifying a number of the issues left open by the initial bulletin, in particular how plan flexibility will (and will not) work, that states will not establish a new EHB every year, and that a state?s commercial plan EHB need not apply to Medicaid. The approach selected by HHS will allow states to maintain their coverage mandates (or at least those that apply to the small group market) until 2016, but will preclude the addition of new mandates. It is still hard to imagine how this is all going to work out in practice, however, and more to the point how plan compliance will ever be monitored, given the ability of plans to substitute services within categories. One must wonder whether in the end it might not have been more straightforward simply to come up with a federal menu of services. http://healthaffairs.org/blog/2012/02/18/implementing-health-reform-essential-health-benefits-and-medical-loss-ratios/ CMS - FAQs on essential health benefits: http://cciio.cms.gov/resources/files/Files2/02172012/ehb-faq-508.pdf Comment: Being the fine gentleman he is, Professor Jost politely states, "One must wonder whether in the end it might not have been more straightforward simply to come up with a federal menu of services." You don't have to wonder. Not only should we have a national standard calling for comprehensive benefits for everyone, we also should have simplified the financing system to make it more equitable and much more efficient so that health care would be accessible and affordable 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 wmspn at wmjwj.org Tue Feb 21 21:43:47 2012 From: wmspn at wmjwj.org (WMass Single Payer Network) Date: Tue, 21 Feb 2012 21:43:47 -0500 Subject: [Health Care Action] Upcoming Events Message-ID: <09ed01ccf10b$cd7a4b60$686ee220$@org> Wednesday February 22 (Fourth Wednesday) MASS SENIOR ACTION COUNCIL ? WESTERN MASS 1:30-3pm, Hobby Club, 309 Chestnut St (enter off Franklin off Liberty; behind YMCA), Springfield (739-4874). Light refreshments, 50/50 raffle. MSAC was founded in 1981 to promote the rights, well being, and dignity of all people, particularly vulnerable senior citizens. Open to people of all ages. MSAC has a proud history of effective community organizing and legislative advocacy on health care, housing, transportation, and other issues. Info: 543-2334, lstone at masssenioraction.org, www.masssenioraction.org. Saturday February 25 (normally Third Saturday in January, April, and September) WESTERN MASS SINGLE PAYER NETWORK 9:30-Noon, Lathrop Village Community Room, 1 Shallowbrook Ln, off Bridge Rd, Northampton. WMSPN is a nonpartisan, nonprofit coalition of organizations and individuals committed to achieving a universal single payer health care system. Top agenda item: Winning Massachusetts Medicare for All. Please visit http://masscare.org/ma-single-payer-bill/. ? Please send agenda items to wmspn at wmjwj.org. ? Please email wmspn at wmjwj.org if you are definitely coming or your organization will definitely be represented. Info: (413) 827-0301 x1, wmspn at wmjwj.org. Tuesday February 28 STAND UP AGAINST THE BAYSTATE BULLY & FOR THE RIGHT TO COLLECTIVE BARGAINING 9am, Springfield Street, Springfield . The Massachusetts Nurses Association/National Nurses United (AFL-CIO) and allies will picket the high-profile dedication of the new $251 million ?Hospital of the Future? because Baystate Health is trying to bully Nurses at Baystate Visiting Nurse Association & Hospice (BVNAH) into accepting a contract that takes away collective bargaining over health insurance and attendance policy. There?s a bus from Greenfield and Northampton for the action. To reserve a seat, contact Leo Maley at LMaley at mnarn.org or 781-520-1483. Info: Joe Twarog, 781-571-9959. Friday March 2 WORK & FAMILY ISSUES WEBINAR 2pm, online. Please join the Labor Project for Working Families and Family Values @ Work for a webinar on campaigns that are winning and gaining momentum: ? Issues that value working families: paid sick days, paid family leave, and other family-friendly policies. ? Paid Sick Days Campaigns: where they are and why they are winning. ? Recent polling and research data that supports this work. Please register here for this webinar! Thursday March 15 MASSACHUSETTS JOBS WITH JUSTICE 20TH ANNIVERSARY DINNER Boston. Info: http://www.massjwj.net/events/jwj-annual-dinner. Saturday April 14 ANNUAL WESTERN MASS. JOBS WITH JUSTICE ORGANIZING CONFERENCE Holyoke Community College. Online Registration is required. Go here and follow these steps, ignoring any payment requests: 1. Click the Select One drop down menu. Make a meal choice. 2. Click Add to Cart. 3. Click Proceed to Checkout. 4. Fill in form, including Password (your choice) at Create New Account. 5. Answer Additional Questions (starred ones are required). 6. Fill in Comments if any ? if you need simultaneous interpretation in Spanish, write ?Spanish?. 7. Click Check out. cid:image001.png at 01CBF21B.01158F20 -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image001.png Type: image/png Size: 7218 bytes Desc: not available URL: From calendar at wmjwj.org Wed Feb 22 10:30:33 2012 From: calendar at wmjwj.org (=?us-ascii?Q?Workers'_Rights_Calendar?=) Date: Wed, 22 Feb 2012 10:30:33 -0500 Subject: [Health Care Action] CORRECTION: MSAC meeting Feb. 29 Message-ID: <007d01ccf176$ebedffe0$c3c9ffa0$@org> From: Linda Stone lstone at masssenioraction.org PLEASE NOTE: 5TH WED. THIS MONTH ONLY! CALL TO ACTION!! Wed., Feb. 29, 1 p.m. at the Springfield Hobby Club 309 Chestnut St (enter off Franklin off Liberty; behind YMCA), Springfield (739-4874) SPEAK OUT ON PVTA FARE INCREASES Help decide on a course of ACTION for MSAC's Greater Springfield Chapter re. fare hikes AND: * Preventing more state budget cuts to vital services * Making affordable housing more available * Guaranteeing home care to all who qualify * Reducing the cost of health care, incl. prescription drugs Come for lunch* and stay for the discussion! *RSVP if you plan to have lunch: Linda Stone Western MA Organizer Massachusetts Senior Action Council 413-543-2334 www.masssenioraction.org -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Wed Feb 22 15:05:45 2012 From: don at mccanne.org (Don McCanne) Date: Wed, 22 Feb 2012 12:05:45 -0800 Subject: [Health Care Action] qotd: 17% of low-wage workers will remain uninsured under ACA Message-ID: Center for Economic and Policy Research February 2012 Health-insurance Coverage for Low-wage Workers, 1979-2010 and Beyond By John Schmitt In 2010, over 38 percent of low-wage workers lacked health insurance from any source, up from 16 percent in 1979. Coverage problems are particularly severe for Latino workers. Almost 40 percent of all Latino workers (not just low-wage workers) have no health insurance of any form. African American (about 22 percent) and Asian (about 17 percent) workers are also much less likely to have coverage than white workers (about 12 percent). Affordable Care Act of 2010 For simplicity, if we assume that all adults ? workers and non-workers ? have the same coverage rate, then under CBO?s projections, workers as a group would have a 5.8 percent non-coverage rate after the ACA. By comparison, in 2010, the actual non-coverage rate for all workers was about 17.7 percent. The CBO gives no guidance about how the coverage improvements for workers would be divided across the wage distribution. If, at the extreme, we assume that all of the uncovered workers are low-wage workers by our definition ? that is that all 5.8 percent of workers remaining without coverage are in the bottom quintile ? then the non-coverage rate for low-wage workers would be about 29.0 percent. This would be a reduction of one-fourth in the share of low-wage workers without coverage relative to the actual non-coverage rate for low-wage workers in 2010 (38.5 percent). A less extreme assumption about the distribution of non-coverage rates by wage level after the ACA would produce larger gains for low-wage workers. For example, if instead we assume that the top 80 percent of workers have a frictional 3 percent non-coverage rate, then an overall non-coverage rate for workers of 5.8 percent implies a 17.0 percent non-coverage rate for low-wage workers, well short of universal coverage, but a non-coverage rate that is less than half of the current rate. The ACA will not produce universal coverage for low-wage workers. But, if the ACA is not enacted ? due to judicial or legislative action ? every indication is that coverage rates will continue their three-decades-long decline. http://www.cepr.net/documents/publications/health-low-wage-2012-02.pdf Comment: Conservatives who oppose health care reform often argue that being uninsured is a consequence of the individual's own personal irresponsibility. Those individuals merely need to shape up and go out and get a job, and then they would have health insurance. The conservatives lose their credibility on this point when the actual data show that 38 percent of low-wage workers, who do go out and get a job, lack health insurance from any source. Because of such deficiencies in our system reform advocates were able to muster the political support to pass the Affordable Care Act - a half-glass reform. Those who view this as a glass half full celebrate the fact that over half of these uninsured workers will become insured under ACA. The advocates of reform who view this as a glass half empty bemoan the fact that ACA will still leave about 17 percent of low-wage workers without insurance. The diversionary half full, half empty debate is particularly tragic when you consider that a single payer national health program would have brought us a full glass. The addendum below is from this same report. It is added because it explains the roots of the decline in coverage rates - an important concept indicating that our battle for health care justice is only a part of the offensive that must take place to expedite social justice throughout the United States. ADDENDUM The decline in coverage rates has its roots in two long-standing economic processes. The first is the rising cost of health care, which has squeezed workers? wages and made it less economical for firms to offer health insurance, especially to low-wage workers. In the absence of reforms to the existing health-care system, these costs ? and implicitly the pressure on workers? after-health-insurance compensation ? are projected to continue rising indefinitely. The other force behind falling coverage rates, especially for low-wage workers, is the decline over the last three decades in the bargaining power of most workers. Beginning in the late 1970s, a set of structural changes in the economy has significantly reduced the bargaining power of workers, especially those at the middle and the bottom of the wage distribution. These structural changes include: a steep decline in unionization; an erosion in the inflation-adjusted value of the minimum wage; the deregulation of many historically high-wage industries (trucking, airlines, telecommunications, and others); the privatization of many state and local government functions (from school cafeteria workers to public-assistance administrators); the opening up of the U.S. economy to much higher volumes of foreign trade; a sharp rise in the share of immigrant workers, who often lack basic legal rights and operate in an economy that provides few labor protections regardless of citizenship; and a macroeconomic policy environment that has typically maintained the unemployment rate well above levels consistent with full employment. All of these changes have acted to reduce the bargaining power of workers, especially those at the middle and bottom of the wage distribution. As a result, workers as a group have seen their relative (and even absolute) wages fall and the availability and quality of health-insurance and retirement plans decline. -------------- 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 Thu Feb 23 15:02:06 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Thu, 23 Feb 2012 15:02:06 -0500 Subject: [Health Care Action] Verizon+Nurses Action This Week & Next Message-ID: <006601ccf266$06783930$1368ab90$@org> Fighting Corporate Greed is as easy as (1) (2) (3) (1) LEAFLET & STAND-OUT AT VERIZON WIRELESS STORES: Pick a Saturday ~ February 25 and/or March 3 Pick an ?Hour of Power? between Noon & 2pm (11am & 1pm in Pittsfield) Pick a VzW Store: Hadley / Pittsfield / Springfield / West Springfield And click here . Or let the Store Captains know you are coming Saturday: 11am to 1pm: 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. Noon to 2pm: 360 Russell St, Hadley : Please let Jon Weissman know you are coming: jon at wmjwj.org, 413-250-5267. 1420 Boston Rd, Springfield : Please let Marty Feid know you are coming: martinfeid at gmail.com, (413) 530-8888. 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). (2) PICKET WITH THE NURSES AT BAYSTATE MEDICAL CENTER: Springfield Street, Springfield on Tuesday February 28, beginning at 9:00am. There?s a bus from Greenfield and Northampton for the action. To reserve a seat, contact Leo Maley at LMaley at mnarn.org or 781-520-1483. For more information, call Joe Twarog at 781-571-9959, jtwarog at mnarn.org. (3) DO IT YOURSELF DELEGATIONS TO VERIZON WIRELESS STORES: We have a letter from community leaders across the nation, including Western Mass., asking Verizon to respect workers? rights. Will you deliver it to a local store manager? Here?s how you do it! ? Talk to a couple of friends, neighbors, relatives, coworkers, or members to see who?s in. Any size delegation is fine. ? Pick any time and store that your delegation wants to visit. See the Western Mass. list above. ? Go to http://www.massjwj.net/news/help-show-community-support-verizon-workers to download the letter and directions. Or get them by email from wmjwj at wmjwj.org. ? Read the directions. ? There?s room on the letter to add your names if you want. ? Visit the store and ask to speak with the manager. Deliver the letter, explaining that you are part of a national movement of people who want respect for Verizon workers. ? Afterward, tell Jon at WMass Jobs with Justice (jon at wmjwj.org) how it went. SAVE THE DATES Thursday March 15 MASSACHUSETTS JOBS WITH JUSTICE 20TH ANNIVERSARY DINNER Boston. Info: http://www.massjwj.net/events/jwj-annual-dinner. Saturday April 14 ANNUAL WESTERN MASS. JOBS WITH JUSTICE ORGANIZING CONFERENCE Holyoke Community College. Online Registration is required. Go here and follow these steps, ignoring any payment requests: 1. Click the Select One drop down menu. Make a meal choice. 2. Click Add to Cart. 3. Click Proceed to Checkout. 4. Fill in form, including Password (your choice) at Create New Account. 5. Answer Additional Questions (starred ones are required). 6. Fill in Comments if any ? if you need simultaneous interpretation in Spanish, write ?Spanish?. 7. Click Check out. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: image001.png Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Thu Feb 23 16:20:59 2012 From: don at mccanne.org (Don McCanne) Date: Thu, 23 Feb 2012 13:20:59 -0800 Subject: [Health Care Action] qotd: Premium increases portend an ominous future under ACA Message-ID: Los Angeles Times February 23, 2012 California health insurers to raise average rates 8% to 14% By Chad Terhune California's largest health insurers are raising average rates by about 8% to 14% for hundreds of thousands of consumers with individual coverage, outpacing the costs of overall medical care. Anthem has proposed raising premiums 9.6% to 13.8% on average, effective May 1 or July 1, for about 700,000 individual policyholders and their family members. Nonprofit Kaiser Permanente increased premiums 9% on average for nearly 300,000 customers last month. Blue Shield of California, also a nonprofit, is boosting average rates by 7.9% for 265,000 members and by 8.9% for 56,000 members, both effective March 1. The cost of goods and services associated with medical care grew just 3.6% over the last 12 months nationally, government figures show. But insurance premiums have kept climbing at a faster pace in California. Insurers defended their rate hikes, saying they are based on their claims experience with the customers they insure and not just the broader rate of medical inflation. They also say that healthier members dropped out of the individual market as premiums rose and the economy worsened in recent years, leaving behind a group of policyholders who have higher average costs. http://www.latimes.com/business/la-fi-0223-health-insurance-rate-hikes-20120223,0,7634380.story Comment: Why should individual health insurance premiums continue to increase at a rate much greater than the cost of goods and services associated with medical care? One of the most important reasons is that health insurance is now so expensive that many individuals who consider themselves to be healthy are choosing to go without coverage. Those who have health care needs make greater efforts to retain their insurance, thereby concentrating high-cost individuals within the insurance risk pools. This is known as adverse selection. As the insurance premiums continue to increase, a greater number of healthier individuals will find the premium costs to be intolerable and will drop out, driving premiums up even higher - a phenomenon known as the death spiral of insurance premiums. One purpose of the Affordable Care Act (ACA) was to correct such dysfunctions of the private insurance industry. Can we really expect adverse selection with skyrocketing insurance premiums to go away once the Act is fully implemented? Keep in mind that in the individual market insurers have been using one of the most effective tools to reduce adverse selection. They have refused to cover individuals with greater health care needs, filling their risk pools with healthier individuals - favorable selection. That is now going away. They are going to be required to insure all applicants. That will surely drive up the premiums for the populations expected to be served by the state insurance exchanges. Under ACA, it is also predicted that 23 million individuals will remain uninsured. A very large percentage of these individuals, who otherwise likely would have participated in the insurance exchanges, will not because of the unaffordable premiums - unaffordable even with the subsidies. Some will remain uninsured based on affordability exemptions in ACA, but some will simply not comply and be subject to penalties which the government may or may not be able to collect. These will be healthier individuals since those with needs will make greater efforts to obtain coverage. More adverse selection. So once we've established the state insurance exchanges, what can we expect? Very high premiums due to adverse selection. A mediocre benefit package based on state small group plans. Very low actuarial values which shift the costs of health care to the very individuals who have greater needs. In other words, UNAFFORDABLE UNDER-INSURANCE will be the new standard in America. We're a better country than that. Let's fix Medicare and provide it 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 don at mccanne.org Fri Feb 24 17:20:36 2012 From: don at mccanne.org (Don McCanne) Date: Fri, 24 Feb 2012 14:20:36 -0800 Subject: [Health Care Action] qotd: Pre-Existing Condition Insurance - only a glimmer Message-ID: CMS February 23, 2012 Covering People with Pre-Exisiting Conditions: Report on the Implementation and Operation of the Pre-Existing Condition Insurance Plan Program Before the Affordable Care Act, Americans with pre-existing conditions who did not receive health coverage through their employers had few affordable options to get the care they needed. In most States, insurance companies could refuse to sell them coverage, charge exorbitant premiums, or offer them coverage that excluded benefits for their health conditions. The law ends discrimination against people with pre-existing conditions. As a bridge to 2014, when these protections apply to all Americans, the law created a new program designed to help the tens of thousands of Americans who have been locked out of the insurance market due to their health conditions. The Pre-Existing Condition Insurance Plan or PCIP is a temporary high-risk health insurance program that makes health coverage available and more affordable immediately to individuals who are uninsured and have been denied health insurance by insurance companies because of a pre-existing condition. Twenty-seven States are operating their own program, often in coordination with existing State High Risk Pools, and 23 States and the District of Columbia have opted to have a Federally-operated program. The PCIP program will continue to provide affordable coverage to consumers who are enrolled and will facilitate their transition to Affordable Insurance Exchanges in 2014. Enrollment as of December 31, 2011: 48,879 http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf Comment: Under the Affordable Care Act (ACA), 48,879 previously uninsurable people with serious medical problems are receiving essential health care services under the pre-exisiting condition insurance program. We can't celebrate this gain because far too many people are still left out. It is a mere glimmer that doesn't light our path to reform. But temporarily we should accept what limited benefits ACA does provide, instead of trying to repeal it, while we work on a program that actually is going to take care of everyone - 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 wmjwj at wmjwj.org Sun Feb 26 12:57:09 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sun, 26 Feb 2012 12:57:09 -0500 Subject: [Health Care Action] Picket Baystate Medical Center, support Nurses' bargaining rights 2/28 Message-ID: <022601ccf4b0$10ec3a00$32c4ae00$@org> Please Forward! Do your family, friends, coworkers, members, staff, and others know about this? It's Time to Stand Up to the Baystate Bully For the Right to Collective Bargaining! Baystate Health walked away from the bargaining table on Feb. 16 because Visiting and Hospice Nurses refuse to give up their right to bargain over their health insurance plan and attendance policy. The right to bargain is a human right protected by the National Labor Relations Act. See the background below. Meanwhile, Baystate Health is dedicating its new $251 million "Hospital of the Future" on Springfield Street, Springfield on Tuesday, February 28. The Massachusetts Nurses Association/National Nurses United (AFL-CIO) and allies will picket this high-profile event beginning at 9:00 AM. There's a bus from Greenfield and Northampton for the action. To reserve a seat, contact Leo Maley at LMaley at mnarn.org or 781-520-1483. The 58 nurses at Baystate Visiting Nurse Association & Hospice (BVNAH) in Springfield have been negotiating for a new labor contract for over a year. The 210 nurses at Baystate Franklin Medical Center (BFMC) in Greenfield are also in the midst of bargaining. One of the largest health systems in New England, Baystate Health is a mix of "non-profit" and for-profit operations that include an academic medical center, a children's hospital, two community hospitals, visiting nurses and home care agencies, medical practices, a health insurance company (Health New England), an ambulance company, and a "captive insurance company" in the Cayman Islands! Baystate employs about 10,000 (the largest private employer in this region), takes in about $1.5 billion, and paid CEO Mark Tolosky (the second highest paid health care CEO in New England) $1.9 million in 2010. This corporate behemoth is an octopus with tentacles into all aspects of our society. It must think that bullying workers is ok behavior. Baystate has hired the notorious union-busting law firm of Jackson Lewis in the form of Howard Bloom in an attempt to bust the two groups of union nurses they bargain with. Its Director of Employee Relations, Jo-Ann Davis, is also a lawyer affiliated with another well-known union-buster, Skoler, Abbott & Presser (SAP) in downtown Springfield. More information about law firms like JL and SAP is here . Video here . At BVNAH, Baystate has put proposals on the bargaining table to take away collective bargaining rights on health insurance and attendance policy (it recently backed down on a similar proposal on wages). Unions are guaranteed collective bargaining by the National Labor Relations Act. The Baystate nurses, members of the Massachusetts Nurses Association/National Nurses United (AFL-CIO), will not give up collective bargaining on any aspect of wages, hours, and working conditions. So on February 16, Baystate declared "impasse." Declaring impasse says, "We're done bargaining!" This is unacceptable behavior in a Union City like Springfield. Springfield City Council was one of the first to endorse the Union Cities Program in 1995 (see also http://prospect.org/article/union-cities) and has regularly reaffirmed its support for workers' rights, including collective bargaining. It is a declaration of war in the workplace: As a legal term, impasse means the parties have reached a point at which further bargaining would be futile. The National Labor Relations Board is empowered to determine if that is true, if the impasse is real. One question is, Did Baystate really negotiate in good faith, demonstrating a real desire to reach agreement? The union has filed charges that it did not. Certainly, demanding that the union give up future bargaining over health insurance and attendance policy does not demonstrate a real desire to reach agreement. If an impasse is legal, federal law allows "implementation", that is, the employer may implement some or all of its contract proposals. This is one of many aspects of federal law that stack the deck against workers, based on the premise that the employer has the right to squeeze profit out of its employees. At this point, the law ignores the role of the employer in creating the impasse. The law does not maintain the previous contract which both parties previously agreed upon. The employer is allowed to pick and chose what it wants to implement and can even ignore those proposals that both parties agreed on during bargaining sessions. In other words, "implementation" gives the employer more favorable terms than does collective bargaining. This is what Baystate wants, even if temporarily. We are waiting to see what Baystate will implement. In October 2007, Baystate completely shut down the Greenfield office of Baystate VNA and Hospice rather than continue to bargain a first contract with the Nurses. It has generally behaved as an anti-union corporate bully towards its employees (see http://wmjwj.org/sites/wmjwj.org/files/BFMC%20WRB.pdf). For more information about Baystate's anti-union labor practices, call Joe Twarog at 781-571-9959. If you have information the Nurses should know, please tell him. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: image001.jpg Type: image/jpeg Size: 19500 bytes Desc: not available URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: image002.png Type: image/png Size: 7218 bytes Desc: not available URL: From wmjwj at wmjwj.org Sun Feb 26 14:21:01 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Sun, 26 Feb 2012 14:21:01 -0500 Subject: [Health Care Action] Greg Speeter Memorial 3/3 Message-ID: <02d201ccf4bb$c7a51bd0$56ef5370$@org> As you know, Greg Speeter, National Priorities Project founder, died Feb. 2. Greg was a long-time member, mentor, and good friend of Western Mass. Jobs with Justice and National JwJ. Greg's memorial will be held on Saturday March 3 at 11am at the Haydenville Congregational Church . The Reverend Dr. Andrea Ayvazian, Senior Church Pastor, will lead the service. The family has requested donations be made to National Priorities Project in lieu of flowers. Read Greg's obituary in the Daily Hampshire Gazette See NPP's tribute page See Greg in NPP's 25th Anniversary video created by the Media Education Foundation See the Media Education Foundation's tribute page Read an article about Greg in the Daily Hampshire Gazette Read a Valley Advocate article about Greg See a photo of Greg speaking about Dream of a Nation at the Odyssey Bookshop in South Hadley, MA -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Mon Feb 27 11:57:32 2012 From: don at mccanne.org (Don McCanne) Date: Mon, 27 Feb 2012 08:57:32 -0800 Subject: [Health Care Action] qotd: Immigrant coverage under health reform Message-ID: Kaiser Commission on Key Facts February 2012 Key Facts on Health Coverage for Low-Income Immigrants Today and Under Health Reform As of 2010, there were 38 million immigrants residing in the United States, accounting for 12.5 percent of the total population. They include 16.7 million naturalized citizens and 21.4 million non-citizens, including both lawfully present and undocumented individuals. The Pew Hispanic Center estimates there were 11.2 million undocumented immigrants in the United States as of 2010, accounting for about 3.7 percent of the total population. In 2010, the median annual household income for non-citizens was $25,000, roughly half the amount for citizen households. Health coverage for naturalized citizens is very similar to that of U.S.-born citizens, with the majority covered through employer-sponsored or other private coverage. However, non-citizens are three times as likely as U.S.-born citizens to be uninsured due to lower rates of both public and private coverage. Coverage Options for Immigrants Under Health Reform Almost all uninsured non-citizens have household incomes that would qualify for Medicaid or tax credits for exchange coverage under reform, but many will continue to face immigrant eligibility restrictions. The Medicaid expansion will make many lawfully present immigrants newly eligible for the program, particularly low-income adults who have very limited eligibility for Medicaid today. However, the five-year wait for coverage will remain in place, limiting eligibility for many lawfully present immigrants, although states will maintain the option to eliminate the waiting period for lawfully residing children and pregnant women. Lawfully present immigrants without access to affordable employer based coverage will be able to purchase health coverage in the new exchanges, and those with incomes up to 400 percent of poverty will be eligible for tax credits. This will include lawfully present immigrants with incomes below 133 percent of poverty who are unable to enroll in Medicaid due to the five-year waiting period. Undocumented immigrants will remain ineligible for Medicaid and will be ineligible for tax credits and prohibited from purchasing coverage through an exchange, even at full cost. Safety-net providers will remain a major source of care for immigrants. Today, uninsured individuals, including many uninsured immigrants, often rely on community health centers and clinics for their care. Safety-net providers are seen as a trusted source for care and are able to offer culturally and linguistically appropriate services that meet the needs of diverse populations. Under reform, these providers will likely remain a primary source of care for millions of newly insured individuals, including lawfully present immigrants, as well as citizens and non-citizens who remain uninsured after 2014. http://www.kff.org/uninsured/upload/8279.pdf Comment: Everyone should have health care. How well will the Affordable Care Act (ACA) work for our immigrant population? It depends partly on immigration status. The ACA provisions apply to naturalized citizens just as they would for native-born citizens. Thus their barriers will be the same as for most of the rest of us. They will face the same issues of whether or not the subsidies will be adequate to purchase private plans, and whether or not they will be exposed to excessive cost sharing with inadequate subsidies when accessing care. Non-citizen immigrants are faced with the additional problem of having household incomes that average only half that of the U.S. median. Those who are lawfully present also must wait for five years before they are eligible for the Medicaid program. They will be eligible to purchase programs in the new exchanges, though the subsidies will likely be inadequate for those with incomes that already don't cover other essential needs. For immigrants who are undocumented, Congress decided to yield to the forces of anti-immigrant politics, and not only make them ineligible for tax credits for the exchange plans, but also to prohibit them from purchasing the plans with their own funds, even at full cost. It is very unfortunate that Congress co-mingled heath care justice with immigration policy. The sanctity of human life should always prevail over the politics of ideology. Yes, some will receive excellent care from our safety-net providers, but many will not. Community health centers cannot possibly fill in the full void in coverage. Most undocumented workers are productive individuals, just like our citizens, and there is no reason that they should not contribute to and participate in a single payer national health program that covers everyone - absolutely 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 wmjwj at wmjwj.org Tue Feb 28 07:34:28 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 28 Feb 2012 07:34:28 -0500 Subject: [Health Care Action] Today: Picket Baystate Medical Center Message-ID: <02be01ccf615$577986b0$066c9410$@org> Here: Springfield Street, Springfield , beginning at 9:00 AM. Attached billboard is on I-91. -------------- next part -------------- An HTML attachment was scrubbed... URL: -------------- next part -------------- A non-text attachment was scrubbed... Name: IMAG0050.jpg Type: image/jpeg Size: 624820 bytes Desc: not available URL: From wmjwj at wmjwj.org Tue Feb 28 11:36:09 2012 From: wmjwj at wmjwj.org (WMass Jobs with Justice) Date: Tue, 28 Feb 2012 11:36:09 -0500 Subject: [Health Care Action] WMJwJ Conference 4/14 Message-ID: <005901ccf637$14a2a7a0$3de7f6e0$@org> Occupy Jobs with Justice! The Western Massachusetts Jobs with Justice Educational, Organizing, & Membership Conference Saturday, April 14, 2012, (note new date), 10am to 5:15pm (includes lunch) Holyoke Community College ~ Kittredge Center 303 Homestead Avenue, Holyoke (easy off I-91) The conference is in partnership with the Kittredge Center for Business and Workforce Development at Holyoke Community College. Online Registration is required. Go here and follow these steps, ignoring any payment requests: 1. Click the Select One drop down menu. Make a meal choice. 2. Click Add to Cart. 3. Click Proceed to Checkout. 4. Fill in form, including Password (your choice) at Create New Account. 5. Answer Additional Questions (starred ones are required). 6. Fill in Comments if any - if you need simultaneous interpretation in Spanish, write "Spanish". 7. Click Check out. There is no cost to attend this conference. It is fully underwritten by the grants and donations of generous supporters. You are invited to add your donation to theirs, now or at the conference. Please visit http://wmjwj.org/sustaining-western-mass-jobs-justice for more information on donations. Keynote Speaker: Stephanie Luce community/labor educator and activist Associate Professor of Labor Studies, Murphy Institute for Worker Education and Labor Studies, City University of New York Tabling Opportunity for Progressive Organizations (send request to wmjwj at wmjwj.org) Organizing Workshops: Good Green Jobs ~ owned by union members? Health Care Justice ~ Massachusetts Medicare for All Student Labor Action Project Tax the Rich! Plenaries: Workshop Report-Backs What is National Jobs with Justice? Labor Organizing + Community Organizing = Jobs with Justice Organizing So Called "Non-Profits" For more information: Western Mass. Jobs with Justice 640 Page Boulevard #101, Springfield MA 01104 v (413) 827-0301 wmjwj at wmjwj.org ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 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: image001.png Type: image/png Size: 7218 bytes Desc: not available URL: From don at mccanne.org Tue Feb 28 15:52:07 2012 From: don at mccanne.org (Don McCanne) Date: Tue, 28 Feb 2012 12:52:07 -0800 Subject: [Health Care Action] qotd: CMS on actuarial value and cost sharing reductions Message-ID: Health Affairs Blog February 28, 2012 Actuarial Value: Why It Matters And How It Will Work By Lynn Quincy On February 24, 2012, the Department of Health and Human Services (HHS) released guidance describing a proposed method for estimating the actuarial value of health plan benefit designs in 2014. The actuarial value measures the percentage of expected medical costs that a health plan will cover. It can be considered a general summary measure of health plan generosity. As such, it can help consumers make sense of their health plan options by providing an overall measure of coverage in addition to discrete information on deductibles, copayments, and coinsurance, etc. A Trade-Off Between Simplicity And Accuracy The bulletin highlights ? but doesn't resolve ? a tension between simplicity and accuracy in the estimation of actuarial value. HHS initially proposes to use a "practical and easy-to-use" calculator that would utilize the "handful" of cost-sharing features that have a large impact on a plan's actuarial value, such as deductible, co-insurance, and maximum out-of-pocket. This approach may not take into account more subtle features of a plan, such as service specific deductions or exceptions to the out-of-pocket limit. There are trade-offs, however, from taking this "practical" approach. First, cost-sharing features that may be only worth a few points of actuarial value can have a big impact on an individual consumer's cost-sharing obligations. Second, high level plan features like the maximum out-of-pocket can vary in how reliably they reflect patient cost-sharing. One study found that plans with similar reported out-of-pocket maximums actually differed by thousands of dollars in the final cost to patients due to exceptions to the maximum. Third, by opting for a simple calculator, HHS envisions insurers using supplementary methods to calculate actuarial value if their plan design doesn't fit neatly into the calculator. This could greatly undermine the goal of using a common method of calculating actuarial value to ensure that plan comparisons are truly "apples to apples." A recent study demonstrated that the same plan design can yield different actuarial value estimates, if different methods are used to calculate it. Addressing A Tension Between Actuarial Value And Out-Of-Pocket Maximums Depending on the actuarial model being used, some researchers have found it impossible to hit the required actuarial value targets and the lower out-of-pocket limit requirements simultaneously. While it may seem counter-intuitive, allowing for a higher out-of-pocket maximum means lower deductibles can be offered while still hitting the required actuarial value target. As many consumers will not hit their out-of-pocket maximum, flexibility to use higher out-of-pocket limits benefits a greater number of consumers. In a nutshell, HHS proposes to let actuarial value targets trump maximum out-of-pocket rules if this conflict arises. HHS intends to publish an annual notice providing guidance as to the out-of-pocket levels that would be consistent with the actuarial value targets for households with incomes from 100 percent to 250 percent of FPL, presumably reflecting the types of estimates being produced by the federal calculator. For households with incomes of 250 percent to 400 percent of FPL ? which are also entitled to lower out-of-pocket maximums under the ACA but remain tied to the standard actuarial value benchmark of 70 percent ? HHS proposes to do away with the requirement for lower out-of-pocket maximums altogether. http://healthaffairs.org/blog/2012/02/28/actuarial-value-why-it-matters-and-how-it-will-work/ CMS: Actuarial Value and Cost-Sharing Reductions Bulletin (16 pages): http://www.cciio.cms.gov/resources/files/Files2/02242012/Av-csr-bulletin.pdf Comment: The actuarial value of a health plan represents the average percentage of covered services that a plan is expected to pay for, the balance being paid by the patient. The Affordable Care Act calls for four levels of plans, ranging from 60 percent to 90 percent actuarial values. Cost sharing, such as deductibles, coinsurance, and maximum out-of-pocket amounts, is an important consideration in determining the actuarial value of the plan. The excerpts above include only two of many complex considerations in trying to standardize rules for establishing actuarial values and associated cost sharing. For instance, in trading off simplicity and accuracy, "plans with similar reported out-of-pocket maximums actually differed by thousands of dollars in the final cost to patients due to exceptions to the maximum." Also, "For households with incomes of 250 percent to 400 percent of FPL ? which are also entitled to lower out-of-pocket maximums under the ACA but remain tied to the standard actuarial value benchmark of 70 percent ? HHS proposes to do away with the requirement for lower out-of-pocket maximums altogether." By selecting this model of reform, not only do we compound the administrative excesses in health care financing, we also compound some of the inequities in our system. Policy wonks will want to read the full CMS Bulletin covering these complex issues (link above). It is hoped that those who continue to push for implementation of ACA will finally realize the futility of their efforts and join us in advocating for equitable, efficient reform for all of us through a single payer national health program. -------------- 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 wmspn at wmjwj.org Wed Feb 29 16:36:11 2012 From: wmspn at wmjwj.org (WMass Single Payer Network) Date: Wed, 29 Feb 2012 16:36:11 -0500 Subject: [Health Care Action] FW: Action Alert: Never Mind the Mandate Message-ID: <00e901ccf72a$283dd610$78b98230$@org> From: Healthcare-NOW! [mailto:email at healthcare-now.org] Can't read this email? View it in your web browser. Healthcare-NOW! Take Action Quickly email Congress and the President to tell them that no matter the outcome of the Supreme Court's decision on the individual mandate, the ACA is flawed. Medicare is constitutional, loved, and should be expanded to cover everyone. take action The Supreme Court will rule on the constitutionality of the individual mandate portion of the Affordable Care Act (ACA), or "Obamacare," in late March. The mandate would require that almost everyone in the US be covered by some form of health insurance, public or private, by 2014 or be fined. Therefore, it's no surprise that the mandate is unpopular with both the right and left. On nearly the same day, single-payer supporters and free market health insurance supporters filed separate amicus briefs asking the Supreme Court to strike down the mandate. Regardless of the Supreme Court's decision, we will still be left with an inadequate healthcare reform law. Even with the mandate, the ACA will leave at least 20 million people uninsured, fail to reduce healthcare costs, and keep multimillion dollar for-profit private insurance companies up and running (and who will undoubtedly find ways to weasel out of any positive aspects of the ACA). Despite what pundits and Obama's administration say, we've still got a long way to go before we get universal, equitable, and affordable healthcare in this country. Since the ACA is clearly a flawed law, let's focus on expanding and improving what we already know works: Medicare. Send an email to Congress and the President now saying: with or without the mandate, we still need Medicare for all. For almost fifty years, Medicare has saved millions of people over 65's lives and lifted just as many out of poverty. Without Medicare and Social Security the poverty rate for seniors (.pdf) would be 48% instead of its current 10%. Medicare operates with a fraction of the overhead cost of private insurance plans. Currently, our multi-payer system takes nearly a third of every healthcare dollar spent to cover administrative costs. Medicare's administrative costs are only 3%. With Medicare-for-all, we would save $400 billion annually. Medicare's patients are much more satisfied than those with private insurance. The National Journal reported that: "56 percent of enrollees in traditional fee-for-service Medicare give their 'health plan' a rating of 9 or 10 on a 0-10 scale. Similarly, 60 percent of seniors enrolled in Medicare Managed Care rated their plans a 9 or 10. But...only 40 percent of Americans enrolled in private health insurance gave their plans a 9 or 10 rating." Given Medicare's success and popularity, one would think it was politically untouchable--but it's not. Republicans proposed making Medicare a voucher program, effectively privatizing and destroying Medicare as we know it. And Democrats have offered cuts to benefits and doctor reimbursements as a compromise for higher taxes on the extremely wealthy. We must act now. With the ruling on the constitutionality of the ACA, healthcare reform is once again on the minds of Congress, the President, and the general public. Send an email to Congress and the President with the following message: No matter the outcome of the Supreme Court's decision on the individual mandate to buy health insurance, the Affordable Care Act is flawed because it leaves millions of people uninsured and does nothing to reduce costs. Medicare is constitutional, loved, and cost-effective and should be improved and expanded to cover everyone under a single-payer healthcare system. In solidarity for single-payer, Healthcare-NOW! National Staff and Steering Committee Sources: - Court Action Could Prolong Health Care Fight - 50 Doctors for Single-Payer Urge Supreme Court to Strike Down Individual Mandate - Four Groups File Amicus Brief Against Obamacare - Health Reform Necessary: But Will the Affordable Care Act Be Sufficient? - Talking Points on Medicare and Social Security - Single-Payer FAQ - Bureaucracy - Who's Afraid of Public Insurance? - The Ryan Medicaid Plan a Threat to Middle Class Security - Supercommittee Dems Offer $350 Billion in Medicare Cuts Healthcare-NOW! survives on the generosity of our supporters. Please consider making a donation or joining Healthcare-NOW! to support our efforts on our secure server. donate store - Follow us on - Facebook Twitter RSS Healthcare-NOW! - 800-453-1305 - 1315 Spruce Street, Philadelphia, PA 19107 empowered by Salsa -------------- next part -------------- An HTML attachment was scrubbed... URL: From don at mccanne.org Wed Feb 29 19:29:09 2012 From: don at mccanne.org (Don McCanne) Date: Wed, 29 Feb 2012 16:29:09 -0800 Subject: [Health Care Action] qotd: Insurers battle and patients lose Message-ID: The Wall Street Journal February 29, 2012 Insurer Battles Physician Group By Anna Wilde Mathews A clash between health insurer Blue Shield of California and a doctor group that sold its operations to UnitedHealth Group Inc. highlights emerging tensions as lines blur between health insurers and medical providers. On Tuesday, the health insurer filed a demand for at least $10.5 million in damages from Monarch HealthCare, a 2,300-physician association based in Irvine, Calif., that last fall sold its management arm to UnitedHealth's Optum health-services unit. Among the allegations: that Monarch sought to steer Blue Shield members away from Blue Shield and toward competing health plans, and that its doctors started declining to see some Blue Shield members. The complaint says these moves violated Blue Shield's contract with Monarch, which the insurer has previously said will end on May 1. "It seems crazy to be contracted with someone who's a direct competitor, and share everything you design with them," said Juan Davila, senior vice president for network management at Blue Shield, which has 3.3 million members. Blue Shield felt its "worry was proved true" by Monarch's alleged actions, he said. At the root of the clash is the deal unveiled last fall for Monarch's operations arm to be acquired by Optum, the unit of UnitedHealth Group, which is also the parent of UnitedHealthcare, the nation's biggest insurer. Because California law bans most entities from directly employing practicing doctors, acquisitions involving independent-practice associations like Monarch often have complex structures. The dispute raises issues for both sides. Blue Shield says in its complaint that it lost existing and prospective members. Also, its provider network will soon lack one of Orange County's biggest doctor groups. Monarch risks losing some patients who are Blue Shield members. In its complaint, Blue Shield said it had around 19,200 members in commercial and Medicare Advantage plans last September who used Monarch doctors. In May, Blue Shield's members have to pay more to keep seeing Monarch doctors, who would become out-of-network providers. Similar static is beginning to surface elsewhere as health plans have begun buying medical providers, and some providers have started making insurer-style moves, with some considering direct approaches to employers and even seeking to launch their own health plans. WellPoint Inc.'s Anthem Blue Cross broke off a deal with Monarch to create a cooperative "accountable-care organization" and also said in a letter to doctors that it will discontinue its health-maintenance organization relationship with Monarch in the future. In the letter last October, an Anthem official said the ACO move came as "a result of the group's pending transaction" with Optum. http://online.wsj.com/article/SB10001424052970203833004577251773887296652.html Comment: These disputes between UnitedHealth's Monarch HealthCare, Blue Shield of California, and WellPoint's Anthem Blue Cross not only impose a great disservice on their patients, but also should outrage all of us over the fact that these health care intermediaries act as if they regard patients to be their chattel - jerking them around in order to fulfill their own business goals. How long are we going to continue to tolerate this reprehensible industry? They may need us, but we don't need them. -------------- 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