June 24, 2009

Dear PNHP Colleagues,

The health reform debate is reaching a feverish pitch, and while it's been gratifying to see the single-payer alternative winning a higher profile in Congress and the mass media (see summary with links, below), we clearly have much more work to do to keep up the momentum.

Today, Drs. Quentin Young and Steffie Woolhandler testified in Congress in support of single payer before the important House Ways and Means, and the Energy and Commerce Committees, respectively.  Interestingly, a former Cigna executive, Wendell Potter, also testified on the Hill today, noting the industry's pernicious influence on the health care debate and even mentioning single payer.

In recent weeks several other PNHPers have testified on the Hill as well, either before official committees (Dr. Margaret Flowers, Dr. Walter Tsou, Dr. Marcia Angell) or to important groups, such as the Blue Dogs (Dr. Rob Stone) and Progressive Caucus (Dr. Deb Richter, Nick Skala).  The growing grassroots pressure for single payer and last month's dignified acts of civil disobedience before the Senate Finance Committee are having an impact!

Our media reach has also widened, including recent interviews of PNHP spokespeople on Bill Moyers Journal, FOX News, CNN, and Democracy Now.  43 physicians joined PNHP online the weekend after the Moyers program. PNHPers have also been featured in interviews, letters, and op-eds in the New York Times, Business Week, Reuters, Time, Washington Post, Capital Times (Madison, Wis.) and Boston Globe, to name a few.

An interview with Dr. Woolhandler in Monday's Boston Globe is reprinted below, along with Dr. Quentin Young's testimony today.  Stay tuned for an appearance by a PNHP member on the Colbert show!

What you can do:

1. Meet with your congresspersons in their home district, or if you can, travel to Washington, D.C., in July to urge your representative and senator(s) to sign on to H.R. 676 and S. 703.  Contact Dr. Margaret Flowers at nose1@aol.com with your anticipated dates of availability if you're able to join her in walking the Halls of Congress for single payer this summer. For lobbying materials, see www.pnhp.org/change.
2. Sign and help circulate the Open Letter from Physicians to President Obama urging him to endorse single payer as the o nly practicable way to attain universal, comprehensive coverage at an affordable price.
3. Speak up in your local media through op-eds and letters to the editor, and offering to be interviewed on health care reform by local radio and television stations. See, for example, this letter from Dr. Edwin Stickney, past president of the Montana Medical Association. If you need help reaching your local media, please contact us.

Thank you for your continued support and especially for your priceless efforts for reform.

Summary of recent developments:

Congressional:
Seven more Representatives have endorsed HR 676, bringing total to 83

PNHPers on the Hill:
Dr. Steffie Woolhandler 6/24/09, Education and Commerce health subcommittee (link)
Dr. Quentin Young testimony 6/24/09, House Ways and Means (link)
Dr. Margaret Flowers, Senate HELP, 6/11/09 (link to testimony and interview link)
Nick Skala's talk to the Progressive Caucus, 6/04/09 (link)
Dr. Deb Richter, Congressional Briefing, 6/10/09 (link to video) 
Drs. Walter Tsou, Marcia Angell (House testimony) 6/10/09
Russell Mokhiber, Single Payer Action, did this very nice interview with Margaret Flowers, 6/11/09 (link)
Dr. Rob Stone (closed-door meeting with Blue Dog health committee) 6/8/09

PNHP Media Highlights
Fox News, Dr. Claudia Fegan, 6/18/09 (link)
Capital Times (Madison, WI) editorial for single payer, 6/10/09 (below)
New York Times article by Robert Pear citing PNHP, 6/10/09 (link)
Washington Post letter by Dr. Jerry Earll, 6/10/09 (link)
Washington Post letter by Dr. James Floyd, 6/17/09 (link)
Democracy Now interview with Dr. Quentin Young, 6/16/09 (link)
Chicago Tribune quotes PNHP member Dr. Peter Orris on physician support for single payer, 6/14/09 (link)
Arizona Daily Star, Dr. Charles Katzenberger, op-ed for single payer, 6/09/09 (below)
Des Moines Register Op-ed, Dr. Jess Fiedorowicz, 6/07/09 (link)
Great Falls Tribune, MT, 6/9/09 (below)
New York Times blog, Drs. David Himmelstein and Steffie Woolhandler; Doctors' Pay, a Key to Health Care Reform: End Insurance's Bad Incentives, 6/19/09 (below)
Editorial Board meeting, Kaiser Health News (upcoming)
Editorial Board meeting, Albany Times (completed, successfull)
PNHP Press Release on medical bankruptcy (link)
Additional medical bankruptcy coverage in the following places (U.S. News and World Report, BusinessWeek, Reuters)
Time Magazine's coverage of insurance company holdings in tobacco study (link)
PNHP Press Release on Insurance Industry Holdings of Tobacco Firm Stock (link)
PNHP Press Advisory on Blue Dogs, 6/8/09 (link)
PNHP Presss Advisory on House Testimony, 6/24/09 (link)

Other Media:
Mike Dennison on Sen. Baucus campaign cash, Montana Standard, Butte (below)
LA Times' Lisa Girion on "fear of single payer" driving private insurers to support health reform this year, particularly individual mandate (link)
Bill Moyers' endorsement of single payer (link)

Action:

Endorse the "Open letter to Obama to support single payer" (link)
Lobby for single payer HR 676 and S. 703 (lobbying materials at www.pnhp.org/change)
Petition for Single Payer by Rep. Bernie Sanders, Vermont (link)

In Memory of Dr. Linda Farley
Wisconsin chapter leader Dr. Linda Farley died on June 9, 2009, of cancer.  She will be greatly missed. 

Single-minded on healthcare

By ELIZABETH COONEY
Boston Globe
June 22, 2009

The debate in Washington about how to overhaul the nation's healthcare system has included little from advocates for a single-payer plan. Dr. Steffie Woolhandler, a Cambridge Health Alliance internist and Harvard Medical School professor who cofounded Physicians for a National Health Care Program, has been raising her voice for a national plan for more than two decades, contending that the current20system based on private insurance - including the Massachusetts model mandating near-universal coverage - does not serve people well, whether they are rich or poor, insured or uninsured. Here is an edited version of an interview last week.

Q. What do you think of current efforts in Washington to improve healthcare?

A. What's currently on the table, what [President] Obama and [Senator Edward M.] Kennedy are talking about, will not fix healthcare. They don't have any way to pay for it. We can't just keep pumping money into the system. We actually have to fix the system.

Q. Why aren't single-payer advocates at the table?

A. I think that was due to the tremendous influence of the private health insurance industry. We've pushed some and the process has moved some. At first Senator [Max] Baucus had 13 people, mostly doctors and nurses, arrested outside the hearing he was leading. We did get a hearing on single payer for the first time in history in the House Education and Labor Committee.

Q. How would a single-payer system pay for itself?

A. A single-payer system contains its own funding. It would fix the system by dramatically reducing administrative costs. Just the complexity of having competing insurance firms and the system overhead make costs go way up. In the United States, administration costs us 31 cents of every healthcare dollar. In Canada, it's about 16.5 cents for every healthcare dollar. If we could have the administrative efficiency they have in Canada, we could move $400 billion in annual costs.

Q. What about waiting lists for care?

A. Canada spends half of what we do per capita on healthcare and they do have some waiting lists, but they're really not as bad as the right wing portrays them. The waiting lists are a result of their level of spending. Our problem in the US is we spend a lot of money but we have a bad system. In Canada they have a good system but they just don't spend enough money on it. We have great hospitals and great nurses and well-trained doctors and lots of fancy technology. We have what we need, and yet we still can't take care of patients because the financing system doesn't work.

Test imony of Quentin Young, M.D., to the House Ways and Means Committee

[The following testimony is the prepared text of the remarks given by Dr. Quentin Young at a hearing on health care reform conducted by the House Ways and Means Committee on June 24 in Washington.]

Testimony of Quentin D. Young, M.D., M.A.C.P., national coordinator, Physicians for a National Health Program

Mr. Chairman, members of the Committee, thank you for giving me the opportunity to comment on the proposal that has emerged from the three key House committees and to articulate the single-payer alternative. I am national coordinator of Physicians for a National Health Program, an organization of 16,000 American physicians who support single-payer national health insurance. Our organization represents the views of the majority of U.S. physicians, 59 percent of whom support national health insurance.

I wish to make two points to the Members of this Committee. The first is that the best health policy science, literature, and experience indicate that the Tri-Committee proposal will fail miserably in its purported goal of providing comprehensive, sustainable health coverage to all Americans. And it will fail whether or not it includes a so-called "public option" health plan.

The second point I wish to make is that single-payer national health insurance is not just the only path to universal coverage, it is the most politically feasible path to health care for all, because it pays for itself, requiring no new sources of revenue.

The difference between single payer and the Tri-Committee proposal could not be more stark: single-payer has at its core the elimination of U.S.-style private insurance, using huge administrative savings and inherent cost control mechanisms to provide comprehensive, sustainable universal coverage. The Tri-Committee discussion draft preserves all of the systemic defects inherent in reliance on a patchwork of private insurance companies to finance health care, a system which has been a miserable failure both in providing health coverage and controlling costs. Elimination of U.S.-style private insurance has been a prerequisite to the achievement of universal health care in every other industrialized country in the world. In contrast, public program expansions coupled with mandates, like those in the Tri-Committee proposal, have failed everywhere they've been tried, both domestically and internationally.

First, because the discussion draft is built around the retentio n of private insurance companies, it is unable - in contrast to single payer - to recapture the $400 billion in administrative waste that private insurers currently generate in their drive to fight claims, issue denials and screen out the sick. A single-payer system would redirect these huge savings back into the system, requiring no net increase in health spending.

Second, because the discussion draft fails to contain the cost control mechanisms inherent in single payer, such as global budgeting, bulk purchasing, negotiated fees and planned capital expenditures, any gains in coverage will quickly be erased as costs skyrocket and government is forced to choose between raising revenue and cutting benefits.

Third, because of this inability to control costs or realize administrative savings, the coverage and benefits that can be offered under the discussion draft will be of the same type currently offered by private carriers, which cause millions of insured Americans to go without needed care due to costs and have led to an epidemic of medical bankruptcies.

Virtually all of the reforms contained in the discussion draft have been tried, and have failed repeatedly. Plans that combined mandates to purchase coverage with Medicaid expansions fell apart in Massachus etts (1988), Oregon (1992), and Washington state (1993); the latest iteration (Massachusetts, 2006) is already stumbling, with uninsurance again rising and costs soaring. Tennessee's experiment with a massive Medicaid expansion and a public plan option worked - for one year, until rising costs sank it.

The inclusion of a so-called "public option" cannot salvage this structurally defective reform package. A public plan option does not lead toward single payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan. A quarter-century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry-picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan - which started as a single-payer system for seniors but has now become a funding mechanism for HMOs - and a place to dump the unprofitably ill.

The $1 trillion price tag on the Tri-Committee proposal already threatens to capsize our new President's flagship initiative. In contrast, single payer avoids these hazardous political waters entirely because it requires no new sources of funding.

In tumultuous economic times, single payer is the only fiscally responsible option. Two-thirds of the American people support it. The majority of physicians are in favor of it, as are the U.S. Conference of Mayors, 39 state labor federations and hundreds of local unions across the country. Millions of Americans are mobilized to struggle for single payer, but your leadership is crucial. I hope this Committee will see fit to provide it.

Thank you.

Say bye to for-profit health insurance

Letter to the Editor
Billings Gazette
June 21, 2009

The for-profit health insurance industry is the major culprit standing in the way of the American people obtaining for themselves their right to adequate universal health care. This industry employs thousands of people whose task it is to find reasons not to insure people (pre-existing conditions) in the first place, then to find ways not to pay claims of those already insured. Further, thousands of employees in hospitals and doctors' offices spend hours on the telephone attempting to file legitimate claims.

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Acting in this way makes parasites out of these employees who spend their time non-productively protecting the profits of these companies instead of facilitating the flow of goods and service from medical providers to their legitimate patients.

Single-payer will eliminate this non-productive industry with a streamlined, publicly financed system. By doing so it will save an estimated $400 billion annually in administrative costs, enough money to guarantee everyone quality, comprehensive care and to eliminate all co-pays and deductibles, with no net increase in our nation's health spending.

It is time for the American people to be aware of this stark reality and rise up against the common enemy of health care reform.

Edwin L. Stickney, M.D.
Billings

[Note from PNHP: Dr. Stickney is past president of the Montana Medical Association.]

Single-payer advocate speaks to Blue Dogs on health reform

Dr. Robert Stone, a leader of Physicians for a National Health Program, an organization of 16,000 physicians who advocate for single-payer national health insurance, spoke to the Health Care Task Force of the Democratic Blue Dog Coalition on Capitol Hill Thursday.

In his remarks, Stone emphasized how single-payer health reform, as embodied in the U.S. National Health Care Act, H.R. 676, is the most fiscally responsible way of addressing the nation's health care woes.

Stone said that by replacing the for-profit, private health insurance companies with a single-payer program - an improved Medicare for All - the United States would save more than $400 billion in administrative costs annually. He also said that single payer is only reform proposal that includes effective cost-containment provisions.

"In fact, the strongest argument for Medicare for All is that it is the most efficient reform proposal with the greatest ability to control costs," Stone said. "That is exactly why so many members of the 'medical-industrial complex' oppose such a plan, because, as the Nobel Prize-winning economist Paul Krugman has said, 'Remember that what the rest of us call health care costs, they call income.'

"In short, single payer is the only plan that pays for itself and covers everyone. It's fiscally conservative and socially responsible," Stone said.

The Blue Dog Coalition's Health Care Task Force was launched in March at the time of Preside nt Obama's White House summit on health care reform. It is chaired by Rep. Mike Ross of Arkansas, and its members include Rep. Jim Cooper of Tennessee, Rep. John Barrow of Georgia, Rep. Earl Pomeroy of North Dakota and Rep. Baron Hill of Indiana, among others. Like the Blue Dog caucus itself, the task force emphasizes fiscal conservatism.

Rep. Hill helped arrange the invitation for Stone to speak to the group.

Several members of the Blue Dog caucus were co-sponsors of the single-payer bill, H.R. 676, in the 110th Congress.

Stone is the director and co-founder of Hoosiers for a Commonsense Health Plan (HCHP) and the state coordinator of Indiana for Physicians for a National Health Program. He has been an emergency department physician at Bloomington (Ind.) Hospital since 1983, and was the medical director of the Community Health Access Program Clinic in Bloomington from 2005 to 2007, until it was transformed into the Volunteers in Medicine Clinic. He continues to volunteer at the new clinic. He is assistant clinical professor of emergency medicine at Indiana University School of Medicine.

Born and raised in Evansville, Ind., Stone graduated from Dartmouth20College and the University of Colorado Medical School. He is a Diplomat of the American Board of Emergency Medicine.