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Gender: Female
Hometown: Washington state
Home country: USA
Current location: Directly above the center of the earth
Member since: Sat Aug 16, 2003, 02:52 AM
Number of posts: 51,907

About Me

Major policy wonk interests: health care, Social Security/Medicare/Medicaid, election integrity

Journal Archives

Stories Of Being Sick Inside The U.S. Health Care System


To get a feeling for what being sick in America is really like, and to help us understand the findings of our poll with the Robert Wood Johnson Foundation and the Harvard School of Public Health, NPR did a call-out on Facebook. We asked people to share their experiences of the health care system, and within 24 hours, we were flooded with close to 1,000 responses.

The stories were often lengthy and detailed. From Oregon to Florida and Maine to Mississippi, Facebook respondents told wrenching tales of bankruptcies, missed diagnoses, medical errors, miscommunication, and treatment that was delayed or foregone because of its cost.

Uncovering the other ALECs


"That Other Bill Mill": Council of State Governments (CSG)

ALEC is far and away the most well known of the consortium of 501(c)(3) organizations that allow corporate influence to seep into every facet of state-level government affairs. CSG, on the other hand, is not so well known.

Upon being sworn into office, all state-level legislators (there are about 7,500 of them total), as well as their respective legislative staffs, automatically become CSG members. The organization's membership also includes representatives from the executive and judicial branches of state governments.

Between 2009 and 2011, CSG's Internal Revenue Service (IRS) 990 forms indicate revenue between $29 and $34 million annually. While most of its sizable budget is covered by taxpayers, some 43 percent - or roughly between $12.5 and 14.6 million, according to its web site; another 29 percent - or almost $8.4 to $9.9 million of these funds - come from what it describes as "entrepreneurial efforts" which can be loosely interpreted to mean anything from publication sales to a sizable chunk from corporate patronage.

Some perspective is warranted: 990s filed by ALEC in 2010 placed its entire budget at just under $6 million.


National Conference of State Legislatures: Corporate-Sponsored "Schmoozapalooza"

The NCSL, considered an "instrumentality of the states" by the IRS, has served a "forum for America's Ideas since 1975." NCSL plays host to a series of educational conferences and task force meetings, and like its cousin, CSG, it boasts a membership that includes every state-level elected official in the United States.

One article comparing NCSL and ALEC reads, "ALEC may appear on the surface to mimic the bipartisan educational archetype of ... NCSL, but ALEC's corporate governance structure, near total reliance on corporate funding, and strong ties to legislators from predominantly one political party make it distinctly different."

Yet, the situation is not so cut-and-dry. Yes, NCSL is different from ALEC, but it still a key tool for corporations.

Global push to guarantee universal health coverage leaves US behind


Even as Americans debate whether to scrap President Obama's healthcare law and its promise of guaranteed health coverage, many far less affluent nations are moving in the opposite direction — to provide medical insurance to all citizens.

China, after years of underfunding healthcare, is on track to complete a three-year, $124-billion initiative projected to cover more than 90% of the nation's residents.

Mexico, which a decade ago covered less than half its population, just completed an eight-year drive for universal coverage that has dramatically expanded Mexicans' access to life-saving treatments for diseases such as leukemia and breast cancer.

In Thailand, where the gross domestic product per person is a fifth of America's, just 1% of the population lacks health insurance. And in sub-Saharan Africa, Rwanda and Ghana — two of the world's poorest nations — are working to create networks of insurance plans to cover their citizens.

"This is truly a global movement," said Dr. Julio Frenk, a former health minister in Mexico and dean of the Harvard School of Public Health. "As countries advance, they are realizing that creating universal healthcare systems is a necessity for long-term economic development."

The underside of employer wellness programs.

Health Affairs
Health Policy Brief
May 10, 2012
Workplace Wellness Programs

The Affordable Care Act of 2010 will, as of 2014, expand employers' ability to reward employees who meet health status goals by participating in wellness programs--and, in effect, to require employees who don't meet these goals to pay more for their employer-sponsored health coverage. Some consumer advocates argue that this ability to differentiate in health
coverage costs among employees is unfair and will amount to employers' policing workers' health.

What are the concerns?

There is widespread support for wellness initiatives in the workplace among both employers and employees. At the same time, there is conflict over programs that tie rewards or penalties to individuals achieving standards related to health status--and especially over those arrangements that affect employee health insurance premiums or cost-sharing amounts.

In general, business groups want employers to have maximum flexibility to design programs with rewards or penalties that will encourage employees to not only participate but also to achieve and maintain measurable health status goals, such as quitting tobacco use or reducing body mass index. They argue that individuals should bear responsibility for their health behavior and lifestyle choices and that it is unfair to penalize an employer's entire workforce with the medical costs associated with preventable health conditions as well as the costs of reduced productivity.

Unions, consumer advocates, and voluntary organizations such as the American Heart Association are generally wary of wellness initiatives that provide rewards or penalties based on meeting health status goals. They are concerned that, rather than improving health, such approaches may simply shift heath care costs from the healthy to the sick, undermining health insurance reforms that prohibit consideration of health status factors in determining insurance premium rates.

They argue that such incentives are unfair because an individual's health status is a result of a complex set of factors, not all of which are completely under the individual's control. For example, genetic predisposition plays a significant role in determining many health status factors, including such attributes as excess weight, blood pressure, blood sugar, and cholesterol levels. Consumer advocates also caution that poorly designed and implemented wellness initiatives may have unintended consequences, such as coercing an individual with a health condition to participate in an activity without adequate medical supervision.

Another concern is that tying the cost of insurance to the ability to meet certain health status goals could discriminate against low-income individuals or racial and ethnic minorities. These individuals are more likely to have the health conditions that wellness programs target and also may face more difficult barriers to healthy living.

These barriers may include some that are work related, such as having higher levels of job stress; job insecurity; and work scheduling issues, including shift work. Barriers outside of work may include personal issues, such as financial burdens, and environmental factors, such as unsafe neighborhoods, poor public transportation, and lack of access to healthy food.

In addition, some critics warn that wellness program requirements may be used to discourage employees from participating in their employers' health benefits plan by making their participation unaffordable. Employers might use a system of rewards or penalties totaling thousands of dollars annually to coerce employees who cannot meet health status goals to seek coverage elsewhere, such as through a spouse's plan; a public option, such as Medicaid; or a separate private plan purchased through the new health insurance exchanges.

Comment by Don McCanne of PNHP: Altruistic employers who, out of the goodness of their hearts, offer wellness programs to their employees, also theoretically benefit by improving productivity through having a healthier work force. These are admirable goals. But employers are now playing the blame game as they use their programs to penalize employees who have medical needs, by reducing their health care benefits and increasing financial barriers to care.

Employers can enhance employee health through work-sourced exercise and nutrition programs, through work safety measures, and through programs such as smoking cessation. In sharp contrast, disease screening should be provided privately in an entirely separate primary care environment where the screening is a part of a comprehensive, integrated health care program that belongs to the patient, not the employer.

Above all, whereas the medical health status of employees should be maintained through the health care delivery system, never, never should the employer be allowed to reduce health care benefits because the employee has greater needs.

This is yet one more reason why health insurance should be totally dissociated from employment. If we had an improved Medicare that covered everyone, health care access would be continuous throughout life, and barriers to care could never be used to punish individuals unfortunate enough to have manifested or contracted medical problems.

Legislation Introduced to Make Health Care a Right in New York State

Single Payer New York
Physicians for a National Health Program
Health-care NOW! - NYC

For Release: May 8, 2012 - NOON (LCA press conference)
For More Information: Mark Dunlea, 518 860-3725

Legislation Introduced to Make Health Care a Right in New York State

Doctors, Nurses, Patients Advocates Applaud Updated Single Payer Medicare for All Legislation by Gottfried, Duane and 70 lawmakers

Doctors, nurses, patients, senior citizens, anti-poverty advocates, faith leaders and medical administrators joined Assemblymember Richard Gottfried and Senator Thomas Duane in unveiling an updated and revised single payer legislative proposal for New York State . More than 70 state lawmakers are cosponsors

Assemblymember Gottfried had initially drafted a single payer plan for New York in the early 90s. The revised legislation incorporates changes that have been made in the state's oversight of health care in the interim, advances in how to provide medical services, and the recent federal changes in the health care system. The legislation builds upon the momentum from last May when Vermont became the first state to enact a universal health care system which the Governor plans to make a single payer system, where on programs pays all bills.

“The current system doesn’t work for patients or health care providers, or for the employers, individuals, and taxpayers who pay for care and coverage today,” said Assembly Health Committee Chair Richard N. Gottfried, author of the bill. “We can get better coverage, get all of us covered, and save billions by having New York provide publicly-sponsored, single-payer health coverage, like Medicare or Child Health Plus but for everyone.”

“Our current health insurance system is driven by uncertainty. Will my family have coverage? Can we afford it?,” said Senator Duane. “Single-payer is about removing that fear from peoples’ lives. It will allow all New Yorkers the same comfort that our seniors get from Medicare, and that our veterans get from TRICARE. It will allow entrepreneurs to worry about product innovation, not health insurance costs. It is time for single-payer in New York .”

Joining Assemblymember Gottfried and Senator Duane at the press conference were Katie Robbins of Health-Care Now!, Vito Grasso, Executive Vice-President of the NYS Academy of Family Physicians, Dr. Asiya Tschannerl of Physicians for a National Health Program, Mark Dunlea of Single Payer NY / Hunger Action Network of NYS, Shaun Flynn of the NYS Nurses Association, and Rev. Bebb Stone.

Assemblymember Gottfried convinced lawmakers four years ago to fund a study of the most cost-effective way to provide health care to all New Yorkers. The answer was single payer, which would reduce overall health care expenditures in New York by $20 billion annually by 2019. The state study said that single payer would be $28 billion cheaper annually by 2019 than the insurance mandate enacted by Congress. In addition to saving money, single payer was the only plan that guaranteed that everyone would have access to health care services.

"The Presbyterian Church U.S.A. has called single payer health care reform 'a moral imperative' since 2008. If I want health care coverage for myself ( and I do), how can I not want it equally for my neighbor whom I am commanded to love as myself?" asked Rev. Bebb Stone. "We believe that the value of persons requires that each person have full access to essential services without regard to ability to pay and on terms that enhance the dignity of the individuals" according to the 2008 resolution.

"Even if the recent federal health insurance mandates survives the legal challenges, it fails to provide health care coverage to everyone and is financially unsustainable. Tens of millions of Americans will discover that the insurance they are forced to buy fails to pay for the health services they will need. Everyone knows that there is a better solution - single payer, expanded and improved Medicare for all - and New York should be the first one to put it in place," said Mark Dunlea, Executive Director of Hunger Action Network.

"The simplest and quickest way to reduce health care costs is to eliminate the money wasted on health insurance, its profits and administrative costs, and the bureaucratic barriers it presents to health providers and consumers. If we got rid of insurance companies nationally, the annual savings would be more than $400 billion," added Dunlea, chair of the state legislative committee of Single Payer New York, an umbrella organization.

"As a physician working in the Bronx , I see every day the profound limits of medicine when patients must ration their care due to high copays and deductibles," said Dr. Asiya S. Tschannerl with Physicians for a National Health Program. "And too many patients have told me that they earn just a few dollars too much to qualify for Medicaid, and are now facing the horrible dilemma of - "do I reduce my income? or go without insurance since I couldn't afford it." Enough is enough. We need a truly universal healthcare system like every other industrialized nation on this planet. Healthcare is a human right, not a privilege! A Single Payer expanded and improved Medicare for all would guarantee healthcare for all," added Tschannerl, a member of Doctors for the 99% and Occupy Wall Street.

"We must end funding the waste, greed, and corruption of the health insurance companies, and move these resources to funding and providing actual healthcare. Insured or not, the Affordable Care Act pits people's needs against profits for corporate-run healthcare. We can reverse this trend and recognize the right to healthcare by implementing the New York Health bill," stated Katie Robbins of Healthcare-NOW! NYC.

"The Nurses Association firmly supports the establishment of a more equitable coverage system that directs scarce healthcare dollars towards providing universal access to high quality, cost-efficient health care for all New Yorkers - regardless of their age, income, health or employment status," according to Deborah Elliott, RN, MBA, Deputy Executive Director, New York State Nurses Association.

Health care costs have DOUBLED over the past ten years

All while the average person's income is shrinking.


Tens of millions of adults under age 65 – both those with insurance and those without – saw their access to health care worsen dramatically over the past decade, according to a study abstract released Monday.

The findings suggest that more privately insured Americans are delaying treatment because of rising out-of-pocket costs, while safety-net programs for the poor and uninsured are failing to keep up with demand for care, say Urban Institute researchers who wrote the report.

Overall, the study published in the journal Health Affairs found that one in five American adults under 65 had an “unmet medical need” because of costs in 2010, compared with one in eight in 2000. They also had a harder time accessing dental care, according to the analysis based on data from annual federal surveys of adults.


RAND’s Kellermann noted that even as the nation’s total health care bill doubled in the past decade to $2.6 trillion, many Americans had difficulty getting treated.
“We’re paying more and more and getting less and less,” he said.

Asked if there was any good news in her report, Kenney said that in contrast to adults, millions more children gained access to care in the past decade, likely because of the availability of public coverage for children through Medicaid and CHIP. The study found the percent of children who had been to a doctor in the past year rose to 92 percent in 2010, from 89 percent in 2000.

Bad Case of PIISD: Private Insurance Induced Stress Disorder

AA psychiatrist diagnoses victims of health insurance


In July 2009, Carol A. Paris, a psychiatrist and an advocate for a single-payer national health care system, found herself on a speakers panel with Donna Smith of Aurora, Colo.

Smith and her husband, Larry, had been featured in the 2007 Michael Moore movie "Sicko." After Larry Smith was diagnosed with chronic coronary disease and Donna Smith contracted uterine cancer, they couldn't keep up with the costs of health insurance. They were forced to sell their home in South Dakota and move into the basement of a daughter's home in Colorado. Moore took them to Cuba for treatment.

"I heard her talk," Paris said, "and I thought, 'That's an amazing story.' I see patients every day being pushed around by the health insurance industry and that story just pissed me off."

The more she thought about it, the more she realized that people dealing with health insurers exhibit some of the same symptoms as patients with post-traumatic stress disorder.
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