Posted Sept. 4, 2010
Kaiser Family Foundation
2010 Annual Survey of Employer Health Benefits

The key findings from the 2010 survey, conducted from January through May 2010, include increases in the average single and family premium as well as in the amount workers pay for coverage. About a quarter (27%) of covered workers have a deductible of at least $1,000 for single coverage, and a greater proportion of workers are enrolled in high-deductible health plans with a savings option (HDHP/SO) than in 2009. Firms responded that they increased cost sharing or reduced the scope of coverage, or increased the amount workers pay for insurance as a result of the economic downturn. The 2010 survey continues to track the percentage of firms offering wellness benefits or health risk assessments and also included questions on health plan quality indicators and benefit changes made as result of the Mental Health Parity and Addiction Equity Act.
Survey results show an average increase in 114% in health care premiums from 2000 to 2010 with employee's share of the cost of health care premiums increasing by 147%.
Read the full report                                        
Read the summary

Posted June 24, 2010
The Commonwealth Fund 2010 Update

The U.S. health system is the most expensive in the world, but comparative analyses consistently show the United States underperforms relative to other countries on most dimensions of performance. Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, coordination, efficiency, and equity. Read the full report.

Why do your premiums go up so fast and your doctors' payments from for-profit health insurance go down?
For-profit health insurance executives are the highest paid CEOs in the U.S. while the average health insurance deductible is now $1200 per year.  How much of your premium goes to actual medical costs and how much goes to CEO salaries, lobbying to overturn consumer protections, disinformation campaigns, and dividend payments to stockholders?  Whistle-blower Wendell Potter reveals the unethical practices of the health insurance industry in his new book, Deadly Spin: An Insurance Company  Insider Speaks Out On How Corporate PR Is Killing Health Care And Deceiving Americans.

Posted June 16, 2010
League of Women Voters endorses single-payer health care

The 150,000-member League of Women Voters called for "an improved Medicare for all,"  i.e. for single-payer health reform, at its national convention on Monday. The League's action - the first major organizational endorsement of single payer since the passage of the Obama administration's health bill in March - was facilitated by the work of PNHP members and other single-payer advocates across the country who have educated their colleagues in the League about the merits of single-payer national health insurance over a period of several years.  Read the PNHP press release and the League of Women Voters Resolution.  

Posted June 10, 2010
HCFAT Blast
Why Health Care is a Human Right: Balancing the Rights of the Individual with the Public Good for a Civil Society.

(On May 14, 2010 Health Care for All Texas participated in a debate at Baylor College of Medicine on health care as a right.  Read our opening and closing statements in support of health care as a human right).
The U.S. stands alone as the only industrialized nation that has not declared health care as a human right and as a result has not established a national health care program.  In the U.S., the clash over whether health care is a human right is fundamentally a disagreement over inalienable rights. In brief, the term inalienable rights refers to "a set of human rights that are fundamental, are not awarded by human power, and cannot be surrendered."  Rights are either negative or positive.  A negative right is basically the "right to be left alone, to not be acted upon, especially through coercion."  Among some rights considered negative rights are: freedom of speech, freedom of worship, habeas corpus and ownership of property.  A positive right permits or obliges action.  Rights considered positive rights include civil and political rights such as police protection of person and property and cultural or economic rights such as public education, health care.
Certainly, there are legitimate concerns about what to establish as a right because whenever one right is established, it inevitably intrudes on another right.  However as Thomas Hobbes noted, if we wish to live in a peaceful society we must “give up most of [our inalienable] rights and create moral obligations" in order to establish a political and civil society.  So the debate is really about to what degree an individual must give up some inalienable rights in order to live in civil society.
One of the most bizarre claims made by some opponents of a national health care program is that if health care is established as a human right in the U.S., doctors would be required to treat for free anyone who wanted health care.  This implausible claim is designed to scare the public and health care professionals.  Clearly upon reflection this would never happen.  No doctor or health professional or facility would be forced to work involuntarily.                     
What would actually happen if the U.S. established the right to health care would be the creation of health facilities, goods and services, such as hospitals, doctors and drugs, that would be of good quality and available to all, on an equal basis.  All health professionals would be paid for their work and would not be required to work for free against their will.  
Fear that we cannot afford universal health care is another significant obstacle to establishing health care as a right.  But in the case of health care, universal, high quality health care is quite affordable – if we eliminate the for-profit health plans from our health system.  Such a change would not decrease the quality or scope of services.  Instead, it would redirect health care dollars that are now spent on wasteful administrative costs by insurance companies and advertising by pharmaceutical companies, as well as eliminating unjustified and excessive private sector profits.
The United States is already the world’s biggest health care spender, exceeding countries that provide universal access to health care.  According to the U.S. government’s General Accounting Office, “If the U.S. were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs [10 percent of health spending] would be more than enough to offset the expense of universal coverage.”  Establishing health care as human right and creating a national health program where access to health care is affordable and based on need, not on ability to pay, is morally right and economically better for our nation than keeping the current system.

Posted June 7, 2010
What is Mental Health Parity?

The Mental Health Parity and Addiction Equity Act requires that a group health plan that provides both medical and surgical benefits and mental health or substance abuse benefits must ensure that the financial requirements and treatment limitations applied to medical and surgical benefits must be applied equally to mental health and substance abuse treatment.  This act mandates that all deductibles, lifetime maximums, and out-of-pocket costs plus the number of sessions per year must be the same for medical and mental health treatment.  Instead of only being allowed 30 visits per calendar year, a plan must allow unlimited visits if they allow unlimited visits for medical care.  
However, not surprisingly, some insurance companies are seeking to block enforcement of the federal mental health parity law.  Ironically, when mental health services are adequately available, costs for medical services drop.  The result is that while costs for increased mental health services do rise under parity, overall health costs are reduced because, often enough, physical symptoms (like headaches, stomach aches, etc.) have emotional or psychological components.  Additionally, many unhealthy behaviors such as smoking, overeating, not exercising enough, excessive alcohol consumption which lead to poor physical health can be effectively treated with psychological counseling and interventions.
Once again, we have an example of how health insurance companies are in business to make money - not take care of our health.  If we had a national health program with universal health care, we could focus our health care dollars on prevention saving lives and money.  It's still true that an ounce of prevention is worth a pound of cure.  Why do we continue to include for-profit health plans in our health system when they block our access to health care because they want to make money? They can't make money if they invest in prevention.  One reason other industrialized countries with national health programs have better overall medical outcomes than the U.S. has is that their systems, whether they are single-payer, Bismarck, or Beveridge models, is that they can focus on health, especially preventive health, instead of profits.  We should do the same.

Letter to Senator Cornyn
April 17, 2010

Senator Cornyn,
I am currently visiting family in Spain.  There are numerous conversations about health care here, both with American citizens and local people.  I wish I could convey to you the total disbelief that I hear about health care financing in the US.  I pay more for parking while seeing a doctor than they pay for a doctor visit.  They are under no illusion that health care is free but in Spain it is financed rationally like roads, fire departments, homeland security and other common needs. 
In the U.S. there is a great model for this in Medicare.  Medicare needs to be improved, expanded, and adequately financed.   It is currently in financial trouble because it covers only the elderly and most sickly groups.  It has also been ravaged by attempts at privatization.  Competition has a place in health care delivery.  I want my doctor to strive to be the best.  Since my insurance company delivers no value, competition makes it no better.  
Please step back and consider not a plan that is Democrat, not a plan that is Republican, but a plan that is RIGHT!!!  Consider what is uniquely American- Improved and Expanded Medicare for All. 
Carolyn Heinz, Treasurer, Health Care for All Texas

Health Care for All Texas Blast
April 10, 2010

As we all know and have experienced, with their for-profit, publicly traded status, health insurance companies have changed their focus from patient care to profits for their stockholders.  One form of protest, divestment, is being encouraged for people who own stock or mutual funds in health care companies. The idea for divestment from the health care industry is modeled on the movement to divest from companies doing business in/with South Africa during its racist, apartheid regime.  Many individuals, institutions, and retirement funds divested and thus helped to end apartheid in South Africa in the late 20th century. It worked then, it would work now.
Are you aware of the specific holdings in your retirement plan? For example, did you know that TIAA-CREF, in which many teachers and college professors have investments for their pensions, is the 12th largest stockholder in WellPoint holding about 5 million shares worth about $320 billion?  Imagine the impact it would have if all these “stockholders” demanded that TIAA-CREF divest from Wellpoint. Here’s an approach that allows us to put our money where our mouth is. Divest. It’s good for your health.
Houston Chapter, HCFAT

April 16, 2010
Washington Post
"UnitedHealth CEO reaps nearly $100 million from stock options"

The chief executive of UnitedHealth Group, one of the nation's largest health insurers, reaped almost $100 million from exercising stock options last year.  Stephen J. Hemsley exercised 4.9 million options in February 2009 at a gain of $98.6 million, the company said in a regulatory filing. Read more...

March 8, 2010
The current proposal for health care reform in Congress includes individual mandates for all Americans to purchase health insurance. Lower income households will be given taxpayer subsidies to purchase private health insurance. In the same proposal, for-profit health plans will be prevented from charging sick people higher rates than healthy people. The theory is that these two requirements will provide a large enough risk pool so that for-profit private plans will be able to offer affordable health insurance with adequate coverage.  
The individual mandate will be a cash cow for the health insurance industry.  Although it has taxpayer subsidies to buy private health insurance there are no regulations on what the for-profit health plans can charge or what minimum level of benefits they must offer. Premiums in California for individual policy holders increased by 39% for this calendar year despite record profits reported by for-profit health insurance companies in 2009. History shows that individual mandates mixed with for-profit private health insurance companies does not bring down costs nor does it improve the benefits offered. Massachusetts is a case in point.
Christine Adams, Ph.D.
Statewide Secretary, Health Care for All Texas

February 22, 2010
Some years ago, state comptroller Carol Keeton Strayhorn wrote an excellent paper which stated clearly that undocumented immigrants pay for a lot more taxes than they receive in services. "The absence of the estimated 1.4 million undocumented immigrants in Texas in fiscal 2005 would have been a loss to our gross state product of $17.7 billion. Undocumented immigrants produced $1.58 billion in state revenues, which exceeded the $1.16 billion in state services they received" and "Consumption taxes make up a greater percentage of total state revenue in Texas than in most other states." 
There are about 6 million uninsured in Texas. Perhaps at most 1.6 million undocumented in Texas. If every single undocumented immigrant left Texas tonight, we'd still wake up tomorrow with 4.4 million uninsured Americans. The same is true for the entire country: 46 million uninsured, possibly 11-12 million undocumented. If  you sent them all away, you'd still have a huge problem of uninsured, working Americans. The health care crisis in America, and the uninsured, have little to do with immigration. That's another problem. The health care crisis in the US is a problem of unchecked health care costs, not immigration.
Ana Malinow, M.D.
Co-founder, Health Care for All Texas
Past President, Physicians for a National Health Program

February 01, 2010 
"Medicare-for-All' Cure for Health Woes Single-Payer System is Best Reform Approach"

The data and evidence are clear: To a scientific certainty, only a single-payer "Medicare-for-All" system of health care financing will solve the serious cost and access problems and achieve good, affordable health care for all in the United States. As a scientist and physician, this is my conclusion after studying the data for years. The data are voluminous, stretching back to World War II, and come not only from the United States, but from all other industrialized countries. Except for the United States, all industrialized countries have some form of universal health care.
Americans are increasingly afraid that they can't afford to get sick, and with good reason. About half of all personal bankruptcies are caused by medical expenses, and 76 percent of these individuals had health insurance when they got sick or injured. Those of us with insurance are paying a greater share of the premium and more deductibles and co-pays as well. Thus, not only do we have 46 million Americans without health insurance, but at least an equal number who are seriously underinsured. With the recent economic downturn, the ranks of those who are uninsured and underinsured are growing. Many are faced with choosing between paying for medicine and needed health care and paying for food and housing. A typical story is: get sick or injured, lose your job, lose your health insurance, go bankrupt. A majority of physicians (59 percent) and an even higher proportion of Americans (at least 62 percent) support single payer national health insurance or "Medicare-for-All". In spite of this, virtually all we are hearing about today are mandate plans that would require everyone to buy the same private for-profit insurance that is already failing us. The for-profit insurance companies and their plethora of plans make for a terribly complex, fragmented, costly and inefficient system. Administrative overhead consumes about 31 percent of health care dollars in the United States, and the for-profit insurance companies are responsible for half of this, or 15 percent of $2.4 trillion. This money, more than $350 billion per year, provides no health care: it is consumed by enormous administrative costs, profits for investors and shareholders, and large salaries for managers of these for-profit insurance companies.
All of the incremental reform programs proposed - tax subsidies, health savings accounts, individual or employer mandates, increased regulation of for-profit insurance companies - keep these proverbial foxes in the henhouse and are doomed to fail to control costs and provide universal access. Competition among the foxes does not benefit the chickens, the patients, the doctors or the hospitals. The for-profit insurance companies fundamentally reduce choice - your preferred doctor or hospital is "out-of-network"? Too bad, we won't pay, says your insurance company.
The data are in. Incremental reforms, mostly mandate schemes which retain the for-profit insurance companies, have been tried in seven states over the past two decades: Massachusetts, Tennessee, Washington, Oregon, Minnesota, Vermont, Maine. In all of these states the reforms have failed to contain costs. In all but Massachusetts, they have failed to reduce the number of uninsured. In Massachusetts, there has been a modest decrease in the number of uninsured, falling from 13 percent of adults in 2006 to 7.1 percent of adults in 2007, but at the cost of a substantial increase in public spending (spending for "Commonwealth Care" was $629.8 million in fiscal year 2007, $1089.2 million in fiscal year 2008 and $1317.7 million in fiscal year 2009). Most of the gain in Massachusetts has come from expanding Medicaid and subsidizing the purchase of private insurance; very few people have signed up for the unsubsidized private insurance. Not to mention that 7.1 percent uninsured is unacceptably high. Far from controlling costs, these mandate plans will add hundreds of billions of dollars to the nation's health care costs.
The United States spends about twice as much per capita on health care as other industrialized countries. Yet it is a myth that the United States has the best health care in the world. The United States ranks near the bottom of industrialized countries in terms of important morbidity and mortality outcomes (for example, life expectancy and infant and maternal mortality).
About 18,000 American adults die unnecessarily every year due to lack of insurance (Institute of Medicine, 2002). As reported in the Archives of Internal Medicine in 2003, repair of an aortic aneurysm cost $8,647 in Canada and $13,432 in the U.S.
What accounted for the substantial difference? Most of the difference was due to much greater overhead costs in the U.S. The surgeons and surgical facilities are top-notch in Canada. The surgeons are very well paid. The difference is that Canada has adopted a true insurance system for financing health care, one that spreads risk across a broad population: a publicly funded single-payer national health insurance plan that eliminates the parasitic, investor-owned "insurance" companies that make profits by enrolling the healthy, screening out the sick and denying claims.
Single-payer national health insurance for financing health care is NOT "socialized medicine." Under a single-payer, "Medicare-for-All" system, delivery of health care remains private. The providers of health care remain private. Patients choose any doctor and any hospital.
Parenthetically, replacing the wasteful for-profit insurance companies with a single-payer national health insurance program for financing health care in the United States would save enough money (more than $350 billion) to not only achieve universal coverage, but allow the coverage to expand and be more comprehensive.
We have an American system that works. It's Medicare. It's not perfect, but Americans with Medicare are far happier than those with for-profit insurance. Doctors face fewer hassles in getting paid, and Medicare has been a leader in keeping costs down. And keep in mind that Medicare insures people with the greatest health care needs: people over 65 and the disabled. We should improve and expand Medicare to cover everyone. In contrast to the for-profit insurance companies, Medicare has a very low overhead - about 3 percent.
Unfortunately, the for-profit insurance companies have been infiltrating Medicare in the form of "Medicare Advantage" plans, substantially raising costs when compared to traditional Medicare.
A single-payer "Medicare-for-All" system is embodied in a bill currently in the U.S. House of Representatives, H.R. 676, sponsored by U.S. Rep. John Conyers, D-Mich., and cosponsored by 93 other members of Congress. Its features are: automatic enrollment for everyone; comprehensive services covering all medically necessary care and drugs; free choice of doctor and hospital, who remain independent and negotiate their fees and budgets with a public or nonprofit agency; processing and payment of bills by a public or nonprofit agency; promotion of job growth and the entire U.S. economy by removing the excessive burden of health care costs from businesses; coverage for everyone without spending any more than we are now.
The growth in health care costs must be addressed if any proposal is to succeed. Single-payer offers real tools to contain costs: budgeting, especially for hospitals, planning of capital investments (to avoid wasteful duplication and concentration of expensive technology), and an emphasis on primary care and coordination of care. Mandate plans offer only false hopes: competition among for-profit insurance companies, computerization and chronic disease management. Competition among the shrinking number of for-profit insurance companies has already failed to contain costs and, in the absence of single-payer and reformed primary care (so that everyone has a primary care home), computerization and chronic disease management will raise costs, not lower them.
Business leaders are well on their way to understanding how the current system makes their businesses uncompetitive with businesses in industrialized countries that have cost-effective health care systems not based on profit.
Finally, the most important group is patients. We are all sometimes patients. All patients must rise up and remove the foxes from the henhouse.
Foxes are not evil, but their nature is such that they must not be allowed in the henhouse.
Dan Wirt, M.D.
Health Care for All Texas
Physicians for a National Health Program