Dare the Republicans to repeal these powerful health insurance reforms!

I just dare John Boehner and Mitch McConnell and the other Republicans to attempt to repeal these excellent reforms.

To be sure, these reforms are measly improvements, when compared to EVERY OTHER industrialized country (and some developing countries!). Congress should have enacted a single payer or a Medicare for all plan.

However, the Republicans' advocacy of the repeal of these reforms will be a delicious opportunity for the Republicans (and Blue Dog Democrats) to reveal themselves as lackeys, behold to the health care industry lobbyists. Just look at the reforms below, posted yesterday by Karen Davis on Huffington Post. The GOP will look heartless in the face of these essential reforms that will end the inhumane denial of health coverage to people that are too sick. Admittedly, too many of the other reforms are not scheduled to kick in until 2014.
(Wonder why the politicians are working for self-interested industry lobbyists, and not Joe and Jane policy-subscriber? See Dave Gilson's great article, "Who Owns Congress" in this month's issue of "Mother Jones" magazine for an article that graphically illustrates how corporate interests underwrite both the Republicans and the Democrats. [Follow the link at Dave Gilson, "Who Owns Congress," for a link to a page that will let you read the article if you provide your email address. Otherwise, support the magazine and buy the October 2010 issue!])
Now, here is the overview of the reforms that the Republicans intend to undo. The Republicans will look so foolish when they try to undo these. I'd like to know how they can rationalize calling preserving health care for children with pre-existing conditions amounts to a British-style socialized medicine!

The reform provisions that go into effect today will bring coverage, financial relief and health security to many, and will also impose important new rules on the insurance industry to prevent future abuses.

As of today, young adults up to age 26 will have the option to enroll in a parent's health plan. Young adults between the ages of 19 and 29 are one of the largest segments of the uninsured; 13.7 million lacked coverage in 2008. Young adults often lose coverage when they age out of their parents' coverage upon graduating from high school or college, or when they become ineligible for public programs like Medicaid and the Children's Health Insurance Program at age 19. In 2014, they will also be able to gain coverage under Medicaid expansion or through state health insurance exchanges with subsidized coverage for people will low or moderate incomes. One million young adults (and their parents) are likely to take advantage of these important changes.

As of today, insurers can no longer place lifetime limits on benefits, and annual limits are severely curtailed. More than 100 million people currently have lifetime limits on the amount that their health insurance will pay, and 18 million have annual limits.

As of today, insurers can no longer retroactively cancel, or rescind, coverage. In what often becomes a nightmare scenario for ill patients and their families, more than 10,000 people each year have their coverage rescinded -- frequently just at the moment they need the coverage the most. Rescissions are no longer allowed.

As of today, there are new options for as many as 400,000 people with preexisting health conditions, who will immediately be able to enroll in new state-based insurance plans, and for the parents of thousands of children with preexisting conditions, who can no longer be denied health insurance for these youngsters.

Medicare beneficiaries who hit the prescription drug coverage gap or "doughnut hole" this year have already begun receiving $250 rebates. And, as of today, Medicare will eliminate cost-sharing for preventive care, and will provide for an annual wellness visit with no copayment. Next year, Medicare will provide a 50 percent discount on brand-name drugs to Medicare Part D enrollees who spend enough on prescription drugs to enter the doughnut hole. And additional discounts on brand-name and generic drugs will be phased in to completely close the doughnut hole for all Part D enrollees by 2020.

A new era in American health care begins today, one that will usher in a new found health and economic security for millions who have struggled too long. But even with all the relief that will come starting today, the record losses in coverage experienced by millions of middle-income families point to the need to accelerate implementation of health reform to provide help faster.

T.R. Reid from Washington Post., debunking myths about health care around world

From Washington Post, Aug. 23, 2009 ... Never too late.
5 Myths About Health Care Around the World
As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

1. It's all socialized medicine out there.

Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.

In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

3. Foreign health-care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

5. Health insurance has to be cruel. Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.

Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
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In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies.

T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care," [the NPR "Fresh Air" interview link] to be published Monday.

Don't give the facts, ma'am; health care rallies are about distrusting government

It's crazy: people from the lower half of society, often lacking health care or enduring financial abuse from insurance companies, are overcome with anger about Congress' proposals (plural, as the House and Senate variations need reconciliation) to reform health care. These tea-bagging yahoos, inspired by lies from FoxNews, are disrupting the public aspect of American republicanism, town meetings.

Michael McAuliff did a great job of doing undercover reporting at the rallies, interviewing the hot-head right-wingers. Important also in his "New York Daily News" report (Sunday, August 30, 2009) was the analysis by academic Carol Weisser (University of Florida).

APALACHICOLA, Fla. - In government, they do not trust.

And there's no way they'll let Uncle Sam run their health care - even if they have none. Even if they already have government-run care, like Medicare, and wouldn't give it up.

"I believe this bill is literally a death bill," said Pam Olsen, a mother of four who has no insurance.

And it doesn't seem to matter what officials say to the contrary.

To find out why, the Daily News made under-the-radar visits last week to contentious town hall meetings in the Florida panhandle district of conservative Democratic Rep. Allen Boyd.

The answer was opponents trust more what they're learning on their own from Internet activist sites, e-mails sent around by folks they know and talk show hosts like Glenn Beck.

Some of the fervor can be blamed on the "Astroturfing" of opponents who seed talking points in grass-roots networks.

But town hall attendees - unaware they were talking to a reporter - said they came to their opinions on their own and were happy to point to sources like Beck, the Web-based 9/12 Project and ResistNet, plus their own research. Some said they maintained their own e-mail networks to spread the truth as they see it.

It all produced a powerful and uniform set of gripes in three standing-room only, hours-long forums attended by The News.

In the minds of many folks packing the sessions, federal intervention in health care will only hurt, and could even doom, the nation.

Signs outside Tallahassee's City Hall were especially extreme. "Obama is not a Nazi - he's worse," declared one. "Das Kapital," proclaimed another, renaming the nation's Capitol after a Karl Marx tome.

Inside, people were more polite, but no less afraid.

"I am a single uninsured mother of an uninsured child, and yet still do not want the government involved in my health care," declared a woman who identified herself as "Jane Doe" because she wanted to protect herself and her daughter from "attacks."

"Our country is going down the wrong path right now. It's going down the path to socialism," said Olsen.

"We the people are afraid that we're being taken over," said another woman to loud applause.

Plenty of Floridians back health care reform, and many turned out in Tallahassee.

But outside the state's capital city, few believed anything good could come from health reform. Even when Boyd, their congressman, said their fears were baseless, it didn't make a difference.

Asked in the Gulf Coast town of Port St. Joe if he'd back provisions to help illegal immigrants, Boyd emphatically denied they were covered.

"There is no - zero, zippity-doo-dah, none - coverage for illegal immigrants," Boyd said, drawing boos and disbelief.

Mike Horan, a Medicare and Veteran's Administration health care recipient with a doctorate in education and a master's degree in social work, wasn't buying what he heard from Boyd in Apalachicola.

"If you think that the federal government can do anything better than private enterprise, show me the agency," he said.

Janice Williamson, who has built her own e-mail list, was so unhappy with Boyd's answers she vowed to "do everything" she could to fight his reelection.

The open disbelief, said Florida State University politics Prof. Carol Weisser, marks a new and disturbing trend.

"We know that trust in government is low," she said. "But there's always been this split where people still like their own congressman."

Suddenly, constituents prefer the flood of scary information from TV and the Internet.

"The communications are what's different, and somehow people are believing them, even though they've got someone they voted for and like telling them otherwise," Weisser said.

University of Missouri Prof. Peverill Squire says the fear isn't just about health care.

"People are desperately trying to hold on to what they may have, and they're fearful that whatever comes out of this debate is going to leave them worse off," he said.

"They fear they're going to get screwed."

Read more: http://www.nydailynews.com/news/national/2009/08/30/2009-08-30_fear__loathing_fuel_health_care_forums.html#ixzz0PoCLXLAJ

Hear stories of how European health care compares with American health care, from Americans living abroad

The commercial media, particularly FoxNews and poorly informed reporters, pump us with stories of the horrors of European public medical care.
Yet, Public Radio International (PRI)'s "The Takeaway" aired this morning (August 28, 2009) interviews with Americans living abroad, to hear how European health care compared with health care in the United States.

Read also the background on the medical systems of Germany and the United Kingdom. They have better rankings in terms of infant mortality rates and life expectancy than the United States has.

Interviews are by John Hockenberry and Femi Oke. Interviewed guests, living abroad, in Bavaria, Northern Ireland and Russia are Cynthia Geyer, Amanda Graham and Lynne Udoalov.
Click here for this and other The Takeaway segments this month on healthcare, or Healthcareroundtablesinternational.

NY Times poll: Americans DO WANT government-run health care program; overview of national health care programs

A front page June 21, 2009 "New York Times" story by Kevin Sack and Marjorie Connelly, "Poll Finds Wide Support for Idea Of Government-Run Health Plan" reports that "The poll found that most Americans would be willing to pay higher taxes so everyone could have health insurance and that they said the government could do a better job of holding down health-care costs than the private sector."
"85 percent of respondents said the health care system needed to be fundamentally changed or completely rebuilt."
Inside this "Times" issue, on page 20, appears a chart with more results from the survey. 72 percent of respondents, said "favor" to this question: "Would you favor or oppose the government's offering everyone a government administered health insurance plan like Medicare that would compete with private health insurance plans?"

65 percent of respondents answered, "Providing for the uninsured," to the question, "Which is a more serious problem right now: keeping health care costs down or providing health insurance for Americans who do not have any?" 26 percent answered, "Keeping costs down."

The leading source of family bankruptcy in the United States is out-of-pocket costs for health emergencies. Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem. Increasing percentages of Americans are uninsured --despite being employed. Employers often devise schemes, such as hiring people only part-time, so as to prevent employees from qualifying for health care. The United States spends six times more per capita on the administration of the health care system than its peer Western European nations.

Some thing is wrong with this system.

* * *

The media and far too many politicians invoke the same argument against health care, often citing only the British health care program. Yet, they ignore the fact that every other industrialized country (European or comparable Asian country, e.g., Japan or South Korea) has a national health care plan.
Indeed, some developing countries have national health care systems, see this wikipedia article citing the systems in Colombia and Ghana.
The British system is unique in that the doctors are employees of the national government. This is not the only possible path to a national health care system.

See the wikipedia article, "Health care system," at the section on "health care by country." In particular, see the section on France. France has a mix of public and private health care. Most doctors are in private practices; there are public and private hospitals. The nation's social security system has organizations that fund public and private health care providers. As the article states, "It generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments." The World Health Organization in a 2000 study of health care internationally, rated France's national health system as being the best system. (See this WHO report, "World Health Organization Assesses the World's Health Systems.")
"The World Health Organization has carried out the first ever analysis of the world's health systems. Using five performance indicators to measure health systems in 191 member states, it finds that France provides the best overall health care followed among major countries by Italy, Spain, Oman, Austria and Japan. . . . . In Europe, health systems in Mediterranean countries such as France, Italy and Spain are rated higher than others in the continent."

The American system is a failure by the financial fairness measure. The WHO report described the issue thusly,

Fairness of financial contribution: When WHO measured the fairness of financial contribution to health systems, countries lined up differently. The measurement is based on the fraction of a household's capacity to spend (income minus food expenditure) that goes on health care (including tax payments, social insurance, private insurance and out of pocket payments). Colombia was the top-rated country in this category, followed by Luxembourg, Belgium, Djibouti, Denmark, Ireland, Germany, Norway, Japan and Finland.

And note the following WHO comparison of a few North American systems, and the United States' place in this comparison:

In North America, Canada rates as the country with the fairest mechanism for health system finance – ranked at 17-19, while the United States is at 54-55. Cuba is the highest among Latin American and Caribbean nations at 23-25

Interested in greater detail from the WHO health care system study?:
"Copies of the Report can be ordered from bookorders@who.ch."

We cannot afford national health care? Looks like we already cannot afford the system we currently have. Compare the health care costs; and note the costs for the United States.
"In 2005, France spent 11.2% of GDP on health care, or US$3,926 per capita. Of that, approximately 80% was government expenditure."
"In 2005, Italy spent 8.9% of GDP on health care, or US$2,714 per capita. Of that, approximately 76% was government expenditure."
"In 2005, the Netherlands spent 9.2% of GDP on health care, or US$3,560 per capita. Of that, approximately 65% was government expenditure."
"In 2005, Sweden spent 9.2% of GDP on health care, or US$3,727 per capita. Of that, approximately 82% was government expenditure."
"In 2005, the United States spent 15.2% of GDP on health care, or US$6,347 per capita. Of that, approximately 45% was government expenditure."
(These data are from the wikipedia article, "Health care system," retrieved July 13, 2009.)

Americans who have used Health Canada implicitly debunk media's lies about Health Canada.

Bill Mann, "Americans Who've Used Canada's Health-Care System Respond to Current Big-Lie Media Campaign"

The scare ads and op-ed pieces featuring Canadians telling us American how terrible their government health-care systems have arrived - predictably.

There's another, factual view - by those of us Americans who've lived in Canada and used their system.

My wife and I did for years, and we've been incensed by the lies we've heard back here in the U.S. about Canada's supposedly broken system.

It's not broken - and what's more, Canadians like and fiercely defend it.

Example: Our son was born at Montreal's Royal Victoria Hospital. My wife got excellent care. The total bill for three days in a semi-private room? $21.

My friend Art Finley is a West Virginia native who lives in Vancouver.

"I'm 82, and in excellent health," he told me this week. "It costs me all of $57 a month for health care, and it's excellent. I'm so tired of all the lies and bullshit I hear about the system up here in the U.S. media."

Finley, a well-known TV and radio host for years in San Francisco, adds,

"I now have 20/20 vision thanks to Canadian eye doctors. And I haven't had to wait for my surgeries, either."

A Canadian-born doctor wrote a hit piece for Wingnut Central (the Wall Street Journal op-ed page) this week David Gratzer claimed:

"Everyone in Canada is covered by a single payer -- the government. But Canadians wait for practically any procedure or diagnostic test or specialist consultation in the public system."

Vancouverite Finley: "That's sheer b.s."


I heard Gratzer say the same thing on Seattle radio station KIRO this week. Trouble is, it's nonsense.

We were always seen promptly by our doctors in Montreal, many of whom spoke both French and English.

Today, we live within sight of the Canadian border in Washington state, and still spend lots of time in Canada.

Five years ago, while we were on vacation in lovely Nova Scotia, the Canadian government released a long-awaited major report from a federal commission studying the Canadian single-payer system. We were listening to CBC Radio the day the big study came out.

The study's conclusion: While the system had flaws, none was so serious it couldn't be fixed.

Then the CBC opened the lines to callers across Canada.

Here it comes, I thought. The usual talk-show torrent of complaints and anger about the report's findings.

I wish Americans could have heard this revealing show.

For the next two hours, scores of Canadians called from across that vast country, from Newfoundland to British Columbia.

Not one said he or she would change the system. Every single one defended it vigorously.

The Greatest Canadian Ever

Further proof:

Not long ago, the CBC asked Canadians (in 2004) to nominate and then vote for The Greatest Canadian in history Thousands responded.

The winner? Not Wayne Gretzky, as I expected (although the hockey great DID make the Top 10). Not even Alexander Graham Bell, another finalist.

The greatest Canadian ever?

Tommy Douglas.

Who? Tommy Douglas was a Canadian politician - and the father of Canadian universal health care.

Busting myths of Canadian national health care

The U.S. media, mainly the corporate media, but also the non-profit media (suckered in by dominant myths about the Canadian health care), undercut public support for a national health care system in the U.S., with cynical, distorting myths about the nature and quality of Health Canada.
See this site, " 'Mythbusters' by the Canadian Health Services Research Foundation" at Physicians for a National Health Program (an American organization, by the way).
Canada Health Services Research Foundation's "competent and scholarly analyses of health policy and financing provide a counterpoint to the dishonest and mendacious “research” produced by corporate and ideologue-funded institutions such as the Fraser Institute. In this series of briefs, CHSRF researchers refute many of the myths about the Canadian health system and publicly-financed health care in general."
Click to access these reports (in PDF) on the facts, to debunk the lies of Fox News and company:
* The myth that: User fees (i.e., copays) would stop waste and ensure better use of the health care system
* The myth that: For-profit ownership of facilities would lead to a more efficient health care system
* The myth that: A parallel private system would reduce waiting times in the public system
* The myth that: Canada has a communist-style healthcare system
* The myth that: Canadian doctors are leaving for the United States in droves

Arm yourselves with these facts, to counter the arguments that Canada's health system is a disaster. Polls show that Americans actually do support a national, government-initiated health care system. The only things that are standing in the way of this: (a) Americans are deceived of the facts by the corporate media, (b) America's congressional representatives are beholden to the health care and pharmaceutical companies from whom they receive campaign contributions.