Posts Tagged ‘health care’
In one of the most conservative states in America, a revolution in health care is quietly happening. People under the age of 65 are actually getting access to affordable health care without relying on health insurance. It’s happening in Montana. Last year, the state’s then-Democratic governor, Brian Schweitzer, went around the state legislature and established the nation’s first free publicly-run medical clinic for state employees and retirees. There are no co-pays or deductibles. Physicians are paid hourly, so there’s no financial incentive for them to give patients costly treatments. Participants can still use their private insurance, so the clinics are really a form of public option. So did the sky fall in the Big Sky state? To the contrary:
The state contracts with a private company to run the facility and pays for everything — wages of the staff, total costs of all the visits. Those are all new expenses, and they all come from the budget for state employee healthcare.
Even so, division manager Russ Hill says it’s actually costing the state $1,500,000 less for healthcare than before the clinic opened.
“Because there’s no markup, our cost per visit is lower than in a private fee-for-service environment,” Hill says.
Schweitzer, a single payer proponent, didn’t need any more studies or commissions or hearings to start this healthcare revolution. He just went ahead and did it. Sure, the state’s Republicans grumbled, but even some of them are admitting that the the state-run model is showing results. Now, there are plans for more clinics. However, the Montana experiment still isn’t universal. It would be even better if all Montanans could use the free clinics. It would save the state even more money. But, opening the clinics to every resident may have run afoul of federal preemption laws. Schweitzer unsuccessfully sought a federal waiver to establish a more inclusive system. Under the Affordable Care Act, states won’t be able to opt out of the law and create alternative healthcare models until 2017.
Since it’s unlikely California will get another single payer bill introduced at the state level anytime soon, perhaps what Schweitzer did in Montana can be replicated at the local level (San Francisco has Healthy San Francisco, a city-run, near-universal program where most participants pay a fee on a sliding scale). At least Californians would be exposed to another positive example of a publicly-run model in action.
In the meantime, it would be nice if Schweitzer had a little chat with Gov. Jerry Brown. Just saying.
I am rooting for Obamacare to succeed. That does not mean we should abandon single payer.
I’m not a single payer nihilist, though there are plenty of people who believe the road to single payer runs through the failure of Obamacare–I’m not one of them.
I know better than most having attended numerous free health clinics around the country that countless millions of Americans will benefit to one extent or another from the Affordable Care Act.
Americans are already benefiting. There are required preventative services at no cost sharing. Young people can stay on their parent health plans until age 26.
And yes, the dreaded pre-existing condition barbarism, will vanish from the face of the earth on January 1, 2014.
This is all the good stuff.
The bad is the United States remains the most expensive health system on the planet with outcomes far below many other nations.
Another reason I want Obamacare to succeed is because economists I admire like Dean Baker say that without the cost savings the ACA hopes to achieve, our healthcare costs will destroy this country.
Despite the political forces arrayed against single payer which is the most expeditious and practical way of saving the United States from fiscal Armageddon, it remains for tens of millions of Americans the goal worth fighting for.
So it is with a heavy heart, that I want to tell you about a new study, which demonstrates that single payer could save $592 billion annually and 1.8 trillion over ten years.
The Expanded and Improved Medicare for All Act, HR 676, introduced into the 113th Congress by Rep. John Conyers Jr.and 37 initial co-sponsors, would establish a single authority responsible for paying for medically necessary health care for all residents of the United States.
Under the single-payer system created by HR 676, the U.S. could save an estimated $592 billion annually by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). In 2014, the savings would be enough to cover all 44 million uninsured and upgrade benefits for everyone else. No other plan can achieve this magnitude of savings on health care.
Specifically, the savings from a single-payer plan would be more than enough to fund$343 billion in improvements to the health system such as expanded coverage, improved benefits, enhanced reimbursement of providers serving indigent patients, and the elimination of co-payments and deductibles in 2014. The savings would also fund $51 billion in transition costs such as retraining displaced workers and phasing out investor-
owned, for-profit delivery systems.
. . .Over time, reduced health cost inflation over the next decade (“bending the cost curve”) would save $1.8 trillion, making comprehensive health benefits sustainable for future generations.
The study is the research of Gerald Friedman, PhD, a professor of economics at the University of Massachusetts at Amherst. The study was released about ten days ago in Washington, D.C., at a congressional briefing. The basis of Dr. Friedman’s research is HR 676 — the Expanded and Improved Medicare for All Act — which is a bill introduced by Rep. John Conyers Jr. (D-Mich.) in February that would establish a single-payer healthcare program. The bill has been proposed for 11 straight years.
And allow me leave you with this somber warning. Here’s a quote which was in the New York Times from Dr. Eric Topol, Chief Medical Officer of the Scripps Clinic in California. In his blog, Dean Baker highlighted the significance of Dr. Topol’s warning. Dean Baker.
In a New York Times article about the ways hospitals promote themselves, Dr Topol said:
“We’re pushing $3 trillion in health expenditures, and one-third of that is waste,” said Dr. Eric Topol, chief academic officer at Scripps Health in California. “Those TV commercials saying ‘I got my cancer care at X hospital’ are a shame, definitely wasteful.”
That one-third waste Dr. Topol is referring to, are the costs of having a for-profit healthcare system, where everyone is in it to make a buck.
And, of course, the parasitic middle man (the for profit insurers) skimming 1/3 of our precious healthcare dollars.
Nyceve is a board member for California OneCare. Originally posted in the DailyKos.