Medicare Commission Proposals; Good, Bad, and Downright Scary
The Federal Advisory Commission on Medicare was due to release
its final report March 1, but did not actually make its final report until March 16. However, the shape of its proposals was clear from preliminary documents. The Commission's proposals were the topic of the March 4 meeting.
With qualified agreement from Republicans and some Democrats, the
Commission's leaders want to replace the current system, in which
Medicare acts as the single payer of covered health expenses for the
nation's elderly. In its place, the Commission proposes giving each
beneficiary a fixed amount of money to use in buying private insurance
or paying for traditional Medicare. This is a voucher system going by the name of "a premium support model."
The purpose of the proposed changes in the program is to shift the costs of medical care away from the Medicare program and onto the personal expenses of the program's beneficiaries. This is not an interpretation of the intent of the Commission, it is a stated goal of the Commission.
Supporters of the proposal say it will reduce costs by encouraging
seniors to shop around for the cheapest insurance. Critics point out
that private insurance has higher administrative costs then Medicare,
that private insurers often skimp on benefits to protect their bottom
line, and that billions of tax dollars from the Medicare system would
be diverted into corporate profits instead of care.
In addition, moving Medicare beneficiaries into private HMOs has
already been problematic. More than 400,000 beneficiaries have been
dropped by HMOs in the past six months because the HMOs said they
weren't making enough money from Medicare business.
Democrats on the Commission, with support from President Clinton,
propose adding prescription coverage to this plan. Drug companies are
expected to oppose adding prescription coverage since Medicare, as a
large purchaser, could then demand lower prices. Meanwhile hospitals
favor moving beneficiaries into many separate plans, thinking that
Medicare would then lose its current power over costs.
The scheduled speaker for our February meeting was unable to attend
the meeting. We had a general discussion about how to raise funds to
support meeting expenses, publications, and the Speaker's Bureau. There
was also a discussion, useful if not conclusive, about the general state
of the single-payer movement in the country and what we might do to
advance the cause locally.
Union Support of Single-Payer
A discussion led by MichUHCAN activist David Green, M.D.
on January 7, 1999. We learned about some of the complexities of the UAW
contracts which weaken this union's support for a national health plan.
MichUHCAN Holiday Get-together
On Saturday, December 12, the party at Pat Cason's house in Detroit
went pretty smoothly. The meat-eaters enjoyed the vegetarian dishes and
the vegetarians ignored the stews and meat sauces with good humor.
Everybody talked to at least one new person. It was a pretty relaxed affair,
just as it was supposed to be. The stragglers even left without having
to be told how late it was.
Reports, Steering Committee Elections
On Thursday, December 3, reports were given on the PNHP National
Convention and the UHCAN National Convention recently held in Washington,
DC; and on the Labor Party National Convention recently held in
Philadelphia. Martha Gruelle, Ed Pintzuk, Susan Steigerwalt, Pat Cason, Julie
Klinker, Art Myatt, Marilyn Schmidt, Flora Hommel, Claudia Seldon, and Martin
Seldon were elected to the Steering committee for 1999.
A Financial Plan for a Single Payer Health System
How do we pay for single payer health care? The beauty of single payer is that
there is a clear, logical, and achievable answer to this question. And MichUHCAN's
own Ed Pintzuk has developed an educational tool to explain the answer - not only
for us to learn from but for us to use as we promote single payer amongst the public.
Ed presented the answer to this often asked question at our November meeting.
Thanks for Speaker's Training
A BIG thank-you to Marilyn Schmidt and Lydia
Steinseifer for organizing October's three-part speaker's training
and to Margie Mitchell for conducting the training. The
workshop was a great success. It was captured on videotape to be used by
others who were unable to attend. Again, thanks to the organizers and
also to all who participated and will now venture out on their own to
"Fairness Agenda for America" Hearings Well Attended
More than 100 people turned out last month for hearings with Rep.
Lynn Rivers and Rep. John Conyers on the "Fairness Agenda for America."
MichUHCAN members Julie Klinker and Susan Steigerwalt testified on
the devastating impact of health care downsizing and the growing
number of uninsured, and called for support of a single payer system.
While most in attendance are already supporters of a progressive agenda,
the hearings were a good opportunity to build coalitions and demonstrate
how most progressive issues are interdependent.
Caring for the Uninsured
Sister Rita Brocke spoke about
The Thea Bowman Nurse Practice Center. Sister Rita is a founder
of the Thea Bowman Nurse Practice Center in Highland Park. It is a free
clinic for the uninsured who otherwise have no source of health care.
Sister Rita shared her experiences providing care to the uninsured and
discussed the difficulties of raising funds to support the work.
Reform or Revolution?
Patient Protection: What to do Now?
The September meeting, held on September 8, featured a discussion
on the question of supporting incremental reforms of the health care
system in the United States. Taking
the side of supporting patients' rights and regulation of private health
care insurers was Ed Pintzuk. Urging us to
concentrate our efforts on the creation of a national health plan was
Susan Steigerwalt. The ideas are not entirely
incompatible. However, when it is a question of what the priorities
of this organization will be and how we should make use of our limited
resources, there is some real conflict between these two approaches.
Two years ago the Detroit Chapter of MichUHCAN decided to devote
substantial energy toward getting patient protection legislation
introduced and passed in Michigan, both in response to a real need for
regulation of managed care and as a means of gaining a broader audience
for talking about and lobbying for single payer, always our primary focus
and ultimate goal. Well, now, in 1998, even the Republicans are
promoting "Patient Protection" and passing bills that do little to
protect the quality of or access to health care. In this context,
MichUHCAN must rethink its stand on Patient Protection work.
MichUHCAN public forum:
Labor, Health Care and Social Justice
The forum was held on Saturday, Sept. 19, 1998, at UAW Local 417,
1640 Stephenson Highway, Troy MI (between 15 & 16 Mile). Speakers were
Tony Mazzocchi of the Labor Party
State Rep. David Gubow, Sponsor of Michigan Single Payer Bill
and Greg Conyers of the Michigan League for Human Services,
August Social Gathering - Potluck Picnic
In August, there was no meeting at our regular location.
There was instead a backyard barbecue at Susan Steigerwalt's home
on Saturday, August 8, from 5:00 to 9:00 PM.
Rep. John Conyers attended and spoke about the Patient
Protection Bills in Congress.
Why You (Probably) Can't Sue Your HMO
The July meeting was held on July 9 to avoid conflict with the
July 4 holiday weekend. Ann Thompson, a local lawyer
who is all too familiar with the defects of the ERISA law, spoke
about why this law, as it now stands, prevents a person who has health
care coverage provided by her employer from holding the health care
insurance company responsible in a court of law for the medical decisions
made within the insurance company. Efforts are being made to change the
federal law which shields the insurer. Insurance companies and HMOs are
lobbying strongly against the proposed changes, which is a clue that these
efforts are on the right track. Bills in Congress with effects on this issue
Medicaid Managed Care
Beverly Lemle, who currently works at the
Neighborhood service Organization, was unable to attend the June 4 meeting
at which she was scheduled to speak on Medicaid Managed Care. Instead,
we reviewed and discussed a set of informational slides on the statistics
of the health care crisis which MichUHCAN recently obtained from
Physicians for a National Health Plan. Ms. Lemle has agreed to present
her talk at a later MichUHCAN meeting.
Nurses successfully Organized at POH
Janise Ripple is an RN at Pontiac Osteopathic
Hospital and was a leader of the recent organizing effort at this health
care facility. At the MichUHCAN regular meeting, Thursday evening,
May 7, 1998, she gave a presentation on how the nurses and technicians at POH
successfully organized with the UAW. The impact of such
successes on health care delivery was discussed. One main point brought
out was the fact that the POH management's treatment of the nurses and
technicians was the most effective organizing tool for the union. In
other words, the people working at this hospital were so mistreated and
their working conditions were so degraded that they were ripe for
Hot off the Presses:
PNHP's new horrifying slides on the health care crisis
On Thursday, April 2, 1998, Dr. Susan Steigerwalt
presented, in slide form, the newest data on for-profit
health care corporations and the health care crisis. This well-
researched set of over 100 slides (the source of each statistic is noted on the
screen) will be available for speakers from MichUHCAN to use when
presenting our point of view in other venues. This was also the regular
membership meeting for the month of April.
DMC Management Response to Unsafe Practices
Presentation by Margot Reid at the
MichUHCAN Detroit Chapter meeting, Thursday, March 5, 1998.
Margot Reid is a Detroit-area Nurse Administrator with expertise in
dialysis care and management who was recently fired by the Detroit Medical
Center after exposing gross problems with morbidity and mortality rates at
the Sinai Hospital-based dialysis center (a jointly owned for-profit
operation of the DMC and Henry Ford Hospitals). After bringing the
dialysis-related problems to the attention of the administration, it was
clear to Reid that proper actions to correct the deficiencies were not
going to be taken, at which time Reid made it clear to administrators that
she would make certain the proper authorities and agencies were notified.
Soon after, Reid was fired. Currently, Reid has a lawsuit pending
against the DMC, David Campbell, and others involved. Families of patients
who died as a result of unsafe dialysis practices have been picketing at
"Fences" Fundraiser a Huge Success
Many thanks to all who supported our February 22 fundraiser at the
Detroit Repertory Theatre - selling tickets, buying tickets, and spreading
the word. A special thanks to Pat Cason and Marilyn Schmidt for their
primary role in organizing the event.
It was a full house for the matinee performance of "Fences" which was
enjoyed by all. Thanks to everyone's efforts, the Detroit Chapter of
MichUHCAN raised well over $1000 which will allow us to continue our work
to achieve quality health care for all.
1998 Steering Committee Named
At the February chapter meeting, the following individuals were named
to the 1998 Steering Committee: Martha Gruelle (chair), Ed Pintzuk
(co-chair), Susan Steigerwalt, Pat Cason, Martin Seldon, Claudia Seldon,
David Green, Flora Hommel, and Julie Klinker. The Steering Committee
meets monthly. Any MichUHCAN member is welcome to attend.
Detroit Chapter Prepares for 1998:
A Report from Recent Planning Retreat
by Martha Gruelle, Detroit Steering Committee
Ten active members of our chapter, and Marge Mitchell, the chairperson
of statewide MichUHCAN, met for an intense Saturday session to look at
where we are and how to move forward. (Thanks to Pat Cason for hosting
the meeting, and to Claudia Seldon for planning ahead and baking enough
goodies for two meetings).
Marge gave a report on statewide MichUHCAN, which has 24 member
organizations and three chapters (Detroit, Ann Arbor, and Lansing).
Activity in the statewide has declined since the Clinton health "plan"
bit the dust; many organizations now see health care reform as less
immediate. But MichUHCAN is still determined, and keeps alive the
state's own single-payer bill, Michicare; backs patient protection
at the state level; provides public education through local cable TV;
and has recently joined the Michigan Consumer Health Coalition, which
watch-dogs quality of care. Suggestions for improving the statewide's
newsletter were discussed at our meeting.
Susan Steigerwalt reported on the Detroit chapter's beginnings and
our recent history. In the past year, we shifted to an emphasis on
protecting patients in managed care plans, hoping to open discussions
on the need for a single-payer plan. The group discussed why this work
has fallen short of our hopes; communication problems internally and
with friendly legislators, the uninspiring nature of this very partial
step; and our inability to tie the issues to real people's immediate
problems and fears.
On the national scene, Susan observed that "activity is fractured."
Attention has turned to state level, not federal campaigns including
work on patient protection, conversion of hospitals to for-profit status,
and single-payer initiative work.
Much of this organizing is "health care worker-driven," says Susan,
including the National Call to Action committee of health care workers
(mostly doctors and nurses), which is challenging for-profit conversions.
We discussed the local Call to Action Committee, the health care advisory
group organized by City Council Member Maryann Mahaffey, and the
coalition organizing around the Detroit Medical Center.
Ed Pintzuk gave a look ahead. He showed the continuing rise in
health care expenditures as a fraction of the economy and predicted
that HMOs will see less increase in profitability (not that they'll
lose money!). Ed mentioned the 27 bills now in Congress to regulate
managed care organizations, and said such regulation can help only if
public pressure is continually applied.
We discussed but did not resolve questions of whether political
forces would actually limit the growth in health care spending, and
whether our friends and neighbors ("the public") would support or
reject a challenge to profit-making in health care.
The group identified three priorities for the coming year:
- Outreach for single-payer - through sending speakers, staffing
literature tables, and holding informal meetings with leaders/members of
groups we would like to work with.
- Building ties with Detroit's African-American community.
- Helping people who have immediate problems getting care through
HMOs/managed care organizations - especially in the Medicaid HMOs.
Being knowledgeable on the steps they need to take and advising them
on the process.
For starters, members at the meeting made plans to staff tables at
several upcoming events and to sponsor a participatory training for
speakers; we planned to invite a member of a Black physicians's group
to speak at an upcoming meting and to keep members informed about
organizing at the Detroit Medical Center; we planned to talk with two
group s we believe will be active advocates for people in Medicaid and
HMOs and report on their work at an upcoming chapter meeting with a view
toward helping out.
As usual, MichUHCAN Detroit chapter activists have outlined an
ambitious program - but that's not all! We also agreed to try to
reach all those in our area who are members but aren't active, and see
if there's's some way they'd like to take part. You needn't wait for
that call. See How to get involved with MichUHCAN,
or call Marilyn (248-674-3520) or Ed (248-737-2275).
THURSDAY, JANUARY 8, 1998
Anne Jenks of the California Nurses Association
discussed the Single Payer Movement in California and how they helped build
a strong coalition for health care justice. Steering Committee elections
originally scheduled for this meeting were tabled because of extended
discussion of California events.
THURSDAY, NOVEMBER 6,
On November 6, MichUHCAN's new piece of literature called
"Facts About Health Care Reform"
was discussed. In printed form, the essential facts are laid out on one side of one sheet
of paper, suitable for distribution at any political event. The version available on this
web site, while including the same facts, will print up on several sheets of paper because of
the constraints of HTML. If you wish to have a copy of the printed flyer,
On Thursday, October 2, 1997, at the regular membership meeting, a panel of nurses
discussed the deterioration in patient care in some Detroit hospitals caused by cutting
hospital nursing staff and attempting to have the work done by technicians who generally
have little or no medical training, and by cutting back on home care visitiations. It was
brought out that patients in hospitals are ususally not aware of the qualifications (or lack
of qualifications) of the people who are administering treatments, drawing blood, or
On Friday, September 26, statewide MichUHCAN held a rally to mark the 30th anniversary of
Medicare from noon to 2:00 Pm at the Federal Building in Detroit. Signatures to oversized
postcards circulated at the Sept. 26 Medicare Rally and thereafter are being sent to
President Clinton. Over 300 signatures urge Clinton to "lead the crusade to make healthcare
a right, not a privilege in America," and to "protect Medicare at all costs and expand it
to all Americans."
On Thursday, September 4, State Senator Alma Wheeler-Smith was the guest speaker
at our membership meeting. (See plans for July, below.)
Nurse's Conference Was Big Success
Nearly 100 Detroit-area
nurses, including some MichUHCAN members, attended a conference presented by the
California Nurses Association on August 20.
Participants were informed about how corporate America is driving the changes in health
care that directly affect working nurses each day through such things as understaffing,
overwork and marked decline in quality of patient care. Nurses learned about strategies
to protect themselves and their patients and heard repeatedly the message of becoming
empowered through conviction, cooperation, and coalition. Several nurses met with Kit
Costello, President, CNA, on August 21, to discuss near-future organizing goals for
Detroit nurses. Expect to see more from Detroit nurses in the months and years to come.
The plan for Thursday, July 10, was to have State Senator Alma
Wheeler-Smith as the guest speaker at the regular Detroit-area membership meeting.
The Senator has introduced a patient protection bill into the state
legislature which was to have been the main topic of discussion. However,
she was unable to attend because the legislature was still in extended
session. Instead, this web site, which was first activated over the
July 4 weekend, was discussed and demonstrated, the opening of the Thea
Bowman Nurse Managed Center (a non-profit center for primary care for
the uninsured) in Highland Park was applauded, and other issues were
discussed. Senator Wheeler-Smith will be rescheduled.
At the regular membership meeting on June 5, 1997 in Berkley, Detroit City council
President Maryanne Mahaffey was the guest speaker. She discussed health care problems
facing the city of Detroit.
There was no central speaker at the May 1, 1977 membership meeting in Berkley. The
agenda focused on how to effectively support pending Michigan state legislation and how
to get other organizations interested in coalition building.
Over 60 people turned out in East Lansing on April 26, 1977 at a forum organized by
MichUHCAN, Health Care for Sale? The audience heard how the powerful
Columbia/HCA was dealt a blow when Attorney General Frank Kelley filed suit and got a
ruling by the Ingham County Circuit Court that such a deal as proposed by the not-for-profit
Michigan Capital Healthcare and the for-profit Columbia/HCA violates state
regulations of non-profit corporations and charitable trusts. Though the ruling is being
appealed, such rulings can slow down Columbia's race to buy up health care.
Keynote speaker Dr. Quentin Young gave a first-hand account of how Chicago's Michael
Reese Hospital, where he is employed, has been affected since being bought by Columbia/
HCA. Speaking in favor of a single-payer health plan, he reminded us that Medicare, the
"most popular and successful social justice program ever" (and a single-payer system)
celebrates its' anniversary on July 30 which we should be celebrating across the nation.
He also pointed out that despite the value of patient-protection bills, "legislators are
ill-equipped to write medical practice acts - it won't get us there." We all must be
actively involved and must keep pushing for more comprehensive reform.