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MichUHCAN Newsletter February 2001

U2K Looks to 2001

by Marjorie J. Mitchell, Chair, Michigan U2K Campaign

As the Universal Health Care Campaign 2000 (U2K) transitions into its 2001 phase, activists and leaders have been reviewing our achievements. The campaign web site, , provides a complete national report. I will limit my comments to Michigan:

1. Our state was one of the national leaders in getting elected official support for universal health care: 50 elected officials in Michigan took the pledge.

2. Representative John Conyers has convened a Congressional Task Force on universal health care legislation. U2K organizations across the country are working to have their congressional delegations join the Task Force.

3. Michigan has 50+ organizations that have joined the campaign thus far. There are an additional 10 (or so) who have joined, but do not yet have their paperwork in to the national office.

4. During the national campaign's October Week of Action, Michigan sent between 4,500 and 5,000 post cards to elected officials and candidates for office urging their support of universal health care. In addition, between 3,500 and 4,000 church bulletins supporting universal health care were distributed to Michigan churches.

The Michigan U2K Campaign is currently planning its activities for 2001. We are considering such things as: a spring "event" with nationally known speakers; more visits to Lansing to enlist the support of additional state legislators; additional post card campaigns, etc. We are seeking input and support from organizational campaign members as we plan activities.

The Michigan U2K Campaign has had a good year, but we have a great deal of work to do before universal health care legislation is a reality. Working together, we will certainly achieve this critically important goal.

News Bits

In January, nurses at Flint's McLaren Medical Center reached a tentative contract settlement with the hospital. The RNs, members of AFSCME Local 875, were on strike for 70 days to win limits on forced overtime, which they say endangers patients. At time of writing, no details were available on the settlement.

On January 1, nearly a million beneficiaries (933,687) were dropped when their HMO's left the Medicare program. The HMO's said they weren't making enough money. Of those dropped, 31% have no other Medicare HMO available; many will be losing the prescription coverage that some HMO's offered. That may boost the demand on Congress for a Medicare drug plan.

A recent national survey, by benefits consultants William M. Mercer Co., showed that fewer than 25% of companies with 500 or more employees currently provide retiree medical benefits. That compares with 40% in 1994.

Governor Engler in January vetoed a bill that would have required insurance companies to pay health care providers for valid claims within 45 days. Engler called the bill an "attempt to micromanage existing contracts between two private parties."

Detroit Chapter Mtg:

Thurs, Feb 1, 7:30 pm

Ida Hellander, M.D., National Staff of Physicians for a National Health Program will speak on "Organizing for Single Payer: National Overview and Leading State Initiatives"

Fundraiser for MichUHCAN

Sun April 1, 8 pm

Second City Comedy Theatre

Tickets: $20, available from MichUHCAN members

Detroit-area activists: pick up tickets to sell, at the February 1 meeting! More info: Marjorie Mitchell (248-477-7911)

Making MICHILD Accessible

MichUHCAN has taken a small step to make the federally-sponsored children's health care program more accessible: We're providing a link from our web site.

In Michigan the program is called MICHILD and provides health insurance for children whose parents' income would make them ineligible for Medicaid. Michigan, like some other states, has done poorly at getting information into the hands of parents whose children need insurance. Thousands of kids who could be enrolled, aren't.

Now the federal government has established a web site ( http://www.insurekidsnow.gov/ ). It has a simplified chart on eligibility plus contact information for each state. MichUHCAN's site ( https://michuhcan.tripod.com/ ) links to this site. Michigan residents can also call 888-988-6300 (toll free) for information on applying for MICHILD.

The e-mail bonus article this month comes to us by way of Jim Ramsell's listserver (single-payer@efn.org). E-mail address for Jim Ramsell: ramselj@efn.org

How to Achieve Health Care for All

The Corporate Model Has Failed:

We Need to Create a Publicly Administered, Universal Risk Pool

How can we provide quality health care to all in this country? In our opinion, the answer lies not in continuing and extending the power and influence of private, for-profit health insurance companies, but in creating a publicly administered, universal risk pool.

The United States, as the wealthiest nation on earth, has the greatest and most technologically advanced health care resources. We have the potential to provide high quality, comprehensive services for everyone. In spite of more limited resources, all other industrialized nations include everyone in their health care systems. We leave 42 million people uninsured, and tens of millions more with impaired access to care because of inadequate health care coverage.

Corporate Health Plans Have Not Solved The Problems

Over the past decade, the country turned to private health plans to control costs and promote higher quality in health care by allowing market forces of competition to play out. In fact, however, health care costs have escalated while benefits have often been cut back.

The fundamental flaw with the corporate approach is that corporations have a mandate to optimize shareholder value, not the health of our nation's people or the humane allocation of our health care resources.

A corporate board must do its best to increase income and reduce expenses, but maximizing profit can only increase the burden on our system. Instead, our health care system should be controlled by an entity that is able to find the best use of our resources.

* In spite of the aggressive practices of private health plans, true health care costs have continued to increase at twice the rate of inflation. These health plans temporarily ratcheted down rates paid to providers, but this has threatened the solvency of the health care delivery system since it failed to reduce the actual costs of providing care.

* The industry has professed to provide choice in care through choice of plans. In reality, it instead has impaired the patient's choice of physicians and hospitals.

* The claim that private health plans have improved quality is belied by numerous studies confirming that for-profit models deliver a lower quality of care than nonprofit models.

* In the best of economic times, corporate health plans have been ineffective in reducing the numbers of uninsured. Most health care economists predict that, with the next major downturn in the economy, tens of millions more will join the ranks of the uninsured.

The most important function of health insurance has been to pool risk. Health plans benefit by excluding those with the greatest health care needs. Now, more and more, for-profit health plans seek to pass risk on to patients and providers.

* Employer-sponsored health plans are embarking on a strategy to shift costs to beneficiaries by increasing out-of-pocket expenses and reducing benefits. Since a large sector of our population has very limited disposable income, access to care will be further impaired.

How Can We Assure that Our Resources Are Directed to Health Care?

Since we have more than enough resources for everyone, we must first assure that everyone is placed in a single, universal risk pool. We need to fund that pool equitably, so each person pays his or her fair share, but no person suffers financial hardship due to health care costs.

Current direct and indirect costs of health care include funds presently paid by employers and individuals, by the government for Medicare, Medicaid, Child Health Plus and government employees health insurance, worker's compensation, the medical part of auto and homeowners' insurance, the medical part of malpractice insurance as reflected in health care costs, local taxes used to fund public health care facilities, the various sources of funds that are utilized by community clinics, funds collected by charitable organizations for various medical conditions, etc.

The direct costs are obvious, and the indirect costs show up as higher consumer prices reflecting the costs of employee benefit programs. Half of these funds already pass through the hands of the government. If you add the tax "subsidy" of employment provided insurance, then well over half of all health care funds are tax-based. Yet the public exercises little control over the health care system.

Many other nations have proven that administrative waste can be reduced by relying on an efficient system of public administration. Resources are used for patient care rather than to support a private bureaucracy. The experience of our Medicare system shows this.

Traditional Medicare has an administrative cost of less than 2% compared to private health plan administrative costs of 9% to 30%. Thus, our universal risk pool should be publicly administered so that our health care resources are directed exclusively to patient care.

What Can We Expect from a Universal System?

* National health insurance would mean social insurance, but not socialized medicine. Our existing private and public health care delivery system would continue to deliver the technologically advanced services that we have come to expect.

* Our health care costs could be controlled on the supply side through health planning and global budgeting of the universal pool, a much more humane approach than controlling costs by making care unaffordable to patients.

* Everyone would have access to care, regardless of financial status or preexisting disorders. Removing means-tested programs would mean that the poor would not be stigmatized.

* Coverage would automatically be assured, not tied to the shifting uncertainties of employment. It would be portable, available in all locations.

* Coverage would be comprehensive, including all beneficial services.

* Since patients would no longer be subject to restrictions of insurance contracts, free choice of physicians and hospitals would be assured.

* Public administration would assure efficiency and fair and equitable distribution of our healthcare resources.

We have the wealth. We have the resources. We have the capacity. We have the most technologically advanced health care system. We have an excellent health care delivery system.

We need to make only one basic change. We need to discard the antiquated, cruel, wasteful, ineffective, corporate model health plans and replace them with an efficient, publicly administered, universal risk pool. To those who tell us that the political will to implement it doesn't exist, we can only reply that creating this political will must be the highest priority of all who hope to achieve a decent healthcare system in this country.

By Don McCanne, MD and
Steffie Woolhandler, MD, MPH
PNHP Board of Directors
January 5, 2001