Insurance, health interests fill Baucus' coffers

By Mike Dennison, Billings Gazette, State Bureau, published June 14

As Sen. Max Baucus has taken the lead on health reform legislation in the U.S. Senate, he also has become a leader in something else: campaign money received from health and insurance industry interests.

In the past six years, nearly one-fourth of every dime raised by the Montana Democrat and his political action committee has come from groups and individuals associated with drug companies, insurers, hospitals, medical supply firms, health service companies and other health professionals.

These donations total about $3.4 million, or $1,500 a day, every day, from January 2003 through 2008.

Baucus, who chairs the Senate Finance Committee, which is drafting a major health care reform bill this month, insists that this cascade of money is not unduly influencing his work.

"No matter the issue, Max always puts Montana first," said his spokesman, Ty Matsdorf. "Max will continue to do what's right for our state, and groups like SEIU (a union representing thousands of health care workers) and AARP (a senior citizens' group) wouldn't line up in support of his health care reform effort if this wasn't true."

Baucus' office also lists numerous examples of how his proposed reforms are challenging the health care and insurance industries, such as requiring insurers to accept all customers, regardless of health condition.

Yet some reform activists and others who watch the political system say it's foolish to think this money doesn't hold some sway.

"When you spend so much of your time raising money, as members of Congress do, from those who have a compelling interest in the outcome of legislation, it has to change what you think about it, and the viewpoints that you have," said David Donnelly, director of Campaign Money Watch, a Washington, D.C., group that tracks money in politics. "It's just human nature. ... and members of Congress are human."

Advocates of national, public health insurance for all -- a proposal largely excluded from the health reform debate -- say their exclusion points to the power of moneyed interests in Congress.

"I'm convinced that this (money) has a profound influence," said Quentin Young, national coordinator for Physicians for a National Health Program. "Otherwise, how could Baucus, an otherwise respected and wise politician, say categorically that single-payer (national health insurance) is off the table?"

Only Baucus' Republican counterpart on the Finance Committee, Sen. Charles Grassley of Iowa, rivals him in terms of percentage of funds from these business sectors.

The Gazette State Bureau examined fundraising data for Baucus, Grassley, Sen. Edward M. Kennedy (who chairs the Senate Health Committee, which is drafting health reform legislation), the other two members of Montana's congressional delegation, and President Barack Obama.

The data are compiled by the Center for Responsive Politics, a nonprofit group that tracks and sorts campaign donors by profession and industry. Here's a summary of what the State Bureau discovered:

From 2003 to 2008, the Baucus campaign and his Glacier PAC, which raises money and distributes it to other candidates, received 23 percent of their $14.8 million from health care and insurance interests.

The $3.4 million from these sectors includes $853,000 from pharmaceutical and health products, $851,000 from health professionals, $467,000 from hospitals and nursing homes, $466,000 from health service and HMO interests, and $784,000 from insurance.

The insurance sector money includes donations from all types of insurance company interests, including health insurance.

• Five of the top 10 specific donor sources for Baucus were drug companies, health insurers or health-related firms. For example, employees of Schering-Plough Corp., a major drug firm, gave him $92,000 over the period, more than any other single source.

• Grassley, the highest-ranking Republican on the Finance Committee, received 23.5 percent of his funds from health and insurance interests but a lesser dollar amount than Baucus ($2.3 million out of $9.8 million total funds).

• Kennedy, a Massachusetts Democrat and a longtime advocate of health care reforms, received only 7.5 percent of his funds from health and insurance interests, or about $1.2 million.

• Sen. Jon Tester, D-Mont., and Rep. Denny Rehberg, R-Mont., had minimal contributions from the health and insurance sectors.

• Obama, whose campaign raised a whopping $745 million in 2007 and 2008, received a relatively small share from health care interests ($19 million, or 2.5 percent) and insurance interests ($2 million, or 0.3 percent).

Baucus has been leading the charge on health care reform in the U.S. Senate since early 2008, holding numerous hearings and Finance Committee meetings on the issue. He released a lengthy "white paper" last November, outlining his reform ideas, and a major bill is expected to be introduced this month.

The general thrust of his proposals is to require all citizens to buy health insurance while also forcing the private insurance industry to stop practices that make coverage unaffordable for many. He supports subsidies to those who may have trouble affording insurance.

However, on a reform bitterly opposed by the insurance industry and most health care interests - a public, nonprofit insurance plan offered by the government - Baucus has been more ambivalent, saying he supports the idea but declining to specify in what form.

Baucus's office supplied nearly 20 examples of stances he has taken in direct opposition to drug, insurance and banking interests that have donated to his campaign funds.

He has supported importing lower-cost prescription drugs from Canada, allowing the government to negotiate for lower drug prices for Medicare recipients, funding research that would show when generic drugs are a better deal than brand-name drugs and reducing Medicare payments to private insurers by $13 billion over five years.

His office also points to an April 2007 Wall Street Journal article in which Baucus was quoted as telling medical industry contributors at a fundraiser, "You should worry about me coming after you."

Donnelly, the Campaign Money Watch director, says the proof on health care reform will be in the final product - and that he's not terribly optimistic.

Health and insurance interests are clearly targeting Baucus and his Finance Committee, which often have shown themselves to be receptive to their influence, he said.

"This debate on health care is a microcosm ... that even after a 'change' election, how much the special interests view (Washington) as their fiefdom," Donnelly said.

Supporters of national health insurance are even less optimistic, noting how Baucus, Obama and leaders in Congress won't even consider their proposal, which they believe would have broad public support.

"I can't think of any reason other than fidelity to your donors, to explain why they would keep us out of the debate," said Young of the physicians group. "Until we get campaign finance reform, it will be very difficult to do anything to challenge the status quo (in health care), and the status quo had better be challenged, because it's a very bad status quo."

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Up in Smoke: Health insurers hold billions in tobacco stocks

by Desiree Evans, published at Facing South, the Journal of the Institute for Southern Studies

A recent study published in the New England Journal of Medicine found that major U.S., Canadian and British life and health insurance companies are investing billions of dollars in tobacco company stock.

Researchers first revealed that health and life insurance companies had major investments in tobacco companies in 1995 in an article in the British medical journal Lancet. More than 10 years later, insurance companies are still deeply invested in "big" tobacco, despite the national calls upon them to divest.

"Despite calls upon the insurance industry to get out of the tobacco business by physicians and others, insurers continue to put their profits above people's health," said Wesley Boyd, the new report's lead author and a faculty member of Harvard Medical School. "It's clear their top priority is making money, not safe-guarding people's well-being."

The report found that seven health and life-insurance companies in both the United States and overseas have nearly $4.5 billion invested in companies whose affiliates produce cigarettes, cigars and chewing tobacco.

"Although investing in tobacco while selling life or health insurance may seem self-defeating, insurance firms have figured out ways to profit from both," Boyd said. "Insurers exclude smokers from coverage or, more commonly, charge them higher premiums. Insurers profit -- and smokers lose -- twice over."

The study highlights New Jersey-based Prudential Financial Inc., which sells life insurance and long-term disability coverage. With total tobacco holdings of $264.3 million, Prudential Financial is a major investor in three tobacco firms, including America's biggest cigarette maker, Virginia-based Philip Morris.

Health advocates point out that these private, for-profit insurers have repeatedly put their own financial gain over the public's health. "It's the combined taxidermist-and-veterinarian approach: either way, you get your dog back," study co-author David Himmelstien explained. "If you own a billion dollars [of tobacco stock], then you don't want to see it go down, you are less likely to join anti-tobacco coalitions, endorse anti-tobacco legislation, basically, anything most health companies would want to participate in."

Moreover, healthcare advocates point to this study as another reason why health insurance coverage should not be left in the hands of private insurers. Himmelstein asked, "Is this who we want running our health care system?"

Going Down Tobacco Road
Worldwide, tobacco is considered the leading cause of lung cancer and a major risk factor for heart attack, stroke, pulmonary disease and cancer. It is the leading cause of preventable deaths, and the leading cause of cancer deaths among men and women, according to U.S. and world health officials. Each year, about 443,600 people in the United States die from tobacco-related illnesses, and worldwide it is a contributing factor in 5.4 million deaths a year. Tobacco kills more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs combined, according to the American Cancer Society.

Tobacco is an issue that the South knows a lot about, considering the region's historical dependence and ties to the tobacco industry. Experts have shown that strong economic and cultural ties to tobacco in the South have often correlated with high rates of tobacco use. While cigarette consumption has been declining and is expected to continue to decline nationwide, the consumption of smokeless tobacco - snuff and chewing tobacco - has actually increased over the past decade, especially in the South. Several Southern states lead the nation in smokeless tobacco use, including West Virginia, Alabama, Kentucky, North Carolina, South Carolina, Tennessee and Mississippi. Yet, research has shown that smokeless tobacco can be just as dangerous as cigarette smoking. Not only can it lead to mouth cancer, smokeless tobacco may also play a role in other cancers, heart disease and stroke.

Several of the Southern states that lead in smokeless tobacco use and have traditional ties to the tobacco industry also comprise what health experts have come to refer to as the "stroke belt" - a swath of states that include North Carolina, South Carolina, Georgia, Tennessee, Alabama, Mississippi, Arkansas, and Louisiana. Americans living in this region have a 15-percent higher stroke risk, and the death rate from stroke is 30 to 40 percent higher than in the rest of the country. Health experts suspect that tobacco use could be one of the contributing behaviors leading to these high rates.

Sweeping Legislative Changes around Tobacco
This has been an exciting week for health advocates. Sweeping changes in how the government controls tobacco are likely to be approved by the Senate despite strong opposition from tobacco interests and the tobacco lobby. The U.S. Senate is set to vote on new laws that for the first time will permit the Food and Drug Administration to regulate the production, sale, and marketing of tobacco products, including limiting how much nicotine is in each cigarette, and banning advertising and marketing aimed at children.

Tobacco regulation has been a long, hard fought for cause due to the power and influence of "big " tobacco and its lobby. Congress has been trying for more than a decade to give the FDA powers over tobacco products, particularly after a 2000 Supreme Court decision that the FDA could not regulate tobacco unless Congress changed the law.
 
A final vote on the bill is expected Thursday, and Democrats say they have enough votes to win final passage. The House passed a very similar bill earlier this year, and resolution of the minor differences would send the bill to President Obama, who supports it. The lone Democrat voting against the move to end debate on the bill Wednesday was Senator Kay Hagan, the newly elected official from North Carolina, one of the historically recognized tobacco growing states.

Supporters of the legislation, including health advocacy groups, have linked reducing the financial costs of tobacco illnesses, about $100 billion a year, to the overall drive to improve the healthcare system. The bill's opponents have voiced concerns that the changes could prove costly in tobacco-growing states such as Kentucky and North Carolina.

Single-Payer Off the Table?
A step forward and a step back, some say. While health advocates celebrate the changes in tobacco laws, the health reform debate of the last couple of months has instead left health advocates with much to be desired.

Currently, the Obama Administration is pushing Congress to pass a healthcare reform bill by the end of the year that would cover most of the nation's 47 million uninsured. As Reuters reported:

Obama has declared this summer "make-or-break" time for healthcare reform and has called on Congress to pass comprehensive legislation by the end of the year, saying America can no longer afford the costs of a system dominated by profit-driven insurance and healthcare companies which leaves 46 million people uninsured.

Though he is leaving the details to Congress, Obama has said reform must ensure a public health insurance option operating alongside private plans, a reduction in basic costs, and assurance that no one is denied insurance.
But healthcare reform advocates are upset that lawmakers have taken a "single-payer" plan off the table. For years health advocates have been calling for a government-financed nationalized health plan - in the form of single-payer legislation. Even though most physicians, health officials and health advocates support single-payer legislation, the option has been excluded from the current debate in Congress. In a single-payer system, as envisioned by most advocates, the federal government would pay for basic medical care delivered by public and private health professionals. The money would come from taxes, and medical bills would go directly to a government insurance plan, similar to Medicare.

Last month, single-payer advocates took to the streets across the country to protest the exclusion of single-payer medical plan from the debate to revamp the nation's troubled health system. During Senate Finance Committee hearings in May, 13 doctors, nurses, lawyers and activists stood up to complain that no single-payer proponent had been invited to take part and were arrested for disrupting the proceedings.

The Harvard doctors involved in writing the recent study published in the New England Journal of Medicine also support a single-payer plan and point to their report as just another reason why health insurance coverage shouldn't be left in the hands of private insurers. Boyd and his colleagues also believe that their findings call into question whether insurers ought to have a voice in the ongoing debate in Washington over healthcare reform.

As they write in their letter published in NEMJ:
"The Obama administration is proposing a major overhaul of the U.S. health care system, and the insurance industry is poised to play a major role in the process. Insurance firms, like any business, are driven by profit, and this fact compromises any health care plan that includes them. In case there is any doubt that insurers place profit above health, consider their investments in tobacco.
...
These facts should discomfit Canadian and British readers as their countries consider further privatization of health insurance. For those of us in the United States, these data are a reminder of the true priority of the insurance industry, which is making money, not ensuring health and wellbeing. These data raise a red flag about the prospect of opening vast new markets for private insurers at public expense, as has happened in our state of Massachusetts, whose recent health care reform is often cited as a model for national reform.
Not only have health insurers and drugmakers contributed millions of dollars to members of Congress, but the powerful private health insurance lobby, along with other corporate and political interests, have been derailing efforts at healthcare reform for years. Observers say this intense lobbying is likely the reason the single-payer option has been largely dismissed from the healthcare reform debate.

Currently Democrats are debating several alternative options for "public" plans, some of which could include a government-financed purchasing pool that people could buy as an alternative to individual health policies offered by private insurers. Private insurers would play a role in all of the proposed plans.

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Single payer health care is the only way to control costs

by Dr. Peter Mahr
Our current healthcare system is a mess for both those who carry health insurance and those without. Only a single payer national health insurance program that provides public financing for privately delivered healthcare services can clean up this mess and provide all Americans access to needed medical services regardless of ability to pay.

In a study released last week we learned that healthcare debt contributed to 62% of personal bankruptcies in 2007. And, surprisingly, 77% of those going bankrupt were insured when they first fell ill. The same year 47% of Americans reported some medical debt or payment problem and 16% of Americans had been contacted by medical debt collection agencies. Despite spending 16% of GDP on healthcare and increases in insurance premiums that dwarf growth in family income, millions are left bankrupt and 50 million more are uninsured. These figures highlight, in the starkest terms, how broken our employer-based private for-profit health insurance system is.

For all our money spent, the result is a fragmented complex healthcare system with poor outcomes. We are far behind other industrialized nations in terms of public health measures. Regional healthcare spending varies dramatically and has more to do with how many doctors there are per capita than other factors. The United States performs poorly on benchmark measures of preventative care and our management of chronic illness mirrors our chaotic and disorganized payment system. We consistently fail to meet evidence-based guidelines for chronic illnesses like diabetes and chronic lung disease.

At the same time business is booming for those who profit from healthcare. From 2003- 2007, the profits of the nation’s largest insurers rose 170.2 % to $12.6 billion. Pharmaceutical companies continue to gross billions of dollars with the top ten firms profiting a total of $75 billion in 2008. For-profit hospital chains and dialysis centers make millions while delivering worse outcomes when compared to non profit alternatives. Surgical sub-specialists make 3-4 times what generalists make.

So what do we do with a healthcare non-system that is a big money maker for insurers, some hospitals and the pharmaceutical industry but leaves one in seven people lacking insurance and most with insurance that is too costly and inadequate? How do we repair a delivery system that is expensive, focuses on moneymaking services rather than primary and preventative care and has little emphasis on evidence-based medicine?

Clearly the solution is to adopt a single payer national insurance program: publicly funded and privately delivered. We already pay for our current system with out of pocket payments and taxes.

Personal income taxes pay for Medicare, Medicaid, public employee health insurance, tax breaks to employers who provide health insurance to their employees and healthcare coverage for military personnel and veterans. The sum total comes to 60% of our total health insurance costs. In essence, we are paying for national health insurance now. We just aren’t getting it. Instead, a single payer system would use tax dollars to provide true comprehensive healthcare coverage for all.

Furthermore, a single payer system is the only reform proposal that would drastically reduce the staggering administrative costs that accompany our private insurance industry. Profit margins, overhead and administrative costs associated with our current private insurance industry remove $350 billion from the healthcare system each year. In reducing administrative costs a single payer plan would save enough money to cover the 50 million uninsured.

Single payer health insurance also holds great promise for reforming the delivery of healthcare. With single payer, a reimbursement system can realign the delivery of healthcare services from one of maximizing profit to one in which we maximize health. Reimbursement for primary and preventative care can be emphasized while specialist and end of life care can be more rationally utilized. Regional spending can be leveled. And a one payer system can bargain effectively with the pharmaceutical
industry, driving down medication costs which currently add $98 billion a year to the cost of our healthcare system.

In short, only a single payer system that eliminates for-profit, private health insurance can generate the cost savings to pay for a truly universal healthcare system. And, only a single payer system, with the tools of bulk purchasing, negotiated fees and global purchasing, can realign our delivery system to emphasize primary preventative care while bringing sanity to our skyrocketing healthcare s pending. A majority of the public and a majority of physicians support the adoption of single payer health insurance.

Now is our chance to embrace true reform.

Dr. Mahr is a family physician who works for the Multnomah County Health Department at East County Health Center in Gresham, OR. He is also chairman of the Portland Oregon chapter of Physicians for a National Health Program.

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Max Baucus, the "Senator for K Street," Should Not Be Deciding Health Care for America

by Kevin Zeese. Published by the Baltimore Chronicle on May 31

Why aren’t single payer advocates allowed to testify before Baucus’ committee? Follow the money.

Senator Max Baucus and the Senate Finance Committee are too corrupted by corporate health industry profiteers donations to give America the health care policy it needs.

Health care is 15% of the U.S. gross domestic product. U.S. health care expenditures, which have been rising rapidly for several years, surpassed $2.4 trillion in 2007, more than three times the $714 billion spent in 1990. The cost of health care is projected to reach $4.4 trillion by 2018. There is a lot of room for corporate profiteering in the increasing cost of health care. The millions the health care industry has invested in Baucus and the Senate Finance Committee could therefore turn out to be very profitable.

It is evident that any bill that comes out of the Senate Finance Committee will be a pro-industry bill that will ensure trillions in profits for the health insurance industry, HMOs and the pharmaceutical industry.

Baucus has held two hearings so far and has refused to allow advocates for the most popular reform—a single payer national health policy—to even testify. Single payer "improved Medicare for all" is favored by more than 60% of Americans as well as majorities of doctors, nurses and economists. It is the most cost-effective and efficient way to provide health care to all Americans from cradle to grave.

Why aren’t single payer advocates allowed to testify before Baucus’ committee? Follow the money. Campaign donations explain why, and demonstrate that the Senate Finance Committee should not be in charge of health care. Senator Reid should remove the health care reform bill from Baucus and start all over before the Health Committee in the Senate.

Here’s why Baucus is not doing the people's business:

According to OpenSecrets.org, over his career he has taken donations from:

* The Insurance Industry: $1,170,313
* Health Professionals: $1,016,276
* Pharmaceuticals/Health Products Industry: $734,605
* Hospitals/Nursing Homes: $541,891
* Health Services/HMOs: $439,700

Baucus has shown his bias and should be removed from leading the health care reform effort by the Democratic Party leadership.

That is a grand total of $3,902,785. Can we trust Baucus to put aside the profits of the industries that have kept him in the Senate? Will he put the people’s necessities ahead of the profits of his contributors? Baucus has shown his bias and should be removed from leading the health care reform effort by the Democratic Party leadership.

In 2008 Baucus had virtually no challenger in Montana. A little-known Republican was on the ballot, and Baucus won with 73% of the vote. But, Baucus sought big donations from big business anyway. He used his connections to corporations with business before his committee to raise an immense campaign fund of more than $11 million. In 2008, 91% of his donations come from individuals living outside of Montana, which is why he is more the “Senator for K Street” then the Senator for Montana. Corporate health profiteers who invested in Baucus will now benefit from his stewardship over health care reform. His 2008 donations from health care profiteers included:

* Insurance: $592,185
* Health Professionals: $537,141
* Pharmaceuticals/Health Products: $524,813
* Health Services/HMOs: $364,500
* Hospitals/Nursing Homes: $332,826

That is $1,826,652 Baucus took from these industries, and now he can reward them by deforming health care reform.

The health care profiteers knew that Baucus would determine their fate and ponied up. Now the only thing standing between them and their payback is a single payer national health care plan. Yet single payer, which would end private insurance and control the cost of pharmaceutical drugs, is not being considered—not even allowed to participate in the conversation before Baucus.

It is not just the chairman of the committee who has received massive donations. The full Finance Committee is a gluttonous embarrassment of campaign pay-offs. In 2008 the committee members received a total of $13,263,986 from industries affected by health care reform. Can we trust this committee to put the interests of the people before their donors?

The donations to the Finance Committee in 2008 included:

* Insurance: $5,103,900
* Pharmaceuticals/Health Products: $3,308,831
* Hospitals/Nursing Homes: $2,809,353
* Health Services/HMOs: $2,041,902

These industries expect to be rewarded with billions, even trillions, in profits and hundreds of millions in corporate welfare. Senator Baucus’s behavior shows they have made a good investment—they've bought themselves a senator who should be called Chairman Blagojevich. He is doing his best to make sure the single payer message is not heard because he knows it is the fairest, most efficient and cost-effective way to ensure health care access for all Americans—but he can't let that be implemented because it would put some of his donors out of business and control the profits of others.

It is time to remove Baucus from the leadership of health care reform. It is time to move the critically important priority of reforming America’s health care system from the Finance Committee and put it before the Senate Health, Education, Labor and Pensions Committee. At least their mission is health care, not money.

Kevin Zeese is the executive director of the FreshAirCleanPolitics.net, which is urging a single payer national health care system as part of its ProsperityAgenda.US project. Along with seven others, Zeese was arrested when he testified from the audience of a recent Senate Finance Committee meeting on health care. See the video on YouTube.

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Doctor Critical of Baucus Promotes Single-Payer Plan

by Mike Dennison. Published on June 6 by The Billings Gazette (Montana).

Maryland psychiatrist Carol Paris is calling herself one of the "Baucus 13" these days - in other words, one of the 13 doctors, nurses and activists arrested last month while protesting before a Washington, D.C., health reform hearing chaired by Sen. Max Baucus, D-Mont.

On Friday, Paris was in Montana, doing what got her arrested: urging Baucus, Congress and the president to consider a single-payer system of national health insurance that covers all citizens equally.

Psychiatrist Carol Paris, one of 13 people arrested last month while protesting before a health-reform hearing chaired by Sen. Max Baucus, spoke at a rally Friday in Helena in favor of single-payer insurance. (Eliza Wiley Independent Record)

"The next 60 days are critical," she told a rally of 150 single-payer supporters in Helena. "We need to keep the heat on Sen. Baucus (and Congress and the president)."

Single-payer advocates held rallies in six Montana cities on Friday.

Paris, 56, is a member of Physicians for a National Health Program, whose 16,000 members are pushing for a national, publicly funded insurance plan that would replace private health insurance. The group paid for her trip to Montana.

In an interview Friday with the Gazette State Bureau, Paris said she used to believe that the private health insurance market could be reformed to improve health care, and she spent several years lobbying the Maryland Legislature.

"After a few years, I came to the conclusion that it was just a phenomenal waste of time," she said. "At that point, I just said, there has to be a better place for me to put my time and energy."

That was just six months ago, when she joined PNHP, to push for a single-payer system.

But Paris and other Maryland-area members found themselves basically ignored by Congress. They planned to protest - and get arrested - at a Senate Finance Committee hearing on health reform, chaired by Baucus.

Paris and her colleagues showed up the morning of May 5, spread themselves among the gallery and, one by one, interrupted Baucus as he started the meeting.

"I interrupt this so-called public hearing to bring you the following unpaid political announcement: Put single-payer on the table," Paris said before she was arrested. "My name is Dr. Carol Paris, and I approved this message."

Capitol police arrested the protesters, who have been charged with disrupting Congress.

Baucus, a key senator in drafting health reform legislation, said last week that he'll ask that the charges be dropped. He's said repeatedly that a single-payer system won't be considered as a reform and is backing changes that maintain private health insurance.

Baucus spokesman Ty Matsdorf said Friday that the senator and single-payer advocates have the same goal of providing "quality, affordable health care to every American," and that Baucus is confident that Congress will pass meaningful reform to "make this goal a reality."

Paris, however, said her experience in private practice has convinced her that true reform can happen only if private health insurance is replaced with national, public insurance for all.

No longer would physicians' staff have to spend hours dealing with multiple insurers on billing, no longer would patients have to do the same, and no longer would patients have to worry about which doctor is "in network," she said. "You can go to any doctor you want," Paris said. "It's the private insurance industry where you can't go to any place you want."

Paris's arrest was covered prominently by her local newspaper but received little or no attention from national news outlets.

She said she's not surprised: "The mainstream, national media have blacked us out as much as Congress has. ... I would say they're following the lead of the president and Congress and simply not giving us a voice."

Yet Paris said the reaction from her patients, as well as many fellow physicians, has been overwhelmingly positive.

She said she hears "over and over and over again" how people are frustrated by the current system, particularly dealing with their insurer, and that as soon as they understand how single-payer would work, they usually support it.

"I think that the only thing that keeps this from happening is the lack of political will by the president and our Congress," Paris said.

© 2009 Billings Gazette

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Facing Down the Private Insurance Industry

by Robert Kuttner. Published on June 4 by The Boston Globe
Despite budget pressures, President Obama has not backed off his commitment to universal healthcare reform. But the devil is in the details. And if he is not careful he could end up with a reform worse than nothing.

A crucial question is whether the law will include a public, Medicare-style plan. This public plan could be used by people who otherwise lack good insurance, or by employers who conclude that the public plan is a better deal for themselves and their workers.

The public plan would be the gold standard of both good coverage and cost-containment. Without the public option, a system to cover everyone by relying on the existing private insurance industry will realize few cost savings. The result would be increased pressures over time to cut care and shift out-of-pocket costs from insurers to consumers.

The administration's projections have relied heavily on the supposed savings of better use of computerized medical records. However, absent a single unified system, or a strong public option, better computerization will not realize major savings.

The US healthcare system is the most expensive and least cost-effective in the advanced world mainly because private insurance companies waste about 25 cents on the dollar on claims, profits, administration, and marketing. They have no serious financial incentives to emphasize prevention, and every possible incentive to avoid sick people. Doctors and hospitals, meanwhile, make their money from increasing costs.

Other countries get better results at lower cost because a universal system naturally emphasizes wellness and prevention, and spends its money on the most cost-effective treatments, not the most expensive ones. Every nation faces similar inflationary pressures because of advances in technology and an aging population; but other advanced countries, using single-payer systems, do a fine job of covering everyone for 10 percent of gross domestic product or less, while we spend upwards of 15 percent and leave out nearly 50 million souls and under-insure tens of millions more.

Obama's plan is a variant of an astute strategy first proposed by the political scientist Jacob Hacker as a solution to two political obstacles to health reform. First, how do you enlist the uninsured and the anxious insured in the same coalition? Second, how do you build momentum for a single-payer system recognizing that there are not the votes to legislate it all at once?

Hacker's insight was that if the government offered a public insurance option, people who liked their present private insurance could keep it, while others could elect the public plan. Coalition problem solved. And the superior efficiencies of the public plan would gradually overtake the rival private plans. Momentum problem solved.

But Hacker neglected one key political detail - the immense power of the private insurance industry. Not surprisingly, the industry's stance is that any public plan must compete on disadvantageous terms. And most Republicans oppose a public plan outright.

Obama, the great conciliator, has chosen to work with the private insurance industry rather than targeting it as the primary obstacle to meaningful health reform. Periodic leaks from the White House suggest that if push came to shove, Obama would ditch the public plan in order to get a bill through Congress.

Senator Max Baucus of Montana, chair of the Senate Finance Committee, is no enthusiast of a public plan. After the New York Times last week reported Baucus sparring with Senator Ted Kennedy on whether to include a public plan, the two senators quickly cobbled together a statement insisting they were really in harmony.

However, in the push to get legislation in the face of fierce industry and Republican opposition, a good public plan could well be tossed overboard. That would leave a legacy of expanded coverage, but a time bomb of exploding costs, underinsurance, and a squeeze on actual care.

I would much rather see Obama battling for public health insurance, making it clear to Americans that the obstacle to real reform is the private health insurance industry. That, however, is not the president we have.

We'll see what kind of public plan, if any, survives.

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Media Quarantine of Single-Payer Continues: Fifteen Years Later, Public Health Insurance Still Taboo

by Julie Hollar & Isabel Macdonald. Published on Thursday, June 4, 2009 by Extra!, a publication of Fairness and Accuracy in Reporting. Reposted on Commondreams.org

As a big healthcare policy debate looms once again in Washington, one thing remains as certain as it was in 1993: A single-payer plan that would provide government health insurance to everyone is off the media agenda.

CNN senior medical correspondent Elizabeth Cohen recently explained why healthcare "reform" is more possible now than it was under the Clinton administration (3/5/09): "Fifteen years ago you sometimes heard-actually you heard quite a bit-people saying: 'Let's have a single-payer system like in Canada. The government is going to be the health insurer for everybody.' You don't hear that as much as you used to. So more people are on the same page more than they once were."

Cohen is right that there were many people in favor of single-payer 15 years ago; as Extra! pointed out back then (7-8/93), polls consistently found majorities supporting tax-financed national health insurance. And the numbers today? A January New York Times/ CBS poll (1/11-15/09) found 59 percent in favor of government-provided national health insurance. In other words, contrary to Cohen's claim, people are on pretty much the same page today as they were 15 years ago.

Her suggestion that it was those loud single-payer voices that stymied "reform" is likewise unfounded; as Extra! reported in 1993, corporate media were then solidly behind the Clinton administration's big insurer-friendly "managed competition" plan-single-payer was hardly discussed in the press. ("The debate over healthcare reform is over. Managed competition has won," the New York Times had already editorialized on October 10, 1992. "The outcome is as wondrous as it is surprising.")

And just as big media silenced single-payer back then, Cohen and her colleagues continue the tradition today. In the week leading up to Obama's March 5 healthcare summit, hundreds of stories in major newspapers and on NBC News, ABC News, CBS News, Fox News, CNN, MSNBC, NPR and PBS's NewsHour mentioned healthcare reform, according to a recent FAIR study (3/6/09). But the idea of single-payer was mentioned only 18 times-and only five of those included the views of single-payer advocates. 

On March 31, PBS's Frontline took an in-depth look at the U.S. healthcare system in Sick Around America, offering a prime opportunity to explore single-payer-or so thought the correspondent originally slated to do the show, T.R. Reid. In Frontline's 2008 special Sick Around the World, Reid examined healthcare systems in other developed countries, concluding that in nations where there is some private-sector role in health financing, one of the central lessons is that they "all impose limits"-including that insurance companies "can't make a profit on basic care." The show discussed single-payer alternatives, including Taiwan's healthcare system.

But in Sick Around America, the only alternative to the current U.S. healthcare system that was examined in any depth was Massachusetts' system of mandating that people buy insurance from for-profit health insurance companies. Reid, who was contracted to be the correspondent for the new documentary, quit over concerns that it contradicted his earlier research (Corporate Crime Reporter, 4/2/09): I said to them, mandating for-profit insurance is not the lesson from other countries in the world.... I said, I'm not going to be in a film that contradicts my previous film and my book. They said I had to be in the film because I was under contract. I insisted that I couldn't be. And we parted ways.

After FAIR criticized the film (4/7/09),  Frontline pointed out that the show's narrator mentions that "other developed countries bar health insurance companies from making profits on basic care and cap their administrative costs." Of course, one brief mention in an hour-long show hardly constitutes a fair hearing.

As FAIR's study found, most mentions of single-payer tend to come from its critics, who bring it up in order to shoot it down-such as when Fox's Sean Hannity argued (2/19/09), "If we look at England, if we look at France, if we look at Canada, the single-payer, the worst thing we can do if we really care about kids is let the government run the healthcare system."

Single-payer did recently get a new proponent in corporate media with MSNBC's hiring of populist radio host Ed Schultz to fill its 6 p.m. slot. Since going on the air April 6, Schultz has questioned guests about single-payer multiple times, as when he asked why the Democrats won't put such a plan on the table (4/27/09): "The majority of the health providers, the majority of Americans want single-payer. You've got a president with a 69 percent approval rating. What are they waiting for?"

Schultz ought to ask the question not just of Democrats, but of his corporate media colleagues as well.


© 2009 Extra! Magazine (FAIR) Julie Hollar is the managing editor of FAIR's magazine, Extra!. Isabel Macdonald is the communications director at FAIR. 

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Baucus: Single payer advocates won't be invited to speak

by David Swanson. Posted June 3 on AfterDowningStreet.org
Senator Max Baucus met Wednesday with advocates for single-payer healthcare, including Senator Bernie Sanders, and told them that he might drop criminal charges against 13 people arrested for speaking up in his hearings, but that he would not include any supporters of single-payer health coverage in any future hearings. According to one report, Baucus suggested that he'd been mistaken to exclude single-payer but asserted that the process of creating healthcare reform legislation was too far along now to correct that omission.

Senator Sanders said after the meeting that if healthcare reform did not create a single-payer system it shouldn't be done at all, and that within three or four years we would realize we'd solved nothing. He said that it would be better to increase funding for community health centers and take steps to make it easier for medical students to go into primary care, than to enact major reforms that didn't go to the root of the problem.

Sanders has a bill (S 486) that makes some of the changes he advocates, as well as a bill (S 703) to facilitate the creation by states of single-payer healthcare systems. Congresswoman Tammy Baldwin has introduced resolutions on the same topic in the House. Dr. Margaret Flowers, co-chair of the Maryland chapter of Physicians for a National Health Program (PNHP), attended a press conference following the meeting on Wednesday and filled me in. She said that while states are pursuing single-payer legislation, it would be much easier for them to succeed if they had waivers allowing federal healthcare dollars to go to the states, and if needed changes were made to the Employee Retirement Income Security Act.

Advocates of single-payer emerged from the meeting with Baucus declaring their determination to push ahead with what they see as a fundamental struggle for human rights. Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee and national vice president of the AFL-CIO, said the fight for single-payer is a civil rights movement, and that people "have to turn up the heat." When someone questions the political viability of single payer, she said, we should question "allowing people to die and suffer for lack of political will."

The press conference, in which Baucus did not participate, was attended by the New York Times, Politico, the Associated Press, Pacifica Radio, Congressional Quarterly, and a camera that Flowers believed belonged to CNN. Sanders opened the press conference with a statement on the domination of the private for-profit health insurance companies wasting $350 billion per year in billing, profiteering, and complexity. If we were serious about healthcare reform, he said, we would be having a serious discussion of single-payer.

Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and senior lecturer at Harvard, said that in her diagnosis the disease was market-driven healthcare in which access is based on the ability to pay.

Dr. David Himmelstein, co-founder of PNHP and associate professor medicine at Harvard Medical School, reported that Baucus had said he might be willing to drop charges of unlawful conduct and disruption of Congress against 13 people but had no intention of opening up any hearings to include single-payer. Himmelstein also announced the release of two new studies. The first, being released Wednesday, reportedly finds that some of the largest investors in tobacco stock are private health insurance companies. The second, to be released Thursday, reportedly shows that not only are personal bankruptcies increasing, but 62 percent of them are now due to medical debt.

Geri Jenkins, RN, co-president of the California Nurses Association/National Nurses Organizing Committee and a practicing registered nurse, reported that Baucus had implied he'd made a mistake in not including single-payer but that it was too late now.

And, finally, Dr. Oliver Fein, president of PNHP and associate dean at Weill Medical College of Cornell University, said that he and his colleagues had asked Baucus for a full hearing on the merits of single payer and asked for the Congressional Budget Office to create a comparison of single payer with whatever plan Congress produces that is not single payer. Senator Sanders said that he would continue to push Baucus to hold a hearing.

Dr. Flowers said that in her analysis the single-payer movement is largely inclined to go in the direction that Sanders stated on Wednesday: support for a single-payer bill or nothing. I asked her whether she believed that those pushing for single payer would ever support a public option as doing more good than harm and whether she thought those pushing for a public option would ever advocate allowing states to enact single payer. Flowers acknowledged that there are many (perhaps even most) people in the public option movement who prefer single payer. In fact, it is difficult to find a supporter of the public option who does not claim to "personally" want single payer but to find it "politically unfeasible." But Flowers said that PNHP does not support a public option and backs only single payer. And she said she was unaware of any advocates of a public option also advocating for allowing states to create single payer.

Author David Swanson has been a journalist and communications director for the Kucinich 2004 presidential campaign, International Labor Communications Association, and ACORN, and is co-founder of AfterDowningStreet.org and Washington Director of Democrats.com.

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Is Obama Naive About the For-Profit Health Industry's Commitment to Real Reform?

by M.S. Bellows, Jr. Posted May 11 at Huffington Post

Optimism is a virtue; it leads us to see the best in people despite their worse sides, and to envision a better future even when we can clearly see the obstacles we currently face. But blind optimism is no virtue. Naive or overeager optimism can lead us to ignore the fact that most people have mixed motives, and to envision a bright future so clearly that we are blind to the obstacles that stand between a hard now and a better then. Wise optimists trust - but verify; they have faith in the better, but do not ignore the worse, angels of human nature.

On Sunday afternoon, two senior Obama Administration officials called a telephonic press conference to announce a huge, positive new development in the healthcare reform effort. When I say senior, I mean pretty darn senior. And they seemed genuinely, sincerely excited about this mysterious new development - excited enough to buzz every national journalist's BlackBerry with an invitation to the conference call in the middle of Mother's Day. They considered the development significant enough to declare an embargo, forbidding journalists to write about it until 9 p.m. Eastern Standard Time. Because the President himself will be announcing this development officially tomorrow morning, they made the call - arranged by the White House press office - "on background," asking not to be identified by name or position.

The big news? Just this: a coalition of health insurance, hospital, pharmaceutical company, and physician trade groups, plus a major union, will promise the President Monday that they will reduce the rate of future growth in the cost of healthcare by 1.5% per year for the next decade.

That's it. And the President will be announcing it himself Monday morning, presumably with equal excitement.

Healthcare will continue to be increasingly expensive for consumers, but not quite as quickly as it was going to be. 7% per year inflation will become 5.5% per year inflation -- that is, if the participants keep their promise. Which, according to the officials, they'll do, not because there's any kind of enforcement mechanism - there isn't one - but simply because they're "Americans."

(That's a quote: Big Pharma, the health insurance lobby, the American Medical Association, hospital industry groups, et al. are going to reduce costs, and presumably profits, solely because they're good "Americans.")

The senior administration officials were hyperbolic, if not hyperventilated. One, focusing on the political battle to enact healthcare reform, called this promise by industry trade groups "a game changer."

The other official, focusing on economic issues, saw this as nothing less than the salvation of the entire federal budget:

"I don't think there could be a more significant step to help struggling families and to help the federal budget than reducing the growth rate of healthcare spending by 1.5 percentage points per year. With regard to the federal budget... the only way that we are going to restore the nation to a sound fiscal path over the long term is to reduce the growth rate in health care costs... Reducing the growth rate of health care costs overall by 1.5% per year would virtually eliminate the nation's long term fiscal gap. ... This, by an order of magnitude, is far more important [than Social Security or related reforms] to the fiscal trajectory that we're on, especially over the long term, than anything else that could be done."

Remember, we're talking about slightly reducing the rate of growth in health care costs, not a reduction in health care costs themselves. That's what's supposedly going to save both American families and the nation's fiscal problems "over the long term."

The journalists on the call, understandably, were more skeptical. The biggies queued up to ask questions: reporters from the New York Times, Wall Street Journal, Associated Press, Washington Post, NBC News, CNN, Los Angeles Times, Reuters. Some asked for wonkish, green-eyeshade details (answers were rarely forthcoming).

Other reporters questioned what mechanisms were in place for making sure those promises are kept (answer: there are none).

In response to a question from Reuters, one of the officials put his trust in the bully pulpit and the Fourth Estate, saying, "I don't know how many of you have made, in-person, a commitment to the President of the United States... There will be accountability not only through regular check-ins with the President of the United States but also through the media, because I have no doubt that you all will be checking up on them."

The other official simply believes that pharmaceutical, insurance and hospital trade groups are acting in patriotic good faith, saying, "These are very sophisticated trade associations which in the past have, one could argue, dragged their feet when it came to the subject of health care reform and certainly cost containment. They're coming forward voluntarily, approaching this President and saying, we want to be part of the solution, we want to be part of getting health care reform done... That fundamentally aligns these major provider groups with the President's goal of getting health care reform done this year. That is a game changer in our opinion."

Eliza Marcus of Bloomberg and Michael Fletcher of the Washington Post asked outright whether the healthcare industry was buying something with this concession. One of the officials dismissed the possibility denied that there have been any discussions at all about the public plan or any other quid pro quo, instead casting the industry coalition in purely patriotic terms: "They put it to me that everybody must share responsibility... they want to get everybody covered..., and they said to me, we know we have to do our part... this is them coming forward as Americans to get this done."

Am I the only one who is puzzled at the Administration taking these groups at their word? Big Pharma, for example, hasn't made a concession yet without something being in it for them. Many of the groups participating in this initiative historically have opposed health care reform and are large donors to the Republican and Vichy Dem politicians who are preparing to mount a political and rhetorical battle against health care reform, as evidenced most recently by the leak of Republican pollster Frank Luntz's so it sounds like Mandatory Gay Nazi Communism.

It's difficult to believe that the concessions being made by the for-profit members of this "patriotic" coalition are unrelated to any hope that Obama can be persuaded to drop his current proposal to include an inexpensive, government-backed, single-payer-style healthcare plan among the options available to consumers once healthcare reform passes later this year. That government-backed option scares the for-profit healthcare industry, because they know they can't compete with it; Medicare, for all its faults, still has the lowest administrative costs than any other health provider in the country, and delivers competent care to millions of Americans who otherwise would go uninsured. For-profits can't top that -- and they know that if millions of Americans sign up for federally-run healthcare and see that it works, the inertia towards single-payer healthcare for everyone may become a juggernaut.

The last question of the call, happily, went to me. I wanted, first, to confirm that the grand announcement was merely about a reduction in cost increases, not a reduction in cost, and second, to know whether Obama, himself, considered a public health care option to be beyond negotiation.

I didn't like the answers I got, though. The first tells me that the Administration is getting too excited about too little. The second fell short of the adamant reassurance I wanted to hear. But decide for yourself:

Bellows: "I have two questions. The first is following up on Michael Fletcher's and Eliza Marcus' questions: is the President still insistent that a public health plan will be among the options offered to people, or is that a bargaining chip in any way? And the second question, following up on Andrew Beatty's: is it correct that the cost per capita will still increase, just not as much as it previously was projected to?

Senior Administration Official #1: "On the second question, the answer to that is yes. Again, what we're talking about here is reducing the growth rate, so yes, health care costs, you should anticipate health care costs will continue to rise, but achieving a slowdown in the rate at which they increase is a, would be a huge accomplishment in terms of freeing up resources for other priorities and in terms of relieving pressure on the federal budget."

The official continued with a justification for accepting continued healthcare cost increases: "One of the reasons that you should expect health care costs to continue to increase is not only that the population is aging, which puts some upward pressure on health spending, but also that as incomes rise over time, it is natural that people want to spend part of their additional income on health care...."

Senior Administration Official #2 on questions one: "On the public plan, this event with the President tomorrow is not about the public plan, we've had no discussion with this group about the public plan, in fact, if I look at the list of trade associations that are part of this, there are different views about it, but the President likes the public plan, it's part of his campaign platform."

I'm not normally a knee-jerk cynic, but this simply sounds naive to me. One of the Obama administration's mantras is "don't let the perfect become the enemy of the good." But in these times, with this mandate and the American people's rare but undeniable hunger for radical change, their motto ought to be: "Don't let the good be the enemy of the perfect."

Radical health care reform - reform that doesn't shave health care costs for regular people, but slashes them; reform that doesn't force single-payer healthcare on the American people too soon, but sets the stage for their eventual, uncomplaining acceptance of it - is within Obama's grasp. He'd be wrong to settle for merely "good" health care - for health care that merely slows the rate at which costs increase, or health care that doesn't include a government-payer option that would demonstrate that a government-sponsored plan can provide better care at lower cost than any profit-driven private plan is capable of.

Single-payer, low-cost healthcare is America's future. By taking for-profit corporate lobbyists at their word, is Obama setting himself up to agree to step off the path to that future? Obama has, within his grasp, that once-in-a-lifetime rarity: a plan that is both nearly perfect, AND achievable. Will he reassure us that nothing less will do for the American people -- people who have put their trust in his commitment to do more than compromise?

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The Profiteers of Suffering--The Top 10 Enemies of Single-Payer

by Russell Mokhiber. Posted on CommonDreams.org on April 16

Most people, when they arrive in Washington, D.C., see it for what it is--a cesspool of corruption.

Two reasonable reactions to the cesspool.

One, run away screaming in fear.

Two, stay and fight back and bring to justice those who have corrupted our democracy.

Unfortunately, many choose a third way--stay and be transformed.

Instead of seeing a cesspool, they begin seeing a hot tub.

The result--profits and wealth for the corporate elite--death, disease and destruction for the American people.

Nowhere does this corrupt, calculating transformation do more damage than in the area of health care.

Outside the beltway cesspool/hot tub, the majority of doctors, nurses, small businesses, health economists, and the majority of the American people--according to recent polls--want a Canadian-style, single payer, everybody in, nobody out, free choice of doctor and hospital, national health insurance system.

Inside the beltway cesspool/hot tub, the corrupt elite will have none of it.

They won't even put single payer on the table for discussion.

Why not?

Because it will bring a harsh justice--the death penalty--to their buddies in the multi-billion dollar private health insurance industry.

The will of the American people is being held up by a handful of organizations and individuals who profit off the suffering of the masses.

And the will of the American people will not be done until this criminal elite is confronted and defeated.

(Remember, virtually the entire industrialized world--save for us, the U.S.--makes it a crime to allow for-profit health insurance corporations to make money selling basic health insurance.)

Before we confront and defeat the inside the beltway cesspool/hot tub crowd, we must first know who they are.

To wit, we present the Top Ten Enemies of Single Payer (listed here in alphabetical order):

American Association of Retired Persons (AARP)
AARP, one of DC's most powerful lobbying groups, has worked inside the beltway for years to defeat single payer. Why? AARP makes about a quarter of its money selling insurance through its affiliate, United Healthcare Group, the nation's largest for-profit insurance company. AARP must defeat single payer--which if enacted, would wipe out that revenue stream.

American Health Insurance Plans (AHIP)
The private health insurance industry. Public enemy number one. The health insurance corporations must die so that the American people can live. Of course, facing the death penalty, AHIP is the most aggressive opponent to single payer. No compromise with AHIP.

American Medical Association
With a shrinking base of doctors (only 25 percent of doctors nationwide belong), the AMA is the most conservative of the doctors' organizations. I just returned from a health care policy forum at the Center for American Progress. As usual, not one of the panelists mentioned single payer. Only during the question period did a self-identified patient/citizen ask the single payer question. And a pit bull-like Nancy Nielsen, president of the AMA, ripped into the questioner. "Sounds more like a statement than a question," Nielsen said. "And clearly you have a point of view about that. And I donít happen to share that point of view." Clearly she doesn't. But just as clearly, the majority of doctors, probably even a majority of doctors who belong to the AMA, support single payer. Nielsen is in denial and must be defeated.

Barack Obama
He was for it when he was a state Senator in Illinois. Now, ensconced in the corporate prison that is the White House, he says single payer is off the table. To get off the list, Obama needs to put single payer back on the table.

Business Roundtable
Dr. David Himmelstein, co-founder of Physicians for a National Health Program (PNHP), was at a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience--made up primarily of representatives of big business--to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: "In private, they support single payer, but they're also thinking--if you can take away someone else's business--the insurance companies' business--you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it's also a cultural thing--we don't do that kind of thing in this country."

Families USA
A major inside the beltway liberal foundation and long-time foe of single payer. Its chief executive, Ron Pollack, was once an advocate for single payer. But no more. In November 1991, Pollack was at a Washington hotel debating Yale University professor Ted Marmor in front of then Arkansas Governor Bill Clinton. Marmor was making the argument for single payer. Pollack against. A November 1994 article in the Washington Monthly, co-authored by Marmor, reported the result this way: "After the two advocates finished, Clinton looked thoughtful, pointed to Marmor and said, 'Ted, you win the argument.' But gesturing to Pollack, Marmor recalls, the governor quickly added, 'But weíre going to do what he says.' Even considering the Canadian system, everyone in the room agreed, would prompt GOP cries of 'socialized medicine'--cries that the press would faithfully report."

Health Care for American Now
The largest coalition of liberal groups promoting a choice between a public plan and private insurance companies. "They are saying--we can't do single payer because Americans donít want it," said Kip Sullivan of the Minnesota chapter of PNHP. "That's based on junk research conducted by Celinda Lake for the Herndon Alliance. It is bad enough to say we can't do single payer because the insurance industry is too powerful to beat. But it is just plain insidious to say we can't do single payer because the American people don't want it. In fact, polling data indicates that two-thirds of Americans support a single payer system. And that level of support exists despite the fact that there is little public discussion about it."

Kaiser Family Foundation
One of the most prestigious liberal inside the beltway think tanks on health reform policy. Saul Friedman is a reporter for Newsday. In February, Friedman wrote an article for Newsday arguing that single payer is suffering from a conspiracy of silence. And he says Kaiser is the most culpable of the co-conpsirators. Kaiser, funded initially by insurance industry money, regularly keeps single payer off the table, Friedman says. When single payer advocates released a study in January asserting that Congressman John Conyers' single payer bill (HR 676) could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers, ìthe Kaiser Family Foundation's daily online report on health care developments at kff.org didn't mention it, Friedman reported. "Nor has Kaiser, the most comprehensive online source of health care information, made any mention of single-payer or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser's own polls." After a number of insistent inquiries, Kaiser told Friedman that they would publish charts in March comparing the Stark and Conyers bills. They never did.

The Lewin Group
The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option, showed that the insurance industry would lose 32 million policy holders if a public plan is enacted. Lewin's health reform policy guru, John Sheils, told the Associated Press: "The private insurance industry might just fizzle out altogether." What the mainstream press didnít report was that The Lewin Group is a wholly owned subsidiary of Ingenix, which is in turn owned by UnitedHealth Group, the nation's largest health insurance corporation. Lewin Group has conducted studies on single payer at the state level--and their studies consistently show that single payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676--which would create a single payer for the entire country and drive The Lewin Group's parent--UnitedHealth Group--out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said "the President didn't propose single payer, did he?" No, he didn't. Thatís why he too is on this list. (Sheils says The Lewin Group has studied national single payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill--including one by Congressman Pete Stark (D-California). Stark's bill would give every American the option of opting into Medicare. But that's not single payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. "The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings." Sheils says that of all the plans studied, the Stark bill saves the most money.)

Pharmaceutical Research and Manufacturers Association of America (PHRMA)
PHRMA chief executive Billy Tauzin says that under single payer, the government would become a "price fixer." By which he means, the government, as a single payer, will have the power to negotiate drug prices downward, thus costing the drug corporations millions in excess profits. In recent years, PHRMA has infiltrated liberal sounding groups like America's Agenda--Health Care for All. PHRMA's Vice President for Government Affairs and Law, Jan Faiks, now sits on the board of America's Agenda and PHRMA contributes money to the group--which has worked in recent years to undermine single payer at the state level. (America's Agenda Mark Blum wonít say how much money PHRMA gives to his group.)

We have met the enemy.

And they ain't us.

Russell Mokhiber is editor of Corporate Crime Reporter and founder of singlepayeraction.org

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"Roll Call" names the ten congressional health care staffers to know

The DC insider take on who's who in health care. In their profiles, most are long on "consensus," short on constituent and human need. Are these folks part of the problem? Can they be part of a single-payer solution? Most are Senate staffers, where Sen. Bernie Sanders (I-VT) has introduced a version of HR 676, S703, which also needs co-sponsors. 

by Stephen Langel and Katie Kindelan, CongressNow Staff and Roll Call Staff; posted at Roll Call, March 31

While President Barack Obama has made reform of the nation's health care system one of his priorities, the real work tends to get done in the legislative trenches. The responsibility for reaching an elusive bipartisan deal will fall to a number of talented legislative staff in both chambers. Here are 10 Hill staffers who will play a crucial role in whatever health care legislation is enacted.

David Bowen, staff director for Senate Health, Education, Labor and Pensions Committee, majority staff
Age: 43
Birthplace: Summit, N.J.
Education: B.S., Brown University; Ph.D., neurobiology, University of California at San Francisco

Bowen serves as Sen. Edward Kennedy's (D-Mass.) "alter ego," taking an approach to developing policy that is based on deal-making and team building.

"I look to Sen. Kennedy as an example," Bowen said. "Throughout his Senate career, he has found his way around legislative obstacles once seen as insurmountable." And for many of those obstacles, Bowen added, he has found a way to turn "what others perceived as an obstacle into a path forward."

David Nexon, now the No. 2 at AdvaMed, the medical device trade association and Bowenís predecessor at the committee, agreed that Bowen takes such an approach. In following Kennedyís lead, Bowen goes into negotiations knowing that he needs to seek common ground in order to develop a lasting deal on policy, Nexon said. And the way to do that is to focus on broad goals rather than narrow policy differences.

Conservative health lobbyists agree. Bowen is "willing to listen to both sides and work to find common ground in order to promote good public policy," one lobbyist said.

Bowen also enjoys his work as a mentor to junior staff.

"The thing I'm most proud of is when former fellows, interns and other colleagues come up to me long after they have left the office and say that working here was the best professional experience of their career," he said. The desire to mentor comes from his own experience as a fellow in Kennedyís office, he added.


Chuck Clapton, health policy director for the HELP Committee's minority health policy office
Age: 40
Birthplace: Boston
Education: B.A., Boston College; J.D., Catholic University's Columbus School of Law

Clapton is the top health care staffer in the HELP minority office and works closely with the majority in finding health care compromises.

Clapton coordinates the health activities of the minority staff and assists his boss, Sen. Mike Enzi (R-Wyo.), in developing policy positions on health reform.

Clapton's cooperative approach follows the lead of his boss, who has a history of working closely with Kennedy and who believes in the 80/20 rule. That means negotiators first identify the 80 percent of a topic where there is agreement, and then try to find a compromise on the remaining 20 percent.

Like many other health care staffers, Clapton points to the Medicare Prescription Drug, Improvement and Modernization Act as his greatest accomplishment. Enacting the Medicare Modernization Act is "the most significant change to Medicare in a generation," he said, and demonstrates the potential to use a "competitive, market-based structure to deliver a high-quality health care benefit in a cost-effective way." (blog editor's note: You might remember that this legislation prohibits the Federal government from negotiating discounts with drug companies and was characterized by Former US Comptroller General David M. Walker as "...probably the most fiscally irresponsible piece of legislation since the 1960s... because we promise way more than we can afford to keep.")

Clapton is seen as a strong asset to the HELP minority because of his experience working in health care in both chambers, one insurance lobbyist said.


Debbie Curtis, chief of staff to Rep. Pete Stark (D-Calif.); professional staff, House Ways and Means Subcommittee on Health
Age: 42
Birthplace: Arlington, Va.
Education: B.A., Boston University

Curtis is quick to minimize the influential role she has played for more than a decade in setting health policy agenda on Capitol Hill.

"I am part of a talented team on the Ways and Means Committee working to pursue better health care policy," Curtis said. "We shine by the policy we accomplish."

Lobbyists say Curtis does not give herself enough credit for the many policy items she has shepherded through the House, from securing preventive benefits in Medicare to passing both the Children's Health and Medicare Protection Act of 2007 and the Patients' Bill of Rights.

"She's like a great player-manager in baseball," said a Democratic health care lobbyist. "She brings out the best in her boss and then can take the field and pitch a no-hitter."

Curtis says achieving health care reform will hinge on both securing a public health insurance option and the willingness of all stakeholders to approach the issue with an open mind. 

"Success hinges on consensus and the ability to maintain the momentum President Obama has clearly given to health care reform," Curtis said. "It will be the difference in our ability to put together what is a very large bill in a time frame that is not very long."



Liz Fowler, senior counsel and chief health counsel to Senate Finance Chairman Max Baucus (D-Mont.)
Age: 42
Birthplace: Taipei, Taiwan
Education: B.A., University of Pennsylvania; Ph.D., Johns Hopkins School of Public Health; J.D., University of Minnesota

Fowler leads the Finance Democrats' health care team. She coordinates health care reform efforts and works closely with the staff of ranking member Chuck Grassley (R-Iowa), along with Senate and House leadership.

The role requires Fowler to be a troubleshooter. "It is my job to find that common ground and mend fences if they need to be mended," she said.

That skill was put to the test when Fowler helped pass the Medicare Modernization Act, which provided a prescription drug benefit for seniors and was one of the hallmark health care accomplishments of the Bush administration. (blog editor's note: see above under Clapton)

This effort was "personally and professionally, one of the most challenging times in my life," Fowler said, because the issues were so complex and Democrats found themselves left out of much of the Republican-led negotiations.

Fowler believes the biggest challenge this year will be "getting the numbers to work" by ensuring that the votes are there to pass health care reform.

Various health care lobbyists cited Fowler's work on the prescription drug benefit as an example of her skill in finding compromises.

Still, Fowler's willingness to work with Republicans and the Bush administration on the MMA could be a hindrance to future negotiations, said one Senate Democratic aide, who added that many Democrats felt that Baucus undercut Senate leadership by reaching a deal with the Bush administration.

"I think a lot of old-timers are going to remember the fights over the MMA," the staffer said.



Mark Hayes, health policy director and chief health counsel for the Senate Finance Committee Republican staff
Age: 42
Birthplace: Shelbina, Mo.
Education: B.S., pharmacy, University of Missouri-Kansas City; J.D., American University's Washington College of Law

Hayes is the lead health care adviser to Iowa Republican Sen. Chuck Grassley, the ranking member of the Finance Committee, and he prepares his boss for negotiations with Chairman Max Baucus (D-Mont.) on a number of issues, including the ongoing health care reform effort.

Hayes, who also serves as a resource for other Republican committee members, has so much authority that one former Senate Democratic aide referred to him as the "101st Senator."

In working to forge a deal on health care, Hayes says he tries to step back and look at the big picture, figuring out policy differences among members and a way to bridge the gaps between them.

Like his Democratic counterpart, Hayes counts passage of the prescription drug benefit as his greatest health care accomplishment.

He served as the principal Republican staff person responsible for moving the drug benefit through committee and into law, at a time when the GOP was in the majority.

In moving his bosses' agenda forward, Hayes uses his ability to explain complex issues in easy-to-understand language, a health insurance lobbyist said. His preparation is also an asset, said Dean Rosen, the former health care adviser to then-Majority Leader Bill Frist (R-Tenn.). (blog editor's note: the Hospital Corp. of America heir) "Almost no staff person comes to a debate more prepared than Mark Hayes," added Rosen, who now is a lobbyist at Mehlman Vogel Castagnetti (blog editor's note: a firm that carries more than $2.25 million in contracts with pharmaceutical and insurance corporations, according to OpenSecrets.org)



Kate Leone, senior health counsel to Senate Majority Leader Harry Reid (D-Nev.)
Age: 37
Birthplace: Princeton, N.J.
Education: B.A., Cornell University, American studies; J.D., Columbia University

While Leone may see herself as a troubleshooter -- watching for potential problems within the Democratic caucus -- her health care peers view her as a deal-maker.

Leone, said one health care activist, is "more of a realist than an activist" who's not interested at "tilting at windmills." This approach is necessary because part of her job is to balance the various interests of the Senate Democratic Conference.

A Senate Democratic aide agrees. "I think she is going to want to guide any health reform to whatever is best for the caucus, not for what's best for certain Members' legacies." (blog editor's note: And what about what's best for the American people?)

The aide added that one of Leone's greatest strengths is to know where the caucus is on any particular issue, where individual Members are and where she can lose a Senator or two without hurting the legislationís overall goal.

Leone says her greatest accomplishment in health care thus far is helping to pass a slew of bills in 2006, including shortfalls in funding for the State Children's Health Insurance Program and problems with the Medicare program -- issues that had been long stalled in Congress.



Liz Murray, senior policy adviser to House Majority Leader Steny Hoyer (D-Md.)
Age: 33
Birthplace: Rochester, N.Y.
Education: B.A., Yale University; M.P.P., Harvard University, Kennedy School of Government

Murray has spent her entire career focused on health care issues. And lobbyists say it shows, describing her as someone with unmatched expertise on the issues and an ability to bring people together to get things done.

"People in my job need to be willing to meet with everyone to bring as many viewpoints back to our bosses as possible," Murray said. "The most productive meetings are ones in which people are informed and can speak to their issue, as a lobbyist but also from the perspective of an everyday American." (blog editor's note: What would she hear about health care if she listened to everyday Americans directly? Even when you call it something scary like "socialized medicine," most Americans support single payer!)

In her 10 years on Capitol Hill, Murray points to President Barack Obama's signing this year of the State Children's Health Insurance Program bill as her proudest achievement to date.

She sees today's health care debate as the greatest opportunity so far for real reform because the public is finally ready for more certainty and affordability in their health care services, and an inspirational president who has made the issue a priority.

"This debate is going to have so many varied interests," said a health care lobbyist who is following the debate closely. "Liz will be the one to build consensus." (blog editor's note: This begs a serious question: consensus among whom? Constitutents? Most Americans back a single payer system. And a majority of one of the most important class of stakeholders--health care professionals--do as well. It's sad to hear the phrase "varied interests" and immediately decode it as "not us".)



Karen Nelson, deputy committee staff director for health for the House Energy and Commerce Committee
Birthplace: Elgin, Ill.
Education: B.A., Cornell University, graduate work at Harvard University

Nelson brings more than 30 years of health care and legislative experience to her role as the top health care staffer on the House Energy and Commerce Committee, including 18 years with Chairman Henry Waxman (D-Calif.).

Lobbyists say it shows in her ability to harness a talented staff and execute her bossís legislative priorities.

"Karen is the heart and soul of the health team," said Rich Tarplin, a Democratic lobbyist and former Clinton health care administration official. "She applies strong policy expertise with strategic ability and strong management skills to get things done."

Nelson has had a hand in almost every piece of major health care legislation to pass through the chamber in the past three decades, from holding the earliest hearings on the AIDS epidemic to developing a food labeling system and securing the Hatch-Waxman provisions that brought generic drugs to market in the 1980s.

"It helps to work for a Member who's both very dedicated to the issues and a skilled legislator," Nelson said. "That, and having a talented and able staff who can define solutions to problems and move legislation forward."

Nelson says high on the agenda for the committee this year is securing a health care reform bill that will meet the goals laid out by the president and largely shared by the Caucus and members of the committee.

"Our job is to find consensus around the goals of quality, affordable coverage for all Americans," she said, "and move that legislation forward."



Bill Pewen, senior health policy adviser to Sen. Olympia Snowe (R-Maine)
Age: 52
Birthplace: Pasadena, Calif.
Education: B.S., health education, Southern Oregon State University; M.P.H., epidemiology, University of Pittsburgh; Ph.D., infectious diseases and microbiology, University of Pittsburgh

During a time of closely divided government, moderates in both parties are in high demand. Snowe is one of the leading Republican moderates, and Pewen is the leader of her health care shop.

Pewen says he likes the role Snowe plays. "I appreciate representing a Member who has worked to bridge divides and build consensus, as that is critical to making reform sustainable over the long term."

Snowe's unique position as a key vote to help Democrats reach the magic filibuster-proof 60 votes puts Pewen in demand and makes for an intense schedule. "He definitely has his hand in nearly everything," one Senate Democratic aide said. "He is the only person I know who carries two BlackBerrys."

Pewen's role was apparent in the fight over health information technology, where the results of his central role in ensuring more stringent privacy protections for electronic medical records were included in the economic stimulus package.

Specifically, Pewen made certain that the bill included a provision requiring that certain unintentional disclosures of patient medical data be considered breaches and thus subject to penalties.




Wendell Primus, senior policy adviser for budget and health to Speaker Nancy Pelosi (D-Calif.)
Age: 62
Birthplace: Eldora, Iowa
Education: B.A., Ph.D., economics, Iowa State University

Primus encompasses the mind of a policy wonk with the political skills acquired through a 30-year career on Capitol Hill. Now, as the Speaker's right-hand man on one of the top issues before Congress, lobbyists say Primus has hit his career stride.

"Throughout his career, this is the job where Iíve seen him be the most impressive," said a longtime health care lobbyist.

Primus began his legislative career on the House Ways and Means Committee, working on issues from income security and welfare reform to Medicare.

He began working for Pelosi four years ago, and today he oversees the complex task of moving legislation from the committee table to the president's desk.

"My role is to advise the Speaker on health care reform and manage legislation at the staff level," Primus said. "Itís making sure that all the bases are touched, from policy development and cost estimates to the press and various stakeholders."

Primus will no doubt play a leading role in crafting legislation aimed at achieving the ambitious overhaul of the current health care system both the Speaker and the president have called for.

"It is a tremendous challenge and opportunity all wrapped into one," he said. "This, how we get health care costs under control, should be a bipartisan issue."

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Labor Leaders Disappointed by Lack of Working People's Voices at Vermont Healthcare Reform Discussion

by the Labor Campaign for Single Payer Healthcare, posted on CommonDreams.org on March 18

Working people's voices were not heard at the Obama Administration's second regional Health Care Summit in Burlington, VT on March 17.

"Despite the fact that several union spokespersons attended the meeting, we were not called upon and unfortunately the voice of workers was shut out of the discussion," said Peter Knowlton, president of the Northeast Region of the United Electrical Workers Union (UE). "When it came to the financial discussion, Gov. Douglas and Gov. Patrick [the two governors moderating the session] only called on wealthy special-interests from the worlds of business and professional circles."

Sandy Eaton, a nurse who attended the forum stated that nurses' voices went unheard as well. "Nurses were well represented, but our voices were not heard -- and the term "nurse" or "hospital worker" was never mentioned in the two hour forum," said Eaton who is a member of the executive board of the Massachusetts Nurses Association.

Outside the auditorium where the summit was held, over 250 labor and community members rallied in support of HR 676 and single payer healthcare. "Our system needs fundamental reform," said Dawn Stanger, President of the Vermont Workers Center-Jobs with Justice. Stanger, a UPS employee and member of Teamsters Local 597, was joined by dozens of unionized nurses who worked next door at Fletcher Allen Health Care, the largest hospital in Vermont.

"We need to build a movement to demand change," Stanger told the crowd. The Vermont Workers Center is coordinating a major statewide "Healthcare Is a Human Right" rally on May 1 at the Vermont Statehouse, which will include U. S. Senator Bernie Sanders. The rally will oppose Vermont Governor Douglas' proposed budget cuts to healthcare programs and support state and national single-payer legislation.

"I was really hopeful that these forums would finally give voice to workers concerns," added UE leader Peter Knowlton. "There were many people there who could have reminded them about the serious problems hourly workers face with skyrocketing premiums and dealing with the horrors of co-pays, deductibles, out-of-pocket expenses and the run around all workers face with managed care. If this forum is any indication of future ones, we will need to be much more aggressive to get our voices heard."

Knowlton, Eaton and Stanger were among the several labor leaders at the forum who support HR 676, the "Expanded and Improved Medicare for All" Act. HR 676 was re-introduced this year by Congressman John Conyers. It currently has 66 congressional co-sponsors. Because it eliminates the private insurance industry from profiting from people's misfortunes and, like Medicare, establishes the federal government as the "single payer" of everyone's medical bills, HR 676 can provide healthcare for all with no co-pays or deductibles in a fiscally prudent manner. HR 676 has the endorsement of hundreds of state and local labor federations and local unions as well as many other civic and religious organizations.

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