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Health Care Justice - NC Update

August 16, 2017

Thanks to ALL for your calls and actions to stop the bad health care legislation in Congress!

Unfortunately, the Republican "health care" bills are like zombies that never seem to entirely die. Read here for one scary scenario...

Take Action for Health Care:

Sat., Aug. 26 & Sun., Aug. 27, 2017:
Pride Festival and Parade (Parade is Sun. noon to 2 pm) Help staff Health Care Justice - NC info table and/or walk with us with our banner in the Parade! Bring signs and sign up here.

Congressional August Recess Actions - Rep. Robert Pittenger Town Halls:

Mon., August 28, 6pm
Team Church (2301 Stevens Mill Rd., Matthews)

Thurs., August 31, 6pm
Providence High School (1800 Pineville-Matthews Rd., Charlotte). An RSVP is helpful to Pittenger but not required.

Email margiestorch@gmail.com if you can attend so we can plan questions!

Recommended:

VIEW, LIKE & SHARE our "American Health Care for All" video. Thanks to Zach Thomas for writing this song and for Brian Kasher and all our volunteer musicians and singers for producing this video. Now, onward to health care for all!

Read a great article on the conservative argument for single payer.


Join Health Care Justice - NC at the Charlotte Pride Exhibit and parade August 26-27

August 15, 2017

You have been invited by Shami Hariharan to sign up for "Health Care Justice, Charlotte Pride Exhibit ." Please click here to view the online sign up sheet.


New video supporting health care for all

August 11, 2017

Thanks to member Zach Thomas for writing the song "Make American Healthcare for All" and to Brian Kasher for producing it.

Feel free to enjoy and share.

Jessica Schorr Saxe


HEALTH CARE JUSTICE - NC: Participate in the Pride Festival and Parade August 26-27, 2017. Promote and Support National Improved Medicare for All.

August 4, 2017

2017 Charlotte Pride Festival & Parade
August 26 - August 27, 2017

FESTIVAL: Saturday, Aug. 26, Noon - 10:00pm and Sunday, Aug. 27, Noon - 6:00pm
PARADE: Sunday, Aug. 27, 1:00pm - 3:00pm

Health Care Justice - NC will have a table at the festival and will participate in the parade. Last year we grew by over 200 new members. Let's do that again!

Volunteers needed! Sign up for any of the listed hours. March in the parade!

RSVP to denisefinck@hotmail.com.


Medicare for All column in today's Charlotte Observer

August 2, 2017

Congratulations to John Clark for having his op-ed published.

Jessica Schorr Saxe


Senate defeats "skinny" repeal 51 to 49 / More about the Daines amendment / Medicare birthday celebration

July 28, 2017

Read here in the New York Times how the Senate defeated the "skinny" repeal of the Affordable Care Act last night. John McCain voted "no" as did Susan Collins and Lisa Murkowski, leaving the Republicans one vote short. It was apparently quite dramatic. Brendan Riley of the NC Justice Center, who stayed up to watch the vote on C-Span, reports that "McConnell gave a speech at the end suggesting that this might be the end of the Republicans' effort to repeal the Affordable Care Act."

The Daines amendment to replace the ACA with single-payer was apparently a political trick: see below.

Now we can celebrate this repudiation of a bill that would result in millions losing health insurance. And, in just 2 days, we can also celebrate the 52nd birthday of Medicare:

Medicare 52nd Birthday Bash!
(Celebrate with Cake, Conversation, and Citizen Calls)
Sunday, July 30, 4:00pm
First Ward Park, 301 E. 7th St. Charlotte, NC
(Bring cupcakes to share if you can.)

And then onward to achieving REAL universal health care by Improving Medicare and expanding it to all!

Jessica Schorr Saxe

***

Senate defeats single payer amendment

By Don McCanne, M.D.
United States Senate, July 27, 2017

In the Senate an amendment to the Republican repeal and replace legislation was introduced by Sen. Steve Daines (R-MT) that would establish a single payer system in the United States - an expanded and improved Medicare for all - using the exact same language as in HR 676 introduced in the House by Rep. John Conyers.

The vote:

0 - Yes
57 - No
43 - Present

All Republicans, including Sen. Daines, voted against it. Democratic Senators Donnelley, Manchin, Tester, Heitkamp, and Nelson, along with Independent Senator King voted against it. All other Democrats voted Present.

Sen. Bernie Sanders had said before the vote that failure of Sen. Daines and other Republicans to vote for their amendment would demonstrate that this was a sham to be used to campaign against moderate Senators in the next election. When no Republican voted for it, most Democrats plus Independent Sen. Sanders voted Present.

It is a sad commentary that the most important health policy legislation ever introduced in Congress - legislation that would have brought health care justice to all - was used by the Republicans as a tool for political chicanery.

Do they think this was some kind of a joke? They just rejected legislation that would have prevented hundreds of thousands of people over the years from facing physical suffering due to lack of medical care, financial hardship, and even death. Death!

We could forgive them for a bad joke, but this?

Mobilize the forces. This is war! Not the guns and bombs type of war but a war against man's inhumanity to man.

***

Man was made to mourn: A Dirge

Many and sharp the num'rous ills
Inwoven with our frame!
More pointed still we make ourselves
Regret, remorse, and shame!
And man, whose heav'n-erected face
The smiles of love adorn, -
Man's inhumanity to man
Makes countless thousands mourn!

- Robert Burns, 1784


Health Over Profit ACTION ALERT - Single Payer vote TODAY, Call Now!

July 27, 2017

Click here to read an urgent message from Dr. Margaret Flowers and the HOPE campaign.


Celebrate Medicare's 52nd Birthday: Sunday, July 30 at 4:00pm

July 26, 2017

Medicare 52nd Birthday Bash!
(Celebrate with Cake, Conversation, and Citizen Calls)

Sunday, July 30: 4:00pm
First Ward Park, 301 E. 7th St., Charlotte, NC

Protect, Improve, and Expand Medicare!

* Protect it, because many in Congress would like to place our best-yet health care program on the chopping block and privatize it.

* Improve it, because despite its valuable contributions, Medicare falls short on dental and drugs and leaves some people still unable to afford care.

* Expand it - to the entire population - allowing us to end the waste of $400 billion annually that is currently spent on the needless bureaucracy and paperwork associated with the private health insurance industry.

By applying the savings to assuring universal care, Rep. Conyers' single-payer legislation would make health care a human right. H.R. 676 currently has 115 co-sponsors.

Feel free to bring cupcakes to share!!!!


Health Care Justice - NC Update: Do or Die Time!

July 26, 2017

URGENT: More Senate Votes Happening Today!

* Calls to Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087) needed NOW. Keep up the pressure!

Though a vote on the BCRA failed last night, other votes are coming. See below for a summary from Brendan Riley*

Keep your calls/tweets/FB posts to all your Senators decrying the process as well as the substance (the bills are fundamentally flawed and can't be fixed).

Take Action for Health Care:

Sat, July 29, 2017:
Health Care Rally in Washington D.C.
www.facebook.com/rallyforhealthcare

Sun, July 30, 2017:
Medicare's 52nd Birthday Bash!
4:00pm at First Ward Park in Charlotte. Share cake, conversation, and calls to Protect, Improve, and Expand Medicare for ALL!

Recommended:

Order a Medicare for ALL sign for your home and/or car by emailing info@healthoverprofit.org. There is no charge, but donations of $10 would be welcome to cover the costs of printing and shipping. Click here to donate.

Read a really good article in USA Today by someone who has lived in 3 other countries and says that universal health care is what real freedom looks like!

* As you may have seen, the BCRA failed tonight. Because it had provisions that are not germane to the budget (either because the Senate Parliamentarian ruled as such or because CBO hadn't yet scored the provisions), the BCRA 3.0 (which was just released tonight) was defeated 57-43 as nine Republican Senators (neither Tillis nor Burr included) joined Democrats to oppose it. This is great news, but this was as-expected. The Senate reconvenes tomorrow morning, scheduled for now to begin at 9:30am.

From our national partner at NHeLP, here is a more detailed update of what happened today and what we can expect tomorrow/moving forward. Pay particular attention to the paragraph about the so-called “skinny bill” (which I’ve bolded below):

Here's where we stand. The MTP passed with VP Pence as the tie-breaking vote. Sen. McCain came back to vote for the MTP but pretty much blasted the process and supported a bi-partisan process for legislation. Take a look at his speech. Sens. Collins and Murkowski opposed the MTP so please make sure you are thanking them! Just because the MTP passed doesn't mean the final bill will pass and we must do EVERYTHING we can to prevent the Senate from passing a bill!

The Senate just finished voting on a Point of Order (POO) brought by Sen. Murray opposing BCRA. The jist of it is that inclusion of the Portman $100 billion Medicaid wrap-around (to allegedly defray costs of Medicaid expansion enrollees who lose Medicaid and go to the marketplace) and the Cruz amendment (allowing issuers to provide non-ACA compliant plans as long as they offer 1 ACA-compliant plan on the marketplace) violate Byrd rules because there isn't a CBO score. Plus we had other Republicans opposing the earlier versions of BCRA for not going far enough. The Point of Order was sustained by a vote of 57-43 so debate on BCRA stops because it would need 60 votes to proceed.

The Senate then adjourned till 9:30am tomorrow. The debate will then continue on the straight repeal without replace (ORRA, the updated version of the 2015 reconciliation bill that passed the House and Senate and was vetoed by Obama). This was the deal Sen. Paul got – to support the MTP, he got a vote on the straight repeal. The vote on that is expected sometime around noon Wednesday and also is expected to fail.

Then on to whatever comes next. We expect a “motion to commit” from the Democrats - -basically to send the bill back to Committees of jurisdiction to develop a bill.

Then also the “skinny” bill which, as Sen. Tester called it, is more like a bait-and-switch. Because if it passes the Senate, it would allow the Senate to go to a conference committee with the House. At that point, Ryan and McConnell would craft a bill that would then have to be voted on by both Senate and House. We believe the “conference committee” bill would have to have a CBO fiscal score before it could be voted on in the Senate but not necessarily a score of the coverage losses. But you can imagine the bill won’t get any better if it goes to conference.

And if this isn't weedy enough, here's an amendment tracker. Not all amendments will ultimately get voted on but we expect vote-a-rama to start sometime Thu and could go thru the night and into Friday (depending on everyone's staying power).

So keep your calls/tweets/FB posts to all your Senators decrying the process as well as the substance (the bills are fundamentally flawed and can't be fixed). If you're in the DC area, join us at a a rally at the Capitol at 5:00pm.

We must keep up the pressure so that we can defeat whatever bill the Senate tries to pass to let them get to the next step. More tomorrow!

Brendan Riley
Policy Analyst, Health Advocacy Project


Health Care Justice update / Call your senators today! / Note events and article

July 24, 2017

URGENT: Vote expected in Senate on Health Care on Tuesday!

* Keep up the calls to Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087).

* Shared attached graphic and message on social media.

Message: The Bill isn't Fixed!

The new Republican health care plan is more of the same hogwash:

* Tens of millions of Americans losing health insurance
* Enormous cuts to Medicaid
* Ridiculous tax cuts for the rich

Take Action for Health Care:

Spread the word on social media and join us!

Tue, July 25, 2017:
Rally Against Health Care Hogwash. Join us for a rally against the Republican "health" plan on Tuesday, July 25th at 11am at the corner of Trade & Tryon Sts. Tell Senators Tillis & Burr that the "new" Senate plan is nothing more than lipstick on a pig. Click here.

Sat, July 29, 2017:
Health Care Rally in Washington D.C.
www.facebook.com/rallyforhealthcare

Sun afternoon, July 30, 2017:
Medicare's 52nd birthday event in Charlotte.
Info to come this week!

Recommend Reading:

An article from the Harvard Business Review about whether the U.S. is ready for single-payer.


We need your help finding business groups or people to hear about single-payer health care!

July 19, 2017

Richard Master who produced the Documentary Fix It: Health Care at the Tipping Point will be coming to Charlotte in October. He also started the organization Business Leaders Transforming Health care. Their website is worth looking at.

We would like to find a business meeting or convention during October in Charlotte where he can present to a large business audience. We need to help the business community understand that it is in their best interest to support Single payer, National Improved Medicare for All.

Do any of you know of a business meeting or convention that will be in Charlotte during October and if so do you have any connections to help get Richard Master on the agenda of that meeting? If so, please contact me at denisefinck@hotmail.com.

Denise Finck-Rothman, M.D.
Membership co-chair
Health Care Justice - NC


Health Care Justice - NC Update / Action ALERT!/Events/Reading

July 14, 2017

URGENT: Your calls, letters to editors, emails needed NOW!

CBO score on the revised Senate "healthcare" bill expected July 15-18.

Senate Motion to Proceed vote expected July 18-19.

Floor vote after 20 hrs. or less of debate expected July 19-20.

* Keep up the calls to Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087).

* Send letters to editor c/o opinion@charlotteobserver.com (130 words or less)

* Shared attached graphic and message on social media.

Message: The Bill isn't Fixed!

Vote NO on the flawed bill that ends Medicaid expansion, cuts and caps Medicaid, raises premiums and deductibles on essential health coverage, and guts consumer protections!

In the short term, stabilize the health insurance marketplace and address affordability for all. Long term solution to cut costs and cover everyone is Improved Medicare for All (HR 676).

The new version of Trumpcare includes changes that would make the health insurance market more perilous and more expensive for many consumers. It allows insurers to sell stripped-down plans and it uses tax incentives to encourage people to buy bare-bones policies -- even though they won't provide the coverage they need when it counts.

Take Action for Health Care:

Spread the word on social media. #protectourcare

Rallies for Health Care for ALL outside Sen. Tillis' Charlotte Office
Check dates at www.facebook.com/CharlotteIndivisible.
11:30am - 1:00pm at 9300 Harris Corners Parkway, Charlotte.

Thu, July 20, 2017:
Health Care Justice - NC Legislative Comittee Meeting
7:00pm at Terry Soffer's home, 5124 Teodrill Ln. in Carson's Pond neighborhood off Rea Road. Email margiestorch@gmail.com for gate code if not received by Sunday.

Mon, July 24, 2017:
Medicare for All March
http://www.millionsmarchingformedicare.org/find-an-event

Sat, July 29, 2017:
Rally for Health Care in Washington, D.C.
www.facebook.com/rallyforhealthcare

July 30, 2017:
Medicare's 52nd birthday
Event info to come - https://townhallproject.com

Call or text "resist" to 50409 and follow the prompts to have a letter with your comments faxed free of charge to your senators.

Recommend Reading:

See another George Lakoff (Prof. of Cognitive Science and Linguist) article on framing progressive issues.

Read here about the support Medicare for all is gaining among southern conservative Democrats.

And this New York Times article about why single-payer health care saves money.


Rep. Alma Adams town hall Monday at 6pm / Two articles refuting criticisms of single-payer health system

July 9, 2017

Dear Health Care Justice friends,

Please see the new location for Rep. Alma Adams' July 10 town hall here. Please let me know if you're planning to go: jessica.schorr.saxe@gmail.com.

And please note these two articles, which refute some of the articles against single-payer.

This one from the Washington Post accurately titled "The dumbest criticism of single payer health care" which addresses, among other things, the claim that it will cost $32 trillion.

And, from Bloomberg View, "The world doesn't mooch off U.S. health care research."

Jessica Schorr Saxe


Latest update for HCJ-NC membership

June 25, 2017

Take Action NOW! Senate BCRA vote expected THIS week!

A U.S. Senate vote on the Republican "Better Care Reconciliation Act" is expected without hearings as early as THIS week. Keep up the calls to Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087).

Tell Senators to slow down the process. Wait to vote until a CBO score is provided on the final bill including amendments. Hold hearings before a vote, and come back to their districts to explain and discuss the bill with constituents before voting.

If the bill comes to a vote this week, tell Senators to vote NO on the "Better Care" Reconciliation Act.

Show Up for Health Care Events!

Spread the word on social media. All hands needed on deck!

TUE, June 27 at noon:
Rally Against Trump Care outside Senator Thom Tillis Charlotte office, 9300 Harris Corners Pkwy, Charlotte, NC, coordinated by Indivisible Charlotte.

TUE, June 27 at 6 pm:
Citizens Hearing on the "Better Care Reconciliation Act" (since Republican Senators won't hold one!) at Little Rock AME Zion Church, 401 N McDowell St, Charlotte, NC.
Info: www.facebook.com...

If you know anyone in ASHEVILLE, forward this event to them:

TUE, June 27 at 7 pm:
Asheville: Healthcare for ALL - A Workable Solution by Indivisible Asheville WND with speakers from Physicians for a National Health Program at Ferguson Auditorium, A-B Tech campus, 340 Victoria Rd, Asheville, NC.
Info: https://indivisibleavl.org...

WED, June 28 at 7 pm:
Phonebanking and Letterwriting sponsored by NC AIDS Action Network and Legal Services of Southern Piedmont. Location at Children and Family's Services Center, 601 E 5th St #450, Charlotte, NC 28202. Dinner provided!
RSVP: www.facebook.com...

WED, July 4, meet at 9:30 am:
Fourth of July Parade in Hickory Grove area. March with Health Care Justice - NC members and banner for Medicare for ALL. Bring signs! Meet at HG Rec. Center, 6709 Pence Rd. RSVP: DeniseFinck@hotmail.com

SUN, July 29, 2017:
Rally for Health Care in Washington D.C.
National info: www.facebook.com...
Interested in joining a bus or carpool to DC? Contact: margiestorch@gmail.com

July 30, 2017:
Medicare's 52nd birthday event. Info to come.

Recommended Reading:

The most comprehensive comparison of ACA, AHCA and BCRA health care bills I've seen.

Here is a good (short) article from FiveThirtyEight about what's in the Senate bill.

Here's a great article from The New York Times: "Get Cancer Now, Before Congress Cuts Your Insurance." If you ever had thought that the insurance industry was working in your interest, read this article. While Ordonez argues that we shouldn't repeal the Affordable Care Act, this is really an argument for providing improved Medicare for All - and providing health care in a rational way instead of the lottery he describes.


Statewide day of action Thursday 6/15: Please take 2 minutes to make calls

June 14, 2017

Take Action Now (NC Call-In Day: Thursday, June 15):

1) A vote in the US Senate on the Republican "American Health Care Act" is expected without hearings or opportunities for amendments before July 4. Call Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087). Tell them to oppose the AHCA and Medicaid cuts.

Here is a suggested script for your call:

Senate Republicans are drafting a secret bill to slash Medicaid and repeal the Affordable Care Act, and they will not share it with the public before they vote. As your constituent, I find this lack of transparency unacceptable. Share your secret bill with your constituents so we can evaluate it.

While we do not know details of your hidden bill, we ask you to do the following:

  • Oppose any bill that caps or cuts Medicaid funding - over one million children and many seniors and people with disabilities in our state rely on it.
  • Oppose any bill that would increase the number of uninsured in our state.

2) You could also call these "moderate" Republican Senators:

Sen Lamar Alexander, (202) 224-4944
Sen Shelley Moore Capito, (202) 224-6472
Sen Bill Cassidy, (202) 224-5824
Sen Susan Collins, (202) 224-2523
Sen Dean Heller, (202) 224-6244
Sen Lisa Murkowski, (202) 224-6665
Sen Rob Portman, (202) 224-3353

Health Care Events:

A Rally Against the Senate's ACHA is being considered with coalition groups.
Want to help? Email margiestorch@gmail.com.

Thursday, July 20th at 7pm
HCJ-NC Legislative Committee Meeting. Info to come.

Recommended Reading:

This unnerving article in the New York Times says that the opposition to the devastating AHCA is lukewarm. Time to activate the troops!

This article talks about the implications of Medicaid cuts for all of us.

Jessica Schorr Saxe

P.S. My current email address is: jessica.schorr.saxe@gmail.com. Do not use my earthlink address.


Health Care Justice - NC members, family and friends. March in the July 4th Hickory Grove Parade in support of expanded, improved Medicare for all!

June 10, 2017

We will be carrying our banner and marching in the July 4th Hickory Grove Parade. Dress in red, white, and blue. Wear silly hats. Carry a Medicare for All sign. All age children are welcome to march with us!

Tuesday, July 4th, 2017

9:30am - Parade Staging at the Hickory Grove Recreation Center

10:30am - Parade Begins with a march down E. WT Harris that ends at the Grove Church

11:30am - 2:30pm - Feel free to join the July 4th celebration with music, food, games and contests.

Important!!!!! RSVP to denisefinck@hotmail.com.


Health Care Justice - NC Update: Actions/Events/Recommended Reading

June 4, 2017

Take Action Now (Please Call Again!):

* The CBO (Congressional Budget Office) score on the impacts of the Republican's AHCA (American Health Care Act) estimates 23 million will lose health insurance, premiums will rise and essential health benefits will not be guaranteed at affordable rates.

Call Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087). Tell them to oppose the AHCA and to maintain essential health benefit requirements. Support Medicare for All as the most cost effective health care.

You could also call these "moderate" Republican Senators:

Sen Lamar Alexander, (202) 224-4944
Sen Shelley Moore Capito, (202) 224-6472
Sen Bill Cassidy, (202) 224-5824
Sen Susan Collins, (202) 224-2523
Sen Dean Heller, (202) 224-6244
Sen Lisa Murkowski, (202) 224-6665
Sen Rob Portman, (202) 224-3353

* Send a letter to Senator Sanders. Bernie Sanders is putting a Medicare for All bill together, and we appreciate that. We also understand that it falls short of HR 676: The Expanded and Improved Medicare for All Act in important ways such as not being comprehensive, including co-pays, allowing people to buy out of the system and keeping investor-owned facilities.

HR 676 was carefully crafted to include policies that will create a comprehensive high quality universal healthcare system in the United States. We are already spending enough money in our country to pay for it. We shouldn't ask for anything less! CLICK HERE TO SEND IT.

Health Care Events:

* Monday, June 5 at 9 pm
Join the next HOPE (Health Over Profit for Everyone) National Call. Dr. Don McCanne will speak about the successful efforts in California to convince legislators to support single payer. The California health bill passed out of the Senate and is headed to the Assembly. We will also discuss what's happening in Congress and upcoming actions.
CLICK HERE TO REGISTER FOR THE CALL.

* Thursday, June 8 at 7 pm
HCJ-NC Legislative Committee Meeting at Julia Westendorf's home: 2229 Chatham Ave., off of Belvedere in the Plaza-Midwood neighborhood. RSVP to margiestorch@gmail.com if you have not previously attended a Legislative Comm. meeting.

Recommended Reading:

This article about the CA single-payer bill becoming a litmus test for CA Democratic legislators is interesting.

Jessica Schorr Saxe


Take action now re: AHCA / Events / Reading

May 25, 2017

Take Action Now:

The CBO (Congressional Budget Office) score on the impacts of the Republican's AHCA estimates 23 million will lose health insurance, premiums will rise and essential health benefits will not be guaranteed at affordable rates.

Call Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087). Tell them to oppose the AHCA and to protect Medicaid from per capita caps/block grants and to stand up for other consumer protections.

You could also call these "moderate" Republican Senators: Lamar Alexander, Shelley Moore Capito, Bill Cassidy, Susan Collins, Dean Heller, Lisa Murkowski and Rob Portman. (google for phone numbers).

FYI, these organizations oppose the ACHA:

American Medical Association, American Nurses Association, American Hospital Association, American Academy of Pediatrics, American Cancer Society, American Heart Association, American Diabetes Association, American Lung Association, March of Dimes and AARP

Health Care Events:

* Sunday June 4 from 2-4 pm
Ben Salem Presbyterian Church, 6801 Monroe Rd., Charlotte (across from East Meck. HS).
KIDS' and Young Adults' Town Hall 1st grade through college age youth get to ask questions about topics our politicians can impact. Youth will lead this event.
Please RSVP: townhallclt@gmail.com

* Thursday, June 8 at 7 pm
HCJ-NC Legislative Committee Meeting at Julia Westendorf's home: 2229 Chatham Ave., off of Belvedere in the Plaza-Midwood neighborhood. RSVP to margiestorch@gmail.com if you have not previously attended a Legislative Comm. meeting.

Recommended Reading (good background for your calls):

https://www.nytimes.com...

Jessica Schorr Saxe


Actions/Events/Recommended Reading

May 21, 2017

Take Action Now:

* The CBO (Congressional Budget Office) score on the impacts of the Republican's AHCA is expected to be released Wed., May 24th. Respond with calls to Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087). Tell them to oppose the AHCA and to protect Medicaid from per capita caps/block grants and to stand up for other consumer protections.

* Advocates can pressure Congress (especially the Senate) during the upcoming Memorial Day recess (May 29-June 2). Find the full toolkit here.

Priority activities over Memorial Day recess include:

* Drive calls, hand-written letters and emails to Senators

* Attend Town Hall meetings, Faith vigils, or tours of health centers and hospitals

* Share consumer stories through LTEs (letters to editors) and social media

Health Care Events:

* Monday, May 22 at 6:30pm at Midwood Int'l. & Cultural Center
HCJ-NC program "Our Path to a National Improved Medicare for All" featuring Dr. Margaret Flowers, founder of HOPE (Health Over Profit for Everyone)
RSVP: DeniseFinck@hotmail.com

* Sunday June 4 from 2-4pm
Ben Salem Presbyterian Church, 6801 Monroe Rd., Charlotte
KIDS' and Young Adults' Town Hall 1st grade through college age youth get to ask questions about topics our politicians can impact. Our youth will lead this event.
Please RSVP: townhallclt@gmail.com

Recommended Reading:

Billionaires make the case for single payer health care to help business competitiveness:

http://healthoverprofit.org...

Jessica Schorr Saxe


Update from Health Care Justice - NC: Actions, events, and link

May 12, 2017

Take Action Now:

Contact Senator Burr (202-224-3154 or 800-685-8916) and Senator Tillis (202-224-6342 or 704-509-9087) to keep healthcare protections in the Affordable Care Act. Save costs by adopting an improved Medicare for All plan with lower administrative costs, less bureaucracy and more freedom of choice of medical providers.

Health Care Events:

Monday, May 15 at 12:30pm at Byrons South End
German Healthcare System (by a dual US / German citizen that lives in each country 6 months of year). Lunch Included. RSVP: jeffm.nyc@att.net

Tuesday, May 16 at noon - 1:00pm
Protest against Trumpcare at Rep. Pittenger's Monroe office at 100 W. Jefferson Street, Suite 1A, Monroe, NC (organized by Indivisible Dist. 9).

Saturday, May 20 at 10:00am
Democratic party Congressional District Conventions (12th Dist. in Charlotte; 9th Dist. in Hamlet). Delegates will vote on Single Payer Resolutions.

Monday, May 22 at 6:30 PM at Midwood Int'l. & Cultural Center
HCJ-NC meeting "Our Path to a National Improved Medicare for All" featuring Dr. Margaret Flowers, founder of HOPE (Health Over Profit for Everyone). RSVP: DeniseFinck@hotmail.com

Recommended Reading:

https://www.washingtonpost.com...

Jessica Schorr Saxe


Two important articles from New York Times about health care costs and business - and the benefits of single payer

May 10, 2017

Thanks to Stephen Phillips for sending this article about Warren Buffet who notes that the real problem for American businesses is the cost of health care. At the end of the short video he mentions single payer.

  • About 1960, corporate taxes were about 4% of GDP. Now they are about 2%.
  • By contrast, 50 years ago health care was 5% of GDP. Now it's about 17%.
  • "Medical costs are the tapeworm of American economic competitiveness."

Buffett is a Democrat, but his partner Charlie Munger is a Republican and has spoken in favor of single-payer health care.

And this article in the Sunday Times explains how the AHCA is really about tax cuts, not health care.

Jessica Schorr Saxe


Important educational meeting with Dr. Margaret Flowers

May 4, 2017

Dr. Margaret Flowers, director of H.O.P.E., Health Over Profit for Everyone, will present Our Path to National Improved Medicare for All:

Monday, May 22, 2017 at 6:30pm
Midwood International and Cultural Center auditorium
1817 Central Ave., Charlotte, NC 28205

All are welcome. Encourage neighbors, co-workers, family, and friends to attend! Especially invite those who fear "socialized medicine" or fear that single payer will lead to a government takeover!

RSVP: denisefinck@hotmail.com.

Jessica Schorr Saxe


Action Alert: U.S. representatives to VOTE TODAY on the latest health care amendment

May 4, 2017

I am forwarding this action alert from the League of Women Voters and urge you to call your representatives - and the others suggested here - today to oppose this bill.

Jessica Schorr Saxe


Correction re: public hearings on Medicaid reform: Please do comment on Medicaid expansions

May 1, 2017

Dear members and friends,

I hope that you will take the time to comment (in person or by email) on Medicaid reform.

This IS an opportunity to promote the need for Medicaid expansion. In particular, you might want to address the question about access to care for substance abuse by talking about the need for expansion.

See my edited original email below:

Dear Health Care Justice - NC members and friends,

See email below from the NC Justice Center about an opportunity for public comment on Medicaid Reform. There are 4 in-person hearings--the nearest is in Greensboro this Monday evening. You may also submit comments in writing.

For those of you who may have experienced working with CCNC (Community Care of NC - the local branch is CCPGM, Community Care Partners of Greater Mecklenburg), you might want to advocate for their role in the transition. If you want more detail about this, let me know.

Jessica Schorr Saxe

Here is what the DHHS press release says regarding written comments:

Written comments can be sent by email to MedicaidReform@dhhs.nc.gov; by U.S. mail to the Department of Health and Human Services, Division of Health Benefits, 1950 Mail Service Center, Raleigh NC 27699-1950; or delivered in person at the Department of Health and Human Services, Dorothea Dix Campus, Adams Building, 101 Blair Drive, Raleigh.

On Tue, Apr 25, 2017 at 11:37 AM, Brendan Riley <Brendan@ncjustice.org> wrote:

Good morning Health Action NC,

You all may have seen that the North Carolina Department of Health and Human Services (DHHS) announced a new process of collecting public input on Medicaid Reform. Specifically, they've noted that they want feedback on how NC Medicaid and Health Choice can:

  • Care for the whole person to improve physical and mental health,
  • Help doctors and other health care providers transition to managed care,
  • Manage care to improve overall health, not only to treat injury or illness,
  • Consider the impact of income, housing, lifestyle and other social circumstances on health and health care services,
  • Improve quality of care,
  • Pay for value, and
  • Increase access to care and treat substance use disorder.

While we all are very interested and concerned about many facets of the transition to Medicaid Managed Care in our state, we're most concerned with the major change's lack of effort to close the coverage gap in Medicaid. As was true during the last round of public comments, this will be a critical opportunity for advocates and consumers to elevate the need for North Carolina to close the coverage gap, and it looks like NC DHHS is interested in hearing about this (see last bullet about "increas[ing] access to care and treat[ing] substance use disorder").

They'll be accepting public comments in writing and at four public hearings in May starting next week:

  • May 1, 5:30-7:30 p.m., Greensboro - Guilford County DHHS Building, 1203 Maple St., Rooms 122 and 123
  • May 10, 3-5 p.m., Greenville - Greenville Convention Center, 303 Greenville Blvd. SW, Emerald Ballroom
  • May 12, 2-4: p.m., Asheville - Asheville-Buncombe Technical College, 340 Victoria Road, Ferguson Auditorium
  • May 16, 6-8 p.m., Raleigh - McKimmon Conference & Training Center, 1101 Gorman St.

Just as many of you did during last year's Medicaid Reform public hearings throughout the state, we as the advocacy community ought to mobilize advocates, providers, consumers in the coverage gap, and others to attend these hearings and speak up for the need to close the coverage gap.

If you're located in/near Greensboro, Greenville, or Asheville, please let us and coalition know if you'd like to be the point-person (using a similar term and system that we employed during last year's hearings) to mobilize consumers and advocates to these hearings. We'll be glad to take the lead and work in partnership with our Triangle-based allies for the Raleigh hearing.

More to come on this in future communications, but we need to start planning soon, as the first hearing in Greensboro takes place this coming Monday, May 1st. For more information, check out this release from NC DHHS.

Brendan Riley
Policy Analyst, Health Advocacy Project
NC Justice Center
brendan@ncjustice.org


Health Care Justice NC has a team for the Charlotte AIDS Walk on May 6. Please join us!

April 28, 2017

Health Care Justice NC is recruiting walkers for our Charlotte AIDS Walk team. Last year, the event drew 1,200 walkers and we hope to have a large presence to carry our banner and give us community exposure.

The date is Saturday, May 6. Registration/check-in opens at 8:00 a.m. in the Gateway Village Promenade, 800 Trade Street in uptown Charlotte. We will have an information table in the registration area.

The walk takes place from 10:00 a.m. to 11:00 a.m. It is only two miles around the uptown area.

Register online at aidswalkcharlotte.org and tell them you are a member of the Health Care Justice NC team. Also, please RSVP to: margiestorch@gmail.com so that we will know how many walkers we have.

The event benefits RAIN, a local non-profit that provides services and support for people living with HIV as well as prevention education.

Thanks,

Jessica Schorr Saxe


Please make calls: It took me <10 minutes to make 4 calls

April 27, 2017

See message here from League of Women Voters.

I called Reps. Pittenger as well as Ted Budd and Walter Jones (as they suggested). I also called Rep. Adams, though I am sure she will vote against the bill. If you are a constituent, say so, but they will take your calls even if you aren't.

It took me less than 10 minutes to make all 4 calls. Someone answered the phone immediately.

Jessica Schorr Saxe


FIX IT! HEALTH CARE AT THE TIPPING POINT. Thur., April 27, 2017 at 6:30pm: RSVP if you haven't.

April 23, 2017

ALL ARE WELCOME for the showing of: FIX IT! HEALTH CARE AT THE TIPPING POINT, a documentary about single-payer health care from the business viewpoint.

"Our businesses are under relentless pressure from increasing health care costs. The devastating impact ripples through our economy..."

Richard Master
Owner, MCS Industries
Executive Producer

Bring family and friends. Invite those with a business connection!!! Everyone is welcome!

April 27, 2017 at 6:30pm
Midwood International and Cultural Center
1817 Central Ave., Charlotte, NC 28205
League of Women Voters office, Rm. 210

Important, please RSVP: denisefinck@hotmail.com


April recess talking points and April 19 Day of Action

April 18, 2017

Hi, friends who support access to health care,

See here for points to make to legislators during the April recess. April 19 is a Day of Action. See actions and simple points below.

1. April recess talking points from Community Catalyst.

2. Simple messaging from NHeLP for tomorrow's National Day of Action.

Let your legislators hear from you!

Jessica Schorr Saxe


Interesting article about increasing support for Medicare for all in Congress

April 16, 2017

Hi, single payer supporters,

This article notes that single-payer has higher support for ever in Congress - with more co-sponsors of H.R. 676, the Expanded and Improved Medicare for All bill, than ever before. And it discusses the reasons.

Jessica Schorr Saxe


Join Medicare for ALL Rally this Sat., April 8: 5:00pm

April 7, 2017

Please join us this Saturday at 5:00pm for the rally (info below). Check the Health Care Justice - NC Facebook page tomorrow for parking suggestions (or see below). After organization speakers, we will invite persons to share a short personal experience with lack of health care or problem with insurance companies.

WHAT: Health Care Solution: Medicare for ALL Rally
WHO: Charlotte-area providers, patients and community groups
WHEN: Saturday, April 8 at 5:00 pm
WHERE: Medical Center Drive, Charlotte, NC 28203 (on sidewalk across from Carolinas Medical Center).

CHARLOTTE -- Republicans in Congress, in an effort to repeal and replace the Affordable Care Act, have not been able to produce a plan that covers everyone and improves upon the status quo as promised by President Donald Trump.

On Saturday afternoon in Charlotte, area patients, health care providers and advocates will tell their stories and urge Congress to support H.R. 676 - proposed legislation for a universal privately delivered, publicly funded health care plan with over 80 co-sponsors.

"The Republicans' health care proposals eliminate essential health benefits (allowing lower-cost junk plans) and do not provide affordable coverage for all," says Jessica Schorr Saxe, MD, a member of Physicians for a National Health Program. "Polls show a majority of Americans, including physicians, support an improved Medicare for All health care system. It is time to join the modern world and treat health care as a priority and national security issue."

How would an Improved Medicare for ALL Plan benefit Americans? It is:

  • Simple - Everyone living in the U.S. is covered regardless of age, economic status or pre-existing conditions. No need for separate Medicaid, CHIP program or health insurance policies.
  • Cost Effective - Eliminates profit-seeking health insurance that increases costs through burdensome administrative bureaucracy, deductibles, co-pays, and rising insurance premiums. 95% of Americans (all but the most wealthy) would pay less through a single publicly funded system.
  • Competitive - Consumers are free to choose doctors without limited insurance networks; government will be able to negotiate lower pharmaceutical prices and other medical costs.

Speakers include representatives of Health Care Justice - NC, Physicians for a National Health Program, League of Women Voters Charlotte Mecklenburg, NAACP Charlotte-Mecklenburg, Charlotte NOW, Action NC, Charlotte Women's March Health Committee and individuals fed up with rising health insurance costs.

###

Details for Saturday's Medicare for All Rally (April 8 at 5 PM): Meet at the big Carolinas Healthcare System Sign (with red Emergency Sign arrow) at corner of Medical Center Drive and Blythe Ave. on sidewalk just across from Carolinas Medical Center in Dilworth. Stay on sidewalk and do not block traffic. We may need to stand in a single line along the sidewalks.

Parking suggestions: 1426 E. Morehead Street (building not currently being used - former ABC store I believe). There is an entrance to the Sugar Creek Walkway behind the building. Walk to Carolinas Medical Center (turn left or east onto walkway). It is about a block to the rising sidewalk up to Carolinas Medical Center.

Also: 1010 Edgehill Road is about 2 blocks from our meet up point. It is the CHS Neurosciences Institutes Neurology Center parking lot - building will not be open for patients at that time. Walk down Edgehill to Brunswick and cross Kings Drive onto Medical Center Drive.


A conservative argument for single-payer health care

April 3, 2017

Hi - many people ask how to appeal to conservatives with a single-payer system. This is an article by F. H. Buckley, the law professor who helped organize "Scholars and Writers for Trump" during the election. It is worth noting that we are hearing more and more people talk about single-payer - from different political vantage points.

Jessica Schorr Saxe


New York Times article about the high cost of "those undecipherable medical bills"

April 2, 2017

Dear single-payer supporters,

This article about the high cost of our complicated medical bills is worth reading. It is at once shocking and not surprising. A few things to note: how our complicated bills contribute to our high cost of health care, how patients with serious illness suffer not only from their illness but from their bills; the industry that has emerged teaching providers how to upcode (i.e., maximize payments for their services) and the complicity of the AMA.

Jessica Schorr Saxe


Republicans for Single-Payer Health Care - The New York Times

March 28, 2017

Good morning, single-payer friends:

This is a fascinating article about how the Republicans may be bringing us close to a single-payer system. Or, in the words of the friends who forwarded it to me, "Imagine ultimately having Trump to thank for single-payer health care."

Jessica Schorr Saxe


Excellent New York Times article about what true freedom in health care would look like

March 19, 2017

This article "The Face Freedom of American Health Care" is an excellent summary of why what is called freedom in health care really isn't--and what would look more like freedom.

Jessica Schorr Saxe


Workshop for members on Sunday, April 2 with Dr. Carol Paris, president of PNHP

March 14, 2017

Hi, friends,

You are receiving this email because you are on my list of Health Care Justice - NC friends. I am writing to tell you of an upcoming workshop for members. If you are interested, I hope that you will join us by signing our resolution here. (If you got another email from me on this topic, let me know, because it means you have joined.)

On the afternoon of Sunday, April 2, we will have a leadership/speaker training for members of Health Care Justice - NC led by Dr. Carol Paris, current president of Physicians for a National Health Program. It will probably start at 1 and run till about 5.

This workshop is for anyone who wants to learn more about Improved Medicare for All, how it would work, what benefits it would have, how it would be funded, etc. It will help you know how to answer challenging questions about it.

Anyone would would like to be a speaker on this topic should come. And we can use more speakers!

I encourage you to join us and attend.

Jessica Schorr Saxe


Karen Garloch's interview with Dr. Robert Zarr in today's Charlotte Observer

March 8, 2017

"As Republicans prepare to gut Obamacare, visiting doctor says he has a better idea"

Jessica Schorr Saxe


What's in the repeal and replace legislation

March 7, 2017

Hi - this is one of the most thorough descriptions I've seen of what's actually in the bill to "repeal and replace" the Affordable Care Act.

If you don't read all of this, I suggest you look at:

  • the description at the beginning about the difference in this process from the passage of the ACA.
  • changes in Medicaid: Jost notes that the bill is more about changing Medicaid than repealing and replacing the ACA.
  • the brief "Summing Up" at the end. It's not too much of a spoiler to tell you that it begins: "In summary, the legislation's tax cuts will be very attractive to wealthy Americans and health insurers and providers, who would get a trillion dollars in tax breaks. It could cause consternation for Medicaid recipients and state Medicaid programs, which would see federal funding for Medicaid steadily diminish, potentially thinning out coverage."

http://healthaffairs.org...

Jessica Schorr Saxe


Very nice interview in Charlotte Post with Robert Zarr, our March 9 speaker

March 6, 2017

"Doctor's prescription for health insurance: Remove the profit motive"

Jessica Schorr Saxe


Please open, download and circulate this concise (1 1/2 page) important single-payer article

February 24, 2017

Dear Health Care Justice members and friends,

PNHP co-founders Steffie Woolhandler and David Himmelstein wrote the article at the link below in a recent Annals of Internal Medicine. This concise article is important for several reasons:

1) It explains how single-payer would fulfill the President's promise to increase coverage and benefits while lowering costs.

2) It responds directly to some some of the current plans being discussed. (And please note that it emphasizes not only the economic benefits but the--actually more important--health benefits of single payer.)

3) It is thought to be the first full-length article calling for single-payer health care in the 90-year history of AIM (a major medical journal).

AIM has made this article open access (also a major decision). If you click on the PDF option, you will be able to see the table clearly.

http://annals.org...

Please do read - and circulate.

Thanks very much,

Jessica Schorr Saxe


Powerful article by a young woman about how her Christian beliefs lead her to support single-payer

February 16, 2017

Thanks to Lou Lesesne for forwarding this article by a teacher about how her Christian faith leads her to support single-payer. I heard the clip of her asking a question of her Congresswoman at a town hall meeting in Tennessee and was impressed with how articulate she is. This article is worth reading by everyone. And, for those of you who are active in churches, I would encourage you to pass on to others.

https://www.washingtonpost.com...

Jessica Schorr Saxe


Comments by Margie Storch at "Have Heart - Don't Gut Health Care" rally

February 15, 2017

Thanks to Margie Storch for representing us on Valentine's Day. Read her remarks below.

***

My heart is breaking today... how about you? My name is Margie Storch and I work 2 part time jobs. My family relies on health care insurance purchased through healthcare.gov and the Affordable Care Act.

Several members in my family have pre-existing medical conditions. Repealing the ACA would allow insurance companies to deny my family health insurance. Thanks to protections mandated by the ACA, my 22 year old son is able to stay on my family policy.

Affordable health care is a matter of national security. Healthcare can mean the difference between life and death. Health affects not only individuals, but families, schools and the workplace. A healthy citizenry means a healthy, productive nation. Republicans must not put Americans at risk by repealing the Affordable Care Act without a plan that is better.

My brother-in-law worked as a cook for a nursing home in Cabarrus County. He made too much money to qualify for Medicaid health care and too little to afford health insurance. He was caught in the medicaid gap that our Republican state legislature has refused to close to help low-income workers. Meanwhile, North Carolinians' federal taxes are being accepted by other states to help their citizens. Does this make sense?

My brother-in-law, a hefty guy, began losing weight but was not concerned until he started having pain. He was diagnosed with stage 4 kidney cancer at an Emergency Room visit. Regular preventive doctor visits could have caught his cancer early enough to be treated. Instead, Jeff is now under Hospice care. People are dying because Republicans have failed to act. This is NOT acceptable. We can do better if elected representatives put the welfare of Americans before the interests of profit-seeking health insurance companies. If politicians don't serve us, we must repeal and replace them!

Congress can improve the Affordable Health Care Act, extend health care to all Americans, reduce costs and greatly simplify our health care system through an improved Medicare for All system. It is a popular healthcare system that works for our seniors and can work for everybody else.

A privately delivered, publicly financed system will reduce health care costs for 95% of Americans - the very rich can afford to pay a bit more in taxes.

Consumers will be able to choose any doctor and not be limited by insurance company networks of doctors or limited prescription formularies.

A universal single-payer health plan will return competition back to healthcare providers. Our massive health insurance bureaucracy adds no value to healthcare, it only adds complexity and unnecessary administrative costs.

Of the 33 highest income countries, the U.S. is the only country that does not have a universal single-payer health system. The U.S. has the highest healthcare costs per person and the lowest heath indicators. It is time we look at the evidence and join the modern world.

I am a member of Health Care Justice - North Carolina. Find us on Facebook. Join our effort to improve ACA protections through improved Medicare for all!


Important educational meeting, March 9 with Dr. Robert Zarr, immediate past president, PNHP

February 15, 2017

EDUCATIONAL MEETING! ALL ARE WELCOME! BRING FAMILY AND FRIENDS!

Thursday, March 9, 2017, 6:30pm
Midwood International and Cultural Center
1817 Central Ave., Charlotte, NC 28205

Dr. Robert Zarr, immediate past president of Physicians for a National Health Program, will speak on: Truth, Clarity, and Demand: A physician's proposal to bring equity and sanity to our healthcare nightmare.

Jessica Schorr Saxe


Brief summary of single-payer vs. other plans

February 12, 2017

Hi - this is worth reading, and looking at the spreadsheet with the comparison of single-payer to ACA and Republican plans.

And the video with clips from the debate between Bernie Sanders and Ted Cruz is also worth watching.

http://www.commondreams.org...

Jessica Schorr Saxe


Important article on proposed changes to Medicare and Medicaid

February 10, 2017

Most of the current debate we hear about health policy is about whether and how and when the Affordable Care Act will be repealed and replaced.

But Drew Altman, CEO of the Kaiser Family Foundation, points out that the Republican plans for Medicare and Medicaid are just as important to pay attention to--and that they would change the fundamental structures and commitments of those important programs.

https://www.washingtonpost.com...

Jessica Schorr Saxe


Improvements under the ACA - and why we need single-payer

February 2, 2017

This is an interesting survey report and commentary.

Much of the information of changes under the ACA is presented to show how far we've come. But, if you review the actual numbers as Don McCanne does in his commentary, it should be obvious that we are not doing as well as we should and could - resulting in many who suffer from lack of needed care and many who have serious difficulty with medical expenses.

http://www.pnhp.org...

Jessica Schorr Saxe


I recommend signing this

January 31, 2017

See below. I signed.

Note that you don't have to be a health professional to sign: when you sign, you can just note that you're a community member.

Jessica

Statement from CIR - Committee of Interns and Residents: We won't let Trump immigration actions stop us from caring for all patients

CIR has prepared an Open Letter to the President informing him of "severe adverse effects and interruptions of care for many of our most vulnerable patients, particularly the underserved in health professional shortage areas." The letter requests him to rescind this order. Health care students, professionals and others concerned are invited to sign the Open Letter at the following link:

https://goo.gl/forms...


Advocacy alert and message from legislative committee

January 31, 2017

Hi - Our legislative committee recommends that you make the calls suggested here today or tomorrow. (Call 866-426-2631 and tell your member of Congress not to repeal the ACA, and not to restructure or cut Medicaid.)

Margie Storch, the new legislative chair, will be convening the committee soon. She would welcome new members. This is certainly where the action will be in this new era of assaults on health care. If you are interested or have questions, contact her at margiestorch@gmail.com.

Jessica Schorr Saxe


Health Care Justice - N.C.: Save the date. Dr. Robert Zarr will be our speaker on Thursday, March 9. All are welcome!

January 30, 2017

Health Care Justice - NC,

Bring family and friends to our next meeting:

Thursday, March 9, 2017, 6:30 PM
Midwood International and Cultural Center
1817 Central Ave. Charlotte, NC 28205

Dr. Robert Zarr, past president of Physicians for a National Health Program, will speak on:

Truth, Clarity, and Demand: A physician's proposal to bring equity and sanity to our healthcare nightmare.


Moral March on Raleigh 2/11/17: It is time to march again in support of Health Care for All!

January 28, 2017

Note that you can start with any of the events. If you want to go to the breakfast, be sure to let Denise know, as they are getting a count for food.

We have been invited to participate in the Moral March on Raleigh, February 11, 2017. We will be joining members of Health Care for All - NC and other health care advocates.

IMPORTANT TO LET OUR REPRESENTATIVES KNOW WE SUPPORT HEALTH CARE FOR ALL! WE WANT THEM TO TAKE THAT MESSAGE TO THE NORTH CAROLINA GENERAL ASSEMBLY AND TO WASHINGTON!

Those of you in medical fields wear your white lab coats!!!!

Breakfast: Upstairs at Mecca Restaurant, 13 East Martin St. 8-9 AM. Free for trainees. Professionals may contribute as able.

Meet at pre-march rally at 9 AM at the corner of Wilmington and South Streets on the steps of Meymandi Concert Hall, Raleigh.

March at 10 AM to the capitol.

The people's assembly will be held near the State Capitol, 1 E. Edenton Street, and last until 12:30 PM.

PLEASE RSVP; denisefinck@hotmail.com to let me know who will be marching. Let me know if you would like to ride share!


Women's March in Charlotte (for all genders): RSVP; details here

January 19, 2017

Health Care Justice will be marching as a group in the Women's March on Charlotte.

Please join us (all genders welcome)!

We are going to meet between 9 AM to 9:30 AM on Saturday 1/21 at the First Ward Park corner of N. Brevard and 8th street. Then we will move to position ourselves for the 10 AM parade which moves down College St., up Tryon St., and then down Church St. to end at Romare Bearden Park. The march is going to be on sidewalks, there are no street closings (that I am aware of at this time). Weather is cloudy and high of 66.

I will bring Health Care Justice Signs. Please feel free to make your own sign.

RSVP: denisefinck@hotmail.com to let me know that you are marching

Denise Finck-Rothman
Membership co-chair, Health Care Justice - NC

See website for more information: womensmarchoncharlotte.com

Update: The Women's March was a great success. Thank you to everyone who joined us!


Another chance to march: Join us for women's march on Sat. 1/21 (all genders welcome); also, link to news story about healthcare rally yesterday

January 16, 2017

Health Care Justice will be marching as a group in the Women's March on Charlotte.

Please let all of us (all genders welcome) come together behind our Health Care Justice banner and stand in solidarity with this noble cause; to move past our fear and take action. See below.

Please RSVP denisefinck@hotmail.com to let me know you will be marching, and for instructions on meeting site and route of march.

We stand together in solidarity for the protection of our rights, our safety, our health, and our families - recognizing that our vibrant and diverse communities are the strength of our country.

The Women's March on Charlotte is being held in alignment with the Women's March on Washington, on January 21, 2017. Charlotte is only one of multiple cities across the nation holding local Women's Marches, sending a clear message to our government that women's rights are human rights.

The Women's March on Charlotte welcomes people of all faiths, genders, ethnicities and sexual orientation; we want our voices and our message to be heard in Washington and around the world.

Mission and Vision: The rhetoric of the past election cycle has insulted, demonized, and threatened many of us - immigrants of all statuses, Muslims and those of diverse religious faiths, people who identify as LGBTQIA, Native people, Black and Brown people, people with disabilities, survivors of sexual assault - and our communities are hurting and scared. We are confronted with the question of how to move forward in the face of national and international concern and fear.

See website for more information: womensmarchoncharlotte.com

Also, Health Care Justice - NC participated in the MLK March on Saturday, as well as the "Save Our Health Care" rally (organized by Margie Storch) on Sunday. Click here for news of the rally.


Health Care Justice - NC: See Below For Important Information for Marching in the MLK parade

January 12, 2017

Health Care Justice Members who have already signed up to march and those that are newly interested, PLEASE EMAIL to me your name and cell phone number.

IMPORTANT! Please click here for information about accessing the parade meeting location at 8:45 AM (roads will be closed at 9 AM) and for parking. I will contact you by cell phone with our location number between 8:45 and 9 AM so that you can find us. Also, parade volunteers at the gathering site will have our location number and can direct you.

Denise Finck-Rothman
denisefinck@hotmail.com

Update: The MLK Parade was a great success. Thank you to everyone who joined us!


Medicaid Expansion: You can contribute to moving this forward; deadline Jan. 15

January 11, 2017

Dear Health Care Justice members and friends,

You are probably aware that Gov. Roy Cooper has announced his intention to move forward with Medicaid expansion. This request is on a fast track at the Department of HHS Division of Medical Assistance.

Please see the NC Justice Center Action Alert below and TAKE SOME ACTION to show your support for Medicaid expansion in our state - which would save lives and decrease suffering (and provide an economic benefit to our state).

I strongly recommend that you submit comments at DMARulesComments@dhhs.nc.gov. If you do not want to write a long letter, even a short one would be helpful to show how important this issue is.

Thanks,

Jessica Schorr Saxe


It is not too late. Sign up to march in the MLK parade January 14th!

January 11, 2017

Health Care Justice members and friends:

March in the Martin Luther King Parade in Uptown Charlotte on January 14th from 10 AM to noon on N. and S. Tryon starting at 9th and ending at Stonewall St.

Please RSVP your interest in participating in the march to denisefinck@hotmail.com.

Note that this march is different from the rally on Sunday. You are welcome to participate in both!

Denise Finck-Rothman
Membership co-chair


Join us for Health Care Rally on Sun., Jan. 15th; Note this is different from MLK parade on Sat.

January 10, 2017

We still plan to march in the parade on Saturday. I will send details of that when we know them. You are also invited to join us at the rally Sunday.

Charlotte Speaks: Save Health Care Rally!
Sunday, Jan. 15 at 4:00pm
Marshall Park, Charlotte, NC
at S. McDowell and E. Third Street

Congressional leaders want to rush through a budget bill that will severely undermine the health care of the American people.

Speak out! Bring yourself, friends, drums, signs, and health care stories.

Jessica Schorr Saxe

Update: Margie Storch gave a stirring speech at the "Save Our Health Care" rally. Thank you to everyone who attended, and let's keep speaking out in 2017.


Please call today: TAKE ACTION! Tell Senators Burr & Tillis to #ProtectOurCare/doesn't take long

January 10, 2017

Dear HCJ - NC members and friends,

In the interests of preserving what access North Carolinians and Americans currently have to health care, we believe that the Affordable Care Act should not be repealed without a clear replacement that at least maintains current coverage levels.

Please call your Senators at (866) 426-2631.

I just did this: When I called the number above, I got a helpful introduction and then was transferred to Sen. Tillis' office where I actually spoke to a person. She told me they had been getting a lot of calls. (I take this to be a good sign.)

I didn't want to listen to the introduction again so I asked her to transfer me to Sen. Burr's office. She did and gave me that # (202-224-3154). I got a recording that said they had had a lot of calls. I was able to leave a message.

Calling both took under 5 minutes. Please do call!

Update: The (866) number listed above has been seeing high traffic. If you get an error message, call the Capitol switchboard at (202) 224-3121 and asked to be patched through OR call the senators at their Washington offices:

  • Senator Thom Tillis: (202) 224-6342
  • Senator Richard Burr: (202) 224-3154

Leave a message to let them know that North Carolinians oppose repeal of the Affordable Care Act!

Jessica Schorr Saxe


Please join me at MeckMin Food for Thought

January 8, 2017

Hi, Health Care Justice - NC members and friends,

I will be speaking on health care as a human right - with practical applications - on Thursday Jan. 19 at lunchtime. It would be great to have some of you join me (click here to register).

There will be a little overlap with the material I will cover at our membership meeting on Jan. 26 but this talk will contain more discussion about the idea of healthcare as a human right and issues other than single-payer.

Please click here to register.

Jessica Schorr Saxe


Excellent summary of why Obamacare should be replaced by single-payer

January 7, 2017

Happy snowy morning, single-payer supporters,

The following article from USA Today is written by Dr. Marcia Angell, a former editor of the New England Journal of Medicine.

She outlines the shortcomings of the ACA, the lack of a feasible Republican plan to replace it, and why single-payer should be our replacement plan:

http://www.usatoday.com...

Stay safe and warm!

Jessica Schorr Saxe


Health Care Justice members and friends: March in the MLK parade January 14th, 10am to noon; show support for health care for all!

January 4, 2017

Health Care Justice members and friends are all invited to march in the Martin Luther King Parade in Uptown Charlotte on January 14th.

We will proudly march behind our banner showing our support for Health Care for All! The larger the number of marchers; the greater our impact!

The parade starts at 9th Street and North Tryon and continues down Tryon to Stonewall.

More details of meeting time and place to follow.

Please RSVP your interest in participating in the march to denisefinck@hotmail.com.

Denise Finck-Rothman
Membership Co-chair


Short article from NY Times worth reading

December 18, 2016

Hi - this article from this morning's Sunday Business section is titled "Get Rid of Obamacare? Be Careful What you Wish For," but it's more than the usual discussion of why it will be impossible to just repeal Obamacare without precipitating a disastrous loss of coverage and a crisis in the insurance industry.

Read to the end for the author's sensible (though, as he acknowledges, politically unlikely) solution:

http://www.nytimes.com...

Jessica Schorr Saxe


Please read this letter. Please consider why Physicians for a National Health Program and Health Care Justice - NC can use your support

December 6, 2016

We are writing to ask you to support Physicians for a National Health Program and our local chapter Health Care Justice - NC.

PNHP is the longtime leader in doing research regarding single-payer, both here and abroad, and educating the public as well as professionals.

We strongly encourage you to join PNHP or donate.

Membership is $120/year for practicing physicians, but only $40 for residents and non physicians. The most useful kind of donation is a recurring monthly donation—but any amount will be welcome.

The easiest way to donate is at: www.pnhp.org/donate.

And we encourage you to look at the website: www.pnhp.org.

As you know, membership in Health Care Justice - NC is free. We have ongoing programming expenses and would appreciate any contribution which can be made at our website: http://pnhphcjnc.org. Or mail a check to:

Health Care Justice
PO Box 32384
Charlotte, NC 28231

If you would like to make these contributions in honor of family or friends to celebrate the holiday or other occasion, please send that information along with your donation check, and we will send out an appropriate acknowledgement.

In these tumultuous times, you may wonder what the role of single-payer supporters should be. It is more important than ever to promote the message that Improved and Expanded Medicare for All would provide access, quality, cost controls and choice. Even as we try to prevent harm to Americans from changes in Medicaid, Medicare, and private insurance, we need to be looking toward the future and a system that will serve us better than our current complex, profit-driven health care system.

Many thanks for your support and for all you have done for the single payer issue this past year: educating yourselves, attending our events, reading updates and discussing this issue with your friends, families and acquaintances. Thanks in advance for your support in the year ahead; do let us know if you would like to volunteer your time and talents.

Wishing good health and good health access to you - and all of our neighbors,

Health Care Justice - NC Board


Pearls from the Physicians for a National Health Program meeting

November 20, 2016

Hi, Health Care Justice - NC members and friends:

Board member Dr. Andrea DeSantis and I attended the annual PNHP meeting (which, I'm happy to say, was also attended by several other members and North Carolinians). Needless to say there was considerable discussion of the implications of the recent election.

Co-founders Steffie Woolhandler and David Himmelstein spoke on "health policy and politics after the 2016 election." I will review some of their information at our membership meeting in January. But, before then, I encourage you to read their article in the Huffington Post. Do note their suggestions about work to be done in the months ahead.

Also notable were :

  • A presentation by Dr. Marcia Angell on "reining in the drug companies," a very clear description of some of the most egregious problems--and what could be done about them. I hope this article will become available on the PNHP website.
  • Dr. Mary Bassett, New York City health commissioner, gave a presentation on racial injustice and how ubiquitous and serious a problem it is in health care.
  • Andrea co-led a workshop on "Organizing medical societies for single-payer" which was well-attended and enthusiastically received.
  • I co-led a workshop at the Leadership Training Institute (the day prior to the meeting) on media training for beginners.

With regard to moving forward under the new administration, there was a consensus that we must continue to defend Medicare and Medicaid from assaults and to minimize damage - and that we must continue to educate (colleagues, citizens, legislators, etc) on single-payer health care. We can make clear that it doesn't have some of the shortcomings of the ACA and that it would be far better with regard to universality of coverage, quality of care, costs, and choice that the current proposals for replacement of the ACA.

It was also suggested that we participate in coalitions of like-minded groups that may be addressing other progressive issues, but are receptive to our health care message.

I attended a workshop on building support for single-payer in Congress in which we were encouraged to talk to our members of Congress and the Senate (or their health policy aides) - whether or not they agree with our positions. Andrea and I met with Rep. Alma Adams' legislative director on Friday. Rep. Adams is a co-sponsor of HR 676, the single-payer bill, and we reinforced the need to support that and encouraged her to talk to colleagues about joining in on the bill. We are also discussing meeting with the staff of our Senators. If you'd like to participate or set up a meeting, let me know.

Jessica Schorr Saxe


"Let's Treat Our Patients, Not Trick Them with Private Insurance" - an inspiring article by a medical student

October 29, 2016

Thanks to Pat Moore for forwarding this article by a med student with her reflections about our current health care system, and what medical student activists are doing about it:

http://www.commondreams.org/views/2016/10/27/lets-treat-our-patients-not-trick-them-private-insurance

Jessica Schorr Saxe


Support for Medicaid expansion

October 17, 2016

Hi - This would be an opportune time to write a letter to the editor about the importance of expanding Medicaid and getting rid of the coverage gap in health insurance.

Here are some talking points:

http://action.ncjustice.org/letter/?letter_KEY=1617

Also, it would be great if someone would address the position of legislators that Medicaid has had continued cost overruns (as was mentioned in yesterday's Observer article which I sent you earlier today).

That is quite misleading as is explained in the following brief:

https://www.communitycarenc.org/media/files/ccnc-data-brief-no-1-medicaid-flat.pdf

Much thanks,

Jessica Schorr Saxe


Be sure you read Observer article about uninsured

October 17, 2016

Hi, single-payer, Medicaid expansion supporters:

I want to make sure you see this article about the uninsured, which includes information about health rankings in NC and the consequences of our refusal of Medicaid expansion:

http://www.charlotteobserver.com/news/politics-government/article108286427.html

Jessica Schorr Saxe


Vote to get a single-payer question in the presidential debate on Sunday

October 5, 2016

I am forwarding this from Health Care for All - SC. Thanks to Dave Keely for thinking of this.

Jessica Schorr Saxe

Make single payer part of the Oct. 9 debate!

The moderators for the next presidential debate have agreed to consider the most popular questions on the Open Debate website. Physicians for a National Health Program [PNHP] has submitted the following question:

"Do you support a single payer health program, aka improved Medicare for all?"

Our question is within striking distance of being considered. If you'd like for single payer to be part of our national debate, please vote today and share the link with your friends!


How would a Medicare buy-in and a public option be designed?

September 30, 2016

For those of you interested in the possibility of a Medicare buy-in and a public option, see below to see all of the issues that would be raised in the design.

The paragraph from the summary is interesting: see if you think it considers all the options. And, as usual, Don McCanne's summary below is insightful.

Jessica Schorr Saxe

"Designing a Medicare Buy-In and a Public Plan Marketplace Option"

By Linda J. Blumberg and John Holahan
Urban Institute, September 2016

Medicare is an attractive basis for developing an insurance alternative (either a direct buy-in or a public option based in some way on Medicare rates) because the program generally has lower provider payment rates and lower administrative costs than private insurers. However, Medicare's structure and cost-sharing requirements are different from private insurers' as well. A Medicare-related proposal could provide more plan choice for those eligible, which would have a significant effect where few or even only one insurer offers coverage in the nongroup insurance market. Depending upon how the proposal is structured, it could reduce costs for younger adults in the private insurance market as older adults leave the risk pool. However, designing such programs raises myriad issues, each with specific implications for costs and benefits to different age groups.

Medicare Buy-In for 55- to 64-Year-Olds

We assume that a Medicare buy-in option would offer enrollees the same covered benefits and cost-sharing structures offered to current Medicare beneficiaries. Even so, a buy-in directly into the existing Medicare options would lead to questions necessitating policy decisions:

* Would potential enrollees have the choice of traditional Medicare, Medicare Advantage, or both?

* Would eligibles be able to choose between a Medicare option and Marketplace-qualified health plans for which they are currently eligible, or would Medicare be their only option outside of employer-sponsored insurance?

* Would enrollees be allowed to make separate purchase decisions for Medicare Parts A, B, and D, or would they have to purchase all if they purchase any? How will consumers respond to offers of coverage that, unlike private insurance options, have no out-of-pocket maximum? Would Medigap or some other supplemental plans be available to the 55- to 64-year-olds?

* How would the unsubsidized cost of coverage be determined? For example, what premium would be charged to individuals with high incomes? Would 55- to 64-year-olds be charged the same premiums as those age 65 and older, even though the premiums would not reflect the cost of coverage for those enrolled? Or would actuaries set premiums based on the benefits provided and cost-sharing requirements for each component? Would the high income surcharges in the current Medicare program apply to the buy-in population?

* Assuming that 55- to 64-year-old enrollees would not pay the same premiums as current-law Medicare enrollees, would premiums reflect the health care costs of only the 55- to 64-year- olds enrolling? Or would premiums be set to reflect enrollees' health care costs being shared by others? For example, their costs could be shared with other nongroup market enrollees or perhaps with current-law Medicare enrollees, but that would require the development of a mechanism for achieving it.

* Would the 55- to 64-year-olds buying in to Medicare be eligible for financial assistance similar to that for Medicare beneficiaries today (e.g., 75 percent of Medicare Part B costs for all but the high-income beneficiaries? Would they be eligible for ACA-like financial assistance, advanced premium tax credits and cost-sharing reductions? Or would no financial assistance be offered at all? If subsidies are provided, how would they be structured? Would actuarial differences between Medicare and Marketplace silver coverage be taken into account, affecting both advanced premium tax credits and cost-sharing reductions?

* Would 55 to 64 year olds with access to an affordable employer insurance plan be permitted to enroll in a Medicare buy-in option?

A Public Option for All Age Groups

A public option is a qualified health plan that would be sold through the ACA's government-created Marketplaces (either federal or state). The public option would bear health insurance risk like other insurers, complying with the ACA's insurance reforms (e.g., modified community rating, guaranteed issue, and essential health benefits) and offering coverage in the same actuarial value tiers.

A public option avoids complexities associated with a Medicare buy-in for 55- to 64-year-olds. Because the option would be structured and operated in much the same way as any other Marketplace-qualified health plan, it would not have different actuarial values, cost-sharing structures, or premium structures than other Marketplace options. The appropriateness of applying a Marketplace subsidy structure to a Medicare product would not be an issue, and risk-sharing questions across different age groups would not arise. Yet several design decisions would remain:

* How would provider payment rates be set? Would they be set consistent with Medicare rates, set consistent with Medicare rates plus some percentage, or based on some other fee schedule? Many states have self-insured plans for their employees; this is another potential platform for creating a public option offered in a state Marketplace.

* If rates are set at the Medicare level (or at some other level that falls below those paid by private insurers), what leverage would the plan have to ensure sufficient provider participation? How does a state's leverage compare with that of the federal government in this respect?

* Should public options be set up in all geographic areas or only those with high premiums, high premium growth, or otherwise weak insurer or provider competition? If the latter, who will judge appropriate locales, and by what metric will an area's appropriateness be assessed?

From the Summary

Regardless of the approach taken, providers are likely to resist new insurance options that may move more patients into plans paying lower rates. While this is to be expected, it highlights the perpetual quandary of health care cost containment. Health care spending and its growth cannot be reduced without either paying less, on average, per unit of service rendered or reducing the quantity of services provided. No matter the strategy for containing costs, achieving that goal will take money out of the pockets of providers. To protect providers financially means abdicating cost-containment efforts of any type.

http://www.urban.org...

***

Comment:

By Don McCanne, M.D.

There is considerable enthusiasm for expanding on the advances of the Affordable Care Act by adding a Medicare buy-in for those 55 to 64, and by adding a public option - an insurance program run by the government competing with private health plans. What is lacking in this discussion is a precise description of either proposal considering that there are a multitude of policy options that must be decided on in order to construct these programs.

In this Urban Institute paper, Linda Blumberg and John Holahan discuss some of the design options, and there are many more. Each option has its own advantages and disadvantages, so it is inevitable that the eventual design would forge a compromise between benefits and deficiencies. Building these two programs on top of our highly fragmented financing infrastructure inevitably perpetuates inefficiencies.

Each program would require an act of Congress. We need only to look at the insurance industry influence in the legislative process that developed the designs for the private insurance exchanges under ACA, for the Part D Medicare drug program, for the private Medicare Advantage plans, for the privatization of the Medicaid programs, for the previous public option proposals that never got off the ground, and for the co-op model that is failing in the marketplaces, and it will be obvious that the Medicare buy-in and public option will be designed to maximize the leverage of the private insurance industry at a cost to potential enrollees and taxpayers. The insurers will introduce features that are designed to make public programs noncompetitive or even cause them to fail.

When you hear people advocate for a Medicare buy-in or for the public option - and those people are everywhere - demand that they show you their model that was distilled from the multitude of policy options. (Be sure to read the Blumberg and Holahan paper so that you understand at least some of the issues.) Without such a model, the design will default to the private insurers.

Once advocates present their definitive model then analyze it to see how well it meets our reform goals. Will it ensure that everyone is covered? (No) Will it slow the increase in health care costs? (No) Will it ensure that everyone has free choice of health care professionals and institutions? (No) Will it remove financial barriers to care? (No) Will it fill in all of the gaps in coverage of our traditional Medicare program? (No)

Efforts to enact a single payer national health program are rejected because the program supposedly is not politically feasible. Does anyone really believe that a Medicare buy-in and a public option would be politically feasible in a Congress dominated by conservatives and neoliberals? It's not the goal of a single payer model that needs to be changed; it's the politics. That takes work. A lot of it.


Health Care Justice Meeting: October 6, 2016 at 6:00pm.
Open to the public. Bring a friend!

September 22, 2016

HEALTH CARE IS A RIGHT, NOT A PRIVILEGE:
STORIES OF HEALTH CARE INJUSTICE, RESOLUTION, AND SOLUTION.

Health Care Justice members and friends - come to our next meeting and bring a friend!

October 6th, 6:00pm, meeting in the auditorium at the Midwood International and Cultural Center, 1817 Central Ave, Charlotte, NC 28205.

Hear compelling stories of how the American Health Care System is failing many individuals.

Share your stories!

Karen Bean, League of Women Voters NC and Chair of the Close the Gap NC Campaign, and Dr. Jessica Schorr Saxe, Chair of Health Care Justice-NC, to lead discussion of short-term and long-term solutions: Medicaid Expansion and Improved Medicare for All!

Any questions? Contact DeniseFinck@hotmail.com.

Please RSVP to DeniseFinck@hotmail.com.


Think NC First event in Charlotte tomorrow (9/20) evening

September 19, 2016

I understand the topic of this event is health issues including health disparities. It might be an opportunity for some discussion about the need for Medicaid expansion (and maybe even the benefit that single-payer would offer).

Jessica Schorr Saxe


Please answer this email with a quick question from Health Care Justice

September 13, 2016

Dear Friend of Health Care Justice,

You are receiving this email because you have indicated an interest single-payer health care and in getting our emails. I am writing to find out whether you want to stay on this list or change your status.

1) If you are a single-payer supporter and have not signed our resolution, I encourage you to do so at: http://pnhphcjnc.org/sign-resolution.php If you do, you will become a member of our organization.

2) If you get duplicate emails from our organization (e.g., if you just got 2 "Save the date" emails from me), you probably signed the resolution at some point. Let me know and I will remove you from the friends list.

3) Some of you do not live in NC. If you wish to stay on the friends' list, please let me know.

4) Of course, if you want to be removed from the list for any reason, please let me know that.

Have I missed any possibilities? Please tell me.

Thanks for your support over the years,

Jessica Schorr Saxe


Save the date October 6 for program

September 13, 2016

Hello, Health Care Justice members and friends,

Our next program will be Thursday, October 6 at 6:00pm at 1817 Central (Midwood International Center).

We will have some speakers who will tell their own stories about their difficulties getting needed health care - and we will talk about solutions and what you can do to help move us toward those solutions.

Save the date - and you will receive an invitation soon.

Jessica Schorr Saxe


Excellent letter to editor from Board member Dr. Andrea DeSantis Barkley

September 4, 2016

Hi,

Please see this letter calling for end to profiteering in health care.

I have it from an excellent source that the original letter contained a plug for single-payer. Too bad it was edited down - but the points made are still excellent.

http://www.charlotteobserver.com/opinion/letters-to-the-editor/article99637312.html

Jessica Schorr Saxe


Important article by Robert Reich - and brief report of Pride parade participation

August 25, 2016

Hi, Single-payer supporters,

Take a look at this important (brief) article by Robert Reich connecting the recent insurance company withdrawals from ACA policies to single payer - and why a single-payer system is inevitable.

Also, Health Care Justice - NC marched in the Pride parade and had an exhibit booth at the festival last weekend. The celebration of our common humanity proved a receptive environment for our message that all people should have health care. We signed up 250 new members. Please look at the picture on our Facebook page (and join it if you haven't).

Jessica Schorr Saxe


Celebrating a successful weekend at the Charlotte Pride Festival & Parade

August 22, 2016

Thrilled to share in the spirit of inclusiveness, Health Care Justice - NC participated in the Charlotte Pride parade on August 21 and had an exhibit booth on August 20 and 21, 2016.

The Pride message that we all share a common humanity resonated with our message that health care should be a basic right. The response was gratifying. Hundreds of people stopped by our booth, and 250 signed our resolution supporting Medicare for All.

Jessica Schorr Saxe


Pride festival: RSVP for booth Aug. 20 or 21, march Aug. 21, or help make posters Aug. 17

August 11, 2016

Hi, Health Care Justice - NC members and friends,

We will participate in the Pride festival Aug. 20-21. Our membership committee has come up with some fun ways for us to participate.

Click here to see what they are and to volunteer for a shift.

A group will make posters on Wed. Aug. 17 at 6:00pm at the League of Women Voters.

To RSVP for that and for more information, contact Denise Finck-Rothman at denisefinck@hotmail.com.

Jessica Schorr Saxe


Two articles worth reading

July 27, 2016

Hi, Health Care Justice - NC members and friends,

I thought you'd interested in the following:

Why Medicare for All won't go away...

http://www.commondreams.org/views/2016/07/26/why-demand-medicare-all-wont-go-away

...and an interesting editorial in the "News and Observer" about the NC request for a Medicaid waiver:

http://www.newsobserver.com/opinion/editorials/article92013412.html

Jessica Schorr Saxe


Two more days to comment on Medicaid expansion if you haven't/see below for suggestions

July 18, 2016

Dear All,

A few of us from Health Care Justice-NC and Health Care for All NC talked to some of the people at CMS who are reviewing the NC Medicaid waiver application.

In addition to their interest in Medicaid expansion, we found that they are interested in concerns about the proposal interfering with the good work that has been done by Community Care of NC and concerns by doctors that introducing managed care organizations would fragment care and lead to more bureaucracy (as some doctors have predicted). These changes might interfere with doctor-patient relationships and might lead to physician attrition from the program.

I encourage you to consider making these points if you agree, as well as those relating to Medicaid expansion that I am including below.

I definitely got the idea that they are paying attention to comments from the public, so please do comment!

Thanks,

Jessica Schorr Saxe

Dear Medicaid expansion advocates,

The NC Department of Health and Human Services submitted the Medicaid Reform 1115 Waiver application to the Center for Medicare and Medicaid Services (CMS) on June 1. CMS will accept public comments on their website until July 20, 2016: https://public.medicaid.gov/connect.ti/public.comments/view?objectId=1886531

The proposed waiver does not currently include the expansion of Medicaid. Please submit a personal comment or comment from your organization that requests the inclusion of Medicaid expansion in the reform waiver.

If you need ideas for what to say, see the template for comments below in this email and also attached. From the template, you can select text to focus on either family benefits or business/economic benefits, or insert your own personal story. Feel free to edit and make this your own. Please email me (karenb@lssp.org) if you submit a comment so we can track public input.

Thank you for your continued support of this issue! - Karen

Template for Comments to the Center for Medicare and Medicaid Services


Excellent NC Medicaid Reform Waiver Brief from NC Justice Center/worth reading whether or not you're commenting

July 14, 2016

Hi, Medicaid expansion supporters,

See excellent brief below. It is worth reading to understand some of the issues involved in the Medicaid waiver - and the shortcomings of the proposed plan.

Comments can be submitted before July 20 at 11 PM.

Note that, if you submitted comments before, they were to DHHS - and according to the brief below, they were reduced to 1 line in a table 50 pages long.

This is an opportunity to submit comments to the federal government which is reviewing the application.

Jessica Schorr Saxe

Good morning everyone,

Attached please find the Medicaid Reform brief. The purpose of the brief is to help explain the content of the waiver application that was submitted to CMS and provide facts with how Medicaid expansion would strengthen the waiver and NC’s Medicaid program. While the brief is not formatted so that you can just “copy and paste,” it should help you add facts and other evidence to your personal stories and/or examples of the need for expansion in your comments.

Regards,
Ciara

Ciara Zachary, PhD, MPH
Policy Analyst, Health Access Coalition
North Carolina Justice Center
224 S. Dawson Street
Raleigh, NC 27601-8068
Office: 919.856.2568

And, if you do decide to comment, here is the link from Karen Bean (karenb@lssp.org): Please submit a comment online by July 20. Send me an email when you comment as we are tracking the number of comments submitted.


Please do comment on Medicaid reform, even if briefly - deadline July 20!

July 9, 2016

Dear All,

If you have not yet commented on the need for Medicaid expansion to be included in the Medicaid reform waiver, PLEASE do so before July 20. You may do this even if you commented or testified in the public hearings.

Karen Bean has prepared comprehensive instructions for commenting. (Thank you, Karen!) Don't be intimidated by the length! Use what you wish. And please comment even if your comments are short.

Click here to access commenting instructions.

Jessica Schorr Saxe


Good news about Pride Parade and Festival

July 8, 2016

Great News! There are great ideas and support for HCJ participation in the Pride Festival and parade. Many have signed up already. Please sign up to march in the parade and/or take a 2 hour shift on August 20th or 21st

The following items would make great additions to the exhibit and the parade. If you can lend these items for the weekend of August 20-21, please let me know.

NEEDED:

  • 1 tent large enough to accommodate 10 foot table
  • 4 five-gallon buckets with covers
  • Wheel chair
  • Someone who can do tricks with wheel chair
  • Gurney

Denise
denisefinck@hotmail.com


Wonderful, fun opportunity to participate in the Pride Parade and Festival, August 20-21, 2016 and build support for Health Care for All!

July 4, 2016

Health Care Justice members proudly marched in support of Health Care forAll/Single Payer in the July 4th Hickory Grove parade with wonderful, positive response from parade watchers and a number of new signers of the resolution. And we had fun doing it! Let us built on that excitement and energy, and start planning for the Pride Parade and Festival August 20-21, 2016, in Uptown Charlotte.

Exhibit: We are needing committed volunteers to take 1-2 hour shifts at the Health Care Justice exhibit from noon - 10 PM on August 20th and noon - 6 PM on August 21st. If interested, please email me dates and times you are available right away. There is a July 15th deadline to submit application. Location of the exhibits, South Tryon between Stonewall and Trade.

Parade: All are welcome including family and friends to march in support of Health Care Justice. March route is 0.75 miles from N. Tryon and Ninth St. south to a left on Trade St. ending on College St. If interested in marching, please email me right away. Deadline for application is August 1st.

These are wonderful opportunities to build support for Single Payer! There is power in numbers! We can make this dream come true!

Denise Finck-Rothman
denisefinck@hotmail.com


Interesting article supporting single-payer from an unusual source

June 28, 2016

Dear Health Care Justice members and friends:

I think you will be interested in this recent article from the Atlanta Journal and Constitution by Jack Bernard, a former Republican elected official:

http://www.myajc.com/news/news/opinion/medicare-an-effective-program-that-needs-expansion/nrmsZ/

Jessica Schorr Saxe


March with us in the July 4th Hickory Grove Parade in support of Health Care Justice

June 28, 2016

Members of Health Care Justice:

We have the opportunity to march in the July 4th Hickory Grove Parade carrying our Health Care Justice banner in support of Single Payer, Healthcare for all! Join the 8 of us who have already committed.

Family and friends are welcome to join in.

Gathering of the marchers is at 9:30 at Hickory Grove Recreation Center, 6709 Pence Rd. Parade starts at 10:30. Route of parade is down Pence Rd. to Hickory Grove Rd., then westbound on East WT Harris Blvd. and ends at The Grove Church, 5735 East WT Harris Blvd., where na 11:30 to 2:30 July 4th celebration will be held.

Please let me know right away so that I can complete the participation form with the number of marchers. More information about the parade: hickorygroveparade.org.

Thank you,

Denise Finck-Rothman
denisefinck@hotmail.com


Calling all Health Care Justice Members and Friends. Build Support for Health Care for All! Show "Fix It" to Friends, Family, Neighbors.

June 22, 2016

Health Care Justice members and friends:

You can help build support for single payer health care for all!

Host a "Fix It" event for family, friends and neighbors in your home.

Fix It: Health Care at the tipping point produced by CEO Richard Master. "...a powerful new documentary that reaches across the political and ideological divide to expand support for major healthcare reform."

Movie and information is available at the website: fixithealthcare.com.

The membership committee can assist you with refreshments, movie showing, and leading the discussion.

Email: DeniseFinck@hotmail.com to let me know you are hosting an event and how we can help.

Jessica Schorr Saxe


Highly recommended article (brief)

June 8, 2016

Hi, Health Care Justice NC Members and Friends,

This is a moving, thoughtful article from the New England Journal of Medicine about medical decision-making that moves from an individual patient to a consideration of how we make decisions as a society.

Jessica Schorr Saxe


Considering the Common Good - The View from Seven Miles Up

By Martin F. Shapiro, M.D., Ph.D.
The New England Journal of Medicine, May 26, 2016

The patient was a French citizen in his late 30s who had been living in Los Angeles. He had acute myelogenous leukemia that was refractory to treatment. He had been hospitalized for several weeks, during which he'd had repeated episodes of pneumonia and urinary tract infections. He had severe thrombocytopenia and constant hematuria, and he required supplemental oxygen and daily transfusions of platelets and red cells. He knew that he had little time left.

"I want to go home to Paris," he told me.

The house staff were able to arrange with Air France to transport him and his wife to Paris, as long as they were accompanied by a physician and a nurse. The residents were not given leave to accompany him, so I did, since I was going off service anyway.

The airline arranged to have oxygen available, and we brought an array of medications and blood products intended to get him safely to Paris. We were concerned about the effects of changes in cabin pressure during takeoff, given his thrombocytopenia and the risk of intracranial bleeding. Takeoff was mostly uneventful, but tachypnea developed. Auscultation was difficult, so we gave him furosemide. He seemed comfortable but remained tachypneic.

About 30 minutes into the flight, the copilot approached us. "We made a mistake," he reported. "We did not board enough oxygen to get to Paris. Would you like us to land in Chicago to pick up some more?"

I was unsure about what to do. The patient's thrombocytopenia had not led to catastrophe on takeoff, but how would an additional landing and takeoff affect him? I asked for time to consider the situation.

As it happened, there was another patient being transported on a stretcher to Paris on the same flight, a woman in her early 20s en route from Tahiti, where she had sustained a subarachnoid hemorrhage. She was comatose. She was accompanied by a French physician. I approached him about my dilemma regarding landing in Chicago.

He looked me squarely in the eye. "My patient's blood pressure was unstable when we landed and took off at Los Angeles," he told me. "Landing in Chicago would be a big risk for her. Your patient is dying. My patient has a small but real chance of long-term survival. My patient's needs should take precedence."

I was taken aback. Should I place my patient at greater risk of dying on this flight in the interest of the well-being of another patient? The nurse shared my misgivings, but we concurred that our patient was certain to die very soon. I informed the copilot that we would take our chances with the available oxygen.

The dilemma on that airplane was unique in some respects, but one issue involved in our decision underlies many treatment decisions made in conventional medical settings, though it's rarely acknowledged explicitly in U.S. medicine. We had to decide which patient would get the treatment that had the potential to improve his or her outcome. They could not both get what was best for them, because the "treatment" for my patient (landing at O'Hare and picking up more oxygen) would clearly endanger the other patient.

U.S. health care prides itself on its great respect for "patient autonomy" - which we tend to translate as giving patients what they want. In many situations, such allocation decisions have implications for others. All too commonly, we admit dying patients to the ICU and keep them there on ventilators until all family members and their religious advisors agree that it's time to stop. We order imaging studies for patients with short-term back pain and no neurologic findings who don't want to try physical therapy first. We administer expensive cancer chemotherapeutic agents in the last weeks of life and insert feeding tubes in patients with end-stage dementia at the behest of their families.

Such actions may show respect for patient autonomy, but they have consequences for others. Keeping a dying patient in an ICU bed may lead to inferior care for another patient who needs that bed. [1] Ultimately, such actions increase costs and divert money into low- or no-value care and away from other communal priorities. Physicians are generally ill prepared to take this bigger picture into account when making clinical decisions.

By contrast, some decision making in universal single-payer health insurance programs, such as Canada's, operates on the assumption that everyone - patients, providers, and policymakers - is in the same boat (or airplane) and that each decision affects others on the ship. Although some people seek care outside the plan, most support the program and see the health system as theirs. [2,3] If care is poor or resources are insufficient, there is often considerable public pressure to address those problems.

The U.S. system instead divides recipients of care by socioeconomic class: some Americans have luxury suites, while others ride in steerage, where the accommodations are of interest only to the people who are relegated there. This system produces good outcomes for some patients, but it fails to avert great hardship and inequity. It also creates circumstances in which physicians fail to meet their ethical obligations - when they provide some people with care that is unneeded or barely needed, sometimes in the service of their own self-interest and thereby reduce others' access to necessary care. [4] A more communitarian approach to decision making might eliminate some of the system's excesses, but it would require physicians to change their behavior, patients to surrender some autonomy, and legislators not to interfere with clinical discussions and decisions by invoking highly charged notions like "death panels."

A good start would be to balance our emphasis on patient autonomy with "respect for the commons." As with the overgrazing of the common pastures in medieval England that led to the enclosure movement, overconsumption of health care by some compromises it as a resource for all. [5] If the United States is to join other industrialized countries in not leaving people to die or suffer owing to lack of health services (even as it spends substantially more than any other country on care), then clinical policy, reimbursement, and the culture of medicine will have to be transformed. We will all need to get used to considering the implications of individual clinical decisions for other patients and society as a whole.

We did not land in Chicago. I did not inform my patient of that option. The Air France crew obtained permission to reduce altitude to about 28,000 ft, thereby increasing cabin pressure. We did not run out of oxygen until we were on the tarmac at Charles De Gaulle Airport. My patient made it to a hospital in Paris and had a wonderful, emotional reunion with his family. He died 5 days later.

http://www.nejm.org/doi/full/10.1056/NEJMp1601144


Thanks to member Tom E. Bowers for "Medicare for All" letter in today's Observer

June 2, 2016

Medicare for all a better option

In response to "N.C. health insurers propose ACA rate increases for 2017" (June 1):

Blue Cross and Blue Shield of North Carolina wants to raise rates 18.8 percent, in part due to a technology system malfunction.

All health insurers have coding problems under the best of circumstances. They also process claims at four to five times the cost of Medicare processing.

Insurers also have shareholder dividends and executive bonuses that Medicare does not have to pay.

Why spend your healthcare dollars on insurance when it could go directly to actual health care?

- Tom E. Bowers, Charlotte


Medicaid Expansion is still a live issue - do read these articles!

June 1, 2016

I wish it were otherwise, but the need for Medicaid expansion has not been resolved in our state. See the excellent report below about Advocacy Day at the General Assembly where dozens (including several members of Health Care Justice - NC) gathered for a press conference and to lobby our legislators.

One of the eloquent speakers was Dr. Stephen Luking who is the author of this moving article:

http://www.greensboro.com/opinion/columns/luking-please-expand-medicaid/article_de8f7c35-5846-5e6c-a259-2d3771ea14c2.html

Do keep this issue alive: Contact your legislators and let them know that we need to expand Medicaid for the welfare of our citizens who need health care and to benefit the economy of NC. If you need talking points, let me know.

Jessica Schorr Saxe


Medicaid expansion remains a hot issue at the NC General Assembly

By Minali Nigam
NC Health News, May 26, 2016

Three years after lawmakers rejected the possibility, Medicaid expansion continues to be a heated and contentious topic. With the Medicaid reform application due to the feds this week, speculation increases: Will CMS approve North Carolina's application without expansion included? Continue reading...


Observations about single-payer vs the US health care system by someone who has experienced both

May 19, 2016

Hi. I find the article below compelling. The author is a former editor of the Canadian Medical Association Journal who came to the US and looked forward to experiencing our market-based system.

Experience has taught him otherwise.

I got this article from Quote of the Day, but left off Don McCanne's comments because the article speaks for itself.

Jessica Schorr Saxe


Commentary: Single-payer essential to controlling health-care costs

By David Woods
The Philadelphia Inquirer, May 16, 2016

One hears these days mutterings by disaffected Americans that if Donald Trump becomes president, they will pack their bags and leave for Canada. One assumes, of course, that no wall will be built along the border to thwart their exit.

I made the reverse trip. Having emigrated from Britain to Canada, where I became the editor in chief of the Canadian Medical Association Journal, I opted to come to the United States in 1988 for personal reasons.

But I was also taken with American rugged individualism and a health-care system focused on market forces and competition. I wrote articles for the Economist Intelligence Unit and other periodicals on the wonders of the American system. In print, I debated longtime advocates of single-payer national health insurance, extolling the virtues of the health-care market that others abhorred.

Gradually, though, I too began to have doubts about market-driven health care. Over the 25 years that I've lived on the U.S. side of the border, I've come to the view that the American health-care system - which still leaves 11 percent of the population uninsured, despite the Affordable Care Act - is inferior to the health systems in Canada and the United Kingdom.

One of the ACA's architects, Dr. Ezekiel Emanuel, describes the U.S. health system as a "terribly complex, blatantly unjust, outrageously expensive, grossly inefficient, error-prone system." Unfortunately, that's still true, six years after the ACA's passage.

The reform didn't address the fundamental problem in U.S. health care: It's more about profit than patients.

Controlling health-care costs is essential to the long-term financial health of the United States. A single-payer system would make truly universal coverage affordable, costing no more than we already spend on health care. Of the $3.1 trillion the United States will spend on health care this year, 63 percent is taxpayer-financed, funding Medicare, Medicaid, and Veterans Affairs, along with private coverage for government employees and tax subsidies for employers.

Because of its fragmented, profit-driven system, the United States spends 18.1 percent of gross domestic product on health care, compared with about 8 percent in Britain and 11 percent in Canada. Much of U.S. health spending is simply wasted. For example, 25.3 percent of hospital expenditures go to administrative costs, compared with 12.4 percent in Canada, where there is a single payer in each province and hospitals are mainly funded on a global or lump-sum basis.

Canadians also save money by training a higher percentage of primary-care doctors relative to specialists, negotiating drug prices with pharmaceutical companies, and prohibiting drug companies from advertising directly to consumers. These measures would save Americans billions annually. Americans spend $1,010 per capita on pharmaceuticals; Swedes spend less than half that, according to the Organization for Economic Cooperation and Development. The reason? Sweden doesn't pay the list price.

Lobbying and influence-peddling by the pharmaceutical and insurance industries keeps the United States from adopting a single-payer health system. Several presidential candidates this season seemed completely under their hypnotic sway. The private insurance industry brazenly tells me, now a U.S. voter, which doctors I can see, charges me astronomical premiums, not to mention co-pays and deductibles, and then wants me to believe that having publicly funded health care that would allow me to go to any doctor in the United States without a $5,000 deductible would be "socialism."

And don't believe the widely held U.S. notion that Canadians suffer long waits for care. That's a canard. We are not going to cut U.S. health spending to Canadian levels. With our much higher level of spending, waits would not be an issue, even with the population aging. Japan and many countries in Europe already have higher percentages of elderly citizens than the graying of the baby boomers is projected to produce.

In his book In Search of the Perfect Health System, British economist Mark Britnell notes that the British love their single-payer National Health Service because of its fairness; it's available to everyone. He even quotes a former U.K. finance minister who said that the NHS is the closest thing the English have to a religion. Their single-payer system keeps quality indexes up and costs down for the population at large. This enables the British to invest additional funds in education and economic stimulation, areas that also contribute to health and well-being.

The United States should take a lesson from the example of nations with single-payer systems. They offer a measure of hope and optimism that high-quality health care can be the right of all Americans, if they demand it.

David Woods is a former editor in chief of the Canadian Medical Association Journal.

http://www.philly.com/philly/health/20160516_Commentary__Single-payer_essential_to_controlling_health-care_costs.html


Worth reading: responses to recent critiques of single-payer proposals

May 18, 2016

Dear Single-payer supporters,

Single-payer proposals have taken a beating recently. Both Kenneth Thorpe and the Urban Institute claim that Bernie Sanders' proposal would cost more than he says. And now Margot Sanger-Katz, writing in the NY Times, has a similar criticism.

Adam Gaffney (below) has responded to Sanger-Katz. But the email below also contains links to the Urban Institute and Thorpe analyses--as well as to the response from Steffie Woolhandler and David Himmelstein, which challenges the assumptions they made to reach their conclusions.

It is worthwhile to be aware of the arguments to be made for single-payer in response to criticism.

Jessica Schorr Saxe


Adam Gaffney responds to NYT's Margot Sanger-Katz on cost of single payer

A Single-Payer Plan From Bernie Sanders Would Probably Still Be Expensive

By Margot Sanger-Katz
The New York Times, May 16, 2016

Bernie Sanders' chances at enacting a "political revolution" are all but gone. But that doesn't mean his policy agenda won't continue to be felt in this election or future Democratic platforms.

One of his signature proposals is to move the country's health care system to a government-run, single-payer system.

But also last week, a detailed analysis of the Sanders health care plan from researchers at the Urban Institute showed that it would probably cost the government double what the campaign proposed. It is the second credible analysis to suggest that the Sanders plan costs more than advertised. (The other comes from the Emory health policy professor Kenneth Thorpe.)

The Sanders campaign and its academic allies dispute some of the Urban Institute's assumptions. A critique of the Urban analysis from David Himmelstein and Steffie Woolhandler, professors of public health at the City University of New York, argues, for example, that drug prices could be pushed even lower. And the Sanders team says that the researchers overestimated the costs associated with administering the government program. But it doesn't argue that the prices paid to medical providers could be cut more sharply.

http://www.nytimes.com/2016/05/17/upshot/why-single-payer-health-care-would-probably-still-be-expensive.html

***

Blog Post: What's Wrong with Margot Sanger-Katz's Single Payer Analysis

By Adam Gaffney, M.D.
The Progressive Physician, May 17, 2016

Yesterday, New York Times health care reporter Margot Sanger-Katz, whose work I very much respect, entered the debate on the costs of Sanders' single payer plan in a piece I find problematic, headlined 'A Single-Payer Plan From Bernie Sanders Would Probably Still Be Expensive." I should first concede, however, the central argument of her article: it is true that a US single payer system would still be relatively expensive as compared to other single payer systems. We would, that is to say, continue to spend more than the United Kingdom or Canada if we transitioned to single payer. At the same time, there would nonetheless be enormous savings from such a transition, and these savings would allow us to affordably achieve real universal health care. This, in my opinion, would still be an excellent deal.

The background to this debate are two analyses of the Sanders' single payer proposal - the first by economist Kenneth Thorpe and the second by the Urban Institute - both of which claimed that the actual costs of Sanders' single payer plan would be significantly higher than what his campaign has predicted. The assumptions of each have been convincingly contested by colleagues David Himmelstein and Steffie Woolhandler: among other points, they argue that both analyses underestimate administrative savings and overestimate the cost of increased health care use resulting from a coverage expansion.

Anyway, without delving into the details, there is something rather puzzling when looking at the analyses of Thorpe and the Urban Institute from a broader perspective. How is it that single payer would massively increase costs in the United States, as these reports contend, even while countries with single payer-type systems - like Canada and the United Kingdom - have much, much lower health care costs than we do?

To answer, a quick side note: our total health spending is, by definition, equal to the quantity of health services delivered multiplied by their price. The US does not consistently use more health services than other high-income nations. Therefore, the fact that we have higher health care costs is mostly explained by higher unit prices for services, as Sanger-Katz and others note. Now us single payer advocates cite lower administrative costs (and lower drug spending) as the major sources of savings under US single payer (effectively lowering the “price” side of the equation). But Sanger-Katz argues that this would be insufficient: prices would have to be slashed across the board, and some services would have to be cut:

Making the American health care system significantly cheaper would mean more than just cutting the insurance companies out of the game and reducing the high administrative costs of the American system. It would also require paying doctors and nurses substantially lower salaries, using fewer new and high-tech treatments, and probably eliminating some of the perks of American hospital stays, like private patient rooms.

Such a transition would, she notes, have some scary sounding downstream consequences: "...making big cuts all at once to doctors and hospitals could cause substantial disruptions in care. Some hospitals would go out of business. Some doctors would default on their mortgages and student loans." My understanding is that we aren't really allowed to effectively default on student loans, but admittedly this all sounds rather dicey.

But this frightful health care meltdown isn't even in the cards. She is correct in a narrow sense: it's true that immediately lowering US health care expenditures to, say, that of the United Kingdom - i.e. from 16.4% to 8.5% of gross domestic product - would require major, disruptive reductions in spending across the board. However, nobody is contending that we do that. The central claim for US single payer is more modest. Use the enormous administrative savings generated under single payer financing in combination with pharmaceutical savings to cover everybody with comprehensive benefits and no cost-sharing. Overall national health spending would, it is true, remain roughly the same (though we could better control cost growth moving forward). But this scenario of widespread hospital bankruptcies and the end of private (or semiprivate?) hospital rooms is a fantasy: nobody wants it to happen, and it's not happening.

It's worth noting that there is also a jarringly inconsistent aspect to single-payer critiques that warn of the threat to health care workers' income. As Woolhandler and Himmelstein note in an article in the Huffington Post, the Urban Institute simultaneously asserted that the coverage expansion under single payer would lead to an enormous increase in spending on physician services - by $1.6 trillion over a decade! - while simultaneously asserting that physician salaries would be "squeezed." Whatever one thinks of how much physicians should be paid, it's hard how these would both happen at the same time.

Transitioning to single payer will not mean reducing our health care expenses to British levels: that is probably not possible, and is certainly not desirable. But that's not to say that the savings from adopting a single payer financing system wouldn't be substantial - we’re talking hundreds of billions annually on administrative savings alone, plus more by reducing drug prices to European levels. With that money, we'll build a much more decent health care system for all to use without having to worry about the cost of being sick, of being pregnant, or simply of obtaining preventive care. No wonder a majority of the country wants it.

Dr. Adam Gaffney is a clinical and research fellow in pulmonary and critical care medicine at Massachusetts General Hospital. His writing has appeared in the New Republic, Los Angeles Review of Books, USA Today, Salon, CNN.com, Dissent, US News & World Report, Jacobin, In These Times, and elsewhere.

https://theprogressivephysician.net/2016/05/17/blog-post-whats-wrong-with-margot-sanger-katzs-single-payer-analysis/

***

Comment:

By Don McCanne, M.D.

There have been a multitude of recent media reports indicating that a single payer program, as proposed by Bernie Sanders, would cost much more than previous estimates have shown. These reports rely on recent analyses by the Urban Institute and by Emory Professor Kenneth Thorpe. Unfortunately, these analyses are being given more credibility than the contrasting conclusions of the nation's two leading experts on single payer - Professors David Himmelstein and Steffie Woolhandler.

NYT's Margot Sanger-Katz reiterated the conclusion that "the Sanders plan costs more than advertised." She is highly credible, and, in fact, she did link to an article on the topic by Himmelstein and Woolhandler. But she suggests that prices paid to medical providers must be cut more sharply than proposed, and, by this, seems to accept the fact that Sanders' single payer proposal is more expensive than anticipated. You may want to read her full article (link above) to better understand Adam Gaffney's response.

Adam Gaffney's full blog response is reproduced here, along with the live links, because it is imperative that we not allow the sometimes blind acceptance by the media of the two recent analyses that use dubious assumptions to refute the great body of policy literature that confirms the efficiency and effectiveness of the single payer model. Gaffney sets the record straight.

Study Gaffney's response and also the prior responses of Himmelstein and Woolhandler (live links in article) so that you will be prepared to refute the claims that single payer is unaffordable. It's our current highly dysfunctional system that is not affordable.

(Keep in mind that some of the misunderstanding is due to the fact that one view is referring only to federal spending and the taxes to pay for it whereas another view is referring to our total national health expenditures, public and private combined. Obviously transferring private health care spending to the federal government would cause federal spending and taxes to increase - the claim being made - but total spending under a well designed single payer system would remain about the same, with administrative and price savings being used for expanded benefits and coverage.)


If you are able, join us in Raleigh May 25 for Day of Advocacy to Close the Gap; Week of Advocacy

May 12, 2016

Please join us in the Week of Advocacy. If you would like to carpool from the Charlotte area please let Karen Bean (karenb@lssp.org) know by noon Thursday, May 12, so we can make more definitive travel plans.

Join members of the North Carolina Medicaid Expansion Coalition for
Close the Medicaid Gap - Week of Advocacy

Patients, healthcare providers, individuals in the coverage gap, and advocates are planning a Week of Advocacy to raise public awareness about the need for North Carolina to close our Medicaid gap. Closing the gap would provide health coverage for half a million North Carolinians and create tens of thousands of jobs. Please join us for any or all of the events below!

Day of Advocacy at NC General Assembly
Wednesday, May 25th, 8:00 a.m. - 3:00 p.m.

8:00 a.m.: Registration
Tentative location: First Baptist Church
99 N Salisbury St, Raleigh, NC 27603

8:45 a.m. - 10:45 a.m.: Educational and Advocacy Training
Tentative location: First Baptist Church
99 N Salisbury St, Raleigh, NC 27603

10:45 a.m. - 3:00 p.m.: Visit with your legislators and watch session
Location: Find your state senators and representatives here: http://www.ncleg.net/representation/WhoRepresentsMe.aspx
Click "Open Member Page" to find his/her phone number and office number. (Most offices are in the Legislative Office Building, 300 N Salisbury St, Raleigh, NC 27603.)

Meetings will not be scheduled in advance for advocates. If you have a relationship with your legislator's office or feel comfortable reaching out to them, please consider contacting them in advance to set up appointments. It is a busy time for legislators, but they or their legislative assistants should be available to talk with you for at least a few minutes.

Afternoon: Press Conference and deliver petitions to Governor's office (Time TBD, based on legislative calendar)
Location: NC General Assembly and Capitol Building

***

We know not everyone will be able to arrive by 8:45 a.m. for the start of training. If you are making a long trip to Raleigh that morning, please listen in on one of the conference calls in advance, and arrive when you are able to!

To prepare for the Day of Advocacy, please consider participating in the following events:

Conference Calls: Preparing for Your Visit
Thursday, May 19th, 6:00 p.m.: Conference Call - "The Facts on Closing the Medicaid Gap"
Monday, May 23rd, 12:00 p.m.: Conference Call - "The Facts on Closing the Medicaid Gap"

The two conference calls will provide identical content, and are intended to prepare advocates to attend the Day of Advocacy on May 25th. Both conference calls will provide talking points and facts on closing the Medicaid Gap, as well as tips for effective advocacy with elected officials.

Phonebanking at NC Justice Center
Monday, May 23rd from 6:00 p.m. - 8:00 p.m.
Location: 224 South Dawson Street in downtown Raleigh
Help make calls to turn out folks to Advocacy Day and contact legislators on closing the gap. RSVP to Ciara Zachary at ciara@ncjustice.org. Dinner will be provided!

Twitter Town Hall hosted by Young Invincibles
Tuesday, May 24th from 2:00 p.m. - 3:00 p.m.

Young Invincibles (@YoungInvincible) and NC Justice Center's Health Access Coalition (@nchealthaccess), will host a twitter chat to promote Closing the Coverage Gap and the upcoming Advocacy Day. For information about the Twitter event, please contact krieg.rajaram@younginvincibles.org.

For more information on any of these events, contact Lee Storrow at lee@ncaan.org or Nicole Dozier at nicole@ncjustice.org.


Released today: A Physicians' Proposal for Single-Payer Health Care Reform

May 5, 2016

Hi, single-payer advocates,

Today, "Beyond the Affordable Care Act: A Physicians' Proposal for Single-Payer Health Care Reform" was released at a news conference and simultaneously published in the American Journal of Public Health.

I hope that you will look at some of the links below--either at the full proposal or a summary.

AND NOTE THAT YOU CAN ENDORSE THE PROPOSAL AT THE LAST LINK. Anyone can endorse--it's not necessary to be a physician...

Jessica Schorr Saxe


AJPH Editorials: Moving Forward From the Affordable Care Act to a Single-Payer System

By Adam Gaffney, Steffie Woolhandler, David Himmelstein and Marcia Angell
American Journal of Public Health, June 2016
Published in advance online May 5, 2016

Conclusions

Despite the ACA, many serious problems remain in American health care. Uninsurance and underinsurance endure, bureaucracy is growing, costs are likely to rise, and caring relationships take second place to the financial prerogatives of health insurers and providers. A single-payer NHP offers a salutary alternative, one that a would at long last take the right to health care from the realm of political rhetoric to that of reality.

http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.303157

***

Beyond the Affordable Care Act: A Physicians' Proposal for Single-Payer Health Care Reform

By The Working Group on Single-Payer Program Design
Co-chairs: Adam Gaffney, M.D., David U. Himmelstein, M.D., Steffie Woolhandler, M.D., M.P.H., and Marcia Angell, M.D.

Abstract

Even after full implementation of the Affordable Care Act (ACA), tens of millions of Americans will remain uninsured or only partially insured, and costs will continue to rise faster than the background inflation rate. We propose to replace the ACA with a publicly financed National Health Program (NHP) that would fully cover medical care for all Americans, while lowering costs by eliminating the profit-driven private insurance industry with its massive overhead. Hospitals, nursing homes, and other provider facilities would be nonprofit, and paid global operating budgets rather than fees for each service. Physicians could opt to be paid on a fee-for-service basis, but with fees adjusted to better reward primary care providers, or by salaries in facilities paid by global budgets. The initial increase in government costs would be offset by savings in premiums and out-of-pocket costs, and the rate of medical inflation would slow, freeing up resources for unmet medical and public health needs.

***

To download the full proposal:
http://www.pnhp.org/beyond_aca/Physicians_Proposal.pdf

Summary of the Physicians' Proposal:
http://www.pnhp.org/beyond_aca/Physicians_Proposal_Summary.pdf

Background Fact Sheet for the Physicians' Proposal:
http://www.pnhp.org/beyond_aca/Physicians_Proposal_Fact_Sheet.pdf

PNHP Press Release
http://www.pnhp.org/beyond_aca/News_Release.pdf

***

From the PNHP website:

Beyond the Affordable Care Act: A Physicians' Proposal for Single-Payer Health Care Reform establishes the vision and principles that will empower Americans to replace our expensive, inadequate, and inefficient collection of health care systems with an improved Medicare for All.

The proposal outlines the general structure of a single-payer system for the United States, including coverage and eligibility; physician and outpatient care payment; global budgeting of hospitals; health planning and capital investments; coverage for medications, devices, and supplies; the establishment of a national long-term care program; cost-containment; and single-payer financing. The proposal also demonstrates the shortcomings of alternatives to National Health Insurance, including the Affordable Care Act.

For further links, including downloading and endorsing the proposal:

http://www.pnhp.org/beyondaca

***

Comment:

By Don McCanne, M.D.

If you have not done so already, please use the links above to endorse and download the Physicians' Proposal, including the Summary and the Background Fact Sheet. It is imperative that we fix our dysfunctional health care system.


See "Fix it" Thursday, May 19, 2016 at 6 PM; Health Care Justice, Morrison Regional Library, Bring a friend!

April 29, 2016

You are invited to a meeting of Health Care Justice.

Bring a friend!

Thursday, May 19th at 6:00 PM; Morrison Regional Library, 7015 Morrison Blvd, Charlotte, NC 28211, first floor meeting room.

Fix It: Health Care at the tipping point produced by CEO Richard Master. "...a powerful new documentary that reaches across the political and ideological divide to expand support for major healthcare reform."

Discussion will follow.

Questions?
DeniseFinck@hotmail.com

You may receive this information again as an Evite.
Be sure to come!


Invitation: Building a Collaborative Medicaid Expansion Effort in Charlotte (May 24 at 10am)

April 18, 2016

Hello Coverage Gap Partners,

Here's an invitation for your members/volunteers in the Charlotte area along with RSVP info below:

Thank you so much for your past and ongoing support of Medicaid expansion efforts in NC. A growing number of Charlotte-area individuals and groups have joined the fight to close the coverage gap!

Based on the old adage "strength in numbers," Legal Services of Southern Piedmont, NC Child, and the American Heart Association would like to convene those working on expansion to share updates on our individual advocacy efforts and develop synergy as a collaborative group. We hope to bring to together a diverse group of stakeholders including small business owners, child advocates, faith community leaders, and health care providers.

Please join us for coffee/doughnuts and an informal conversation about the possibilities of collaborative efforts. Together we can make a difference!

Tuesday, May 24, 2016
10:00 to 11:30 am
American Heart Association - Charlotte
15th floor conference room
128 South Tryon Street
Charlotte, NC

RSVP by May 18 to Karen Bean at karenb@lssp.org.

Feel free to forward to other colleagues or groups who may be interested in participating!


Powerful op-ed from today's News & Record! And, if you haven't commented on Medicaid expansion, please do so by tomorrow (op-ed should inspire you)

April 17, 2016

Hi, All,

Do check out this wonderful column at the link below that was forwarded by the Medicaid expansion group.

And, if you haven't commented on the need for Medicaid expansion, please do so by tomorrow:

http://act.progressnc.org/sign/medicaid-privatization-public-comment/

This amazing op-ed was featured on the front of the Ideas section with bold color graphics:

http://www.greensboro.com/opinion/columns/luking-please-expand-medicaid/article_de8f7c35-5846-5e6c-a259-2d3771ea14c2.html

Jessica Schorr Saxe


Please comment on Medicaid expansion/Medicaid reform within the next 2 weeks: your comments can be brief, but your voice should be heard

April 3, 2016

Please do comment on the need for Medicaid expansion as part of Medicaid reform--and for the need to have rational Medicaid reform (including maximizing the role of Community Care of NC).

You can comment by email--and it doesn't have to be lengthy:

http://act.progressnc.org/sign/medicaid-privatization-public-comment/

(There are no more public hearings in our area, but let me know if you want links to the others.)

See below for talking points.

Let me know if you have any questions.

Jessica Schorr Saxe


About the NEED FOR MEDICAID EXPANSION

I think it's most important they tell their story or a story of a loved one/community member or from their perspective as a teacher, provider, etc. They can also use the Cone Report for numbers. Below are ideas and further below are 2 talking point versions.

Also see this link and go down to where it talks about the impact and if someone has diabetes, or needs cancer screenings they can use those numbers

They can talk about the family profiles here:

They can also talk those who work in: construction, home health, food/beverage, child care related jobs are in the gap.

Talking Points 1 & 2

  • Expansion is critical for containing costs in Medicaid, which is a key goal of North Carolina's Medicaid Reform. Without expanding health coverage to people in the gap who oftentimes have many unmet medical needs, they will receive inconsistent health care. Many people in the coverage gap obtain Medicaid for short periods of time and use more services, which is more costly.
    Expansion will keep Medicaid costs. People who are in the gap often delay care for things that are minor but then when care is inevitable, it costs more and costs them more quality of life.
  • North Carolina Department of Health and Human Services (NCDHHS) will struggle to maintain access for Medicaid patients as the health care infrastructure erodes, especially in vulnerable rural areas, as a result of refusing to close the coverage gap. Clinic and hospital closings will only accelerate in the future if we do not access additional federal funds.
    North Carolina Department of Health and Human Services (NCDHHS) will have a difficult time assuring that providers can offer the same level of care to the patients who currently receive Medicaid services if we don't expand Medicaid, bringing in federal dollars. Clinics and hospital closings especially in rural areas, may continue.
  • It is unlikely that the federal government will continue to grant the state Delivery System Reform Incentive Payments when we are refusing to tap existing federal funds as the Affordable Care Act (ACA) intended.
    It is unlikely that the federal government will continue to provide grant payments to the state when we are refusing to bring in existing federal funds as the Affordable Care Act (ACA) was intended.
  • Hospitals and clinics are struggling with a lack of revenue and resources. Reform without Expansion may lead to more health care facility closings if they do not have the funds to adapt. Expanding coverage would provide these health systems with additional revenue to cover a portion of and reduce the amount of uncompensated care.
    Hospitals and clinics are struggling with a lack of revenue and resources. Reform without Expansion may lead to more closings if they do not have an increase in funding. Expanding coverage means more patients will be paying customers-providing additional revenue to cover a portion of and reduce the amount of care for which these providers do not get reimbursed.
  • It will be challenging to fully integrate behavioral health and substance use disorder treatment with primary care as many people are unable to access the long-term supports and services they need due to a lack of insurance.
    It will be challenging to fully bring behavioral health and substance use disorder treatments into primary care since many patients are unable to access the long-term care and recovery services they need when they lack insurance.
  • The federal government is unlikely to believe that our state is truly innovative and takes its commitment to improving the lives of low-income citizens seriously when we are refusing federal funds to extend insurance coverage to 500,000 more people.
    SAME.

Best,

Nicole Dozier
Director, Health Access Coalition
NC Justice Center

AND, about maintaining CCNC in MEDICAID REFORM:

I was very happy to hear so many providers advocating on behalf of CCNC last night so I think it is good for you to note the good work and the national recognition CCNC has received in your comments. Your comments can also include that NC DHHS can work with CCNC without dismantling it while reforming Medicaid. Our Medicaid Reform fact sheet notes some unintended consequences for replacing CCNC.

I hope this email is helpful. Please feel free to contact me if you need additional feedback.

Thanks!
Ciara

(from Ciara Zachary, also of the NC Justice Center)


Medicare-for-all is Winning the Debate

March 25, 2016

Joe Sparks, brother of Harry Sparks,wrote an excellent blog entry that explains the advantages of a Medicare-for-All system:

Medicare-for-all Is Winning the Debate

I encourage you to read it as he addresses the major points for it and arguments against it including the myth of the benefit of high-deductible plans and the issue of the actual cost of a single-payer system.

Jessica Schorr Saxe


Please speak up for Medicaid expansion: in person or by phone, talking points attached

March 23, 2016

Please see important message below from Karen Bean about the Medicaid Reform public hearings. Your voice is needed! Note you can call in if you are unable to attend. See attached talking points.

I'm sure Karen would be glad to answer any questions (contact information below).

Jessica Schorr Saxe


The North Carolina Department of Health and Human Services (NCDHHS) is drafting a Medicaid reform waiver application -- the document needed to get federal approval -- and is asking for public input about Medicaid reform. Since we believe that Medicaid expansion is an essential part of Medicaid reform, we want to make our voices heard!

The public hearings below will take place in our region on March 31. We need volunteers to attend and comment on why Medicaid expansion coupled with reform is critical for North Carolina's future. Comments at the hearings are limited to two minutes.

March 31, 2016
Union County Dept. of Social Services
Auditorium
1212 W. Roosevelt Boulevard
Monroe, NC 28110
2 p.m. - 4 p.m.

March 31, 2016
Central Piedmont Community College, Merancas Campus
Auditorium
11930 Verhoeff Drive
Huntersville, NC 28078
6:30 p.m. - 8:30 p.m.

You also may listen and comment by phone during the March 31 Session, 2-4 p.m.

  • No registration is necessary.
  • Dial 1-888-585-9008 and, when asked, enter conference room number 780073319#
  • When asked, state your name.
  • To make a comment, press *9 on your phone. The moderator will tell you when it is your turn to make a comment.

If you want to speak at the meeting, please share personal stories of people you know who are in the Medicaid gap and explain why expansion is important to you personally. If you are not sure what to say, see the attached talking points.

If you cannot attend any of the public hearings, you can make your voice heard online. Tell Governor McCrory and the General Assembly that Medicaid reform needs to include the 500,000 North Carolinians who are in the healthcare coverage gap. Click this link to add your comments: http://bit.ly/1XHOAwI

Please email me (karenb@lssp.org) and let me know if you are available to speak at the Monroe hearing or email madisonh@lssp.org if you can speak at the Huntersville hearing. Your voice is vital to expanding Medicaid in North Carolina! Thank you for your help.

Sincerely,
Karen Bean

For further information:

http://www.ncdhhs.gov/nc-medicaid-reform/public-hearings

http://www.ncchild.org/what-children-need/healthy-children/

http://www.conehealthfoundation.com/foundation/

Ensuring a full measure of justice for those in need

Karen Bean
Medicaid Expansion Organizer
Legal Services of Southern Piedmont
1431 Elizabeth Avenue
Charlotte, NC 28204
704-808-4149 direct dial
karenb@lssp.org

www.lssp.org


Death of pioneering single-payer supporter: Dr. Quentin Young, 1923 - 2016

March 9, 2016

See PNHP's announcement below, as well as article in today's Observer:

http://www.charlotteobserver.com/news/article64754222.html

Dr. Quentin Young had a lifelong commitment to social justice. He had a long-standing relationship with PNHP, as well as leading and working with many organizations (see below).

Just a couple of years ago, he published his autobiography "Everybody In, Nobody Out: Memoirs of a Rebel Without a Pause."

I had the privilege of talking to him a couple of times at the PNHP national meetings, and he was down-to-earth, energetic, and an entirely nice guy.

He will be much missed.

Jessica Schorr Saxe


Dear colleague,

I write to announce with great sadness the death at age 92 of Quentin Young, M.D., PNHP's national coordinator from 1992-2014, a physician beloved by his patients, colleagues and students, and a lifelong fighter for social justice.

Quentin was an extraordinary human being, and his death leaves a huge hole in our hearts and in our movement. We must resolve to carry his work forward to win single payer.

I know I speak for all of us when I say we extend our heartfelt condolences to his family and friends.

This morning PNHP released the statement below. News stories about Quentin's life and work have already begun to appear, and our national office has started to receive many moving tributes and remembrances of Quentin from his colleagues and friends.

Quentin was an inspiration, particularly to young people. Matthew Petty, PNHP's executive director, writes, "Quentin's optimism and energy has kept me has kept me going for over 10 years with PNHP, and his memory will keep me going until we achieve single payer, Medicare for all."

If would like to share a story or tribute with us for possible publication in the PNHP newsletter or on our website, please send it to info@pnhp.org. If you would like to make a gift in Dr. Young's memory, you can do so on a special page here.

Sincerely,

Robert Zarr, M.D., M.P.H.
President
pres.zarr@pnhp.org

Statement in memory of Dr. Quentin Young, 1923 - 2016

The following statement was released today by Dr. Robert Zarr, president of Physicians for a National Health Program.

Dr. Quentin D. Young, who served as national coordinator of Physicians for a National Health Program from 1992-2014, and who also served the organization's past president, died on March 7 in Berkeley, Calif., where he had been under the watchful eyes and care of his daughters and other family members. He was 92.

In addition to his work with PNHP, Dr. Young co-founded and chaired for many years the Chicago-based Health and Medicine Policy Research Group.

Dr. Young was known for his sharp, clear-eyed analysis of social and economic problems, particularly in health care, his deep commitment to social justice and racial equality, his quick wit, his insuppressible optimism, personal courage, and his ability to inspire those around him to join him in the battle for a more equitable and caring world.

Beginning in the late 1980s, he was perhaps the nation's most eloquent and high-profile spokesperson for single-payer national health insurance, or improved Medicare for all, and was a vigorous champion of single-payer legislation, notably "The Expanded and Improved Medicare for All Act," H.R. 676, sponsored by Rep. John Conyers Jr. and others.

Dr. Young graduated from Northwestern Medical School and did his residency at Cook County Hospital in Chicago. During the 1970s and early 1980s, he served as chairman of the Department of Internal Medicine at Cook County, where he established the Department of Occupational Medicine. In 1983, Chicago Mayor Harold Washington appointed him president of the Chicago Board of Health, where he served with distinction. From 1952 to 2008, he was an internal medicine doctor in private practice in Chicago's Hyde Park community, where he lived most of his life.

For many years Dr. Young hosted a popular program on WBEZ, Chicago's public radio station, where he discussed health and social issues and took calls from listeners.

In 1998, he had the distinction of serving as president of the American Public Health Association and in 1997 was inducted as a Master of the American College of Physicians. In 2009 he was appointed Health Advocate for the state of Illinois by Gov. Patrick Quinn.

In addition to his distinguished career as a physician, Dr. Young was a leader in public health policy and medical and social justice issues. He was Dr. Martin Luther King Jr.'s personal physician during the latter's stays in Chicago, and during the civil rights era he served as national chairman of the Medical Committee for Human Rights.

In 1999, Physicians for a National Health Program established the "Quentin D. Young Health Activist Award" to honor physicians and other health professionals who exemplify Dr. Young's commitment to social justice. It is regarded as PNHP's highest award.

In his 2013 autobiography, "Everybody In, Nobody Out: Memoirs of a Rebel Without a Pause," Dr. Young wrote as follows:

"From my adolescent years to the present, I've never wavered in my belief in humanity's ability - and our collective responsibility - to bring about a more just and equitable social order. I've always believed in humanity's potential to create a more caring society.

"That viewpoint has infused my relations with family, friends, patients and medical colleagues. It's been a lifelong, driving force to promote equality and the common good, and I believe it has served me well.

"I suppose being a physician has made it easier for me to work toward this goal. Easier, that is, than if I had chosen a different occupation. I've spent a lifetime trying to help others - in my daily rounds, in my clinic, as a hospital administrator, at demonstrations, in my work with health advocacy groups - and it all adds up to deeply rewarding career. Few people have such good fortune.

"But as you've no doubt noticed in the preceding pages, my views and actions have also propelled me into sharp conflict with institutions and person who would perpetuate injustice. That was true yesterday; it remains true today. My work is unfinished."

PNHP extends its condolences Dr. Young's family and friends, and we pledge to carry on his work, forever inspired by his example.

Physicians for a National Health Program (www.pnhp.org) is an organization of 20,000 physicians who advocate for single-payer national health insurance. It was founded in 1986.


Invitation to: Closing the Gap Panel Discussion, March 16 @ 11:30 a.m.

February 25, 2016

The League of Women Voters of Charlotte-Mecklenburg, along with the NC Justice Center, Legal Services of Southern Piedmont, NC Child, and American Heart Association/American Stroke Association are on a mission to educate the community about Medicaid expansion. Medicaid expansion in North Carolina can be a complicated and daunting thing to dissect, so we've brought in some help.

Join us for lunch on Wednesday, March 16 from 11:30 a.m. - 1:00 p.m. at Myers Park Baptist Church in Heaton Hall (1900 Queens Road, Charlotte, NC, 28207) as we learn more about bringing affordable health insurance to our state.

Panelists Susan F. Shumaker, RN, MHA, FACHE (President, Cone Health Foundation), Rob Luisana (Managing Partner, Pilot Benefits) and Adam Linker (Co-director, Health Access Coalition at the NC Justice Center) will discuss the impact that decision has had on our state, and how a future decision to expand coverage could change the state of North Carolina as we know it.

Please register - goleaguego.org/Lunch.html - for this event and order a box lunch (optional) by March 10, 2016.

PLEASE BRING YOUR MEMBERS/CLIENTS/SUPPORTERS.

We need everyone to learn more about the benefits of closing the gap. Please use these materials to INVITE your members and supporters to the event:

Hope to see you AND your supporters there!


Responses to recent criticisms of single-payer health care

January 22, 2016

Hi.

Single-payer has been much in the news lately, criticized by Chelsea and Hillary Clinton, and by Paul Krugman in the New York Times.

This has generated many responses worth reading.

Note that PNHP welcomes this debate. Please do see their response below - with attention paid to the myths that are out there (and which you undoubtedly hear):

http://www.pnhp.org/news/2016/january/doctors-group-welcomes-national-debate-on-'medicare-for-all'

And here is another excellent, brief and clear article by Dr. Adam Gaffney in US News and World Report:

http://www.usnews.com/debate-club/is-single-payer-health-care-a-good-idea/single-payer-is-worth-fighting-for

Jessica Schorr Saxe


What questions do you want covered on Feb. 4, and some single-payer news

January 19, 2016

Hi, single-payer supporters,

As I think about the single-payer update meeting for Feb. 4, I realize there are a lot of possible topics that could be covered in a limited period of time. Please let me know what you are most interested in. And you might think about this as a place to get answers to some of the objections you hear when you talk to others about Improved and Expanded Medicare for All.

Among the topics we could discuss are:

  • Changes in economic inequality
  • Racial inequalities
  • Medicare Advantage plans (.e.g., added expense and shortcoming)
    high deductible health plans (and the fallacy of the "skin in the game" justification)
  • Medicaid--why we need expansion, and the shortcomings of Medicaid and why we need more than expansion
  • For-profit vs. not for profit health care
  • Pharmaceuticals (costs, etc)
  • Review of comparisons of US vs. other countries re:
    • Health care costs
    • Health statistics (including information that shows that our poor health outcomes are not due to poorer health habits)
  • Canada's national health program

Let me know what you'd like to hear!

Single-Payer has been in the news lately. Thomas Friedman wrote a column for the NYTimes that was reprinted in the Observer in which he outlined an agenda that "could actually make America great again." The first item was a "single-payer universal health care system."

http://www.charlotteobserver.com/opinion/op-ed/article53350135.html

On a less positive note, Hillary Clinton attacked Bernie Sanders' single-payer proposal. There has been a considerable response in the media about her disingenuousness--e.g., from Bill Moyers and Ezra Klein. And yesterday, in the New York Times, Paul Krugman has highly critical of the pursuit of single-payer. Though he's a really smart guy, I think that some of his comments were inaccurate. (e.g., he thinks there would be a big backlash from all the people who have great employer-sponsored insurance. I am skeptical that there are many of those around--at least not many people who have actually been sick and tried to use it.)

I try not to flood you with information, but, you'd like more on this topics, let me know.

Jessica Schorr Saxe


Good News About Medicaid Expansion

January 14, 2016

Hi, All,

Obama's proposed 2017 budget includes the federal government covering 100% of the cost of the newly-eligible Medicaid recipients for 3 years no matter when a state accepts the Medicaid expansion.

(Previously this was available only to states that accepted the expansion by 2014.)

NC is now one of only 19 states that hasn't expanded Medicaid, so maybe this will prove to be an incentive:

http://thehill.com/policy/healthcare/265824-obama-proposes-funding-boost-for-states-to-expand-medicaid

Talk this up on social media, discuss with your friends and anyone you know in political life or the media.

As we all know, we eventually need to go beyond Medicaid expansion to a system that would cover everyone equitably. But Medicaid expansion is something we could accomplish in the shorter term that would help hundreds of thousands of North Carolinians.

Jessica Schorr Saxe


Once again, in case you think you're in a minority, look at this

December 18, 2015

Hi, single-payer supporters,

A recent Kaiser Family Foundation poll shows that a majority of Americans favor the idea of Medicare for All.

So, once again, if some responds to your support of single-payer by saying, "Isn't that idea dead?" or "aren't you in a minority?," you can assure them the single-payer idea is alive and that, if fact, you're not in a minority (and that maybe they'd like to get on board if they're not already).

See below for the report and for Don McCanne's comments.

Jessica Schorr Saxe


Kaiser Health Tracking Poll: December 2015

By Bianca DiJulio, Jamie Firth, and Mollyann Brodie
Kaiser Family Foundation, December 17, 2015

From the Tracking Poll:

As the presidential primaries inch closer and candidates begin to debate the intricacies of their platforms, a long-discussed health policy option has reemerged in debate between democratic candidates; the idea of creating a national health plan in which all Americans would get their insurance through an expanded, universal form of health insurance called Medicare-for-all. When asked their opinion, nearly 6 in 10 Americans (58 percent) say they favor the idea of Medicare-for-all, including 34 percent who say they strongly favor it. This is compared to 34 percent who say they oppose it, including 25 percent who strongly oppose it. Opinions vary widely by political party identification, with 8 in 10 Democrats (81 percent) and 6 in 10 independents (60 percent) saying they favor the idea, while 63 percent of Republicans say they oppose it.

From the Press Release:

Recently Democratic presidential candidates Hillary Clinton and Bernie Sanders debated the idea of "Medicare-for-all," which involves creating a national health plan in which all Americans would get their insurance through an expanded version of the Medicare program. A large majority of Democrats (81%) support the idea of Medicare-for-all, as do most independents (60%), while most Republicans (63%) oppose the idea. The poll did not ask about details or tradeoffs.

At the same time, few Democrats say the issue will be the driving force behind their vote: just 5 percent of Democrats say that it will be the single most important factor in their presidential vote. A third of Democrats (34%) say it will be very important, but not the most important factor, while others say it will be one of many factors they will consider (36%) or that it won't matter at all (5%). Future polls may explore the issue in greater depth.

KFF December 2015 Tracking Poll:

http://kff.org/uninsured/poll-finding/kaiser-health-tracking-poll-december-2015/

Press Release:

http://kff.org/health-costs/press-release/few-uninsured-know-date-of-pending-deadline-for-obtaining-marketplace-coverage-many-say-they-will-get-coverage-soon-though-cost-is-a-concern/

***

Comment:
By Don McCanne, M.D.

Many political insiders contend that a single payer national health program - an improved Medicare for all - is off the table, so essentially all current political efforts are directed to paring back or modifying the Affordable Care Act - Obamacare. Bernie Sanders does not agree and has injected Medicare for all back into the political arena. So what do Americans think about Medicare for all?

This new poll shows that there has been no decline in support of Medicare for all in that 58 percent of Americans still support the concept, in spite of implementation of the Affordable Care Act. Although there is a partisan divide - 81 percent of Democrats support it and 63 percent of Republicans are opposed - it should be noted that 60 percent of independents also support the idea.

Although this poll did not identify reasons for the opinions, it is likely that many who do not support the concept are simply ideologically opposed to social solidarity, though they would likely use different labels (freedom, markets, individual responsibility, etc.). Others may be opposed because they believe the system is working for them and are concerned about the uncertainties of change.

The poll asked Democrats who support Medicare for all whether this issue might affect their vote in the 2016 presidential election. Although they report that only 5 percent of all Democrats consider it to be the most important factor in their vote, in fact most Democrats do consider it to be a factor to some degree, with only 5 percent saying that it is not important.

So now that the Affordable Care Act has been implemented, Americans still want something better. The majority of Americans, including the majority of independents, support Medicare for all. Let's work on it.


How you can help with Medicaid expansion efforts: Medicaid gap story collection

December 2, 2015

Dear Health Care Advocates,

Here is an opportunity for you to assist with the Medicaid expansion initiative over the next few months. Please let me know if you are interested:

The NC Community Health Center Association is collecting stories of people who fall in the health insurance (Medicaid) gap. They would like to take advantage of ACA enrollment events to "capture" people who've just learned from navigators that they are in the gap and collect their personal stories about not having health insurance. They need volunteers who are not assisting people with enrollment to do this. Since there probably would be only a couple of enrollment events between now and the end of enrollment (Jan. 31), it would not demand a lot of time. In advance of the events, volunteers would need to attend a training session. We are talking about scheduling the training sessions during the first week in January. Please let me know if you are interested and more details will follow.

Planned Parenthood (Emily Callen in Raleigh) is leading this effort to recruit and train volunteers and Legal Services of Southern Piedmont (Madison Hardee) is working on this too.

If you have any questions, let me know.

Thanks so much!

Karen Bean
704-596-4689


New York Times article: the title says it all: "Many say high deductibles make their health law insurance all but useless"

November 15, 2015

This article makes clear why the ACA isn't a solution to health care availability in the US.

It shows that many people can't afford to use their health insurance because they can't pay the high deductibles.

http://www.nytimes.com/2015/11/15/us/politics/many-say-high-deductibles-make-their-health-law-insurance-all-but-useless.html?_r=0

This is a case for single-payer if there ever was one (and, of course, it is just one of many).

Jessica Schorr Saxe


Guilford Panel Mon.11/16: Single Payer & Environ. w/J.Stein, J.Kotch, more

November 12, 2015

Consider attending this forum which includes Jonathan Kotch, President, of Health Care for All-NC.

It is in Greensboro on Monday evening.

If any of you are able to attend, please let me know.

Jessica Schorr Saxe


Excellent Column from News and Observer

November 10, 2015

Dear Health Care Justice--NC members and friends,

Dr. Jonathan Kotch, President of Health Care for All-NC had an excellent column in yesterday's News and Observer about the connection between the recent stories about the increase in white male deaths and the increase in insurance rates in NC (and do note the insurance commissioner's reference to Medicaid expansion)

It is aptly titled:

"White male deaths, high insurance rates and demanding the return of democracy"

http://www.newsobserver.com/opinion/op-ed/article43847655.html

Jessica Schorr Saxe


In case you thought technology was the solution to US health care woes

October 24, 2015

Here's an article about Fareed Zakaria's talk to a crowd of health care CIOs in which he explains that technology is not a magic bullet. He explains that why health care doesn't operate by usual market mechanisms and notes "The revolution that's needed here is not an information revolution, it's a political revolution."

http://www.healthcareitnews.com/news/zakaria-health-it-no-magic-bullet

Hear, hear!

Jessica Schorr Saxe


Alma Adams co-sponsors HR 676, the Medicare for All bill

September 26, 2015

Rep. Alma Adams of the 12th Congressional District has signed on as co-sponsor to HR 676, the single-payer bill.

She is the first co-sponsor from the Carolinas in this Congress.

Please contact her to thank her.

And thanks to our members who contacted her over the last several months to encourage her to sign.


Medicaid expansion as a social Justice issue: Temple Beth El Wed. Oct 7 at 5:30 PM

September 26, 2015

Join us for an event updating us on the continued need for Medicaid expansion on Oct 7 at 5:30.

This will be held at Temple Beth El, and the public is welcome.

If you know you will be coming you might RSVP to me, but RSVPs are not required.


TAKE ACTION: Medicaid expansion calls, tweets, and letters

September 22, 2015

See instructions from Moms Rising about contacting legislators to add Medicaid expansion to the Medicaid reform bill currently in the legislature.

I did both the letter and calls and they are simple and quick.

(I'm not on Twitter, but maybe you are!)

Jessica Schorr Saxe

The outreach below went out to our membership today. If you'd like to take action by sending a letter to your rep and senator through our system, click here: http://action.momsrising.org/letter/tell-nc-lawmakers-medicaid-reform-should-include-expansion-500k-uninsured-adults-nc/

ALSO! I set up call in lines for both the House and Senate (to send a text message to our members, but they can be used by anyone to call in). Feel free to push them out:

And - FINALLY - Here are some click-to-tweets for the House and Senate majority and minority leadership. Simply click the hyperlink and it will populate the Tweet for you.


September 17, 2015

Dear Health Care Justice-NC members and supporters,

Please see letter below from Robert Zarr, President of Physicians for a National Health Program.

Let me draw your attention to the following (corresponding to his numbered points)

1) the Census Bureau report. Here’s the article  about it in the Observer on-line today (probably in tomorrow's print edition): http://www.charlotteobserver.com/living/health-family/article35480226.html

The point that Zarr makes about underinsurance is critical. Consider writing a letter to the Observer to point out the shortcoming of the report. See the PNHP press release at the bottom of the email for information.

2) Note the Wall Street Journal article controversy.. I would note that you have to be a WSJ subscriber to read the original article, but the follow-up articles are interesting. The costs of single-payer health care are often exaggerated by those who don’t factor in the considerable savings.

3) Take a look at the articles on Quality Improvement on the Health Affair blog and the editorial on Pay for Performance, both by the founders of PNHP. The amount of gaming of the system and lack of real evidence for Pay for Performance are downright discouraging.

And note the invitation to attend the PNHP national meeting at the bottom of Zarr’s letter. It’s a great meeting, and I hope to go—and to see you there.

Jessica Schorr Saxe


September 16, 2015

Dear colleague,

I wanted to draw your attention to three developments, all of which lend themselves to letters to the editor or op-eds (if you are so inclined):

1. This morning the Census Bureau announced that the number of uninsured people in the U.S. dropped to 33 million in 2014, down from 42 million in 2013. In other words, there was a net gain of about 9 million people with insurance.

While any drop in the number of uninsured is to be welcomed, the remaining number of people who lack coverage – 33 million – is still intolerable. We know that lack of insurance leads to unnecessary suffering, hardship and premature death. But a comparable number of uninsured is expected to persist for another decade.

Moreover, the Census Bureau report does not address the rapidly worsening problem of underinsurance, which is deterring many millions of the insured from seeking needed care – again, with costly and tragic consequences.

It’s clear that we urgently need to move beyond our existing arrangements to a single-payer system. PNHP issued a news release on the Census Bureau’s findings, making these and other points, shortly after they were announced. See the full text of the release below.

2. On Monday the Wall Street Journal published a story with an alarming and highly misleading headline: "Price Tag of Bernie Sanders’ Proposals: $18 Trillion." Upon reading the story, it becomes clear that $15 trillion of this amount is the estimated cost of a single-payer system over a 10-year period (as calculated by economics professor Gerald Friedman at UMass, Amherst, in his economic analysis of Rep. John Conyers’ bill, H.R. 676) – without taking into account the substantial savings that such a system would yield to 95 percent of U.S. households.

Politico reports that Sen. Sanders, a longtime advocate for single-payer reform (including now as a candidate in the Democratic presidential primary), told MSNBC yesterday that the Journal had "significantly exaggerated" the costs of a single-payer program and hadn't accounted for the benefits of "eliminating the cost that you incur with private health insurance."

Sanders added: "The truth of the matter right now is that as a nation, we spend far, far more on health care per person than the people of any other nation. And yet we continue to have about 30 million people who have no health insurance, many more who are underinsured and we pay, again, by far, the highest prices in the world for prescription drugs. No question to my mind that moving toward a Medicare-for-all, single-payer program is the most cost-effective way to provide health care to all of our people."

Friedman issued his own reply to the Journal article in his “Open Letter to the Wall Street Journal on its Bernie Sanders Hit Piece” at The Huffington Post.

For the record, PNHP is nonpartisan and neither supports nor opposes any candidate for public office. But we do take an interest in campaign health reform proposals, especially when the discussion includes single payer.

3. New research: Drs. Steffie Woolhandler and David Himmelstein, co-founders of PNHP, had two articles published recently that look at the impact of Medicare’s pay-for-performance incentives.

One, titled “Quality Improvement: ‘Become Good At Cheating And You Never Need To Become Good At Anything Else,’” appeared at the Health Affairs Blog on Aug. 27. Here’s the opening paragraph of PNHP’s news release on the article:

Hospitals’ growing practice of re-labeling Medicare patient readmissions as “observation stays,” or treating returning Medicare patients in the emergency room, has allowed many hospitals to skirt Medicare’s financial penalties for poor-quality performance that were mandated by the Affordable Care Act, researchers say. However, such practices, while aiding a hospital’s bottom line, constitute a form of gaming that frequently leaves patients worse off financially.

The other, titled “Collateral Damage: Pay-for-Performance Initiatives and Safety-Net Hospitals,” appeared at Annals of Internal Medicine on Sept. 8. Again, from PNHP’s news release:

Medicare’s pay-for-performance incentives, which financially reward or punish hospitals depending on whether they hit specific numerical targets in matters such as curbing inpatient readmissions, are having the unintended side effect of taking dollars away from the nation’s historically cash-strapped safety-net hospitals and boosting the revenue of wealthier hospitals that serve an economically better-off patient base.

****

Finally, I hope you’ll be able to join me at PNHP’s Annual Meeting in Chicago on Oct. 31. If you haven’t already registered for the meeting, please do so now. If you can’t make it to Chicago, please donate to the Nicholas Skala Scholarship Fund to help medical students from around the country participate. It’s a great investment!

Cordially,

Robert Zarr, M.D., M.P.H.
President
pres.zarr@pnhp.org


FOR IMMEDIATE RELEASE
September 16, 2015

Contact: Mark Almberg, PNHP communications director, 312-782-6006, cell: 312-622-0996mark@pnhp.org

More Americans gain health coverage, but many can’t afford to use it: doctors group

Census Bureau says number of uninsured has dropped to 33 million in wake of Affordable Care Act, but is silent on problems of rising deductibles, copays, coinsurance and narrow networks that deter people from seeking care

“The Census Bureau’s official estimate that 33 million Americans lacked health insurance in 2014 reflects a significant and welcome drop from the 42 million it reported as uninsured in 2013,” said Dr. Robert Zarr, president of Physicians for a National Health Program, today. “But the number of people who remain without coverage is still intolerably high. And the Census Bureau report leaves entirely unmentioned the millions of people who have health insurance but who can’t afford to use it because of high deductibles and copays.”

“Having health insurance is better than not having coverage, as several research studies have shown,” Zarr, a Washington, D.C.-based pediatrician, continued. “For example, the 33 million people the Census Bureau says were uninsured in 2014 means that approximately 33,000 people died needlessly last year because they couldn’t get access to timely and appropriate care.” He cited a landmark study in the American Journal of Public Health showing that for every 1 million persons who are uninsured in a given year, there are about 1,000 deaths linked chiefly to that factor.

“That’s an unnecessary death every 16 minutes,” Zarr said. “That’s completely unacceptable. Moreover, the Congressional Budget Office predicts at least 27 million people will be uninsured every year for the next 10 years – so that’s tens of thousands of preventable deaths, year in and year out.

“And keep in mind that even if all the states had accepted the Medicaid expansion, about 24 million people would still be uninsured under the Affordable Care Act,” he said. “We simply can’t go on like this.”

Zarr pointed out that the problem of underinsurance – i.e. of people having skimpy policies with high deductibles, copays, and other forms of cost sharing that deter them from seeking care and that leave them vulnerable to financial distress and medical bankruptcy in the event of serious illness – is not something the Census Bureau addresses in its annual reports. But it should take this question up, he said, especially in view of how rapidly the problem is worsening.

“A recent study by the Commonwealth Fund shows that about 31 million people who have health insurance – nearly a quarter of all non-elderly adults – are underinsured, nearly double the rate in 2003,” Zarr said. “Of these, 44 percent went without a doctor’s visit, medical test, or prescription due to cost, while 51 percent had problems paying off medical bills or were paying off medical debt over time.

“The average deductible – i.e. before insurance kicks in – for families with popular silver plans in 2015 is estimated to be $6,010, and out-of-pocket costs for copayments and deductibles, after premium payments, for a family of four with an income of about $60,000 per year can be as high as $13,200,” he said. “And of course this applies to ‘in network’ services only. Out-of-network costs can go much, much higher. Such financial barriers are untenable, economically and morally.”

“In short, under the new health law we’re witnessing a dramatic acceleration of the trend of shifting more and more medical costs onto the shoulders of patients and their families, even as medical costs and premiums rise and as private health insurance companies reap record profits.

“How is it possible that in 2015 one of the richest countries in the world still does not guarantee every resident the right to health care?” Zarr continued. “This question would not be necessary if we had a health care system worthy of the name – single-payer national health insurance, or an improved and expanded Medicare for All.”

“A single-payer system would achieve truly universal care, affordability, and effective cost control. It would put the interests of our patients – and our nation’s health – first.”

Zarr continued: “Our patients, our people and our national economy cannot wait any longer for an effective remedy to our health care woes. The stakes are too high. We need to move beyond the administratively wasteful, complex and inadequate ACA to a more fundamental, comprehensive single-payer national health program for all.”

Physicians for a National Health Program (www.pnhp.org) is a nonprofit research and education organization of more than 19,000 doctors who support single-payer national health insurance.


Come to Medicaid expansion - Day of Action, July 16 12:30-1/Please RSVP if possible

July 7, 2015

Please join us for the “Where’s the Plan?” Day of Action.

WHO:  Medical professionals, impacted people, community health advocates and dozens of concerned citizens

WHAT:  Demonstration and press conference to urge Governor McCrory to present his solution to close the Medicaid gap

WHERE:  Charlotte Mecklenburg Government Center – Plaza side, 600 E. Fourth Street, Charlotte  (In the event of rain, the event will be held in the Government Center Lobby)

WHEN:  Thursday, July 16th,  12:30 to 1:00 pm (Attendees should arrive at noon.  Signs will be provided.)  

PURPOSE:
The “Where’s the Plan?” Day of Action is intended to send a clear message that the 500,000 hard-working North Carolinians in the Medicaid coverage gap can wait no longer- the Governor must act swiftly to propose a plan that includes addressing Medicaid expansion.

The Charlotte "Where's the Plan?" Day of Action event is one of six demonstrations and press conferences taking place across the state July 16th to illustrate the local impact and wide-spread public support for closing the Medicaid coverage gap. Speakers will highlight unnecessary deaths and missed opportunities for economic growth resulting from state leaders’ refusal to expand Medicaid. Local collaborators include Planned Parenthood South Atlantic, League of Women Voters – Charlotte Mecklenburg, Health Care Justice – North Carolina, ActionNC, Legal Services of Southern Piedmont, and Little Rock AME Zion Church.

Governor McCrory stated on multiple occasions that he would announce his Medicaid proposal after the King v. Burwell U.S. Supreme Court opinion which was decided in June. Advocates maintain that North Carolina can afford to wait no longer to address Medicaid expansion, citing studies indicating the Medicaid gap results in more than 1,000 deaths each year and has cost NC 43,000 jobs.

“Where’s the Plan?” Day of Action events will take place in Charlotte, Asheville, Greensboro, Raleigh, Greenville, and Fayetteville. Local activists across the state will also contact the Governor's office and take action via social media to urge Governor McCrory to show North Carolina citizens a clear plan that closes the coverage gap in our state.

Please let me know if you can attend!


June 26, 2015

Hi, Single-Payer supporters,

By now you've probably been inundated with responses to the Supreme Court decision maintaining the subsidies in King v. Burwell.

I'm sure you all agree that this was a good decision because of all the devastation that would have been wreaked by the loss of subsidies on all those who depend on them--and for those downstream who would also have been affected.

The PHNP press release is an excellent summary of the issues.

I encourage you to write a brief letter to the Charlotte Observer in response to the Supreme Court decision making the point that it's good that the subsidies were upheld but that ultimately we need a single-payer system. You will find all the points you need in the PNHP communication. You can email your letter to: opinion@charlotteobserver.com

I also encourage you to communicate this to any other media sources as well as friends, colleagues, etc.

While rejoicing in this victory, we need to move forward to a system that has true universal coverage, quality, and cost controls.

Thanks.

Jessica

PS Believe it or not, I try to limit these emails so as not to inundate you. But I have a number of other things that may interest some of you--an excellent Harpers July 2015 article about the status of the ACA (it is brutal and accurate), a recent Paul Krugman article about the legacy of slavery--and how it is seen in which states expanded Medicaid, an article by Wendell Potter about the influence of the insurance companies on the Supreme Court decision. If you want any of those, let me know at jsaxe@earthlink.net


Commentaries on Robert Reich's Medicare for all proposals

June 23, 2015

Hi, Health Care Justice--NC members and friends,

A couple of days ago I sent around a brief video by Robert Reich supporting Medicare for All and promoting an initial step of a public option of buying into Medicare in the healthcare exchanges.

Below the summary of Reich's article are commentaries by  David Himmelstein and Steffie Woolhandler (PNHP founders) and PNHP commentator Don McCanne. They discuss the risk of taking what looks like an incremental step that would lead to a single-payer system, but which might in fact cause more problems than it solves.

Jessica

Making the Economy Work for the Many and Not the Few

#11: Medicare Isn't the Problem; It's the Solution

By Robert Reich
HuffPost Politics, June 22, 2015

Again and again the upcoming election you'll hear conservatives claim that Medicare -- the health insurance program for America's seniors -- is running out of money and must be pared back.

Baloney. Medicare isn't the problem. In fact, Medicare is more efficient than private health insurance.The real problem is that the costs of health care are expected to rise steeply.

>Medicare could be the solution -- the logical next step after the Affordable Care Act toward a single-payer system.

Please see the accompanying video -- #11 in our series on ideas to make the economy work for the many rather than for the few. And please share.

Some background: Medicare faces financial problems in future years because of two underlying trends that will affect all health care in coming years, regardless of what happens to Medicare:

The first is that healthcare costs are rising overall -- not as fast as they were rising before the Affordable Care Act went into effect, but still rising too quickly.

The second is that the giant post­war baby boom is heading toward retirement and older age. Which means more elderly people will need more health care, adding to the rising costs.

>So how should we deal with these two costly trends? By making Medicare available to all Americans, not just the elderly.

Remember, Medicare is more efficient than private health insurers ­­ whose administrative costs and advertising and marketing expenses are eating up billions of dollars each year.

If more Americans were allowed to join Medicare, it could become more efficient by using its growing bargaining power to get lower drug prices, lower hospital bills, and healthier people.

Allowing all Americans to join Medicare is the best way to control future healthcare costs while also meeting the needs of the baby boomer and other Americans.

Everyone should be able to sign up for Medicare on the healthcare exchanges set up under the Affordable Care Act. This would begin to move America away from its reliance on expensive private health insurance, and toward Medicare for all - a single­ payer system.

Medicare isn't a problem. It's part of the solution.

http://www.huffingtonpost.com/robert-reich/medicare-solution-for-making-economy-work_b_7635620.html

Video: https://www.facebook.com/moveon/videos/vb.7292655492/10152825520900493/

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Public Plan Option in a Market of Private Plans

By David Himmelstein, M.D. and Steffie Woolhandler, M.D., M.P.H.
March 26, 2009

The “public plan option” won’t work to fix the health care system for two reasons.

1. It forgoes at least 84 percent of the administrative savings available through single payer. The public plan option would do nothing to streamline the administrative tasks (and costs) of hospitals, physicians offices, and nursing homes, which would still contend with multiple payers, and hence still need the complex cost tracking and billing apparatus that drives administrative costs. These unnecessary provider administrative costs account for the vast majority of bureaucratic waste. Hence, even if 95 percent of Americans who are currently privately insured were to join the public plan (and it had overhead costs at current Medicare levels), the savings on insurance overhead would amount to only 16 percent of the roughly $400 billion annually achievable through single payer — not enough to make reform affordable.

2. A quarter century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan — which started as the single payer for seniors and has now become a funding mechanism for HMOs — and a place to dump the unprofitably ill. A public plan option does not lead toward single payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan.

http://www.pnhp.org/news/2009/march/himmelstein_and_wool.php

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Comment by Don McCanne

In his enthusiastic endorsement of single payer Medicare for all, Robert Reich also renews the call for the “public option” of allowing people to purchase Medicare through the exchanges established by the Affordable Care Act. During the health care reform process, the public option had wide support, but was first weakened considerably and then eventually rejected by Congress in a power play by Sen. Joseph Lieberman.

In spite of the modest benefits of the Affordable Care Act, nothing has changed that would alter the concerns about the public option expressed by David Himmelstein and Steffie Woolhandler and others of us at PNHP.

At the time the public option was being considered, I wrote the following: “The option to purchase a public plan within a market of private health insurance plans would merely provide one more player in our inefficient, dysfunctional, fragmented, multi-payer system of financing health care, that is if the public option even survives the political process. It would leave in place the deficiencies that have resulted in very high costs with the poorest health care value of all nations (i.e., overpriced mediocrity in health care).”

Even if Medicare were offered for purchase in the exchanges, the premiums would not be competitive with the low-actuarial-value silver and bronze plans with their very high deductibles, especially since the Medicare risk pool includes higher cost elderly and disabled individuals. If Medicare were revised to make it competitive, benefits would have to be reduced when what we need instead is an improved Medicare with expanded benefits.

One possibility would be to provide subsidies for those electing the Medicare option, but either the beneficiaries’ share would still be too great, certainly making the plan non-competitive, or the public subsidies would have to be greater than those for the private low-actuarial-value insurance plans - an approach that would be vigorously opposed by the all-powerful private insurers.

Besides, it is unlikely that Congress would support higher subsidies for a public option Medicare when their agenda has been the opposite - providing higher subsidies for the private Medicare Advantage plans, sending us in the direction of a privatized Medicare.

Although Robert Reich proposes a public option version of Medicare as a way to begin moving us toward a single payer Medicare for all, it is difficult to perceive how the transition would take place. Offering an option to purchase Medicare is a very small step that leaves everything else in place. As Medicare Advantage demonstrates, one-third of beneficiaries have moved in the opposite direction - from traditional Medicare to private insurance options. That would continue as long as Congress continues to advance policies that cater to the insurers more than they do to the public.

Reich seems to be recommending a two step path to reform - one step offering the Medicare option and a second step of converting to single payer Medicare for all. Quentin Young has compared that to taking two steps to cross a chasm. That first step can lead to a serious misadventure, but it should not be a surprise.


"Medicare for All" in less than 2 minutes by Robert Reich

June 22, 2015

See Robert Reich's 2-minute video on why we need Medicare for All.

Thanks to 2 of our members for passing this on.


Administrative spending on ACA is billions above what it would have been without the ACA

May 29, 2015

This article shows new research about the excessive administrative costs of the ACA.

Between 2014 and 2022, the government projects $273.6 billion (that's about 1/4 trillion $) overhead spending above what we would have spent without the ACA--averaging out to $1,375 per newly insured person each year.

http://healthaffairs.org/blog/2015/05/27/the-post-launch-problem-the-affordable-care-acts-persistently-high-administrative-costs/

Obviously we need a system that spares us the complexity and all these administrative costs, which are mostly due to private insurance overhead.


Article from American physician who is moving to Canada

May 29, 2015

This article is interesting because the author describes how hard it has been to practice in the US and to feel she must dun her patients for their bills. She has decided to practice in Canada. Note what the article says about the number of Americans who have come there.

http://www.pnhp.org/news/2015/april/why-this-us-doctor-is-moving-to-canada


Interesting article about medical bills

May 7, 2015

This article by Elisabeth Rosenthal is from the Sunday New York Times about how hard medical bills are to decipher. It notes that one study showed that 90% of hospital bills contain errors--the link to that article is also interesting.

http://www.nytimes.com/2015/05/03/sunday-review/the-medical-bill-mystery.html

This article reflects my experience. I've made it somewhat of a hobby (though not my most fun hobby) to try to understand my family's bills. Despite being reasonably well-educated, a medical professional and now having considerable experience, I continue to get bills that are baffling.

If you look at this, be sure to read the last paragraph to get an indication about just how complicated it is to understand bills.

Jessica Schorr Saxe


Keep the need for Medicaid expansion visible: Tell Governor McCrory to Close the Coverage Gap

April 16, 2015

Thanks to Karen Bean for forwarding this from the League of Women Voters.

We need to keep the Medicaid expansion issue (AKA closing the coverage gap) in the public eye--until it's solved.

See below about contacting the governor--and note there is help with drafting a letter.

Jessica Schorr Saxe


3 short single-payer pieces

April 15, 2015

See below for an excellent article from the PNHP blog about the shortcomings of the private insurance industry and the need for single-payer health care.

And go to the following link for a letter to The State by Dr. Emilio Perez-Jorge, member of Health Care for all SC, supporting the Palmetto Comprehensive Health Care Act, a single-payer bill in the SC legislature.

http://www.thestate.com/opinion/letters-to-the-editor/article18426215.html

And see my op-ed in the April 10 Charlotte Observer about the misguided use of "skin in the game" in defense of high deductible insurance plans and other cost-sharing: http://www.charlotteobserver.com/opinion/op-ed/article17978219.html

Jessica Schorr Saxe

PNHP Blog
April 8, 2015
Why the Private Health Insurance Industry Has to Go
By John Geyman, MD

The private health insurance industry in the U.S. has had a long run since shifting to medical underwriting and a for-profit status in the early 1960s. It finds itself increasingly dependent on the government as the costs and prices of health care have continued upward since the 1980s. Its many perks from government include tax exemptions for employer-sponsored insurance (ESI), privatized Medicare and Medicaid programs, and longstanding over-payments to Medicare Advantage programs. The Affordable Care Act (ACA) has added to these perks since 2010 with subsidized premiums through the exchanges, a “risk corridor system” to protect insurers from losses, and allowing automatic self-renewal for 2015 plans.

Incremental attempts to contain health care costs and reform the system since the 1990s have built upon our current multi-payer financing system. After five years’ experience with the ACA, we now know that insurers themselves are a major barrier to achieving the kind of access to affordable care that our population so desperately needs.

Here are some of the major reasons why private health insurers warrant no further bailout by government and taxpayers.

1. Continued discrimination against the sick.

Despite the supposed consumer protections in the ACA, a 2014 letter from more than 300 patient advocacy groups to the Secretary of Health and Human Services described continuing ways that insurers still discriminate against the sick, including benefit designs that limit access, high cost-sharing, restrictive drug formularies, inadequate provider networks, and deceptive marketing practices. A recent study by Kaiser Family Foundation found that only one-third of households with incomes between 100 percent and 250 percent of poverty have enough liquid assets to pay their deductibles, while only about one-half can meet out-of-pocket limits. As other examples, Wellpoint developed an algorithm to search its database for patients with breast cancer with an intent to cancel their policies, while many insurers place all drugs used to treat such complex diseases as cancer, multiple sclerosis and HIV in the highest drug formulary cost-sharing tiers, thereby reducing insurers’ costs but making the drugs unaffordable for many patients.

2. Fragmentation, inefficiency, and exorbitant administrative overhead.

There are some 1,300 private insurers still trying to maximize their income by avoiding the costs of sicker patients. Their administrative overhead is more than five times higher than that of the single-payer program in two Canadian provinces; the overhead of private Medicare Advantage plans averages 19 percent vs. the 1.5 percent for traditional Medicare. Although the ACA set limits of 20 percent for overhead in the individual market and 15 percent in large-group markets, a recent study has found that those requirements had no effect on insurers’ overhead spending over the first three years of the ACA.

3. Increasing costs for less coverage

The ACA provided insurers with four levels of coverage—the so-called “metals”—with actuarial values (what insurers pay vs. what patients pay) ranging from 60 percent (bronze) 70 percent (silver) to 80 percent (gold) and 90 percent (platinum). Not content with those levels of coverage, the industry through its trade group, America’s Health Insurance Programs (AHIP), has been lobbying hard for copper plans with only 50 percent actuarial value. Silver plans have been the most popular on the exchanges, so that patients are left with almost one-third of their costs, plus the cost-sharing that was required to get and maintain their policies. All this has led to an epidemic of underinsurance, whether the plans are purchased through the ACA exchanges or through the private insurance markets. The ACA has made the mistake of focusing on raising the numbers of Americans with “insurance”, but has not been effective in containing prices or costs of health care, with the result that an increasing proportion of these costs are shifted to patients and families. One-half of bronze plans in seven large U.S. cities require enrollees to pay the deductible (often $5,000) before covering a doctor’s visit.

4. Gaming the ACA for profits more than service to patients

There are many examples of this, starting with Medicare Advantage. Many insurers have been cited by the Centers for Medicare & Medicaid Services (CMS) for serious violations of Medicare’s patient protection requirements, including inappropriate denial of coverage and failure to consider physicians’ clinical information. Humana, one of the largest Medicare Advantage insurers in the country, is facing scrutiny from the U.S. Department of Justice for its risk-adjustment practices, which “upcode” the severity of patients’ illnesses in order to gain increased reimbursement, even as they lobby Congress for continued high over-payments. Meanwhile, some insurers are marketing short-term plans that last less than 12 months, evading any of the ACA’s requirements.

5. Private insurance has priced itself out of the market.

Premiums keep going up at rates much higher than the cost of living, with little or no containment by regulators. As examples, MetroPlus, a popular new entrant on the New York exchange in 2014, has requested rate hikes of up to 28 percent in 2015 for some of its enrollees, while Florida Blue, the state’s largest insurer, has announced an average rate increase of 17.8 percent for 2015. One can argue that the private insurance industry should be regarded as obsolete and not worth saving. However, the ACA has extended its life, including almost $2 trillion in federal subsidies over the next ten years (if these subsidies survive a U.S. Supreme Court ruling on their legality in coming months). Insurers have focused on attracting enrollees with low premiums, high cost-sharing, and low levels of actual coverage. Large insurers such as Wellpoint (Anthem) and Humana expect to receive $5.5 billion in 2015 through the ACA’s “risk corridor” provision that protects them from “losses.”

6. As their business plan dictates, insurers are leaving unprofitable markets without regard for patients’ needs.

Private health insurers are all about making money, so they leave unprofitable markets regardless of the public’s needs. A recent example is Blue Shield of California (which just lost its state tax-exempt status with a surplus of more than $4 billion), which withdrew from 250 zip codes in California throughout the state in 2014.

Based on the above, the time has come for us to replace private health insurers with a more efficient, not-for-profit single-payer financing system—national health insurance (NHI)—which could be enacted by passage of H. R. 676, Expanded and Improved Medicare for All.

Reference:
Geyman, JP. How Obamacare Is Unsustainable: Why We Need a Single Payer Solution for All Americans. Friday Harbor, WA, Copernicus Healthcare, 2015, http://www.johngeymanmd.org

Other references are available at either link below.

PNHP Blog:
http://pnhp.org/blog/2015/04/08/why-the-private-health-insurance-industry-has-to-go/

Huffington Post (Same article):
http://www.huffingtonpost.com/john-geyman/why-the-private-health-in_b_7029594.html


Health: The Right Diagnosis and the Wrong Treatment by Marcia Angell | The New York Review of Books

April 6, 2015

Thanks to both Pat Moore and John Clark for sending this article. You may have read Steven Brill's Time magazine article "Bitter Pill" and read about his recent book about the American health care system. I agree with Marcia Angell that he got the description of our failings right--and the prescription for change completely wrong.

Jessica Schorr Saxe


Invitation to hear 2 HCJ--NC members talk about Medicaid expansion on April 15

April 5, 2015

Ann Newman and Karen Bean will be discussing the need for Medicaid expansion in NC at the League of Women Voters lunch meeting on Wed. April 15.

As you know HCJ--NC is supporting the Medicaid expansion--as we work for the more definitive solution of single-payer health care.

Invitation is below.

http://lwvcm.celebrations.com/April2015Lunch

Jessica Schorr Saxe


Information about Medicaid expansion

March 24, 2015

Ann Newman, Karen Bean and I drove to Raleigh today for Medicaid Expansion Advocacy Day. We were heartened to hear that bills have been introduced in both the House (HB 330) and Senate (SB365). While no one expects any movement on expanding Medicaid any time in the near future. speakers suggested that there has been a little bit of progress.

For more information about today's events, see:
ABC11: http://abc11.com/politics/advocates-call-for-north-carolina-to-expand-medicaid/570675/
WRAL: http://www.wral.com/advocates-plan-day-to-call-for-nc-to-expand-medicaid/14535451/

And, for more information about the impact of Medicaid expansion with a county-by-county breakdown, see: ncmedicaidexpansion.com.

Did you realize that expanded Medicaid would cover over 32,000 people and create an estimated 2400 jobs in Mecklenburg County in 2016?

Please do contact your legislators and let them know that you support Medicaid expansion. And, if you're interested in more information, let me know.

Jessica Schorr Saxe


Please come! Medicaid Expansion Advocacy Day, Tue 3/24/15

March 13, 2015

See excellent email below sent by Gary Greenberg of Health Care for All NC.

If you are available, consider coming to Raleigh to advocate for Medicaid expansion.

If you can come, let me know. And let me know if you'd like to car pool.

Health Care Justice--NC will be represented, and we will include our fliers in the information distributed.

Thanks!
Jessica Schorr Saxe


Corrected email Medicaid Expansion actions

February 10, 2015

See note below from Karen Bean, co-chair of our Legislative Committee, requesting that we write post cards to key players in the decision about expanding Medicaid.

It doesn't take long! Don't have a post card? I used a 6" x 4" plain index card and taped my typed message to it. A post card stamp is 34 cents.

And when you open the attachment, note the typo on Gov. McCrory's name.

From Karen:
The Medicaid Expansion scripts are attached for distribution. The Steering Committee agreed last night to write individual postcards to the key players involved in bringing Medicaid Expansion to the floor. Handwritten postcards may receive more attention than email.

This attachment includes:
~ 9 versions of messages asking for North Carolina to accept Medicaid Expansion funding. Select scripts and feel free to personalize and edit.
~ Addresses of Governor McCrory, Senator Phil Berger, and Representative Tim Moore
~ A link to identify your own representatives. Postcards to them would be helpful also!

Please let me know who you send postcards to as we are tracking this for “Close the Gap” grant reporting.

Thanks!
Karen (beank@bellsouth.net)


What It's Like When You're An American Using Britain's NHS

January 31, 2015

Thanks to David Caldwell for forwarding this article comparing the American health care system with Britain's from someone who has used both.

http://www.businessinsider.com/an-american-uses-britain-nhs-2015-1

This is particularly interesting because the UK has a system that is much more "socialized medicine" than many other developed countries.

Jessica


qotd: New poll on single payer and a Medicare buy-in

January 24, 2015

Thanks to Pat Moore for sending the following link to a Common Dreams article about a recent poll showing that a majority of likely voters would favor a single payer plan: http://www.commondreams.org/news/2015/01/20/single-payer-its-what-people-want

And see below for more on this poll--and Don McCanne's comments on why voluntary buy-in to a public option (which polled even higher) is not really a good option.

Jessica

From: Don McCanne
Date: Thu, Jan 22, 2015 at 4:18 PM

Progressive Change Institute
Poll of Likely 2016 Voters
Conducted by GBA Strategies, January 9-15, 2015

SINGLE PAYER HEALTHCARE VIA MEDICARE

“Enact a national health plan in which all Americans would get their insurance through an expanded, universal form of Medicare.”

51% Support
36% Oppose
12% Neutral

Percent supporting by party

79% Democrat
23% Republican
45% Independent

MEDICARE BUY-IN FOR ALL

“Give all Americans the choice of buying health insurance through Medicare or private insurers, which would provide competition for insurance companies and more options for consumers.”

71% Support
13% Oppose
14% Neutral

Percent supporting by party

77% Democrat
63% Republican
71% Independent

https://s3.amazonaws.com/s3.boldprogressives.org/images/Big_Ideas-Polling_PDF-1.pdf

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Comment by Don McCanne

This poll shows that the nation’s attitude towards single payer remains essentially unchanged. About four-fifths of Democrats support single payer, three-fifths of Republicans are opposed, and Independents remain evenly split. But what about the attitude towards the “public option” - allowing all Americans the choice of purchasing Medicare instead of private insurance?

Support for the option of a Medicare buy-in is strong across the political spectrum. What can we make of this?

The debate in Congress during the reform process was highly partisan, the public option having been defeated by the defection of just one senator - Joseph Lieberman. The support that we now see amongst Republican voters is probably genuine. The opposition of the Republican members of Congress at that time was probably more related to the decision to defeat the Affordable Care Act (ACA) regardless of any benefits in it, just to “make Obama a one-term president.”

If the Republicans in Congress can forget about their prior opposition and decide that they want to move forward with constructive policies, those who want changes in Medicare may decide that placing it in competition with private insurance plans may bring market concepts to the traditional Medicare program. They can conveniently ignore the fact that the current market experiment with private Medicare Advantage plans has been unsuccessful in providing comparable benefits at a lower cost.

The Democrats in Congress are likely to support a renewed effort to enact a public option, especially since many still regret that it was not included in ACA.

We have to keep in mind that the insurance industry was successful in changing the public option from a Medicare plan to a public plan that had most of the unfavorable features of private health plans along with restrictions on how it could compete with private plans. This was to prevent it from having an “unfair advantage” in the marketplace - by giving the private plans an unfair advantage over the public option.

During the implementation of ACA we have seen that the private insurers still control the puppet strings. Should the political environment become more favorable for a public option, we can be sure that the insurance industry will once again write the legislation, creating a flawed public option that will surely invoke the wrath of those enrolling in the program, “proving” once again the meme that “the government can’t do anything right.”

These comments bring back memories of how the reform debate was hijacked by histrionics over the public option, which played into the hands of the insurance industry. The debate should have been over single payer, but remember we were emphatically and ungraciously denied a seat at the table from very early on in the process (back when the Democratic strategists in control wanted us to sell “CHOICE” to the public - choice of private health plans - and single payer was banned from the strategy sessions).

Little attention was given to the fact that adding another option - the public option - would still leave in place our inefficient, costly and highly dysfunctional system. We would have gained virtually none of the other benefits of single payer. And that would still be true if we abandon our quest for single payer and head off towards the Medicare buy-in. We would still have an outrageously expensive system with profound administrative waste, and intolerable inequities in affordability and access.

At least more Democrats favor single payer (79%) than favor the Medicare buy-in (71%). We need to start tailoring our message to appeal to the Republicans and Independents as well.


Charlotte Observer article about Jan. 20 speaker Dr. Oliver Fein

January 12, 2015

http://www.charlotteobserver.com/2015/01/12/5442216/charlotte-speaker-touts-single.html#.VLSD6MbZjwc


What really happened to Vermont single-payer

January 11, 2015

Many of us were looking to Vermont to lead the way by having a state single-payer plan.

It was a big disappointment when Gov. Shumlin backed off from those plans a few weeks ago.

Unfortunately those plans were never truly single-payer.

See here for an explanation of what really happened by the founders of Physicians for a National Health Program--and a commentary by Don McCanne that reminds us us that all is not lost--and that we need to keep plugging away at this important issue.

Jessica Schorr Saxe

Comment by Don McCanne

The special weekend release of this commentary is designed for widespread distribution to help bring together members of the single payer community, not only within PNHP but also including all individuals and organizations that have been and will continue to be dedicated to the cause of health care justice for all.

The value of this commentary by Steffie Woolhandler and David Himmelstein is that it provides a general perspective on what actually did happen, and leaves us with a positive sendoff on the path forward.

Their description of the events that actually took place allows us to dismiss the tangle of minutiae that has not only been disruptive within the single payer camp but has also allowed the conservatives and libertarians to falsely label the single payer concept as an abject failure. Much more importantly, this commentary provides lessons that can help reunite all of us, on both the state and national levels, in our common quest for single payer reform.

Please share the commentary or the link to it with your single payer colleagues and organizations.

Onward together!


2 recent Charlotte Observer articles

December 20, 2014

Here are 2 recent Observer articles that highlight the need for a single-payer health system in more and less obvious ways.

The first article (posted Dec. 11) is the more obvious. The headline in the print version was "America awash in medical debt." It notes that almost 20% of US consumers with credit records (almost 43 million people) have medical debt. More than half of all debt comes from medical expenses.The problem is not only the amount of medical costs, but also how unexpected--and baffling--the bills are.

http://www.charlotteobserver.com/2014/12/11/5377153/429-million-americans-have-unpaid.html#.VJW0jAGIBA

These are issues that would obviously be remedied by single-payer.

The 2nd (posted Dec. 16) "Rush is on to get in to see doctors" describes the end-of-the year rush for people to get doctor's appointments-- e.g.,if they have met their 2014 deductible and want to get in before they start a new deductible countdown or if they have money left in flexible spending accounts. And many will not be able to get appointments and will lose money.

http://www.charlotteobserver.com/2014/12/16/5388823/year-end-rush-on-doctors-offices.html#.VJW2jAGIBA

While this may not be quite as obvious, this is also an argument for single-payer. Why should there be a mad rush for health care at the end of the calendar year due to quirks of insurance coverage? What if we were all just covered continuously?

Now that's something to look forward to.

Watch for our Jan. 20 event with Dr. Oliver Fein.

Thanks to those of you who have contributed to HCJ--NC--and those who plan to.

Have a happy holiday season!
Jessica Schorr Saxe


Please help us in our work: please read

December 6, 2014

Many thanks for your support and for all you have done for the single-payer issue, educating yourselves, attending our events, reading materials, and, most importantly, discussing this issue with your friends, families and acquaintances.

We are in the process of bringing to you events, and speakers for the coming year 2015. Mark your calendars for a national speaker coming Tuesday evening January 20!

We are a volunteer organization with a hard-working steering committee as well as other active members. As you know there are expenses associated with our work.

As you consider your end-of-year contributions, please make a donation to assist us to continue our work in advocating for and educating the public about single-payer health care.

You may donate at our website http://pnhphcinc.org or mail a check to:
Health Care Justice--NC
PO Box 32384
Charlotte, NC 28204.

Also, you are encouraged to become a member of the national organization, Physicians for a National Health Program. Membership fees are:
Physicians in active practice $120.00
Residents, retired and low income physicians $40.00
Non-physicians $40.00
You may access their website at: http://www.pnhp.org.

And consider volunteering your time and talents to Health Care Justice--NC.

Wishing you a Happy Holiday Season.

Jessica Schorr Saxe and the HCJ-NC Steering Committee


Is anyone available to speak in favor of Medicaid expansion in Raleigh on Wed Dec 10 U.N.

December 6, 2014

See below: the approach to this is that NC is in violation of UN Article 25 - Health Care for All.

If you can go, you can contact Will Cox directly.

Do let me know if you're going.

Jessica Schorr Saxe

NC Legislature's Refusal to Expand Medicaid Violates the Basic Human Rights of 500,000 People

We are asking for physicians, healthcare advocates and human rights advocates who are willing to speak at an upcoming press conference on the North Carolina Legislature's refusal to expand Medicaid. Participants are encouraged to address the impact of this decision and the right of all individuals to have equitable access to high-quality health care, which should be provided as a public service.

What: Press conference to address North Carolina's violation of Article 25 of the U.N. Declaration on Human Rights
Where: The press room of the North Carolina General Assembly in Raleigh, NC
When: Wednesday, December 10th at 10:00am

To commemorate Human Rights Day on December 10 when the UN General Assembly ratified the Universal Declaration of Human Rights in 1948, we propose holding a brief press conference at the North Carolina General Assembly to change the conversation about the seriousness of the North Carolina government’s outrageous decision not to expand Medicaid. At the press conference, NC Senator Earline Parmon and others will demand the expansion of Medicaid and stress the importance of providing every North Carolinian with greater access to health care. We would also like to have supporters sign the Medicaid Expansion Resolution that was drawn up by Health Care for All NC.

The North Carolina General Assembly's refusal to expand Medicaid could result in the deaths of 1,000 to 2,800 North Carolinians because of inadequate access to health care. Over 1 million people remain without health insurance in the state, including between 300,000 to 500,000 individuals who would be eligible if Medicaid were expanded. The refusal to expand Medicaid constitutes a violation of Article 25 of the United Nation's Universal Declaration of Human Rights which states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services..."

For further information contact Will Cox.


NY Times article on the important problem of underinsurance--and why the ACA isn't solving everything

Much of the discussion about the ACA focuses on the issue of insured vs. uninsured and skirts the issue of the underinsured.

In fact, underinsurance is a serious problem which may actually be increasing.

Read about it in this excellent NY Times article.


Wonderful (and brief) article about what medicine is--or should be--all about

December 3, 2014

I usually confine these mailings to communications that are explicitly about single-payer (or urgent access issues such as Medicaid expansion).

This beautifully written 1-page article in JAMA (and written by Dr. Daaleman from the family medicine department at UNC) talks about the need to restore mercy as a foundation for our practice. I am sending it just because I think it is so important.

And, if you read carefully, you will see that some of the barriers to mercy--such as "administrative waterboarding" (an apt phrase) and emphasis on "production-based activities"-- are obstacles that would be improved if we had a single-payer, nonprofit-dirven health care system.

Enjoy reading it.


Please look at sign, circulate petition to expand Medicaid in NC

November 3, 2014

Please look at this petition to expand Medicaid in NC which is being circulated by our friends at Health Care for All NC.

I hope that you will sign. Note the faith-based emphasis. I hope that you will circulate it in your congregations--and respond if your congregation would like a presentation on the Medicaid expansion.

The Petition to Expand Medicaid in North Carolina


And to anyone who could go to Raleigh on Monday: Medicaid Expansion Rally w/NAACP, Raleigh, this Mon 10/20

October 18, 2014

This comes from Health Care for All NC, our sister organization.

If anyone can attend, please do!

It looks like it will be a powerful event.


Mecklenburg County Expand Medicaid Vigil: tomorrow Sat. Oct 18

October 17, 2014

Joel Segal, one of our partners in working for the Medicaid expansion, sends this about a vigil for the Medicaid expansion to be held in Charlotte tomorrow.

This is part of a national movemnt.

Dear Friends:

Greetings!

Just got this from PDA. MOVEON is sponsoring a national Medicaid expansion vigil tomorrow, Saturday, October 18, 7:00pm, Charlotte City County Building, 600 East 4th Street.

Please send this email to all of your friends, colleagues, and family members. There is already national press regarding the “death count vigil."

Best,
Joel


Please read this about high-deductible health plans

October 14, 2014

You will read much about how many people are moving to high-deductible health plans, either to take advantage of lower premiums or because that is all that is offered them. The theory is supposed to be that this will be a motivator to spend more wisely on their health care.

Please see here--and note that these plans affect both access and financial well-being.

Jessica Schorr Saxe


Invitation to press conference TOMORROW Oct 7 at 11: ACA Medicaid Expansion And Universal Health Care Press Conference

October 6, 2014

We invite you to this press conference that we are co-sponsoring in support of the Medicaid expansion and single-payer health care.

Ann Newman will speak for Health Care Justice--NC.

Feel free to let me know if you have plans to attend.


Ed Weisbart Grand Rounds and NY Times article about the ACA

August 4, 2014

Last Thursday evening we had a very successful Standing Room Only talk by Dr. Ed Weisbart. Thanks to those of you who attended. For those of you who couldn't (or who want to hear more), here is a Grand Rounds he did last November: http://www.pnhpmo.org/friendship-grand-rounds.php (And I'm trying to get a presentation with more current information but have not yet been able to access it.)

And yesterday's NY Times had an article about the implementation of the Affordable Care Act. I send the link with Don McCanne's commentary below. I think he is quite right that the problem is not people's ability to understand the ACA and the policies that are available, the problem is that complexity is part of its design (and, as far as I can tell, it's impossible for mortals to understand).

My prediction is that we will hear a lot about the euphoria of people who are finally insured--and that, before too long, much of that euphoria will be replaced by distress,as people discover they cannot afford their co-pays or deductibles and that the doctors they want to see are not in their networks. Etc.

The New York Times
August 2, 2014
Newly Insured, Many Now Face Learning Curve
By Abby Goodnough

Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly.

The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage.

Many people who signed up for private coverage through the new marketplaces had never had health insurance, and even the basics — like what a premium is and why getting a primary care doctor is better than relying on the emergency room — are beyond their experience. Others have a sense of how insurance works but find the details of the marketplace plans confusing, especially if they signed up without the help of someone who understood them.

Insurers, too, are trying to help ease their new members’ confusion. Independence Blue Cross, which enrolled 165,000 people in its marketplace plans, has representatives traveling the Philadelphia region this summer in a tractor-trailer, the Independence Express, and offering educational seminars. Independence also has tried to reach all of the new members by phone to welcome them and “make sure they understand what they bought,” said Paula Sunshine, the company’s vice president of consumer sales and marketing.

The company knew going in that the learning curve would be steep. It held focus groups last year with nearly 2,000 people and found, for example, that virtually none knew what coinsurance was.

In one sign of widespread confusion, a recent Kaiser Family Foundation survey of programs that helped people apply for marketplace coverage found that 90 percent had already been re-contacted by consumers with post-enrollment questions.

http://www.nytimes.com/2014/08/03/us/newly-insured-by-health-law-millions-face-a-learning-curve.html

****

Comment by Don McCanne

If health care reform had worked the way it should have, today anyone could get the health care that he or she needed without having to worry about how to pay for it. What are we seeing instead? Just trying to enroll in health care coverage has been a very difficult process for many, and tens of millions will still remain uninsured. And today’s article shows how problematic the next step is - trying to put your coverage to use.

Some of the problems have already been widely publicized. Newer plans, especially those in the exchanges, have low actuarial values (i.e., very high deductibles and other excessive cost sharing). Cost sharing can make care unaffordable for those with modest incomes. Plans are now using narrow- and ultra-narrow networks of hospitals and health care professionals which limit patients’ choices in their health care, often preventing access to the most appropriate physicians and hospitals. We are now seeing tiered levels of specialized services and pharmaceuticals in which patients are financially penalized if they use specialists or drugs in the higher, more expensive tiers even if they are clearly preferred for medical reasons. The penalty is assessed by the insurers strictly to dissuade patients from using more expensive care even though it may be better care. Patients are also having difficulties determining not only whether specific providers are in or out of their networks, but also which tier they are in and what that means. Furthermore, the provider enrollment in these networks is quite unstable, not to mention the instability that arises when the patient must change plans and therefore change networks. This says nothing about the problems patients face when they try to get an appointment and find that there are no openings, or find that the distances are too far - directly due to the insurance innovation that promises a higher volume of patients to fewer physicians so that insurers can get greater discounts, even though overloading their practices. The list goes on and on with administrative excesses that are designed to enhance the business performance of the insurance products at a cost to the patients that they should be serving.

It should not have been this way. A single payer national health program would have automatically enrolled everyone; it would have included all providers, and it would have been financed through equitable taxes, making it affordable for everyone.

Although this New York Times article presents the problem as a need to teach individuals the complexities of using these newer insurance products, the problem is actually the complexities themselves and the tremendous injustices that ensue.

The remainder of this comment is composed of more excerpts from the NYT article. The experience of Salwa Shabazz should enrage us and drive us to demand health care justice for all. Her case shows us the compelling need for comprehensive structural reform of our health care financing system.

The following are excerpts from the NYT article (link above):

Last week, Salwa Shabazz arrived at the office of a public health network here with a bag full of paperwork about her new health insurance — and an unhappy look on her face. She had chosen her plan by phone in March, speaking to a customer service representative at the federal insurance marketplace. Now she had problems and questions, so many questions.

“I’ve had one doctor appointment since I got this insurance, and I had to pay $60,” Ms. Shabazz told Daniel Flynn, a counselor with the health network, the Health Federation of Philadelphia. “I don’t have $60.”

Mr. Flynn spent almost two hours going over her Independence Blue Cross plan, which he explained had a “very complicated” network that grouped doctors and hospitals into three tiers. Ms. Shabazz, who has epilepsy, had not understood when she chose the plan that her doctors were in the most expensive tier.

“None of that was explained when I signed up,” she said. “This is the first I’m hearing it.”

Independence Blue Cross has focused on making sure people understand the tiered-network plan that Ms. Shabazz chose, which was popular because of its relatively low price but also particularly hard to understand. Ms. Shabazz, 38, paid only about $32 a month in premiums, with federal subsidies of $218 covering the rest. But she could not afford the $60 co-payments to see her specialists on her annual income of $19,000.

Her financial situation worsened when she had to quit her job at the Pennsylvania Liquor Control Board in June because of the epilepsy, she said. She had called the federal marketplace to report her change in income, and had received a letter that she handed to Mr. Flynn, hoping he could explain it. The news, he said, was not good: With no more paychecks, she had fallen into the so-called coverage gap, earning too little to keep qualifying for the subsidies that made her premiums affordable, but likely still not qualifying for Medicaid because Pennsylvania has not expanded that program, as 26 states have under the Affordable Care Act.

“You’ll probably have to cancel your plan,” he said.

Ms. Shabazz’s mother, Waheedah Shabazz-El, who had accompanied her to the appointment, shook her head as her daughter wiped away tears. “There are so many layers to this,” Ms. Shabazz-El said.

Closing comment by Don McCanne: We are not powerless. Let’s demand single payer, and not let up until we get it.


Charlotte Observer article about our speaker

July 24, 2014

Here's the on-line version of the article about Dr. Ed Weisbart which will be in tomorrow's paper: http://www.charlotteobserver.com/2014/07/28/5071943/missouri-doctor-in-charlotte-to.html#.U9bJ-vldVTI

Pass this on to your friends--and note the information about location and time of Dr. Weisbart's talk on Thursday and how to RSVP (if you haven't already).


Waiting Times for medical care--are they really better in the US?

July 8, 2014

Americans often say that one of the benefits of our system is not waiting for medical care.

But is it true that we don't wait as long as people in other countries?

See this excellent NY Times article by Elisabeth Rosenthal which refers to a recent study by the Commonwealth Fund that compares wait times in different countries: http://www.nytimes.com/2014/07/06/sunday-review/long-waits-for-doctors-appointments-have-become-the-norm.html


Death of a giant in the single-payer--and medical--world

June 22, 2014

Dr. Arnold Relman, a longtime editor of the New England Journal of Medicine, researcher, clinician, and man of many accomplishments died recently on his 91st birthday. He was a major advocate for single-payer medicine--just one of the many ways in which he was a visionary. He persisted in writing about it and advocating for it, long after most people would have retired to the golf course. In fact, he was at the PNHP national meeting last fall, speaking eloquently on the need for a single-payer system.

This NY Times obituary describes his remarkable career.


See excellent blog entry by Joseph Sparks on PHNP website

May 28, 2014

Joseph Sparks, who is the brother of Harry Sparks, a Health Care Justice--NC member and volunteer, wrote a blog post that was picked up by PNHP.

It has a very clear message about single-payer, which you might want to read to share with friends and colleagues.

The entry can be found here on the PNHP site.


On Medicine and Money

May 3, 2014

I've had discussions with many of you about the relationship between medicine and money (and how money drives so many decisions about medicine).

See below for a thoughtful commentary on that issue that appeared in JAMA.

It was inspired by the publicity given to "Medicare millionaires" that followed a report by CMS--and that the author points out that the issue of medicine and money is much broader and deeper.

Be sure you read through to his conclusion.

JAMA Forum
April 30, 2014
On Medicine and Money
By Eli Y. Adashi, MD, MS

As might have been anticipated, much of the media coverage of the release of the CMS data focused attention on health care professionals dubbed “Medicare millionaires” and their practice patterns. Tantalizing as such details might be, more profound issues were being sidestepped. In particular, little has been said with respect to the uncomfortable relationship between medicine and money.

This is an unfortunate state of affairs, because the ethical and moral challenges associated with the juxtaposition of medicine and money are highly deserving of our attention.

Many see the pairing of money and medicine as a nonissue, and instead view it as capitalism at its best, with medicine being just another market in which competition reigns supreme. For proponents of this point of view, health care professionals might be seen as operatives in a retail business, wherein the volume of sales (of health services) carries the day, creating a vibrant health care market that sparks the scientific innovations upon which we have all come to depend. They see the business model of medicine as no different than that of any other field of pursuit, naturally rooted in foundational libertarian principles. Viewed in this light, the intersection of medicine and money is as American as apple pie. Exemplified by the time-honored “private practice” of medicine, this all-out embrace of the business principles of a market economy remains undiminished—if increasingly untenable.

But there’s a potential flaw in this line of reasoning: the presumption of a fail-safe firewall between financial considerations and clinical decision making. Sadly, that may not always be the case.

Clearly, opinions vary widely as to the ethical and moral wisdom of mixing medicine with money. Some would favor a lightly regulated, self-policing field, wherein unfettered entrepreneurship and Medicare millionaires are bound to thrive. According to this outlook, infractions perpetrated by a select few do not warrant the imposition of blanket, heavy-handed oversight.

But those who consider medicine and money to constitute a volatile mix may express preference for another model, such as a national health care system buttressed by a single governmental payer, in which value rather than volume of services determine provider compensation. Under this system, Medicare millionaires are unlikely to flourish.

http://newsatjama.jama.com/2014/04/30/jama-forum-on-medicine-and-money/


Article on health care spending and the limits of Obamacare

April 24, 2014

This article from the New York Times discusses how the Affordable Care Act will not control costs--and how various experts predict that we will continue to see an increase in spending and % of GDP that we spend on health care.

In the article, it talks about various approaches--but isn't explicit about the elephant in the room--the amount of money that we needlessly spend on insurance companies and administrative costs.

Even if you don't read the whole article, read the conclusion.

http://www.nytimes.com/2014/04/23/business/economy/forecasting-the-scale-of-health-spendings-climb.html?_r=0


Watch This Doctor Totally School An Anti-Obamacare Senator On Health Care

March 16, 2014

Thanks to those of you who told me that my last email didn't have a link for the exchange between Sen. Burr and Dr. Danielle Martin, VP of the Women's College Hospital in Toronto.

If, for some reason, the link doesn't send, you can go to the Huffington Post website and search "Richard Burr" and it will come right up.

http://www.huffingtonpost.com/2014/03/13/danielle-martin-richard-burr_n_4958164.html


Excellent short article: The ACA and America's Health-Care Mess | Dollars & Sense

January 26, 2014

This article was written by Gerald Friedman who spoke here last May.

It's a great summary of the ACA (achievements and short-comings) vs. single-payer.

Note the graph about the expense of ACA vs single-payer.

http://dollarsandsense.org/archives/2014/0114friedman.html


Save the date

January 19, 2014

On February 13th we are planning to show a short documentary on the Canadian health care system and hold a panel discussion on single payer. Look out for an evite coming your way soon.


Moral March and Medicaid article

January 18, 2014

There is an important Moral March in Raleigh on Sat, Feb. 8. See message below. I'd like to know whether any of you plan to go--and whether anyone is going as a health professional and/or would be willing to represent Health Care Justice--NC.

Also, I have attached an excellent editorial about Medicaid from the American Journal of Public Health sent by David Keely, President of Health Care for All SC. It counters the arguments that anti-Medicaid expansion people are using about the Oregon Medicaid "experiment" which they are saying showed no benefit. It's a little wonky but worth reading.

Dave participated in South Carolina's Truthful Tuesday rally: http://www.truthfultuesday.net/