Single payer links of the day

By Don McCanne, M.D

H.R. 2 passed in the House today by a vote of 392 to 37. It goes to the Senate where it will be voted on tomorrow. But is this really about the “doc fix” – eliminating SGR? Speaker of the House John Boehner clarifies that for us. It’s about entitlement reform and H.R. 2 begins that process.

Entitlement reform…

Entitlement reform is kleptocracy speak for take money from workers.

North Adams, Massachusetts: North County Cares Coalition to Hold Day of Action for Restoration of a Full Service Hospital

Despite High Rates of Nursing Injuries, Government Regulators Take Little Action

What Happened in Vermont: Implications of the Pullback from Single Payer

Better health care for Vermont

There are two bills currently winding their way through our Legislature, however, which will go a long way toward correcting this problem and attaining the goals called for in Act 48. These are H.207 and S.88. They propose to create a system of publicly funded access to primary care for all Vermonters, cutting back on the excessive expense of people utilizing emergency rooms as their doctors because barriers like lack of health insurance or insanely high deductibles shut them out of primary care. Unimpeded access to primary care is ethically, financially, morally and absolutely essential.

Higher Medicare costs planned for some seniors in 2018

Senators reject push to restore Medicaid funding

Single payer links of the day

Proposed SGR deal would advance GOP goal of privatizing Medicare

Senator Ben Sasse of Nebraska: House Should Reject Medicare Change

Stop-gap Medicare ‘doc-fix’ will cost seniors

Maine State Nurses Association/National Nurses Organizing Testimony in Support of LD 815, “An Act to Establish a Single-Payer Health Care System.”

Pushing to help health profiteers

MONTPELIER — Lawmakers are considering a scaled-back health care bill that strips out a proposed payroll tax.

Medicare for all could replace Obamacare

Time to Demand Medicare for All and Social Security Benefits We Can Live On!

Via Naked Capitalism: California has a Medi-Cal “estate recovery plan” [KQED]. That’s when ObamaCare forces you into Medicaid, tells you it’s free, and it turns out it’s a lien against your estate. Boy, will your kids be surprised!

Healthcare debate at Georgetown University

Free to public, but RSVP is necessary.
Note – If taking public transportation, the D6 bus is your best bet. Consult Metro Trip Planner for your best route.
Georgetown – Debate: “Be It Resolved: Affordable, quality healthcare develops from maximizing freedom of choice – not government programs or mandates.”

WHEN: March 27, 2015 @ 6:00 pm – 8:00 pm
WHERE: Georgetown U. School of Medicine – New Research Building Auditorium
Georgetown University
3900 Reservoir Road Northwest, Washington, DC 20007
COST: Free, but RSVPs requested.
There is a parking garage located under the Leavey Center accessible from Reservoir Road, or there is the Southwest Parking garage accessible from Canal Road.

Debate Venue Details:

Date: Friday, March 27, 2015

Time: [Eastern] 6:00 PM Reception with soft drinks and hors d’oeuvres; Registration and initial voting
6:30 Debate Begins
7:45 Debate Ends. Final voting, tally.
8:00 Announcement of results.

Place: Georgetown University School of Medicine
Room — New Research Building Auditorium
3900 Reservoir Road Northwest,Washington, DC 20007
Moderator: Michael Ramlet (Morning Consult)

Arguing the Affirmative:
Dr. Josh Umbehr MD (AtlasMD)
Dr. Lee Gross, MD (Epiphany Health, Inc.)
Arguing in Opposition:
Dr. Dennis McIntyre, MD
Dr. Adriane Fugh-Berman, MD

Obamacare and small business

Small businesses struggle with health care law

The Affordable Care Act, which as of next Jan. 1 applies to all companies with 50 or more workers, requires owners to track staffers’ hours, absences and how much they spend on health insurance. Many small businesses don’t have the human resources departments or computer systems that large companies have, making it harder to handle the paperwork. On average, complying with the law costs small businesses more than $15,000 a year, according to a survey released a year ago by the National Small Business Association.

It does not have to be this way. If DC had a single payer system everyone would pay a healthcare tax, similar to the Medicare payroll tax, and we would all be covered. Because the system would be universal it would be far cheaper than Obamacare.

Under Obamacare states, including DC, can opt to have their own single payer system. This would divert thousands of dollars that currently goes to health insurance companies, and redirect it to the local economy. It would be a HUGE economic boon.

If you want to help me so this, send a note to

Single payer links of the day

A new poll shows that more than half of Americans — including 80 percent of Democrats and a quarter of Republicans — support expanding health reform to “Medicare for All.”

Private medicare advantage plans stole $12 billion in “improper payments” in 2014

50% of those who purchased insurance in exchange will owe repayment–average is $794.

Republicans attack social compact with HR 1470

How Obama’s Plan to Control Health-Care Costs Could Fail; Medicare is betting on new payment models. The early results are thin

DaVita pulled into federal investigation over Humana’s Medicare Advantage risk adjustment practices

Via Kay Tillow

Dr. Robert Zarr prescribes exercise

To Make Children Healthier, A Doctor Prescribes A Trip To The Park

About 40 percent of Zarr’s young patients are overweight or obese, which has led the doctor to come up with ways to give them very specific recommendations for physical activity. And that has meant mapping out all of the parks in the District of Columbia — 380 parks so far.

The parks, mapped and rated based on facilities and in a searchable database by zip code, can be linked to patients’ electronic medical records. Zarr did it with help from the National Park Service and volunteers from George Washington University’s School of Public Health, park rangers and other doctors. Zarr also received some funding for the project from the National Recreation and Park Association, the National Environmental Education Foundation, and the American Academy of Pediatrics.

Dr. Michael Greger should take a look at this as he is always encouraging physicians to prescribe exercise. This shows what is involved. If you want compliance it is not enough to tell your patients to take excercise, you must lay out a practical plan as to how they could do that.

Zarr is the head of the DC Chapter of Physicians for a National Health Plan.

Single payer links of the day

D’Oh! D.C. Health Link allows its Web domain to expire

Adam Hudson, a spokesman for D.C. Health Link, confirmed Wednesday the domain was accidentally allowed to expire.
“The domain name comes up for an annual renewal, and did expire briefly yesterday,” Hudson said. “Once this happened, our IT team took quick action and resolved the issue in a matter of minutes. We have taken immediate steps to ensure that the renewal process is handled smoothly every year going forward.”

Geyman takes on Obamacare, touts single-payer system in latest book

In his newly published book, “How Obamacare is Unsustainable,” Geyman contends the three primary goals of the Affordable Care Act’s three primary goals—affordability, near-universal coverage and improved quality of care—are not being met and that a single-payer healthcare system is the best solution for all Americans, and for reform of U.S. health care.

Assemblyman Richard Gottfried is leading the effort to establish a single payer system in New York state.

Under Health Care Act, Many Tax Filers Are Discovering Costly Complications

Via Naked Capitalism: A $6.6 Million CEO Dreams of a “Doctor-Less” Future Health Care Renewal. More lunatic triumphalism from over-paid CEOs.

More from Naked Capitalism: Obamacare Is Spurring Startups and Creating Jobs Bloomberg. Startups to manage ObamaCare’s useless and artificially created complexity because markets.

EMERGENCY! The MIPS stake is plunging into the heart of traditional Medicare

The excerpts from H.R. 1470, above, reveal how the government intends to fulfill its goal of supposedly converting Medicare from a system that pays based on volume to a system that is based on value. Since the excerpts represent only a small sampling of this bill, it would be wise to download the full bill. You can gain a better understanding of the bill by skimming through the 158 pages, reading only the lines in full capital letters, while reading in full any section that piques your interest. It takes just a few minutes. That’s too much? Remember, this bill is about to become law and we will have to live with it perhaps for decades (the scorned SGR has been with us for 18 years).

One ominous clause in the bill is Sec. 2(e)(6) on page 101 of the GPO version. It calls for a study of “the feasibility of integrating alternative payment models in the Medicare Advantage payment system.” That is code language to clarify that these onerous requirements of MIPS apply only to the traditional Medicare program and not to the private Medicare Advantage plans. Why is that important?

NNU and Reclaim Chicago’s Mayoral Endorsement – Signal of New Political Movement

In accepting the endorsement today of Reclaim Chicago, Garcia compared the new independent political organization to the grassroots workers’ movement that powered Washington’s Rainbow Coalition to a surprising 1983 victory over the city’s infamous Democratic machine, led for decades by Mayor Richard “Boss” Daley.

Health insurance company stock dumping

The health insuracne companies know that their days are numbered. They know that they have a doomed business model. Proof of this is contained in their SEC filings of insider trades. The senior management of these companies have been dumping their stock for decades.

In the past six months insiders at AETNA have dumped 20,221 shares of stock. Insiders at UnitedHealth Group dumped 136,200 shares. Insiders at Cigna dumped 265,494 shares. Insiders at Humana dumped 8,621 shares. These are not the actions of management that believes in their business model. These are the actions of management that knows that their days are numbered and are simply squeezing the last dime out of their companies.

They know they have a doomed business model, why don’t the rest of us?

Under Obamacare states, which includes DC, can set up their own single payer systems. I intend to organzie a movement to bring single payer to DC. If you would like to help with this, send me a note at

Health care links of the day

Wes Rivers of the DC Fiscal Policy Institute thinks that DC Health Link is working well. Personally I found it impossibly confusing. At least one navigator agrees.

Over at PHNP Dr. McCanne informs that Blue Shield of California has lost its tax exmppt status.

NY Assembly member Richard Gottfried is working to bring a single payer system to NY State. You can follow him on Twitter.

Canadians like their single payer system.

The Affordable Care Act has not reduced insurers’ administrative waste

Sutter Santa Rosa Nurses Vote to Approve Possible Strike

Kay Tillow tells us that the ACA did not end discrimination against those with pre-existing conditions.

Announcing the campaign to bring a single payer healthcare system to DC

After much thought I have decided to shutter my PR business to establish a campaign to bring a single payer healthcare system to the District of Columbia. Obamacare allows for states, which would include DC, to establish their own single payer systems, if they so desire. It would be by far the most sensible thing for DC to do.

For freelancers such as myself it would offer complete health security for far less than what we now pay in health insuracne premiums. For small business if would offer lower healthcare costs and the chance to compete with the largest employers for the best talent, as paying for healthcare would no longer be a factor. For the city it would drastically lower costs as the pool of payers would be universal and we would only be paying for actual healthcare, not health insurace executives. Most of our healthcare money is eaten up in administrative costs, less than half of it goes to actual health care.

What I visualize is a true single payer system, free at the point of service, no copays. The health tax, which would be based on income, would cover everything. That means the healthy adult of 25 would wind up subsizing the health care of the 60 year old heart patient.

This is the system in Canada, here is how it works:

The province does charge a small monthly premium (ours is $108/month for a family of four) for the basic coverage. However, most people never even have to write that check: almost all employers pick up the tab for their employees’ premiums as part of the standard benefits package; and the province covers it for people on public assistance or disability.

“The basics” covered by this plan include 100% of all doctor’s fees, ambulance fares, tests, and everything that happens in a hospital — in other words, the really big-ticket items that routinely drive American families into bankruptcy. In BC, it doesn’t include “extras” like medical equipment, prescriptions, physical therapy or chiropractic care, dental, vision, and so on; and if you want a private or semi-private room with TV and phone, that costs extra (about what you’d pay for a room in a middling hotel). That other stuff does add up; but it’s far easier to afford if you’re not having to cover the big expenses, too. Furthermore: you can deduct any out-of-pocket health expenses you do have to pay off your income taxes. And, as every American knows by now, drugs aren’t nearly as expensive here, either.

Filling the gap between the basics and the extras is the job of the country’s remaining private health insurers. Since they’re off the hook for the ruinously expensive big-ticket items that can put their own profits at risk, the insurance companies make a tidy business out of offering inexpensive policies that cover all those smaller, more predictable expenses. Top-quality add-on policies typically run in the ballpark of $75 per person in a family per month — about $300 for a family of four — if you’re stuck buying an individual plan. Group plans are cheap enough that even small employers can afford to offer them as a routine benefit. An average working Canadian with employer-paid basic care and supplemental insurance gets free coverage equal to the best policies now only offered at a few of America’s largest corporations. And that employer is probably only paying a couple hundred dollars a month to provide that benefit.

You read that correctly, in Canada a family of four pays $108/month in health tax for inclusive coverage. No out-of-network doctors, no drugs that are off the list of covered drugs, complete coverage for $108 a month. That is what we could have if we cut out the health insurace parasites.

Currently the DC government pays a company like Kaiser Permanente $4,847 a month with the DC worker paying an additional $1,171 a month. Imagine if DC could pay $108 per month per employee and get more complete coverage. In 2003 PNHP estimated that DC would save 1.2 billion with a single payer system.

Why haven’t we done this already? Because the health insurace companies in our country have enormous power and becase we give up without trying. Our biggest opponents are the ones in our head.

So I have decided to lead the effort to bring single payer to DC. I will be blogging here until I am able to set up an organization with its own website. If you want to help with this effort, contact me at