To listen to our next program on February 16, click on the picture at left which will take you to WCAN’s web site. Once there, click the icon captioned “Click Here to Listen.” (The web site offers help should you encounter any problems.)  Deb's guest will be Dave Steil, businessman and President of Health Care 4 All PA, speaking on the effects of the current health care system on business, what single-payer could do for business, and how to convince your legislator. During the show you can call 1-800-921-2204 with your questions or comments or email them to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

By Ralph Nader, CounterPunch

03 February 12

Looking at millions of individual bills that makeup the 2.7 trillion dollars of annual health care costs opens a gigantic window on the massive waste, redundancy, profiteering, fraud and sometimes criminal over-billing.

Here is a partial example of what I mean, in the words of Philip M. Boffey, the estimable science writer for the New York Times:

“Why does an appendectomy in Germany cost roughly a quarter what it costs in the United States? ($3,285 compared to $13,123). Or an MRI scan cost less than a third as much, on average, in Canada? ($304 compared to $1,009).

“Americans continue to spend more on health care than patients anywhere else. In 2009, we spent $7,960 per person, twice as much as France, which is known for providing very good health services. And for all that spending, we get very mixed results—some superb, some average, some inferior—compared with other advanced nations.”

Moreover, France and Germany, Italy, England, Canada, Belgium, Sweden and all other western countries plus Japan and Taiwan cover almost all their citizens, unlike the U.S. where 50,000,000 people are uninsured.

Boffey, who wrote a book on the National Academy of Sciences, (The Brain Bank of America: An Inquiry into the Politics of Science), under our sponsorship in 1975 goes on to cite the comparative price report of the International Federation of Health Plans in 2010. They are stunning! For Britain, Canada, France, Germany and the U.S. respectively, the average cost in dollars for bypass surgery is $13,998, $22,212,

Boffey adds other explanatory factors. These include higher administrative costs to deal with insurance paperwork, higher insurance company profits and executive compensation and less developed electronic health records leading to costly errors.

Except for Germany there are somewhat longer waiting times for some patients to see a specialist in these countries. But in the U.S. seeing specialists is often prohibitively expensive, and if you cannot afford such services, that is the longest waiting time of all.

A recent commentary in the Mayo Clinic Proceedings last August by Charles. W. Slack and Warner V. Slack, MD suggests another compelling comparison—between outcomes in different states in the U.S. They ask “why, for example, do Mississippi, Louisiana, and Georgia have such a high rate of mortality amenable to health care when compared with Idaho, Oregon and Washington.” Wide differences between states and counties have been documented regarding the cost of identical operations, frequency of operations such as cesarean sections or hysterectomies and other surgical disparities studied under controlled variables.

Health care bills come with hefty levels of fraud. From the historic study twenty years ago by the then General Accounting Office of the Congress to the present estimates by the nation’s leading expert in this field, Professor Malcolm Sparrow at Harvard University, fully ten percent of all health care expenditures are the result of computerized billing fraud and abuse. That will be $270 billion this year.

Dr. Sparrow, an applied mathematician, says it could be higher if the federal government would simply do a more detailed study. He adds that the enforcement budget should be one percent of the estimable volume of fraud. In actual practice, the enforcement budget is less than one/tenth of one percent, even though every dollar of enforcement brings in at least seventeen dollars back. (See Dr. Sparrow’s website:http://www.hks.harvard.edu/fs/msparrow/ )

Obviously the corporate fraud lobby is stronger than the taxpayer/consumer lobby in Washington, D.C. But why the health insurance companies, a formidable force in their own right when it comes to protecting its turf against single payer or full Medicare insurance (see singlepayeraction.org) do not do more to stop fraudulent billing practices, is a puzzle.

All in all, the health care industry is replete with rackets that neither honest practitioners or regulators find worrisome enough to effectively challenge. The perverse economic incentives in this industry range from third party payments to third party procedures. Add paid-off members of Congress who starve enforcement budgets and the enormous profits that comes from that tired triad “waste, fraud and abuse” and you have a massive problem needing a massive solution.

So, voters, why not start challenging all candidates for elective office to make this vast daily heist a front burner campaign issue.

January 31, 2012

Dear Friends,

Most of you have likely heard the disappointing news that our bill, SB 810, the California Universal Health Care Act, failed to move off the Senate Floor by January 31st, meaning it cannot advance further in the legislative process this year. Despite our unwavering advocacy, too few members were willing to cast votes in favor of SB 810 this year, including several members who had voted for the legislation before.  Unfortunately this means that Californians will continue to have a broken health care system in dire need of change, but that is not for lack of effort.

I want to thank and recognize the valiant efforts of the many groups and individuals who worked so hard to make our universal health care bill a reality.  First, the California School Employees Association and California Nurses Association led lobbying efforts on behalf of SB 810 all year.  Also, Campaign for a Healthy California, Health Care for All, California Physicians for a National Health Plan, California One Care, Single Payer Now, California Alliance for Retired Americans, California Health Professional Student Alliance, League of Women Voters and many other groups organized their members to advocate on behalf of the bill.

Finally, thousands of individual advocates made phone calls, attended meetings, marched and held signs at rallies, and sent letters, faxes and emails in favor of SB 810. Together, these efforts sent a strong message to legislators that the single-payer health care movement is here to stay.  I thank all of these passionate supporters from the bottom of my heart. 

The single-payer movement is based on a long-term vision and strategy. This setback does not change our work to advocate for universal health care. We have always found the courage to speak out for health care for all, even when others around us told us it was not the right time. Ultimately, the powerful interests that favor doing nothing to repair our health care system can only be overcome by courage and determination – something our movement has in abundance.

I encourage you to continue building support for universal health care at the grass roots level within your communities. Reach out to your co-workers, neighbors, friends, and family members about why their elected officials should vote for Medicare for All. Help build our case to the governor, other elected officials and those who are currently seeking office so that they know the people of California support single-payer legislation.

As the author of SB 810, I share your deep commitment to this cause, this movement, and the people behind it. We will not stop fighting until we have comprehensive health care for every Californian.

Sincerely,

Senator Mark Leno

Posted 1/23/12 

The journey I embarked on when I made the decision to leave a successful career in the health insurance business was a spiritual one. I can trace the decision to a true epiphany, to the very moment I saw hundreds of people standing, soaking wet, in long, slow-moving lines, waiting to get medical care that was being provided in animal stalls at a fairground in Wise County, Virginia.

It hit me immediately that had my circumstances been a little different when I was growing up near there, I could have been one of those people. It also hit me that the work I was doing as a spokesman for the insurance industry was making it necessary, at least in part, for those people to resort to such humiliation to get basic medical care. One of my responsibilities was to persuade Americans of the lie that most of the uninsured are that way by choice, that they have shirked their responsibility to themselves and their families. Nothing could have been further from the truth. Our so-called health care "system" had simply left them behind.

I cannot tell you why I felt compelled to drive from my parents home in Kingsport, Tennessee to Wise County -- a distance of about 50 miles -- on that late July day in 2007. What I can tell you is that stretch of U.S. Highway 23 turned out to be my Road to Damascus. For the past few years, I have been dedicated to spreading the truth about how health insurance companies really operate in this country.

Last year my new career attracted the notice of Matthew Heineman, a documentary filmmaker in New York. He and his team interviewed me for a movie, Escape Fire, that premiered Friday at the 2012 Sundance Film Festival here in Park City. I have not seen anything that better captures just how dysfunctional our system really is and how urgent it is for us to transform it.

I was invited to the premier and to be part of a town hall-type discussion with others who were interviewed for the film, including famed cardiologist Dr. Dean Ornish and Dr. Don Berwick, who served until recently as head of the U.S. Center for Medicare and Medicaid Services.

As fate would have it, I am staying in a hotel with a magnificent view of one of Park City's most famous ski slopes. Had I been here just a few days earlier, I very possibly might have witnessed a tragedy that sent shock waves through the sports world.

While training on that halfpipe slope, Canadian freestyle skier Sarah Burke suffered a torn vertebral artery in her neck that caused bleeding in her brain, an injury that she would die from last Thursday, the day my family and I checked into the hotel. Just 29, Burke was considered a top-flight "acrobat-on-skis," and a medal contender at the 2014 Winter Olympics in Russia.

Instead, her family will be laying her to rest in her native Canada -- and pleading for money to help cover the estimated $550,000 they owe for the medical care she received at University of Utah Hospital over nine days.

The irony is that had the accident occurred in Canada, her family would not be having to come up with more than half a million dollars to pay for her care. Her care would have been covered because, unlike the U.S., Canada has a system of universal coverage.

An estimated 700,000 American families file for bankruptcy every year because of medical debt. No one in Canada finds themselves in that predicament, nor do they face losing their homes as many Americans do when they become critically ill or suffer an injury.

One of the things my colleagues in the insurance industry tried to get Americans to believe was that Canadians flock to the U.S. to get medical care they cannot get in their own country. That is a myth. Yes, some Canadians come to the U.S. for treatment, but not in large numbers. In fact, polls in Canada consistently show high levels of satisfaction among citizens with their country's single-payer system.

I probably would not have known about a fundraising effort that has been started by Burke's friends had my wife not come across a tweet about it Friday morning. I haven't been able to find anything about it so far in any media here in Utah. There was a report about her accident on the morning news, but no mention of the fundraiser.

I did find information about it in the Toronto Star, which quoted family members as saying they were "moved by the sincere and heartfelt sympathy" expressed by supporters worldwide. It is clear the family needs help. Not only are they grieving, they are facing financial ruin, simply because Sarah Burke's accident was in the United States of America.

I'm certain I would not have known anything about this had I not been interviewed for Escape Fire last year, or invited to come to Park City and stay at a hotel with a window overlooking the last slope Sarah Burke would ever ski. My spiritual journey continues.

by Roger Bybee

With a raft of new Charles Dickens biographies hitting bookstores this fall, it is difficult not to quote the classic chronicler of the Victorian era's polarities when describing the state of America's healthcare system: "It was the best of times, it was the worst of times.”

The good times are concentrated among corporate executives. Healthcare, insurance and drug company CEOs have actually managed to displace bankers as the best-rewarded bosses in America. The Guardian archly reported recenty: "Pity Wall Street's bankers. Once the highest-paid bosses in the land, they are now also-rans. The real money is in healthcare and drugs, according to the latest survey of executive pay."

Among the big winners in healthcare listed by the UK-based newspaper:

• John Hammergren, chief executive of McKesson Corporation, a pharmaceutical distribution corporation, took home a breathtaking $145,266,971 in 2010.
• Joel Gemunder, outgoing president of Omnicare, a pharmacy company that dispenses drugs in nursing homes, benefited handsomely from s 2010 total pay package worth $98,283,242.
• “CVS Caremark, which operates 7,000 pharmacies across the US, awarded chief executive Thomas Ryan $68,079,823 in 2010.
• Ronald Williams, boss of health insurance giant Aetna, made $57,787,786 in 2010.

But for America’s healthcare consumers, the bad times got worse. Despite the slow-moving implementation of the 2010 Patient Protection and Affordable Care Act (PPACA), the system’s vital signs indicated critical condition:

• 53 million Americans are now uninsured, up from 34 million in 1990.
• As many as 82,000 Americans die annually due to a lack of access to healthcare, according to a new Commonwealth Fund study that roughly doubles the previous estimate.
• 62% of personal bankruptcies are accounted for by an unaffordable stack of medical bills brought on by a family members’ health crisis.

Sweeping cuts in Medicaid by U.S. governors threaten to throw more people, including children, into icy uninsured waters. For example, Wisconsin Gov. Scott Walker is aiming to slice Medicaid rolls by 65,000, including 30,000 children.

Healthcare insurance has become so expensive that Americans have cut back on their visits to doctor’s offices by 17 percent, even as a growing share of Americans admit that they have skipped needed medical care because high-cost, high-deductible plans continue to proliferate.

But even with the implementation of state-level healthcare exchanges under the PPACA (aka, “Obamacare”), don’t expect much improvement except in curbing the most egregious abuses of insurers, warns Dr. Don McCanne, senior health policy fellow of the Physicians for a National Healthcare Programs.

Once the exchanges are in place in 2014, moderate-income Americans are certain to find themselves ensnarled in fights with the IRS over the proper level of subsidies they need to pay for a level of healthcare insurance that many doctors consider “skimpy."

Until the point where the inadequacy of PPACAA’s coverage becomes clear and Americans grow infuriated over fighting to pay for inadequate coverage., we seem destined for several more years of "unaffordable under-insurance," as McCanne told In These Times earlier this month. When frustration over the new status quo boils over, Americans will be ready to have a serious debate about the single-payer "Medicare for all” plan that replaces for-profit insurers.

Street Speech, The Voice from the Streets of Columbus, Dec 2-15, 2011
The New Homeless, by Eileen Hiltbrand, Street Speech vendor

Before I became homeless my vision of the homeless was that of a scraggly man with a bottle of cheap booze wrapped in a paper bag, begging for spare change and sleeping under a bridge. Oh how experiences can change one's perspective.

I am homeless. I have a college degree in business and in which I graduated Summa Cum Laude from the Ohio State University. I also have a Doctorate in which I graduated Cum Laude. You wouldn't picture me as "one of those homeless people." Yet I am.

There are many of me out here. We sell these papers to keep a roof over our heads, provide the basics that we all need on a daily basis, or to pay our medical needs and co-pays. That's not to say that some of us aren't those "scraggly men" who live under a bridge. Please don't assume, however, that the image of the "scraggly man" represents the whole of us.

Each of us are unique and different as to what brought us into homelessness. In my case, I developed heart problems/failures in March of 2005. Six weeks later, I woke up from a coma owing $1.2 million for healthcare. Thereafter, I lost my house and subsequently a condo that I rented. Although I had health insurance my entire life, United Health Care denied my claims and I was too sick, and they were too big for me to fight. Ergo, I found myself homeless.

I won't go into details about the basements, carports, etc. into which I crawled to find a warm place to sleep. Needless to say, those of us who are homeless are not all derelicts, drunks, or crack-heads.

Let me just say thank-you for purchasing our papers when you see us standing out on these street corners. I can only speak for myself but it means the world and my life to me. Thank you.

About Street Speech

Street Speech is a monthly social justice newspaper, published by the Columbus Coalition for the Homeless since March 2008. Street Speech serves as a voice for the most vulnerable in our community by publishing articles and creative writing by currently and formerly homeless individuals and by educating the community about the issues facing homeless persons in Columbus