Official estimates by the Census Bureau showing an increase of about 1 million in the number of Americans without health insurance in 2010 – to a 35-year high of 49.9 million persons, or 16.3 percent of the population, under the bureau’s revised calculation method – underscore the urgency of going beyond the Obama administration’s federal health law and swiftly implementing a single-payer, improved Medicare-for-all program, spokespersons for Physicians for a National Health Program said today.
"Tragically, we know that the new figures of uninsured mean a preventable annual death toll of about 50,000 people -- that's about one death every 10 minutes," said Dr. Garrett Adams, president of PNHP, a nationwide organization of 18,000 physicians. (photo: Joe Newman / Public Citizen) Employment-based coverage continued to decline. The bureau said 55.3 percent of Americans were covered by employment-based plans in 2010, down from 56.1 percent in 2009. It was the eleventh consecutive year of decline, from 64.2 percent in 2000.
In Massachusetts, whose 2006 health reform is widely viewed as the model for the federal health law, 370,000 people remained uninsured in 2010, representing 5.6 percent of the population, a jump from 4.3 percent who were uninsured in 2009.
Some states posted greater than a 3-percentage-point to 5-percentage-point increase in their uninsured rate, namely Idaho, Louisiana, Mississippi, Montana and South Carolina. In terms of absolute numbers, Louisiana had the largest increase in the number of uninsured, 240,700, followed by New York (177,700) and South Carolina (173,300). (See link to table of historical state-based data below.)
Among various population groups, the greatest loss of coverage was among working-age adults between the ages of 35 and 64, people with incomes below $49,999, and people with disabilities. Hispanics continue to disproportionately face uninsurance (30.7 percent), compared with blacks (20.8 percent), Asians (18.1 percent) and non-Hispanic whites (11.7 percent).
About 7.3 million children remain uninsured, the bureau said. Young people between the ages of 19 to 25 had a drop of 1.6 percentage points in their uninsurance rate, a figure the Census Bureau suggests is linked to the federal health law’s provision that allows dependent children to be covered under a parent’s health plan.
Lack of health insurance is known to have deadly consequences. A 2009 study in the American Journal of Public Health showed that 45,000 deaths annually can be linked to lack of coverage. Along the same lines, studies have shown that uninsured people with chronic illnesses like heart disease often delay or forgo care, often leading to serious complications of their medical condition and, in some cases, premature death.
"Tragically, we know that the new figures of uninsured mean a preventable annual death toll of about 50,000 people -- that's about one death every 10 minutes," said Dr. Garrett Adams, president of PNHP, a nationwide organization of 18,000 physicians.
The Louisville, Ky.-based physician said that even if the administration's new health law works as planned, the Congressional Budget Office estimates 23 million people will remain uninsured in 2019.
Adams was in Washington today, testifying before a subcommittee of the Senate Health, Education, Labor and Pensions Committee on the topic, “Is poverty a death sentence?”
Significantly, the Census Bureau said the number of people living in poverty, 46.2 million, is the largest number recorded in the 52 years such estimates have been published.
The increase in the uninsured would have been significantly higher had it not been for an increase in the number of people covered by government health programs such as Medicare, Medicaid, and military health care. Some in Congress have urged substantial cuts to such programs, particularly Medicare and Medicaid. If implemented, such cuts would almost certainly increase the uninsured rate in years ahead.
"The only remedy for this persistent problem is to insure everyone," Dr. Adams said. "And the only way to insure everyone at a reasonable cost is to enact single-payer national health insurance, an improved Medicare for all. Single payer would streamline bureaucracy, saving $400 billion a year on administrative overhead, enough to pay for all the uninsured and to upgrade everyone else's coverage. The new system’s bargaining clout would also help rein in rising costs."
Dr. Steffie Woolhandler, professor at the City University of New York School of Public Health and visiting professor of medicine at Harvard Medical School, noted that the Census Bureau was once again silent on the pervasive problem of "underinsurance."
"Not having health insurance, or having poor quality insurance that doesn't protect you from financial hardship in the face of medical need, is a source of mounting stress, personal bankruptcy and poor medical outcomes," Woolhandler said.
Referring to the Affordable Care Act, she said, “The new law’s subsidies for health insurance will not be sufficient to provide quality and affordable coverage to the vast majority of Americans. Tens of millions will remain uninsured, underinsured and without access to care. We need more fundamental reform. We need a single-payer national health insurance program."
FOR IMMEDIATE RELEASE:
3:00 PM Sept. 26, 2011
SPAN OHIO OPPOSES OHIO BALLOT ISSUE #3
Amendment to the Ohio Constitution
Single Payer Action Network Ohio is opposed to amending the Ohio constitution as stipulated in ballot issue 3 slated for the November ballot.
First there are serious fundamental legal contradictions within issue 3 that call into question the validity of states to attempt nullification of federal statutes in this way. Second, the idea that Ohio would amend its constitution to preclude the citizens of this state from enacting legislation through democratically elected representatives is antithetical to the freedoms we value as a self governing society. In addition, state laws already enacted with respect to health care access whether through workers compensation or state administered federal safety net programs, could be harmed dramatically by this vaguely written and poorly informed restrictive covenant.
Lastly, in spite of the passage of federal legislation to regulate and expand health insurance access, much more action is needed to secure the access to necessary care that enables the exercise of individual freedom. Tying the hands of state representatives with an amendment to the Ohio Constitution that says in effect “the state may not act” is inherently undemocratic and restricts the democratic freedoms of Ohio citizens.
Vote NO on Ohio Ballot Issue #3
Contact: Kurt Bateman, Director
The Healthcare Movie, a documentary film narrated by Keifer Sutherland, will be shown across the state wherever we can gather a group. The film deals with the ways in which the U.S. and Canadian healthcare systems diverged over the past half century and how cultural perceptions can be changed to improve the provision of care. So organize a potluck at a space in your community where the film can be played from DVD and projected with an adequate audio system. The film runs about one hour and discussion will follow. In addition, there will be an opportunity to participate in the Healthcare Human Rights Collaboration picture petition and obtain copies of the official Healthcare for All Ohioans Act petitions for circulation. To preview a trailer for the movie go to: http://www.healthcaremovie.net/. Contact SPAN State Director Kurt Bateman to schedule your screening today! Phone 614-562-1066 or email firstname.lastname@example.org.
FOR IMMEDIATE RELEASE:
Single-Payer Action Network Ohio Disappointed But Undeterred by Passage of State Issue 3
Columbus, Ohio – November 15, 2011 - On Tuesday November 8, 2011 Ohio voters approved Issue 3, the so-called health care freedom amendment to the Ohio constitution.
Single Payer Action Network Ohio (SPAN Ohio) was disappointed by the passage of Issue 3 but will not be deterred from our goal of comprehensive lifetime health care for all. Our educational and public policy organizing efforts continue unabated.
Issue 3 was aimed at the Patient Protection and Affordable Care Act (PPACA) passed by Congress in 2010 but is expected to negatively affect many health care programs in Ohio as was made clear by the almost universal condemnation of the proposal by newspaper editorial boards across the political spectrum.
Issue 3’s impact on the provision of health care in Ohio will be determined in large part by the outcome of constitutional challenges to federal health care reform now moving through the courts. The US Supreme Court will ultimately decide the issue.
Regardless of their decision, SPAN Ohio will continue its efforts to educate the state legislature and the public at large on the need for a single-payer health care system as the most efficient means of providing every Ohioan with what is a basic human necessity.
Kurt Bateman, Director
Single Payer Action Network Ohio
New York Times - June 12, 2011
By PAUL KRUGMAN
Every once in a while a politician comes up with an idea that’s so bad, so wrongheaded, that you’re almost grateful. For really bad ideas can help illustrate the extent to which policy discourse has gone off the rails.
And so it was with Senator Joseph Lieberman’s proposal, released last week, to raise the age for Medicare eligibility from 65 to 67.
Like Republicans who want to end Medicare as we know it and replace it with (grossly inadequate) insurance vouchers, Mr. Lieberman describes his proposal as a way to save Medicare. It wouldn’t actually do that. But more to the point, our goal shouldn’t be to “save Medicare,” whatever that means. It should be to ensure that Americans get the health care they need, at a cost the nation can afford.
And here’s what you need to know: Medicare actually saves money — a lot of money — compared with relying on private insurance companies. And this in turn means that pushing people out of Medicare, in addition to depriving many Americans of needed care, would almost surely end up increasing total health care costs.
The idea of Medicare as a money-saving program may seem hard to grasp. After all, hasn’t Medicare spending risen dramatically over time? Yes, it has: adjusting for overall inflation, Medicare spending per beneficiary rose more than 400 percent from 1969 to 2009.
But inflation-adjusted premiums on private health insurance rose more than 700 percent over the same period. So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse. And if we deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get private insurance — if they can — that will cost much more than it would have cost to provide the same coverage through Medicare.
By the way, we have direct evidence about the higher costs of private insurance via the Medicare Advantage program, which allows Medicare beneficiaries to get their coverage through the private sector. This was supposed to save money; in fact, the program costs taxpayers substantially more per beneficiary than traditional Medicare.
And then there’s the international evidence. The United States has the most privatized health care system in the advanced world; it also has, by far, the most expensive care, without gaining any clear advantage in quality for all that spending. Health is one area in which the public sector consistently does a better job than the private sector at controlling costs.
Indeed, as the economist (and former Reagan adviser) Bruce Bartlett points out, high U.S. private spending on health care, compared with spending in other advanced countries, just about wipes out any benefit we might receive from our relatively low tax burden. So where’s the gain from pushing seniors out of an admittedly expensive system, Medicare, into even more expensive private health insurance?
Wait, it gets worse. Not every 65- or 66-year-old denied Medicare would be able to get private coverage — in fact, many would find themselves uninsured. So what would these seniors do?
Well, as the health economists Austin Frakt and Aaron Carroll document, right now Americans in their early 60s without health insurance routinely delay needed care, only to become very expensive Medicare recipients once they reach 65. This pattern would be even stronger and more destructive if Medicare eligibility were delayed. As a result, Mr. Frakt and Mr. Carroll suggest, Medicare spending might actually go up, not down, under Mr. Lieberman’s proposal.
O.K., the obvious question: If Medicare is so much better than private insurance, why didn’t the Affordable Care Act simply extend Medicare to cover everyone? The answer, of course, was interest-group politics: realistically, given the insurance industry’s power, Medicare for all wasn’t going to pass, so advocates of universal coverage, myself included, were willing to settle for half a loaf. But the fact that it seemed politically necessary to accept a second-best solution for younger Americans is no reason to start dismantling the superior system we already have for those 65 and over.
Now, none of what I have said should be taken as a reason to be complacent about rising health care costs. Both Medicare and private insurance will be unsustainable unless there are major cost-control efforts — the kinds of efforts that are actually in the Affordable Care Act, and which Republicans demagogued with cries of “death panels.”
The point, however, is that privatizing health insurance for seniors, which is what Mr. Lieberman is in effect proposing — and which is the essence of the G.O.P. plan — hurts rather than helps the cause of cost control. If we really want to hold down costs, we should be seeking to offer Medicare-type programs to as many Americans as possible.
Published on Friday, December 23, 2011 by In These Times
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.
New York Times, July 24, 2011
By PAUL KRUGMAN
At the time of writing, President Obama’s hoped-for “Grand Bargain” with Republicans is apparently dead. And I say good riddance. I’m no more eager than other rational people (a category that fails to include many Congressional Republicans) to see what happens if the debt limit isn’t raised. But what the president was offering to the G.O.P., especially on Medicare, was a very bad deal for America.
Specifically, according to many reports, the president offered both means-testing of Medicare benefits and a rise in the age of Medicare eligibility. The first would be bad policy; the second would be terrible policy. And it would almost surely be terrible politics, too.
The crucial thing to remember, when we talk about Medicare, is that our goal isn’t, or at least shouldn’t be, defined in terms of some arbitrary number. Our goal should be, instead, to give Americans the health care they need at a price the country can afford. And throwing Americans in their mid-60s off Medicare moves us away from that goal, not toward it.
For Medicare, with all its flaws, works better than private insurance. It has less bureaucracy and, hence, lower administrative costs than private insurers. It has been more successful in controlling costs. While Medicare expenses per beneficiary have soared over the past 40 years, they’ve risen significantly less than private insurance premiums. And since Medicare-type systems in other advanced countries have much lower costs than the uniquely privatized U.S. system, there’s good reason to believe that Medicare reform can do a lot to control costs in the future.
In that case, you may ask, why didn’t the 2010 health care reform simply extend Medicare to cover everyone? The answer, of course, is political realism. Most health reformers I know would have supported Medicare for all if they had considered it politically feasible. But given the power of the insurance lobby and the knee-jerk opposition of many politicians to any expansion of government, they settled for what they thought they could actually get: near-universal coverage through a system of regulation and subsidies.
It is, however, one thing to accept a second-best system insuring those who currently lack coverage. Throwing millions of Americans off Medicare and pushing them into the arms of private insurers is another story.
Also, did I mention that Republicans are doing all they can to undermine health care reform — they even tried to undermine it as part of the debt negotiations — and may eventually succeed? If they do, many of those losing Medicare coverage would find themselves unable to replace it.
So raising the Medicare age is a terrible idea. Means-testing — reducing benefits for wealthier Americans — isn’t equally bad, but it’s still poor policy.
It’s true that Medicare expenses could be reduced by requiring high-income Americans to pay higher premiums, higher co-payments, etc. But why not simply raise taxes on high incomes instead? This would have the great virtue of not adding another layer of bureaucracy by requiring that Medicare establish financial status before paying medical bills.
But, you may say, raising taxes would reduce incentives to work and create wealth. Well, so would means-testing: As conservative economists love to point out in other contexts — for example, when criticizing programs like food stamps — benefits that fall as your income rises in effect raise your marginal tax rate. It doesn’t matter whether the government raises your taxes by $1,000 when your income rises or cuts your benefits by the same amount; either way, it reduces the fraction of your additional earnings that you get to keep.
So what’s the difference between means-testing Medicare and raising taxes? Well, the truly rich would prefer means-testing, since they would end up sacrificing no more than the merely well-off. But everyone else should prefer a tax-based solution.
So why is the president embracing these bad policy ideas? In a forthcoming article in The New York Review of Books, the veteran journalist Elizabeth Drew suggests that members of the White House political team saw the 2010 election as a referendum on government spending and that they believe that cutting spending is the way to win next year.
If so, I would respectfully suggest that they are out of their minds. Remember death panels? The G.O.P.’s most potent political weapon last year — the weapon that caused a large swing in the votes of older Americans — was the claim that Mr. Obama was cutting Medicare. Why give Republicans a chance to do it all over again?
Of course, it’s possible that the reason the president is offering to undermine Medicare is that he genuinely believes that this would be a good idea. And that possibility, I have to say, is what really scares me.
By the St. Louis Dispatch Editorial Board | Posted: Wednesday, August 10, 2011 12:00 am
If America truly is serious about dealing with its deficit problems, there's a fairly simple solution. But you're probably not going to like it: Enact a single-payer health care plan.
See, we told you weren't going to like it.
But the fact is that everyone who has studied the deficit problem has agreed that it's actually a health care problem — more specifically, the cost of providing Medicare benefits to an aging and longer-living population. The bipartisan National Commission on Fiscal Responsibility and Reform reported last December: "The Congressional Budget Office (CBO) projects if we continue on our current course, deficits will remain high throughout the rest of this decade and beyond, and debt will spiral ever higher, reaching 90 percent of GDP in 2020.
"Over the long run, as the baby boomers retire and health care costs continue to grow, the situation will become far worse. By 2025 revenue will be able to finance only interest payments, Medicare, Medicaid, and Social Security. Every other federal government activity — from national defense and homeland security to transportation and energy — will have to be paid for with borrowed money."
That being the case — and nobody argues that it isn't — there are two broad ways for the government to address its spiraling health care costs. One, shift more of those costs to recipients, by trimming benefits and/or extending eligibility ages and indexing eligibility to personal income. This is politically unpalatable, particularly to most Democrats, President Barack Obama being a conspicuous exception.
The second way for government to address its health costs is not to shift them, but to reduce them. This is what a single-payer health care system would do, largely by taking the for-profit players (insurance companies for the most part) out of the loop.
The advocacy group Physicians for a National Health Program estimates that "private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for all Americans."
Once everyone is covered, the government would have the clout to bring discipline into the wild west of health care spending. It could insist that providers be paid for quality of service, not quantity. Health facilities and equipment could be managed by regional boards. Medical services could be "bundled" — rather than paying hospitals and doctors and laboratories separately, there would be fixed prices for treatments. And so on.
The Patient Protection and Affordable Care Act passed in 2009 contains many pilot programs designed to test cost-reduction strategies. Most of them won't kick in for another six to eight years, by which time health care costs will be approaching 20 percent of U.S. gross domestic product. The combined state and federal share of that will be 49 percent, up from 45 percent today.
Indeed, a study published this month in the journal Health Affairs estimates that while the Affordable Care Act will pay for itself by 2020, it won't actually "bend the cost curve," as the Obama administration had hoped. But the study, done by the Actuary Centers for Medicare and Medicaid Services, says the ACA will significantly slow the rise of health care costs to state and local governments.
But consider those two findings: In effect, they say that if reducing overall health care costs is the goal, then the ACA didn't go far enough. Thirty million more people will be insured and government costs will grow more slowly. But overall health care costs will continue to explode.
Sooner or later, a nation serious about controlling spending must take broad control of the health care system.
It surely won't be sooner. Compared to the political fight that would erupt over a single-payer plan, the congressional battle over the Affordable Care Act would seem as tame as resolution praising mom, the flag and apple pie.
The ACA was a compromise. Mr. Obama brought everyone to the table — doctors, insurance companies, drug companies, hospitals — and came away with a "best we can get" kind of bill. Many of those at the table turned around and lobbied against it or sought special favors once the bill came before Congress.
It passed by narrow margins, and Congress is decidedly more conservative now. Indeed, the new House majority has voted to repeal the ACA and challenges to its constitutionality continue to work their way toward the Supreme Court.
But now, like a baby discovering its toes, Congress has discovered the deficit. And the plain fact is that unless you want to commit political suicide and cut Medicare to the bone — as Rep. Paul Ryan's, R-Wis., budget plan would do — the best way to seriously address long-term deficits is to get control of health care costs through a single-payer plan.
In 2008, when health care costs amounted to "only" 16 percent of U.S. gross domestic product, Great Britain was spending 8.7 percent of its GDP on health care, and Canada was spending 10.4 percent. Both nations have single-payer plans. Quality of care scores in both nations are at least comparable, and in most cases, better.
Eventually, the United States will have a single-payer plan. But we'll waste a lot of money and time getting there.
Rep. Hayes, I write you this open letter in response to your Circleville Herald column of 10 August “Health Care Close to Home”. I sincerely invite you to spend a shift or two with me in the emergency department to see and feel face to face the desperation of the tens of thousands of down-home Ohioans without access to healthcare. These are not slackers or persons who just wish to freeload on your tax dollars, they are our neighbors and friends, the barber who cuts your hair, the server who waits on you, the clerk in the that large store. Often they are working two jobs trying to make ends meet, while cutting back on their own medicines to save for kid’s school supplies. Come and feel the pain of real persons suffering and dying in your district having been abandoned by profitable insurance companies, whose profit margins are at record levels (“Health Insurers Make Record Profits as Many Postpone Care” New York Times 14 May 2011).
Like you, I too have problems with the Patient Protection and Affordable Care Act (PPACA), called “Obamacare” by detractors when “Romneycare” is in fact more accurate, as the PPACA is modeled after Massachusetts healthcare reform signed by Republican governor Mitt Romney in 2006. I have problems with the PPACA not because of your concern that it is a government program controlled by inaccessible far-away elected representatives, but because it keeps in place private health insurance companies controlled by even more inaccessible, often dishonest, and even farther away corporate boardrooms that I can’t even un-elect.
Dishonest a strong word? The Associated Press article of 27 July “Insurers Allegedly Provided Inaccurate Medical-Loss Ratios” notes several Florida insurance companies took advantage of lax oversight under Governor Rick Scott, falsely claiming they spent funds on children’s Medicaid when in fact they pocketed the cash. Florida Governor Rick Scott, a tea party favorite, presided as CEO of the Hospital Corporation of America/Columbia Healthcare when his company was fined one of the largest penalties ever levied by the federal government for insurance fraud. Rep. Hayes, your column implies that the PPACA removes local choices that “are best handled by the people closest to home who know the situation best.” Ask your constituents how much honest close-to-home help they received from their health insurance company.
Rep. Hayes, Ohioans health is at risk not because of too much government, but too little. We the people have failed to demand that our elected representatives appropriately oversee and regulate Wall Street traded health insurance giants that increase their bottom line by not keeping their word on the promise they offer: financial security in the face of illness. Wendell Potter, former Cigna public relations officer turned whistleblower and author of “Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR is Killing Health Care and Deceiving Americans” warns “One of the secrets to achieving these [record profits] is what the insurers euphemistically call ‘medical management’. That often translates into denied claims and denied coverage for doctor-ordered care. The fewer claims they pay and the more procedures they refuse to pay for, the more money is left over for investors to put in their pockets… … It’s to the insurer’s advantage for it to be complicated and confusing and hard to deal with insurance companies. They profit as a result of the confusion.” Private for-profit health insurance companies, these are the real death panels.
Rep. Hayes, for the sake of all Ohioans I urge you to support HB 287 the “Ohio Health Security Act” introduced by Reps. Bob Hagan and Mike Foley. HB 287 would move Ohio closer to a single payer model, shown throughout the industrialized world to be the most cost-effective and compassionate. Vermont has just passed single payer—no one in Vermont will die for lack of health insurance. The prestigious New England Journal of Medicine, September 2009, published “Health Insurance and Mortality in U.S. Adults” estimating that 45,000 Americans die yearly from lack of health insurance; this does not include those who die as a result of denied claims. Some of these deaths are your constituents.
Rep. Hayes, until we reach single payer you can save the lives of many Ohioans by reining in the worst of health insurance company abuses by supporting the PPACA. Under these reforms no Ohioan can be denied insurance for pre-existing conditions, no neighbor of ours will find their insurance taken away when their care threatens company profits. Arbitrary denials of claims by insurers will, for the first time, be subject to appeal, as will premium increases. Insurers will be forced to spend at least 80-85% of all premiums collected on direct patient care. Under the Patient Protection and Affordable Care Act more Ohioans will live, certainly the best “down home” neighborly gift we can give.
Brad Cotton, member Physicians for a National Health Program
Published: Thursday, November 10, 2011, 5:15 AM Updated: Thursday, November 10, 2011, 8:02 AM
"In the short term, not a lot," said Matt Albers, a health care lawyer with the Cleveland office of Vorys, Sater, Seymour and Pease who has studied the amendment but did not take a position during the debate on the issue.
Supporters of Issue 3 cheered it as a repudiation of President Barack Obama's health care policy.
But experts like Albers agree that the issue will have no impact on the legal tussle in federal courts over the new federal health care law, although it will prevent Ohio from enacting its own Massachusetts-style law.
Beyond that, there's plenty of disagreement over whether the broadly worded amendment will invite lawsuits, lead to confusion and interfere with the state's powers to protect public health and regulate the medical and insurance industries.
Denny Recker, the legislative chair for the Ohio Association of Health Underwriters, said the amendment "creates as many questions as it answers" but does not alter deadlines for Ohio that are "looming very quickly" under the new federal law.
On Tuesday, a District of Columbia federal appeals court became the latest to uphold the Affordable Care Act, which opponents refer to as Obamacare. The court ruled that the law's requirement that most Americans get health insurance is constitutional.
Federal judges in two states have found the law unconstitutional while three others have upheld it. Most legal experts expect the law to eventually land in front of the U.S. Supreme Court.
"Issue 3 will have no ability to forestall the federal legislation if it passes muster," Albers said. "It's really sort of an internal state decision not to go forward with a state-level mandated health insurance program."
In other words, voters have tied the hands of Ohio lawmakers looking to move the state to a Massachusetts-style system -- a remote possibility now with a Republican-dominated legislature.
Other legal experts who opposed the legislation, such as Case Western Reserve University law professor Max Mehlman, see troubling consequences. The amendment bans new health care mandates passed after March 19, 2010, which has the effect of freezing laws or rules made before that date.
Mehlman says that jeopardizes more recent changes to state law such as restrictions on late-term abortions signed into law recently by Gov. John Kasich. Under the amendment, no law could prohibit the purchase of health care except in cases to deter fraud or wrongdoing.
So could getting an abortion be considered the purchase of health care?
Kellie Copeland, head of the Ohio chapter of the National Abortion Rights Action League, said her group is studying the amendment to see if it could be used to overturn the recent restrictions.
"We are absolutely looking at it," Copeland said. "We believe that the late-term abortion ban poses a danger to Ohio women because it doesn't have adequate health exceptions, and this may provide an opportunity to go after it."
Maurice Thompson, head of the 1851 Center for Constitutional Law and the author of Issue 3, said state lawmakers probably will end up enacting legislation saying abortion doesn't fit the definition of health care to head off such a suit.
"I think there will be clamor with the abortion issue to make it clear," Thompson said. "Somebody on the left could very well decide to run it up the flagpole."
Other future medical regulations could be affected, such as new immunizations the state health department wants to mandate or new ways the state medical board might want to regulate the doctor-patient relationship, according to Mehlman.
"My hope is that people would not challenge actions that would be clearly in the public benefit, but libertarians could certainly sue to stop new vaccination programs if they wished," Mehlman said.
Thompson said the state health department would still hold broad powers to protect the public health but would be barred from imposing immunization mandates that weren't absolutely necessary.
Albers said the amendment's broad language makes it certain to be batted around by the courts in a number of different cases.
"It's open to significant amounts of interpretation, so it's difficult to say what the long-term impact will be," he said.
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