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JOIN YOUR LOCAL ACTION TEAM!         MAY 30 HCAO ANNUAL MEETING

Job Announcement: Health Care for All-Oregon seeks Executive Director

    Health Care for All-Oregon seeks a dynamic and creative Executive Director to shape, inspire, and manage the organization’s future, in close collaboration with its talented team of hard-working staff, enthusiastic statewide volunteers and committed Board of Directors. 
    Health Care for All-Oregon is a 501©(4) nonprofit based in Portland, OR, with a sister organization, the HCAO Education Fund, a 501©(3) charitable organization. HCAO is a statewide coalition of over 110 member organizations, working to bring universal, publicly funded health care to Oregon and (eventually) the entire United States.
    The Executive Director is responsible for operations and personnel management, fundraising and fiscal oversight, board engagement and community relations, and working with a growing network of volunteers building Oregon’s health care reform movement.
    For more information on HCAO and HCAO EF go to www.hcao.org  and www.hcaoef.org.
Please see Job Description Here.
     We offer competitive salaries, excellent benefits, a pleasant working environment and an exciting opportunity to work for one of Oregon’s foremost change campaigns. Salary is based on a nonprofit scale ranging from $45,000 to $55,000, commensurate with experience.
      HCAO is committed to workplace diversity and inclusion. We are an equal opportunity employer and do not discriminate in hiring or employment on the basis of race, color, religion, national origin, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law. Qualified candidates from diverse personal, cultural, and ethnic backgrounds are encouraged to apply.
    To apply: Send a cover letter describing why you believe you are a strong candidate for this position, a resume describing relevant education, training and employment and three references to: Health Care for All-Oregon, 619 SW 11th Ave., #121, Portland, OR 97205, or e-mail to lee@mainstreetalliance.org. Applications will be reviewed beginning April 30, 2015.

For further information contact Lee Mercer, President, Health Care for All-Oregon, 831-818-5247lee@mainstreetalliance.org

Health Care for Immigrants — Implications of Obama's Executive Action

Notably, however, the Obama administration has indicated that immigrants covered under the new policy will continue to be excluded from the ACA's exchanges and tax credits. Similarly, immigrants targeted by the executive action will for the most part remain ineligible for federally funded Medicaid, though some states do provide publicly funded health insurance for some classes of undocumented immigrants. To the extent that work permits lead to an increase in taxes paid by undocumented immigrants, ongoing exclusion of these immigrants from the programs supported by such taxes would be increasingly inequitable.

Benjamin D. Sommers, M.D., Ph.D

Benjamin D. Sommers, M.D., Ph.D

New England Journal of Medicine: Perspective
N Engl J Med 2015; 372:1187-1189March 26, 2015DOI: 10.1056/NEJMp1414949
by Benjamin D. Sommers, M.D., Ph.D., and Wendy E. Parmet, J.D.

On November 20, 2014, President Barack Obama announced his intention to grant millions of undocumented immigrants a reprieve from the threat of deportation, along with the possibility of legal employment in the United States. The announcement came shortly after midterm elections that saw Republicans take control of the Senate and bolster their majority in the House of Representatives, and it followed more than a year of congressional gridlock over the comprehensive immigration-reform bill passed by the Senate. The subsequent decision by a federal district judge in Texas to put President Obama's plan on hold has cast into doubt a policy that — if ultimately upheld — could have substantial effects on the health care system.

The cornerstone of the President's policy is a plan to allow up to 5 million undocumented immigrants (“covered immigrants”) to live and work in the United States. Modeled on the 2012 Deferred Action for Childhood Arrivals (DACA) program, which applied to young adults who arrived in the United States as children, the new policy will allow many more adults who have been here since 2010 to receive deferred-action status. The population affected by the policy is one that currently experiences major disparities in health care coverage and access. Immigrants are far more likely than native-born residents to be uninsured: among adults, an estimated 40% of legal permanent residents and 71% of undocumented immigrants are uninsured, as compared with 15% of U.S.-born citizens.1 Not surprisingly, health care utilization is far lower among immigrants than among citizens.

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Medicare at 50 — Origins and Evolution

Comments; 1) the author does not emphasize that Medicare in its current state is the most efficiently run insurance program in the country, 2) the author does not mention as cost-saving measures either the problems of malpractice reform or medical school debt, and 3) most relevant to HCAO, if there were a national single-payer health care system paid for by combination of income tax and VAT(ie ongoing sources of revenue), there would be no worry about depletion of the Medicare fund. 
Jerry Robbins MD, Newport

Medicare.jpeg

Health Policy Report, Mary Beth Hamel, M.D., M.P.H., Editor
David Blumenthal, M.D., M.P.P., Karen Davis, Ph.D., and Stuart Guterman, M.A.
N Engl J Med 2015
; 372:479-486January 29, 2015DOI: 10.1056/NEJMhpr1411701

Many Americans have never known a world without Medicare. For 50 years, it has been a reliable guarantor of the health and welfare of older and disabled Americans by paying their medical bills, ensuring their access to needed health care services, and protecting them from potentially crushing health expenses. However, as popular as Medicare has become, Congress created the program only after a long and deeply ideological struggle that still reverberates in continuing debates about its future. Nor was the Medicare program that was signed into law by President Lyndon B. Johnson on July 30, 1965, identical to the program we know today. As we mark the beginning of Medicare's 50th anniversary year, this first report in a two-part series recounts the history of this remarkable health care initiative and explains how it came to be, what it has accomplished, and how it has evolved over the past five decades. In the second report in the series, we will describe the ongoing challenges of the program and discuss proposals to address them.

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Part 2: Medicare at 50 — Moving Forward

David Blumenthal, M.D., M.P.P., Karen Davis, Ph.D., and Stuart Guterman, M.A.
N Engl J Med 2015; 372:671-677February 12, 2015DOI: 10.1056/NEJMhpr1414856

As Medicare enters its 50th year, this popular federal program faces profound challenges to its effectiveness and sustainability in future decades. In this report, we review these problems, building on the issues raised in our earlier article.1 We also review several options to strengthen the program and enhance its viability.

Critical Changes Facing Medicare
Rising Expenditures

Perhaps the most important challenge facing Medicare is the prospect of increasing expenditures, driven in large part by demographic trends. As the U.S. population ages, the number of people who are eligible for Medicare benefits will grow, from 52.3 million in 2013 to 81.8 million in 2030.2 From 2009 through 2013, Medicare spending per beneficiary increased at a historically low annual rate of 1.0% in nominal dollars and actually decreased in real terms (accounting for inflation). Over the next decade, slow growth in Medicare spending per beneficiary is expected to continue, but because of substantial increases in the number of beneficiaries, the growth in total program spending will outpace that in the overall economy (Figure 1 Figure 1Projected Annual Growth Rates for Total Medicare Spending, as Compared with the Gross Domestic Product (GDP) and Medicare Enrollment, 2013–2023.). Total Medicare spending is expected to increase from 3.0% of the nation's gross domestic product (GDP) in 2013 to 3.8% in 2030, and the program's share of the federal budget is expected to increase from 14.4% to 15.8%.3 These fiscal trends will create continuing pressure to reform the program.

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Report: Advocacy visits to Senators Beyer and Edwards

by David Ivan Piccioni, HCAO Eugene

At one of my visits Wednesday with Lee Beyer I told him my story which I had made into a letter to editor. It is bellow for reference:

Drug price disparities are unfair     
Register Guard 9/1/2014  (Labor Day)
I recently had a biopsy performed to check for liver damage due to hepatitis C. Medicaid excluded me from treatment because my liver looked good enough that they didn’t believe it will be the cause of my death.
Talking to the doctor, I learned that Medicaid wouldn’t pay to treat my condition because of the cost: $84,000.
He said I could take my prescription to Canada and buy the drugs there for $48,000. But that wasn’t what blew my mind; he also said for the price of a round-trip ticket to Iran or Saudi Arabia, or many African countries, I could buy the medication for a thousand dollars.
What? Who says America’s the land of the free? Free to be ripped of by dog-eat-dog capitalism.
I can’t figure out why pharmaceutical corporations are willing to bankrupt Americans while not doing the same to foreigners — after all, they only care about maximizing their profits.
Gilead, the company that currently owns the intellectual property for the medication, will eventually lose some of its loot to other chemists who will modify Sovaldi just enough so it still works but is novel enough to be patented.
Problems such as this are why the Affordable Care Act is far from what the Eugene group Health Care for All Oregon is advocating: single-payer or expanded Medicare for everyone.

I told Lee Beyer that our obstacles were the Insurance companies and the fact that we can't negotiate for prices with big pharma. He agreed about the Insurance, but said that negotiating with the drug companies is impossible because of a congressional clause which prohibits the gov't from bargaining with them. Some people think that the fact that drugs are cheaper in other countries means the big pharma companies are doing them a favor on the back of Americans who pay inflated prices. This is not so. Drug companies always get the most they can in any country. The fact that they negotiate fairly is credit to other countries' leaders and laws. It seems that if there are differences of 84 to 1 in American drug prices vs. say Saudi Arabia shows that this is one of the first problems to tackle: that congressional prohibition that inhibits fair business transactions and negotiating.

Also in a room full of people prompted by one of my questions, Chris Edwards disclosed that the Insurance companies have always offered him money. He said at first he turned it down, but then as he said "because I always vote against them I decided to take their money" "if they are dumb enough to give me money even though I vote against them, I'll take it". I am not mentioning this as an attack on senator Edwards, but I told him it was hard for me to believe the corporations would throw away money and really get nothing. And I told him health insurers are very powerful and they are not "dumb"; there might be strings invisible but real none the less.

Dave

Herb Rothschild Jr.: Support single-payer

RELOCATIONS
Posted Jan. 24, 2015 
Ashland Daily Tidings, Opinion

This year marks the 50th anniversary of the Voting Rights Act of 1965 and of the enactment of Medicare. Not long ago, a U.S. Supreme Court dominated by Republican appointees gutted the Voting Rights Act, and a Democratic president who never could have been elected without it took Medicare for Everyone off the table when he proposed his much ballyhooed health reform.

The American Medical Association tried to defeat Medicare. It cleverly labeled all such proposals “socialized medicine.” Medicare isn’t socialized medicine. The VA health care system is socialized medicine. Its hospitals are publicly owned, and VA staff are salaried employees paid with tax dollars. Medicare is only an insurance program.

So Medicare didn’t threaten the livelihood of physicians. Instead, it added huge numbers of paying clients to their patient base. The AMA had identified the wrong threat. The real threat emerged in the 1980s. It was the private insurance industry, not public insurance, that drastically interfered with the practice of medicine.

Private insurance plans forced most physicians to join groups like health maintenance organizations, hospital systems, and other large groupings — some of them corporations interested in profits, not health care. Often physicians couldn’t treat their patients without approval for payment from the patients’ insurance carriers, whose on-staff medical personnel could second-guess the attending physician. In more subtle but ever-present ways, the imposition of a corporate model has distorted the practice of medicine and diminished the satisfaction of practitioners.

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    Health insurers press for high-deductible, low-benefit policies

    by Wendell Potter for the Center for Public Integrity

    As we head into the final stretch before next week’s midterm elections, Americans continue to have wide-ranging views of Obamacare, but even many who have an unfavorable view of it say they would rather see Congress improve it than get rid of it.

    In fact, according to the Kaiser Family Foundation’s most recent tracking poll of public opinion about the law, released last Tuesday, almost two-thirds of the public would rather see their member of Congress work to make the law better than to repeal and replace it.

    The big, unanswered question, though, is what to fix and how to do it.

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    How the Republican Tempest Over the Affordable Care Act Diverts Attention from Three Large Truths

    ROBERT B. REICH, Chancellor’s Professor of Public Policy at the University of California at Berkele

    ROBERT B. REICH, Chancellor’s Professor of Public Policy at the University of California at Berkele

    from the Robert Reich blog
    Friday, November 22, 2013

    Having failed to defeat the Affordable Care Act in Congress, to beat it back in the last election, to repeal it despite more than eighty votes in the House, to stop it in the federal courts, to get enough votes in the Supreme Court to overrule it, and to gut it with outright extortion (closing the government and threatening to default on the nation’s debts unless it was repealed), Republicans are now down to their last ploy.

    They are hell-bent on destroying the Affordable Care Act in Americans’ minds.

    A document circulating among House Republicans (reported by the New York Times) instructs them to repeat the following themes and stories continuously: “Because of Obamacare, I Lost My Insurance.” “Obamacare Increases Health Care Costs.” “The Exchanges May Not Be Secure, Putting Personal Information at Risk.”

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