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JOIN YOUR LOCAL ACTION TEAM!         MAY 30 HCAO ANNUAL MEETING

Help Plan Next Steps Towards Single Payer in Oregon

Register now for the May 30th HCAO Annual Meeting

Health Care for All-Oregon will discuss next steps in our campaign for single payer health care in Oregon at the HCAO Annual Meeting Saturday, May 30, 9:30 a.m.-3:30 p.m, at the SEIU 503 Ballroom, 6401 SE Foster, Portland. Representatives of our 110 member organizations and chapters, as well as other HCAO activists from around the state will attend (you are invited, register now!), review progress during the 2015 legislative session and plan next steps.

Also at the May 30 HCAO Annual Meeting, we will get updates from Senator Michael Dembrow on progress on SB 631 (the Health Care for All Oregon Plan), HB 2828 (the Health Care Study Bill) and other legislation supported by HCAO during the 2015 legislative session.

Finally, members will have the opportunity to consider and vote on critical bylaw revisions and a slate of leaders including the Board of Directors and Officers. Nominations are also accepted from the floor.  

Click HERE for the May 30 HCAO Membership Meeting agenda.                

See you there!                                                                   

 -Lee Mercer, HCAO Board President

Register now for the May 30th HCAO Annual Meeting

Report on SB 631 Hearing

Today’s testimony was the most powerful and eloquent of all the three hearings on single payer health care I have attended since 2011.

After the testimony of Sen. Dembrow, Sen. Monnes Anderson made a comment to the effect that other countries offering universal health care pay more taxes than Americans do. That is correct. We need a one sentence response to comments like that. Here is my offering.

The amount of money that Oregonians currently pay in health insurance premiums and out of pocket payments exceeds the additional taxes they would pay to participate in a statewide single payer program.

That reduction is corroborated by all 28 American studies of single payer health care and the experiences of all single payer health care systems in the US and around the world. The reward for relabeling what Oregonians already pay as premiums and out of pocket payments is a net reduction in health care costs, a lower cost of doing business in Oregon, the end of labor strikes over benefits, assured access to every family regardless of income or employment, the ability of Oregonians to seek care from any provider, and guaranteed payment to providers no matter who their patient might be.

The penalty is the indignity of relabeling health care payments as “taxes.” Some voters in Oregon would still find that penalty intolerable. Fortunately, not all of them.

Samuel Metz. MD

Paul Perkins – SB 631 Hearing – Written Testimony

I’m a self-employed guy who provides administrative and documentation services to a number of clients from my home in Beaverton. My virtual assistant business shrank dramatically after the economic crash in 2008, and even at its best it didn’t produce enough income to afford health insurance. I’d heard stories like this for years but never expected to end up telling one myself.

In May of 2013, I was hospitalized with a condition that required emergency surgery. I was less than 48 hours in the hospital. The bills began coming in with sonic speed, almost before I got home. There were some preliminary test charges I knew about and paid, then the hospital bill came and I thought the nightmare was over. But I started getting nickeled and dimed for all this other stuff, including a bill in excess of $450 for some person I'd never seen to spend a few seconds reading the X-rays and CT scans. Then when I thought it was all over, the surgeon's bill came separately, two months later, for another $9,000. The bills totaled nearly $33,000. Even after negotiating for a lower amount due to my limited means, the bills wiped out my modest life savings.

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Oregon advocates testify for universal health care

Saerom Yoo, Statesman Journal May 4, 2015

(Photo: ANNA REED / Statesman Journal)

(Photo: ANNA REED / Statesman Journal)

Advocates for a universal state health system urged legislators Monday to consider how Oregon could create a publicly funded, single-payer health system.

The Senate health care committee heard testimony on Senate Bill 631, which would establish such a system, but the proponents weren't asking the panel to pass the bill. They acknowledged Oregon wasn't ready to enact the policy.

Instead, they used the hearing as a platform to voice why they thought pursuing universal health care as a long-term goal was important. They asked for funding for a study to examine how Oregon could finance such a system.

Charlie Swanson, of Eugene, said the rising cost of health care in the U.S. creates hardships for individuals who cannot afford medical care (even with insurance), for employers that lose their competitive edge and for the state government that struggles to invest in other important programs.

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Medicare Advantage Money Grab

More whistleblowers allege health plan overcharges
Cases target Medicare Advantage billing practices

Federal court records show at least a half dozen whistleblower lawsuits alleging billing abuses in these Medicare Advantage plans have been filed under the False Claims Act since 2010.

Federal court records show at least a half dozen whistleblower lawsuits alleging billing abuses in these Medicare Advantage plans have been filed under the False Claims Act since 2010.

by Fred Schulte
Center for Public Integrity, April 23, 2015

Privately run Medicare plans, fresh off a major lobbying victory that reversed proposed budget cuts, face new scrutiny from government investigators and “whistleblowers” who allege plans have overcharged the government for years.

Federal court records show at least a half dozen whistleblower lawsuits alleging billing abuses in these Medicare Advantage plans have been filed under the False Claims Act since 2010, including two that just recently surfaced. The suits have named insurers from Columbia, S.C., to Salt Lake City, Utah to Seattle and plans which have together enrolled millions of seniors; lawyers predict more whistleblower cases will surface. The Justice Department also is investigating Medicare risk scores.

Though specific allegations vary, the whistleblower suits all take aim at these risk scores. Medicare uses the scores to pay higher rates for sicker patients and less for people in good health. But officials were warned as early as 2009 that some plans claim patients are sicker than they actually are to boost their payments.

Privately run Medicare Advantage plans have signed up more than 17 million members, about a third of people eligible for Medicare, and are poised to get bigger. Their lobbying muscle is keeping pace with that growth. Earlier this month, the industry overturned proposed cuts sought by the Obama administration for a third straight year, instead winning a modest raise in payment rates for the programs.

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Why this U.S. doctor is moving to Canada

After five years of constant fighting with multiple private insurance companies to get paid, Dr. Emily Queenan decided to try her luck up north

By Emily S. Queenan, M.D.
The Toronto Star, April 28, 2015

I’m a U.S. family physician who has decided to relocate to Canada. The hassles of working in the dysfunctional health care “system” in the U.S. have simply become too intense.

I’m not alone. According to a physician recruiter in Windsor, Ont., over the past decade more than 100 U.S. doctors have relocated to her city alone. More generally, the Canadian Institute for Health Information reports that Canada has been gaining more physicians from international migration than it’s been losing.

Like many of my U.S. counterparts, I’m moving to Canada because I’m tired of doing daily battle with the same adversary that my patients face – the private health insurance industry, with its frequent errors in processing claims (the American Medical Association reports that one of every 14 claims submitted to commercial insurers are paid incorrectly); outright denials of payment (about one to five per cent); and costly paperwork that consumes about 16 per cent of physicians’ working time, according to arecent journal study.

I’ve also witnessed the painful and continual shifting of medical costs onto my patients’ shoulders through rising co-payments, deductibles and other out-of-pocket expenses. According to a survey conducted by the Commonwealth Fund, 66 million – 36 per cent of Americans -- reported delaying or forgoing needed medical care in 2014 due to cost.

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Why Universal Health Care Is Essential for a More Equitable Society

by Anja Rudiger, Director of Programs, National Economic and Social Rights Initiative
Huffington Post Blog: Posted March 31, 2015

The prospects for universal health care in the United States appear unusually bleak these days. Just as the first U.S. state -- Vermont -- was getting ready to implement a universal, publicly financed health care system, its governor pulled the plug on his support. Years of studies, preparations and proposals, a mountain of supportive data and a clear legal mandate fell by the wayside as soon as Governor Shumlin felt that the political stars were no longer aligned. Meanwhile, in Washington DC, even the Affordable Care Act's approach of making private health insurance more affordable by subsidizing over-priced insurance products is under attack in the Supreme Court.

Why is universal health care, which is commonplace around the world, so hard to achieve in the United States? Why are we unable to overcome a market-based system that leads to a hundred thousand unnecessary deaths each year? Corporate interests in maintaining this system are powerful, as is a culture of competition and consumption that sees health as a personal choice rather than a human right. The odds against universal health care advocates are long: What does it take to turn a market commodity into a public good, and dismantle an entire industry along the way?

For the past few years, as the limitations of the Affordable Care Act were becoming increasingly clear, a mass people's movement in the small state of Vermont paved the way for universal health care, winning the passage of a 2011 law that mandated the state to financed its health system publicly and equitably and guarantee access to care for all. Yet as the governor's recent about-face illustrates, the task at hand remains challenging.

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Prescription price shock: OSU/OHSU study takes drug industry to task

Angie Mettie mettiea@ohsu.edu  Lead author Dan Hartung's study found that one drug that originally cost $8,700 now tops $62,000.

Angie Mettie mettiea@ohsu.edu  Lead author Dan Hartung's study found that one drug that originally cost $8,700 now tops $62,000.

Elizabeth Hayes Staff Reporter- Portland Business Journal
Health Care Inc. NW, Apr 24, 2015,

Drugs for treating multiple sclerosis have skyrocketed 700 percent in the past 20 years, even as newer drugs have come on the market, according to a study out today from researchers at Oregon State University and Oregon Health & Science University.

“New drugs came on the market 30 to 50 percent higher than existing therapies, which ratcheted up their prices to meet the prices of the new drugs,” said Dan Hartung, the study’s lead author and an associate professor in the OSU/OHSU College of Pharmacy.

First-generation drugs from the 1990s ranged from $8,000 to $10,000 a year. Today, all MS drugs cost at least $50,000 a year, well above inflation, Hartung said. One drug that originally cost $8,700 now tops $62,000.

The study highlights an industry driven by profits, using non-transparent pricing policies, and to a healthcare system that places no limits on the escalation. Also, many “biologics,” or specialty drugs, don’t come in cheaper generic forms.

The end result? Another industry that’s “too big to fail,” the authors assert.

The study also compared the U.S. to other countries. MS drugs here cost two to three times the list prices in Canada, Australia or the United Kingdom, where the governments purchase medications directly from vendors.

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Healthcare Industry Convinces Courtney to Kill Price Transparency Bill

A compromise measure from Sen. Steiner Hayward that would have opened up health insurance tools with price information to all consumers won the needed support of Sen. Monnes Anderson, but last-minute pressure on the state’s top lawmaker stopped the price transparency bill dead in its tracks.

by Chris Gray, for The Lund Report, April 22, 2015

Senate President Peter Courtney, D-Salem, halted a legislative effort to force hospitals and health insurers to be more candid about their prices following closed-door negotiations with their influential lobbyists.

The move rankled some in Courtney’s caucus who have been steeling for greater reforms after Oregon was given an F along with 44 other states by the Catalyst for Payment Reform, a national organization that scores states on price transparency. Four East Coast states plus Colorado got a passing grade.

Senate Bill 891 in its original form would have required hospitals to post their prices for common procedures paid by health insurers, Medicare, Medicaid, the school districts and state employees. In the amended version, the public would be given access to online tools with price information from the health insurers that is currently given only to enrolled health plan members.

“I was all set to move it,” Monnes Anderson told The Lund Report. “There were some political decisions made at a higher grade than I,” including “negotiations in the president’s office” with insurers, who claimed the Legislature was already asking a lot from them, she said.

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Insurers backed Obamacare, then undermined it. Now they're profiting from it

Commentary: playing all sides of the street on Obamacare

by Wendell Potter
The Center for Public Integrity, April 20, 2015

Anyone who still thinks the Affordable Care Act was a “government takeover of health care” should consider this headline from the news pages of last Thursday’s Investor’s Business Daily:
UnitedHealth Profit Soars On Obamacare, Optum—April 16, 2015

That’s from a Wall Street publication whose editorial writers have rarely missed an opportunity to bash the health care reform law. Here are a few other headlines, these from IBD’s editorial page, just since the first of this year.
More Phony ObamaCare Numbers From The White House—March 16, 2015
Shock Poll: Half The Uninsured Want Obamacare Repealed—March 3, 2015
Democrats Keep Running Away From ObamaCare—February 2015
CBO Now Says 10 Mil Will Lose Employer Health Plans Under ObamaCare—January 27, 2015

It wouldn’t surprise me if UnitedHealth Group executives helped shape the opinions of those editorial writers during the reform debate.  One of the things I did in my old job  as head of PR for one of the country’s other big for profit-insurers was arranging for my CEO to have “desk side chats” with bigwigs at important publications like Investor’s Business Daily. We would often leave those meetings with an invitation to submit an op-ed, as was the case several years ago when Ed Hanway, Cigna’s CEO at the time, and I visited with then Dow Jones CEO Peter Kann and Daniel Henninger, deputy editor of The Wall Street Journal editorial page.

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