Single-Payer Health Care: Debate on Smart Talk

This morning (October 2, 2017), the local public radio station in Harrisburg, PA aired a program on universal health care, often called single-payer health care or Improved Medicare for All.  They presented a debate between insurance industry members, legislators, and advocates for single-payer health care.

Three women holding up posters that say

Advocating for Medicare for All – a universal, single-payer healthcare program. Photo Courtesy of National Nurses United.

The radio clip that I’m embedding below discusses HB 1688, the Pennsylvania Health Care Plan.  This bill was reintroduced in the PA House of Representatives on Friday, September 29. It is a state-based universal health coverage for residents of Pennsylvania via a single-payer health care payment program which redirects Medicare and Medicaid funds into a single state funding program where 9 out of 10 people will have reduced healthcare costs and where you get to select your own doctors, healthcare providers, and hospitals. Decisions about treatment are made between the healthcare provider and the client.

The debate on both the state and federal ideas for universal health care follows Rep. Pam Delissio’s summary of her bill. Here is Part 1 of the debate on SmartTalk:

And here is Part 2 of the debate on universal single-payer healthcare:

Rep. Delissio has been the prime sponsor of HB 1688 for the last three sessions of the PA General Assembly. Here’s a 2016 presentation on the Pennsylvania Healthcare Plan by Representative DeLissio on her bill. FYI, the bill number did not change between the current and last session.  So when she talks about HB 1688, she is presenting essentially the same plan (with some minor tweaks).

The Pennsylvania Health Care Plan

Are you frustrated with your insurance plan? Have you, or someone you love, been denied coverage? Well here in Pennsylvania, we have new universal health care bill that has been introduced to improve upon the Patient Protection and Affordable Care Act (aka Obamacare) and provide access to healthcare for ALL Pennsylvania residents.

The bill — HB 1688 — was introduced into the PA House of Representatives on Monday, November 9, 2015 and sent to the House Health Committee for review and mark-up. The prime sponsor is Rep. Pam DeLissio.  Here’s what she says about this new legislation:

I am introducing legislation to establish the Pennsylvania Health Care Plan. 

Similar legislation has been introduced on at least 3 occasions in the House over the past 7 years.

This legislation sets out a blueprint of bold steps that will result in a healthier citizenry at a lower cost with no co-pays, deductibles or premiums or concern about networks and with the freedom and flexibility to choose their health care providers. 

This legislation is possible because the Patient Protection and Affordable Care Act allows states the option to innovate with their own health care plan as long as the proposed plan is more economical and efficient.

This proposed legislation meets that criteria.  This option for the states to innovate becomes available in 2017. 

This legislation improves upon our current health care delivery system in many ways.  First and foremost, it preserves the private practice of medicine and the right of patients to choose their healthcare providers.

Briefly, the Pennsylvania Health Care Plan is a system in which the Pennsylvania Health Care Agency administers a plan that ensures the cost-effective delivery of covered services that range from catastrophic care to wellness and preventative care. 

Health Care Providers would have autonomy over patient care.

The program will be supported by the savings realized from replacing today’s less than efficient, often profit-oriented, multiple payer system with a streamlined Pennsylvania Health Care Trust Fund.

The Pennsylvania Health Care Trust Fund will be funded by a 10% employer tax paid on payroll and a 3% personal income tax.

Using our respective Caucuses as an example, we would save millions in health insurance costs if we were to pay an amount equal to 10% of our payroll.

A benefit to Plan participants is knowing definitively their healthcare cost exposure for the year. 

Graphic display of the details of the PA Health Care Plan as presented by Rep DeLissio to her colleagues in her Co-Sponsorship Memo.

Graphic display of the details of the PA Health Care Plan as presented by Rep DeLissio to her colleagues that she included with her Co-Sponsorship Memo.

And here is a summary HB 1688 (thanks to Healthcare for All PA for reviewing and summarizing the The Pennsylvania Health Care Plan). It…

  • Covers all Pennsylvania residents
  • Gives citizens the freedom and flexibility to choose their health care provider while at the same time preserving the private practice of medicine:
    • Allows free choice of providers, including specialists, without pre-approvals or referral
    • Provides comprehensive coverage
    • Give health care providers autonomy over patient care.
  • Doesn’t exclude or limit coverage due to preexisting conditions
  • Creates cost savings for citizens, businesses, municipalities and school districts:
    • Eliminates co-payments, deductibles, point-of-service and networks
    • Eliminates premiums. They are replaced by a 3% tax on adjusted gross income and Businesses will pay a 10% tax on payroll, (most businesses pay far more for employee health benefits, which will be eliminated under this Plan).
    • Benefits businesses by lowering costs for Worker’s Comp, Vehicle Insurance and Liability Insurance due to removal of medical component.
    • Removes retiree healthcare costs from businesses, municipalities and school districts
    • Creates this cost savings by replacing our less than efficient, confusing multi-payer system with a streamlined single-payer system.
  • Covers all of the following, but is not limited to:
    • All medically necessary inpatient and outpatient care and treatment, both primary and secondary
    • Emergency services
    • Emergency and other medically necessary transport to covered health services
    • Rehabilitation services, including speech, occupational, physical and massage therapy
    • Inpatient and outpatient mental health services and substance abuse treatment
    • Hospice care
    • Prescription drugs and prescribed medical nutrition
    • Vision care, aids and equipment
    • Hearing care, hearing aids and equipment
    • Diagnostic medical tests, including laboratory tests and imaging procedures
    • Medical supplies and prescribed medical equipment
    • Immunizations, preventive care, health maintenance care and screening
    • Dental care
    • Home health care services
    • Chiropractic and massage therapy
    • Complementary and alternative medical procedures that have been shown by the National Institute of Health’s Division of Complementary and Alternative Medicine to be safe and effective for possible inclusion as covered benefits
    • Long-term care for those unable to care for themselves independently, including assisted and skilled care

Currently there are four cosponsors of the bill — Rep Pam DeLissio, Rep W. Curtis Thomas, Rep Patrick J. Harkins, and Rep Mark Rozzi. But we need more co-sponsors and citizen calls for passage of this bill.  So we need your help.

Join us and act now! Contact your state representative now and urge them to support the ‘Pennsylvania Health Care Plan legislation’, this new and innovative health care plan will cover ALL Pennsylvania residents.  Find your representative by clicking on this link. Then call, write, and visit your Representative to ask her/him to cosponsor and support an improvement in our health care system here in Pennsylvania.

Then share this blog with your family, friends, and business colleagues so that they too can call for this change.

Thanks!

The French Way or the Broken US Way of Healthcare?

Advocates for Single Payer Healthcare Rallying in 2009 in Harrisburg, PA

Advocates for Single Payer Healthcare Rallying in 2009 in Harrisburg, PA

Anya Schriffrin has just written a wonderful piece on universal health care from the French perspective called “The French Way of Cancer Treatment.”  She discusses the differences in the treatment her father received at Sloan Kettering Memorial Hospital v. his treatment at Cochin Hospital, a public hospital in Paris.

The differences she saw in her father’s cancer treatment in both countries included:

Issue

At Sloan Kettering (United States)

At Cochin (France)

 

Average length of treatment day

7.5 hours

90 minutes

How specialists see patients

Patient traveled to each specialist’s office

All specialists came to see patient either in home or in the hospital room.

Treatment received

Chemo selected based on insurance company’s formulary

Chemo selected based on doctor’s determination of best treatment

Who paid for meals while in hospital

Patient

Hospital: Included in treatment

Who paid for transportation to and from hospital

Patient and/or Insurance Company

Hospital: Included in treatment

Type of medical care

Insurance based, for-profit

Universal Health Care

Average cost/person for medical care in each country (2011)

$8,608

$4,086

% of Country’s Gross Domestic Product for Health Care

17.9%

11.6%

 

The one statement that stood out for me on the French system was this:

“There were other nice surprises. When my dad needed to see specialists, for example, instead of trekking around the city for appointments, he would stay in one room at Cochin Hospital, a public hospital in the 14th arrondissement where he received his weekly chemo. The specialists would all come to him. The team approach meant the nutritionist, oncologist, general practitioner and pharmacist spoke to each other and coordinated his care. As my dad said, ‘It turns out there are solutions for the all the things we put up with in New York and accept as normal [emphasis added].’

As a cancer survivor, I can attest to similar experiences in the United States just about a quarter century ago.  Nothing has changed.  Like Ms. Schriffrin’s father, my visits to the hospital often took 7-8 hours after getting up way before the break of dawn to travel 3 hours to the hospital to be one of the first people to wait in line to see the doctors and other specialists.  I too had one doctor who wandered in to the clinic for my chemo 7-8 hours AFTER he was scheduled for treating patients. In that particular case, he kept patients and nursing staff waiting until about an hour after the clinic should have closed for the day.  And I had to fight for my life with two insurance companies in order to get the bone-marrow transplant I needed.

My story is similar to many others here in the states.  That’s why I support national universal, single-payer healthcare via Congressman John Conyers’ (D-MI) HR 676 in the United States.  It’s why I support federal legislation to expand the Affordable Healthcare Act to all states to create a state-level single-payer plan like what Vermont has already passed and signed into law. It’s why I support the plan that Senator Bernie Sanders (I-VT) has crafted; it’s called the American Health Security Act of 2013 bill and it creates state-level single-payer healthcare programs with Federal support.   It’s why I am a board member of Health Care for All PA Education Fund.  And it’s why I support the Pennsylvania Health Care Plan proposed by Pennsylvania State Senator Jim Ferlo.

We can do better here in the US.  Better than what Ms. Schriffrin’s father and I have both experienced.

Let’s fix this broken US healthcare system.  Let’s create access to quality healthcare for all via a universal, single-payer healthcare program in the United States.  Check it out.  Let’s do healthcare the French Way in the American style as suggested by Congressman John Conyers Jr. (D-MI), Senator Bernie Sanders (I-VT),  PA Senator Jim Ferlo, the state of Vermont, and Health Care for All PA.