Pace Poll: New Yorkers favor a government-run health insurance plan

This via the Brian Lehrer show on WNYC.

A new poll by Pace University/New York Magazine/WCBS 2 News/WNYC asked New Yorkers to compare single-payer health insurance with an individual mandate to purchase private insurance, along the lines of the Massachusetts plan. Evidently, Mr. Lehrer himself put forward the idea for the question.

This morning during his "Pacing Politics" segment Brian Lehrer struck a note of astonishment that 48% of New Yorkers support the abolition of private health insurance in favor of a solitary publicly financed government-run plan, while 35% supported a statewide mandate that individuals purchase private health insurance.

The overall poll sought to gauge public opinion on a variety of candidates and issues on the eve of the elections; there was only one question on health care.

The results do not add up to 100% - at this point we only have the data via the link above.

The actual question -- as it appeared for the pollsters to ask:

Question 43:

Now I'm going to read you some statements about health insurance, which helps people pay doctors' bills and other medical expenses. When I am done, please tell me which one you agree with more.
[ROTATE]

Statement A:
Some/Other people say that New York State should require people without health insurance to buy it and that the government should help people pay for health insurance if they can't affort it. They say that many unisured people are young, healthy, and financially well-off, so their failure to buy health insurance forces the rest of us to pay more than our fait share of the high cost of caring for the sick.

Statement B:
Some/Other people say that New York State should create a government-run health insurance program to replace private health insurance companies and provide health insurance to everyone. They say that the private insurance companies drive up the cost of health care by acting as useless middlemen between doctors and patients, and they say that people in other countries spend less money on health care while enjoying better health because they don't waste money on insurance
companies.

Which statement do you agree with more?

Results:

22% strongly agree with A
13% somewhat agree with A
29% strongly agree with B
19% somewhat agree with B

Overall (by 48% to 35%) New Yorkers favor a "government-run health insurance program" to a plan that would "require people without health insurance to buy it."

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Medicare for All is a smart decision for business world

By DR. RICHARD PROPP
First published: Sunday, October 22, 2006

Every day across New York, doctors, their employees and hospital workers spend much valuable time anxiously dealing with health insurance company employees. And every day, businesses begin the multimonth process of evaluating old and new insurance plans, investing more and more to provide decent health insurance in an attempt to retain good employees and keep them healthy. Increasingly, businesses give up providing health insurance because they can't afford it.

The United States is the last country in the industrial world without a universal health care system. We spend more per capita ($6,102) yet cover a smaller proportion of the population than Canada ($3,165), France ($3,159), Germany ($3,005) or the United Kingdom ($2,546). At least 47 million Americans lack health insurance. Our outcomes for infant mortality and life span are worse than in these other countries, the Organization for Economic Cooperation and Development reported this year.

The universal health care movement seeks a practical way to solve the health care needs of all Americans. Because the business of America is business, and with apologies to the Letterman staff, here are the top five reasons the business community should care about expanding the federal Medicare program for seniors and those who are disabled to provide Medicare for All: (5) More capable employees: Fully insured part-time and full-time employees mean improved wellness, less absenteeism and better retention. (4) Reduced auto, truck and business insurance costs: Businesses will pay less for upfront insurance because most of the medical portion of bodily injury or chronic disability care needs of an injured party will be covered by Medicare For All. (3) Reduced administrative responsibilities. Expansion of Medicare to cover all citizens, financed by the government but run privately, would eliminate costly employer time and energy to explain benefits each time a new plan is purchased or an old plan is changed. All bills would be paid from a single pool, eliminating time spent dealing with multiple bills from multiple vendors of multiple services using multiple forms. Improved employee morale would follow and labor management expenses would decrease as negotiations on health care benefits would be off the table. Providers and consumers on a payment council would negotiate fair and affordable reimbursements. (2) New money for investments and payroll. The money that responsible large and small businesses pay for health care costs represents a substantial portion of their annual overhead. The modest tax increases that would be required to cover Medicare For All will leave substantial savings in annual overhead costs. Where will businesses spend that windfall? On better wages? Investment in new equipment to be more competitive in the global economy? To create better working conditions?

And the No. 1 reason small and large businesses will benefit from universal health care: (1) Reduced workers' compensation costs. Workers' compensation is a huge cost for businesses because of high rates that cover long-term health care costs. Medicare For All would include high quality standard coverage for illnesses or injuries, work related or not, thus eliminating the portion of premiums that pays for special health care under Workers' Compensation.

The Medicare system is in place. It has a low and reasonable 3 percent overhead for administration. It is essentially nonprofit. Remuneration decisions are politically negotiable; witness the rollback of planned fee cuts for 2006 that would have decreased physician participation. Medicare quality initiatives are active and Medicare quality data are available on the New York state Health Department Web site.

It is time to end the procrastination and to expand Medicare to all citizens. Citizens are in favor of this. A recent Zogby International poll of 1,200 New York residents found 62 percent would prefer a universal health care system like Medicare. An October 2003 Washington Post/ABC poll found by a 2-to-1 ratio Americans preferred a universal system that would provide coverage to everyone under a government program as opposed to the current employer-based system. We challenge the politicians and business community to act now.

Dr. Richard Propp is chairman of the Capital District Alliance for Universal Healthcare Inc.

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Hear Steffie Woolhandler on Friday October 13th

Steffie Woolhandler, MD, MPH, co-founder of Physicians for a National Health Program, will speak at two locations in the Albany area on Friday, October 13. Below is a synopsis of her planned remarks. These events, part of the Capital Region Social Forum, are free and open to the public.

The first will be a talk by Dr. Woolhandler at the University at Albany Uptown Campus, Humanities Building, Room 132, from 4 - 5:30 p.m.

The second is a presentation by Dr. Woolhandler followed by a panel discussion at Siena College: "Health Care in Crisis: Toward Universal Coverage" at 7:30 p.m. in the Key Auditorium in Roger Bacon Hall. Contact: 518-783-2398. Panelists: Dr. Duane Matcha, Siena College; Dr. Blanca Ramos, University at Albany; and Dr. Andy Coates, physician and local PNHP member.

Dr. Woolhandler is an Associate Professor of Medicine at Harvard and co-director of the Harvard Medical School General Internal Medicine Fellowship program. She worked in 1990-91 as a Robert Wood Johnson Foundation health policy fellow at the Institute of Medicine and the U.S. Congress. Dr. Woolhandler is a frequent speaker and has written extensively on health policy. A co-founder of Physicians for a National Health Program (PNHP) and current PNHP Board member, she co-edits PNHP’s Newsletter and is a principal author of PNHP articles published in the JAMA and the New England Journal of Medicine. She is also principal author of articles in Health Affairs, including the most-widely read Health Affairs article of 2005 - the investigation of the role of health care costs in American personal bankruptcies.

She has appeared on CounterSpin, Democracy Now!, Bill O'Reilly, and elsewhere.

Steffie Woolhandler is a compelling speaker as well as a national leader. Her understanding of American health care and her clear voice for change are crucial for all of us. Please attend one of these meetings!


Summary of Presentation
Steffie Woolhandler, M.D., M.P.H.

More Americans lack health insurance today than at any time since the start of Medicare and Medicaid in the mid 1960s. Meanwhile, workers are paying a higher share of premiums (and larger co-payments and deductibles) as firms shift costs onto employees. Seniors have also faced rising out-of-pocket costs. While the uninsured face the gravest problems, few Americans have adequate coverage. Most who need long term nursing home care pay out-of-pocket until they are impoverished and qualify for Medicaid; private insurance covers only 7% of nursing home costs. About half of all bankruptcies involve illness or medical debts.

Lack of coverage, insurance hassles, and other problems paying for care endanger the health of millions. Many of those with no, or poor, coverage forego care for potentially life threatening symptoms such as chest pain or a breast lump. HMOs often erect barriers to care, even in emergencies. For terminally ill patients and their families the burden of illness is often compounded by financial suffering. Women frequently delay prenatal care because they're uninsured or unable to pay.

While millions of Americans are denied needed care, hospital beds lie empty every day and millions of Americans are subjected to unnecessary and even harmful tests and procedures. Meanwhile a growing army of health bureaucrats struggles to keep sick patients away from idle health care resources and personnel.

Recent health policies have encouraged market-based strategies - an expanded role for investor-owned firms, reliance on competition to control costs and streamline care, and the erosion of insurance coverage that is supposed to force patients to shop wisely for care.

Contrary to widespread perceptions, Medicare's costs have risen less than those of private insurers (where managed care has predominated). While market enthusiasts push Medicare to enroll seniors in HMOs, an AARP study shows that few seniors could make informed HMO choices; the sickest and frailest are most vulnerable to being duped.

As managed care came to dominate health insurance, for-profit HMOs eclipsed non-profit plans. Yet the non-profit plans that are losing out in the marketplace rank higher on every quality measure collected by the National Committee for Quality Assurance.

Some do well under our current health care system - notably the CEOs of large health care firms. Yet their firms have demonstrated a flexible sense of morality. For instance, the two largest investor-owned hospital chains have admitted to illegal schemes to pad their revenues. But even when not engaged in unlawful behavior, for-profit hospitals cost more and provide worse care. In communities whose medical market in dominated by investor-owned hospitals, health costs are higher and rising faster than in areas dominated by non-profits. Much of the excess costs of for-profit hospitals are due to higher administrative costs; expenditures on clinical personnel are actually lower than at non-profits. Death rates at for-profit hospitals are 7% higher than at comparable non-profit hospitals, and have been for at least a decade.

Poor quality has also been endemic among other types of for-profit health facilities, e.g. nursing homes and dialysis.

Drug companies are the largest for-profit health care firms. In the past decade drug costs have soared. In the U.S., where firms have escaped the price regulations prevalent in other nations, drug prices are outrageous, fueling drug firm profits that outstrip any other industry.

International experience proves that universal coverage is feasible and improves health. Every other developed nation assures health coverage for the entire population. Our infant mortality rate, among the lowest in the world in 1950, is now disturbingly high. We trail other nations on life expectancy, and score poorly on measures of premature death. Meanwhile, our health costs per capita are nearly double those of any other nation, and rising more rapidly. Indeed, GOVERNMENT spending on health care in the U.S. exceeds TOTAL health spending in any other nation.

Yet Americans have fewer physician visits and lower hospital use per capita than other nations. Surveys of English-speaking countries show that Americans face the greatest barriers to care.

As the U.S. was implementing Medicare and Medicaid in the mid 1960s, Canada was putting in place national health insurance. Despite waits for some specialized care, studies continue to find that quality of care for Canadians is at least as good as the care received by INSURED Americans (though Canada spends far less. And national health insurance has effectively contained costs in Canada - perhaps too effectively. Canada's single payer system greatly simplifies administration, cutting insurance overhead to about 1% (vs. 15% of premiums in the U.S.) and reducing bureaucratic costs for hospitals and doctors. Overall, Canada saves about $857 per capita annually on bureaucracy alone.

Surveys have consistently shown wide popular support for universal coverage, though political leaders' views reflect the more conservative convictions of the business community. Indeed, most medical school facutly and deans now favor single payer national health insurance. Yet Congress and most state legislatures are swayed by the massive donations that come largely from the wealthiest Americans. As a result, policy debate is dominated by options that protect insurers and the drug industry.

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Chapter Begins Physician Recruiting Campaign

Thanks to a very generous donation from a prominent member of the Capital Region business community, our chapter will sponsor a series of receptions and dinners this fall and winter.

We hope to bring physicians together at convenient times and in convenient places to discuss the work of our chapter. We will make the case for a universal health care system through a single payer funding mechanism. We hope to create a place where physicians can explore their concerns surrounding such a transformation. We are confident we can inspire further interest and commitment to our cause.

This is a critical moment for our crumbling and expensive health care system. In light of recent events in California, and with a new New York Governor arriving in just few months, there is no doubt that health care will rise to the top of issues facing a new administration.

We need to grow.

There is strength in numbers and our local benefactor - an individual who not only believes that every American ought to have decent affordable health care but also would like to help American business compete with other industrialized countries that pay far less per capita on health care costs - has challenged the local physician community to join PNHP and get involved.

If you have any ideas about this major initiative - individual physicians to whom we should reach out, ideal venues (e.g., lunch time meetings or presentations at subspecialty chapter meetings, restaurant owners interested in our work,) please email or call us ASAP if you have any suggestions. Please help us set up meetings with your colleagues and friends.

Paul Winkeller

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