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!
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 PresentationSteffie 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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