Monday, February 18, 2008

Chapter update: 2008 past and future

Some of our activities so far in 2008

Chapter member have already participated this year in the following events (and probably more):
1/3 Sicko film showing and discussion at Bethlehem Public Library
1/7 Small group discussion about single payer health reform at a Delmar coffeehouse (follow-up to a showing of Sicko)
1/8 People's State of the State rally at the NY Capitol
1/17 Founding of the Syracuse chapter of PNHP, 2 public talks at
Upstate Medical University
1/28 Sicko film showing and discussion in Pine Hills neighborhood of
Albany
1/29 Op-ed by Dr. Propp in Times Union
1/31 Testimony to NYS Insurance Department against merger and
conversion of GHI and HIP to a for-profit health insurance company
1/31 Single payer presentation to >100 Public Employees Federation
union members at the department of Environmental Conservation
Ongoing: Participation in MSSNY task force on health reform
PNHP submitted a New York State single payer proposal for consideration by the Governor's commission that will study methods of attaining universal health coverage in New York.

Upcoming events

Monday, Feb 25, at 6:30 pm: Roundtable discussion of "Why American Needs National Health Insurance" at the Clifton-Park-Halfmoon Public Library, 475 Moe Road, Clifton Park. Panelists: Matt Funicello, owner of Rock Hill Bakehouse in Moreau; Patricia Reed, NP, League of Women Voters; Howard Tanenbaum, MD, ophthalmologist in Canada and the US, vice-chair of our PNHP chapter; Paul Sorum, MD, PhD, chair of our chapter. Moderator: Christy Staats, Clifton Park Single Payer Committee cstaats[at]nycap[dot]rr[dot]com.

Wednesday, Feb. 27, at 11 AM: Single payer press conference, in the LCA press room (room 130), Legislative Office Building, State and Swan Street. To support the resolution introduced by Assemblyman Ortiz (NY Assembly bill K779) to call on the US House of Representatives to pass the single-payer bill HR 676 and to support single payer at state level. Ortiz has confirmed attendance, Gottfried has been invited. SHOW THE PRESS AND THE LEGISLATURE THE STRENGTH OF SUPPORT FOR SINGLE PAYER! Contact Mark Dunlea (the organizer of the press conference) at Hunger Action Network, 434-7371 xt 1# if you want to participate.

Wednesday, Feb. 27, at 7:30 pm: the next meeting of the Executive Committee of our chapter. All chapter members are welcome to attend. Please e-mail us if you would like to come.

Thursday, Feb. 28: two different (though overlapping) coalitions of health care reformers are meeting in Albany! In the morning, at 9:30 am, the coalition of groups working for universal health insurance in NY organized by Mark Dunlea will meet at the Westminster Presbyterian Church, 85 Chestnut St. (1/2 block from the Capitol) to formulate a legislative agenda and plan of action. In the afternoon, the Health Care for All New York group will be meeting. It is organized by a variety of reformist organizations (including Citizen Action) that reject single payer as politically impossible and is funded by a grant from the Robert Wood Johnson Foundation. WE NEED TO KEEP REMINDING THESE COALTIONS (ESPECIALLY THE AFTERNOON GROUP) THAT SINGLE PAYER IS THE BEST SOLUTION. CAN ANYONE ATTEND EITHER OR BOTH OF THESE MEETINGS?

Friday, Feb. 29 at 7:00 pm: Showing of SICKO in downtown Troy at Christ Church on State St. and 5th Avenue (on Troy Night Out). Discussion afterwards led by Euthemia Matsoukas. HELP EUTHEMIA RALLY THE AUDIENCE TO WORK FOR SINGLE PAYER.

Sunday, Mar 2, 2:00-5:15 pm, at First Lutheran Church, 181 Western Ave, Albany: forum on health care and hunger, sponsored by Faith and Hunger Network, Capital District Alliance for Universal Healthcare (CDAUH), Interfaith Impact, FOCUS Churches, Bread for the World, and Reform Jewish Voice of NYS.
Agenda:
2:00 Welcome
2:15 Universal Health Care for NYS
a. 20 minutes - presentation from Spitzer administration on their health reform plans
b. 15 minutes - responses by leaders of faith community and CDAUH
c. 20 minutes - Q and A and comments
3:15 Bread for the World presentation on their Offering of Letters (international aid)
3:45 break
4:00 workshops
a. 2008 NYS Legislative Agenda on Ending Poverty - e.g., welfare, other - Mark Dunlea, Hunger Action Network
b. Speaking in the Faith Community on Economic Justice - Andreas Kriefall, ARISE
c. Other
5:00 Closing remarks, next steps
5:15 Adjournment
For more info, contact Mark Dunlea at Hunger Action Network, 434-7371 ext 1#

Saturday, Mar 8, 10:00 am-noon; panel discussion on health reform, sponsored by the League of Women Voters of Rensselaer County & the New York State Nurses Association. Panelists: Richard Kirsch, Executive Director of Citizen Action of NY (supporting a combined private-public plan); James Sinkoff, CEO Whitney M. Young Health Clinic; a representative from the NYS Nurses Association; and Paul Sorum, MD, PhD, chair of the Capital District Chapter of Physicians for a National Health Program

Saturday, Mar 8, all day - PNHP table at the downstate New York American College of Physicians meeting.

Saturday, Mar 8, 10am - 4pm - New York Metro PNHP chapter annual speakers training/leadership meeting - email for details

HOLD THE DATE: Tuesday, May 6: lobby the state legislators on single payer
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Saturday, February 09, 2008

GHI/HIP change could hurt health care

By RICHARD PROPP
First published in the Albany Times Union
Tuesday, January 29, 2008


The huge combined health insurance company GHI/HIP wants to convert from nonprofit to for-profit status. Shocked? I doubt it. Empire Blue Cross-Blue Shield set the example in 2002.

So, if this new conversion application is approved, will Capital District Physicians Health Plan and MVP Health Care follow suit? As Oscar Wilde once said, "I can resist everything except temptation."

The Capital District Alliance for Universal Healthcare believes that health care is a necessity and a social good, and that everyone should have access to high-quality, appropriate and necessary health care. The GHI/HIP "for profit" quest does not appear to further that goal.

The GHI/HIP conversion issue emphasizes many of the ongoing concerns as to whether insurance companies should continue to play such a critical role in determining who gets health care, and how and when.

When a health insurance company seeks for-profit status, it appears it has made a decision to fundamentally change how it operates to acquire a large infusion of cash. This fundamental change will logically result in a shift from a consumer-satisfaction priority to a shareholder-satisfaction focus.

Shareholders need to be kept happy, and the way to keep them happy is to make the company very profitable. How can that possibly benefit the consumers, or would-be consumers, of health insurance products? It certainly won't bring down the cost of health insurance coverage.

There is no assurance, likewise, that the large infusion of cash generated by a conversion to for-profit status will be used to benefit those who have, or would like to be covered by, a health insurance policy. The history of Empire BCBS is relevant. Its assets were used to increase its CEO's total compensation of $2.1 million in 2002, the year it got approval to convert to for-profit, to $15.5 million in 2006.

GHI/HIP's request was first disclosed publicly Dec. 13 and requires careful scrutiny. Why is the Insurance Department review timeline so short? Hearings are scheduled today in New York City and Thursday in Albany. There is no justifiable reason to act in haste on this important issue. The Empire BCBS approval process took five years.

The following questions should be asked at the hearings so that an informed and thoughtful decision can be made:

* What are the consequences of the company going from an ethic of subscriber value to one of shareholder value?

* Will the need to assure adequate profits mean premiums will increase and that more care will be denied or delayed?

* 2.7 million people lack health insurance in New York. What effect will conversion have on that number?

* How much of the new revenues generated by going for-profit will finance GHI/HIP lobbyists, and will they work for consumers or shareholders?

* In four other states, Kansas, Maryland, Washington and North Carolina, requests for for-profit status were declined after serious scrutiny by insurance regulators, including the hiring of independent outside experts who studied the impact on the insurance market and access to health care, marketplace competition and industry concentration. Are there no other management alternatives to for-profit? Are relevant studies being carried out by this administration?

* GHI/HIP has $900 million in reserves and just bought Connecticare for $350 million. Why does GHI/HIP need for-profit status to secure its future?

Dr. Arnold Relman, a physician, teacher and thoughtful national medical leader, has written that the key to saving America's health care lies in having a nonprofit health care system that includes everyone. It seems to us that approving GHI/HIP's conversion is inconsistent with that idea, will only benefit the shareholders and executives, and will result in worse health care in New York state.

Richard Propp, M.D., is chair of the Capital District Alliance For Universal Healthcare Inc.
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Friday, February 08, 2008

Dr. Sorum testifies

Report on the GHI/HIP conversion hearing.

At the hearing, the 4 representatives from HIP/GHI argued, repeatedly, that they need to have access to public capital markets in order to get money to improve their infrastructure so that they can compete successfully with the big private insurers. The chair of the insurance department panel was obviously skeptical but asked mostly technical questions. (In fact, most of the capital investments would, I think, be for HIP's role as a health provider, not as an insurer--it apparently runs hospitals and community health centers.)

The first speaker, our own Arnie Ritterband, gave an eloquent and articulate condemnation of for-profit insurers. The second speaker, from HANYS (Hospital Association of NYS), talked like a PNHP member as well, citing (if I remember correctly) the overwhelming evidence that quality is lower with for-profit insurers. I was the third speaker and contended that for-profit is contrary to the nature of health care and health insurance; I will copy my testimony below. Finally, the head of the NY insurance lobby gave a quite incoherent defense of the merger. I left after that.

Two of the insurance panelists, Troy Oeschner and Kathy Shure, are on the governor's commission to study how to achieve universal health insurance in NY. Even if we didn't stop the merger (which will no doubt take place in spite of our arguments), our case against for-profit insurance might have an impact on the work of the commission.
Paul

Presentation to the Superintendent of Insurance in Opposition to the Planned Conversion to For-Profit Status of HIP and GHI
Albany, January 31, 2008

Paul Sorum., MD
Professor of Internal Medicine and Pediatrics
Albany Medical College

I am a primary care physician for children and adults. My patients expect me to take care of them, not to make profits off of them. I am a teacher of medical students and residents; these future doctors are bright and talented young people who could, if they chose, make lots of money in other careers, but they want, above all, to comfort and heal people who are ill.

The fundamental goal of health care is to provide care to all those who need it, whatever their income, their social status, their habits. It is not to make profits. The fundamental role of health insurance should be to enable patients and health care providers to come together-to provide access to patients and fair reimbursements to providers. It should not be a means of making profits.

Health care is a social good: it is in the interest of society and its members that everyone be as healthy and productive as possible. Health insurance plays, therefore, an important social role. It should not be allowed to become instead a machine to generate high salaries for executives and profits for investors.

The Spitzer administration is aware that all New Yorkers should have health insurance. It is aware of the social importance of health insurance and of society's responsibility to provide access to health care to its citizens. The Spitzer administration should not, therefore, allow health care to become even more subject to, and a victim of, the dictates of the insurance market.

If you allow HIP and GHI to merge and become an investor-owned, for-profit company, you will create a new imperative-the need to make profits for the investors, for the shareholders. How can the company do this? As you well know, it cannot raise premiums above those of its competitors if it wants to sell its health policies to employers (or, to a much lesser degree, to individuals). To get money for the investors, it must-and other for-profit health insurers do--decrease the percentage of premiums spent on actual health care services. To do this, the for-profit company must limit care when possible and must pass along expenses to patients and providers (in the form of denials of payments, prior authorizations, ever-changing formularies, and the hospital and office staff dedicated to submitting claims, obtaining prior authorizations, and the like). The patients, my staff, and I work for the insurance company so that it can pay its executives and shareholders.

No wonder then that, in ratings of health insurers in terms of customer satisfaction and quality, not-for-profit insurers do consistently as well as or better than for-profit insurers. For example, the Health Care Report Card for 2007 of the NYS Health Accountability Foundation (at http://hcrc.abouthealthquality.org) rates for Albany County 3 not-for-profits (CDPHP, MVP, and GHI) and 2 for-profits (Empire Blue Cross Blue Shield and Blue Shield of Northeastern New York). In customer satisfaction, CDPHP is first and MVP second, although GHI is last. In the NCQA/US News &World Report rankings of Best Health Plans in 2007, among commercial plans, Harvard Pilgrim Health Care (not-for-profit) is #1 in the country; MVP (not-for-profit ) at #19 is the highest in New York State.

I speak in the name of the current and future physicians who are dedicated, above all, to the health and well-being of their patients. I speak also in the name of their patients and of all other patients in New York State. I urge you to stop the scandal of using the health insurance of the people of New York as a means to generate high salaries for health insurance executives and profits for individual investors. I urge you to tell HIP and GHI that they must remain as not-for-profits dedicated to the good of individual patients and of the public.
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