Single Payer Healthcare coming to Ohio's Ballot?

[ArchTeryx]

I'll take something of a chance and crosspost this to Latest Breaking News. It may be a crack in the armor of the Rethuglican party here in Ohio...

Insurance plan puts pressure on taxes
Group pushing concept of medical care for all, with state paying tab
Monday, February 28, 2005
Suzanne Hoholik
THE COLUMBUS DISPATCH
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Imagine going to the doctor’s office, a dentist or even a hospital emergency room and never seeing a bill.

In fact, Ohio would pick up the tab.

A group that wants to create a new government agency that would insure all Ohioans says this scenario doesn’t have to be a fairy tale.

The Single-Payer Action Network Ohio wants to create a $38 billion health system paid for by cutting administrative costs and adding taxes.

Under its plan, individuals who earn more than $90,000 annually and all businesses would pay into the Ohio Health Care Fund.

Backers, including some labor unions, doctors, nurses, lawmakers and religious organizations, are collecting signatures to put the issue on the November 2006 ballot.

Of course, there is opposition, including legislators, medical associations and insurers.

But with 1.3 million Ohioans uninsured and health-care costs skyrocketing, something has to be done, says Jerry Gordon of SPAN Ohio.

<snip>


"We have 45 million people in this country that are uninsured," Gordon said. "They don’t have lines to wait in, but that’s because they don’t go to the doctor."

For more information on the proposed single - payer plan , visit www . spanohio . org

Full article: http://www.dispatch.com/news-story.php?story=dispatch/2... (subscription required, unfortunately)

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If Ken Blackwell and the Rethuglicans can play the initiative game, so can we! This sort of bill would be a lifesaver for me even IF my taxes went up!

-- ArchTeryx

[shoelace414]

1. Hajauluia!

[cmd]

2. It won't make it to the ballot unless we help out

I'm the most guiltly of all. I have the information that I need to get involved, but I am so tired right now that I just don't have the will. Would someone please give me a good kick in the rear to get me going again?

[frisbeez]

3. system v. insurance

is this system to provide statewide health insurance, or is a system where the doctors will work for the state?....will there be rationing of things like transplant and dialysis??????????

[ArchTeryx]

4. Neither.

It's a system where the state basically acts as a single-payer for medical bills. The way the article is worded, there'll be no co-insurance or deductables, though I would imagine there'd be at least nominal co-pays.

And there's definitely no rationing in the works. Doctors won't WORK for the state, but hospitals, clinics, etc. will be PAID by the state. That's the essense of single payer. Go to a doctor's clinic, get treated, that's it. No bills to you.

Is it reall that simple? Of course not. But it's a helluva lot simpler then the current system in Ohio, and guess what? Things like transplants and dialysis are ALREADY being rationed -- to those that can afford to pay. My health insurance would probably cover neither, as they both are way too expensive.

-- ArchTeryx

[iverglas]

28. and that is EXACTLY how Canada's system works

Doctors won't WORK for the state, but hospitals, clinics, etc. will be PAID by the state. That's the essense of single payer. Go to a doctor's clinic, get treated, that's it. No bills to you.

Doctors (and physiotherapists, and x-ray/medical labs, etc.) do NOT work "for the state" in Canada. Most doctors are in private practice. Those other medical professionals and technicians who are not employed by hospitals are employed by private companies that supply physiotherapy, x-ray, diagnostic testing and other services, and are paid directly by the public insurer.

The Ohio proposal sounds rather similar to permutations of the system in Ontario in recent years (different provinces have slightly different schemes) -- a "surtax" on high earners, and a payroll tax on employers. (There are various ways of funding single-payer systems. Some Cdn provinces have sliding-scale monthly premiums, maxing out at around $100/month for the higest-earning family of 4+.)

I have to say that I suffered rationing in Ontario last month. I went in to a private x-ray facility (on a walk-in, wait 15 minutes basis) for a chest x-ray the nurse practitioner at my clinic had ordered, and I couldn't get a mammogram until the next day. Damn! Oh, okay, if there hadn't been a cancellation I would have had to wait until the next week. And then when I needed a follow-up mammogram, the receptionist squeezed me in about a week after I called ... and then I screwed up and missed that appointment and had to wait another week.

My dad had to wait 3 days to be transferred from a small-city secondary hospital to a big-city tertiary hospital for a heart pacemaker a couple of years ago. But since the ambulance to get him the 60 miles there and back was free of charge to him (as, of course, the surgery was), we didn't worry too much.

Then the next year, when he was in hospital outside Toronto dying (although we didn't quite know at the time) of metastacized melanoma, it took 2 days to schedule him for radiation therapy, and another 2 days a couple of weeks later to schedule him, on a Sunday, for hip joint surgery to relieve his pain.

Yes, some people in some locations are waiting too long. Yes, we have a shortage in some professions (radiation technologists for quite some time, family doctors more recently). But no, that is not inherent in the system. As in the UK after Maggie Thatcher, so in Canada after 2 decades of right-wing federal and provincial governments: underfunding and tax cutting tends to do this sort of thing.

Things like transplants and dialysis are ALREADY being rationed -- to those that can afford to pay. My health insurance would probably cover neither, as they both are way too expensive.

You betcha. It's just then when it's the rich what get and the poor what don't, nobody calls it "rationing". They just call it "bad luck", I suppose.

[ArchTeryx]

33. Rationing is already happening.

My adventure through the land of ulcerative colitis has proven that. It takes me many weeks...sometimes as much as 6-8 months...to get scheduled for a colonoscopy. The GI specialist is backlogged anywhere from 2-6 months at any given time, and seeing her requires an entire afternoon, as she's often double-booked.

The only alternative is an ER visit and hospital stay if I need to be tested immediately. I do have that option (and had to use it once for an attack of life-threatening pancreatitis) but it's hideously expensive.

I don't see this as superior in ANY way to a single-payer system, and in fact vastly inferior -- because I pay BIG bucks for the privilege of using it!

-- ArchTeryx

[cmd]

5. All medical bills will be sent to one payer

From the website:

------------------------------------------------------------------------
About SPAN Ohio
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WHO WE ARE – The Single-Payer Action Network Ohio (SPAN Ohio) is a statewide coalition of individuals and organizations in Ohio that seeks fundamental health care reform in our state and country so that every resident is guaranteed full and comprehensive coverage. This includes the full range of medical services, hospitalization, prescriptions, vision care, dental care, mental health care, long-term care, and care for all injuries and illnesses. We advocate the establishment of a public fund that would pay all health care bills without co-payments or deductibles. The plan we call for is sometimes referred to as a single-payer, health-care system.
 
WHAT WE DO – We carry out a variety of programs designed to educate and inform on the need for single-payer. SPAN Ohio chapters function democratically in deciding what the group’s activities shall be. We distribute educational materials, organize public meetings featuring physicians and others with expertise on health care issues, circulate petitions, and introduce single-payer resolutions to labor unions, health care professionals, faith groups, city councils, county commissions, and community organizations. Wherever possible, SPAN representatives speak to people concerned about our health care system's worsening crisis. A focus of our efforts is to build a powerful grass roots movement that will get the Ohio General Assembly to act without delay to pass a comprehensive, publicly-funded, not-for-profit health insurance program that will cover all residents of Ohio. This would be a stepping stone toward achieving a national health care system, which is our ultimate goal. We also support putting the single-payer issue on the ballot so that the people of Ohio would have a say in deciding what kind of a health care system they want.
 
HOW TO REACH US -  Voice mail: 216-736-4766 — Email: [e-mail] — Web site: www.spanohio.org

[mongo]

20. *KICK*

I know how you feel cmd. I know I went into a depression after the election, which has gone on for most of this winter.

But hey, I guess it's time for us to dress our wounds, get up, and fight again. Even if it is sometimes like we're jousting at windmills.

I'm going to start looking into this this week. PM me with any info you have.


<big hug>
mongo

[lavenderdiva]

21. here ya go!

:kick:

[annabanana]

27. here ya go cmd:

:kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick:
:dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem:
:kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick:
:dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem: :dem:
:kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick: :kick:

[shadowknows69]

6. packing up the moving van now. n/t

[frisbeez]

7. state run HMO

this sounds like a statewide HMO, i dont think it would work.....
and although i agree there is some rationing with regards to transplant,,,,,there is none with regards to dialysis

[frisbeez]

8. and?

will only those who earn more than 90k foot the bill?

[Rose Siding]

9. Have you an alternate suggestion?

Is the current system acceptable to you?

[frisbeez]

11. no

the current system is not working so well either, but i dont think any system will work untill we as a society understand that for everybody to have basic needs covered, some cant have extraordinary (usually useless) care.....

[pokercat999]

19. I have a very viable alternative.

I keep hearing everyone say that we have the "best" military in the world, and I guess they're correct. Why not have a US Health Service. Make it like the military, top Docs would be equal to Generals etc. You could treat things like elective cosmetic surgery the same way we treat personal body guards. Just think, if we use the military model we could have the "best" health care in the world.

Know why it wouldn't work, just look at who would get hurt $$ wise and you will find the answer. Like in most things in America just follow the money and you'll find the answers.

[Rose Siding]

23. That's a good alternative

but not likely, for the reasons you cite. Considering that Dems in the Senate helped defeat the last Dem president's health care plan, it is a certainty that *this* administration will never approach a solution that would be superior to this chance in OH.

My question was in response to the denegration of that plan. I'd like to see ANY plan that has a chance succeed.

Since the Feds won't do it, more than one state will have to take it on. If not, the state that has worked out the coverage plan will see an immigration of the sick and needy and an exodus of insurance providers. PBS' Now this week discussed this as the failure of a plan considered by the last independent governor of Maine. I'd imagine the OH plan would have the same challenge- maybe they've dealt with it in the legislation; I don't know.

[customerserviceguy]

32. I saw that PBS show

and I think that the former Maine governor is correct. The only state that has had any semblance of a universal health care system is Hawaii, and nobody can drive to that state.

It really will take a national solution, but I guess it has to be more broken before enough people realize that something's wrong. Here in Utah, there are the haves and the have nots when it comes to health care, and the haves are completely oblivious to the have nots.

[knitter4democracy]

13. That's because the Feds pay for dialysis.

Dialysis is taken care of by the Feds--was written into the Medicare and Medicaid stuff. At least, that's what my husband, an internist, told me.

Rationing is already happening; it's just not done fairly or simply. It's not even based on ability to pay so much as employers' ability to pay, which doesn't make sense, socially.

[iverglas]

29. it could be

But there's no reason for it to be.

In Canada, doctors NEVER have to obtain prior approval for treatment provided, tests ordered, etc.

As long as the service is "medically necessary", i.e. covered by the plan, the doctor provides/requisitions it as required in his/her professional judgment only. No calls to administrative personnel to justify the treatment/service, no second-guessing of bills submitted for payment.

(Examples of "medically necessary" services, at what might be seen as the margins, are abortion and sterilization, and of course all pre-natal and perinatal care. Examples of services not regarded as "medically necessary", and not covered, are sterilization reversal, and removal of the annoying sebaceous cyst I have acquired on the top of my head ... but it would probably cost me under $100 to have it done privately, and if it were medically problematic or suspect removal would be covered.)

[Ilsa]

10. Oh. I thought you said "Single Prayer Healthcare".

"Nevermind," as Emily Litella would say.

[athenap]

12. This may open the door

to nationalized health care (not a problem in my book)

And as one of the folk who would still pay taxes into it, I'm more than happy to do so. It's not like my current taxes are going to anything more noble. I'm sick and tired of paying taxes that go for stupid things like Yet Another Stadium, or the corporate welfare paving of the parking lot at the new Super-Wal-Mart.

Once people see that NHC does NOT equal "soup-kitchen" style lines of bleeding and wounded people (and you know, really, if you've ever been in a doc's office or ER, you're already waiting in a line; it's just got couches and a tv and old magazines to read while you wait...and wait...and wait...), then the tide of public opinion can change.

I'm definitely looking into this. It's come at a great time...I woke up this morning incensed at my insurance company and what luck to see this on DU.

[cmd]

14. Thank you, athenap

If you pm me you snail mail addy, I will forward the literature I have to you. It is a program worth pursuing, but it will be a major battle with the establishment.

[nedbal]

15. 1) 90k sounds like it's designed to fail

I didn't look at the the plan but that 90k figure sounds way high.

2) dialysis is funded by Medicare now and is not rationed or at least if you need it you get it, enough to keep going, in France and other places you get more dialysis time on the machines as opposed to here. As with many things it's a complicated formula of who pays what and when.

3) due to the high cost of dialysis, kidney transplants are funded as are many other kinds of transplants

be a organ donor, that is what limits most transplants

save a life , sign your donor card and let friends and family know of your wishes

[JDPriestly]

16. Well meant, but very risky plan

This measure will fail unless we do the groundwork. I see two problems: 1) Ballot measures are not appropriate for complex issues.
2) It's going to take years of education to get voters vote for single payer health care plans. There's a lot of work to do before this should go on a ballot anywhere. It is terribly harmful to a cause to lose a ballot initiative on it.

Americans have been propagandized against government playing a role in their own health care for years now. Of course, government already does play the decisive role in how we get health care, who gives it and who they pay for it, but people don't know that.

We need to point out that the government already decides who gets to practice medicine, what companies can insure them, what medicines they can buy, and, really, ultimately, how much they pay for health care. The government and everyone's taxes already pay for health care for the poorest of us, the elderly and for the extremely ill. That one last step of allowing the government to make sure that everyone else has the same access to good health care as those groups do is not really such a big step. We will all benefit from it, just as we benefited when the FDA was created and separated the snake oil from scientifically tested medications. And just as we do from the licensing of doctors and nurses.

[Egalitariat]

17. In all honesty, I don't see how this can fail

if you get it on a ballot - referendum style.

When you consider that one very large group of voters get most of the direct benefits, and another very small group of voters have to pay for it. Majority rules, right?

Too bad we can't get referendum measures on federal ballots.

[sandnsea]

18. It failed in Oregon

And Oregon is more liberal than Ohio. First, the post above where the person says "packing up the moving van", is one reason. Putting the tab on business and the wealthy is another, they'll just leave the state. Then you'll have a system with increased pressure from low income patients and less wealthy people to pay for it which will eventually mean decreased service or increased taxes. Government will direct health care and when people see the VA, they don't want that. It failed 60/40 in Oregon, but that was still better than I expected.

[parsifal_e]

22. Kick!! n/t.

[goodhue]

24. excellent

How many signatures do they need?

[many a good man]

25. It can't work

Its a missing a vital ingredient: cost containment.

If you don't control health care costs, benefits will have to be slashed. Double digit cost increases will bankrupt any plan --govt or private-- if not checked in time.

[iverglas]

30. then how the hell

... does Canada, and do all the western European nations, and Australia, and New Zealand, maintain a publicly funded health care system ... and still have better health outcomes in many significant respects than are found in the US?

If you don't control health care costs, benefits will have to be slashed. Double digit cost increases will bankrupt any plan --govt or private-- if not checked in time.

It really is worth considering starting off "containing" those costs by eliminating the enormous administrative expenses of the system you currently have.

http://content.nejm.org/cgi/content/short/349/8/768

Results
In 1999, health administration costs totaled at least $294.3 billion in the United States, or $1,059 per capita, as compared with $307 per capita in Canada. After exclusions, administration accounted for 31.0 percent of health care expenditures in the United States and 16.7 percent of health care expenditures in Canada. Canada's national health insurance program had overhead of 1.3 percent; the overhead among Canada's private insurers was higher than that in the United States (13.2 percent vs. 11.7 percent). Providers' administrative costs were far lower in Canada.

<the last point refers to the administrative burden on physicians in private practice who must deal with insurers>

Between 1969 and 1999, the share of the U.S. health care labor force accounted for by administrative workers grew from 18.2 percent to 27.3 percent. In Canada, it grew from 16.0 percent in 1971 to 19.1 percent in 1996. (Both nations' figures exclude insurance-industry personnel.)

Conclusions
The gap between U.S. and Canadian spending on health care administration has grown to $752 per capita. A large sum might be saved in the United States if administrative costs could be trimmed by
implementing a Canadian-style health care system.

[many a good man]

34. This is how

Its great that nationalizing the insurance side will save 15%. But that won't help much when health care costs go up 15-20% PER YEAR. Its not just the overhead and greed of private insurance companies-- its the skyrocketing price of health care, too.

All the countries you listed have extremely strong government influence over the prices charged by health care providers. In fact, in many European countries the care is provided by the government itself. In Canada, where the providers remain mostly private and only insurance is nationalized, there is still strong govt control over pricing.

I'm not knocking single-payer-- its best hope we have-- but any single payer plan is doomed to failure and bankruptcy if it doesn't give government the power to control costs.

This is a reality check. If you want to discuss single-payer, you have to talk about cost containment. And you have to talk about "rationing"-- we can't just give unlimited services to everyone without high cost (taxes) and long lines.

[OzarkDem]

26. Might be a red herring

Will have to see what develops.

[Rainscents]

31. It's lot cheaper to do this (no more insurance company to deal with)

in a long run. As it is, states pick up the tabs right now for people who don't have insurance and these people goes to emergency room in the hospital because, they are only ones who have to treat them because it is the law! Going to Emergency room cost so much more!

[Doremus]

35. A single payer system is efficient and less costly

People on Medicare already have a single-payer system.

Medicare dictates how much doctors, hospitals and other care givers can charge. Patients pay annual deductibles and some out-of-pocket expenses, or have supplemental coverage that takes care of them.

I'm all in favor. Do-nothing, deadwood rethugs have this state in a stranglehold, so a grassroots campaign will be the ONLY way it will ever be even talked about, let alone put to a vote.

The problem will be getting the Kool-Aid drinkers to vote for it. On that I'm not very optimistic. One thing about Ohio repugnicans: their tractors have more horsepower than they have sense.

[not fooled]

36. Just by getting rid of the cost of insurance...

...considerable savings will be attained. I have heard that insurers' paperwork + profit add at least 25-33% to the cost of healthcare. If the proposed Ohio system cuts out these parasites, expect considerable savings that can be used to fund the program.

Also expect the insur / for-profit aspects of the system to scream bloody murder (and pump millions into the anti- campaign). It will be interesting to see whether they succeed in conning the public to vote against this.