National Doctors Organization: 50 million uninsured shows urgency of single-payer Medicare for All

[Better Believe It]

FOR IMMEDIATE RELEASE
Sept. 13, 2011

Number of uninsured climbs to highest figure since passage of Medicare, Medicaid
50 million uninsured shows urgency of enacting single-payer Medicare for all: national doctors group

Official estimates by the Census Bureau showing an increase of about 1 million in the number of Americans without health insurance in 2010 – to a record high of 49.9 million persons, or 16.3 percent of the population, under the bureau’s revised calculation method – underscore the urgency of going beyond the Obama administration’s federal health law and swiftly implementing a single-payer, improved Medicare-for-all program, spokespersons for Physicians for a National Health Program said today.

Employment-based coverage continued to decline. The bureau said 55.3 percent of Americans were covered by employment-based plans in 2010, down from 56.1 percent in 2009. It was the eleventh consecutive year of decline, from 64.2 percent in 2000.

In Massachusetts, whose 2006 health reform is widely viewed as the model for the federal health law, 370,000 people remained uninsured in 2010, representing 5.6 percent of the population, a jump from 4.3 percent who were uninsured in 2009.

Some states posted greater than a 3-percentage-point to 5-percentage-point increase in their uninsured rate, namely Idaho, Louisiana, Mississippi, Montana and South Carolina. In terms of absolute numbers, Louisiana had the largest increase in the number of uninsured, 240,700, followed by New York (177,700) and South Carolina (173,300). (See link to table of historical state-based data below.)

Among various population groups, the greatest loss of coverage was among working-age adults between the ages of 35 and 64, people with incomes below $49,999, and people with disabilities. Hispanics continue to disproportionately face uninsurance (30.7 percent), compared with blacks (20.8 percent), Asians (18.1 percent) and non-Hispanic whites (11.7 percent).

About 7.3 million children remain uninsured, the bureau said. Young people between the ages of 19 to 25 had a drop of 1.6 percentage points in their uninsurance rate, a figure the Census Bureau suggests is linked to the federal health law’s provision that allows dependent children to be covered under a parent’s health plan.

Lack of health insurance is known to have deadly consequences. A 2009 study in the American Journal of Public Health showed that 45,000 deaths annually can be linked to lack of coverage. Along the same lines, studies have shown that uninsured people with chronic illnesses like heart disease often delay or forgo care, often leading to serious complications of their medical condition and, in some cases, premature death.

"Tragically, we know that the new figures of uninsured mean a preventable annual death toll of about 50,000 people -- that's about one death every 10 minutes," said Dr. Garrett Adams, president of PNHP, a nationwide organization of 18,000 physicians.

The Louisville, Ky.-based physician said that even if the administration's new health law works as planned, the Congressional Budget Office estimates 23 million people will remain uninsured in 2019.

Adams was in Washington today, testifying before a subcommittee of the Senate Health, Education, Labor and Pensions Committee on the topic, “Is poverty a death sentence?”

Significantly, the Census Bureau said the number of people living in poverty, 46.2 million, is the largest number recorded in the 52 years such estimates have been published.

The increase in the uninsured would have been significantly higher had it not been for an increase in the number of people covered by government health programs such as Medicare, Medicaid, and military health care. Some in Congress have urged substantial cuts to such programs, particularly Medicare and Medicaid. If implemented, such cuts would almost certainly increase the uninsured rate in years ahead.

"The only remedy for this persistent problem is to insure everyone," Dr. Adams said. "And the only way to insure everyone at a reasonable cost is to enact single-payer national health insurance, an improved Medicare for all. Single payer would streamline bureaucracy, saving $400 billion a year on administrative overhead, enough to pay for all the uninsured and to upgrade everyone else's coverage. The new system’s bargaining clout would also help rein in rising costs."

Dr. Steffie Woolhandler, professor at the City University of New York School of Public Health and visiting professor of medicine at Harvard Medical School, noted that the Census Bureau was once again silent on the pervasive problem of "underinsurance."

"Not having health insurance, or having poor quality insurance that doesn't protect you from financial hardship in the face of medical need, is a source of mounting stress, personal bankruptcy and poor medical outcomes," Woolhandler said.

Referring to the Affordable Care Act, she said, “The new law’s subsidies for health insurance will not be sufficient to provide quality and affordable coverage to the vast majority of Americans. Tens of millions will remain uninsured, underinsured and without access to care. We need more fundamental reform. We need a single-payer national health insurance program."

*****

Historical state-by-state data on the uninsured from 2007-2010, compiled by PNHP staff from the Census Bureau’s newly adjusted data, can be found here: http://www.pnhp.org/sites/default/files/docs/2011/Uninsured-by-state-2007-2010.pdf

Physicians for a National Health Program (www.pnhp.org) is an organization of more than 18,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call [phone].

http://www.pnhp.org/news/2011/september/number-of-uninsured-climbs-to-highest-figure-since-passage-of-medicare-medicaid

[Tuesday Afternoon]

1. k&r

bravo. Doctors.

[InkAddict]

13. Hardly...

Her plate was full and her coping mechanisms failed. After a few days in hospital, she made a choice. It had taken many years for her to decide to leave the abuse, financial and emotional/psychological - a personal violence that left few visible scars but wore away at her confidence as she lost her home, her savings, her life insurance, and her small pensions/401s until there was little left of her efforts. The children had launched from the nest, each with 4-year degrees and hope, but lesser prospects. She found an apartment. She had, at least, stable employment in a medical practice. She'd find another PT job, anything really, to meet her expenses and save for an attorney to represent her interest. Her co-workers helped to stock her new and separate pantry. She was relieved that her last mammogram and a biopsy had not revealed a breast cancer though a pre-existing condition was the likely way insurance companies would read the codes. Unfortunately, on that fateful day, her physician employer decided to stop providing paid healthcare to his employees. To be fair, though much better positioned from the get-go, he'd had to augment his already superb educational advantages and buy some new credentials and equipment to plunge into the related 1st responder field while cutting his medical practice expenses as he, along with his base of self-pay-only patients, slipped into the post-9/11 deteriorating economy of fear. DO NO HARM?

Overnight her income would drop $300 a month should she choose to keep the plan. Overnight, she had a choice - forego healthcare and immediately find a second FT job that might provide healthcare benefits though the general economy was rapidly deteriorating--or allow the abusive spouse back into her life who, at best, at least, and at the moment, provided an intermittent joint living wage and intermittent healthcare by reason of his intermittent employment. Her RW fundamentalist family of origin was unsupportive of her plight; friends drifted away as her ability to participate in the smallest of activities lagged. Without going to the shelter,a system of which she was terrified, perhaps there would be another opportunity or perhaps he'd make good on his promises; perhaps, perhaps, perhaps...she'd learn, as a final stage of grief, to accept that into her old age, till death do us part, one way or the other and then thereafter, she'd never be able to meet her basic need to NOT live like the neglected child and learn how to gratefully die quickly. DO NO HARM?

Within that scenario, she had saved enough to see a doctor to lighten her depression and anxiety with medication. Her spouse saw that family doctor too. There was a small balance on HIS account that the staff assured him would not be problematic. He paid off the account but was told the physician no longer wished to provide services to him or his family. DO NO HARM?

Within that scenario, with an allied health information background and education, she had found an excellent PT job in the new city where her spouse was now intermittently employed again and that, at least, provided sick time and 1/2 paid vacation benefits but no healthcare. Her co-workers were friendly, but she had trouble relating to their activities, an unaffordable lifestyle to her. One year into the job, her employer merged with another practice and management started looking at their own bottom line. The goverment mandated an EMR and would help practices obtain and implement. She wasn't worried; she was tech savy and would be an asset with her skills. Unfortunately, her employer outsourced the back office tasks she had previously done in preparation for those mandated policies. Indeed there were workers in another state or in India that would cost less and were more worthy of a paycheck. Her job duties deteriorated to pushing a print button, stuffing envelopes, and collecting charts for filing. She had asked if she was eligible for "employee assistance" and for full-time status. Instead, she was to work more hours without the benefits they gave others. She figured it was merely to boost her wages toward the inevitable layoff. She was right. Knowing full well that her spouse was among the long-termed unemployed, they gave her a pink slip, oily-mouthed compliments on what a great employee she had been, and two weeks pay. She no longer had a doctor to write a script but then she could no longer afford the visit or script anyway. She wept in anger, in frustration, in pain, and applied for her "entitlement." DO NO HARM?

From her lower middle class status TPTB decried as parasitic and despite successfully balancing a home and raising "good" children into capable adulthood in hidden adverse conditions, she had slipped into old-age, or was that age-old, poverty. Either way, she no longer visited the beauty salon for even a haircut nor home-colored the gray. She forced herself to buy frivolous birthday cards for family that had once received gifts, and yes, she'd watch the kids' dogs while they vacationed. Christmas would be even more dismal than the many before; the future looked to remain dismal. Of course, she had made bad choices, she had been lazy, she apparently had worked all those years as an office slug, she HAD been young and, by other accounts, was still at best a prodigal child of God but at worst, a useless eater, with an undeserved Internet connection.

GOD BLESS US EVERYONE, Mr. Scrooge!

[IndyPragmatist]

2. Most doctors that I know are against expanding Medicare and Medicaid

because of how they are administered. Most of these would support a national healthcare system, but do not want it to be created using Medicare or Medicaid as an example. There is so much red tape to deal with that medical billing specialists are constantly forced to learn the new code. Additionally, they are often shorted on payments or find that some of the procedures aren't covered after the fact.

This all came because people wanted to find ways to make them more cost effective. Poor logic led to partial payments and stringing doctors along for extended periods of time.

We need to fix these issues because if we don't, we will continue to see costs skyrocket as they will just pass the costs on to others.

[w8liftinglady]

3. you are correct in THAT aspect

most doctors I know would prefer to see their patients early in the disease process- when the cure rate is higher(I deal mainly with diabetes,lung,brain and heart diseases).The issue of public/private coding to accomodate secondary insurance has complicated matters.Universal healthcare is the ONLY logical solution.

[ljm2002]

8. So they don't have to learn new codes from private insurers?

They don't have to pay staff to haggle with private insurance companies? They don't have to deal with extra red tape because of all the different providers, each of whom has a slightly different way of doing things?

Medicare and Medicaid are suffering because they are underfunded, because they cover those who would otherwise have no recourse -- in other words, the old and the infirm. Also of course these government programs are under constant attack, and as a result the politicians find it convenient to make cuts from these programs, including lowering the amounts the programs will pay at all, which naturally results in more doctors dropping out from them.

A single payer system would remove these issues. Of course there will always be some red tape. But everything I've read about Medicare indicates its overhead expenses are far, far lower than those of private insurers.

Bottom line, I think the Medicare-for-all is the way to go, and I think that the issues you raise are important but do not apply only to Medicare and Medicaid.

[siligut]

4. These are the people who went into medicine to actually help people

It wasn't the money or the prestige, it was truly the desire to be of benefit to humanity.

[w8liftinglady]

7. Which is why I hate to see Ron Anderson of Parkland catch crap

http://www.pnhp.org/single_payer_resources/physicians_proposal_intro.php

[Coyote_Bandit]

5. Health care is a luxury in this country

even among some who have health insurance. That's what happens when someone has an insanely high deductible. That's what happens when docotr visits and/or prescription drugs are not covered by a policy. That's what happens when someone is afraid of losing what meager health coverage they have should they be diagnosed with a chronic condition requiring ongoing treatment. Defining those without meaningful access to healthcare as only the uninsured is a gross understatement of those who find themselves in such circumstances.

[WinkyDink]

6. NEVER will happen. Too many billionaires buying too many politicians. That discussion is OVER, DEAD.

NOW Europe is being pressured to rescind ITS health-care systems.

[TreasonousBastard]

9. OK, so the 250 million who HAVE healthcare coverage should lose theirs...

to Medicare?

Can't help wondering about those 18,000 doctors who want their incomes reduced by 20% while having more procedures denied.

[Better Believe It]

10. Why are you attacking this progressive doctors organization?

"Can't help wondering about those 18,000 doctors who want their incomes reduced by 20% while having more procedures denied."

They must be radical comminist professional leftist pinkos!

What makes you think this doctors organization advocates denying medical procedures for the ill and injured?

Perhaps you can link us to some statement along those lines made by the doctors organization and/or its leaders.

If you can't do that, why have you made the false claim that they advocate denying needed medical procedures and leveled a broadside attack on this organization?

[xchrom]

11. +1

[TreasonousBastard]

12. Really now...

Medicaid is falling apart because of state budget problems, with less and less covered (like preventive care) and payment rates being reduced. Good luck finding a Medicaid doctor.

Medicare, while orders of magnitude better than Medicare in care delivered, is happily "fixing" itself by reducing payment rates and does not by any means cover everything, hence the need for medigap coverage (from those evil insurance companies). It's fast becoming as hard to find a Medicare doctor as a Medicaid one.

A properly designed single payer plan might work, although it's having problems in England because of skyrocketing costs, but the plans we have are NOT the properly designed ones which would work universally.

This group is obsessed with single-payer, as if that is the only answer. What about the vast majority of doctors who are against expanding Medicare and Medicaid as they exist now?

Universal coverage is not necessarily single-payer. Note that France, Germany and Italy, which have care significantly better than ours, are not single-payer although they are universal.