[lbo-talk] Fwd: lbo-talk post from jlandy at igc.org requires approval

[Joanne Landy]

I re-sent a much shorter version. I hope that's ok.
At 09:00 PM 8/9/2006 -0400, you wrote:
>[bounced because HTML coding drove it over the length limit - P L A I
>N   T E X T   P L E A S E ! ! !]
>
>From: Joanne Landy <jlandy at igc.org>
>Date: August 9, 2006 8:39:28 PM EDT
>To: lbo-talk at lbo-talk.org
>Subject: Re: [lbo-talk] Fwd: Change to Win: Stand up for universal
>health care
>
>
>Many members of Physicians for a National Health Program participated
>in the Citizens Health Care Working group sessions held around the
>country. Below are comments from the NY Metro Chapter of PNHP.
>--Joanne Landy, Executive Director,PNHP-NY Metro
>
>THE CITIZENS HEALTH CARE WORKING GROUP LISTENED TO THE AMERICAN
>PUBLIC WITH ONE EAR
>By Len Rodberg, Ph.D.
>Physicians for a National Health Program, NY Metro Chapter
>
>The Citizens Health Care Working Group was created by the Medicare
>Modernization Act of 2003 to provide opportunities for the American
>public to "engage in an informed national debate to make choices
>about the services they want covered, what health coverage they want
>and how they are willing to pay for coverage."After a long and
>involved process, which included the holding of community meetings in
>some 40 communities across the country as well as receipt of
>thousands of online and written individual responses, the CHCWG has
>issued a set of Interim Recommendations (at
>www.citizenshealthcare.org) and invited comments on them on a form
>provided at that site.The deadline for comments is August 31,2006. A
>month later, the Group will issue final recommendations for
>consideration by the President and Congress.
>
>The legislation creating the Working Group directed it to submit "an
>interim set of recommendations on health care coverage and ways to
>improve and strengthen the health care system based on the
>information and preferences expressed at the community
>meetings"(Emphasis ours). (Sec. 1014(h)(4)(D)) The principal
>recommendation of the Working Group is "It should be public policy
>that all Americans have affordable health care." This followed from
>the central message that it heard in these meetings, which it
>described as follows: "Across every venue we explored, we heard a
>common message: Americans should have a health care system where
>everyone participates, regardless of their financial resources or
>health status, with benefits that are sufficiently comprehensive to
>provide access to appropriate, high-quality care without endangering
>individual or family financial security" (Emphasis in original).
>Accordingly, the Group went on to make the historic pronouncements
>that (1) "It should be public policy, established in law, that all
>Americans have affordable health care coverage" and (2) "Assuring
>health care is a shared social responsibility." (Emphasis ours)
>However, in their subsequent elaboration, the Working Group seems to
>ignore, in very important respects, the clearly expressed views of
>those attending the community meetings. Some key examples:
>1. The recommendations assert that "no specific health care financing
>mechanism is optimal." This conflicts with the views of large
>majorities of respondents who supported a publicly-funded national
>program. Twenty-five of 29 community meetings supported "Create a
>National Health Program" as the most heavily favored answer to the
>question "If you believe it is important to ensure access to
>affordable, high quality health care coverage and services for all
>Americans, is most important to you/which of these proposals would
>you suggest for doing this?"(Appendix B, p.7). On-line, 72.2% of
>respondents -- far more than chose any other option -- agreed with
>the option "Create a national health plan, financed by taxpayers, in
>which all Americans would get their health insurance."(Appendix C, p.
>6)  And the CHCWG reported, in "Dialogue with the American People,"
>that "when asked to evaluate different proposals for ensuring access
>to affordable high quality health coverage and services for all
>Americans, individuals at all but four meetings ranked 
[this option]
>highest." (p. 41)
>
>2. The CHCWG recommends that a "core" benefit package be defined for
>all Americans. This seems to have been an assumption of the Working
>Group rather than a response to the views expressed in community
>meetings or by individual respondents, who were never asked whether
>they supported the idea of limited coverage to basic or "core"
>services. In fact, the Working Group reports in "Dialogue with the
>American People" that "many participants
were also concerned about
>arbitrary limits on coverage and were not comfortable with bare-bones
>benefit packages."(p.2) Moreover, "individuals voiced support for a
>fairly comprehensive basic benefit design" (p. 10) And these
>comprehensive services should be affordable; the Working Group
>reported that "a commonly expressed view was that a simpler system
>[such as the national program favored by the large majority of
>respondents] would result in lower administrative costs." (p.3)
>
>The concept of limiting benefits to "core" services grew out of
>Congress's charge to the Working Group to determine "what trade-offs
>are the American public willing to make in either benefits or
>financing to ensure access to affordable, high quality health care
>coverage and services". However, the clear answer from the public, as
>expressed in the community meetings and individual responses, was
>that simplification of the system and cost savings through
>information technology, quality improvement, and regulation of prices
>would make such trade-offs unnecessary ("Dialogue" p. 30; online poll
>items 8e and 12c). As the CHCWG reported in "Dialogue with the
>American People." "Although worded in a variety of ways, the single
>most common response to the question about trade-offs can be
>summarized as 'No trade-offs'."(p. 34)
>
>3. Beyond its proposed limitation to core services, the CHCWG's
>discussion of Recommendation 1 suggests that even for core services
>they are thinking of means-tested co-payments. Community meetings and
>individual respondents rejected this approach. The Working Group
>says, "Financial assistance will be available to those who need it."
>Three paragraphs later they comment that certain financial
>protections "such as those against catastrophic [and impoverishing]
>health care expenditures" may need to wait until some efficiency
>gains are realized. And, in discussing Recommendation 5, they call
>for providing consumer information on cost sharing in federally
>funded health programs.
>
>The primary purpose of health care reform is to ensure that financial
>barriers do not keep anyone from receiving necessary care. But
>because the CHCWG has largely failed to focus on any cost control
>strategy other than limiting covered services to a "core" set, their
>recommendations are potentially harmful to people's health. Shared
>social responsibility at the level of system financing means that
>people contribute according to their ability. But the CHCWG's
>recommendations abuse this principle when they extend it to mean cost
>sharing at the point that someone needs health care. The threat of
>facing out-of-pocket costs would deter many from getting needed care.
>Justifying cost sharing at the point of service delivery is a
>socially irresponsible way to apply the principle of shared social
>responsibility.
>
>Comments on the Interim Recommendations
>
>Recommendation 1: It should be public policy that all Americans have
>affordable health care.
>
>         We applaud this recommendation. It is encouraging to see an
>entity created by the U.S. Government supporting the concept of
>universal health care, the principle that everyone in this country
>should have access to the health care they need without facing
>financial barriers that would discourage them from seeking care. We
>believe it is long past time for the United States to move toward
>this goal, which every other advanced country has already achieved.
>
>         We do not, however, accept the idea, which the CHCWG
>supports, that Americans should have access to only a "core" set of
>services, with the wealthy able to buy their way into more services.
>Other, less wealthy countries have shown that comprehensive services
>can be made available to everyone without creating such a two-class
>system. An American system should also provide access to a
>comprehensive set of services, without bias or exclusion.
>
>Further, the concept of making "financial assistance available to
>those who need it" suggests that this will be a means-tested system.
>We believe that everyone should have access to health care without
>having to face such demeaning examinations of their finances.
>
>         We believe there should be a universal, government-financed
>system of national health insurance that will make health care
>available to everyone. This country has the financial means to do
>this; in fact, many studies show that we can do this without spending
>any more than now.
>
>Recommendation 2: Define a "core" benefit package for all Americans.
>
>         As we have stated above, we do not accept the concept of
>this recommendation. Experience with Medicare in this country, and
>with the health systems of many other countries, has shown that
>comprehensive benefits can be provided without excessive spending and
>without creating a two-class system, one for those who can afford
>only "core" services and another for those who can afford to buy
>more. We need to avoid such a two-tiered system; this country should
>move as quickly as possible to a single system for all.
>
>Recommendation 3: Guarantee financial protection against very high
>health care costs.
>
>         A comprehensive, publicly-financed system could provide
>access to a full range of services without need for any special
>"catastrophic" coverage such as this recommendation suggests.
>Further, since such a system will facilitate access to low-cost
>primary care, this will reduce the need for the high-cost services
>that this recommendation addresses.
>
>Recommendation 4: Support integrated community health networks.
>
>         We support this recommendation. Such networks are an
>efficient, community-friendly way of providing services.
>
>Recommendation 5: Promote efforts to improve quality of care and
>efficiency.
>
>         We strongly support this recommendation. We believe that
>creating a universal, publicly-financed system will provide the best
>means of achieving this, since this will enable the quality of care
>to be measured and the current wasteful administrative costs of
>private insurance to be eliminated.
>
>Recommendation 6: Fundamentally restructure the way palliative care,
>hospice care and other end-of-life services are financed and provided.
>
>         We strongly support this recommendation as well. We are a
>humane society, and we should show treat our people humanely
>throughout their lives, including at the end of life.
>
>
>>At 05:37 PM 8/9/2006 -0400, you wrote:
>>
>>--- Change to Win <takeaction at changetowin.org> wrote:
>>
>>Date: Wed, 09 Aug 2006 21:04:07 GMT
>>From: "Change to Win" <takeaction at changetowin.org>
>>Subject: Stand up for universal health care
>>
>>We believe that the time has come for universal health care --
>>and you can help make it a reality.
>>
>>The Citizens' Health Care Working Group was set up by Congress
>>to find out how to fix our broken health care system. It is
>>currently talking to average Americans around the country to
>>find out how we feel about the state of health care today.
>>
>>This important group has developed a set of proposed solutions
>>for the health care crisis, and they are seeking comments from
>>the public on their recommendations. The comment period ends on
>>August 31 -- and with it, our opportunity to ensure that the
>>needs of working people are addressed when the recommendations
>>are presented to Congress.
>>
>>You can help by submitting comments on the Working Group's
>>recommendations. Follow this link to go to a Web page where you
>>can read and comment on each recommendation:
>>
>>    * http://www.citizenshealthcare.gov/speak_out/ircomment1.php
>>
>>There are six different recommendations on the online form that
>>you can comment on. We believe the last two recommendations on
>>this form are the most important ones to comment on. While they
>>are not numbered online, they are Recommendation 5 (which has
>>two parts) and Recommendation 6.
>>
>>We've prepared talking points for you to look over as you
>>provide your comments on these two recommendations. You can
>>download them (in Adobe PDF format) by following this link:
>>
>>    * http://www.changetowin.org/pdf/CHCWGTalkingPoints.pdf
>>
>>If you would like more information, including an analysis and
>>critique of the Working Group's recommendations, you can go
>>here:
>>
>>    * http://www.uhcan.org/campaign/files/resources/analysis.doc
>>
>>Working people's voices need to be heard in this debate. The
>>health of our families depends on it. Help us make a better
>>future by standing up for universal health care today!
>>
>>Thanks for all your support,
>>
>>Anna Burger
>>Chair, Change to Win
>>
>>--------------------------------------------------
>>
>>Visit the web address below to tell your friends about this.
>>
>>
>>http://changetowinaction.org/join-forward.html?
>>domain=ctw_action&r=rpLEwlK1DPIe
>>
>>If you received this message from a friend, you can sign up for
>>Change to Win at:
>>
>>http://changetowinaction.org/ctw_action/join.html?r=rpLEwlK1DPIeE
>>
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>>http://mailman.lbo-talk.org/mailman/listinfo/lbo-talk
>>
>
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