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Rep. Markey co-sponsors "Medicare for All" bill

by: Rand Wilson

Mon Jun 15, 2009 at 13:43:05 PM EDT


(So ... what's the angle on this? Single-payer's not going to pass, so is this a little subtle way of changing the terms of debate, to get folks to take single-payer seriously, thereby strengthening the public option? Whatevs, it's welcome. - promoted by Charley on the MTA)

On June 12, Rep. Edward Markey became the seventh member of the Massachusetts Congressional delegation to co-sponsor H.R. 676, the "Medicare for All" approach to health care reform written by Rep. John Conyers.

Rep. Markey joins Massachusetts Representatives Michael Capuano, William Delahunt, Barney Frank, James McGovern, John Olver and John Tierney and 75 other members of Congress as a co-sponsor of H.R. 676.

Rep. Markey has already played an important role helping to write H.R. 676.  When he was initially approached about becoming a co-sponsor in 2006, he expressed support for the goals of the legislation, but had strong reservations about having a national health plan subjected to an annual appropriations process.  Because of his suggestions, H.R. 676 now contains a Trust funding mechanism similar to Medicare's.

Dave Bjorkman, a resident of Malden for more than 20 years, was one of 52 constituents who signed a letter put together by Jobs with Justice's Health Care Action Committee and MassCare on May 11 asking Rep. Markey to become a co-sponsor of H.R. 676.  "From my experience working at GE, we know we can't solve the problems in health care through collective bargaining or by just tinkering with incremental reforms," he said.  Bjorkman is a machinist at the General Electric Company in Lynn and member of IUE-CWA Local 201.  

"By taking more of the cost of health benefits away from employers, Medicare for All would make companies more competitive in the global economy.  It would also allow our union to focus on other priorities," added Bjorkman.  For many years Local 201 has been helping to spearhead health care reform efforts in Massachusetts.  "With Rep. Markey's support for Medicare for All, everyone can see the momentum for comprehensive reform is growing in Massachusetts and across the nation."

Bjorkman was also part of a smaller group of 18 constituents who met with Rep. Markey's District Director Mark Gallagher and Congressional Aide Patrick Lally on May 20.  On June 10, along with many other Seventh District constituents, he leafleted the public urging Markey to support HR 676.

Jobs with Justice and MassCare are planning more actions to convince the three remaining Members of Congress from Massachusetts (Reps. Lynch, Neal and Tsongas) to co-sponsor.

Rand Wilson :: Rep. Markey co-sponsors "Medicare for All" bill
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I just can't seem to fall in love with H.R. 676 (0.00 / 0)
I much prefer the "option" .

The government has a way of making things far more complicated than they need to be.  Although initially it may be a wonderfully run and patient focused system, I
don't believe it would remain that way if there were no other options for citizens to choose.

I will give the supporters of H.R 676 a lot of credit for their unrelenting fight to pass this bill.  

WE NEED A PUBLIC OPTION


Insurance is a tricky thing. (6.00 / 2)
Truth is it's incredibly complicated already.  This is because there is an enormous amount of baggage tailoring a given provider's rules so that they can make a profit.  The benefits and the subscriber portfolio need to be manipulated to within an inch of their lives.  The irony is that once you accept all taxpayers as your portfolio of subscribers (foregoing the need to manipulate the portfolio) the potential is to vastly simplify the system actually.  Most of the benefit manipulations are actually in service to manipulating the subscriber portfolio.  Particular benefits are often priced so as to 'force out' the people who need them.  Of course costs are a consideration... but cost issues are supposed to be mitigated by aggregating them and spreading them across the whole pool's premiums.  In practice, though, the real key is to manipulate the pool in order to avoid paying out in the first place (and, of course, to avoid paying out in any case when possible).  This whole aspect of the business plan is a huge part of why individual systems are complicated... oftentimes the complications are buried in lots of details that you don't find out about until you're in need.  Elimination of this aspect of the business plan has the potential to actually greatly simplify things.  An irony, though is that I suspect that in practice it might actually look more complicated.  This is because the business plan's complications are largely hidden from the consumer (until they are in need anyway... then they are a club against the consumer to be used to avoid paying out).  A single payer system's complications, such as they are, will be on the front end and much more visible, if less in magnitude.

"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)

[ Parent ]
While you are looking at it from the corporate level.... (0.00 / 0)
I am looking at it from the consumer experience level.
It absolutely infuriates me the way the whole process is manipulated, as you say, where profit is the primary focus and an individual's health and well being are of little concern. It's because of the desire to keep payouts low and profits high, we, as consumers, have to deal with the obsurdity of going back and forth with insurers and hospitals to get medical claims processed.

denied, applied to deductible
denied, bill motor vehicle insurance
denied, not a covered service
denied, benefits exhausted, bill health insurance
denied, not insured
denied, other insurance primary

Often, these denials are inaccurate, processed by a medical biller or claims analyst who is handling hundreds of claims per day.

I have little hope that a single payer, fully government run health insurance system would feel obligated to provide excellence in customer service to the entire country, when the consumer had no other choice but to tolerate the experiences.

Why do I feel this way?  Because I have had lovely experiences with both the Registry of Motor Vehicles and the IRS. Minor issues that needed a pound of paperwork to resolve. Terrible customer service associates who thrive on making people miserable everyday(and there are people like that).

A good example of how a system can get over the top is the way motor mehicle titles are handled.  If there is a single slip of the pen, the whole thing is invalid.  You must go back to the person you purchased the car from, have them apply for a new title, which can take, uhmmmmm, is it a month I think, then they must fill it out again, and GOOD GOD what if they make another mistake. Don't forget that middle initial now, and make sure you sign on the correct line because if you don't, it's back to drawing board for a new title to start all over again.

Can you imagine?!?

I'd be happy to support a government insurance "option".



WE NEED A PUBLIC OPTION


[ Parent ]
Actually,... (0.00 / 0)
... a single payer option would provide the single best chance to streamline any system of 'back and forth between insurers and providers'.  Market leverage is a great thing for getting those you interact with to get on the same page,... just as WalMart.  Furthermore, the profit motive and business plan is to make it difficult to pay out.  In a public single payer system, while there is incentive not to approve everything all the time, the incentive is to systematize what you want to approve so that you don't have to waste any money on 'back and forth'.  The private insurer's aren't wasting money when they do a 'back and forth' because that's actually how they manipulate the makeup of the pool, which is real mechanism for how to generate profit for them (that and claim denial).  

The incentives for how the bureaucratic side gets run are aligned differently.

"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)


[ Parent ]
because the status quo (0.00 / 0)
is so utterly fantastic.

The only thing to fear is fear itself.  

---
My thoughts are mine and mine alone. They should not be considered representative of any other organization, group or person - save me.

~Ryan.


[ Parent ]
Medicare for all? (4.60 / 5)
I used to run an 1,100-person ERISA health plan spanning the US, from Seattle to Miami, from LA to Boston.  It's members would do anything (and did) to preserve their benefits beyond the statutory age 65 kick-out because Medicare was a cluster-f*** compared to their plain-Jane HMO.

Who thinks Medicare is (a) better run than private insurance plans, (b) more efficient than private plans, (c) has better coverage and benefits than private plans, or is (d) more compassionate than private plans?

Nobody.  Especially MD's, who booed Barry at the AMA convention.  Why are more and more of them refusing to accept Medicare patients?  Medicare sucks and their reimbursement rates stink.  This is the model we want for our health insurance system?  You must be kidding.

Medicare is the worst health insurance program in the US.  After seeing how they treated my grandmother, I'd rather be insured by Wal Mart.


AMEN and thank you for that (4.00 / 3)
I have talked about this until I have blue in the face.
try and find a physician/health care provider who will take a medicare Pt now. If you were a fromer Pt they will grudgingly keep you. If you are a new pt ----forget about it. The office paperwork is beyond belief, the paper work for medical documentation is beyond belief and comprehension and reimbursement is laughable. medicare and medicaid are a catastrophe and Markey ( the idiot obviously did ZERO research) is attempting to stick this up our kiester. I know a lot of docs who are on the cusp of retirement that are saying that if congress passes this nonsense---they are out the door.  God save us from the good intentions of fools who will bury us all.

[ Parent ]
As far as I can tell... (0.00 / 0)
...you still haven't proposed a better solution.

[ Parent ]
Solution? (4.00 / 1)
Think that is fair to point out problems w/o having to have the solution in hand.

Literally, figure my wife and my bro-in-law would be 6 feet under by now under a government run plan (and I'm not spinning rhetoric).  Health Care also has a third dimension: time.  How much exactly do you value your life when things are seriously wrong?  Camcer doesn't cooperate with rationing lists.


[ Parent ]
You don't think.. (6.00 / 1)
... we ration now?  We ration by pricing millions out of the system.

"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)

[ Parent ]
When (4.00 / 1)
you or your wife are facing catastrophic illness, please post again about a macro v. micro approach to health care.  Do you exactly wonder why there are so many foreigners who come to our hospitals in Boston?

I appreciate when I'm dealing with the people I love being responded to by physicians, rather than bureaucrats.  Hopefully for you, this post won't resonate with your family or the people you care for.  My wife's life literally depended on rapid detection (and bucking the system to figure out that her "imaginary" complaint as her PHP put it was actually a benign tumor).  Diseases operate on their own time line.


[ Parent ]
God, I hope that someone can figure out an edit button on this site (0.00 / 0)
not benign, MALIGNANT.

[ Parent ]
I have a disease,... (6.00 / 1)
... that while not catastrophic, will likely be part of my death (death by x due to complications with his disease).  Simply put, if we had sane insurance in this country I wouldn't have this problem (it would have been caught earlier when I could have still done something about it).  Simply put, while I was one of the millions of uninsured, it mattered.  

Now multiply that by millions.

"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)


[ Parent ]
It sucks depending... (0.00 / 0)
... on rapid detection when you don't get to even see a doctor.  This is what it means for millions who are out there with nothing.

"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)

[ Parent ]
The myths keep on coming (0.00 / 0)
Decisions by doctors rather than bureaucrats is exactly what we are trying to achieve.  You seem to assume that your wife would not have benefited under a universal system, but I fail to the evidence to back up that claim.

[ Parent ]
The time myth (6.00 / 1)
Of course time is a factor.  As with justice, health care delayed may well be health care denied.  You've made an assertion about time, but I have no reason to believe your family would not have been treated in a timely fashion in what you call a "government-run" system.  That BTW, is another misnomer, I believe most people are calling for a government-financed system as opposed to a government-run system.

[ Parent ]
First of all.. (6.00 / 1)
...the article says he was booed over malpractice caps, not universal coverage.

Second, everything I've heard and read indicates that getting rid of Medicare would be political death, so it must be popular.


[ Parent ]
Update (0.00 / 0)
I watched his speech on CSPAN last night.  There was some mild groaning about caps, hardly what I would think of as hostile booing which both the commenter and the linked article seemed to imply.  Overall, it sounded like the speech was generally well-received by the AMA.  It certainly was not a campaign rally, but there was plenty of applause throughout the speech, some quite enthusiastic.

[ Parent ]
Actually (0.00 / 0)
Who thinks Medicare is (a) better run than private insurance plans, (b) more efficient than private plans, (c) has better coverage and benefits than private plans, or is (d) more compassionate than private plans?

A lot of people. The majority of America wants much more government in their health care, not the other way around. Meh likes da google.  

---
My thoughts are mine and mine alone. They should not be considered representative of any other organization, group or person - save me.

~Ryan.


[ Parent ]
Why? (6.00 / 2)
"Especially MD's, who booed Barry at the AMA convention.  Why are more and more of them refusing to accept Medicare patients?"

Maybe because they're retired?

It is a common misconception that this organization speaks on behalf of most American physicians but that is a misconception with very serious consequences at such a critical time in the healthcare reform debate. So long as the public, the media and our elected officials lump all physicians together as "the AMA", then we are guilty by association of a failure of our hippocratic oath to "first, do no harm".

In fact, the AMA represents less than 1/3 of America's physicians and half of those are retired.




Shoe bomber, underwear bomber -- why aren't we waging war on clothes?

[ Parent ]
Universal coverage, single payer and multiple providers: way to go. (0.00 / 0)


What a stupid comment (0.00 / 0)
How old are you? 32? 28?  Medicare will not be there for you even as currently designed only for 65-year-olds and up.  Add everyone to it and it'll implode in a few years.

Medicare is running in the red RIGHT NOW, careening towards insolvency as soon as 2018.  In 2004 that insolvency date was 2026.  It already has an $74 trillion unfunded liability (as of 2008), up from the projected $61.6 trillion cited in 2004.

Put that into perspective.  Current year deficits are in the $2 trillion range.  The CURRENT unfunded liability is approaching 35 times more than that.  $2 trillion is around $6,700 per person in the US (300 million).  $74 trillion is $247,000 per person.

That huge slug of 65-year-olds coming down the road into the Medicare system is what is accelerating its collapse.  I suspect the next estimates will place system meltdown inside Obama's first term.

Do you understand the implications of this unfunded liability?  If so, how is adding 250,000,000 million heads to Medicare going to solve the problem?



[ Parent ]
You're right. (0.00 / 0)
Imagine if we put 75% of the money we're spending on private insurers when we transform medicare into medicare for all.

Your assuming the funding glut would continue.  You can't assume that, given the radically difference in funding and coverage.


"It is not because things are difficult that we do not dare, it is because we do not dare that things are difficult." - Seneca (5 BC - 65 AD)


[ Parent ]



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