NAHA Monthly Meeting — Monday, August 2 , 2010  @ 5:30 PM

Huntsville/Madison County Public Library, 901 Monroe Street  (downtown)

The meeting is in Room AB, on the first floor. After you enter the library’s front door, turn right towards the auditorium.

Oliver Fein, MD

President, Physicians for a National Health Program

Robert Wood Johnson Health Policy Fellow

Past Vice President of the American Public Health Association    

All three events are FREE and open to the public

For more information, call (256) 489-3884, e-mail lahaynes@knology.net  or online www.NorthAlabamaHealthcareForAll.org      

1)  Friday, Feb. 26,  6:00 p.m.

“Healthcare Reform 2010: Where Do We Go From Here?” Physicians understand the urgent need for healthcare reform — for the good of patients, the profession and the U.S. economy. However, according to Dr. Fein, the present legislation in Congress is not going far enough AND is headed in the wrong direction. This talk, by a leading advocate of an expanded and improved Medicare for All (single payer) program, will describe what’s really happening with our healthcare system and where we need to go from here to reach universal, high quality coverage at an affordable cost for all. Audience Q&A will follow.   The presentation will include updates and responses to President Obama’s healthcare summit to be held in Washington, DC, on the day prior to this event.   

Speaker:   Oliver Fein, MD, president, Physicians for a National Health Program, www.pnhp.org  (New York, NY)

Location:  Shelby Center for Science and Technology, UA Huntsville Campus. Room 107 Auditorium. (near intersection of Sparkman Drive and Lakeside  http://www.uah.edu/map/color_map.pdf )

Co-sponsors:  UA Huntsville Political Science Department and Alabama A&M University Political Science Department  

———————————————-    

2)  Saturday, Feb. 27, 10 – 11:30 a.m.

“Healthcare Justice: The Moral Imperative for Universal Healthcare from a Christian Perspective”

This event offers an overview of problems with the healthcare system, the status of reform legislation, and an affordable solution aimed at just and equitable healthcare for all. We begin by laying out an ethical framework for the discussion. Speakers then address various aspects of healthcare justice and the moral imperative they see as central to the Christian perspective. Audience Q&A will follow.   

Location:  Faith Presbyterian Church, 5003 Whitesburg Drive, Huntsville. Fellowship Hall. (at intersection of Airport and Whitesburg)    

Speakers: 

+  Oliver Fein, MD, president, Physicians for a National Health Program (New York, NY)

+  Arthur Sutherland, MD, board member, Tennessee Health Care Campaign, and national board member of PNHP (Memphis, TN)

+  Abi Carlisle-Wilke, M.Div., Senior Associate Pastor, Trinity United Methodist Church (Huntsville, AL).  

Moderator:  Rev. Frank Broyles, Interfaith Mission Service  

Supported by:  Interfaith Mission Service;  Indian Creek Primitive Baptist Association;  Greater Huntsville Interdenominational Ministerial Fellowship.   Coffee, fruit and pastries will be available.  

———————————————    

3)  Saturday, Feb. 27, 1 – 3 p.m.

“Point / Counterpoint: Fixing the American Health System” Physicians from opposite ends of the policy spectrum will present their solutions to our health care crisis. Dr. Oliver Fein, president of PNHP, will present the case for expanding and improving Medicare to all. Dr. Allan Goldstein, Alabama delegate to the American Medical Association, will focus on quality of healthcare as a way to reduce costs, and the reforms necessary to reach that goal. Audience Q&A will follow.     

Location: Crestwood Medical Center, One Hospital Drive, Huntsville. First floor auditorium.  (near intersection of Airport and Whitesburg)   

Speakers: 

+  Oliver Fein, MD, president, Physicians for a National Health Program  (New York, NY)

+  Allan Goldstein, MD, past president, Medical Society of the State of Alabama; current delegate to the American Medical Association representing Alabama. (Birmingham, AL)    

———————————————-

Speaker Biographies:  

Oliver T. Fein, MD  (New York, NY) Dr. Fein is president of Physician for a National Health Program, a nonprofit organization of over 17,000 physicians who support single-payer national health insurance. He is a general internist who is active in clinical practice, he is also professor of clinical medicine and clinical public health at Weill Medical College of Cornell University, where he serves as associate dean responsible for the Office of Affiliations and the Office of Global Health Education. Dr. Fein has advocated for an expanded role for primary care, for academic health centers in urban health care delivery systems, and for national health system reform. He was Robert Wood Johnson Health Policy Fellow during 1993-1994, when he worked in the office of Senate Democratic Majority Leader George Mitchell. He spent 17 years at the Columbia Presbyterian Medical Center developing community-based ambulatory care practices and the Division of General Medicine. He is chair of the New York State Chapter of PNHP and immediate past vice president of the American Public Health Association. Dr. Fein received the Elnora M. Rhodes Service award from the Society of General Internal Medicine in 1999; the Haven Emerson Award from the Public Health Association of New York City in 2001; and the Lifetime Achievement Award from the Robert Wood Johnson Health Policy Fellowships Program in 2008.    

Allan R. Goldstein, MD  (Birmingham, AL) Dr. Goldstein is a native of Cleveland, Ohio, and a graduate of “The” Ohio State University School of Medicine. He has been in practice since 1972 and is Board Certified in Internal Medicine and Pulmonary Diseases. He continues to have an active practice and serves as both a Primary Care Physician and a Consultant. He has been involved in organized medicine for over 30 years. He has served on the Board of the Jefferson County Medical Society and has been its President. He has served on the Board of Censors of The Medical Association of the State of Alabama, been a member of both the Board of Medical Examiners and the State Committee of Public Health and has been the President of The Medical Association of the State of Alabama. Presently, he is a Delegate to the AMA , representing Alabama. He is a patient advocate and supports quality and efficient care initiatives that will lead to reduced cost by decreasing the need for unscheduled visits, Emergency Department visits and hospitalization. He is a strong advocate for the patient-doctor relationship and for patient focused care.    

Arthur J. Sutherland III, MD, FACC  (Memphis, TN) Dr. Sutherland is a retired physician and founder of the Sutherland Cardiology Clinic. He currently works with The Healthy Memphis Common Table which is addressing the obesity and diabetes epidemics in Memphis and the Mid-South. Improving health literacy and elimination of social and health related disparities are high priority agenda issues. Dr. Sutherland is also a member of the Memphis School of Servant Leadership and works with the Memphis Theological Seminary in its urban ministry program. He is currently serving as chairman of the Tennessee chapter of Physicians for a National Health Program and is on the national PNHP Board of Directors. In addition, he is on the state Board of Directors for the Tennessee Health Care Campaign. Both PNHP and THCC have been working for health care justice for over 20 years.      

Abi Carlisle-Wilke, M.Div.  (Huntsville, AL) Abi Carlisle-Wilke is the Senior Associate Pastor at Trinity United Methodist Church in Huntsville, AL. She earned her Master of Divinity degree from Southern Baptist Theological Seminary in 1978. Her studies also include training in Clinical Pastoral Education beginning with The University of Louisville Health Sciences System, Louisville, KY and then at Carraway Methodist Medical Center in Birmingham, AL.  She has served as Chaplain/Pastoral Counselor for Brookwood Medical Center, South Highland Hospital, and Carraway Methodist Medical Center in Birmingham, AL; and then for the Pastoral Institute/Bradley Center in Columbus, GA.    

Frank Broyles, M.Div   (Huntsville, AL) Reverand Frank Broyles currently serves as Minister of Church and Community with the Faith Presbyterian Church in Huntsville, Alabama. He also serves as Executive Minister of the Huntsville Association for Pastoral Care (HAPC); Program Director of the Area Chapter of the National Conference For Community and Justice; and Senior Program Specialist for the Interfaith Mission Service. He served as the first Administrative Director of Hospice of Huntsville; for fifteen years as Director of the Campus Ministry Association at UAH; and for twelve years as Adjunct Instructor at the School of Theology at the University of the South. He earned his B.A. from Rhodes College (Southwestern at Memphis) and his Master of Divinity from Vanderbilt Divinity School. He carried out post-graduate non-degree studies at Sewanee’s School of Theology. Rev. Broyles’ commitment to ecumenical and interfaith understanding has been significant and lasting. He has received close to 30 awards and recognitions for community service in inter-agency, ecumenical, and interfaith work.     

_______________________________________

               North Alabama Healthcare for All presents …

                         Oliver Fein, MD

President, Physicians for a National Health Program

Robert Wood Johnson Health Policy Fellow

Past Vice President of the American Public Health Association

All three events are FREE and open to the public

For more information:  (256) 489-3884  Lahaynes@knology.net

1) Friday, Feb. 26,  6:00 p.m.
“Healthcare Reform 2010: Where Do We Go From Here?”

Physicians understand the urgent need for healthcare reform — for the good of patients, the profession and the U.S. economy. However, according to Dr. Fein, the present legislation in Congress is not going far enough AND is headed in the wrong direction. This talk, by a leading advocate of an expanded and improved Medicare for All (single payer) program, will describe what’s really happening with our healthcare system and where we need to go from here to reach universal, high quality coverage at an affordable cost for all. Audience Q&A will follow.

The presentation will include updates and responses to President Obama’s healthcare summit to be held in Washington, DC, on the day prior to this event.

Speaker: Oliver Fein, MD, president, Physicians for a National Health Program, (www.pnhp.org)

Location: Shelby Center for Science and Technology, UA Huntsville Campus. Room 107 Auditorium. (near intersection of Sparkman Drive and Lakeside  http://www.uah.edu/map/color_map.pdf )

Co-sponsors: UA Huntsville Political Science Department and Alabama A&M University Political Science Department
———————————————-
 

2) Saturday, Feb. 27, 10 – 11:30 a.m.
“Healthcare Justice: The Moral Imperative for Universal Healthcare from a Christian Perspective”

This event offers an overview of problems with the healthcare system, the status of reform legislation, and an affordable solution aimed at just and equitable healthcare for all. We begin by laying out an ethical framework for the discussion. Speakers then address various aspects of healthcare justice and the moral imperative they see as central to the Christian perspective. Audience Q&A will follow.

Location: Faith Presbyterian Church, 5003 Whitesburg Drive, Huntsville. Fellowship Hall. (near intersection of Airport and Whitesburg)
Speakers:
+  Oliver Fein, MD, president, Physicians for a National Health Program (New York, NY)

+  Arthur Sutherland, MD, board member, Tennessee Health Care Campaign, and national board member of PNHP  (Memphis, TN)

+  Abi Carlisle-Wilke, M.Div., Senior Associate Pastor, Trinity United Methodist Church (Huntsville, AL)

+  An additional local minister is being added to the panel.

Moderator: Rev. Frank Broyles, Interfaith Mission Service
Supported by: Interfaith Mission Service;  Indian Creek Primitive Baptist Association;  Greater Huntsville Interdenominational Fellowship.

Coffee, fruit and pastries will be available.
—————————————————–
 

3)  Saturday, Feb. 27, 1 – 3 p.m.
“Point / Counterpoint: Fixing the American Health System”

Physicians from opposite ends of the policy spectrum will present their solutions to our health care crisis. Dr. Oliver Fein, president of PNHP, will present the case for expanding and improving Medicare to all. Dr. Allan Goldstein, Alabama delegate to the American Medical Association, will focus on quality of healthcare as a way to reduce costs, and the reforms necessary to reach that goal. Audience Q&A will follow. 

Location: Crestwood Medical Center, One Hospital Drive, Huntsville. First floor auditorium.  (near intersection of Airport and Whitesburg)
Speakers:
+  Oliver Fein, MD, president, Physicians for a National Health Program  (New York, NY)
+  Allan Goldstein, MD, past president, Medical Society of the State of Alabama; current delegate to the American Medical Association representing Alabama.  (Birmingham, AL)

———————————————-
Speaker Biographies:
 

Oliver T. Fein, MD   (New York, NY)

Dr. Fein is president of Physician for a National Health Program, a nonprofit organization of over 17,000 physicians who support single-payer national health insurance. He is a general internist who is active in clinical practice, he is also professor of clinical medicine and clinical public health at Weill Medical College of Cornell University, where he serves as associate dean responsible for the Office of Affiliations and the Office of Global Health Education.  Dr. Fein has advocated for an expanded role for primary care, for academic health centers in urban health care delivery systems, and for national health system reform. He was Robert Wood Johnson Health Policy Fellow during 1993-1994, when he worked in the office of Senate Democratic Majority Leader George Mitchell. He spent 17 years at the Columbia Presbyterian Medical Center developing community-based ambulatory care practices and the Division of General Medicine.  He is chair of the New York State Chapter of PNHP and immediate past vice president of the American Public Health Association. Dr. Fein received the Elnora M. Rhodes Service award from the Society of General Internal Medicine in 1999; the Haven Emerson Award from the Public Health Association of New York City in 2001; and the Lifetime Achievement Award from the Robert Wood Johnson Health Policy Fellowships Program in 2008.

Allan R. Goldstein, MD   (Birmingham, AL)

Dr. Goldstein is a native of Cleveland, Ohio, and a graduate of “The” Ohio State University School of Medicine. He has been in practice since 1972 and is Board Certified in Internal Medicine and Pulmonary Diseases. He continues to have an active practice and serves as both a Primary Care Physician and a Consultant. He has been involved in organized medicine for over 30 years.  He has served on the Board of the Jefferson County Medical Society and has been its President. He has served on the Board of Censors of The Medical Association of the State of Alabama, been a member of both the Board of Medical Examiners and the State Committee of Public Health and has been the President of The Medical Association of the State of Alabama. Presently, he is a Delegate to the AMA , representing Alabama.  He is a patient advocate and supports quality and efficient care initiatives that will lead to reduced cost by decreasing the need for unscheduled visits, Emergency Department visits and hospitalization. He is a strong advocate for the patient-doctor relationship and for patient focused care.

Arthur J. Sutherland III, MD, FACC   (Memphis, TN)

 Dr. Sutherland is a retired physician and founder of the Sutherland Cardiology Clinic. He currently works with The Healthy Memphis Common Table which is addressing the obesity and diabetes epidemics in Memphis and the Mid-South. Improving health literacy and elimination of social and health related disparities are high priority agenda issues. Dr. Sutherland is also a member of the Memphis School of Servant Leadership and works with the Memphis Theological Seminary in its urban ministry program. He is currently serving as chairman of the Tennessee chapter of Physicians for a National Health Program and is on the national PNHP Board of Directors.  In addition, he is on the state Board of Directors for the Tennessee Health Care Campaign. Both PNHP and THCC have been working for health care justice for over 20 years.

North Alabama Healthcare for All is a nonprofit, all-volunteer organization promoting a healthcare system which provides quality healthcare at an affordable cost to all Americans. We believe healthcare is a human right.

The most effective and cost efficient way to accomplish healthcare for all is through an expanded and improved Medicare-for-all type system. (This is also called universal single payer healthcare, government-funded healthcare, or national health insurance.)

We are a chapter of the national organization Physicians for a National Health Program. Like our parent group, we are not just physicians — membership is open to anyone.

For more information or to sign up for our email list, go to www.NorthAlabamaHealthcareForAll.org

CANCELLED — NAHA Monthly Meeting — Monday, July 5 , 2010  @ 5:30 PM

Huntsville/Madison County Public Library, 901 Monroe Street  (downtown)

The meeting is in Room AB, on the first floor. After you enter the library’s front door, turn right towards the auditorium.

“Candlelight Vigil in Memory of Those Who Die for Lack of Health Insurance”

Thursday, Dec. 10   (Human Rights Day)

@ 4:30 – 6:30 PM

Location:  Steps of the Madison County Courthouse, downtown Huntsville

East Side Square  (near corner of Franklin St. and the downtown square)

Info:  Lahaynes@knology.net 256-429-8639   www.NorthAlabamaHealthcareForAll.org

On Human Rights Day, our Huntsville organization joins with other healthcare reform groups around the country to say that healthcare is a human right — and to remember the nearly 45,000 citizens who die each year due to the lack of health insurance. (This number includes 1,031 Alabamians per year; 19 people per week!)

Proposed healthcare legislation will still leave tens of millions of Americans without health insurance, and the body count will continue to rise. Is that the best America can do? We think not!  The answer is to build on what works by expanding an improved version of Medicare to everyone. It’s called Medicare for All — covering every single person from birth to death.

Yes, it’s a busy time of year but we ask you to come stand with us for at least part of this vigil – to show your support for healthcare as a human right and to remember those who are literally dying at the hands of our broken healthcare system.

Bring candles and signs (we’ll have extras of each).

See you there!

Linda Haynes, Co-Coordinator

North Alabama Healthcare for All

256-429-8639 cell

lahaynes@knology.net

_______________________________________

DIRECTIONS TO MADISON COUNTY COURTHOUSE, downtown Huntsville

The vigil is on the east side steps of the courthouse located on East Side Square.

+  From Governor’s Drive — Go north on Franklin, which turns into East Side Square.

+  From Memorial Parkway — Take the Clinton St exit. Go East on Clinton towards downtown. Turn Right on Jefferson St., which becomes West Side Square. Turn left on South Side Square, and left on East Side Square.

+  From I-565 — Take the Jefferson St exit towards downtown. Turn right on Jefferson St., which becomes West Side Square. Turn left on South Side Square, and left on East Side Square.

_______________________________________

North Alabama Healthcare for All is a nonprofit, all-volunteer organization promoting a healthcare system which provides quality healthcare at an affordable cost to all Americans. We believe healthcare is a human right. The most effective and cost efficient way to accomplish healthcare for all is through an expanded and improved Medicare-for-all type system. (This is also called universal single payer healthcare, government-funded healthcare, or national health insurance.) We are a chapter of the national organization Physicians for a National Health Program.  Like our parent group, we are not just physicians — membership is open to anyone.

For more info or sign up for our email list  www.NorthAlabamaHealthcareForAll.org

I wanted to thank everyone who came out for the healthcare rally this past Saturday morning to protest the TEA party folks across the street (corner of Memorial Parkway and Governors Drive). Wish I could have been there to join you … it was obviously in great hands with those who did coordinate and participate!

Special thanks go to:
+ Charles King – who stepped up to coordinate this event and gave great quotes about Medicare for All which appeared on the Channel 19 and Channel 48 newscasts.
+ Tom Moss — for photos of the event and his quote that appeared in the Huntsville Times article.
+ Jerry Burnett — for photos of the event (see links below to all the photos)
+ Esther Davis — for her quote appearing in the Huntsville Times article.
+ Barb Adle — for her quote in the Channel 48 newscast

LINKS TO OUR PHOTOS:

+ FACEBOOK http://www.facebook.com/NorthAlabamaHealthcareForAll?v=photos#/album.php?aid=163735&id=159504394739

+ YAHOO GROUP PAGE http://groups.yahoo.com/group/NorthAlabamaHealthcareForAll/photos/album/118682654/pic/list

IN THE MEDIA:

Huntsville Times article http://www.al.com/news/huntsvilletimes/local.ssf?/base/news/125888496798620.xml&coll=1

Channel 19 — has two segments on the healthcare rallies http://www.whnt.com/
Scroll down to TOP VIDEOS and select “Huntsvillians Debate Healthare Bill” and “Huntsville Healthcare Debate”

Channel 48 — “Local groups rally in anticipation of key Senate health care vote”
http://www.waff.com/global/Category.asp?C=151146&clipId=&topVideoCatNo=15046&topVideoCatNoB=105966&topVideoCatNoC=105977&topVideoCatNoD=110674&topVideoCatNoE=109699&clipId=4323408&topVideoCatNo=15046&autoStart=true

Beautiful job, everyone, for standing up on this vital issue!

Linda

Talking points on HR 3962

Overall -

The bill is completely inadequate in expanding coverage and controlling costs. It is essentially an insurance industry bailout. Most provisions to expand coverage don’t even go into effect until 2013, after which it still leaves at least 17 million Americans uninsured.

The insurance industry hijacked the process: Private insurers get millions of mandatory new customers and about $600 billion in taxpayer subsidies. This will have the effect of making the health insurance lobby even more powerful, and more able to hijack political processes in the future.

It forgoes over $400 billion annually in potential savings on overhead and bureaucracy in the health system – enough to cover all 47 million uninsured – by retaining profit-driven private health insurers instead of replacing them with a streamlined, more efficient, Medicare for All system.

It makes private health insurance mandatory for middle-income working people, forcing them to buy a defective product. It will become a federal crime to be uninsured, with a penalty of 2.5 percent of income, starting in 2013. Families of very modest means, at 200-400 percent of poverty, will be required to spend an unaffordable 8-12 percent of their incomes on insurance premiums if they don’t have employer-sponsored coverage. Since the bill institutionalizes different levels of benefits and allows for skimpy plans (e.g. “bronze”), the mandated insurance may not even cover their health needs.

We will have a nation of underinsured families and businesses who will be paying money they can hardly afford for health plans that will never meet their needs. Globally, the U.S. economy will continue to be at a competitive disadvantage.

A Medicaid expansion will cover more low-income Americans, but coverage gains – both in Medicaid and for people receiving tax assistance to buy coverage – will be short-lived because the cost is unsustainable as we’ve seen in several states that have attempted reform in recent years.

People in other developed nations all use some form of non-profit national health insurance to get better care for less money. Their average per capita cost of healthcare is about half what it is in the United States, yet people in Canada and western Europe live about two years longer and have lower infant mortality. As with our traditional Medicare program, they have completely free choice of doctor and hospital. We need to start from scratch with a Medicare-for-all, single-payer approach.

On private insurers

Private health insurance is an overpriced, defective product, and this bill won’t change that. The majority of Americans who face medical bankruptcy start their illness with private health insurance, but are bankrupted anyway by gaps in coverage, like co-payments, deductibles and uncovered services.

Individuals and families with incomes up to 400 percent of poverty ($73,240 for a family of 3) are eligible for skimpy subsidies to buy coverage through a new “insurance exchange.” Families of very modest means (200-400 percent of poverty) are still responsible for paying an unaffordable 8-12 percent of their income towards health insurance premiums.

The bill bans denials of coverage based on pre-existing conditions (starting in 2013) and recissions (retro-active cancellation of coverage) immediately. But insurers are still allowed to deny claims, and two industry whistleblowers (Dr. Linda Peeno and Wendell Potter) have testified before Congress that the industry is now so sophisticated in its ability to deny claims, control care, and cherry-pick that these protections are essentially worthless.

Similarly, caps on out-of-pocket expenses (at $5,000 for individuals and $10,000 for families) don’t prevent medical bankruptcy because they don’t include expenses for uncovered services.

Insurers are supposed to spend 85 percent of premiums on care, but experience from Minnesota shows that insurers are able to circumvent this rule easily by categorizing administrative expenses as “clinical” or “quality improvement.”

On Medicaid and community health center expansion

The bill expands Medicaid after 2013 to additional low-income Americans (up to 150 percent of poverty), which is good, but you don’t need this bill to expand Medicaid. Also, rising costs, and a lack of funds for Medicaid at the state level, will quickly erode any gains in coverage.

The bill increases funding for community health centers, which again, is good, but this could be done independently.

The bill eliminates the Children’s Health Insurance Program in 2014, routing the beneficiaries into Medicaid (under 150 percent of poverty) or into the purchase of private coverage), adding hassle and possibly disrupting care arrangements for these children.

On the public option

The public plan option is a sham. According to the Congressional Budget Office, the premiums will actually be higher than premiums in the private sector, and fewer than 2 percent of Americans will enroll. So the public plan option will be an expensive, tax-funded subsidy to private health insurance, because the public plan option will take the sickest patients off their hands. It won’t expand coverage or decrease costs.
On the employer-mandate

Starting in 2013, employers with payrolls over $500,000 are required to provide coverage and pay a share of the premiums (72.5 % for individual, 65% for family coverage) or pay an 8 percent payroll tax.

Employers are not required to meet benefit standards until 2018, but even then are only required to help fund the “lowest cost plan” that meets the “essential benefits package,” and so may offer very skimpy coverage. The “basic plan” on the insurance exchange, for example, is only required to cover 70 percent of benefit costs. As there are no cost controls, coverage will deteriorate further, leading to a rise in underinsurance nationwide.

Millions of working Americans will continue to lack coverage. In Hawaii, which has had an employer mandate since the 1970′s, many employers circumvent the requirement by hiring part-time employees or using consultants. Also, small businesses are not required to provide coverage (but receive a paltry tax credit for two years if they do).

On the insurance exchange and tax subsidies

The bill creates a national insurance exchange, a marketplace where individuals and small business would go (after 2013) to buy insurance. If you have subsidized coverage, you would have to buy your insurance through the exchange. Like the “Connector” in Massachusetts, the exchange will add another layer of bureaucracy to the health system, and an additional 4 percent overhead to every health plan.

Subsidies for low-income people to purchase coverage will be hopelessly complex, requiring verification of income, citizenship, employer size, etc.

Millions will have their subsidies change as they change or lose jobs. Imagine finding a job, losing your insurance subsidy, then being laid off your job and applying for a subsidy all within a year. How would this work?

On evidence that this bill won’t reduce the number of uninsured or control costs

The coverage gains from the bill won’t last. What’s happened in the past when bills like this have passed in the states is that they run out of money very quickly, healthcare is simply unaffordable, and then you start to see the coverage expansions cut back. The subsidies shrink, the Medicaid shrinks, and then you’re back at square one, where you’ve spent a lot of money and not made any progress. And we’ve seen this over and over in the United States-in Massachusetts in 1988, in Oregon in 1992, in Washington 1993-passed bills virtually identical to what’s being passed in the House right now, and there was no durable improvement in the number of uninsured in those states. Healthcare was not affordable ten years after those bills were passed.

The Massachusetts plan is the model for this bill. Massachusetts expanded Medicaid (which again, is good, but you don’t need this bill to expand Medicaid) and passed an individual mandate that makes it illegal to refuse to purchase private health insurance. The fine is up to $1,068. The plan has been very expensive. The state has opted to pay for that by taking money from safety net clinics and hospitals, so that safety net providers that care for immigrants, the mentally ill, people with substance abuse, that provide primary care, they’ve seen their funds shrunken, so that money could be handed over to purchase insurance policies.

On the anti-abortion provisions

The bill applies restrictions to policies sold through the insurance exchange to undermine women’s rights. It creates an insurance exchange, a marketplace where you would go to buy your insurance. If you have subsidized coverage, you would have to buy your insurance through the exchange. And any insurance plan purchased through the exchange would have to exclude coverage of abortion. So, for the first time, Congress has stepped in and said that even with your own money, with private money, it’s illegal for insurance to cover abortion. It’s a tremendous step backwards for women’s rights.

On prescription drug costs

It fails to lower drug costs for the majority of Americans and those unable to afford expense medications. Drugmakers have raised wholesale prices on brand name drugs by 9 percent this year alone in anticipation of reform.

Biotech firms receive a windfall 12 year patent on new drugs.

A very small share of the population, Medicare recipients who are in the doughnut hole, will receive a discount on brand-name medications.

The doughnut hole is reduced in size until it is eliminated in 2019.

Overall, the pharmaceutical industry is thrilled with the bill, and Wall Street has rewarded them by driving up the value of their stocks.

On undocumented immigrants

Requires verification of citizenship to apply for subsidies for the purchase of insurance. Thus, the bill mandates that non-citizens buy insurance, but leaves it unaffordable for them.

Medicare Advantage Plans

The bill phases out overpayments to Medicare Advantage plans. It also requires them to spend at least 85 percent of premiums on care, but as shown in states like Massachusetts, insurers can easily circumvent this rule.

Summary of commendable features – some may not make it into final bill

Medicaid expansion (delayed until 2013) to about 10 million people

Increased funding for community health centers (to double capacity over time) and other community programs like home visiting programs.

Increased funding for primary care health professional education

Phasing out of doughnut hole in Medicare prescription drug plan by 2019 and Medicare Advantage plan overpayments

Eliminating pre-existing conditions (2013) and recissions (2010)

Extending health benefit tax benefits available to married couples to domestic partners

Extending parental coverage to children aged 26-27

Progressive tax on the wealthy for funding instead of taxing health plans that are comprehensive (so-called “Cadillac” plans).