Editor's Note: If you have a personal story you’d like to share about health care costs that proved to be particularly challenging, please write to us at firstname.lastname@example.org. Every story makes a difference in helping to move our state toward affordable, universal health care that covers everyone.
“Thank You!” Allen Avenue UU Church for your contribution to Maine AllCare
The Social Action Committee of the Allen Avenue Unitarian Universal Church in Portland at work.
The members of Allen Avenue Unitarian Universalist Church, Portland ME, after nomination by its Social Action Committee, have chosen to donate one third of a monthly offering to further the work of Maine All Care. The contribution of $500.00 will help the Church live up to its commitment to “foster social responsibility”, as the congregation is committed to seeing that all citizens of Maine have health care.
Maine AllCare is grateful for all contributions toward our work in informing and advocating for health care for ALL Maine people, whether from church groups, businesses or individual donors. All contributions are tax deductible. If you would like to discuss your potential contribution – what it might accomplish – please contact board member Karen Foster, Treasurer at email@example.com.
No Surprise – U.S. Medical Care Most Expensive In The World, Yet Leaves Millions Without
2013 Survey documents most prescribed drug and medical costs
The International Federation of Health Plans released its 2013 Comparative Price Report – Variation in Medical and Hospital Prices by Country and the United States leads the way with the highest costs anywhere.
The latest report documents drug and medical costs in 25-countries, ranging from most poor to most wealthy. US prices are two to nine times higher than anywhere else. Please click on the graph for the full story.
Some of the key countries participating in the IFHP survey include: Canada, England, Netherlands, New Zealand, Spain, Switzerland and the US. This year’s survey includes pricing for several specialty prescription drugs, along with prices for other prescription drugs and a variety of medical procedures. Prices for each country are submitted by participating federation member plans, and are drawn from public or commercial sectors.
Here are a couple of examples: Geevec, used to treat cancers including some types of leukemia costs $1,141 in Canada, $3,633 in Switzerland and $6,214 in the US (where prices can run over $11,000). Humira, used to treat rheumatoid arthritis, costs $881 in Switzerland and an average of $2,246 in the US (and can be as much as $4,000).
A frequently used diagnostic tool, MRI, costs $138 in Switzerland, $350 in Australia, and an average of $1,145 in the US (and can be as high as $2,900). And a relatively common surgery, appendectomy, costs $4,995 in the Netherlands, $5,177 in Australia and an average of $13,910 in the US (or as high as $29,000).
The price variations bear no relation to health outcomes: they merely demonstrate the relative ability of providers to profiteer at the expense of patients, and in some cases reflect a damaging degree of market failure.—IFHP Chief Executive Tom Sackville
For more information about IFHP, which are more than 80 member insurance companies operating in 25 countries, many of whom offer some type of universal coverage, please click here.
Big News! Legislature Approves LD 1345 as Amended
A Resolve to produce 3 design options for creating a universal system of health care in the State
Augusta - On Wednesday, April 2, 2014 the Maine State Senate passed LD 1345. The vote to approve the bill was 20 to 14, along strict partisan lines. Every Republican Senator voted against the resolve "... that all Maine residents have access to and coverage for affordable, quality health care." This followed action from the previous day when the House passed LD 1345 by a 91 to 52 majority vote; four Unenrolled and three Republican members of the House of Representatives voted in support of the bill.
Further, "The amendment requires the joint standing committee of the Legislature having jurisdiction for insurance and financial services matters to solicit the services of one or more consultants to propose design options for creating a universal system of health care in the State. The resolve requires the consultant or consultants to submit a proposal by December 2, 2015 containing at least 3 design options that comply with the federal Patient Protection and Affordable Care Act." In other words, the Legislature wants to have solid data in hand, based on a current comprehensive study of all aspects of our health care financing and delivery system.
The next steps will see the bill move back to the House, then onto the Governor. You can find more detailed information about the House and Senate actions, amendments, roll-calls regarding LD 1345 here. Additionally, Maine Public Broadcasting Network reporter Patty Wight has an excellent radio summary of the April 1, 2014 House debate on the bill.
We at Maine AllCare want to thank everyone who came to testify in support of this health-care-for-all-Mainers bill on January 9th, and to those who called and emailed your Legislators - you made a difference! We want to say special thanks to Representative Priest, sponsor of the bill, and to Senator Gratwick our champion in the Senate. And thanks to all the members of the Maine House and Senate who understood the economic and human advantages of moving to a simple, state-wide health financing system that covers everyone and costs less than what we're paying today. We hope that those who are not yet convinced, and even those who are adamantly against it, will review the hard date to be produced by the proposed study and join us in in making Maine more healthy, prosperous and competitive. Let's do the right thing, please support health care for all us. Thank you.
The Maine AllCare Board
CHARITY AS HEALTH CARE POLICY – WE CAN AND WILL DO BETTER!
The following from the New York Times Editorial Board gives yet another anecdotal example of the irrational and unfair national policy, even with the Affordable Care Act fully implemented; one, that necessitates a “charity” mentality in order to provide essential health care to Americans. We must do better. We can do better.
Here in Maine, we will do better once we enact a universal single payer health system that will cover everyone. Rep. Priest’s bill, LD 1345, currently before the Legislature’s Joint Committe on Insurance and Financial Service will accomplish exactly that: cover everyone for less than what we pay today, as a state. Everyone will be one plan with a comprehensive set of benefits, choice of providers, publicly financed with focus on efficiency and accountability.
Please join Maine AllCare and let’s work together to make universal health care a reality here in Maine! Most importantly, please contact your Maine State Senator and Representative and ask them to support LD 1345, An Act To Establish a Single-Payor Health Care System To Be Effective in 2017.
If you need more information please Write to us and we’ll tell you how else you can help. Thank you.
The Opinion Pages | EDITORIAL from THE NEW YORK TIMES
Help With Medical Bills
By THE EDITORIAL BOARD JAN. 17, 2014
In September 2012, as Gladys Puglla was thanking everyone for coming to a community organization board meeting, she blacked out from a stroke. It felt, she recalled, as if “my soul was leaving my body.”
She woke up at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. After surgery and a nine-day hospital stay, Ms. Puglla owed about $138,000 — after her health insurance paid its share of the medical bill.
There was no way Ms. Puglla, a clerical worker, could pay that astronomical amount on her $37,000 annual salary. The community organization where she volunteers, Make the Road New York, assigned a staff lawyer free of charge, and with help from the Community Service Society, a New York Times Neediest Cases Fund agency, negotiated with doctors and the hospital to reduce the balance to $6,900. After the Neediest Cases Fund agreed to pay $3,450, Cornell forgave the remainder. The fund also agreed to pay an ambulance bill of $1,020.
Clearing that medical debt was critically important, but Ms. Puglla still struggles with co-payments for continuing therapy, doctors’ visits and medicine. Because of those bills, she has fallen behind on her rent and is battling eviction.
But that is another fight, she said. For now, she is back at work and getting back on her feet.
Donations to The Times’s Neediest Cases Fund go to seven charities: Brooklyn Community Services; Catholic Charities of the Archdiocese of New York; Catholic Charities Brooklyn and Queens; the Children’s Aid Society; the Community Service Society of New York; the Federation of Protestant Welfare Agencies; and the UJA-Federation of New York. To help, please send a check to: The New York Times Neediest Cases Fund, 4 Chase Metrotech Center, 7th Floor East, Lockbox 5193, Brooklyn, N.Y. 11245. Or call (800) 381-0075 and use a credit card. You may also donate at www.nytneediestcases.com.
Misguided partisanship equals misery for millions
Editor's note: In its December 2013 report, "LIVES AND LIVELIHOODS LOST: The High Cost of Rejecting Medicaid Expansion", Healthcare for America NOW documents the harmful effects of partisan decisions by 25 governors – all Republicans – who refused federal money to provide health care for the most needy. These are folks who make less than 138 percent of federal poverty level, currently $15,865 a year for an individual, and $32,499 for a family of four.
In Maine, over 24,000 adults fall in this category and are left out in the cold, uninsured. Thanks to Governor LePage's rejection of the federal offer to pay 100 percent of the cost for this much needed Medicaid expansion through 2019 and 90 percent beyond, thousands of Mainers will have to keep their fingers crossed in the hopes of not getting sick. This, in addition to the over 144,000 thousand currently uninsured adults in our state. The good news is that most are eligible for some level of subsidy – up to 400 percent of the federal poverty level – through the Affordable Care Act (ACA). Unfortunately many of us will still not be able to afford private health insurance, even with help from the ACA. By rejecting Medicaid expansion the governor exacerbates and already trying situation.
What is the solution? Expand Medicaid, to all qualified individuals and families immediately, as the first step in a longer process to make comprehensive and affordable health care accessible by everyone in Maine. In early 2014 the state legislature will meet to revisit both these issues, expanding Medicaid and planning for universal health care. We will keep you informed about the dates and times of the January hearings, and how you can express your support and make a difference.
Executive Summary from the report.
THE AFFORDABLE CARE ACT (ACA) gives 16 million uninsured Americans access to non-emergency health care for the first time by offering more than $800 billion in federal funding to states over the next 10 years to expand Medicaid. So far, 25 states and the District of Columbia have opted to take advantage of this money to provide health coverage to adults with incomes of up to 138 percent of the federal Poverty level. This Medicaid expansion will improve individuals’ health, extend thousands of lives, increase economic growth and strengthen the financial stability of hospitals on which both rich and poor rely.
In the rest of the states, political leaders who are openly hostile to the law are prioritizing their anti-ACA agenda and callously denying health benefits to millions of adults who would otherwise be eligible for Medicaid. The states that so far have opted out of Medicaid expansion are rejecting a breathtaking $426 billion in federal funds over 10 years. These infusions of federal funds would spark regional economies by increasing employment, boosting household spending and generating significant tax revenue to support state and local services.1
When uninsured people gain Medicaid coverage, they become healthier and life expectancy increases.2 but in states that refuse to expand Medicaid, nearly 5 million people will find themselves in limbo— unable to afford unsubsidized private insurance and also ineligible for both the public safety-net program and subsidies to purchase plans in the ACA marketplaces. Significantly, research shows that closing this “coverage gap” could save the lives of more than 27,000 people in 2014. Governors and legislators who refuse to fully participate in Medicaid must face up to the moral and ethical implications of blocking health coverage for their most vulnerable constituents. This policy choice is not only unconscionable, it harms everyone in those states, whether insured or not.
Governors and state legislators who fight the health care law by failing to use available federal funds to expand Medicaid enrollment also compromise the economic competitiveness and fiscal outlook of their states, according to data developed by health care advocates, hospital associations, think tanks, universities and researchers. Hospitals in non-expansion states will be put at a severe competitive disadvantage that will result in insurers excluding them from their networks, which in turn will force hospital administrators to offset lost business with increased out-of-pocket costs for people with private insurance. Rejection may satisfy the ideological fervor of officeholders averse to the ACA, but it does not relieve health care providers of the legal obligation to provide emergency care and stabilization to the uninsured under the Emergency Medical Treatment and labor Act, which was signed into law by President Ronald Reagan in 1986. State and local governments, private insurers, hospitals and doctors must shoulder the costs of caring for the uninsured. While expansion states enjoy new federal investment and economic growth, residents of non-expansion states will face a declining quality of life, a weaker economy, and destabilized hospitals—including some that will be forced to close their doors.
MEDICAID EXPANSION offers states a historic opportunity to improve the health and extend the lives and productivity of their residents while infusing billions of federal dollars into state economies and creating large numbers of good jobs. Study after study has shown that by refusing to offer health coverage to low-income Americans, governors and state lawmakers are depriving their people and their local governments of increased jobs and tax revenue. Hospitals are particularly likely to be disadvantaged by rejection of Medicaid expansion. Their DSH payments will fall while they remain legally and morally obligated to cover the patients who remain uninsured because of counterproductive political decisions. Expanding Medicaid eligibility under the ACA is the right and responsible choice. State leaders guided by partisan politics and ideological purity rather than logic, evidence and simple arithmetic pose a threat to the lives and general well-being of their constituents and the health of their economies.
In 2009, ideologues opposed to health reform spread phony stories about “death panels” to scare Americans into thinking the law would block their medical care when they needed it most. These falsehoods about the ACA were thoroughly debunked. Now in 2013, it turns out that the only real death panels consist of governors and lawmakers standing in the doorway of state Medicaid expansion, blocking access to health care for nearly 5 million Americans.
From Around the World
A November 2013 health systems survey of 11 industrialized countries, from Austria to Australia, was completed by The Commonwealth Fund, a private foundation working towards high performance health systems. They found that American adults are more likely to forego health care because of cost than people living in the other countries surveyed.
Some of the key findings include:
37 percent of U.S. adults skipped care,
23 percent had medical bill problems,
and 41 percent spent $1,000 or more out-of-pocket on care in the last year. These figures compare very unfavorably with those of the United Kingdom and Sweden where as few as 4 percent to 6 percent experienced cost related difficulties. For more key findings as well as the complete report please click here.
This survey is very useful in helping readers better understand the similarities and differences between the various industrialized nations' health care systems, including their major components, such as method of financing, coverage, role of government vs insurance companies, cost sharing, low income exemptions and others. You can download the Full Report free of charge here by scrolling to the bottom of the page, and click on "Downloads".