Thursday, December 12, 2013

High Insurance Rates Anger Some Ski-Country Coloradans

More From Shots - Health News HealthIf You Drank Like James Bond, You'd Be Shaken, TooHealthWhy Meningitis That Hit Princeton Is Hard To Beat With VaccinesHealthScientists Turn To The Crowd In Quest For New AntibioticsHealthHigh Insurance Rates Anger Some Ski-Country Coloradans

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Wednesday, December 11, 2013

Health Exchange Enrollment By State, In 2 Charts

More From Shots - Health News HealthSome Young Athletes May Be More Vulnerable To Hits To The HeadHealthGlobal Malaria Deaths Hit A New LowHealthStaph Germs Hide Out In The Hidden Recesses Of Your NoseHealthHealth Exchange Enrollment By State, In 2 Charts

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Monday, December 9, 2013

Will Obamacare Play Big In 2014? Keep An Eye On N.H. Senate Race

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Sen. Jeanne Shaheen, D-N.H., on Capitol Hill earlier this year.

J. Scott Applewhite/AP

Sen. Jeanne Shaheen, D-N.H., on Capitol Hill earlier this year.

J. Scott Applewhite/AP

With a new White House push to promote the Affordable Care Act well underway, the question is whether an improved HealthCare.gov site and onslaught of positive talking points will be enough to bolster Senate Democrats facing tough races in 2014.

One re-election fight to watch is Democratic Sen. Jeanne Shaheen's in New Hampshire, where she's been taking heat for supporting the new health care law.

Step inside a small diner called Chez Vachon in a working-class section of Manchester, N.H., and you'd never guess the White House is actually regaining its footing on the health care rollout. The president is reporting promising enrollment numbers and a faster website, but John Hill couldn't care less. He says the price of his insurance has skyrocketed.

"We asked why the price of the insurance was so high," says Hill. "They said, 'Well, the new Obamacare law. That's the reason why.' "

That law had some pretty severe repercussions in New Hampshire. A strong Tea Party faction in the state legislature voted down a state health insurance exchange, so everyone in the state applying for insurance under the Affordable Care Act has to sign up on the federal government website.

But that federal exchange has drawn only one insurance provider for New Hampshire: Anthem Blue Cross and Blue Shield. And Anthem shut out 10 of the state's 26 hospitals from its health plans on the exchange, which means traveling in a car for an hour or more for many people in northern New Hampshire who need to see a doctor.

Hill says he's absolutely not voting for Shaheen next year.

"She voted for this. She knew what she was getting into," says Hill. "Now she realizes, 'Oh, this is a big mistake.' "

Shaheen was one of most vocal Democrats to criticize the launch of HealthCare.gov. She's demanded an extension of the enrollment period, and asked President Obama to appoint someone to oversee website fixes into next year.

Theresa Avard says Shaheen's just trying to have it both ways by distancing herself from a law that so many people in New Hampshire hate.

"You can't be a yo-yo," says Avard. "I'm sorry, you know. That's what I call my grandchildren when they don't do right. They yo-yo, up and down."

But Shaheen rejects the suggestion that she's just protecting herself for the next election cycle.

"This should not be about politics. This should be about good policy," says Shaheen. "I've been working on health care issues since I first was elected to the state senate from the seacoast of New Hampshire over 20 years ago."

On this day, she's touring the National Visa Center in Portsmouth to draw attention to a program granting visas for Iraqis and Afghans who risked their lives working for the U.S. Since the rollout of the new health care law, Shaheen hasn't hosted any town hall meetings. But she says her office has been inundated with angry complaints from people upset about the launch.

Still, Shaheen says: "It's a long time from now to [November of] 2014. And I think we're going to get the problems fixed with the health care law.

"I think there will probably be other things that come up, just as there are when we're making that significant of policy change," says Shaheen. "But the way to deal with it [is] to find those fixes."

Toppling Shaheen in 2014 is going to take a formidable force. She was a popular three-term governor who's still enjoying pretty solid poll numbers.

"For Shaheen, right now, Obamacare is the only cloud in the sky in New Hampshire," says Dante Scala, a political scientist at the University of New Hampshire. "So what she needs to do is just keep guard and not become complacent with what is clearly a winning position at this point."

Former Sen. Scott Brown of Massachusetts keeps flirting with the idea of running against her, and he has the star power, but he still won't commit.

Bob Smith, a former U.S. senator, has announced his candidacy, but he still needs to move back to New Hampshire from Florida, where he failed twice to win a Senate seat. And the other Republican candidates just don't have much name recognition.

As split as New Hampshire is over the health care law, it's a big question whether people are going to be focusing on other things by next fall.

Back at Chez Vachon, Bob Garon says Republicans need to give up on their obsession with the Affordable Care Act.

"I really don't think that we are going to elect a politician because of Obamacare," says Garon. "I think what's going to sink in is it's the law � whether you like it or not. You can bounce it around and play tennis with it all you want, but it's the damn law."

But the New Hampshire state Republican Party says it plans to make Obamacare a central issue next fall.

"There's no question that what voters care about right now is the collapse of Obamacare � the failed rollout, the increased costs, the decreased access to quality health insurance," says Jennifer Horn, chair of the New Hampshire Republican Party. "So absolutely that is something we will be talking about."

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Saturday, December 7, 2013

Canceled In California: People Eye Health Plans Off Exchange

More From Shots - Health News Health23andMe Bows To FDA's Demands, Drops Health ClaimsHealthHoped-For AIDS Cures Fail In 2 Boston PatientsHealthCanceled In California: People Eye Health Plans Off ExchangeHealthMedical Journal Goes To The Dogs

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Friday, December 6, 2013

Medical Journal Goes To The Dogs

More From Shots - Health News HealthMedical Journal Goes To The DogsHealth CareWhite House Cites Pre-Existing Condition Case From Its Own RanksHealthFDA Expected To Approve New, Gentler Cure For Hepatitis CHealthHealthCare.gov Now Allows Window Shopping, And A Do-Over

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Wednesday, December 4, 2013

Second Meningitis Outbreak Erupts In Southern California

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Mercy Killers – Video Interview with Michael Milligan

Arts Happening Presents: Mercy Killers

Arts Happening Presents: Mercy Killers from Northside Town Hall on Vimeo.

Mercy Killers is a one-man play by Michael Milligan. Joe loves apple pie, Rush Limbaugh, the 4th of July and his wife, Jane. He is blue-collar, corn-fed, made in the USA and proud, but when his uninsured wife is diagnosed with cancer, his patriotic feelings and passion for the ethos of life, liberty and the pursuit of happiness are turned upside down.

mercykillerstheplay.com

Video by Lehman Film Productions � lehmannfilms.com

Performed at Engine Co. 212, future home of the Northside Town Hall � northsidetownhall.org

Tuesday, December 3, 2013

Nonprofits Challenge Missouri Licensing Law For Insurance Guides

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Monday, December 2, 2013

Obama Launches HIV Cure Initiative, Ups Pledge For Global Health

More From Shots - Health News HealthObama Launches HIV Cure Initiative, Ups Pledge For Global HealthHealthAlleged Perils Of Left-Handedness Don't Always Hold UpHealthAs Polio Spreads In Syria, Politics Thwarts Vaccination EffortsHealth CareACLU Sues, Claiming Catholic Hospitals Put Women At Risk

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The Real Fix for Obamacare’s Flaws: Medicare for All

Lost amidst the well-chronicled travails of the Affordable Care Act rollout are the long term effects of people struggling to get the health coverage they need without going bankrupt.

If that sounds familiar, it’s because that’s been the main story line of the US healthcare system for several decades. Sadly, little has changed.

Still, with all the ACA’s highly publicized snafus, and less discussed systemic flaws, there’s no reason to welcome the cynical efforts to repeal or defund the law by politicians whose only alternative is more of the same callous, existing market-based healthcare system.

US nurses oppose the rollback and appreciate that several million Americans who are now uninsured may finally get coverage, principally through the expansion of Medicaid, or access to private insurance they’ve been denied because of their prior health status.

At the same time, nurses will never stop campaigning for a fundamental transformation to a more humane single-payer, expanded Medicare for all system not based on ability to pay and obeisance to the policy confines of insurance claims adjustors.

Website delays � the most unwelcome news for computer acolytes since the tech boom crashed � are not the biggest problem with the ACA, as will become increasingly apparent long after the signup headaches are a distant memory.

What prompted the ACA was a rapidly escalating healthcare nightmare, seen in 50 million uninsured, medical bills plunging millions into un-payable debt or bankruptcy, long delays in access to care, and record numbers skipping needed treatment due to cost.

The main culprit was our profit-focused system, with rising profiteering by a massive health care industry, and an increasing number of employers dropping coverage or just dumping more costs onto workers.

The ACA tackles some of the most egregious inequities: lack of access for many of the working poor who will now be eligible for Medicaid or subsidies to offset some of their costs for buying private insurance through the exchanges, a crackdown on several especially notorious insurance abuses, and encouragement of preventive care.

But the law actually further entrenches the insurance-based system through the requirement that uncovered individuals buy private insurance. It’s also chock full of loopholes.

Some consumers who have made it through the website labyrinth have found confusing choices among plans which vary widely in both premium and out of pocket costs even with the subsidies, a pass through of public funds to the private insurers.

The minimum benefits are also somewhat illusory. Insurance companies have decades of experience at gaming the system and warehouses full of experts to design ways to limit coverage options.

The ACA allows insurers to cherry pick healthier enrollees by the way benefit packages are designed, and as a Washington Post article noted on 21 November, consumers are discovering insurers are restricting their choice of doctors and excluding many top ranked hospitals from their approved “network”.

The wide disparity between the healthcare you need, what your policy will cover, and what the insurer will actually pay for remains.

Far less reported is what registered nurses increasingly see � financial incentives within the ACA for hospitals to prematurely push patients out of hospitals to cheaper, less regulated settings or back to their homes. It also encourages shifting more care delivery from nurses and doctors to robots and other technology that undermines individual patient care, and that may work no better than the dysfunctional ACA websites.

Is there an alternative? Most other developed nations have discovered it, a single-payer or national healthcare system.

Without the imperative of prioritizing profits over care, Medicare for all streamlines the administrative waste and complex insurance billing operations endemic to private insurance. That waste is a major reason why the US has more than double the per capita cost of healthcare of other developed nations, yet lower life expectancies than many.

Medicare for all eliminates the multi-tiered health plans that plague both the individual and group insurance markets that are tied to the girth of your wallet not your need for care. Class, gender, and racial disparities in access and quality of care vanish under Medicare for all.

It’s beyond time that we stop vilifying government and perpetuating a corporatized healthcare system that has abandoned so many. We can, with a system of Medicare for all, we can cut healthcare costs and promote a much more humane society.

Friday, November 29, 2013

HealthCare.gov Team Working Through Holiday To Meet Deadline

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Tuesday, November 26, 2013

Rep. Issa Takes Anti-Obamacare Campaign To The States

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Monday, November 25, 2013

21 Ways the Canadian Health Care System is Better than Obamacare

Dear America:

Costly complexity is baked into Obamacare. No health insurance system is without problems but Canadian style single-payer full Medicare for all is simple, affordable, comprehensive and universal.

In the early 1960s, President Lyndon Johnson enrolled 20 million elderly Americans into Medicare in six months. There were no websites. They did it with index cards!

Below please find 21 Ways the Canadian Health Care System is Better than Obamacare.

Repeal Obamacare and replace it with the much more efficient single-payer, everybody in, nobody out, free choice of doctor and hospital.

Love, Canada

Number 21:
In Canada, everyone is covered automatically at birth � everybody in, nobody out.

In the United States, under Obamacare, 31 million Americans will still be uninsured by 2023 and millions more will remain underinsured.

Number 20:
In Canada, the health system is designed to put people, not profits, first.

In the United States, Obamacare will do little to curb insurance industry profits and will actually enhance insurance industry profits.

Number 19:
In Canada, coverage is not tied to a job or dependent on your income � rich and poor are in the same system, the best guaranty of quality.

In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage.

Number 18:
In Canada, health care coverage stays with you for your entire life.

In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you for as long as you can afford your share.

Number 17:
In Canada, you can freely choose your doctors and hospitals and keep them. There are no lists of �in-network� vendors and no extra hidden charges for going �out of network.�

In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking � thus restricting freedom of choice � and if you want to go out of network, you pay for it.

Number 16:
In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums.

In the United States, under Obamacare, for thousands of Americans, it�s pay or die � if you can�t pay, you die. That�s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time.

Number 15:
In Canada, there are no complex hospital or doctor bills. In fact, usually you don�t even see a bill.

In the United States, under Obamacare, hospital and doctor bills will still be terribly complex, making it impossible to discover the many costly overcharges.

Number 14:
In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone.

In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 18 percent of its GDP and still doesn�t cover tens of millions of people.

Number 13:
In Canada, it is unheard of for anyone to go bankrupt due to health care costs.

In the United States, under Obamacare, health care driven bankruptcy will continue to plague Americans.

Number 12:
In Canada, simplicity leads to major savings in administrative costs and overhead.

In the United States, under Obamacare, complexity will lead to ratcheting up administrative costs and overhead.

Number 11:
In Canada, when you go to a doctor or hospital the first thing they ask you is: �What�s wrong?�

In the United States, the first thing they ask you is: �What kind of insurance do you have?�

Number 10:
In Canada, the government negotiates drug prices so they are more affordable.

In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases, so they remain unaffordable.

Number 9:
In Canada, the government health care funds are not profitably diverted to the top one percent.

In the United States, under Obamacare, health care funds will continue to flow to the top. In 2012, CEOs at six of the largest insurance companies in the U.S. received a total of $83.3 million in pay, plus benefits.

Number 8:
In Canada, there are no necessary co-pays or deductibles.

In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans.

Number 7:
In Canada, the health care system contributes to social solidarity and national pride.

In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.

Number 6:
In Canada, delays in health care are not due to the cost of insurance.

In the United States, under Obamacare, patients without health insurance or who are underinsured will continue to delay or forgo care and put their lives at risk.

Number 5:
In Canada, nobody dies due to lack of health insurance.

In the United States, under Obamacare, many thousands will continue to die every year due to lack of health insurance.

Number 4:
In Canada, an increasing majority supports their health care system, which costs half as much, per person, as in the United States. And in Canada, everyone is covered.

In the United States, a majority � many for different reasons � oppose Obamacare.

Number 3:
In Canada, the tax payments to fund the health care system are progressive � the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent.

In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.

Number 2:
In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story.

In the United States, Obamacare�s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage �we have to pass the bill so that you can find out what is in it.�

Number 1:
In Canada, the majority of citizens love their health care system.

In the United States, the majority of citizens, physicians, and nurses prefer the Canadian type system � single-payer, free choice of doctor and hospital , everybody in, nobody out.

Saturday, November 16, 2013

Making Moves In Food Delivery, Chess And Health Care

Listen to the Story 3 min 55 sec Playlist Download Transcript  

The online magazine Ozy covers people, places and trends on the horizon. Co-founder Carlos Watson joins All Things Considered regularly to tell us about the site's latest discoveries.

This week, Watson tells host Arun Rath about a delivery service that allows you to track your food in real time, a chess master who is making the board game sexy and his recent interview with President Bill Clinton.

The New And The Next Shaking Up The Food Delivery Model Enlarge image i Radius Images/Corbis Radius Images/Corbis

"A couple of young guys who were UC Berkeley grads � food obsessed � were finding that they couldn't get their favorite foods delivered. So, they starteda new service called Caviar, that for a flat fee is creating quite the Uber-like stir around San Francisco and now in Seattle and New York. ...

"They've got a lot of your basics, whether it's fish tacos or pulled pork sandwiches, but they also have some of the higher-end restaurants who in the past have been a little hesitant about delivery who have agreed to do it."

Read 'Caviar: Like Uber For Eaters' At Ozy.com

Sexy Moves In The World Of Chess Enlarge image i Courtesy of Ozy.com Courtesy of Ozy.com

"Chess is not always the sexiest sport. But the No. 1 chess player in the world is a young guy from Norway named Magnus Carlsen, who is becoming quite the sensation. He is not only a champion chess player but he is also a male model and that's a very different look from Bobby Fischer or Garry Kasparov, who were two other famous chess champions of the past. ... Guys like Kasparov and others are saying, 'I hope he does really well and puts chess back into the larger mainstream conversation.' "

Read 'Meet the New Ambassador of Chess' At Ozy.com

President Bill Clinton Talks Health Care With Ozy Youtube/YouTube

"He reminded us that when President George W. Bush rolled out the Medicare Part D plan that there also were a number of hiccups in the early days. So, that was his way of offering context to the current troubles with HealthCare.gov. And saying, be a little bit patient. While there may be a number of troubles in the first couple months with HealthCare.gov, they ultimately should be fixable and this won't have been the first time that we've had to smooth over some things in the early going."

Read 'Assessing the Healthcare Rollout' At Ozy.com

Share Facebook Twitter Google+ Email Comment More From The New And The Next Pop CultureMaking Moves In Food Delivery, Chess And Health CarePop CultureDigging Into The Truth About Messages, Images And Hard TimesPop CultureA Male Belly Dancer, Social Activism On Instagram, 'Thriller'Pop CultureA Teenage Music Phenom, Infographics, Motorcycles In Vietnam

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Friday, November 15, 2013

Medicare Penalizes Nearly 1,500 Hospitals For Poor Quality Scores

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Obama Moves To Delay Cancellations Of Insurance Plans

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Wednesday, November 13, 2013

Can Young People Get Obamacare For $50 A Month? Sometimes

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Tuesday, November 12, 2013

Clinton To Obama: Honor Promise That People Can Keep Coverage

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Despite Health Law, Uninsured Rely On Prevention Care Patchwork

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Medicaid Questions Slow Insurance Purchases On Colorado Exchange

More From Shots - Health News HealthShift In Cholesterol Advice Could Double Statin Use HealthClinton To Obama: Honor Promise That People Can Keep CoverageHealthSo, You Have Gonorrhea. Who Tells Your Ex?HealthMedicaid Questions Slow Insurance Purchases On Colorado Exchange

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Friday, November 8, 2013

In Massachusetts, Health Care Prices Remain Hard To Get

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NJ Resident Struggles for Long-Term Care, Calls for Medicare for All

From the Courier-Post –

Mike Pollock calls himself a squeaky wheel.

Since 2002, the Atco resident has fought with insurance companies, medical agencies and doctors after his wife, Kathy, 61, survived a brain tumor and later two debilitating strokes that left her partially paralyzed.

After their private insurance and savings were exhausted, the Pollocks needed Medicaid to pay for Kathy�s long-term care.

But since 2011, when the state started contracting with managed care companies to handle Medicaid administration, Pollock has been spending more time on the phone, dealing with denials.

�It�s become more about the money,� said Pollock, who owns Atco Hardware Store. �When the state ran Medicaid, the people who ran Medicaid cared about doing their job. Now, you�ve got people worried about the bottom line.�

Though Kathy Pollock is covered under Medicare and Medicaid, her husband spends part of each day fighting for her medical care and supplies. Lately, he�s been arguing to have her physical and occupational therapy reinstated since it ended nearly three months ago. She has since regressed, he said, and can no longer feed herself.

Horizon NJ Health, the managed care company administering her Medicaid, also stopped providing the diapers he prefers, he said. His biggest fear is that Medicaid will cut into funding for Kathy�s beloved home health aides, who care for her while he works. He already fought a reduction in their $10-an-hour pay.

�It�s a distraction that I don�t need,� said Pollock, who wrote about previous bouts with managed care in his book, �From Death�s Door to Disney World: An Advocate�s Story.�

�If you talk to the people out there who are dealing with this on a daily basis, they�ll tell you there are people that are lost, who don�t know what to do. It�s a terrible situation.�

There are caregivers like Pollock across the state. Beverly Roberts, director of mainstreaming medical care for the Arc of New Jersey, hears complaints about cuts in the number of home health aide hours her clients are given each week. The nonprofit serves people with intellectual disabilities � patients who typically don�t improve.

�If anything, things get more difficult as the individuals get larger and heavier, and mom and dad get older and more frail,� said Roberts.

Advocates can file an appeal, she said.

They can also share their experiences publicly. New Jersey’s Medical Assistance Advisory Council allows the public to ask questions or comment on agenda items during its quarterly meetings. The council advises Valerie Harr, director of the state�s Division of Medical Assistance and Health Services. The next meeting is Nov. 22 in Ewing.

�It�s very upsetting when families are going through such difficulty,� said Roberts, who sits on the panel.

New Jersey is expanding its use of managed care companies to administer state-funded medical assistance. Studies have shown such arrangements modestly improve care and reduce costs, according to the Center for State Health Policy at Rutgers University.

But Pollock can�t imagine how. He wants a legislative remedy and a single-payer system like Medicare.

�It saves them tons of money by people being home, but they don�t care if Kathy doesn�t get the medical supplies that she needs,� Pollock said.

�It�s not about the patient. It�s about the money.�

Persistence Pays Off For Uninsured Alaskan

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Thursday, November 7, 2013

How The Affordable Care Act Pays For Insurance Subsidies

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Wednesday, November 6, 2013

Administration Looks To Give Labor Unions Health Tax Relief

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Monday, November 4, 2013

Bariatric Surgery Can Keep Pounds Off For Years

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Saturday, November 2, 2013

Adding To Insurance Confusion, Outside Groups Try To Cash In

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Friday, November 1, 2013

Appeals Court Gives Texas OK To Enforce Abortion Law

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Wednesday, October 30, 2013

Why Insurers Cancel Policies, And What You Can Do About It

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Notices Canceling Health Insurance Leave Many On Edge

More From Shots - Health News HealthOnline Advice Can Hurt Teens At Risk For Suicide, Self-HarmHealthNotices Canceling Health Insurance Leave Many On EdgeHealthThe Long List Of Health Apps Features Few Clear WinnersHealthWhy Insurers Cancel Policies, And What You Can Do About It

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Confused About Health Insurance? Take Our Quiz!

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Monday, October 28, 2013

Some Health Screenings May Harm More Than Help

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Wednesday, October 23, 2013

White House Turns To 'Rock Star' Manager For Obamacare Fix

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Tuesday, October 22, 2013

Enrollments For Health Care Exchanges Trickle In, Slowly

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Monday, October 21, 2013

If A Tech Company Had Built The Federal Health Care Website

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Thursday, October 17, 2013

If A Tech Company Had Built The Federal Health Care Website

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HealthCare.gov was meant to create a simple, easy way for millions of Americans to shop for subsidized health care.

Instead, in a little two more than weeks, it has become the poster child for the federal government's technical ineptitude.

A dysfunctional contracting system clearly bears some of the blame. But entrepreneurs in Silicon Valley likely would have approached the project differently from the start.

A week after the site launched, NPR spoke to Suzanne Cloud, a jazz musician based in Philadelphia. At that point, Cloud had spent hours on the site, trying to sign up for coverage. "Something went wrong, and it just went to a page with all kinds of html stuff," she said.

This week, Cloud says she gave up on the website and ended up registering by phone. The folks on the phone took all of her information � then asked if she'd like to pick out her plan online or receive information about her health care options via snail mail.

Cloud chose snail mail. "Once I signed up with the telephone, I didn't go back and try the site again," she said.

At 17 days old, HealthCare.gov has become a bit of a joke � even to folks like Cloud, who were eagerly awaiting its rollout.

So how could a roughly $400 million software project that had been in the works for years have so many problems at its launch? One bit of advice from Silicon Valley: Start small.

"It's not as if Facebook says, 'OK, here is our six-year plan for how we're going to make Facebook.com,' " says entrepreneur Ben Balter. "They build one feature at a time, and take a step back, look at how the feature is be used, before they go on to the next feature."

Balter says you build something small, you test it, and when it works for your users, then you take the next step. Right now, Balter works for GitHub.

"GitHub is a social code-sharing service," he says. "Think of it like Facebook for code. So instead of posting pictures of your kids or posting ... on Twitter what you had for lunch, you are showing what projects you're working on."

By sharing the code you are writing, lots of people can critique it, find the bugs, offer ideas and make sure it works. It's called open source, and Balter believes HealthCare.gov should have been written that way from the start.

"Why would you make that code private?" Balter asks.

But often when things don't work in government, the impulse is to duck and cover and clamp down on information.

"I think the key reason is the way projects get funded," says Michael Cockrill, who used to work in startups and is now the chief information officer for Washington state.

He says to get a software project funded in the public sector, typically you have say exactly what it is going to do, spell how much it will cost and when you will finish.

"As a result, you end up creating this culture that is all about doing what you said you were gonna do," Cockrill says.

It's a culture that is risk-adverse and terrified of public failure. You can't learn from little failures or adjust course midstream. And instead of taking big jobs, breaking them down into small tasks and testing for success at each step, a project like HealthCare.gov becomes a giant all-or-nothing gamble.

Cockrill says too often it's a gamble taxpayers loose.

"You've made all these commitments about what you are going to build. What is it going to look like upfront," Cockrill says. "And even if the market changes underneath you, and even if your customers need something different � which you know always happens � you made a commitment a big public commitment, and they've written it into budgets and law."

Cockrill and many others around the country are trying to help governments become more flexible and agile as they embark on software development projects.

"It's really hard to convince people to kind of trust you," he says. "Especially when you are saying, 'Look I don't know exactly what is going to look like � but we are going to do what matters most first.' "

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Friday, October 11, 2013

California Trains Helpers To Meet Demand For Health Insurance

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FAQ: What Retirees And Seniors Need To Know About The Affordable Care Act

This is one of several explainers to help consumers navigate their health insurance choices under the Affordable Care Act, or as some call it, Obamacare. Click here for answers to other common questions. Have a question we missed? Send it to health@npr.org. We may use it in a future on-air or online segment.

I am on Medicare. Do I need to use one of the new health insurance exchanges?

No. Medicare is not part of the health insurance exchanges. The exchanges won't be selling so-called "Medigap" policies that supplement the coverage seniors get through Medicare.

Seniors will still get health coverage through Medicare's traditional fee-for-service program or Medicare Advantage plans, private health insurance plans that are approved by Medicare. Those who are enrolled in Medicare Part A, which covers hospital care, or the Advantage plans will meet the health law's mandate for individuals to have insurance.

Does the health care law offer any new benefits for Medicare beneficiaries?

Beneficiaries receive more preventive care services � including a yearly "wellness" visit, mammograms, colorectal screening, and more savings on prescription drug coverage. By 2020, the law will close the Medicare gap in prescription drug coverage, known as the "doughnut hole." Seniors will still be responsible for 25 percent of their prescription drug costs.

Does the health law require higher-income Medicare beneficiaries to pay more for their Medicare prescription drug coverage?

It does. Currently, Medicare beneficiaries who earn more than $85,000 ($170,000 for a couple) pay more for their Medicare Part B premiums, which cover physician and outpatient services. The health law brought that same sliding-scale approach to beneficiaries' prescription drug coverage in Medicare Part D for those with incomes of more than $85,000 ($170,000 for a couple). Those income thresholds will be frozen through 2019.

If I'm retired and my former employer offers me insurance, can I shop on the exchange to get a better deal?

Even if your former employer offers coverage, you can opt to buy a plan on the exchange. However, you may not be eligible for a subsidy.

See other Frequently Asked Questions on the Affordable Care Act:

Understanding The Health Insurance Mandate And Penalties For Going Uninsured All About Health Insurance Exchanges And How To Shop At Them A Young Adult's Guide to New Health Insurance Choices How Obamacare Affects Employers And How They're Responding Where Medicaid's Reach Has Expanded � And Where it Hasn't

Additional coverage from NPR Member Stations:

California (KQED, San Francisco) California (KPCC) California (KXJZ Capital Public Radio, Sacramento) Colorado (Colorado Public Radio) Massachusetts (WBUR, Boston) Minnesota (Minnesota Public Radio) Georgia (WABE, Atlanta) New York (WNYC) Oregon (Oregon Public Broadcasting) Pennsylvania (WHYY newsworks.org) Texas (KUHF) Texas (KUT, San Antonio)

This FAQ was produced through a collaboration between NPR and Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonpartisan health-care policy research organization. The Kaiser Family Foundation is not affiliated with Kaiser Permanente.

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Thursday, October 10, 2013

Employers Trim Health Costs By Cutting Coverage For Spouses

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Wednesday, October 9, 2013

Is Obamacare Enough?

Without Single-Payer, Patchwork U.S. Healthcare Leaves Millions Uninsured

From Democracy Now –

Despite helping expanding affordable insurance, “Obamacare” maintains the patchwork U.S. healthcare system that will still mean high costs, weak plans and, in many cases, no insurance for millions of Americans. We host a debate on whether the Affordable Care Act goes far enough to address the nation�s health crisis with two guests: Dr. Steffie Woolhandler, a primary care physician and co-founder of Physicians for a National Health Program; and John McDonough, a professor at the Harvard School of Public Health and former senior adviser on national health reform to the U.S. Senate Committee on Health, Education, Labor, and Pensions. Between 2003 and 2008, McDonough served as executive director of Health Care for All in Massachusetts, playing a key role in the passage of the 2006 Massachusetts health reform law, known as “Romneycare,” regarded by many as the model for the current federal healthcare law.

Tuesday, October 8, 2013

First Step In Health Exchange Enrollment: Train The Helpers

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Questions Rise As Health Care Exchange Draws Near

Enrollment in the Affordable Care Act health exchanges is set to begin Oct. 1. But many eligible Americans still have questions.

Tell Me More reached out to listeners via Facebook and Twitter in an attempt to help answer their questions about the law. Host Michel Martin spoke with Mary Agnes Carey, a senior correspondent at Kaiser Health News � a news service not affiliated with Kaiser Permanente.

On searching for other affordable care options

Listener Caitlin Stevenson: "When the Affordable Care Act goes into effect, if I'm already covered by an employer's health plan, am I still eligible to shop for more affordable care? The plan that my job offers costs more than $350 a month for my husband and me � that's more than a car payment! Will we � healthy adults, 26 and 31— be able to find a plan that costs less than this?"

Carey answers: "Anyone can shop on the exchange. The question here is whether or not they can qualify for a subsidy of purchased coverage. ... In order to qualify for a subsidy, two things have to happen. No. 1: The ... health insurance offered by her husband's employer has to cost more than 9.5 percent of their household income or the plan, if it covers at least 60 percent of the covered medical expenses. [What] I mean is that if it pays for 60 percent of the medical expenses, they could not get into the exchange. So it either costs more than 9.5 percent of the income or it doesn't pay for 60 percent of the covered services. If one of those things happen, they might be able to qualify for a subsidy."

On options for graduating students

Graduate student Lorrie Guess: "I obviously don't know yet if I'm going to have a job that offers me coverage and I don't want to pay a fine if I don't buy the coverage in case I get a job that offers me health insurance. On the other hand, I don't want to buy coverage only to get a job that ends up covering me and then find out that I'm paying for no reason."

Carey answers: "Well here's a couple of ideas. No. 1, is there any way to extend her student health insurance for a period of time after graduation as she decides where she's going to go and what job she has and whether or not she has coverage? That's one thing. Secondly, while the enrollment period for the first year of the Affordable Care Act ends at the end of March, there are things called qualifying life events � you lose your insurance at work, you get married, you have a child. I think graduating from college would be one of these. ... [And she] could get coverage on her parents' health insurance plan for a period of time. As we know, the Affordable Care Act allows that up to age 26."

On mental health options

Carey says, "As part of the Affordable Care Act ... there will be more coverage of mental health services. ... And also there has to be parity between what a plan offers on health services and what they offer on mental health services. But this is an area where I would urge caution, for people to look at and see how parity is defined, how it's implemented in a particular policy. Because this has been a concern � the mental health parity law passed a few years ago, [and while] some of the regulations have come through with it others have not. But it's definitely an area worth watching for people that are enrolling in the exchange coverage."

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One Key Thing No One Knows About Obamacare

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Commander In Chief, Explainer In Chief Tout Health Care Law

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President Obama joins former President Clinton to talk about the health care law, during the annual Clinton Global Initiative meeting Tuesday in New York.

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President Obama joins former President Clinton to talk about the health care law, during the annual Clinton Global Initiative meeting Tuesday in New York.

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President Obama's health care law has so far survived challenges in Congress and the courts. But its biggest test could begin next week. That's when the online marketplaces offering health care coverage to the uninsured are set to start signing people up. The question is, will they come?

Of the uninsured surveyed by NBC and the Wall Street Journal this month, only about 1 in 3 said they're likely to use the exchanges. Obama is trying to make the argument that signing up is a good deal: "In many states across the country, if you're, say, a 27-year-old young woman, don't have health insurance, you get on that exchange, you're going to be able to purchase high-quality health insurance for less than the cost of your cellphone bill."

The White House is enlisting nurses, ministers, celebrities, even radio DJs to help spread that message. On Tuesday, Obama got some help from former President Bill Clinton. The two leaders sat side by side in a pair of overstuffed armchairs at the Clinton Global Initiative for a televised � if somewhat wonky � conversation about health care economics.

It's the nature of insurance, Obama said, for healthy people to subsidize those who need more care. Clinton says that's why it's important to get healthy young people enrolled in the insurance exchanges.

"This only works, for example, if young people show up," said Clinton. "We've got to have them in the pools. Because otherwise all these projected low costs cannot be held if older people with pre-existing conditions are disproportionately represented in any given state."

Clinton understands those economics, having launched his own, unsuccessful push for universal coverage 20 years ago this week. Obama got further, pushing his bill through Congress, but he notes the battle to implement the law is far from over: "Let's face it: It's been a little political, this whole Obamacare thing."

The administration is now using social media and other tactics honed during the president's re-election campaign to promote enrollment in the health care exchanges. Obama acknowledges they're battling a multimillion-dollar advertising blitz mounted by the president's critics.

"Those who have opposed the idea of universal health care in the first place and have fought this thing tooth and nail through Congress and through the courts and so forth, have been trying to scare and discourage people from getting a good deal," said Obama.

Congressional Republicans also continue to challenge the law, which was passed over their unanimous opposition in 2010. Despite the battle being waged within the Republican ranks right now over tactics like the filibuster and a threatened government shutdown, Senate GOP leader Mitch McConnell says his party is united in its opposition to the health care overhaul.

"Obamacare hasn't even been fully implemented yet but we can already see the train wreck headed our way," said McConnell. "Major companies have been dropping the health care plans their employees have and like. And every week it seems there are new reports about glitches that will hurt families, compromise personal information, or expose the American people to fraud."

The administration has been forced to delay some elements of the law, including a requirement that large employers provide health care coverage or pay a penalty.

On the plus side, Clinton noted Tuesday the growth in health care costs has slowed dramatically in recent years, though analysts are unsure what's behind the change. Obama says if U.S. health care costs could be brought in line with other countries, it would largely fix the federal deficit and make U.S. employers more competitive.

"This has everything to do with the economy, in addition to what I consider to be the moral imperative that a mom should not have to go bankrupt if her son or daughter gets sick," said Obama.

Obama plans to deliver another health care speech Thursday, as the countdown to enrollment continues.

Share Facebook Twitter Google+ Email Comment More From Health Care HealthIt's Time To Rediscover The IUD, Women's Health Advocates SayPoliticsGovernment Shutdown? 'This Is Democracy In Action'HealthDespite Many Warnings, Antibiotics Are Still Overprescribed HealthPart-Time Workers Search New Exchanges For Health Insurance

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Would A Federal Shutdown Delay Health Care Exchanges?

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Tech Problems Plague First Day Of Health Exchange Rollout

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Monday, October 7, 2013

Medicaid Looks Good To A Former Young Invincible

More From Shots - Health News HealthDelaying Aging May Have A Bigger Payoff Than Fighting DiseaseHealthNobel Winners Decoded How Neurons And Cells Talk To Each OtherHealthFor Boys With Eating Disorders, Finding Treatment Can Be HardHealthIt's Time To Rediscover The IUD, Women's Health Advocates Say

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A Medicaid Expansion In Pennsylvania May Take Time

More From Shots - Health News HealthDelaying Aging May Have A Bigger Payoff Than Fighting DiseaseHealthNobel Winners Decoded How Neurons And Cells Talk To Each OtherHealthFor Boys With Eating Disorders, Finding Treatment Can Be HardHealthIt's Time To Rediscover The IUD, Women's Health Advocates Say

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Would A Federal Shutdown Delay Health Care Exchanges?

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Saturday, September 21, 2013

How Many Die From Medical Mistakes In U.S. Hospitals?

More From Shots - Health News ScienceIn Life, Man Immune To HIV Helped Scientists Fight VirusHealthHow Many Die From Medical Mistakes In U.S. Hospitals?HealthStudy Finds Mixed Results For Back Braces To Treat Scoliosis HealthEven As MERS Epidemic Grows, The Source Eludes Scientists

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Tuesday, September 17, 2013

For-Profit Online Insurance Brokers Gear Up To Sell Obamacare

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Uninsured Numbers Drop A Bit On The Eve Of Health Law Debut

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Sunday, September 15, 2013

Shumlin Payroll Tax to Fund Single Payer Unpalatable to Business

If Gov. Peter Shumlin pursues a payroll tax to fund a publicly financed health care system, he will meet heavy resistance from one of the state�s most influential business groups.

Betsy Bishop, president of the Vermont Chamber of Commerce, says her organization and its members would not look favorably on a payroll tax.

�When you take away the decision-making process, but leave the payment still in place, it disconnects the employer from the payment,� she said. �What we�re interested in is continuing a system where employers, if they are paying for health care, have some level of control over what they are paying for.�

Last week, Shumlin told Times Argus Editor Steve Pappas that a payroll tax would be one of the vehicles for funding a single-payer, universal health care system in Vermont. Shumlin has been touting single payer for years, but he has provided little detail to date about how the state would pay for the system.

�Clearly, the payroll tax is going to have to play a major role,� he told Pappas.

Shumlin�s Office of Health Care Reform is working on a financing plan to raise an estimated $1.61 billion for the system, and the governor says he will hand the plan to the Legislature in January 2015. The state would not be eligible for a waiver from the Affordable Care Act to implement a single payer plan until 2017.

�Opponents are going to say this will be the biggest tax increase in Vermont history � fair enough,� Shumlin told Pappas. �But it�s going to be the biggest health care premium reduction in American history. We�re just going to swap a health care premium for a publicly financed health care premium.�

Continue reading…

Shumlin Payroll Tax to Fund Single Payer Unpalatable to Business

If Gov. Peter Shumlin pursues a payroll tax to fund a publicly financed health care system, he will meet heavy resistance from one of the state�s most influential business groups.

Betsy Bishop, president of the Vermont Chamber of Commerce, says her organization and its members would not look favorably on a payroll tax.

�When you take away the decision-making process, but leave the payment still in place, it disconnects the employer from the payment,� she said. �What we�re interested in is continuing a system where employers, if they are paying for health care, have some level of control over what they are paying for.�

Last week, Shumlin told Times Argus Editor Steve Pappas that a payroll tax would be one of the vehicles for funding a single-payer, universal health care system in Vermont. Shumlin has been touting single payer for years, but he has provided little detail to date about how the state would pay for the system.

�Clearly, the payroll tax is going to have to play a major role,� he told Pappas.

Shumlin�s Office of Health Care Reform is working on a financing plan to raise an estimated $1.61 billion for the system, and the governor says he will hand the plan to the Legislature in January 2015. The state would not be eligible for a waiver from the Affordable Care Act to implement a single payer plan until 2017.

�Opponents are going to say this will be the biggest tax increase in Vermont history � fair enough,� Shumlin told Pappas. �But it�s going to be the biggest health care premium reduction in American history. We�re just going to swap a health care premium for a publicly financed health care premium.�

Continue reading…

Friday, September 13, 2013

AFL-CIO Reaffirms Commitment to Single Payer–Demands Fixes to ACA

From All Unions for Single Payer –

The just concluded AFL-CIO convention reaffirmed its commitment to a single payer health care system while demanding that the Affordable Care Act (ACA) be fixed to protect Taft-Hartley (multiemployer) plans, to end the excise tax, to make employers cover workers who average 20 hours a week, to require construction companies with 5 or more employees to provide health care, to penalize companies who dump their workers onto Medicaid, plus more.

Some of the debate on the resolution can be seen here:

Full text of the resolution can be found here.

Wednesday, September 11, 2013

Health law’s ailments can be cured by single-payer system

All the shortcomings of the healthcare restructuring result from the decision to leave it in the hands of private insurers.

With the Oct. 1 rollout of a major facet of the Affordable Care Act on the horizon, you’ll be hearing a lot about the glitches, loopholes and shortcomings of this most important restructuring of America’s healthcare system in our lifetimes. Here are a couple of things to keep in mind:

First, the vast majority of these issues result from one crucial compromise made in the drafting of the 2010 law, ostensibly to ease its passage through Congress. That was to leave the system in the hands of private health insurance companies.

Second, there’s an obvious way to correct this flaw: The country should progress on to a single-payer system.

The idea that the ACA is a logical precursor to single-payer, in which the government would be the source of all medical reimbursement, has been gaining traction as key thresholds for healthcare reform approach. The biggest milestone is the Oct. 1 launch of open enrollment for the health insurance exchanges that will offer individual insurance starting Jan. 1.

Last month, Senate Majority Leader Harry Reid made that point in a Nevada news broadcast, calling the ACA “a step in the right direction” but adding that the U.S. would have to “work our way past” private insurance-based healthcare. “We’re far from having something that’s going to work forever,” he said.

“There isn’t a popular groundswell yet” for a single-payer plan “because most people haven’t seen the ACA at work in detail yet,” says David Himmelstein, a professor of public health at the City University of New York and co-founder of Physicians for a National Health Program, the leading advocacy group for single-payer healthcare. But he anticipates that discontent will start in October “and accelerate through the winter.”

Among the law’s shortcomings, he says, are the lack of effective provisions to control healthcare costs and insurance premiums. Premium regulation remains in the hands of the states, and many don’t have strong regulatory oversight of health insurance. In California, health insurance premiums are exempt from prior approval by the insurance commissioner, unlike home and auto insurance. (An initiative to remove the exemption will appear on the November 2014 ballot.)

That’s not to say that the ACA won’t make health insurance more affordable and accessible to millions of Americans now excluded from the market. Published exchange premiums in 18 states have generally come in below expectations, and the federal subsidies available to most buyers will make them cheaper still.

In some cases the premiums may be higher than those of plans on the market now. But because of exclusions for preexisting conditions — which will no longer be legal — they’re actually unavailable at any price to people who will have no trouble qualifying for the exchange plans.

The ACA’s critics observe that a plurality of Americans still view the ACA unfavorably (43%, according to an opinion poll released in June by the Kaiser Family Foundation). They rarely acknowledge, however, that nearly 1 in 5 of those critics think the law doesn’t go far enough — that is, further toward single-payer.

In its earliest incarnation, the Affordable Care Act included a prototype government single-payer provision — the “public option,” a government-sponsored plan to compete with commercial insurers in the exchanges. The public option was deleted at the insurance industry’s insistence.

But the U.S. does offer a healthcare program that resembles single-payer. It’s Medicare, the broadly popular health plan that covers all Americans over 65. Medicare’s administrative costs are only about 2%, and its size gives it the clout to extract large discounts from doctors and hospitals. That’s why one oft-proposed version of single-payer is “Medicare for all” — simply expand its coverage beyond the 65-plus.

Canada’s single-payer system is another model. It’s popular and efficient and costs about one-third of America’s system to administer. Don’t believe the myths purveyed about Canada’s healthcare by the U.S. insurance industry’s minions.

As health economist Aaron Carroll has documented, Canadian patients and doctors are satisfied with the program. As for the contention that it “rations” care, he points out that care in the U.S. is rationed by cost: one-third of adult Americans surveyed by the Commonwealth Fund in 2010 said they had put off important treatment because of the cost. In Canada, the figure was 15%.

There’s little question that taking private insurers out of the American healthcare system would save hundreds of billions of dollars a year. Dozens of studies of federal and state single-payer proposals have found that single-payer plans could provide universal coverage — not even the ACA does that — and still save money.

Estimates of the administrative costs of commercial health insurers exceed 10%. That doesn’t include the costs to doctors and hospitals of maintaining billing staffs to deal with insurers and keep all their rules and peculiarities straight, or the time lost to individuals and their employers of navigating this unnecessarily byzantine system.

Add those, and the overall administrative costs embedded in the U.S. healthcare system come to 31% of all spending, according to a 2003 article co-written by Himmelstein for the New England Journal of Medicine. Administrative and clerical workers accounted for nearly 44% of all employees in doctors’ offices, they calculated.

What do Americans receive in return for all this overhead? Practically nothing. The insurance industry says its role is to hold down costs by negotiating for preferential fees from doctors and hospitals and trolling for abuses, but the truth is they’re totally ineffective at cost control.

Just last year I reported on an admission by Aetna and United Healthcare, two of our biggest insurers, that they had been snookered to the tune of $60 million by one chain of small surgical clinics in Northern California. That happened because the insurers didn’t hire enough staff to give the claims from those clinics decent scrutiny — in other words, their administrative costs, high as they were, didn’t buy adequate oversight.

The result, to cite just one example, was that United paid the chain more than $97,000 for a kidney stone operation that it usually covers for $6,851.

“Private insurance is a parasite in the system,” says Arnold S. Relman, the former editor of the New England Journal of Medicine and an advocate of healthcare reform. “It adds nothing of value commensurate with its cost.”

Relman believes that fixing the healthcare system will require more than single-payer. The delivery of care needs to be reorganized by promoting the formation of more “accountable care organizations” — medium- and large-scale group practices with hospital affiliates whose physicians would be salaried to discourage the overuse fostered by the fee-for-service system.

What’s really needed is political will. It would help if big companies, which grouse incessantly about the rising costs of covering their employees, would throw their weight behind a system that would relieve them of that burden.

The forces of opposition won’t lie down; the insurance industry won’t give up its central role in the healthcare system without a costly and bruising fight, as it showed in Congress and in numerous states, including California, where single-payer plans were on the table.

“It’s going to be a slow and painful process,” Relman says. “But sooner or later we’ll have to turn to single-payer. It’s the only logical solution.”