"The “Blues” had been ruled tax-exempt by Internal Revenue regulations since their inception in the 1930s, apparently because they were regarded as community service organizations. The Tax Reform Act of 1986 removed BlueCross BlueShield plans’ tax exemption because Congress believed that “exempt charitable and social welfare organizations that engage in insurance activities are engaged in an activity whose nature and scope is inherently commercial rather than charitable,” and that “the tax-exempt status of organizations engaged in insurance activities provided an unfair competitive advantage.”

The 1986 Act, however, introduced the special deduction described above, in part because of their continuing, albeit more limited, role in providing community-rated health insurance. In particular, Section 833(c)2(c) links the special deduction for BlueCross BlueShield plans to the provision of high-risk and small-group coverage."

Source: http://subsidyscope.org/nonprofits/tax-expenditures/blue-cross-blue-shield/

Long story short: You cannot claim to be a not-for-profit charitable foundation and be an insurance company at the same time. The term "insurance" implies that the insurer will only devote a fraction of the money to providing true health care. While BCBS started off with good intentions and a very good idea, BCBS has turned into just another health insurance company paying millions in bonuses to CEOs, denying essential health care to applicants and customers while raising health fees by 50% in many states.

We don't need "health plans" or "health insurance". The people of the United States need true health care. Not a system that moves towards fee-for-service and discourages high quality health care, but a system that establishes integrated, comprehensive health care bringing together inputs, delivery, management and organization of services related to diagnosis, treatment, care, rehabilitation and health promotion. The first step in doing so is to make sure that health insurers spend at least 95% of all revenues on true health care, not the 80-85% proposed by the federal health care bill. The ultimate goal is getting rid off the middlemen and putting health care into the hands of health care providers, such as doctors and hospitals, who treat us as patients and not customers or numbers in accounting.

I feel embarrassed by these images. How can the wealthiest nation in the world spend $700 billion on war an destruction and not a single dime on providing universal health care for all Americans??

In an article called "Enough is Enough" by famous M.D. Mehmet Oz he talks about how he volunteered at this Free Clinic sponsored by CareNow. "The group was informally established by a team of first responders who’d learned the art of swooping in to help after hurricanes, earthquakes, wildfires and tsunamis. In May 2009, they held the largest free clinic ever, also in Los Angeles, and a breathtaking 8,000 people showed up. After that, CareNow was formally founded, with the goal of providing care when there is no natural disaster.
[...]
At what point, I wondered that day and still wonder now, will we finally say enough? The medically underserved are, most commonly, the medically uninsured, and they number in the tens of millions. Many don’t have jobs, but just as many do. Their companies may not offer health insurance, or they simply may not be able to afford the monthly payroll deductions that would be required to enroll."

Read more: http://ideas.time.com/2011/10/31/enough-is-enough/#ixzz1cxdqBlQY

The part in bold is what I and many single payer health-care proponents have been talking about for years. A true universal health care system that can negotiate prices will not only favor the patient, but also the employer who would not have to pay impossibly high payrolls forcing them between cutting medical benefits or firing people.
Our nation is third world when it comes to health care. This is a completely unacceptable state that must be changed as soon as possible with something that is more comprehensive, more aggressive and ultimately more affordable than the current wasteful public-private health-care system AND the subsidized private health-care system in the Affordable Care Act.

I'm dreaming of an America where every person has a Medicare card in the pocket, where parents don't have to worry about whether they can afford a treatment their child needs, and where small businesses don't have to choose between cutting health benefits and laying off people because of the cost of care.
I'm dreaming of an America where people can finish their mental health treatment, where hospitals are rewarded for caring about patients and where people are not treated as numbers, but as humans with dignity.

There are not too many news on health care reform. Some have passed bills, other are on their way implementing the laws. But, there is something that might threaten all the progress that has been done for health care reform. President Obama's approval rating has been dropping as he continued to give in to Republican pressure. Bills that promised progress have been watered down to a degree where they are simply ineffective. On top of that, the Republican Party wants to see the Democratic President fail, even when it means to oppose their own ideology. It is incredibly important that Obama stays President for two reasons:

1. He's a leader. No doubt. There is no other Democratic candidate who could replace him on time and convince our nation that he/she is a good leader for this country.
2. The GOP candidates are completely nuts! All of them would repeal health insurance reform on day one and even privatize popular health care services such as Medicare. The Tea Party has forced the Republican Party to adopt its extremist ideologies or face losing voters during the primaries.

One cannot reason with the current Republican Party line-up. They do not care if they kill millions as long as their insane ideology is in place and enforced.

Yes, Obama has done relatively little in progress, but it is progress that we can built on. I take Obama over any of those nutjobs anyday.

Sorry. I haven't updated on the latest in health care. I was a bit too distracted with another blog.
1. Birth Control will be considered preventive care under HCR.

I don’t know if you already knew about this. But, health care reform now considers birth control preventative care. That means the pill will be free-of-charge.
Very good news. If the right-wing pro life crowd would use its brain, they would realize that this policy will prevent a lot of abortions thus help them far more than making abortions illegal.

Now I hope health insurance will include dental care, too. That the industry split health from dental care is the biggest scam in history. When I moved here, I didn’t know that and I’m still a bit surprised about the fact.

Source: www.abcactionnews.com/

2. U.S. MDs spend $83,000 (yearly) on insurance administration costs.

"The survey research reveals that physician practices in the United States incur nearly $83,000 in administrative costs per physician each year, nearly four times the amount spent by their Canadian counterparts. The U.S. could save almost $27.6 billion in annual health spending if administrative costs were similar to those in Canada."
Does not surprise me at all. We need to go from private, for-profit health insurance to a healthier public, non-profit health care system.

Source: www.californiaonecare.org

3. Medicare turns 46 this year.

"Since its inception, Medicare has afforded hundreds of millions of Americans access to high-quality health care. It has reduced poverty among seniors and improved the financial security of their families. It has become one of the most popular government programs in history."
In fact, it is so popular, not even the Republican Party was able to reduce or repeal it and Tea Partiers continue to shout "keep government out of my Medicare" although it is a government program. The program has improved over the years, but there is still a LOT to do.

Source: www.pnhp.org/blog

http://www.healthcare.gov/center/councils/nphpphc/strategy/index.html

On June 16, 2011 the National Prevention, Health Promotion, and Public Health Council, announced the release of the National Prevention Strategy, a comprehensive plan that will help increase the number of Americans who are healthy at every stage of life. The National Prevention Strategy recognizes that good health comes not just from receiving quality medical care, but also from clean air and water, safe outdoor spaces for physical activity, safe worksites, healthy foods, violence-free environments and healthy homes. Prevention should be woven into all aspects of our lives, including where and how we live, learn, work and play. Everyone—businesses, educators, health care institutions, government, communities and every single American—has a role in creating a healthier nation.

I think free preventive care is the best part that Progressives were able to put into the health reform package. It will save thousands of lives every month and improve the health of millions of Americans. Coming from Germany where preventive care has high priority, I can confirm that it works and that people like it.

And this will do even more wonders in a country so unhealthy due to the lifestyle, nutrition, and the lack of information of how to prevent life-threatening sicknesses. Take a look at the graph below. Click the link above for more information and the PDF file that lines out the National Prevention Strategy.

Today, Dr. Hsiao submitted the first draft to design a universal health care system.

You can Download the full draft here: Link
You can watch the full draft here: Link

Vermonters will be able to choose between 3 proposals:

Option 1
1A--Govern­­ment-run Single Payer system with comprehens­­ive benefit package
1B—Governm­­ent-run Single Payer system with essential benefit package

Option 2—Public Option

Option 3 (Public-Pr­­ivate Single Payer)
Essential benefit package, Independen­­t board, third party manages provider relations and claim adjudicati­­on/proces­s­ing

About 1A and 1B:
Comprehens­ive Benefit Package:

• Reduce financial barrier to provide easy access to all health services, including nursing home and homecare.
• Cover dental, nursing home and homecare.
• Emphasis prevention and primary care
• Financial risk protection against health expenditur­e tjat causes impoverish­ment.

• Services covered: Prevention­, medical, mental health,oth­er profession­als, drugs, dental, vision, nursing home, and homecare.
• Cost sharing by patients: Very small co-payment­s to discourage improviden­t demand while not impede access.

Essential Benefit Package:

• Cover every resident with at least 87% of medical and 77%of drug expenses (as the average private health insurance now covers)
• Expand coverage for dental and vision care.
• Exclude nursing home and homecare.
• Emphasize prevention and primary care
• Financial risk protection against health expenditur­e that causes impoverish­ment by capping out-of-poc­ket cost.
• Availabil­ity of supplement­al coverage in addition to the essential benefit package with private insurance.

• Services covered: Prevention­, medical, mental health, other profession­als, drugs, some dental and vision.
• Cost sharing by patients: Modest copayments for outpatient services (no copayment for preventive services), and deductible and coinsuranc­e for inpatient hospital services.

This is how much the options would save comparatively: Savings estimates and payroll contributions: Note: Even if Vermont would go with the single payer health-care system that provides comprehens­ive care (health, vision, dental + very low co-pay), employers would still save money.

Dr. Hsiao recommends Option 3 which would create an independent single payer system that provides services through the private sector. It would save the most money and be the most flexible.
I disagree. Option 1A would cost more the first year, but the cost would lower over time compared to people living with Option 1B or 3 who would also have to purchase supplementary dental insurance. Does the first draft take that into consideration? I doubt. I also think that Option 3 is based on ideal market conditions which are never given in the real economy.

Option 1A provides far superior services over the long-run and avoids that Vermont has to go through decades of trial-and-error only to come to the same result that we see in European countries = a comprehensive universal health-care system.
My thoughts go hand-in-hand with Don McCanne's, MD, findings. He is Senior Health Policy Fellow at Physicians for a National Health Program and also well-known for his voice in the successful California OneCare campaign.
http://vermontforsinglepayer.org/expertscomment

However, I agree with the concepts of Option 3. The single payer health-care system should be government-owned but operate with the least distortion through interest groups in favor of the beneficiaries.

A lot of things happened in the last two months regarding health care.

1. The first wave of Health insurance reform came into effect:
Insurers will no longer be able to

• Deny coverage to kids with pre-existing conditions.
• Put lifetime limits on benefits.
• Cancel your policy without proving fraud. Health plans can’t retroactively cancel insurance coverage
• Deny claims without a chance for appeal.

Consumers will be able to

• Receive cost-free preventive services.
• Keep young adults on a parent’s plan until age 26.
• Choose a primary care doctor, ob/gyn and pediatrician.
• Use the nearest emergency room without penalty.

Source: http://www.healthcare.gov/news/factsheets/overview.html

Well, but all these things will not help as long as they only apply to new individual insurance plans. In addition to that, those plans are 30% higher so the overwhelming majority will not be able to afford care. 2. California is the first state to create its state health exchange:
It will create a five-member oversight board that will be responsible for running the exchange and negotiate premiums. The legislation forbids insurance industry representatives, health care providers and others with direct conflicts of interest from taking a seat on the board. Other bills were also signed to increase transparency of premium hikes and to bar insurers from denying coverage for children.
Source: http://www.eastvalleytribune.com/local/health/article_62db4fdc-d232-11df-86bb-001cc4c03286.html

While this might seem like a big step, mainstream media completely ignored the bills, Schwarzenegger vetoed:

• AB 1600, mental health parity
• AB 2402, limiting rate increases
• SB 56, public health options
• AB 2540, increase fines for improper rescinding of consumer’s coverage

"The bills Schwarzenegger rejected would have forced insurers to provide mental health benefits on par with physical health benefits, limited rate increases to once a year, limited the ability of insurance companies to rescind policies when consumers seek benefits, and allowed county health systems to venture into the broader marketplace now controlled by private insurance companies."
Source: http://www.healthycal.org/schwarzenegger-vetoes-health-reform-bills.html 3. U.K. conservatives are dismantling the NHS, the overwhelming majority is opposed:
"The coalition government’s plans for the NHS represent the final conversion of healthcare into something to be bought, with really good care going to those who can pay for it and only a defined ‘package’ of free treatments, of declining quality, for everyone else.

What has already occurred with dentistry, physiotherapy, podiatry and other services will start happening across the board. ‘Top-ups’ and ‘co-payments’ will become standard. Some treatments will cease to be available freely on the NHS and have to be paid for – if you can afford it.

It’s already happening all over England, as staff and services are cut to meet the government’s demand for £20 billion ‘savings’ over the next five years. GPs are being told to refer many fewer patients to specialists."
Source: http://pnhp.org/news/2010/october/dismantling-the-nhs

Once again, people will suffer because conservatives refuse to understand that health care cannot be compared to a car or a house. Demand and supply can't apply to something everyone needs to survive. A good health care system must make millions of "irrational" choices in order to save human lives.

On Sunday, Health Insurance Reform passed the House and got signed by the President on Tuesday. What is going to follow is the Reconciliation bill.

Or should I better say a reconciliation bill? Because we still have a long way to go until we have a health care system that serves the people, a system in which you can put your life into the hands of the government and not private enterprise who will sell it on the Stock market, a system in which you won't have to worry about which doctor or hospital will cover you because you are free to go to any hospital and doctor without any fees.

This system could be a multi payer health-care system (Public and Private plans), a single payer health-care system (One single fund) or a publicly-funded health-care system (Completely government-run). No matter which one the United States will choose, it will save trillions over decades.

California once again is a pioneer in this field. With two single payer health-care bills vetoed by Schwarzenegger in 2006 and 2008, California Legislature is taking its thrid run on a Single Payer Health-Care system that could be signed by the new Democratic Governor (Jerry Brown) or passed after the state elections through a healthy majority that can override the veto. All my hope is in this bill. If it passes, other blue states will follow suit in a matter of months followed by red states in a matter of years.


Links:
California Universal Health-Care. A story of struggle.

We have to thank the House and private Health insurance companies.

• The House because they pushed for a petition to revive the public option. They really are our Representatives.
• Private health insurance companies for raising the rates. That makes even the last one realize that they are exploiting people.

Using the President's proposal as a base, decided to pass Health Care Reform within a week, Nancy Pelosi decided to ignore Stupak's Abortion compromise and to move forward. Obama set the deadline on March 18, 2010, however Hosue Democrats decided to vote on the bill before that date.

What would follow would be a comprehensive amendment that includes the public option and revives many other progressive proposals that have passed the House.

41 Senators have signed the petition to revive the public option. It also is certain that two more Senators (Rockefeller and Harkin) will vote for a public option. Including Vice President Biden, that makes 44 votes which means we need 6 more votes to introduce the Public Option through reconciliation! Let's hope they can make it.

Links:
Who signed the Petition for a Public Option:
http://whipcongress.com/
Public Option revived (Huffington Post)
http://www.huffingtonpost.com/2010/03/11/the-public-options-last-s_n_495383.html?page=2&show_comment_id=42042752#postComment
Pelosi proceeds without Abortion compromise:
http://www.huffingtonpost.com/2010/03/11/house-dems-will-forge-ahe_n_495720.html

The White House Health Care proposal is up (click on the image). It is very similar to the Senate health care bill, except for some little changes.
For example:

• The federal government will pay 100% (2014-2019) and then 90% of the tab for expanded Medicaid, relieving state governments from the financial burden.
• Senator Nelson's special exempt has been stripped off.
• The ridiculous excise tax on high cost health insurance has been postponed (hopefully infinitely).
• Some people also speculate that the White House proposal could mean the end of Obama's special deal with PhRMA that forbids Americans to buy cheaper drugs from Canada.

The public option is not mentioned because it "would not have the votes." But there are Senators and Representatives who try to revive a government health insurance option through reconciliation. Without the public option, many people also have concerns whether it can pass the House which strongly endorsed the public option and does not want to give up on their historic piece of legislation.

President Obama will be at the summit for six of his valuable hours. I doubt that Republicans will give in. They are too irresponsible to care about the country and too blinded by the money from the private health insurance lobby.