Conyers and McDermott have
introduced a single-payer, single-benefits
package, privately/publicly delivered, health plan covering all
with all medically necessary care, with a 15-year plan for converting
for-profit health facilities to not-for-profit.
The implications of plan cause a major shift in the debate over health care,
raising the question of what happens in capitalism when health care becomes
a cost of doing business, rather than a business itself.
Kaiser Daily Health Policy Report, February 5, 2003
Reps. Conyers, McDermott Introduce Bill That Would Establish National
Single-Payer Health System
Rep. John Conyers (D-Mich.), ranking member of the House Judiciary
Committee, and Rep. Jim McDermott (D-Wash.), a member of the House Ways and
Means Health Subcommittee, have introduced a bill that would create a
national single-payer health system, CongressDaily reports. According to
McDermott, the bill would have the federal government finance but not
administer the system and would keep the current system of private
physicians and hospitals. McDermott said it is "nonsense to suggest the
nation cannot afford such a system," noting that the federal government
"already spends $2,600 per person" on health care through Medicare,
Medicaid, other public health plans and tax exclusions for employers who
provide workers' coverage. Conyers said, "Even the people who don't like
[a
single-payer system] are moving to it. There's nothing else left" (Rovner,
CongressDaily, 2/4). According to a bill summary, the system would expand
the current Medicare system to all
funded through the existing Medicare payroll tax and a new payroll tax and
would provide coverage for a variety of services, including primary care,
prescription drugs and dental and vision services.
Physicians for a National Health Program (PNHP) carries
a summary:
http://www.pnhp.org/nhibill/nhi_execsumm.html
Brief Summary of Legislation
The United States National Health Insurance Act establishes a new American
national health insurance program by creating a single payer health care
system. The bill would create a publicly financed, privately delivered
health care program that uses the already existing Medicare program by
expanding and improving it to all
in
Americans, guaranteed by law, will have access to the highest quality and
cost effective health care services regardless of one's employment, income,
or health care status.
With over 42 million uninsured Americans, and another 40 million who are
under insured, the time has come to change our inefficient and costly
fragmented health care system. The USNHI program would reduce overall annual
health care spending by over $50 billion in the first year. In addition,
because it implements effective methods of cost-control, health spending is
contained over time, ensuring affordable health care to future generations.
In its first year, single-payer will save over $150 billion on paperwork and
$50 billion by using rational bulk purchasing of medications. These savings
are more than enough to cover all the uninsured, improve coverage for
everyone else, including medication coverage and long-term care.
Employers who currently provide coverage for their employees pay an average
of 8.5% of payroll towards health coverage, while many employers can't
afford to provide coverage at all. Under this Act, all employers will pay a
modest 3.3% payroll tax per employee, while eliminating their payments
towards private health plans. The average cost to an employer for an
employee earning $35,000 per year will be reduced to
$1,155, less than $100
per month.
95% of families will pay less for health care under
national health
insurance than they do today. Seniors and younger people will all have the
comprehensive medication coverage they need.
Who is Eligible
Every person living in the
receive a United States National Health Insurance Card and i.d number once
they enroll at the appropriate location. Social Security numbers may not be
used when assigning i.d cards. No co-pays or deductibles are permissible
under this act.
Benefits/Portability
This program will cover all medically necessary services, including primary
care, inpatient care, outpatient care, emergency care, prescription drugs,
durable medical equipment, long term care, mental health services,
dentistry, eye care, chiropractic, and substance abuse treatment. Patients
have their choice of physicians, providers, hospitals, clinics, and
practices.
Conversion to a Non-Profit Health Care System
Private health insurers shall be prohibited under this act from selling
coverage that duplicates the benefits of the USNHI program. They shall not
be prohibited from selling coverage for any additional benefits not
covered
by this Act; examples include cosmetic surgery, and other medically
unnecessary treatments.
Cost Containment Provisions/ Reimbursement
The National USNHI program will annually set reimbursement rates for
physicians, health care providers, and negotiate prescription drug prices.
The national office will provide an annual lump sum allotment to each
existing Medicare region, which will then administer the program. Payment to
health care providers include fee for service, and global budgets.
The conversion to a not-for- profit health care system will take place over
a 15 year period, through the sale of
be made for loss of business profits, but only for real estate, buildings,
and equipment.
Funding & Administration
The United States Congress will establish annual funding outlays for the
USNHI Program through an annual entitlement. The USNHI program will operate
under the auspices of the Dept of Health & Human Services, and be
administered in the former Medicare offices. All current expenditures
for
public health insurance programs such as S-CHIP, Medicaid, and Medicare will
be placed into the USNHI program.
A National USNHI Advisory Board will be established,
comprised primarily of
health care professionals and representatives of health advocacy groups.
Proposed Funding For USNHI Program: $1.86 Trillion Per
Year
A payroll tax on all employers of 3.3%. Maintain employee and employer
Medicare payroll tax of 1.45%. Implement a variety of mechanisms so that low
and middle income families pay a smaller share of their incomes for health
care than wealthiest 5% of Americans; i.e, a health income tax on the
wealthiest 5% of Americans, a small tax on stock and bond transfers, and
closing corporate tax shelters. A repeal of the Bush tax cut of 2001.
The text of the bill is available at:
http://www.pnhp.org/nhibill/nhi_bill_final.pdf
Physicians for a National Health Plan's Press release emphasized doctor
support and involvement in the plan:
CONTACTS:
Kimberly Soenen, PNHP 312.782.6006 kimberlysoenen@pnhp.org
Joel Segal, Office of Rep. John Conyers 202-223-5843
joel.segal@mail.house.gov
Physicians Propose Solution to Rising Health Care Costs and Uninsured
Introduce National Health Insurance Bill in Washington, D.C.
progressive leaders of Congress will hold a press conference briefing
Tuesday, February 4,
new bill, The United States National Health Insurance Act, a single-payer
national health program. The legislation proposes an effective mechanism for
controlling skyrocketing health costs while covering all 42 million
uninsured Americans. The bill also restores free choice of physician to
patients and provides comprehensive prescription drug coverage to seniors,
as well as younger people.
"Good news," says Dr. Quentin Young, convener of the physician panel.
"There
is now a way to exit the nightmare of a collapsing health system. We no
longer have to put up with the outrageous costs that keep millions of
Americans from receiving medical care and needed medications. Nor will tens
of thousands of families have to declare bankruptcy over medical bills.
Universal national health insurance (single payer) takes the resources we
have in place and deals with them in an intelligent manner, excluding the
tragic hemorrhage of resources into non-health entities."
Dr. Marcia Angell, former editor-in-chief of the New England Journal of
Medicine*, is the spokesperson for the Physicians Working Group on
Single-Payer National Health Insurance, an ad-hoc collaboration of the
nation's top physicians. Dr. Angell will present the proposal at the
briefing.
Other members of the group include Dr. Gerald Thomson and Dr.
Christine
Cassel, former Presidents of the American College of Physicians, the second
largest medical association in the country; Dr. Rodney Hood and Dr. Gary
Dennis, former Presidents of the National Medical Association; Dr. Elinor
Christiansen, immediate Past-President of the American Medical Women's
Association; and Dr. Ron Anderson, CEO of Parkland Hospital in Dallas,
Texas. (*Affiliations for identification only. A
full list of Working Group
members is at the end of this release).
Representative John Conyers, Dean of the Congressional Black Caucus and
ranking minority Member of the House Judiciary Committee will introduce The
United States National Health Insurance Act on February 4. A long time
advocate of national health insurance, Rep. Conyers closely collaborated
with the Physicians Working Group on the bill.
Additionally, nearly 4,000 individual physicians have
endorsed the
physicians' proposal including two former Surgeons General (Dr. David
Satcher and Dr. Julius Richmond); a Nobel Laureate (Dr. Bernard Lown); the
highly respected authors of major textbooks of surgery and family practice
(Dr. William Silen and Dr. Robert Rakel, respectively); and a leading
organizer of emergency services in NYC on 9/11(Dr. Lewis Goldfrank, Chairman
of Emergency Medicine at New York University).
Also joining the physicians and Congressmen to endorse the National
Health
Insurance Act will be Dr. Maya Rockeymoore, Urban League Director of Health
Policy; Dean Baker, Co-Director, Center for Economic and Policy Research;
and Hillary Shelton, a spokesperson for Julian Bond, Chairman of the NAACP.
Original Congressional co-sponsors of the NHI bill at press
time are: Dennis
Kucinich (OH), Luis Guitierrez (IL), Jim McDermott (WA); Bobby Scott (VA);
Donna Christensen (Virgin Islands); Barbara Lee (CA); Danny Davis (IL);
Major Owens (NY); Jesse Jackson Jr. (IL); Maurice Hinchey (NY); Donald Payne
(NJ); Elijah Cummings (MD); Carolyn Kilpatrick (MI); Alcee Hastings (FL);
Chaka Fattah (PA); Ed Towns (NY); John Lewis (GA); BennieThompson (MS);
Eleanor Holmes-Norton (delegate for DC), and Raul Grijalva (AZ) (listing in
formation).
National Health Insurance Act Press Conference February 4, 2003 11am 2226
Rayburn House Office Building, Judiciary Committee Room
*Physician Working Group Members
Marcia Angell, MD Spokesperson Past Editor New England Journal of Medicine
Quentin Young, MD Convener National Coordinator PNHP Former President
American Public Health Association
Joel Alpert, MD Former President American Academy of Pediatrics
Ron Anderson, MD President and CEO Parkland Health &Hospital System
Peter Beilenson, MD, MPH Commissioner Department of Health, Baltimore
Christine Cassell, MD Former President American College of Physicians Dean,
Oregon University School of Medicine
Elinor Christiansen, MD Past President American Medical Women's Association
Olveen Carrasquillo, MD, MPH Assistant Professor of Medicine Columbia School
of Medicine Advisory Committee Member National Hispanic Medical Assn. Gary
Dennis, MD Former President National Medical Association
David Himmelstein, MD Associate Professor of Medicine Harvard Medical School
Co-Founder, Physicians for a National Health Program
Rodney Hood, MD Past President of the National Medical Association which
represents African-American physicians
Edith Rasell, MD, PhD Minister for Labor Relations in Community and Economic
Development for the United Church of Christ
Helen Rodriguez-Trias, MD Past President American Public Health Association
(recently deceased)
Sindhu Srinivas, MD Past President American Medical Student Assn.
Gerald Thomson, MD Former President American College of Physicians
Walter Tsou, MD, MPH Former Commissioner of Health, Philadelphia
Steffie Woolhandler, MD, MPH Associate Professor of Medicine Harvard Medical
School