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6.27.10, NYC: Private Health Insurance Must Go! in Gay Pride Parade

June 21, 2010

Now organizers can publicize their own actions!
This entry
is on New York Activist Calendar (

`Private Health Insurance Doesn’t Cover Your Ass` Pride Contingent
Sunday, June 27, 2010 – 1:00pm
37th Street btw. Park & Madison: Section 12, Group 3. [updated location]
Trains: #6 to 33 St. (at Park Av.); #4, 5, 7 or S “Shuttle” to Grand
Central-42 St. (at Park & Lex); D, F, N, Q, R to 34 St.-Herald Sq.
(at 6th Av. & Broadway); map:
Please RSVP to
Background: Private Health Insurance Must Go! Coalition

[Come march and leaflet in Pride wearing a giant plastic “ass” that
pokes out from the back of your hospital gown. -t.]

Join the Private Health Insurance Must Go! Coalition ( in a
Single Payer, Medicare for All! contingent at the parade. We will
line up at 1:00 on 37th Street between Park and Madison. We are
Section 12, Group 3.

To join us, please RSVP to [1]

Watch the fabulous video of the
PHIMG/ACT-UP/PNHP contingent from last year’s march.

We will carry our beautiful new PHIMG banner, as well as our giant
“not covered” banner. Costumes for the day, and PHIMG T-shirts (to
buy), (and maybe the Mobilization T-shirts), will be available.


Milliman Medical Index proves that PPACA (Obamacare) is already a failure‏

May 12, 2010
Milliman, Inc.
May 2010
2010 Milliman Medical Index
The annual Milliman Medical Index (MMI) reports total annual medical spending for a typical American family of four covered by an employer-sponsored preferred provider organization (PPO) program. The MMI represents the total cost of payments to healthcare providers, and excludes the non-medical administrative component of health plan premiums.
The total 2010 medical cost for a typical American family of four is $18,074.
This is an increase of 7.8%. This is the third year in a row that the annual rate of increase has been below 8%; however, the dollar increase of $1,303 is still the highest we have seen in the last 10 years and since the inception of this index.
Cost Implications of Healthcare Reform on Family of Four
While employers are making the immediate changes required to their benefit plans and adapting their longer-term benefit strategy to the new regulatory environment, healthcare costs continue to increase at rates exceeding most other costs of doing business. Debate continues on the extent to which the changes from healthcare reform have potential to bend the long-term cost curve; however, for the near term, the underlying drivers of increasing healthcare costs are not expected to immediately change.
Efforts to enforce insurance rate controls may have indirect impact on the growth in healthcare costs but still do not address the underlying cost of care. For now, the onus of control remains with insurers, who will attempt to put pressure of providers to lower costs to a level that approved premium rates can support. There may be more extensive shift in market dynamics in 2014, when the government takes on an even larger proportion of payment responsibility due to expansion in Medicaid, the creation of exchanges, and the availability of subsidies for certain lower-income individuals.
While underlying cost drivers as yet remain relatively unchanged, there are some changes that will have a predictable effect on cost. The most immediate changes, such as increasing dependent coverage up to age 26 and elimination of lifetime and annual benefit maximums, will cause a direct shift in costs from employees to employers. Other options that will be implemented later, such as federally-mandated state health exchange plans, require much deeper analysis before an employer can make an informed decision. Because the practical implementation of this new legislation has not yet been defined, many employers are choosing to delay changes to their benefit plans for future annual benefit cycles, although it is very possible that those changes could be dramatic.
Looking into the future for the “typical family of four” represented by this analysis, the cost implications of reform are unclear. Much depends on the underlying medical cost that is dissected in this report. When it comes to cost control, the status quo is not encouraging. If reform or some other factors can motivate a reduction in the underlying cost of care, it will have important implications for the future cost of care for American families.
Comment:  The Milliman Medical Index (MMI) is especially significant this year because it proves that the Patient Protection and Affordable Care Act (PPACA) is already a miserable failure even before the provisions of the act take place. The MMI for 2010 is $18,074. Let’s look at what that means under the PPACA.
It’s important to understand precisely what the MMI is. It is the average amount that is already being spent on actual health care for a typical family of four enrolled in an employer-sponsored Preferred Provider Organization (PPO) plan. It does not include any of the administrative expenses or profits of the private insurers.
Already there’s a problem. Since the MMI represents the amounts being paid by PPOs, the discounts for network physicians and hospitals and other products and services are already built in. The MMI represents a lower level of spending made possible by contracting payment rates with the physicians and hospitals that are included in the networks. That means that families for whom the spending is at MMI levels have lost their right of free choice of physicians and hospitals unless they are willing and able to pay significant financial penalties for obtaining care outside of the networks. The plans that will be available in the state insurance exchanges will be network-restricted managed care plans – mostly PPOs with some HMOs. Health care reform that takes away choice is not the reform that we wanted.
One of the most important measures in PPACA attempts to address the problem of high costs and the poor coverage of the plans currently available in the individual and small group markets. Individuals and small employers who are having problems finding adequate affordable plans will be able to buy plans in the insurance exchanges that theoretically have the same benefits and cost efficiencies of the large group market currently available to larger employers. If these exchanges actually work as intended, then the MMI will represent the average cost of health care for a family of four enrolled through the exchanges. This assumes that the insurers will cooperate and not continue to use deceptive innovations that have resulted in lower-value products in the individual insurance markets.
Assuming that the exchanges work as intended, keep in mind that the insurers offering individual and small group plans within the exchanges will be required to maintain a medical loss ratio of 80 percent. That is the amount that must be spent on actual health care – the amount that is represented by the MMI, minus the out-of-pocket expenses. They will keep 20 percent for their own administrative costs and profits (or even more if they are successful in their current efforts to shove some of their administrative costs into the medical loss ratio by reclassifying these administrative costs as “health care).
So let’s look at the numbers. The standard Silver plans offered by the exchanges will have an actuarial value of 70 percent. That means that the plans will pay an average of 70 percent of the costs and the other 30 percent will be paid out-of-pocket by individuals and families, partially offset by subsidies for those who qualify. Using the 2010 MMI, the plans will pay for a family of four an average of $12,652 (70 percent of $18,074). The twenty percent for administrative costs and profits will add another $3,163 ($12,652 is 80 percent of the premium) which means that the premium that the insurer will have to charge will be $15,815 ($12,652 plus $3,163). The out-of-pocket portion for the family will be $5,422 (30 percent of $18,074). The the total average cost for the family for both the premium and out-of-pocket expenses combined will be $21,237 ($15,815 plus $5,422).
These are averages. To determine what each family actually would pay is more difficult because of several variables, including sliding scale subsidies for the premiums, sliding scale subsidies for the out-of-pocket expenses, opt-out eligibility based on the level of household income, and out-of-pocket spending, especially for those whose incomes exceed the eligibility thresholds for the subsidies.
Nevertheless, let’s look at a family of four with an income at 400 percent of the federal poverty level – the threshold at which they qualify for neither the subsidies for premiums nor the subsidies for out-of-pocket costs. That income level is $88,200. That family would pay an average of $21,237, or 24 percent of their income, for health care, leaving them $66,963 for all of their other expenses. But since that is average, those with greater health care needs would face even larger out-of-pocket costs, which could be staggering. Even if the plan is promoted as having a stop-loss, private insurers are infamous for leaving patients stuck with charges for non-covered services and out-of-network providers. The bottom line is that PPACA has not ensured that the hard-working American family is protected from financial hardship or even personal bankruptcy should significant medical needs arise.
There are those who say that health care reform is done; we now have PPACA. They say that although it will likely require some adjustments along the way, our task now is to make it work. To those individuals I can only say, step back and look at the confounded mess! It will never insure everyone. It will never make health care affordable for each and every individual and family. It will never control administrative waste as it continues to add on more and more administrative complexity.
We need to keep and build on some of the health system reforms in PPACA, such as the reinforcement of our primary care infrastructure. But we desperately need to dump the sick, fragmented financing system that wastes so much in resources and perpetuates the profound inequities and physical and financial suffering experienced in our system. We need to enact an improved Medicare for all, and do it ASAP!

Socialized healthcare: The ‘untouchable’ of UK politics

May 7, 2010

More such info available at

May 5, 2010
Socialized healthcare: The ‘untouchable’ of UK politics
By Paul Armstrong

After weeks of feverish election campaigning, Britain’s political parties have fought over every issue, from the economy to the country’s nuclear deterrent, with one exception: the National Health Service.

To many Republican politicians in the United States, a publicly-funded national health system like the NHS is the embodiment of austere, Soviet-era style medical care, but in the UK it is viewed as sacrosanct.

Centrally-funded through taxation, pressure to respond to growing demand has seen record levels of investment in the past decade.

Ruth Thorlby, a research fellow at the King’s Fund, told CNN that all the major parties appreciate the NHS strikes an emotive chord with the public and that it is a price worth paying. She said: “We have this extraordinary political consensus now that the funding structure of the NHS is sound.”

Conservative leader David Cameron seems as committed to the NHS as Labour, despite his party’s ideological disposition to the private sector.

He recently acknowledged its value on his party’s Web site. “Millions of people are grateful for the care they have received from the NHS — including my own family,” he said.

“One of the wonderful things about living in this country is that the moment you’re injured or fall ill — no matter who you are, where you are from, or how much money you’ve got — you know that the NHS will look after you.”

Cameron’s words were reinforced by the party’s election manifesto, in which it calls itself “the party of the NHS” and pledges “never to change at the idea at its heart that healthcare in this country is free at the point of use and available to everyone based on need and not ability to pay.”

Comment from Physicians for a National Health Program Senior Health Policy Fellow Don McCanne, M.D.: The United Kingdom has the ultimate system of socialized medicine: a government-owned and government-administered National Health Service (NHS). Though their system is much less expensive than ours in the United States, it is viewed as sacrosanct by the British citizens.

The system was launched in 1948 [that’s right, u.s. inhabitants, 1948! And Churchill opposed it!] by a left-wing Labour government, but its appeal has become so universal that the right-wing Conservative party now claims to be “the party of the NHS.”

In the United States we have chosen a right-wing solution over which we remain politically divided because of its serious flaws. Since we spend far more on health care than any other nation, we should be able to use those funds to craft a system with such intense universal support that we would consider ours sacrosanct as well.

Of course we can. Try to convince senior Tea Baggers to relinquish their Medicare, even though it is a government program. Medicare is a right that they have earned merely by being American taxpayers. Just imagine improving Medicare and providing it to everyone. After people experienced the benefits of an improved Medicare for all, can you imagine a major political party campaigning against the program? In fact, it’s the Republicans who are now expressing outrage over the fact that PPACA includes some reductions in Medicare funding.

Now that the Republican party seems to be presenting itself as “the party of Medicare,” wouldn’t you think that the Democrats would want to trump them by becoming “the party of an improved Medicare for all”?


March 22, 2010

Just received this message from Facebook:

“Block! You are engaging in behavior that may be considered annoying or abusive by other users.

You have been blocked from commenting on public posts because you repeatedly misused this feature. This block will last anywhere from a few hours to a few days. When you are allowed to reuse this feature, please proceed with caution. Further misuse may result in your account being permanently disabled. For further information, please visit our FAQ page,”  for posting the following warning:


The above warning contains no racist, misogynist, classist, homophobic, bigoted, “violence-inciting,” or hate language, concepts, or references, nor is it in any way “profane,” as Facebook permits posts reflecting all types of anti-social thinking, but obviously prohibits expression it deems to be a threat to regimes to which it pledges its allegiance.

Facebook has issued this threat to anyone who dare speak the truth that the regime that controls this barbaric society perceives as a challenge to itself, and it is necessary to convey this threat to all Facebook account holders, including those who receive my posts. Therefore, any one who has received my posts who no longer receives them in the future and has not “de-friended” me needs to understand that it will be because Facebook has committed censorship against me, and that it is doing the bidding of the criminal corporate regime that continues to destroy an already criminal society.

Thurs 2/25/10 NYC: Protest Obama’s Health Summit with Aetna 17 at Manhattan Criminal Court

February 24, 2010
Thurs 2/25/10 NYC: Protest Obama's Health Summit with Aetna 17 at Manhattan Criminal Court
List-Subscribe: <>,
PHIMG General Member List Serv (News) 
Hi All,
Just a reminder! This is one of at least 10 single-payer actions 
happening across the country on Thursday.
It'll be a quick action--8:45 to 9:15am--photo ops, quick interviews, 
then we have our hearing.
See you all there,
Join Aetna 17* on Thursday, February 25, as we return to court on the 
day of Obama's healthcare reform summit:
* Aetna 17 are single-payer activists who sat-in at the insurance 
giant Aetna last September to expose their deadly profiteering and to 
push for Medicare for All
What:  Protest Obama's Health Summit with Aetna 17
When: Thursday, February 25, 8:45am-9:15am
Where: Criminal Court of New York City, 100 Centre St. (below Franklin)
On the same day President Obama convenes a "make-or-break" bipartisan 
summit on healthcare reform, the 17 protesters who sat-in at Aetna 
are returning to court to continue our legal battle.
While we're there at the court house, we figure we'd use the 
opportunity to answer a question Obama asked during his State of the 
Union address:
"If anyone from either party has a better approach that will bring 
down premiums, bring down the deficit, cover the uninsured, 
strengthen Medicare for seniors, and stop insurance company abuses, 
let me know."
OK. "Obama, Letting You Know: Medicare for All"
(that's the message on our giant banner, plus we'll be wearing 
Medicare for All shirts)
We need your support, so please show up and bring a lot of people 
with you! Photographers from the wire services (Getty and others) 
will be there, and we have gotten into the New York Times and USA 
Today before, so let's make it big and give the reporters an 
alternative angle to report on the Obama summit story!
See you there.
Aetna 17

Medicare for All supporters: WHERE DO WE GO FROM HERE?

December 17, 2009
I do not have the answer; but the question is a necessary beginning.
Barack Obama is launching [or his he continuing?] a mammoth effort to move the political center of the U.S. to the right. It is a stunning ambition far beyond the reach of Reagan, Clinton, or the Bush dynasty. His extraordinary Oslo speech, referencing Martin Luther King Jr. to declare that “war is peace”; was nothing short of wizardry on the world stage. Now we have the possibility of the doctrine of perpetual war prosecuted by the U.S.  rising to a universal norm of humane conduct. In addition to the triumphalist new vision of the U.S. on issues of war and peace, the U.S. fervently ignores the most urgent threat to human survival that is presented by global climate destruction. Both of these issues profoundly impact human health.
We as healthcare activists must now forge a political strategy within the political terrain of a powerful and ultra-modern nation-state that is systemically defying, through deliberate deceptions, norms of civil conduct that once offered some buffer to the decent of the modern world into barbarism and unprecedented human suffering. So what do the political and economic elites of the U.S. really care about the guarantee of comprehensive healthcare to those within their borders?
The answer is clear. They are perfectly comfortable convincing us that they are helping us while they systematically attempt an historic transfer of enormous resources from us to an industry that perpetuates the healthcare crisis by denying access to healthcare for its own self-aggrandizement. At the same time, these elites have the temerity to lie about their intention by declaring that universal healthcare access has now been achieved through legislation that is being hatched in the White House. This is moral depravity at a scale that many of us find impossible to internalize because it is far too painful to bear.
So what do we do? We must internalize it because when we do, we give rise to the seeds for our renewed activism and courage. We must become stronger to withstand what is at hand.
We need to appreciate that we are far from being alone. Folks across this nation, ordinary folks like you and me who have become active on these issues, are now far less naive than they were just 18 months ago. Indeed, there has been (and it is still ongoing) a sea change in consciousness among ordinary grassroots human rights organizers that is preventing them  from being as gullible to charismatic pied piper political leaders of this recent period who have depended on our ignorance and need to feel good and to be reassured.
This is a sign of hope.
If I had one recommendation, it is this: we must build and sustain larger and more diverse mass high profile direct actions in the streets across the country for Medicare for All. We must forever end inordinate deference to elected officials. We must push them to represent us. We can not expect them to lead us to victory. We must lead ourselves to victory.
Lastly, Obama blinded sided us once already, but it must never happen again. In the future, we should only have ourselves to blame. Toto has pulled back the curtain.
Now is the time for us to go back to our base, to go home. There is no place like it.

PHIMG (Private Health Insurance Must Go! coalition) will be planning its series of next direct actions in NYC. Go to

Ajamu Sankofa
a co-founder of PHIMG

[Kill the bill! No to President Rahm’s healthcare sell out / insurance Co. bailout. Medicare for All! Now is the time to take the movement to the next level.]

Democrats Lash Out At Obama Over Health Care Disappointments

The Huffington Post   |  Rachel Weiner
First Posted: 12-16-09 01:40 PM   |   Updated: 12-16-09 01:48 PM

Congressional Democrats are starting to voice their anger at President Obama over the way health care legislation has been compromised, blaming him for not fighting harder.

“The president keeps listening to Rahm Emanuel,” said Rep. John Conyers (D-Mich.). “No public option, no extending Medicare to 55, no nothing, an excise tax, God!” he exclaimed about the Senate health care bill to Roll Call. “The insurance lobby is taking over.”

“The White House has been useless,” Rep. Dave Obey (D-Wis.), the chairman of the powerful Appropriations Committee, told Politico. Referencing Senate delays, he said, “It’s ridiculous, and the Obama administration is sitting on the sidelines. That’s nonsense.”

While many House Democrats have expressed anger with the Senate for the watered-down bill, Rep. Anthony Weiner (D-N.Y.) argued that it was really Obama who let centrists take control. “Snowe? Stupak? Lieberman? Who left these people in charge?” he said. “It’s time for the president to get his hands dirty. Some of us have compromised our compromised compromise. We need the president to stand up for the values our party shares. We must stop letting the tail wag the dog of this debate.”

Sen. Russ Feingold (D-Wisc.) similarly suggested that blaming Lieberman was ignoring the real culprit — Obama.

“This bill appears to be legislation that the president wanted in the first place, so I don’t think focusing it on Lieberman really hits the truth,” said Feingold. “I think they could have been higher. I certainly think a stronger bill would have been better in every respect.”

As Politico’s Craig Gordon noted about the president’s health care maneuvering, “Time and again, [Obama] rebuffed Democrats’ requests to speak up more forcefully about what he wanted — a strategy that allowed Obama to preserve maximum flexibility to declare victory at the end of the process, no matter what the final bill looked like.”

Rep. Lynn Woolsey (D-Calif.), pointed to polling that suggests Democrats will face trouble with their base if they don’t deliver a strong bill. “Thirty percent of Democrats will not come out and vote if there is no public option in the health care bill,” she said. “What does that tell you?”

Medicare For All Amendment Needs Debate and a Vote In the Senate

December 14, 2009
Update from Donna Smith, California Nurses Association, on Sen. Sanders Single-Payer Amendment
Single-Payer Amendment Needs Debate and a Vote In the Senate

Time to let Senate Majority Leader Harry Reid know that the American people want a debate and a vote on Medicare for all, single-payer healthcare during this Congressional effort.  And it’s crunch time for the Sanders/Brown/Burris Medicare for all, single-payer amendment in the Senate.

In the effort to move something quickly, some amendments may not be considered unless the Leader perceives the importance of such consideration or the consequences of not hearing amendments that are critical to various Senators and constituencies.

Amendment No. 2837 would extend healthcare as a basic human right to all.  The three original sponsors of the amendment understand that the American people need access to care that is not dependent on wealth or level of private insurance coverage.

Call Senator Reid today.  Tell him you want Senator Sanders’ amendment number 2837 to be debated and you want a vote to be taken.  Phone in DC at 202-224-3542 or the Capitol Switchboard at 866-220-0044 or 202-224-3121, or Senator Reid’s Las Vegas office at 702-388-5020

Medicare Buy-In?
from Don McCanne’s Quote of the Day
December 9, 2009
Harry Reid: Democrats reach ‘broad agreement’
By Carrie Budoff Brown & Patrick O’Connor

Senate Democrats have reached a “broad agreement” on a health reform bill,
Majority Leader Harry Reid said Tuesday night ? a plan that would replace
the public option in the current Senate bill with a new national insurance
plan offered by private insurers, and a chance for older Americans to ?buy
in? to Medicare.

To win over liberals disappointed at losing the public option, Democrats
would allow older Americans starting at age 55 to buy into Medicare, the
popular program for the aged. The Medicare expansion would be a significant
victory for Democrats, who spent years pushing for it. The proposal would in
effect create a public health insurance option for older Americans, since
Medicare is government-funded and government-run.

Comment:  The most efficient, most effective, and least expensive method of
providing reasonably comprehensive health care for everyone would be to
replace all current public and private financing programs with a single,
improved Medicare program that covered absolutely everyone. Some have
suggested that we can do this incrementally, with the first step being to
allow individuals 55 and over to buy into Medicare. Is this a good idea?

Harvard professor Steffie Woolhandler provides us with some insight:
“Lowering the eligibility age for Medicare to 55 only works if it is
mandatory.  Otherwise it becomes the place where all the sickest patients
get dumped.  That might be okay for the sick people since Medicare is often
better and more secure than private coverage, but it would drive total
health care costs (and premiums) up, not down.”

The current Medicare risk pool is composed of seniors with a high rate of
chronic disease and with the expenses of end-of-life care, plus younger
individuals with long-term disabilities. Since this is a very high cost
population, the prorated premiums would be unaffordable for most individuals
55 thru 64. A separate risk pool would have to be established that would be
limited to this age bracket. Unfortunately, 55 thru 64 is still the most
expensive age sector of all individuals under 65 and so premiums would still
be unaffordable for most, especially after you add in the impact of adverse
selection as Steffie Woolhandler has described.

Suppose that a Medicare buy-in for those over 55 were to be established, and
that higher government subsidies were provided to cover the higher costs,
then what do you have? You have created a public option. Yet the reason
being given for the Medicare buy-in is that it is a trade-off to get the
progressives to agree to abandoning the public option.

So the agreement seems to be to eliminate the public option from
consideration by establishing a public option. But is the proposal a public
option that would allow everyone the opportunity to buy into Medicare?
Apparently not. After all, this is Congress at work.

Although details have not been released, it appears that this Medicare
buy-in would be limited by the same rules already proposed for the public
option. Individuals who already are eligible for employer-sponsored
coverage, Medicare, or Medicaid would not be eligible to participate in the
insurance exchange, yet the Medicare buy-in would not be available outside
of the exchange (except perhaps during a transition before the exchange is
established). Thus the net effect of this buy-in is to further limit the
public option only to those 55 and over who meet all other qualifications
for the exchange – a ratcheted-down version of the public option.

An elective buy-in for Medicare will only add to the perpetuation of
inequities, fragmentation, administrative inefficiencies, inadequate fiscal
supervision and other deficiencies that plague our health care financing
system. Adding to our dysfunctional system only compounds the dysfunction.
We need to replace the system with an efficient single payer model.

Could we do that in incremental steps by first moving absolutely everyone
over 55 into our existing Medicare program? Yes, but why would we do that?
There would be complex transitional issues in changing this sector from a
revenue source for Medicare into both a revenue source and an expense as
they become beneficiaries of the program. Another increment could be
MediKids for all children, though that would involve other transitional
issues. Then how soon would we phase in everyone else, with yet still more
transitional issues?

Incremental steps increase the complexities and costs of the transition
while delaying access for many who already have impaired access and
financial burdens caused  by our dysfunctional system.

A single, disruptive transition would actually be more efficient
administratively, while lowering transitional costs. Much more important, a
single transition would ensure that no person would have to wait any longer
to access the care that he or she needs merely because of an inability to
pay for that care.

If we advocate for less than we need, we’ll end up with cheap chits that
will eventually be traded away, and then what are we left with?

– Jean (forwarded from Healthcare-NOW!)

“I refuse to live in a country like this, and IÔÇÖm not leaving.” -Michael Moore