#1 What the United States spent on health care in 2009 was greater than the entire GDP of Great Britain.

#2 According to the Bureau of Economic Analysis, health care costs accounted for just 9.5% of all personal consumption back in 1980.  Today they account for approximately 16.3%.

#3 The United States spent 2.47 trillion dollars on health care in 2009.  It is being projected that the U.S. will spend 4.5 trillion dollars on health care in 2019.

#4 One study found that approximately 41 percent of working age Americans either have medical bill problems or are currently paying off medical debt.

#5 According to a report published in The American Journal of Medicine, medical bills are a major factor in more than 60 percent of the personal bankruptcies in the United States.  Of those bankruptcies that were caused by medical bills, approximately 75 percent of them involved individuals that actually did have health insurance.

#6 Over the past decade, health insurance premiums have risen three times faster than wages have in the United States.

#7 The chairman of Aetna, the third largest health insurance company in the United States, brought in a staggering $68.7 million during 2010. Ron Williams exercised stock options that were worth approximately $50.3 million and he raked in an additional $18.4 million in wages and other forms of compensation.  The funny thing is that he left the company and didn’t even work the whole year.

#8 The top executives at the five largest for-profit health insurance companies in the United States combined to receive nearly $200 million in total compensation for 2009.

#9 Even as the rest of the country struggled with a deep recession, U.S. health insurance companies increased their profits by 56 percent during 2009 alone.

#10 According to a report by Health Care for America Now, America’s five biggest for-profit health insurance companies ended 2009 with a combined profit of $12.2 billion.

#11 In the United States, health insurance administration expenses account for 8 percent of all health care costs.  In Finland, that figure is just 2 percent.

#12 Health insurance rate increases are getting out of control.  According to the Los Angeles Times, Blue Shield of California announced plans earlier this year to raise rates an average of 30% to 35%, and some individual policy holders were slated to see their health insurance premiums rise by up to 59 percent.

#13 According to an article on the Mother Jones website, health insurance premiums for small employers in the U.S. increased 180% between 1999 and 2009.

#14 Since 2003, health insurance companies have shelled out more than $42 million in state-level campaign contributions.

#15 There were more than two dozen pharmaceutical companies that made over a billion dollars in profits each during 2008.

#16 Each year, tens of billions of dollars is spent on pharmaceutical marketing in the United States alone.

#17 Prescription drugs cost about 50% more in the United States than they do in other countries.

#18 Nearly half of all Americans now use prescription drugs on a regular basis according to a CDC report that was recently released. According to the report, approximately one-third of all Americans use two or more pharmaceutical drugs, and more than ten percent of all Americans use five or more drugs on a regular basis.

#19 According to the CDC, approximately three quarters of a million people a year are rushed to emergency rooms in the United States because of adverse reactions to pharmaceutical drugs.

#20 The Food and Drug Administration reported 1,742 prescription drug recalls in 2009, which was a gigantic increase from 426 drug recalls in 2008.

#21 Children in the United States are three times more likely to be prescribed antidepressants than children in Europe are.

#22 The percentage of women taking antidepressants in America is higher than in any other country in the world.

#23 Lawyers are certainly doing their part to contribute to soaring health care costs.  According to one recent study, the medical liability system in the United States added approximately $55.6 billion to the cost of health care in 2008.

#24 According to one doctor interviewed by Fox News, “a gunshot wound to the head, chest or abdomen” will cost $13,000 at his hospital the moment the victim comes in the door, and then there will be significant additional charges depending on how bad the wound is.

#25 Why are c-sections on the rise?  It is because a vaginal delivery costs approximately $5,992, while a c-section costs approximately $8,558.

#26 According to the CIA World Factbook, the United States had a higher infant mortality rate than 45 other nations in 2009.

#27 The infant mortality rate in the United States is nearly three times as high as it is in Singapore.

#28 It is estimated that hospitals overcharge Americans by about 10 billion dollars every single year.

#29 In fact, one trained medical billing advocate says that over 90 percent of all the medical bills that she has audited contain “gross overcharges“.

#30 It is not uncommon for insurance companies to get hospitals to knock their bills down by up to 95 percent, but if you are uninsured or you don’t know how the system works then you are out of luck.

#31 Over the last decade, the number of Americans without health insurance has risen from about 38 million to about 52 million.

#32 People living in the United States are three times more likely to have diabetes than people living in the United Kingdom.

#33 Today, people living in Puerto Rico have a greater life expectancy than people living in the United States do.

#34 According to OECD statistics, Americans are twice as obese as Canadians are.

#35 Back in 1965, only one out of every 50 Americans was on Medicaid.  Today, one out of every 6 Americans is on Medicaid.

#36 The U.S. government now says that the Medicare trust fund will run out five years faster than they were projecting just last year.

#37 It is being projected that the federal government will account for more than 50 percent of all health care spending in 2012.

#38 Greece has twice as many hospital beds per person as the United States does.

#39 The state of California now ranks dead last out of all 50 states in the number of emergency rooms per million people.

#40 According to one survey, approximately 1 out of every 4 Californians under the age of 65 has absolutely no health insurance.

#41 According to a PricewaterhouseCoopers report, “inefficient claims processing” costs the U.S. health care system 210 billion dollars every single year.

#42 Today, approximately 40% of all U.S. doctors are age 55 or older.

#43 According to the American Association of Medical Colleges, we were already going to be facing a shortage of more than 150,000 doctors over the next 15 years even before Obamacare was passed.

#44 An IBD/TIPP poll taken back in August 2009 found that 4 out of every 9 American doctors said that they “would consider leaving their practice or taking an early retirement” if Congress passed Obamacare.

#45 According to a survey published in the New England Journal of Medicine, approximately one-third of all practicing physicians in the United States indicated that they may leave the medical profession because of the new health care law.

#46 According to a Merritt Hawkins survey of 2,379 doctors that was conducted in August 2010, 40 percent of all U.S. doctors plan to “retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care” at some point over the next three years.

#47 According to the executive director of Physician Hospitals of America, Obamacare has already forced the cancellation of at least 60 doctor-owned hospitals that were scheduled to open soon.

#48 According to a report released in 2010, Americans spend approximately twice as much as residents of other developed countries do on health care.

#49 If the U.S. health care system was a country, it would be the 6th largest economy in the entire world.

#50 According to numbers released by Deloitte Consulting, a whopping 875,000 Americans were “medical tourists” in 2010.

In 2009 when the Washington beltway was tied up with the health care reform tussle, Montana Democratic Senator Max Baucus, chairman of the all powerful Senate Finance Committee, said everything was on the table–except for single payer.  When doctors, nurses and others rose in his hearing to insist that single payer be included in the debate, Baucus had them arrested.  As more stood up, Baucus could be heard on his open microphone saying, “We need more police.”

Yet when Senator Baucus needed a solution to a catastrophic health disaster in Libby, Montana, and surrounding Lincoln County, he turned to the nation’s single payer healthcare system, Medicare, to solve the problem.

Baucus’ problem was caused by a vermiculite mine that had spread deadly airborne asbestos killing hundreds and sickening thousands in Libby and northwest Montana.  The W. R. Grace Company that owned the mine denied its connection to the massive levels of mesothelioma and asbestosis and dodged responsibility for this environmental and health disaster.  When all law suits and legal avenues failed, Baucus turned to our country’s single payer plan, Medicare.

The single payer plan that Baucus kept off the table is now very much on the table in Libby.  Unknown to most of the public, Baucus inserted a section into the health reform bill that covers the suffering people of Libby, Montana, not just the former miners but the whole community—all covered by Medicare.

• They don’t have to be 65 years old or more.
• They don’t have to wait until 2014 for the state exchanges.
• No ten year roll out—it’s immediate.
• They don’t have to purchase a plan—this is not a buy-in to Medicare—it’s free.
• They don’t have to be disabled for two years before they apply.
• They don’t have to go without care for three years until Medicaid expands.
• They don’t have to meet income tests.
• They don’t have to apply for a subsidy.
• They don’t have to pay a fine for failure to buy insurance.
• They don’t have to hope that the market will make a plan affordable.
• They don’t have to hide their pre-existing conditions.
• They don’t have to find a job that provides coverage.

Baucus inserted a clause in the Affordable Care Act to make special arrangements for them in Medicare, and he didn’t wait for any Congressional Budget Office scoring to do it.

Less than two months after the passage of the health reform bill on March 23, 2010, Nancy Berryhill of the Social Security Administration in Denver joined personally in setting up an office in Libby to sign up these newly eligible people.  “This is a new thing,” Berryhill told the Missoulian.  “No other group like this has ever been selected to receive Medicare.”  Berryhill issued a nationwide alert to inform anyone who had lived or stayed in Lincoln County of their eligibility.  She opened a storefront in Libby at the old downtown city hall where she signed up 60 people on the first day.  She plastered the towns of Whitefish and Eureka with pamphlets explaining the program and added three new staffers to the office in Kalispell.

Berryhill said she did not know how much the care would cost.  That kind of analysis was beyond her directive to sign the people up.  There have been no reports of competition from the private for-profit Medicare Advantage plans.  The sick are not profitable.

No one should begrudge the people of Lincoln County.  The mine wastes were used as soil additives, home insulation, and even spread on the running tracks at local schools.  Miners brought the carcinogens home on their clothes.  The W. R. Grace Company dumped much of the clean up costs onto the federal government.  A June 17, 2009, order by the Environmental Protection Agency, the first of its kind, declared Lincoln County a public health disaster.  The Libby Medicare provision in the health reform law is based on the area covered by that EPA order.

Baucus gave his reasons to the New York Times for its only story on this unique benefit:  “The People of Libby have been poisoned and have been dying for a decade.  New residents continue to get sick all the time.  Public health tragedies like this could happen in any town in America.  We need this type of mechanism to help people when they need it most.”

Health tragedies are happening in every town.  Over 51 million have no insurance.  Over 45,000 uninsured people die needlessly each year.  Employers are cutting coverage and dropping plans.  States in economic crisis are slashing both Medicaid and their employees’ plans.  Nothing in last year’s reform law will mitigate the skyrocketing costs.  Most insurance is threadbare and doesn’t cover.  More than 50% of us now go without necessary care.  As Baucus said of Medicare, “We need this mechanism to help people when they need it most.”  We all need it now.

Bill Clinton recently stated that the U. S. could give coverage to all for one trillion dollars a year less than we now pay if we adopted the system of any other advanced nation.  (Unfortunately, he did not say this when it would have mattered most during the 1993 and 2009 health care reform debates.)

Other industrialized countries have found that to cover everyone for less they must remove the profit-making insurance companies.  Congressman John Conyers has reintroduced HR 676, the Expanded and Improved Medicare for All Act, which does exactly that.  There are 60 cosponsors.  It would cover all medically necessary care for everyone including dental and drugs by cutting out the 30% waste and profits caused by the private insurers.

So as the Ryan Republicans try to destroy Medicare and far too many Democrats use the deficit excuse to suggest cuts in its benefits, let us counter with the Libby prescription to clean up the whole mess.  Only a single payer, improved Medicare for All, can save and protect Medicare, rein in the costs, and give us universal coverage.

Medicare will celebrate its 46^th birthday on July 30, 2011, and all are invited to join in the festivities.  Medicare was passed in 1965 and implemented within less than a year.  When we pass HR 676, this single payer bill, we can all be enrolled in the twinkling of an eye.

Steil, president and owner of a small manufacturing company in Bucks County, Pa., told me he grew increasingly frustrated about having no leverage in dealing with private insurers, which demanded double-digit premiums increases every year.

Shumlin, who along with his brother took over the management several years ago of a travel business their parents founded, echoed the same frustration. Shumlin, who also served as a legislator, shared another frustration with Steil: not being able to help political constituents, many of them farmers and small business owners, who called begging for help in finding coverage.

“During my 16 years in the legislature, my staff and I were frustrated time and again trying to help people who had lost their coverage and couldn’t find a single insurer willing to offer them a policy, usually because of a preexisting condition of some kind,” Steil said. “We could deal with almost everything else, but this was one thing we could not solve. There simply was no solution.”

I know exactly what he means. I have spoken to hundreds of groups about the health insurance industry over the past two years, and invariably at least one person — and sometimes several — will grab me afterwards to ask for my advice on obtaining coverage. They assume that someone who spent two decades as an insurance company executive ought to be able to help them out.

Unfortunately, I have no better answers than Steil or Shumlin had for those constituents. If you’ve been sick in the past, or have a spouse or child who has been treated for one of hundreds of conditions insurers consider “preexisting,” about the only way you can get coverage is to convince an employer that still offers health care benefits to hire you. Good luck pulling that off in this economy.

And if you would much rather work for a small employer or become your own boss, be prepared to remain in the ranks of the uninsured. 

The number of employers of any size still offering coverage dropped from 69 percent to 60 percent between 2000 and 2009, according to the Kaiser Family Foundation. The decline has been much steeper among small businesses with 10 or fewer workers. In 2009, far fewer than half of them were still offering coverage.

The Affordable Care Act, which provides tax breaks to small employers if they offer coverage and subsidize premiums for their workers, might at least slow that trend. Some of the big insurance companies have reported a recent uptick in the number of small businesses offering coverage — many for the first time — as a result of those tax breaks.

But even with financial help from the government, most small companies are still finding it difficult to pay what insurance firms are demanding. Another Kaiser Family Foundation study found that health insurance premiums employers paid for their workers in 2010 stood at $13,770 for family coverage — more than double what they paid just 10 years earlier.

In a Crain’s magazine survey of 300 small businesses in Michigan earlier this month, 24 percent said they had considered cancelling their group policies in 2011, primarily because of rising premiums. Several employers in Michigan did drop coverage.

Of those that decided to offer benefits for at least another year, a growing percentage are making employees pay a heftier share of the premium, and they’re shifting them into plans with higher deductibles. A survey this month by PriceWaterhouseCoopers (PwC) found that 17 percent of employers offered high-deductible plans, up from 13 percent last year. PwC says that if the trend continues — and why wouldn’t it? — high deductible plans will be the most common type of coverage by 2014.

Low income individuals and families will become eligible that year for subsidies from the federal government to help them pay their premiums. But even so, Steil and Shumlin don’t believe the current system, dominated by private insurers, is sustainable in the long haul. You can’t keep shifting more of the cost of both coverage and care to people–and also make them pay increasing amounts of tax dollars in subsidies that will go straight to private insurers–and not expect people to eventually stage a rebellion.

Private insurers, say Steil and Shumlin, have had their chance to control costs and expand access and have failed miserably. It is time, they believe, to replace them with a single payer — the government.

Dr. Deb Richter, president of Vermont Health Care for All.

Gov. Shumlin calls her the “backbone” of the grassroots effort that helped persuade the Democratic-led state legislature to pass the bill this spring.

“…we’ve had struggles up ’til this point, and no one said we could get this far, and people were basically naysayers saying that you’ll never get this far. And we’ve gotten this far. And I think the same energy that got us this far—we have a congressional delegation that is superb. We have a wonderful legislature; at this point, they’re all in—most of—the majority are in favor of single payer. And, of course, we have our governor, who campaigned on this issue, and a strong grassroots movement in the state of Vermont. And all of those together are really going to be needed to get us to where we need to go in 2017, or hopefully 2014.”

“…in Buffalo, 40 percent of my patients had no insurance, and many of them died young as a result of preventable illnesses, as a result of having been on and off insurance. And I had dozens of examples that—from my own practice, just me—if you multiply that times 700,000, you get an idea of how widespread this problem was.

And in addition, the amount of administrative burden and all of the bureaucracy that was—I’m a primary care physician, and all of the bureaucracy that we had—the hoops we had to jump through just to get patients the care they needed was ridiculous. And we know that 31 percent of the healthcare dollar is spent on administrative costs, transaction costs and paperwork. And just ask any primary care doctor, and they can tell you that they actually live that every single day.

So those are the things that I think resonated with people. I think people who had gone to the doctor 30 years ago and didn’t see all those people behind the counter just pushing paper, it’s something that they all felt. And we’re seeing this. More and more in the middle class is now experiencing what the poorer folks used to experience in terms of access. And I think that now that we have probably a majority of the population experiencing problems, this is something that’s resonating. And I do believe that that’s one of the major reasons that we got this legislation passed this year.”

“…there was a public hearing for providers. This was—included hospitals. And what we found was, two to one were in favor of single payer. And that’s particularly true in the primary care specialty. Eighty percent, roughly 80 percent nationally and in other state polls have shown that primary care, 80 percent of them are in favor. And we—our American Academy of Family Physicians Vermont chapter endorsed it. Our Vermont Psychiatric Association endorsed it.”

Part 2 of the interview here

For 18 years, Wendell Potter worked in the health insurance industry. Now’s he’s writing about it. In this video column, Potter looks at how Vermont is trying to create a single payer health care system.

“People should go where they are not supposed to go, say what they are not supposed to say, and stay when they are told to leave.” –Howard Zinn

Well, that quote pretty well sums up “what to do”. But my biggest challenge is “how”. Specifically, how do I neutralize some pretty powerful fear?

I was scared Friday when I joined Margaret Flowers to attempt to deliver a message to the President. My thoughts raced. We’re talking secret service.

“How do I get myself into these things?”
“This is crazy.”
“This is pointless.”
“I can’t even make sensible statements; I know what I want to say but I’m so nervous.”
“Other people are so much more knowledgeable and speak so much more eloquently.”
“But I am doing it!”

We stood in front of the Harbor Hotel in Baltimore clutching a banner that read “Letting you know. Medicare for all” and Margaret’s letter for the President written in response to his appeal for solutions to health reform. The hotel manager, police and secret service surrounded us and asked us to move.

If you watch the video, you’ll see that there was a point, a moment, which felt suspended in time, when Margaret looked at me and I looked at her and we both knew “we ain’t goin’ across the street.”

The feeling associated with that awareness was not fear, or anger, or self-righteous indignation. It was a feeling of quiet liberation. The things I was saying to myself, thoughts powerful enough to imprison me in a jailhouse of fear, had been neutralized. In their place was a calm determination to trust my intuition.

My gut told me “so be it. You’re doing the best you can. This is a no-brainer. Gotta do it. Margaret and I have been needing some quiet time to catch-up; might as well be in a police station.”

My gut has a great sense of humor.

Fear overcomes me when I listen to my head; calm enfolds me when I listen to my gut.

So, for what it is worth, here are few tips for “doing cd for Single Payer”:

1. Ignore your head. That means, all those familiar thoughts that leave you feeling fearful and bad.

2. Listen to your gut. You know it’s your gut talking if you start feeling calmness, clarity, and quiet determination.

3. We need people engaging in “gut-driven” cd to right all kinds of wrongs. Be authentic; for many of us, the gut issue is Medicare For All. If yours is the environment, then do cd for that.

4. Don’t try this alone. Take a friend. Or several.

5. Do the best you can. Speak from your heart. Once you’re in handcuffs, the worst is over. The “authorities” aren’t your enemy; most will treat you respectfully and the ones who don’t are just having a bad day. Don’t take it personally.

6. I like to take a “token” with me, tucked in my pocket with my driver’s license. For me, it’s a picture of my grandchildren and the holy card from my father’s funeral. It reminds me that he would be proud of me and that I’m doing this for the people who inspire me–my family and my patients.

7. If you have the choice of doing cd in the winter or the summer, definitely choose summer! Wear layers either way because it’s cold in jail.

Remember that we all have talents to contribute. Without Bill Hughes taking the video, our action wouldn’t have been as fruitful. Without Kevin Zeese, we’d have worried about our families and “legal stuff.” Without Mark Almberg, we wouldn’t have a press release. Without researchers like David Himmelstein and Steffie Woolhandler, we wouldn’t have compelling data to support us. We draw support from each other.

As Margaret Mead said: Never doubt that a small group of thoughtful committed citizens can change the world. Indeed, it is the only thing that ever has.”

On Jan. 29, 2010, Doctors Margaret Flowers and Carol Paris were arrested outside a hotel, at the Inner Harbor, in Baltimore, MD, where President Barack Obama was to give a speech. They were on a sidewalk outside the Renaissance hotel holding a banner. The doctors had a letter that they wanted to give to the President and/or one of his aides, re: Medicare for All. They were arrested for trespassing, according to to a police officer at the scene. Later after getting into a police car, this reporter was advised, the two doctors were released, without going to the local lockup. Each was then given” a citation” for trespassing. For background on this issue, check out Dr. Flowers visit to the White House, on Jan. 28, 2010, at: http://www.youtube.com/watch?v=xxziSR…

“It took our FUBARed health insurance system to finally push immense talent Vic Chesnutt over the cliff of despair this week. He needed kidney surgery and faced losing his home to pay for it. A songwriting hero to people like Kristin Hersh, Michael Stipe and Patti Smith, the Athens, Georgia performer took an overdose and spent his last few days in a coma.

In a “Fresh Air” interview a few weeks ago, he talked about the impossible economic demands he faced, despite help from Sweet Relief, the musicians’ health care fund. “I don’t want to die,” he told Terry Gross.”

Hundreds of emergency workers who responded to the September 11, 2001, attacks in the United States have been protesting in the capital, Washington, DC.

They say they are angry that it has taken eight years for congress to discuss healthcare now needed for those who have fallen ill as a result of working in the skyscrapers’ ruins.

Many of those first responders are slowly dying from illnesses contracted at Ground Zero.