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Thursday, December 17, 2009

Pennsylvania Healthcare Update

Yesterday the single-payer movement in PA gat a hearing before the State Banking Committee. Here is a first hand report. It sounds like it was a very successful event, nudging the idea forward:

WRITTEN BY JERRY POLICOFF: As most of you know (I hope), today (12/16/2009) single-payer healthcare got its first ever hearing before a Republican-chaired political committee, not just in Pennsylvania, but anywhere. I was privileged to be there, and I came away more optimistic than ever that we are going to pass this legislation, but I thought Dr. Walter Tsou really summed up well what happened today. Walter is a member of PNHP (Physicians for a National Health Plan) and is the former Philadelphia Health Commissioner. I am sure he would not object to my circulating his impression of today’s hearing:
Today’s hearing was filmed by the Senate, and we hope to have copies soon that will be available for distribution. Walter Tsou’s impressions of today’s hearing follow:

WRITTEN BY WALTER TSOU: Since I haven't seen an eyewitness account yet on today's hearing on the Pennsylvania Senate Banking and Insurance Committee hearing on SB 400, I would offer my comments.

My overall impression was this was an enormously successful and impressive showing for Pennsylvania state single payer. Yes, I may be biased, but our four panelists did a superb job in explaining the Family and Business Health Security Act. To explain why I say this consider that Senator Don White, Chair of the Senate B and I Committee concluded the hearing with a comment that rather than this being a one time hearing, he started by saying that "there were those who said I should not have this hearing", but he believed it was a "positive" hearing and that it should be the beginning of a series of hearings on this most important topic. And remember, this is a committee chaired by the Senate Republicans, not the Democrats. He had two pages of questions and not enough time to ask them. One big concern was the 11 personal board which oversaw the plan even though they are appointed by the elected leadership and the Governor.

The hearing began with Senator White, a former insurance broker, welcoming everyone and inviting Senator Jim Ferlo, the lead sponsor of the bill to explain why he introduced it. Ferlo explained the need to look at different approaches rather than be tied to the usual failed insurance model. A state single payer plan would free up employers from the onerous burden of health insurance and provide health insurance for everyone at far less money.

Chuck Pennachio, Exec. Dir of Healthcare for all PA from Bucks County spoke next and further explained why the single payer approach was consistent with Republican values - good value for money spent and how the bill actually worked.

Patricia Eakin, RN from Philadelphia explained that she was a nurse in one of the busiest ERs in Pennsylvania at Temple and that she sees the problems of the lack of insurance on a daily basis. She gave some examples of the problems faced by people who have lacked insurance. She noted how her hospital was losing money because they had to spend it on billing personnel because her hospital had so many people without insurance or on Medicaid. This has worsened with the recession.

Dwight Michaels, MD, a republican family practice doctor from Gettysburg spoke about how his experience with private insurance and taking care of his patients has driven him into supporting single payer. He says it is impossible to practice because his five person group has 20 different insurance plans all with different rules and it was impossible to spend time taking care of patients because so much of his time was spent justifying things with the insurers. It was a vivid description of the life of a family doctor in a dysfunctional system.

David Steil, a former republican state legislator and now head of a small business was an inspired choice. Not only did he know all of the senators, but as a republican he broke the stereotype that all single payer people are left wing liberals. Mr. Steil spoke about how he tries to run a business, but that the cost of health care has made his business uncompetitive especially in international markets where his competitors have much cheaper health benefits. He also spends too much time figuring out his employees benefits when he is trying to run a business.

I think this panel worked extremely well. Not only were they excellent speakers, but they spoke from real world experiences, not as paid lobbyists. And two were republicans which was an added bonus. The committee had many questions, but none were nasty and all seemed genuinely interested in the real world experiences of the panelists. And the room was packed with 90% supporters of SB 400. I don't think this was lost on the committee.

The opposing panel were all known lobbyists for their respective interest groups. They gave the usual refrain of condemning single payer.

NFIB speaker - simply said business doesn't want single payer, but admitted that health care costs are the number one concern of businesses. They want a different solution.

PA Medical Society - wants tort reform but not single payer because it would be too powerful in controlling reimbursements (and costs).

Capitol Blue Cross - gave a confusing talk about the problems with the Washington federal bill and then simply concluded that SB 400 is just like the Washington bill and should be rejected. Of course, nothing in the federal bill even resembles single payer which is why it is so unpopular.

Hospital Association - opposes any government controls generically. Gave a knee jerk opposition to single payer.

Insurance Federation - same as the hospitals. they of course, oppose single payer.

There was not much time for questions for them, but frankly they were clearly lobbyists and not a very interesting opposing panel. If this was a debate, I think the clear winners were the single payer SB 400 panel who did a great service in advancing the bill today. I know state single payer gained some respect in the room today.

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