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Once again, prognosis for Pa. health-care progress is grim To fix health care, focus on uninsured
Poor Pennsylvanians need access to care
“More than a year ago, Gov. Ed Rendell
made access to health care a major issue in this state with his ''Cover
All Pennsylvanians'' proposal. Since then, the fact that tens of
millions of Americans lack health insurance has become a major issue in
the presidential race, too.
“It's important to note that of the
current $1.35 the state collects on each pack of cigarettes, 25 cents
goes to subsidize the malpractice insurance system (MCare) for
Pennsylvania physicians. Stabilizing the high cost of malpractice
insurance has been crucial to stem the tide of physicians leaving the
state. But Gov. Rendell wants to tap the growing MCare surplus to help
pay for extending coverage to uninsured Pennsylvanians. There is some
irony is a proposal to help extend health insurance to uninsured
Pennsylvanians would target a program designed to make sure there are
enough doctors in the state to provide that care. But Gov. Rendell has
turned that around by asking why lawmakers were able justifying taxing
tobacco users to help doctors but can't find the political will to do
the same to help uninsured Pennsylvanians. “…it's not fair to uninsured Pennsylvanians, nor wise public policy, for state lawmakers to wait and see what happens on the national stage regarding universal health care. The legislators were elected to be leaders and the Senate should lead by extending health insurance coverage to as many Pennsylvanians as they can.” Health-care stalemate must end “Politics is often defined by conflict. Many
Pennsylvanians even relish a healthy political battle. But state Senate
Republicans are playing with fire on health care -- the kind that could
cost you your favorite doctor or specialist if a stalemate over
malpractice insurance isn't resolved soon. Malpractice: Senate Republicans are blocking health
care “Now it's up to the Senate to approve Senate Bill 1137, which would break the stalemate over malpractice subsidies and significantly expand access to free or low-cost health insurance coverage. This should be as simple as getting an X-ray, but Senate Republicans oppose it for reasons that are just as transparent. “The plan passed by the House last month, called Pennsylvania Access to Basic Care, would cover 217,000 Pennsylvanians ages 19 to 64 who don't have health insurance now. The current adultBasic plan, which has 53,174 enrollees, would be folded into the new program. Eligibility requirements are essentially the same -- applicants must have lived in the state for at least 90 days and not had health insurance for six months unless the reason is job loss. Some recipients pay a premium for coverage on a sliding scale, depending on income. “Any question of whether there is a need for this coverage can be answered by looking at the waiting list for adultBasic, which has included 80,000 to 90,000 people for months. The need may be even greater, when you consider that some people see that long a list and decide not to bother applying. “Currently, the state subsidizes a portion of the cost for doctors, and the fund is on track to have a $504 million surplus by the end of June. Of that, $246 million would be directed to the ABC program. The rest would be used to phase out the malpractice program, including coverage of the unfunded liability of future malpractice claims. “But the real threat to this bill comes from Senate Republicans. They say they don't like the cost, and they've made a disingenuous claim that Democrats haven't said how they'll pay for the program. “That's because there's a $120 million annual gap in funding, which, not coincidentally, is the amount that would be raised by tobacco tax increases previously proposed by Mr. Rendell. But the House Democrats' proposal doesn't spell that out. “Pennsylvanians want health care coverage. The state Senate should stop being an obstacle and deliver it to thousands of them.” Editorial: Malpractice Subsidy “Thousands of Pennsylvania doctors have been shown to a seat in the waiting room next to the state's nearly 800,000 uninsured adults. Maybe together they can get better attention from the Republican-led state Senate. “Physicians and the uninsured have a shared stake in seeing the end of an apparent grudge match that has Senate leaders blocking Gov. Rendell's efforts to expand health care for poor and low-paid Pennsylvanians. “The smaller House-approved health plan more than met Republican concerns over cost. It also provided incentives for small businesses to offer insurance to lower-wage workers, and embraced the GOP's core proposal for medical savings accounts, which would enable individuals to purchase high-deductible health-care policies. Another progressive proposal from the House would assure that health insurers could not turn away people due to medical histories. “From the physicians' perspective, there's even more at stake since the House also approved a generous extension of the MCare abatement. Over a 10-year period, the state would bestow $3.3 billion more in aid to help doctors cover malpractice insurance costs. “Rather than debate the workable House plan authored by Rep. Todd Eachus (D., Luzerne), though, senators sent the House a stopgap proposal for a one-year renewal of MCare. “Doctors should find it odd that Senate leaders still are being supported by the Pennsylvania Medical Society and the hospitals' trade group. “With billions more in aid being offered to them, physicians have to be asking themselves why their mouthpieces are taking the wrong side in this health-care reform debate.” Physicians, needy Pennsylvanians deserve better than
this Mcare deadlock “The state Legislature delivered another of its maddening, do-nothing, fumble-the-ball performances this week regarding the fund that helps physicians pay for malpractice insurance. As a result, the fund lapsed on Tuesday and the Pennsylvania Medical Society told its members to expect to start paying more. “It still is possible that the Senate will adopt a plan already passed in the House on March 17 that would preserve the fund for 10 years while connecting it to Gov. Rendell's plan to cover more working-poor Pennsylvanians. But for now, that isn't happening. “Money for the MCare fund comes from a 25 cent-per-pack
cigarette tax and a surcharge on traffic tickets. In recent years, the fund
has had a surplus, and it has been growing. “Good question. Gov. Rendell has been willing in the past to use brinksmanship with the Legislature, and bigger challenges on passing the 2007-2008 budget are looming. He probably could extend the MCare fund by executive order, but why should he? He offered the Legislature a viable program to serve both the needs of physicians by extending the fund and the needs of Pennsylvanians who can't afford insurance. The Senate should pass it.” Small businesses & health care (Op-Ed) “NOBODY will benefit more from HB 2005, the health-insurance reform bill now wending its way through the state Legislature, than the commonwealth's small businesses. Yet the official lobbyists in Harrisburg for small business - the Chamber of Commerce and the National Federation of Independent Businesses - are fighting to block it. “These so-called "representatives of business" don't actually represent most small businesses in the state. And what's worse - and this is the dirty little secret of health-care lobbying in Pennsylvania - the leaders of these organizations are fighting insurance reform out of their own self-interest, not out of a concern for their own members. “The chamber and NFIB provide health insurance to their members. Indeed, a chunk of their budgets comes from this. The reforms contained in the bill - which would protect small businesses and consumers - will cut into their profits. “The Health Insurance Reform Bill will help small businesses and individuals buy affordable health insurance in many ways. “Many owners of small businesses like ours want to provide health insurance for our employees both because it's the right thing to do and because we know that providing the insurance makes good business sense. “The bill will enable small businesses like ours to provide insurance to our employees. Every small business in the state will benefit. So it's time we small business owners stand up and speak out. Maybe we can drown out the voices of those who claim to speak in our name while only standing up for themselves.” Use of liability fund surplus would help uninsured
“For the past five years, Pennsylvanians have helped to reduce physicians’ costs and maintain access to medical care by steering hundreds of millions of tax dollars into a fund that covers a portion of doctors’ liability insurance. “Because of an improved liability environment, that fund now has a substantial surplus. It’s reasonable and fair to use a portion of that surplus to address another major health care issue: the high number of uninsured, low-income workers in the state. “The fund, which is fueled by a 25-cents-per-pack tax on cigarettes, now has a $400 million surplus. “This past week, the House passed a bill that would use part of that surplus to provide basic health care coverage for about 270,000 low-income working adults who cannot afford private insurance. “Using the surplus would not jeopardize the premium subsidies for physicians, which have been extended by the Legislature on a year-to-year basis since the original passage of the program. “But the overall health care system would benefit, as well. Coverage for uninsured workers would sharply reduce the amount of uncompensated care now provided by hospitals and other providers, thus improving their bottom lines. “The Senate should approve the House bill. The issue, just as it was when the physicians’ premium subsidies were at issue, is broad access to medical care.” Pa. Health Care Out in the cold "But while many in Washington are talking about health care, Gov. Rendell has put forth a smart and workable plan to provide health-care coverage for nearly 800,000 uninsured Pennsylvanians. "Even better, the plan seems fiscally sound, and is financed in a way that won't kill taxpayers. "So what's the holdup on Rendell's plan? "Talk to your legislators. Especially the ones with the Rs after their name. "Lawmakers have had more than a year to consider the signature piece of Rendell's sweeping ‘Prescription for Pennsylvania’ plan. "OK. Does anyone have a better plan? If so, let's see it. If not, voters should lobby their lawmakers for Rendell's plan. It's a winner for the uninsured, the insured, businesses and hospitals. "And it only costs smokers a dime." Rendell changes tactics, improves health care bills "Despite his reputation for playing hardball in order to cut deals, Gov. Ed Rendell has lobbed a big, fat softball at the medical community in an effort to expand the state’s health care coverage of low-income workers. "The Legislature should pass the package prior to the March 31 expiration of the program that benefits physicians." Improved 'Cover All Pennsylvanians' plan deserves Legislature's support "Now, a month later, the second half of this legislative session is under way and Gov. Rendell's plan is back in the spotlight. Last year, we had reservations about how the state would pay for the very important goal of helping part-time and low-wage employees get health coverage. The Governor's current plan addresses those concerns. With one relatively small question about what will happen in the out-years of Gov. Rendell's 10-year program, "Cover All Pennsylvanians" deserves to be enacted. "The big change that the governor made at the end of last year was to remove a payroll tax that would have collected funds from employers to cover almost 800,000 uninsured adults in Pennsylvania. Instead, he would raise the cigarette tax by 10 cents a pack and enact a new tax on cigars, chewing tobacco and snuff, products whose sale is taxed in every other state. Last year, 71 percent of Pennsylvanians in a Quinnipiac University poll said they favor raising tobacco taxes to pay for health care." Pa. can lead by example | Rendell revises plan for uninsured citizens "Last year, Gov. Ed Rendell devised a way to provide coverage for Pennsylvanians who lack health insurance, and now he’s found a better way to pay for it. "The help that the governor has been proposing in his Cover All Pennsylvanians plan is an attempt to do what the federal government has failed to accomplish, and the revamped version is an improvement over his original initiative. "...Rendell’s initiative is a more direct remedy for an ailment that afflicts Pennsylvania and the rest of the nation. "Pennsylvania now has an opportunity to help its uninsured citizens and to lead the nation by example." Tweaking the system to cover health care for all in the state may be possible, but hardly probable "Gov. Ed Rendell made another pitch this week in behalf of his health insurance proposal, "Cover All Pennsylvanians," which is aimed at insuring the estimated 767,000 adults in Pennsylvania who lack coverage. "Behind the numbers, as the governor sought to demonstrate, are real people facing real difficulties trying to gain affordable access to the health care they or their family members require. "In short, the system is in crisis. Anyone who fails to recognize that must be living on another planet. "The uninsured are large in number but unorganized. The defenders of the status quo are relatively few but powerful and influential. Guess who is going to win this battle again this year." Use MCare surplus to insure 70[0],000 "...Someone always pays for treatment of the uninsured. Insured workers face higher premiums; indirect taxes rise and health-care institutions charge more to paying customers to cover the costs. In the long run, establishing better coverage for low-income workers would improve the health care system in terms of quality and cost. Insured people generally are healthier than the uninsured because they seek treatment sooner, before conditions become acute and acutely expensive to treat. And broad coverage will help the health-system become more stable, financially. "Lawmakers should address health care access as a systemic matter and approve the plan to broaden that access to as many workers as possible." Ratings, standardized benefits worth a look from legislators "Lobbyists for Pennsylvania’s businesses have vigorously opposed Gov. Ed Rendell’s plan to tax the payrolls of companies that don’t offer insurance to their employees, though you have to wonder if that truly reflects the view of the great majority of businesses that do pay to insure their employees." Rendell’s Health-Care Plan; Recovering nicely "Just a few months ago, the first components of Gov. Rendell’s sweeping health-care proposal appeared to be on life support… So it was a minor miracle that the governor the other week had a pen poised above legislation for the infections and expanded-care measures. With the stroke of that pen, Rendell put the state in the forefront of efforts o safeguard patients from infections, expand access to care, and begin to stem the rise of medical costs… As big as those steps are, the effort to plug gaps in the health insurance safety net is even more important. Rendell’s “Cover All Pennsylvanians” plan would alleviate personal suffering, improve productivity, and reduce health-care costs." Workplace Smoking Ban; Loopholes in the law will cost lives "It's hard to get around the fact that the us surgeon general says neither ventilation nor no-smoking areas can isolate patrons from secondhand smoke, which contains dozens of known carcinogens. "Any talk of watering down the smoking ban makes no sense from a health perspective- and that’s what should guide this debate. No one in the General Assembly should cast a vote that, in effect, attempts to protect some citizens' health but not that of others." Erie Times-News "Smoking literally costs Pennsylvania a fortune. So a major tactic in Pennsylvania Gov. Ed Rendell’s Prescription for Pennsylvania health-care-reform package is a statewide ban on smoking in publicand work spaces. But Rendell also wants the state Legislature to wield more weapons in the commonwealth’s necessary offensive against smoking. He is calling for higher tobacco taxes to help raise $151 million to improve health care in Pennsylvania. This is a long-overdue revenue broadside against a deadly public-health hazard." Ben Waxman, student at Juniata College "According to the U.S. Census, 72 percent of all 18- to 25-year- olds lack health insurance. Medical bills are one of the leading reasons that young people drop out of college. Juggling school, work and family without health care is simply too difficult for many students. "In addition, many jobs held by young adults have low wages and lousy benefits. A recent report from Demos Foundation found that young people face a number of serious economic challenges. The average college student graduates with more than $20,000 worth of debt. The spiraling cost of living, which includes medical expenses, makes it harder and harder for young adults to make ends meet. "Young people are not always the most effective lobbyists, but that doesn’t mean we should be ignored. Health care coverage is an incredibly important issue and any reforms will have a major impact on my generation. If political leaders want to make Pennsylvania more competitive, they will address this." Alan Sager and Deborah Socolar, directors of the Health Refrom Program at Boston University School of Public Health "Most politicians offer only rhetorical cost controls for fear of offending powerful caregiver groups. Rendell goes further. "He usefully proposes that insurers must devote at least 85 percent of small-business premiums to care, thereby cutting marketing, profit and administration. "Affordable health care is in reach. Current spending – about $110 billion this year in Pennsylvania – can pay for the care that works for all who need it." Rendell plan is worth a look "And Gov. Rendell recently unveiled his “Prescription for Pennsylvania,” which, if embraced and adopted by the General Assembly, would make private health insurance available for everyone in the state while, if its projections are accurate, reducing the costs. "While saving the details for a future editorial, there is much to like in Rendell’s plan. It is not, he insists, a “big government program” funded solely by state money supported by endless levels of bureaucracy. Nor is it a single-payer plan. It builds upon the current system of private company-provided health insurance." Concept is laudable; delivery will be key "Since Gov. Ed Rendell announced his proposal for universal health-care coverage in Pennsylvania, on health-care provider after another has had pretty much the same reaction: They applaud the governor’s willingness to broach the subject and look forward to working with him to develop the final product." The Right Rx; Not a perfect, but Rendell’s plan rightly takes "While there will be those who believe Rendell’s “Prescription for Pennsylvania” plan goes too far or not far enough, it strikes us as a worthy effort. It seeks to build on the existing system’s strengths, while addressing some of its weaknesses. It doesn’t seek to reinvent the wheel, a surefire recipe for political deadlock. "With advice and suggestions from a broad range of stakeholders, Rendell and his health advisor, Rosemarie Greco, have offered a proposal that is eminently doable. Its success or failure will depend on whether legislators are prepared to grapple with an extremely complex issue in a straight-forward manner, weathering what could be an unparalleled lobbying effort by some special interests to protect their own interests at the cost of the greater good." Health Care in Pa: Greater than the parts, if the parties agree "The state’s leadership on providing health insurance for kids – just expanded last year to cover every child – is a good omen for Rendell’s broader health reform. Given a growing national clamor for reform, it’s also the right moment to try to make health care accessible and affordable for every grown-up." John M. Baer "With the boldest, most comprehensive proposal of his incumbency, Gov. Ed is looking to change the face of health care in Pennsylvania… His proposals unquestionably are good ideas for the health of the state and the head of the state."
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