[From: Elizabeth Allen spktruthtopower200@yahoo.com]

The following statement was released today by leaders of Physicians for a National Health Program, www.pnhp.org. Their signatures appear below.

As much as we would like to join the celebration of the House’s passage of the health bill last night, in good conscience we cannot.

We take no comfort in seeing aspirin dispensed for the treatment of cancer.

Instead of eliminating the root of the problem – the profit-driven, private health insurance industry – this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers’ defective products, and turn over to them vast amounts of public money.


About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.

Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.

Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.

The bill will drain about $40 billion from Medicare payments to safety-net hospitals, threatening the care of the tens of millions who will remain uninsured.

People with employer-based coverage will be locked into their plan’s limited network of providers, face ever-rising costs and erosion of their health benefits. Many, even most, will eventually face steep taxes on their benefits as the cost of insurance grows.

* Health care costs will continue to skyrocket,
as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.

* The much-vaunted insurance regulations – e.g. ending denials on the basis of pre-existing conditions – are riddled with loopholes, thanks to the central role that insurers played in crafting the legislation. Older people can be charged up to three times more than their younger counterparts, and large companies with a predominantly female workforce can be charged higher gender-based rates at least until 2017.

Women’s reproductive rights will be further eroded, thanks to the burdensome segregation of insurance funds for abortion and for all other medical services.

IT DIDN’T HAVE TO BE LIKE THIS. Whatever salutary measures are contained in this bill, e.g. additional funding for community health centers, could have been enacted on a stand-alone basis.

Similarly, the expansion of Medicaid – a woefully underfunded program that provides substandard care for the poor – could have been done separately, along with an increase in federal appropriations to upgrade its quality.

But instead
the Congress and the Obama administration have saddled Americans with an expensive package of onerous individual mandates, new taxes on workers’ health plans, countless sweetheart deals with the insurers and Big Pharma, and a perpetuation of the fragmented, dysfunctional, and unsustainable system that is taking such a heavy toll on our health and economy today.

This bill’s passage reflects political considerations, not sound health policy. AS PHYSICIANS, WE CANNOT ACCEPT THIS INVERSION OF PRIORITIES. We seek evidence-based remedies that will truly help our patients, not placebos.

A genuine remedy is in plain sight.
Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That’s enough to cover all the uninsured and to upgrade everyone else’s coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly two-thirds of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

We pledge to continue our work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for All.


Oliver Fein, M.D.

Garrett Adams, M.D.

Claudia Fegan, M.D.
Past President

Margaret Flowers, M.D.
Congressional Fellow

David Himmelstein, M.D.

Steffie Woolhandler, M.D.

Quentin Young, M.D.
National Coordinator

Don McCanne, M.D.
Senior Health Policy Fellow


Physicians for a National Health Program (www.pnhp.org) is an organization of 17,000 doctors who support single-payer national health insurance. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.


Myth vs Truth

1. This is a universal health care bill.

The bill is neither universal health care nor universal health insurance.

Per the CBO:

  • Total uninsured in 2019 with no bill: 54 million
  • Total uninsured in 2019 with Senate bill: 24 million (44%)

  • 2. Insurance companies hate this bill

    This bill is almost identical to the plan written by AHIP, the insurance company trade association, in 2009.

    The original Senate Finance Committee bill was authored by a former Wellpoint VP. Since Congress released the first of its health care bills on October 30, 2009, health care stocks have risen 28.35%.

    3. The bill will significantly bring down insurance premiums for most Americans.

    The bill will not bring down premiums significantly, and certainly not the $2,500/year that the President promised

    Annual premiums in 2016, status quo / with bill:

    Small group market, single: $7,800 / $7,800

    Small group market, family: $19,300 / $19,200

    Large Group market, single: $7,400 / $7,300

    Large group market, family: $21,100 / $21,300

    Individual market, single: $5,500 / $5,800*

    Individual market, family: $13,100 / $15,200*

    4. The bill will make health care affordable for middle class Americans.

    The bill will impose a financial hardship on middle class Americans who will be forced to buy a product that they can’t afford to use.

    A family of four making $66,370 will be forced to pay $5,243 per year for insurance. After basic necessities, this leaves them with $8,307 in discretionary income � out of which they would have to cover clothing, crredit card and other debt, child care and education costs, in addition to $5,882 in annual out-of-pocket medical expenses for which families will be responsible.

    5. This plan is similar to the Massachusetts plan, which makes health care affordable.

    Many Massachusetts residents forgo health care because they can’t afford it.

    A 2009 study by the state of Massachusetts found that:

    • 21% of residents forgo medical treatment because they can’t afford it, including 12% of children
    • 18% have health insurance but can’t afford to use it

    • 6. This bill provide health care to 31 million people who are currently uninsured.

      This bill will mandate that millions of people who are currently uninsured must purchase insurance from private companies, or the IRS will collect up to 2% of their annual income in penalties. Some will be assisted with government subsidies.

      7. You can keep the insurance you have if you like it.

      The excise tax will result in employers switching to plans with higher co-pays and fewer covered services.

      Older, less healthy employees with employer-based health care will be forced to pay much more in out-of-pocket expenses than they do now.

      8. The “excise tax” will encourage employers to reduce the scope of health care benefits, and they will pass the savings on to employees in the form of higher wages.

      There is insufficient evidence that employers pass savings from reduced benefits on to employees.

      9. This bill employs nearly every cost control idea available to bring down costs.

      This bill does not bring down costs and leaves out nearly every key cost control measure, including:

      • Public Option ($25-$110 billion)
      • Medicare buy-in
      • Drug reimportation ($19 billion)
      • Medicare drug price negotiation ($300 billion)
      • Shorter pathway to generic biologics ($71 billion)

      • 10. The bill will require big companies like WalMart to provide insurance for their employees

        The bill was written so that most WalMart employees will qualify for subsidies, and taxpayers will pick up a large portion of the cost of their coverage.

        11. The bill “bends the cost curve” on health care.

        The bill ignored proven ways to cut health care costs and still leaves 24 million people uninsured, all while slightly raising total annual costs by $234 million in 2019.

        “Bends the cost curve” is a misleading and trivial claim, as the US would still spend far more for care than other advanced countries.

        In 2009, health care costs were 17.3% of GDP.

        Annual cost of health care in 2019, status quo: $4,670.6 billion (20.8% of GDP)

        Annual cost of health care in 2019, Senate bill: $4,693.5 billion (20.9% of GDP)

        12. The bill will provide immediate access to insurance for Americans who are uninsured because of a pre-existing condition.

        Access to the “high risk pool” is limited and the pool is underfunded. It will cover few people, and will run out of money in 2011 or 2012

        Only those who have been uninsured for more than six months will qualify for the high risk pool. Only 0.7% of those without insurance now will get coverage, and the CMS report estimates it will run out of funding by 2011 or 2012.

        13. The bill prohibits dropping people in individual plans from coverage when they get sick.

        The bill does not empower a regulatory body to keep people from being dropped when they’re sick.

        There are already many states that have laws on the books prohibiting people from being dropped when they’re sick, but without an enforcement mechanism, there is little to hold the insurance companies in check.

        14. The bill ensures consumers have access to an effective internal and external appeals process to challenge new insurance plan decisions.

        The “internal appeals process” is in the hands of the insurance companies themselves, and the “external” one is up to each state.
        Ensuring that consumers have access to “internal appeals” simply means the insurance companies have to review their own decisions. And it is the responsibility of each state to provide an “external appeals process,” as there is neither funding nor a regulatory mechanism for enforcement at the federal level.

        15. This bill will stop insurance companies from hiking rates 30%-40% per year.

        This bill does not limit insurance company rate hikes. Private insurers continue to be exempt from anti-trust laws, and are free to raise rates without fear of competition in many areas of the country.

        16. When the bill passes, people will begin receiving benefits under this bill immediately

        Most provisions in this bill, such as an end to the ban on pre-existing conditions for adults, do not take effect until 2014.

        Six months from the date of passage, children could not be excluded from coverage due to pre-existing conditions, though insurance companies could charge more to cover them. Children would also be allowed to stay on their parents’ plans until age 26. There will be an elimination of lifetime coverage limits, a high risk pool for those who have been uninsured for more than 6 months, and community health centers will start receiving money.

        17. The bill creates a pathway for single payer.

        Bernie Sanders’ provision in the Senate bill does not start until 2017, and does not cover the Department of Labor, so no, it doesn’t create a pathway for single payer.

        Obama told Dennis Kucinich that the Ohio Representative’s amendment is similar to Bernie Sanders’ provision in the Senate bill, and creates a pathway to single payer. Since the waiver does not start until 2017, and does not cover the Department of Labor, it is nearly impossible to see how it gets around the ERISA laws that stand in the way of any practical state single payer system.

        18 The bill will end medical bankruptcy and provide all Americans with peace of mind.

        Most people with medical bankruptcies already have insurance, and out-of-pocket expenses will continue to be a burden on the middle class.

        • In 2009, 1.5 million Americans declared bankruptcy
        • Of those, 62% were medically related
        • Three-quarters of those had health insurance
        • The Obama bill leaves 24 million without insurance
        • The maximum yearly out-of-pocket limit for a family will be $11,900 (PDF) on top of premiums
        • A family with serious medical problems that last for a few years could easily be financially crushed by medical costs

        • *Cost of premiums goes up somewhat due to subsidies and mandates of better coverage. CBO assumes that cost of individual policies goes down 7-10%, and that people will buy more generous policies.


          1. March 11, Letter from Doug Elmendorf to Harry Reid (PDF)

          2. The AHIP Plan in Context, Igor Volsky; The Max Baucus WellPoint/Liz Fowler Plan, Marcy Wheeler

          3. CBO Score, 11-30-2009

          4. “Affordable” Health Care, Marcy Wheeler

          5. Gruber Doesn’t Reveal That 21% of Massachusetts Residents Can’t Afford Health Care, Marcy Wheeler; Massachusetts Survey (PDF)

          6. Health Care on the Road to Neo-Feudalism, Marcy Wheeler

          7. CMS: Excise Tax on Insurance Will Make Your Insurane Coverage Worse and Cause Almost No Reduction in NHE, Jon Walker

          8. Employer Health Costs Do Not Drive Wage Trends, Lawrence Mishel

          9. CBO Estimates Show Public Plan With Higher Savings Rate, Congress Daily; Drug Importation Amendment Likely This Week, Politico; Medicare Part D IAF; A Monopoloy on Biologics Will Drain Health Care Resources, Lancet Student

          10. MaxTax Is a Plan to Use Our Taxes to Reward Wal-Mart for Keeping Its Workers in Poverty, Marcy Wheeler

          11. Estimated Financial Effects of the “Patient Protection and Affordable Care Act of 2009,” as Proposed by the Senate Majority Leader on November 18, 2009, CMS (PDF)

          12. ibid

          13. ibid

          14. ibid

          15. Health insurance companies hang onto their antitrust exemption, Protect Consumer Justice.org

          16. What passage of health care reform would mean for the average American, DC Examiner

          17. How to get a State Single Payer Opt-Out as Part of Reconciliation, Jon Walker

          18. Medical bills prompt more than 60 percent of U.S. bankruptcies, CNN.com



          1. health-on-line

            Talking about the 23 million that will remain uninsured is a bit sensationlist I think. Yes, that will be the case but what about the more than 30 million that will have health care where they didn’t before. Most of those that will remain uninsured will be illegal immigrants.
            It’s important to remember that health care is a huge issue and it can only be tackled a little bit at a time. To ensure that millions more have health insurance than currently do is a good thing and should be applauded – no governmetn could solve the wider issue overnight for everyone.

          Leave a Reply

          Your email address will not be published. Required fields are marked *