PUBLIC CITIZEN HEALTH RESEARCH GROUP SIDNEY M. WOLFE, M.D., EDITOR August 2009 +VOL. 25, No . 8 Dr. Sidney Wolfe's Testimony before Subcommittee on Health at Hearing on Health Insurance Tbe following testimony was given A recent national Harris Poll some of the money that is necessary by Dr. Sidney M. Wolfe, acting (October, 2008) asked the following to fund health insurance. Several president ofPublic Citizen and editor question: "Which of these industries weeks ago,. the collective forces of of the Health Letter, on june 24, do you think are generally honest and the health industry promised that they 2009. trustworthy - so that you normally could voluntarily save two trillion believe a statement by a company dollars over the next 10 years. at if you picked up the in that industry? "Only one out of 14 But the amount that can be saved morning paper tomorrow people (7 percent) thought that the over the next ten years by just W:nd saw the following health insurance industry is honest eliminating the health insurance headline: "50 People Died Yesterday and trustworthy. The only industries industry and the $400 billion of Because they Lacked Health in the survey that were even more excessive administrative costs it Insurance"? The next day, the same distrusted than the health insurance causes each year is $4 trillion, in one headline - and the next as well. industry were HMO's (7 percent), oil fell swoop. This would be enough This is the average number of people (4 percent) and tobacco (3 percent). to finance health care for all without in the United States who, according The Congress, on the other hand, the additional revenues the Congress to a 2004 report by the Institute of trusts the health insurance industry and the Administration is desperately Medicine of the National Academy and feels compelled to come up seeking. of Sciences, die each day - more with a "solution" that avoids a big As an example of administrative than 18,000 a year - because they fight with them, not only writing waste, over the last 30 plus years lack health insurance. How should them into the legislation but assuring there have been maybe two and a we respond to this unacceptable and further growth of that industry. The half, three times more doctors and embarrassing finding? Congress wants to believe that the nurses, in proportion with the growth Not by saying, as President Obama health insurance and pharmaceutical in population. But over the same has said that if we were starting now industries will be good citizens and from scratch, we would have a single­ voluntarily lower their prices to save continued on page 2 payer, but it's too disruptive or, as the health insurance industry recently CONTENTS said, having the public option would be too "devastating". What could be Dr. Steffie Woolhandler's Testimony before Health Subcommittee more disruptive and devastating than at Hearing on Health Insurance ...... .... ... ........ .... .. ...... ... .................... ... ... ....... 3 being one of 45+ million people who are uninsured, from whose ranks Letter to the Editor of the Washington Post Regarding the Coverage come 18,000 people who die each year of the Recent Congressional Hearing on Single-Payer ................................. 4 because of this dangerous status? Ineffectual Medical Treatments Misleadingly Produce "Good" Results .... .... 5 The real question is why should we tolerate the fragmented, highly profitable, administratively wasting RecaUs june 17, 2009 -july 14, 2009 private health insurance industry any This month, digoxin and kick body boards are on the list ...... ... ... ............. 7 longer? In this regard, the public is way ahead of either President Obama or the Congress in its distrust of the Outrage Medical Publisher Offers Bribes for Writing Favorable Book Reviews ...... l2 health insurance industry. VISIT HEALTH RESEARCH GROUP'S WEB SITE AT WWW.CI'fiZEN.ORG/HRG/ from page 1 Health Insurance. Is everyone else fact that 40 percent of our people are wrong and only the US is right? uninsured. They passed, essentially, interval, there are 30 times more A recent study by the international single-payer plan and within a few health administrators. These people OECD (Organization for Economic years 90-95 percent of the people are not doctors. They're not nurses. Co-operation and Development) were covered. They're not pharmacists. They're not provided health insurance data In the U.S. we have had experiments providing care. Many from its 30 member as well with seven states having of them are being countries (Europe, instituted various versions of the paid to deny care. There is no way we Korea, Japan, Mexico, public/ private combination that this So, they are fighting are ever going to Canada, the United legislation seeks to provide. In none with the doctors, with get to having good States and others of these states has this worked, once the hospitals to see health insurance including Australia, several years had elapsed, despite how few bills can be for everyone, as New Zealand and initial enthusiasm and short-lived paid. That's how the Iceland). The latest decreases in the uninsured. insurance industry long as there's a data from those So as we consider what to do, which thrives by denying health insurance countries showed that experiments do we follow? The ones care, paying as little industry, in the way, 27 of the 30 had health that were successful, all of which, for out as it can, getting obstructing care. insurance coverage for all practical purposes, eliminated the the healthiest patients. more than 96 percent private for-profit insurance industty, There is no question of the population, with or the failed U.S. state examples, all that we have a fragmented health only Germany having any non-public of which were built on this industry? insurance industry. And it thrives on coverage (10.3 percent). The other If instead of saying that a single being fragmented, avoiding any kind three were Mexico with 60.4 percent payer program is not politically of serious centralized examination covered - all with public coverage, possible, the President and the or control. The drug companies Turkey, with 67.2 percent covered, Congress need to say, "It is not make much more money with this also with public coverage and the only politically possible, politically insurance fragmentation, because U.S. with 84.9 percent covered 57.5 feasible, but it's the only practical there's no price control. The insurance percent with private and 27.4 percent way national health insurance will companies make much more money with public coverage. ever happen." Anything short of that because they can push away people In Canada, back in 1970, they were is essentially throwing tens of billions who aren't going to be profitable, let spending the same percentage of their of dollars at the insurance industry. public programs take care of these gross national product as we were And if you~re afraid of the insurance patients who are "unprofitable." on health. They also had millions of industry, than you're afraid of doing What the President and the Congress uninsured people and many of the the right thing: Having everybody are really, realistically advocating - same insurance companies such as in, and nobody out of having health since there is absolutely no possibility Blue Cross, Blue Shield. They decided insurance. + of having enough money to cover all to just get rid of the health insurance people in this country as long as the industry. They had experimented private, for-profit health insurance with it in Saskatchewan ten years industry is allowed to exist- is more earlier and it had worked so well, incremental reform, not National they couldn't wait to do it nationally. Health Insurance. It is now 44 years So, where there's a will, there's a since Medicare and Medicaid came way. There is no way we are ever into existence. In the interim, there going to get to having good health have been many experiments in this insurance for everyone, as long as country and abroad to try to provide there's a health insurance industry, in universal health coverage. the way, obstructing care. Other countries have uniformly Other more recent experiments rejected the private for-profitinsurance abroad include Taiwan. In 1995, industry and have adopted National Taiwan had said, we don't like the 2 + August 2009 Dr. Steffie Woolhandler's Testimony before Health Subcommittee at Hearing on Health Insurance The following testimony was and uninsured. And insurance overpriced coverage like this left 1 in given on june 24, 2009 by Steffie regulations like those proposed in 6 Massachusetts residents unable to Woo/handler, M.D., M.P.H. , co­ the tri-committee bill cannot fix these pay their medical bills last year. founder of Physicians for a problems. Meanwhile, nsmg costs have National Health Program, before the We in Massachusetts have seen forced the Legislature to rob Peter in Subcommittee on Health at the House in action a plan like the one you're order to pay Paul. Funding cuts have Committee on Energy and Commerce considering. In my state, beating decimated safety-net hospitals and Hearing on Health Insurance. your wife, communicating a terrorist clinics, and the current budget drops threat and being uninsured all carry coverage for 28,000 people. r. Chairman, members $1,000 fines. Yet despite these steep As research I published in the of the Committee. I'm fines, most of the new coverage in New England journal of Medicine MSteffie Woolhandler. I am a our state has come from expanding showed, a single-payer reform could primary care doctor in Cambridge, Medicaid-like programs at great save about $400 billion annually by Massachusetts, and associate public expense.