People Before Profits:

MNA Activists Alert:

We are joining other citizen and health care advocacy groups in organizing a
Community Rally for Health Care Reform in Lynn, to coincide and demonstrate
support for GE Workers who will be participating in a two-day strike over
efforts by the corporation (one of the wealthiest companies in the world) to
unilaterally impose new co-pays for health insurance for all their workers,
including the retirees. This is not an issue for GE workers alone, but is one
being faced by all working people, including nurses. See information on this
rally below and please try and attend.

Community Rally for Health Care Reform

Seniors, doctors, nurses, unemployed and low-income workers, and the
uninsured are joining striking GE workers to say:

Health Care for All ... Not Health Cuts at GE!

January 15, 3:00 - 5:00 pm (come anytime)
Nandee's, Lynn, Massachusetts
(corner of Market and Andrew St)

Here's why:

a. 2.2 million seniors have been thrown out of HMOs
b. 50,000 low-income people in Mass. will lose their health coverage April 1
(1)
c. GE is increasing workers co-pays by as much as 40 percent (2)
d. The World Health Organization now ranks U.S. health care 37th in world (3)
e. 41 million people are uninsured
f. Premiums are expected to increase by 15.4 percent this year (4)

Learn more about how providing a health care plan that covers everyone and
eliminates wasteful red tape can save money while protecting seniors and
giving workers and responsible employers a better deal. Find out more about
why the health care crisis can't be solved if we continue to rely on an
employer-based, private insurance system.

Sponsored by: Jobs with Justice, IUE-CWA Local 201, Lynn Health Task Force,
Massachusetts Senior Action Council, MASS-CARE, Massachusetts Nurses
Association, SEIU Local 285, Health Care for All, Ad Hoc Committee to Defend
Health Care.

For more information call:

IUE-CWA Local 201 781- 598-2760
Jobs with Justice 617 - 524-8778
Special needs rides available, call 599-7032

(1) 50,000 Stand to Lose MassHealth Eligibility Because of Budget Cuts,
Boston Globe, July 20, 2002
(2) GE Braces for Strike as it lifts CoPays, Washington Post, January 1, 2003
(3) US Health Care System Ranked 37th, Boston Globe, June 21, 2000
(4) Last two facts from Outlook 03, Modern Healthcare, January 6, 2003

Nurses protest lack of contract
<http://www.eagletribune.com/news/stories/20030109/HA_002.htm>
Jean MacDougall-Tattan, Lawrence Eagle-Tribune, January 9, 2003

... 50 nurses held a candlelight vigil because they have been working 15
months without a contract. As nurses patrolled up and down the sides of Brown
Street holding candles and signs that said, "I support Merrimack Valley
nurses" and "A fair contract for Merrimack nurses," security guards made sure
demonstrators stayed on the road and off hospital property. ... Registered
nurses at Merrimack Valley Hospital are frustrated and angry that 15 months
of negotiations have resulted in no contract. When the nurses announced the
vigil, the hospital called it a picket line and warned that employees
scheduled to work better cross it. Hickey said the vigil is not a picket line
and its purpose is to speed up negotiation and get the contract finished.
"This is not a picket line. Everyone here is off-duty and no one has been
asked not to work," Hickey said. City Councilors William H. Ryan and James J.
Fiorentini mingled with demonstrators. Fiorentini said he was there to listen
and learn. Ryan was there to support the nurses. "I'm here for solidarity
with the unions. They need to be recognized. This city was built on good
labor relationships. The new owners of the hospital are Southerners from a
right-to-work state, but in Massachusetts we respect labor. This Tennessee
group will learn that nurses are a powerful group in Massachusetts," Ryan
said. ... Essent Healthcare, a for-profit company from Nashville, bought the
city-owned Hale Hospital in September of 2001. Back then Essent said it would
not honor the union contract in place for Hale nurses but would negotiate a
new contract. ...

Hello Everyone,

On behalf of the Merrimack Valley RN bargaining unit I want to extend a
sincere thank you to all who braved the cold to join us last night for our
candlelight vigil. It was an impressive show of unity with nurses from
Lawrence General, Anna Jaques, Cambridge, Whidden, Quincy, UMass Worcester,
and Northeast in Beverly; MNA Board members, and MNA Staff joining well over
60 of our MVH nurses. I am hopeful that this will be the impetus for the
hospital to settle this contract very soon.(One can only Hope!) Again I am
most appreciative of your support in our struggle to obtain a fair and
equitable first contract with the hospital.

Thanks, Jeanine Hickey

GE Facing 2-Day Job Action
<http://www.ctnow.com/business/hc-gestrike0108.artjan08,0,4373761.story?coll=h

c%2Dheadlines%2Dbusiness>
John Christoffersen, Associated Press, January 8, 2003

Fairfield, Conn. - Thousands of General Electric Co. workers plan a two-day
national strike next week to protest an increase in health care copayments,
GE and union officials said Tuesday. Union officials say as many as 20,000
employees will go out on strike Jan. 14 and 15 in what will be the first
national strike at General Electric since 1969. GE said it received strike
notification from The International Union of Electronic
Workers/Communications Workers of America (IUE/CWA), which represents about
13,900 employees, or 5 percent of GE's total work force. The United
Electrical Radio and Machine Workers of America, which represents about 5,000
GE employees, will strike at the same time, said Stephen Tormey, the union's
secretary. On Jan. 1, General Electric said it increased four co-payments for
employees participating in the GE Health Care Preferred plan by about $200
for each employee in 2003. GE's average health care cost for each employee is
expected to be $2,350 higher in 2003 than in 1999, the company said. ...

Youngstown, Ohio-Area GE Workers to Join Strike over Health Care Co-Pays
<http://hoovnews.hoovers.com/fp.asp?layout=displaynews&doc_id=NR200301081180.3

_6d2a000a55c0a985>
Vindicator, January 8, 2003

Austintown, Ohio - About 800 General Electric Co. employees at three local
plants will join thousands of unionized GE workers nationwide in a 48-hour
strike next week in a protest of increases in health care co-payments. Janet
Bernard, president of Local 734, International Union of Electrical
Workers-Communication Workers of America, said the walkout is set to start
with the midnight shift Monday and to continue through Wednesday at midnight.
"Technically, we have to call it a strike, but it's more like a protest or a
demonstration," she said. "We want the company to take us seriously. Even
though they're sending our jobs to Mexico and overseas, we want them to know
that the union is still a force to be reckoned with at the bargaining table."
...

GE union calls for 2-day national strike
<http://www.boston.com/dailyglobe2/008/business/GE_union_calls_for_2_day_natio

nal_strikeP.shtml>
Reuters, January 8, 2003

General Electric Co.'s largest US union yesterday called a two-day national
strike beginning Jan. 14 as workers battle the conglomerate over an increase
in their out-of-pocket medical expenses. The first national strike at GE
since 1969 would affect up to 17,000 workers who belong to the International
Union of Electronic Workers, Communication Workers of America, union
president Edward Fire said. ''This is one of those things where we feel we
have to draw the line with [GE], and that's exactly what we're doing,'' Fire
said. The union, whose members work in most GE operations, ranging from
manufacturing to broadcasting, said GE has increased employee out-of-pocket
health care expenses, on average, by $400 per year. The company said the
average annual increase was only $200 per employee. The IUE-CWA workers
represent about 5 percent of GE's global work force. GE said it counts 13,900
IUE-CWA workers in its employee ranks. ...

Health insurance costs fire up unions
<http://story.news.yahoo.com/news?tmpl=story&u=/usatoday/20030109/ts_usatoday/

4764629>
Julie Appleby, USA Today, January 9, 2003

Rapidly rising health care costs are causing strife at bargaining tables
nationwide as employers seek to shift some of the burden to workers while
unions battle to save benefits. The first major skirmish this year is
expected Tuesday when up to 17,500 General Electric unionized workers plan to
begin a two-day strike to protest higher health insurance deductibles that
are expected to cost GE's full workforce at least $28 million. As spring and
summer approach, the auto industry, telecommunications firms, state workers
and janitors are also expected to face tough negotiations over new contracts.
While health care coverage has always been an issue at the bargaining table,
it has risen to the No. 1 spot because of rapidly rising medical inflation.
''Until we take some of the profit out of health care and start serving the
needs of people, this crisis will not get better,'' says Stephen Tormey,
spokesman for the United Electrical, Radio and Machine Workers of America,
one of two unions that has called the strike at GE. ...

California:

The Case for Single Payer
<http://www.scma.org/magazine/scp/wn03/shearer.html>
John R. Shearer, MD, Sonoma Medicine, Volume 54, Number 1 (Winter 2003)

The health care crisis in Sonoma County is a local manifestation of a
systemic failure of health care delivery across the United States. The system
(or non-system) that we now cope with is a complicated and inefficient mix of
private and public health insurance. The goals of private insurers involve
business considerations much of the time: competition, marketing, CEO
salaries, and profits. Insurance premiums paid for health care are diverted
and wasted by billions of dollars of middleman expenses. At the same time,
state and federal budget considerations undermine realistic support for
programs such as Medicare, Medicaid, and others. This public/private system
has been modified many times, and still the situation worsens. The result:
millions uninsured, more millions underinsured, hospitals failing, doctors
struggling financially, and shortages of nurses and other health
professionals. It is no longer credible to maintain that the current system
works; it is also no longer meaningful to proceed with modifications of a
system that has failed. And, over and above economic and political issues,
there is the moral issue of health care justice. What is vitally needed is a
program that provides access to quality health care for everyone in
California, with free choice of doctor and hospital. A single-payer system,
publicly funded and administered by the state, fulfills the requirements of
such a program.

Quote-of-the-day mailing list: Quote-of-the-day@mccanne.org
<http://two.pairlist.net/mailman/listinfo/quote-of-the-day>

Tenet reveals new US probe
Medicare payments at issue, hospital says
<http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/01/03/

MN126770.DTL>
Wyatt Buchanan, San Francisco Chronicle, January 3, 2003

Garamendi returning, faces industry challenges
<http://www.bayarea.com/mld/mercurynews/business/4873290.htm>
Deborah Lohse, The Mercury News, January 4, 2003

John Garamendi, elected in November to the insurance commissioner job he held
a decade ago, has a plateful of problems awaiting him as he takes office
Monday in Sacramento. Most of all, Garamendi - a Democrat widely viewed as a
future gubernatorial candidate - plans to pound the pulpit for "universal
health insurance,'' which he envisions as coverage that every Californian
will have whether they are employed or not. Garamendi plans to continue his
decades-long quest for "universal health care" similar to the national
systems of Canada or other nations. ...

Tenet faces federal suit over Medicare billings
<http://www.boston.com/dailyglobe2/010/business/Tenet_faces_federal_suit_over_

Medicare_billingsP.shtml>
Associated Press, January 10, 2003

Maine:

Study says single-payer system feasible
<http://www.sunjournal.com/story.asp?slg=121902single>
Bonnie Washuk, Lewiston Sun Journal, December 19, 2002

Augusta - Maine's combined health care spending, including public and private
dollars, was $4.7 billion in 2000. Now it's $6 billion and will explode to
$8.4 billion by 2004, Deborah Chollet of Mathematica Policy Research Inc.
told a legislative committee Wednesday. "It's the Pac Man that eats your
state if it continues at this rate," she said. Costs will hit nearly $11
billion in 2008 if the status quo continues. The Washington, DC, firm that
studied health care costs and spending in Maine has concluded that a
single-payer system is economically feasible. It cautioned, however, that the
plan would be expensive without "cost sharing" or co-payments. "This is
Mathematica's Christmas present to the state of Maine," said former Rep. Paul
Volenik, D-Brooklin, co-chairman of the Health Security Board. "This is
doable." Under one plan being considered, most needs - including prescription
drugs, basic dental and mental health - would be covered. The poor would make
no co-payments, while moderate or high-income residents would make
co-payments such as $10 to see a primary care doctor, $20 for a specialist,
$10 for generic drugs and $35 for name-brand prescriptions. One way to pay
for such a plan would be a new 10 to 11 percent payroll tax that would
replace insurance premiums. ...

Massachusetts:

Beacon Hill grapples with quagmire of health care for the poor
<http://www.s-t.com/daily/12-02/12-15-02/b06sr076.htm>
Jennifer Peter, Associated Press, December 15, 2002

Doctor cites support for changing system
<http://www.berkshireeagle.com/Stories/0,1413,101%257E6282%257E1055767,00.html

?search=filter>
DR Bahlman, Berkshire Eagle, December 16, 2002

Pittsfield - Support for a single-payer health care insurance system appears
to be gaining among health care providers in Berkshire County, according to a
survey conducted by a Great Barrington physician. Dr. David Lippman said
that, of those who responded to his survey of all practicing physicians in
the county, 86 percent stated that they might favor a single-payer system.
The survey was sent to members of the Berkshire District Medical Society; he
could not provide exact figures about the numbers of surveys sent out or
returned. He noted that many of the county's health care providers were not
surveyed because they are not on the rolls of the medical society, which has
about 200 members. He also said that a wide range of opinions were expressed.
"Some said they wanted the government out of it entirely," he said. Lippman
and other members of MassCare, a statewide organization that advocates for a
single-payer "universal" health care system, note that Massachusetts
residents pay the highest health care costs in the nation - 30 percent above
the national average per person, according to a 2000 study by two Boston
University researchers - and that a single-payer system would reduce those
costs substantially. "The whole state will pay less for health care under a
system that will cover every single person in the state," said Jean Dillard
of Lenox, a nurse who is a member of MassCare. "If such a system had been
instituted in 2000, the state would have saved approximately $1.2 billion in
that year alone." Citing the BU study, Dillard declared that "the biggest
things we're paying for now are administrative costs and the million-dollar
salaries of CEOs of insurance companies and pharmaceutical companies." Under
a single-payer system, said Dillard, "you could forget those costs, forget
the costs of advertising that those companies and some hospitals and some
doctors do, forget about costs of the bodily injury coverage in auto and
homeowners' insurance policies and the bodily injury portion of Workers'
Compensation." ...

Support grows for single-payer
<http://www.berkshireeagle.com/Stories/0,1413,101%257E6267%257E1057425,00.html

?search=filter>
Berkshire Eagle, December 17, 2002

Would that the Legislature give serious consideration to the recommendations
of the Berkshire District Medical Society. Eighty-six percent of the county's
doctors responding to a society survey have expressed approval for a
single-payer health care system providing health insurance for all
Massachusetts residents. Although HMOs were supposed to keep them down, the
costs for health care coverage have been skyrocketing instead, as those
signing up for next year's benefits are discovering. The situation in
Massachusetts amounts to a crisis: Half a million citizens are without health
coverage; those who do have insurance pay premiums 30 percent higher than the
national average. The financial stress the current system imposes upon our
hospitals, doctors, and care givers, and the resulting abbreviated medical
care available to the average person, is too high a price to pay for homage
to the golden calf of free enterprise. A single-payer system makes economic
and moral sense.

Blue Cross to give doctors care-, cost-based bonuses
<http://www.boston.com/dailyglobe2/351/nation/Blue_Cross_to_give_doctors_care_

cost_based_bonusesP.shtml>
Liz Kowalczyk, Boston Globe, December 17, 2002

Blue Cross has new bonus plan: To pay doctors' groups that keep costs low
<http://ledger.southofboston.com/archives>
Julie Jette, The Patriot Ledger, December 18, 2002

Final Report - Advisory Committee on Consolidated Health Care Financing
<http://www.state.ma.us/healthcareaccess/pages/pdf/appendjj.pdf>
Statement by Phil Mamber, President, Massachusetts Senior Action Council,
December 18, 2002

The long overdue, state funded report on how to consolidate health care
financing and achieve universal health care access and coverage, while
failing to accomplish its assigned task, adds to the growing list of data
supporting a single payer health system.

The report concurs with the long held position of MSAC that a universal,
comprehensive, single payer system is the only system that would guarantee
coverage for every Mass. resident and the report graphically demonstrates
that billions of dollars are wasted on administrative costs in the present
fragmented and inefficient system. However, the report fails to fullfill its
mandate to develop a plan for consolidating all health care financing and
also fails to use as one of the models the most efficient and cost effective
single payer system.

Also, the final recommendation of the consultants to continue incremental
additions to Mass Health fly in the face of today's reality. We can see today
that when the economy goes sour that the poorest and frailest among us will
be the first to lose their health care.

This report comes out at a time of crisis for health care in our state.
Because of the budget crisis created by the economic downturn and excessive
tax breaks to corporations and the wealthy, over 50,000 Mass. Health
recipients will lose coverage next year. Thousands of seniors are being
thrown out of medicare HMOs. Workers are paying more and more for less and
less health care coverage. Early next year, workers at GE in Lynn may strike
over increased health care costs. And, in fact, most strikes over the past
decade have been about who pays how much for what level of health care. The
number of completely uninsured is going up and the World Health Organization
rates our nation 37th in the world in health care coverage for our people.

If we learn nothing else from the health care crisis in our state, it should
be that when times get tough, the poorest and frailest among us will always
be the first to lose their health care unless everyone in our state is an
equal stakeholder in the same system. That is why we should go for the best -
a universal, comprehensive, single payer health care.

For More Information, Contact: John Boesen (617) 442-3330 or Phil Mamber
508-697-5849

Panel eyes options for health coverage
<http://www.businesstoday.com/business/business/heal12202002.htm>
Jennifer Heldt Powell, Boston Herald, December 20, 2002

Providing health care for everyone in the state would cost up to $48 billion
a year, about $6.6 billion more than is now spent, said a report released
yesterday. The long awaited report from a legislative Advisory Committee
outlines three universal coverage options. It will be turned over to the
Legislature by the end of the year. ``We don't see this proposal as offering
the ultimate solution, but we do see it as an extremely important step in
that direction,'' said Dr. John Goodson, a committee member and universal
health care advocate. Government and private payers will spend $41.4 billion
on health care this year, the report said. But more than 399,000 people had
no insurance. The cheapest universal health care plan outlined in the report,
with a price tag of up to $45.3 billion, would expand Medicaid eligibility.
The next option would require everyone to buy or get health insurance. The
total cost would be $45.7 billion. Under the final and most costly plan, the
state would become the sole payer of health care. The $48 billion cost would
be covered by a variety of taxes. The planning started two years ago when the
state was better off, said Rick Lord, president of the Associated Industries
of Massachusetts. ``It's a worthy goal, but I think it's unrealistic given
the current financial troubles.'' Sen. Mark Montigny (D-New Bedford),
co-chairman of the advisory committee, said the report should spark a debate
in the upcoming legislative session. ...

Consultants urge universal health care in Mass.
Plan to be proposed to Legislature would cost up to $6b extra
<http://www.boston.com/dailyglobe2/354/business/Consultants_urge_universal_hea

lth_care_in_Mass_P.shtml>
Liz Kowalczyk, Boston Globe, December 20, 2002

As health insurance grows too expensive for many people to afford,
consultants this month will deliver to the Legislature a controversial
solution: a plan for establishing universal health care in Massachusetts that
would cost an extra $3 billion to $6 billion annually but would provide rich
benefits to every person. Two years ago, the Legislature appointed a special
advisory committee and requested a consultants' plan to guarantee health
insurance for all state residents. But that was a year when Massachusetts
residents nearly approved a referendum requiring medical coverage for all
residents, and before one of the worst financial crises in the state's
history. Now, as universal health care supporters gear up again to push the
idea, the Legislature is in the middle of subtracting - not adding - health
care services and the incoming governor is firmly opposed to a single-payer
system. ''Given the state's dire financial circumstances, this is not the
appropriate time to be talking about dramatic expansions of health care,''
said Mitt Romney's spokesman, Eric Fehrnstrom. Supporters said they are
realistic about the budget crisis but that the consultants' report is a way
to open the debate. They will ask the Legislature to appoint a special
commission to build consensus for health care as a right in Massachusetts and
draw up a more detailed plan. ...

Response to Publication of LECG Report on Consolidated Healthcare Financing
Massachusetts Campaign for Single Payer Health Care (MASS-CARE), December 20,
2002

Report of LECG, consultants commissioned by the Massachusetts Legislature,
finds single payer system is the only model to deliver health care for all
but fails to deliver long-awaited "road map" for legislators to follow to
achieve universal coverage and unified funding system.

Boston, Mass. - LECG, the consulting firm hired to guide Massachusetts in
providing health care for all is about to release a report that shows that
"single payer" is the only way to actually achieve health care coverage for
every resident. The report also confirms that almost 40% of every health care
dollar now spent in Massachusetts goes to administrative costs. However, the
report, due for official release on December 30, does not fulfill the purpose
for which it was commissioned in the view of MASS-CARE, the coalition of more
than 80 organizations that support a single payer system in Massachusetts.
According to MASS-CARE's Chair, Margaret O'Malley, RN, "This report is a
politically biased product. A full and fair analysis was sabotaged by
powerful special interests. As a result, LECG fails to provide legislators
the long-awaited 'road map' to achieving universal coverage and the funding
system that would fairly pay for it." In the summer of 2001, the Legislature
appropriated $250,000 to develop a transition plan for "consolidated health
care financing and streamlined health care delivery accessible to every
resident in the Commonwealth" as its commitment to advocates for health
reform who, in turn, agreed to push for universal coverage through the
Legislature instead of through a ballot initiative. The legislation called
for the creation of a guide for legislators to move from the present chaos to
a unified, universal system. MASS-CARE believes the report fails to deliver
on its mandate. LECG presents three models of health care delivery, two of
which do not meet the standards of universal coverage and consolidated
financing. While acknowledging that only the single payer proposal meets both
standards, LECG neglects to objectively analyze the costs and benefits of all
three models. In its analysis of its "single payer"model, LECG underestimates
the savings that would be achieved by creating a real single payer system in
Massachusetts. The basic premise of a single payer system is the elimination
of the costs of dealing with the bureaucracy of private insurance. Yet LECG
has assumed a significant continuing role for insurance companies in its
"single payer" model, thus retaining a large component of administrative
costs. At the same time, LECG assumes there will be no savings from a system
that provides timely, coordinated care in appropriate settings instead of the
costly care we all hear about when sick, uninsured folks end up in ER's with
health problems that could have been treated more cost-effectively before
they became serious. Furthermore, in its comparison of single payer to the
two models not providing universal coverage, LECG omits the costs of those
remaining uninsured as though people without insurance have no health care
costs. Such omissions in LECG's analysis could have inflated their
bottom-line cost estimate for a "single payer" system by as much as $3
billion. If so, moving to a true single payer system would more than pay for
comprehensive coverage and benefits, including prescriptions and long-term
care. That would be consistent with previous reports of two consultants
commissioned by the Massachusetts Medical Society. Independently, they
concluded that if Massachusetts adopted a single payer system covering
everyone, it would save us $1billion annually. In its report of 140-plus
pages, LECG does furnish useful information which, oddly, is not usually
available to policymakers in Massachusetts. While other states routinely
collect data on the condition of their health systems, several years ago
Massachusetts stopped collecting this information, essential to informed
decision-making, The information collected by LECG demonstrates that
"business as usual" is simply unsustainable. With the highest costs in the
nation, the Massachusetts health care system threatens to bankrupt the State
budget, as well as health facilities, employers and individuals while leaving
over 400,000 uninsured, mostly workers and their children. Nurse economist
Judith Shindul-Rothschild points out that this year is the right time to cut
back on costs by enacting single payer. "The Massachusetts budget is
projected to reach record deficit levels and 52% of that budget is directed
toward health care. We as a State must make up our minds to act." The
Legislature expected a report to help Massachusetts move to a health care
system that fairly and efficiently provides coverage and care for all. In the
end, the LECG report did not deliver what their contract called for, thereby
placing the taxpayers' investment in a better health care system at grave
risk. Policy analyst Barbara Roop concludes, "A determined reader of the LECG
report will be rewarded, and perhaps surprised, when they discover that,
despite its very conservative assumptions, LECG concludes that its single
payer model is the only proposal examined that will provide universal
coverage and the only proposal that will save money. A real single payer
system would save substantially more."

Consumers face prescription tax
<http://www.boston.com/dailyglobe2/355/business/Consumers_face_prescription_ta

xP.shtml>
Bruce Mohl, Boston Globe, December 21, 2002

No time for universal health
<http://ledger.southofboston.com/archives>
The Patriot Ledger, December 26, 2002

The commonwealth is in a full-fledged fiscal crisis, with state services
affecting virtually every resident being cut. Health care is no exception. In
fact, the poor who receive care through Medicaid are losing numerous
benefits, and hospitals are bracing for even harder times. Against this
backdrop, a published report that says local health-care advocates are
proposing a new debate on universal health care is just incredible. What can
these people be thinking? The notion is to appoint a special commission to
examine health care as a right in Massachusetts. Why now? Because, as one
supporter said, ''You're never going to change things unless you're willing
to start looking at how to do it.'' This country needs to have a health care
debate, but this state doesn't need to have one, certainly not now. The best
minds in and out of state government will be spending the next few years
figuring out how to sustain bedrock health services while state revenues are
dropping and reimbursements from Washington continue to decrease. ...

Mass. group backs ban on drug firms' gifts to docs
<http://www2.bostonherald.com/news/local_regional/docs12272002.htm>
Michael Lasalandra, Boston Herald, December 27, 2002

Some options to beat new prescription tax
<http://www.boston.com/dailyglobe2/363/business/Some_options_to_beat_new_presc

ription_taxP.shtml>
Bruce Mohl, Boston Globe, December 29, 2002

The mentally ill deserve better care
<http://www.boston.com/dailyglobe2/363/oped/The_mentally_ill_deserve_better_ca

reP.shtml>
Mark Vonnegut, MD, Boston Globe, December 29, 2002

$11m Medicaid cut takes effect today
<http://www.boston.com/dailyglobe2/001/metro/_11m_Medicaid_cut_takes_effect_to

dayP.shtml>
Alice Dembner, Boston Globe, January 1, 2003

Shooting suspect left mental health system
<http://www.boston.com/dailyglobe2/003/metro/Shooting_suspect_left_mental_heal

th_systemP.shtml>
Ellen Barry & Farah Stockman, Boston Globe, January 3, 2003

Blues pledge to guarantee Magellan bills
<http://www.businesstoday.com/business/business/blu01032003.htm>
Jennifer Heldt Powell, Boston Herald, January 4, 2003

'Boutique' medicine emerging as expensive alternative
<http://ledger.southofboston.com/archives>
Sue Reinert, The Patriot Ledger, January 4, 2003

Health officials preparing for flu epidemic
As part of plan to curtail diversions of ambulances
<http://ledger.southofboston.com/archives>
Sue Reinert, The Patriot Ledger, January 4, 2003

Disabled man's death expands state inquiry
<http://ledger.southofboston.com/archives>
Casey Ross, The Patriot Ledger, January 6, 2003

Advice for the new governor
Heroic measures need on health
<http://www.boston.com/dailyglobe2/006/oped/Advice_for_the_new_governorP.shtml
>
John D. Goodson, MD, Boston Globe, January 6, 2003

Is there a crisis in health care? Most have heard the cries of alarm enough
to be skeptical, but the true crisis is probably close enough that you or
someone well known to you will be personally touched in the year ahead. Who
will not have health insurance, who will not be able to afford medication,
who will spend a day or more in an emergency room waiting for a bed? The
control of health care costs has become a national priority. Health insurance
premiums have jumped 12 percent, a rate of inflation that surely cannot
continue. Paychecks have been tapped dry by the faltering economy and growing
unemployment rates. Single-income families are in distress. The federal
government is unable to allocate more resources to health care. The
prescription benefit of Medicare is an unfulfilled promise. Massachusetts is
cutting state expenditures. Tax revenues are down, the economy is weak, and
there is no more money to spend on health care. Can we find a way to expand
access and preserve excellence with the dollars we currently spend on health
care? Can we be smarter, more rational, and more humane with our state's
health care dollar? ...

Hurting the state's most vulnerable
<http://www.boston.com/dailyglobe2/007/letter/Hurting_the_state_s_most_vulnera

bleP.shtml>
Robert Restuccia, Boston, Boston Globe, January 7, 2003

Your Jan. 1 City & Region story ''$11m Medicaid cut takes effect today''
provides insight into the human dimension of the elimination of coverage for
eyeglasses, dentures, orthotics, and prosthetics to thousands of the
Commonwealth's most vulnerable residents. It is heartening that some
providers are pursuing a strategy of seeking help from charities and dipping
into their own funds to try to meet patients' needs rather than allow people
to go without these essential services. However, we believe that a more
direct approach is needed. More than 140 organizations, led by Health Care
For All, are trying to overturn and restore these cuts. By eliminating
Medicaid coverage for these services, Massachusetts is losing $11 million of
federal funding that can be used to pay for these critical services. Denying
health care coverage for essential services is fundamentally immoral. We are
too affluent a society to tell a 21-year-old amputee that we cannot afford to
provide him with an artificial limb or a nursing home resident that we cannot
provide her with dentures or eyeglasses.

Robert Restuccia is Executive Director, Health Care For All, Boston.

A recurring fiscal malady
<http://www.boston.com/dailyglobe2/007/business/A_recurring_fiscal_maladyP.sht

ml>
Charles Stein, Boston Globe, January 7, 2003

The New England Journal of Medicine recently published a study on one of the
most controversial health care experiments of the 1990s: the 24-hour
maternity stay. Pushed by health maintenance organizations on both coasts,
the quicker deliveries were designed to cut the length of hospital stays and
save money. The move sparked a huge backlash against managed care - opponents
derisively labeled the shorter stays ''drive-through'' deliveries - and the
HMOs retreated. The New England Journal study suggests the angst may have
been misplaced. In Boston, at least, the babies did fine. They had no more
medical problems than babies whose mothers stayed in the hospital the
traditional two days. But the study was interesting for more than its
conclusion. It was a reminder that until quite recently, America had a
definite strategy for keeping a lid on health care costs: squeezing the
hospital system. For most of the 1980s and 1990s, both the government and
private sectors worked hard to shorten hospital visits, cut the number of
hospital beds, and, in some cases, eliminate hospitals altogether. It was a
market approach that treated health care like the steel or automobile
industries: Wring out the inefficiencies, and you will cut the costs. Now
that medical costs are rising rapidly again, it is worth asking a few
questions about the old strategy: Did it shrink the system? Did it restrain
costs? And why isn't it working anymore? On the first count, the answer is
clear: The system got smaller. Over the course of the 1990s, the number of
hospital beds in Massachusetts declined by 24 percent, the number of
inpatient hospital days dropped by 28 percent, and the average length of stay
fell 21 percent. ..

Tufts Health Plan will shed up to 80 jobs in bid to cut costs
<http://www.boston.com/dailyglobe2/010/business/Tufts_Health_Plan_will_shed_up

_to_80_jobs_in_bid_to_cut_costsP.shtml>
Liz Kowalczyk, Boston Globe, January 10, 2003

USA:

More states flirt with universal healthcare
From Maine to California, interest revives in a policy once derided as
'Hillary-care.'
<http://www.csmonitor.com/2002/1216/p02s01-uspo.html>
Mark Sappenfield, The Christian Science Monitor, December 16, 2002

Santa Rosa, Calif. - Nearly a decade after President Clinton turned
"universal healthcare" into perhaps the most dreaded phrase in the American
political vocabulary, the topic is beginning to reemerge in states
nationwide. In the past few months, Maine has created a state board to draw
up proposals for universal care. The Rhode Island General Assembly released a
study on the idea. Oregon put it on the ballot, and the head of one of
California's largest health-insurance companies has called for a plan to
cover all residents. The return of universal healthcare as a serious issue of
debate, so soon after its rejection by Congress and the country, points to
more than bad economic times, experts say. It is an indicator of how dire the
situation in American healthcare has become. Some observers suggest this year
could be a perfect storm, as new drugs and technologies drive up costs, the
ranks of the uninsured grow, and states slash deficits by cutting medical
aid. Others suggest that the crisis hasn't yet reached the level of the early
1990s, which gave rise to the Clinton plan, spearheaded by his wife, Hillary.
This time, however, pressure for reform is coming not from the top down, but
from states themselves. What happens in a handful of these states - from
California to Maine - could shape the nation's healthcare discussion. ...

FDA counsel's rise embodies US shift
<http://www.boston.com/dailyglobe2/356/nation/FDA_counsel_s_rise_embodies_US_s

hiftP.shtml>
Michael Kranish, Boston Globe, December 22, 2002

Editorial Comment: In Seachange Bulletin #98, we pointed out the
anti-single-payer bias of NBC's coverage of the Oregon ballot question
Measure 23 (ACTION ALERT: NBC Slams Universal Health Care), and urged readers
to send in letters of protest. Here's the response of one Massachusetts
nurse. By the way, NBC is owned by GE. - SE

To Roger O'Neil and Tom Brokaw,

I have been a nurse for 14 proud years. I have worked on health care reform
issues because as someone on the front lines who is also a health care
consumer, I have been deeply concerned and affected by the increasing
difficulty of getting insurance coverage, and of providing the care that sick
people need. I am also a person who is disturbed by the erosion of
investigative journalism. The piece on Measure 23 in Oregon that you aired on
Nov. 5 was neither impartial nor factual. You failed to mention that the "big
3 health insurers" in Oregon who oppose the measure stand to lose millions of
dollars, which feed their profits, their bloated executive salaries, and
their shareholders. They are the same entities who routinely and increasingly
deny needed medical care while raising premiums, pricing hundreds of
thousands of Oregonians out of the health insurance market. You also claimed
that the proponents of Measure 23 describe it as "free" when in fact the
language of the question clearly states that it is "affordable". This piece
was an example of slanted, dishonest "journalism" at its worst. It was merely
editorializing, and you should be ashamed to be hucksters for the owners of
NBC, General Electric, who are heavily invested in the still profitable
health insurance industry. Meanwhile, my patient's insurance companies deny
the care that the physicians and myself know that they need. If you are still
engaged in honest reporting, try reporting a few facts; over 40 million
Americans, most of whom are working and many of whom are children, have no
health insurance coverage of any kind. They are not sufficiently impoverished
to be on Medicaid, yet the costs of significant health care expenditures
frequently bankrupt these families entirely. The National Academy of
Sciences, appointed by the Institute of Medicine, announced on Nov. 19 that
the nation should adopt a universal health coverage plan (like every other
developed country in the world,) as 14% of the US population is uninsured. In
the interests of fairness, which you seem to be not interested in at all, you
should do a factual piece on health care and insurance, this time not
representing the industry, but investigating the issues affecting health care
consumers, doctors, nurses, and the millions of working uninsured. Have you
heard of mega-mergers whereby local commmunity hospitals are frequently
closed, millions of dollars are channelled into executive salaries and the
expansion of large, urban centers, while nurses walk off the job due to
literally dangerous working condition, for patients and themselves, and
hard-working people are unable to afford health insurance? It is a big,
important, and frightening topic. By acting as the mouthpiece for the
insurance industry, you have done nothing to advance the understanding of the
subject; rather, you have deceived Americans with your overt bias and
misinformation. For shame.

Most Sincerely Yours, Martha Klein, RN, MPH

Health care is in 'dire need' of remedies
<http://www.usatoday.com/news/health/2002-12-29-health-care-usat_x.htm>
Susan Page, USA Today, December 30, 2002

Washington - Old foes whose battles have stymied action on health care for
nearly a decade finally agree: Something needs to be done. Their
prescriptions still differ, but leaders of both parties say the growing
number of uninsured Americans and the spiraling increase in health care costs
are pushing the politically treacherous issue onto the national agenda again.
"The health system is so stretched and stressed that something has to be
done. The health care system is in dire need of some sort of transformation,"
Health and Human Services Secretary Tommy Thompson says. "Our current system
is quite literally collapsing," says former vice president Al Gore. The
election last week of Tennessee Sen. Bill Frist as Senate majority leader has
boosted the prospects for action. A doctor who has emphasized health care
issues, Frist noted his experiences when he spoke to reporters after Senate
Republicans chose him to succeed Mississippi Sen. Trent Lott, who resigned
under fire. "We need to focus on the uninsured and those who suffer from
health care disparities that we so inadequately addressed in the past," Frist
said. ...

Penalized drug firm softens sales tactics
<http://www.boston.com/dailyglobe2/002/nation/Penalized_drug_firm_softens_sale

s_tacticsP.shtml>
Anne Barnard, Boston Globe, January 2, 2003

Ill-treated veterans
<http://www.boston.com/dailyglobe2/002/editorials/Ill_treated_veteransP.shtml>
Boston Globe, January 2, 2003

A Rational Health System
<http://www.latimes.com/news/printedition/opinion/la-le-mccanne4jan04.story>
Don McCanne, MD, San Juan Capistrano, Los Angeles Times, January 4, 2003

Re "Rx for Universal Care," editorial, Dec. 29: Although every caring person
agrees that the debate on universal care needs to be moved into the
mainstream arena, considerable confusion remains. Should we build on the
current system of employer-sponsored plans and public programs or should we
replace them with a single-payer system? Although continuing to use private
plans would perpetuate the tremendous administrative excesses that waste
resources that should be directed to patient care, fewer public tax dollars
would be required to expand coverage to everyone. But most individuals and
businesses should be concerned not only about their tax expenditures for
health care; they should be concerned about their total health-care
expenditures, both public and private. An increase in tax funding should not
be objectionable when it is offset by an even greater reduction in private
health-care spending. In a universal system, rationing is determined
primarily by the capacity of the system. A system that reduces administrative
waste increases its capacity. We may be so averse to the words "tax" and
"government rationing" that we may want to continue with a system that wastes
more funds and results in greater rationing. But then again, maybe we're
ready to agree that rational policy should prevail over rhetoric.

Don McCanne, MD is President, Physicians for a National Health Program.

Your editorial has it exactly backward. The plan discussed would cost more
money than a single-payer system. It would increase administrative costs and
add to the increasing complexity and inconsistencies of the present system.
The math is simple: Administrative costs take 3% of the Medicare single-payer
health-care dollar; they take 20% to 30% of the health-care dollars of the
current multipayer system. The single-payer administrative savings can
provide broader coverage for all at much less cost. Any needed increase in
taxes would probably not exceed money we are already paying as part of many
other insurance coverages: personal auto, homeowners liability, workers
compensation, etc. Your dismissal of a single-payer system on grounds that it
has failed to gain needed support is irresponsible. If The Times threw its
support behind a single-payer system your reason for rejecting it would
immediately become untrue. - George E. Delury, Carpinteria

Your editorial quotes the head of Blue Shield of California as advocating a
mandatory medical insurance system requiring all but the smallest employers
to either provide it or contribute to a state insurance pool. There already
is a universal medical program being planned in the form of a bill to be
carried by state Sen. Sheila Kuehl (D-Santa Monica). This would cover all
Californians and be funded by the money already being spent in this state for
medical care and health insurance. The medical insurance industry is opposed
to this legislation because it would eliminate all insurance providers that
do not provide direct services. The plan would use existing doctors,
hospitals, laboratories and other licensed providers of medical services.
What would be eliminated are the marketing, competition, redundant
administrations, stockholder profits, multiple requirements and billing
programs and other costs generated by the for-profit medical insurance
system. Except for the relatively small cost of a state oversight and billing
system, the money would be spent on patient care and everyone would have
medical coverage. - Melvin H. Kirschner, MD, Van Nuys

They Can See It Coming
<http://www.washingtonpost.com/wp-dyn/articles/A9659-2003Jan4.html>
Marcia Angell, MD, The Washington Post, January 5, 2003

We decided to ask forward-looking writers and thinkers: What can't we see
that's coming?
Marcia Angell, former editor-in-chief of the New England Journal of Medicine:

I see the rapid collapse of our health-care system in 2003. The inherent
failings of this system were partly masked by the prosperity of the late
'90s. But with increasing unemployment, businesses no longer have to compete
to attract workers by offering full health benefits. They're free to drop
benefits altogether or limit them severely, and they can require workers to
pick up more of the tab themselves. So people end up paying for their health
care out of pocket or doing without. That's what I mean by the collapse of
the system. About the only part that is working is Medicare, and that is a
publicly funded, single-payer program within the system. ...

When Cure Is Worse Than Disease
<http://www.cbsnews.com/stories/2003/01/09/opinion/meyer/main535869.shtml>
Dick Meyer, CBSNews.com, January 9, 2003

Washington - Despite all the frightening news about war, terrorism, smallpox,
cloning and the revival of "Star Search" right here on CBS, the story that
scared me the most this week was a boring one about health care statistics.
"Health-Care Spending Rises 8.7%, Fastest Expansion in 10 Years," ran the
headline in The Wall Street Journal. I quake - and not because I'm a deeply
informed health policy wonk and really understand what this stuff means. I
worry because I remember reading the same headlines in the late 1980's and
early 1990's. And I remember what happened next. The Hillary Commission.
Managed care. HMOs. PPOs. PDOs. Before then, the only O I had ever heard of
was in UFO. So I wonder what's going to happen this time. The government
report on 2001 health spending said something is bound to happen,
"Historically, increases of this size have been closely followed by
government policy changes or private sector initiatives to put the brakes on
health care spending growth." Uh-oh. The Republicans know exactly what they
want to do to control the growth of health care spending; they want to make
Medicare and other public programs more like private, market systems. More
like managed care. That's what scares me most. But this latest report seems
to weaken the case for privatizing public programs. ...

Bill Frist:

Hooray! The Republicans are dropping that bad old southern boy Sen. Trent
Lott, who spoke in code to his good old boys, for that good old southern boy
Sen. Bill Frist, who is more concerned that vaccine makers are protected from
liability suits. We have known for years that southern politicians used code
to tell their white constituents that they were really one of them. Both the
GOP and DEMS used these codes but the GOP welcomed the likes of Strom
Thurmond, Jesse Helms and Phil Gramm into their party to win the South. We
will have to wait and see if Lott and his Republican colleagues have really
changed. Now the Republicans want to turn to Bill Frist whose family founded
the for-profit hospital chain Hospital Corporation of America. A provision
that Frist wrote to protect vaccine makers just happened to be slipped in at
the last moment by retiring Rep. Dick Armey into the Homeland Security bill.
By the way, the Bush administration just blocked a draft agreement for the
World Trade Organization to allow poor countries to order cheap copies of
patent drugs. My, my, we do have to protect that 19% profit for the
Pharmaceutical Industry. Ho, hum. Sounds like the same old GOP to me.

Timothy G Macchio, Boston, Massachusetts, USA

A Spoon Full Of Sugar
Is Bill Frist Bitter Medicine?
<http://tompaine.com/feature.cfm/ID/6991/view/print>
Joshua Micah Marshall, tompaine.com, December 23, 2002

Karl Rove may have spent the last two weeks pulling the remaining hair out of
his head over the messy and embarrassing Trent Lott affair. But whatever
damage it may have had on the GOP's (and thus the administration's) image,
the White House could not have been more pleased with the end result: the
elevation of Senator Bill Frist to serve as the next Senate Majority Leader.
Frist was on George W. Bush's short-list of possible vice-presidential
candidates in 2000 and he remains a close White House ally. But the
connection runs deeper. Frist is a 50-year-old Southern senator cut from
President Bush's 'compassionate conservative' fabric. Trent Lott never really
warmed hearts at the White House partly because administration leaders
doubted his political skills. But he is also weighed down with lots of the
old-style, hot-button conservative baggage the White House is trying to leave
behind. Frist is different. He is affable, attractive, professedly
non-ideological and - like the president - firmly allied with large corporate
interests. In Frist's case, those industries are the health care and
pharmaceutical industries who want a decisive hand in shaping the health-care
reform agenda which seems certain to be at the heart of the next congress. ...

Frist leadership in Senate shows clout of doctors
Most physicians see no easy fixes
<http://www.boston.com/dailyglobe2/005/nation/Frist_leadership_in_Senate_shows

_clout_of_doctorsP.shtml>
Raja Mishra, Boston Globe, January 5, 2003

Malaysia:

MMA seeks health cover for all
Pritam Singh, New Straits Times, December 22, 2002

Kuantan - The Malaysian Medical Association (MMA) has proposed to the
Government the setting up of a national health financing scheme that will
provide coverage for all citizens. MMA president Datuk Dr N. Athimulam said
under the proposal, already presented to Prime Minister Datuk Seri Dr
Mahathir Mohamad, the young would subsidise the old, and the rich would
subsidise the poor. "The MMA feels any insurance scheme should be owned and
run by the Government, and operated as a non-profit entity," said Dr
Athimulam at the 20th annual installation dinner of the MMA's Pahang branch
here last night. Dr Athimulam said insurance schemes run by private companies
were profit-oriented and were only willing to insure the healthy. "The
private sector should not compete with the scheme, but complement it, and the
Government should be the single payer of medical expenses."

New Brunswick:

Hospital group says no to private management
<http://nb.cbc.ca/template/servlet/View?filename=nb_lordprivate010303>
CBC, January 2, 2003

Fredericton - The New Brunswick Health Coalition is rejecting Premier Bernard
Lord's musings about privately managed hospitals. Lord says allowing private
companies to own or maintain hospitals is an idea worth looking at. He also
says medical services wouldn't be affected and would remain public and free.
But health coalition spokesperson Wayne MacDonald says Lord's guarantee may
not be worth much. ...

MA Report: <http://www.state.ma.us/healthcareaccess/pages/pdf/report_1.pdf>
ME Report: <http://www.state.me.us/legis/opla/MathematicaFinalReport.pdf>
RI Report:
<http://dcc2.bumc.bu.edu/hs/Upload112702/SPRI%20RI%20UHC%20report%2025%20Nov%2

002%20final%20with%20summary.pdf>

Web Directory:

AARN <http://www.aarn.org>
Australian Nursing Federation <http://www.anf.org.au>
California Nurses Association <http://www.calnurses.org>
Canadian Federation of Nurses Unions <http://www.nursesunions.ca>
CCDS <http://www.cofc.org>
Irish Nurses Organisation <http://www.ino.ie>
Labor Party <http://www.thelaborparty.org>
LabourStart <http://www.labourstart.org>
Maine State Nurses Association <http://www.mainenurse.org>
Massachusetts Ad Hoc Committee <http://www.massadhoc.org>
Massachusetts Green Party <http://www.massgreens.org>
Massachusetts Nurses Association <http://www.massnurses.org>
MASS-CARE <http://www.masscare.org>
New York Professional Nurses Union <http://www.nypnu.org>
New Zealand Nurses Organisation <http://www.nzno.org.nz>
PASNAP <http://www.pennanurses.org>
PNHP <http://www.pnhp.org>
Revolution Magazine <http://www.revolutionmag.com>
Seachange Bulletin <http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition <http://SAZNC.homestead.com>
Union Web Services <http://www.unionwebservices.com>
United Health Care Workers <http://www.uhcw.org>

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