FIX IT - Health Care at the Tipping Point DVD

This video was produced by the president of a multimillion dollar company, MCS Industries, in Pennsylvania who eloquently points out how of the rapidly escalating and unpredictable costs of healthcare are his biggest expense the biggest threat to his solvency as business and why he favors single payer (single risk pool, unified payer) health care.  The full video is about an hour long, the shortened version is 40 minutes. There is a three minute trailer as well on the disc.

If you are interested in seeing the video or obtaining a copy, please contact us and we will make it happen.

Fix It Healthcare - At The Tipping Point a powerful new documentary that reaches across the political and ideological divide to expand support for major healthcare reform.

Here is what Ralph Nader has to say about FIX IT in a recent Huffington Post column:

Just when the prospects for single-payer or full Medicare for everyone, with free choice of doctors and hospitals, appear to be going nowhere, from Pennsylvania's Lehigh Valley comes a stirring that could go national and make single-payer a reality.

Throwing down the gauntlet on the grounds of efficiency and humanness, businessman Richard Master, CEO of MCS Industries Inc., the nation's leading supplier of wall and poster frames, is bent on arousing the nation's business leaders to back single-payer - the efficient full Medicare for all - solution.

The woefully wasteful and profiteering health care industries have blocked majority opinion, and a majority of physicians and nurses, to keep the present sky-high costly system in place, that receives huge taxpayer subsidies without any reasonable, and meaningful, price restraints. Health care companies exploit the complexities of Obamacare, which is powerless to restrain price spirals (note the staggering rise in recent prices of certain drugs). But the health care industry cannot defeat an organized business community fed up with uncontrollable cost burdens and the further competitive disadvantages they experience with western European countries, Japan or Canada - countries that have single-payer systems at half the per capita costs or less.

Mr. Master's first step is now complete. He has produced a short movie called "Fix It: Healthcare at the Tipping Point" which makes a powerful business case for replacing the current wasteful multi-payer system with a single payer one. He traveled with his award-winning filmmakers to Canada, where he interviewed doctors, nurses and conservative business people. The latter were aghast over why their fellow conservatives in the U.S. are not seeing the light.

One industrialist, Dann Konkin, told the filmmakers that he embraces the Canadian healthcare system because it reduces his company's costs. The film quotes Michael Grimaldi, former president of General Motors of Canada, as declaring that the Canadian healthcare system "significantly reduces total labor costs for automobile manufacturing firms." His predecessor, Jack Smith, who went on to head the entire General Motors, said much the same. more

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Why Canadian Hospitals Outperform U.S. Hospitals

From the Huffington Post:

by Co-founder, Physicians for a National Health Program, Professor, Public Health, CUNY, advisor,, and David Himmelstein Co-founder, Physicians for National Health Program, Professor Public Health, CUNY, advisor,

In many countries, bereaved families get condolence cards and flowers. In the U.S., they are also deluged with hospital bills and insurance paperwork.

That paperwork isn't merely an insult. It costs U.S. society a fortune. Take hospitals, for instance. According to research we recently published in Health Affairs, U.S. hospitals spent $215 billion in 2011 on billing and administration, a striking 1.43 per cent of GDP.

Put another way, about $1 of every $4 of U.S. hospital spending goes to bureaucracy rather than patient care.

Other countries manage modern, first-rate hospital systems for far less. While administration devoured $667 per capita annually in the U.S., we found that Canada spent only $158, Scotland $164, England $225 and the Netherlands $325.

If U.S. hospitals ran as efficiently as Canada's, the average U.S. family of four would save $2,000 annually on health care.

Moreover, U.S. hospital paperwork costs have risen sharply since 2000, even after adjusting for inflation. In contrast, administration's share of hospital budgets in Canada has actually fallen since 1999.

A generation ago, it took just one or two managers to run a U.S. hospital. Now, the CEO has been joined by "chief officers" for operations, finance, compliance, information, quality management, and more.

Each chief commands his/her own legions - hundreds of billing and registration clerks, referral managers, upcoding specialists (to translate doctors' diagnoses into the most profitable billing codes), and massive IT departments whose first commandment is "get the bill right."

Why are U.S. hospitals so inefficient? Our multiple-payer insurance system forces every hospital to negotiate rates with dozens of insurance plans, each with its own coverage rules, billing procedures and documentation requirements. And each hospital must collect deductibles, co-payments and co-insurance from tens of thousands of patients.

In contrast, Canada and Scotland -- where bureaucratic costs are lowest -- have single-payer systems that reject this kind of red tape and the need to bill for every Band-Aid. They pay hospitals simple lump-sum budgets, the way we fund local fire stations. And like fire departments, their hospitals don't need to collect from each victim of misfortune.

But the complexity of hospital billing isn't the only thing driving bureaucracy. Hospitals have been forced to add layers of business expertise in order to survive in our market-driven system.

A hospital that doesn't show an operating profit can't fund essential new investments in new equipment and cutting-edge services, or modern buildings. That means administrators have to devote resources to financial gaming like marketing lucrative services (e.g. sports medicine); billing units to squeeze every penny from insurers and patients; and strategies to recruit profitable (well-insured) patients, and avoid unprofitable (e.g. uninsured) ones.

The dismal record of for-profit hospitals illustrates the problem with running hospitals as businesses. The for-profits have higher death rates and employ fewer clinical personnel like nurses than their non-profit counterparts. But care at for-profits actually costs more, and they spend much more on the bureaucracy, a reflection of the high cost of implementing shrewd financial strategies.

Canadian and Scottish hospital administrators don't have to play financial games to assure their survival. Government grants -- rather than operating profits -- pay for new buildings and equipment. Even in France and Germany, where hospitals bill multiple payers, bureaucratic costs are modest because government directly funds most hospital investments.

England and the Netherlands provide unfortunate counter-examples. Pro-market reforms initiated during the Thatcher era have driven English hospital administrative costs sharply higher. And only U.S. hospitals have higher administrative costs than those in the Netherlands, where radical market-oriented reforms now pressure hospitals to show a profit.

Economics textbooks hold that subjecting medicine to market forces will stimulate efficiency and root out waste. But reality stubbornly refuses to obey. In health care, market-oriented policies encourage hospitals to shift resources to business strategies that boost the bottom line, but contribute nothing to care.

Dr. Steffie Woolhandler is an advisor with and co-founder of Physicians for a National Health Program. She is professor of public health at the City University of New York and lecturer in medicine at Harvard Medical School. She is also an internist at the Montefiore Medical Center in New York.

Dr. David Himmelstein is an advisor with and co-founder of Physicians for a National Health Program. He is professor of public health at the City University of New York and lecturer in medicine at Harvard Medical School. He is also an internist at the Montefiore Medical Center in New York.

You can help MVHCA as we work for publicly funded universal health care like the rest of the developed world by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

This U.S. doctor is moving to Canada. Find out why.

This story of a U.S physician, Emily Queenan, moving to Canada so that she could care for patients without spending most of her time fighting with private insurance gives the flip side of the argument that if a universal publicly funded system is adopted in Oregon the physicians will flee to other states. Many physicians want to care for their patients without fighting insurance.

You can help MVHCA as we work for single payer health care by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Here's the story as published in the blog of Kevin Pho MD:

I’m a U.S. family physician who has decided to relocate to Canada. The hassles of working in the dysfunctional health care “system” in the U.S. have simply become too intense.

I’m not alone. According to a physician recruiter in Windsor, Ont., over the past decade more than 100 U.S. doctors have relocated to her city alone. More generally, the Canadian Institute for Health Information reports that Canada has been gaining more physicians from international migration than it’s been losing.

Like many of my U.S. counterparts, I’m moving to Canada because I’m tired of doing daily battle with the same adversary that my patients face – the private health insurance industry, with its frequent errors in processing claims (the American Medical Association reports that one of every 14 claims submitted to commercial insurers are paid incorrectly); outright denials of payment (about one to five percent); and costly paperwork that consumes about 16 percent of physicians’ working time, according to a recent journal study.

I’ve also witnessed the painful and continual shifting of medical costs onto my patients’ shoulders through rising co-payments, deductibles, and other out-of-pocket expenses. According to a survey conducted by the Commonwealth Fund, 66 million — 36 percent of Americans — reported delaying or forgoing needed medical care in 2014 due to cost.

My story is relatively brief. Six years ago, shortly after completing my residency in Rochester, New York, I opened a solo family medicine practice in what had become my adopted hometown.

I had a vision of cultivating a practice where patients felt heard and cared for, and where I could provide full-spectrum family medicine care, including obstetrical care. My practice embraced the principles of patient-centered collaborative care. It employed the latest in 21st-century technology.

I loved my work and my patients. But after five years of constant fighting with multiple private insurance companies in order to get paid, I ultimately made the heart-wrenching decision to close my practice down. The emotional stress was too great.

My spirit was being crushed. It broke my heart to have to pressure my patients to pay the bills their insurance companies said they owed. Private insurance never covers the whole bill and doesn’t kick in until patients have first paid down the deductible. For some, this means paying thousands of dollars out-of-pocket before insurance ever pays a penny. But because I had my own business to keep solvent, I was forced to pursue the balance owed.

Doctors deal with this conundrum in different ways. A recent New York Times article described how an increasing number of physicians are turning away from independent practice to join large employer groups (often owned by hospital systems) in order to be shielded from this side of our system. About 60 percent of family physicians are now salaried employees rather than independent practitioners.

That was a temptation for me, too. But too often I’ve seen in these large, corporate physician practices that the personal relationship between doctor and patient gets lost. Both are reduced to mere cogs in the machine of what the late Dr. Arnold Relman, former editor of The New England Journal of Medicine, called the medical-industrial complex in the U.S.

So I looked for alternatives. I spoke with other physicians, both inside and outside my specialty. We invariably ended up talking about the tumultuous time that the U.S. health care system is in — and the challenges physicians face in trying to achieve the twin goals of improved medical outcomes and reduced cost.

The rub, of course, is that we’re working in a fragmented, broken system where powerful, moneyed corporate interests thrive on this fragmentation, finding it easy to drive up costs and outmaneuver patients and doctors alike. And having multiple payers, each with their own rules, also drives up unnecessary administrative costs — about $375 billion in waste annually, according to another recent journal study.

I knew that Canada had largely resolved the problem of delivering affordable, universal care by establishing a publicly financed single-payer system. I also knew that Canada’s system operates much more efficiently than the U.S. system, as outlined in a landmark paper in The New England Journal of Medicine. So I decided to look at Canadian health care more closely.

I liked what I saw. I realized that I did not have to sacrifice my family medicine career because of the dysfunctional system on our side of the border.

In conversations with my husband, we decided we’d be willing to relocate our family so I could pursue the career in medicine that I love. I’ll be starting and growing my own practice in Penetanguishene on the tip of Georgian Bay this autumn.

I’m excited about resuming my practice, this time in a context that is not subject to the vagaries of backroom deals between moneyed, vested interests. I’m looking forward to being part of a larger system that values caring for the health of individuals, families and communities as a common good — where health care is valued as a human right.

I hope the U.S. will get there some day. I believe it will. Perhaps our neighbor to the north will help us find our way.

Emily S. Queenan is a family physician. This article originally appeared in Evidence Network.

Health care costs keep Oregon ex-pats in Canada

MVHCA, PNHP, and Mad As Hell Doctor member Mike Huntington wrote a great letter to the Corvallis Gazette-Times.

March 24, 2015 9:00 am

I spoke with my cousin Debbie at a recent family gathering. She and her husband grew up in the United States and then, long ago, moved to Canada for work. Both have dual citizenship. They love and miss Oregon. For years they have hoped to return permanently to Coos County.

But they don’t dare.

So long as they stay in Canada they have affordable tax-based healthcare insurance, Canadian Medicare, giving them access to good care that is free of US-style financial torment.

But if they come home to Oregon they have only unaffordable and troublesome options. They would have to pay $1,000 to $2,000 a month for a high deductible policy that provides no guaranteed access to care or protection from financial ruin.

They know that healthcare fees are the greatest cause of financial indebtedness in the United States and most families facing medical bankruptcy did indeed have insurance at the time they became ill or injured.

Debbie clings to hope. She knows that Oregon has a vibrant grassroots movement for legislation that will guarantee access to healthcare for all Oregonians without financial ruin or needless delay.

My cousin has a homesickness we can cure. She can return to Oregon without fear if we create a better and less expensive healthcare system that is based on need instead of the market.

Please tell your legislators it’s time to get well beyond the mixed benefits of Obamacare and Oregon’s Coordinated Care Organizations — with Health Care for All Oregon,

Michael Huntington MD


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A Canadian physician responds to Gov. Pence’s Medicaid program

Yesterday’s Quote of the Day (“Government supports rotten teeth for patients in poverty”) discussed the Medicaid waivers obtained by Indiana Governor Mike Pence. Today’s post continues on that topic.

The Goal Was Simplicity; Instead, There’s a Many-Headed Medicaid

By Margot Sanger-Katz
The New York Times, January 28, 2015

Indiana has become the latest Republican-led state to expand its Medicaid program as part of the Affordable Care Act. As has become the pattern, it was done with a series of waivers from particular federal requirements.

When the state’s governor, Mike Pence, announced the news on Tuesday, the focus of his speech was less about his state’s decision to embrace this part of Obamacare than about the special concessions he’d been able to extract from the Obama administration.

Newly eligible Medicaid recipients will have to pay monthly premiums or be locked out of certain services, he announced, and higher-earning beneficiaries who fail to pay will be shut out of the program for six months. People who use the emergency room frequently will need to pay higher co-payments than the federal government has ever allowed.

The provisions, designed to encourage residents to take more responsibility for the costs of their health care, break new ground in what the Obama administration will allow in exchange for expansion.

NYT Readers’ Comments:

By Bob Solomon, MD
Edmonton, Canada

You live in "Cloud-Cuckoo Land" in the fantasy you have the best medical care system on earth. Baloney. Check it out.

Canada is right next door. Come see how a sane federal health plan works, covering all and ensuring that (1) we live longer, (2) we have fewer chronic ills, (3) we have lower cost drugs, (4) we have lower cost hospitals, (5) we have lower cost operations, (6) we have lower accounting costs for all parties, and (7) we have no medical bankruptcies and impoverishment anywhere, for any income, for the unemployed, for the elderly. Long waits for ER? I waited 4 minutes for an asthma attack to be dealt with, 2.4 hours for a minor ear problem -- wax. In Philly, I waited 2.4 for a back injury. Twice. So no difference.

We get free (tax-paid) care in Alberta. No out of pocket, no minimum, no exclusions, no co-pays, no nothin'.

Premiums exist in certain provinces: $35 a month per person or about that, and some people purchase extended coverage. I also pay approx. $1200 a year for added features: free or nearly free drugs, and a large subsidy for glasses, hearing aids, private rooms, canes, and things like that.

Americans live in a "exceptional" med world -- a medical services madhouse. It was not created by ACA, of course. And because of the med and drug and hospital corporations, I mean "people", and the know-little-or-nothing GOP, it was ensured to endure after ACA. Medical madness is still a disease you need to cure.


By Don McCanne, MD of PNHP

Denying poor people dental care simply because they cannot pay the premium, as Pence's program does, defies logic. Does sentencing poor people to rotten teeth truly motivate them to find money that they don't have in order to provide them with the "dignity to pay for their own health insurance"?

Does Pence propose that we change the rhetoric from "skin in the game" to "rotten teeth in the mouth"?


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"42,000 Canadians come to the United States for care" - Really?

Comment By Don McCanne, M.D.

Each year the Fraser Institute of Canada issues a report claiming that over 40,000 patients leave Canada for medical care. Yet a highly credible study done over a decade ago revealed that many of these supposed patients were merely “phantoms in the snow” and that this is another “zombie idea” that, on logic or evidence, is "intellectually dead" but “can never be laid to rest because (the concept is) useful to some powerful interests.” So it is important to understand the source of the Fraser numbers.

More importantly, the premise of those who use these unreliable numbers of patients exiting Canada for care is that single payer financing results in excessive queues which then triggers this exit. That should not necessarily follow since queues can be tamed if the stewards of the system are attentive to system capacity and queue management. Many nations with comprehensive systems do not have problems with queues.

In contrast, in the United States, the financial barriers to care (that do not exist in Canada) are so great that tens of millions who need care do not even gain a place in the queue - rationing based on ability to pay. Only a fool would recommend our callous system over Canada’s egalitarian single payer system.

Warning: click here for the wonkish calculations and the full article.

Canada's Healthcare System Explained!

This great video explains how both Canada and the USA have Medicare.  The difference is that in Canada, Medicare is for everyone, regardless of age.  It explains how Canadian Medicare works, and answers questions like:

Why do Canadians flock to the US for care?


Why are pysicians fleeing Canada? 

Answers: the aren't!

This video found at the Incidental Economist.