DATELINE: Ojo Rojo

Larry interviewed on Fort Bayard

2011-07-07T22:43:00.000-06:00

Historic fort faces uncertain future: krqe.com

We Need Health Care, Not Health Insurance - Albuquerque Journal North

2009-11-15T10:49:00.001-07:00

November 15, 2009

A very complex, mandatory private insurance scheme recently passed the U.S. House. The public is being overwhelmed by sound bites on one hand about how great it is, on the other, how terrible. We are hearing few of the details that are actually in the bill. Having read the bill, it is clear now that what started as health reform has emerged from the political process as health "deform," building on the worst, not the best of the current system.

It is still a toss-up as to whether the Senate will pass any bill this year. However, due to intense political pressure, the Senate is likely to pass a bill that will make some House provisions better and others worse. What actually comes out in the final conference-committee bill is anyone's guess at this point — so little time, so many deals still to be made, so many political funders to be appeased.

A careful analysis of the bill shows that it is designed more for political goals than to eliminate financial barriers to health care. For example, the actual coverage doesn't even begin until 2013, opportunistically after the next presidential election, in 2012. Run on having accomplished "historic reform" but before anyone actually experiences how bad it is? How cynical is that?

Yes, there are some good provisions. The best relate to improving existing programs like the Indian Health Service, community health centers, and health professionals education and training; all are important for New Mexico.

But there bad provisions, which comprise most of the 1,990 pages of the bill. Five key reasons this legislation must be stopped:

• If passed, this law will move the U.S. farther from universal health care, making it harder than ever to accomplish health care justice in the future. If Congress does not have the courage to stand up to the private insurance industry now, it will be even more difficult in the future, especially after giving the industry trillions of new dollars through this terrible legislation. Let's call this what it is: another corporate bailout on the backs of working people.

Pay attention to your federal representatives as they carefully talk about "health insurance reform." They aren't talking about health reform any more. Congress could have defended and built up a system based on popular, high-quality government-run health programs like the military and veterans fully socialized health systems or Medicare, a single-payer program. Instead, the president and Congress let the corporations and government-haters take control of the agenda.

• The legislation institutionalizes permanent inequality in health care. Unlike Medicare where all beneficiaries have a single plan, this bill further divides the U.S. system into tiers based on ability to pay. It creates basic, enhanced, premium and premium-plus plans. A basic plan will provide only 70 percent of the coverage of a "reference benefit package," one that includes even fewer services than most insured people have today. The bill doesn't even mention coverage for essential services like vision and adult dental care except in the most costly premium-plus plan.

• Out-of-pocket costs remain sky high. Everyone will be required to pay monthly insurance premiums. Some low-wage workers will receive taxpayer subsidies on a sliding scale. The lowest income people will have full subsidies. But remember, this is not money for care, it is support only to buy insurance.

Almost everyone will have to meet a deductible, capped in the bill at $1,500 a year, higher than most insurance-plan deductibles today. On top of this, insurance companies can charge even more under various "cost sharing" schemes for items like co-pays and co-insurance.

The bill puts a cap on cost sharing, but the total amount is obscene. The cap for an individual is $5,000 a year and for a family it is $10,000 before the plan must cover everything. Well, not exactly everything. Even after paying this huge amount of money, the legislation still allows the corporations to make us pay, billing for non-network providers and, since it is not a comprehensive benefit package, we are still on our own to pay for health care that the plans refuse to cover.

The legislation creates a law to let these corporations increase what they charge people as they get older. In fact, they can be charged up to twice as much as younger people for identical coverage.

• The legislation makes it illegal to not buy health insurance. The penalties are described in a section of the legislation called "Shared Responsibility." This will let the IRS impose a tax of up to 2.5 percent of modified adjusted gross income for not having health insurance. People on the financial edge, people fighting foreclosure to stay in their homes or people who are unemployed all or part of a year will not be able to afford the insurance premiums or the penalties for not having insurance.

• We will all be drowning in paperwork, which will continue to drive up administrative costs. Right now, insurance administrative waste is about 30 percent of every health care dollar— or about $1 billion a day. Adding more people to an insurance-based system will result in even more money going into this bottomless pit.

As if this isn't bad enough, the government will be setting up many new agencies to oversee the whole process including, at the top, the Orwellian Health Choices Administration, headed by the Health Choices Commissioner. This is not an agency to help us make health care choices, but to choose a health insurance company. The IRS will play a very large role in everything from certifying our income for subsidies to monitoring and taxing people who don't buy insurance.

Health Insurance Exchanges will be created across the country with at least one in every state offering both Web sites and telephone assistance. This is where we will go every year to pick our insurance plan in an open enrollment period of at least 30 days between September and November. We can add this unpleasant task to all of our other fall chores.

It is hard to imagine the chaos and wasted resources with the entire country picking insurance plans at the same time, attended by marketing, billboards, advertising and misinformation. We will gamble as we choose a plan, decide which corporation will be the best for us, hoping we pick one that is not dominated by corporate bureaucrats focused on rationing care to maximize their profits. It is not an easy task and if a wrong plan is selected, we are stuck for a year, until the next national open enrollment cycle.

The United States can do better. We can build on a strengthened and well-funded Medicare program. In Medicare, when a person reached the age of eligibility or is determined to qualify because they have a permanent disability, they are in, and there is no re-enrollment.

Imagine real reform, as simple as adding people ages 55 to 65 years old to Medicare in 2010, 35-55 in 2011, and so on until everyone is included by 2013. The bills that promote this kind of reform are under 200 pages, they are simple to implement, cost effective and equitable. Choose a doctor, choose a hospital when needed and let the government pay the bills. Everyone in one system.

That is what real health reform would look like.

Miller is a long-time public health professional and health care advocate. She lives in Ojo Sarco.

URL: http://www.abqjournal.com/north/opinion/1523131northopinion11-15-09.htm

KUNM COMMENTARY: SOLD OUT - Money and Lies Versus Our Health

2009-08-29T14:19:00.001-06:00

AIRED August 18, 2009 KUNM-FM, www.kunm.org

Sold out. It is really sinking in now that my worst fears about a forced bailout for the insurance industry is about to take place – again.

I am sad and angry. Angry that the media treats what should be an important national discussion like a sports event. Angry that our Congressional delegation supports a national plan that makes no sense for New Mexico.

Sad because I know that having an insurance card is not the same as having access to health care. Insurance is a profit making business that wins when customers pay in more than is spent paying for care.

In the past ten years, the average family premium has more than doubled, soaring from $5,800 dollars a year to $12,500. The extra money did not buy better health. It led to a decade of obscene insurance executive pay, reaching tens and hundreds of millions of dollars each for every year of successful corporate rationing.

These profits also raised a lot of cash to buy political influence. In the same ten years that premiums for families doubled, federal politicians got a cool $3.4 Billion in campaign contributions from the health sector.

2008 was a big investment year; $167 Million to Congressional candidates, $18.7 Million to the Obama Campaign and $7.3 Million to McCain. In three months this spring - April to June – members of Congress collected over $15 Million in bribes disguised as campaign contributions from the health sector. While that sounds like a lot to us, it is pocket change for these corporations with the billions in profit they make every year by rationing care.

Last week the White House branding was redesigned. It was so subtle that most people did not notice. Everything stayed all red, white and blue but Health Care Reform was dead - gone, from the banners, from the websites, from the speeches. Replaced by the words “Health Insurance Reform.”

The White House and Congress are obsessed with getting anything that they can spin in the media as a win. The discussion is no longer about how to provide access to health care to all Americans. Both sides are fixated on the next election. No matter what really happens, both sides will claim a victory. The problem with this is that we the people have already lost.

The President said reform was going to build on the system already in place. So far, so good.

The current system is mostly public. The public and publicly funded systems cover two out of every 3 Americans. If the President means what he says, then the public system is the foundation to build on.

The dominance of a two-party system in the US prevents real change; everything is about my side-your side, good-bad, we win-you lose.

And until special interest money is out of our political system, the public interest will NEVER come first. People voted for change but it is beginning to feel like all we got is a different cast of corporate-owned yes-men and women at the White House and Congress.

HEALTH REFORM - Where is the Wizard of Oz When We Need Him?

2009-08-29T12:35:00.003-06:00

In Print and Online

Horse Fly
Taos, New Mexico  August 15, 2009

By Carol Miller

The people are crying-out for access to health care. The economy is in
freefall with no sign yet of the bottom. It is time for bold action. Poll
after poll finds that two out of every three Americans supports converting
to a universal health care system similar to Medicare.

I find myself wishing there was someone like the Wizard of Oz to give
courage to politicians, the courage to stand up for us—the people, the
taxpayers, the voters.

So, what’s the problem?

One problem is that most elected leaders, from the president on down, are
cowards when it comes to standing up to the corporations. A few recent
examples: bailouts for banks while homeowners still face foreclosure and
homelessness; the AIG mega-insurance corporate bailout; and the current
and most cruel bailout—protecting large sickness insurance corporations
rather than giving us guaranteed access to health care. This is not
reform.

A truly reformed system would focus on improving health by expanding
public health, prevention, wellness programs, and easy access to health
care without causing fear as to how individuals will pay for it.

It is becoming obvious that there is more interest in raising current and
future campaign funds than giving us access to the higher quality,
lower-cost health care that the rest of the industrialized world enjoys.

How much money has corporate health care invested in politicians to
protect their profits? In the past 10 years, a cool $3.4 billion. 2008 was
a big investment year for health corporations: $167 million to
Congressional candidates (60% to Democrats), $18.7 million to the Obama
Campaign, and $7.3 million to McCain. While that sounds like a lot to us,
it is pocket change for these corporations—they make billions in profit
every year.

A Billion Dollars a Day
I know there are a lot of numbers in this commentary, but if you want to
memorize only one, here it is: health insurance administrative costs alone
waste one billion dollars a day, $365 billion dollars a year, and a
trillion dollars every two and a half years. This is a trillion dollars
that are sucked out of the health care system every couple of years for
wasteful paperwork and corporate profit. Not one penny of this provides
any health care. This is why the corporations are fighting to have the 49
million uninsured handed over to them.

Elected Politicians are Helping Government Haters Kill Health Reform
When our elected officials refuse to strongly defend the popular,
lifesaving and well-run government health programs, they open the door and
airways to endless government bashing. We see now how out of control these
government haters have become. Some of these are even the people we have
elected to represent us!

Why won’t the president stand up and defend government health programs? He
has had so many opportunities, but instead he plays into the hands of the
sickness insurance corporations, feeding the myth that people like their
insurance companies.

U.S. Socialized Medicine Is Popular
Americans are so trained to think that socialized anything is bad that
they get frightened when they hear lies in the media that the government
is going to impose socialized medicine. The definition of socialized
medicine is when the government owns the hospitals and clinics and all of
the staff are government employees.

This system actually sounds very familiar to 20 million Americans, and
almost one out of every four New Mexicans. You know why? The United States
already has a very large socialized medical system that includes military
health, veteran’s health, and the Indian Health Service.

Why doesn’t President Obama ever mention this? He could let people know
that the VA is a great system, recently honored as having the highest
patient satisfaction of all health plans for the sixth year in a row. The
military has always had a socialized health system, and service members
consider it the most important benefit of service.

America Already Has a Single Payer System
It is amazing that the thought of government-run health care frightens so
many people, including those who already have it. The United States today
has the largest single payer health care system in the world, with 103
million beneficiaries—more than one out of every three Americans.

In New Mexico, 800,000 people have single payer health care, through
Medicare and Medicaid. Add in the more than 400,000 in the socialized
system, and two out of every three New Mexicans is already in government
run health care. The truth is, most of them like it and are more satisfied
with their coverage and care than people in corporate sickness insurance.

Here is why Medicare is popular—it keeps the private delivery system
intact and leaves it to the government to pay the bills. If people want
“choice,” they will find more choice of doctors and hospitals in Medicare
than any other insurance plan.

The president has said time and again that if we were starting the system
from scratch, he would favor a single payer system. He is clear that he
knows it is the best. But he always follows this up with the comment that
a lot of people like what they have, so we will build on the current
system. But 123 million people already have government health care, 41% of
the country. Why not get to universal health care by building on these
systems?

At a recent AARP Forum on Health Reform, President Obama was unable to
convince a Medicare beneficiary that Medicare is actually a government-run
program. The person refused to believe that the government could operate
such a great program.

Rather than standing up for the government, the president missed the
perfect opportunity to educate and move the country. He could have
explained that reform will not be about taking away anything from the 45
million seniors in Medicare, but instead would welcome their children and
grandchildren to join them in the most popular government program.

Compare that to the current system which has grandma in Medicare, mom and
dad either uninsured or in another plan, and often the children in yet
another, each with annual enrollment, changing rules, and benefits unknown
until you are sick and an insurance company bureaucrat tells your doctor
what care you can get. Imagine the whole family in one health system, with
the same rules, benefits, and enrollment for life—this is an idea worth
fighting for!

People Like Their Insurance?
Really? Who are these people? This is a huge lie. The president says it
over and over. Our members of Congress say it over and over, but repeating
this lie will never make it true.

For the most part, people like their doctors and the hospitals and clinics
where they get care, but in my many years of working in health care, I
have never met anyone who told me they love their insurance company.

Insurance companies collect money every month, supposedly to pay for
health care, but their profits are based on denying and rationing as much
care as possible. The rationing starts before someone even signs up for an
insurance plan, because sales agents are trained to discourage or deny
coverage to sick people or people who they think might become sick.

With corporate for-profit insurance, you never know in advance what will
be paid for and how much they will leave for you to pay. Too many people
have learned the absolute heartlessness of ruthless insurance companies.
More than 500,000 people in the United States go bankrupt every year as a
result of medical bills or illness. Most who declare medical bankruptcy
are “insured,” or so they thought. They paid their premiums every month,
but when they or a family member became sick, they learned that they were
not protected from financial ruin.

Who benefits from this system? Insurance executives and CEOs with sky-high
compensation packages reaching to the tens and hundreds of millions of
dollars. The former CEO of United Health Care holds the record, receiving
over one billion dollars in a single year in salary and stock options.
This is the same corporation that just “won” the contract to run the
behavioral health system in the State of New Mexico.

Continuing the for-profit sickness insurance industry and using tax
dollars to expand it further is yet another unaffordable corporate
bailout. This is a nonessential industry that makes profits from rationing
health care to people who need it and, even worse, it rations the care to
people who have already paid for it!

My challenge to the New Mexico Congressional delegation and the president
is this: even if you don’t have the courage to support a transformation of
the health care system that would let everyone into a restored Medicare
program, why not at least let the 49 million uninsured enroll in this most
popular government program? This is the easiest and least costly way to
cover the uninsured.

There are two bills in Congress to create a Medicare-for-All program,
House Bill 676 and Senate Bill 703. On July 30th, U.S. House of
Representatives Speaker and California Congresswoman Nancy Pelosi
committed to a vote on HB676 when Congress comes back from vacation in
September.

The outcome of that vote depends on us making sure that all of our
representatives know we oppose the looming corporate bailout and want
health care, not health insurance.

What we want is simple: one system, everyone in, nobody out.

KUNM Commentary: WAKE UP NEW MEXICO Part 2 Private Insurers Already Having Field Day

2009-07-09T18:44:00.003-06:00

Listen online: http://kunm.org/news/audio/070809MILLER2.mp3

Because I have only a few minutes, I want to run through some New Mexico data and weave them into an analysis you won't hear anywhere else.

First, almost all health care in New Mexico is either provided or subsidized by government, which of course means us - taxpayers. Even people who don't pay income taxes pay for health care. Sales taxes raise money for county indigent funds. In some of our counties, land and home owners also pay for health care through property taxes.

One of the worst lies thrown around every time Congress debates health care is that the U.S. will end up with “socialized medicine.” Socialized medicine is when government owns and operates the health facilities and employs doctors, nurses and the rest of the staff.

You know what? The US already operates one of the world's largest socialized medicine systems, but unlike the other countries that use it to care for everyone, in the US socialized medicine is only enjoyed by 20 million people, about 7% of the population.

In New Mexico nearly one out of every four people is in a socialized medicine system - three times the national rate. Adding together the military, VA and Indian Health Service, nearly a half million New Mexicans are eligible for government owned and operated health care.

Another 750,000 New Mexicans are enrolled in Medicare and Medicaid, both federal programs. Then add in 49,000 federal employees in New Mexico. We pay for them and their dependents too.

Now we've reached 73% of the state receiving health care through federal programs and there are still a lot more New Mexicans with taxpayer funded health care to add in.

There are sixty thousand state employees and ninety thousand local government employees. Using 2.7, a low number for calculating family size and dependents, brings in another 400,000 people eligible for publicly funded care.

Here's a caution about the data. It's very difficult to separate out the numbers of people eligible for multiple programs, for example a veteran might also be eligible for Indian Health and Medicare and show up in those numbers too. To adjust for any overcount, I have reduced the totals by 20%.

Even with this adjustment downward, 70% of New Mexicans are covered by public programs. This is very different from most other states. Nationally more than 160 million people are already covered through federal, state and local government public programs.

In conclusion, the so-called private insurance market does not exist. It is a myth. A dangerous myth, one that provides cover to politicians wasting public money to prop up a non-essential industry.

Fifteen years ago when health reform efforts failed, our legislators and Congressional delegation chose the private insurance industry over their constituents. First the legislature handed over Medicaid with its nearly half million New Mexicans to insurance corporations. Then Congress gave private insurance access to Medicare beneficiaries and more recently created an overpriced, for-profit prescription program.

Although Medicare and Medicaid were working efficiently as government programs, they were handed over to private corporations. Millions of dollars that should provide health care are instead wasted on insurance overhead, marketing, paperwork and profit. And still, the Industry wants more, they want it all.

Guaranteed health care justice demands a public solution, not a transfer of tax dollars to private for-profit companies. It is time for health care, not health insurance.

KUNM Commentary: WAKE UP NEW MEXICO Part 1 The Government is About to Sell us Out to Insurance Companies

2009-07-08T10:37:00.003-06:00

Listen: http://kunm.org/news/audio/070709MILLER1.mp3

WAKE UP NEW MEXICO! The government is about to sell us out to the insurance companies! This is not a joke or an exaggeration. Our time to speak out is NOW.

Many of you know me as a number cruncher, the researcher with a lot of facts and data. I will be sharing some with you tomorrow, but because we are at an urgent crossroads I am speaking now as your neighbor and friend.

Like you, I am sick and tired of watching our family and friends sobbing in anguish when they can’t pay a hospital or doctor bill - or delay getting even life saving care when they need it.

Expanding insurance will NEVER equal universal access to care. Its administrative costs alone waste ONE BILLION DOLLARS A DAY; money that could provide a lot of health care, instead, thrown down the drain on paperwork. The insurance corporations are salivating at the thought of the government handing them additional profits on the 45 million people currently without insurance.

This is a white-collar crime in plain sight. If we the people are passive, the President and a cowardly Congress will try to make us believe – again – that more insurance, more technology and more band-aids will fix a broken system.

I want my tax dollars used to pay for health care including public health and prevention, not a hidden corporate bailout. Insurance CEOs make bonuses based on how good they are at rationing care to sick people; most earn millions and some have earned hundreds of millions of dollars a year by having their companies refuse to pay for health care.

Here in New Mexico the so-called economic “downturn” is a crisis. What good is an insurance card with complicated rules and high fees when you are out of work and short on cash? Here is a fact so unbelievable that you might think I am making it up – but the President and Congress are seriously considering a mandate forcing everyone to buy insurance or be fined ever-increasing penalties. What do they not understand about how broke we are?!

The best way to assure universal access to health care is through expanding Medicare. Medicare is not perfect and it will need funding at a level to restore recent cutbacks and undo privatization. However, opening Medicare is the most fiscally conservative and least-disruptive way to cover everyone; simple changes to an existing, very popular program. Medicare already funds the private delivery system, so everyone keeps their same providers if they want and the government pays the bills.

The wonderful diversity that New Mexico is known for, also leads to diverse and special needs in providing health care to everyone. None of the national bills address our reality, here on the ground, in the New Mexico health care system.

Wake up New Mexico. We only have a few weeks to be raucous enough that our Congressional delegates get it. They must hear us loud. We don’t want excuses, we don’t want to hear about not having enough votes. This is their time to show courage and leadership and represent New Mexico, not support a complicated national bill that will need endless tinkering. The only way for them to prove that our health is more important than bailing out the sickness insurance industry is for them to fight and vote for universal health care. The two bills that must be passed are House Bill 676 and Senate Bill 703.

It is time for one system with one set of rules for all of us; everybody in, nobody out.

NM Free Press: Why (fiscal) Conservatives Love Medicare-for-All

2009-06-28T19:50:00.002-06:00

Call me old fashioned, but a true conservative is someone who conserves, dislikes wasting money and is offended by endless corporate bailouts by hard-working taxpayers. A fiscal conservative like me. As a public health professional, I want to see health dollars used to keep people healthy through public health and wellness programs, as well as provide medical care when it’s needed.

We have a health care crisis in the United States. Nearly 50 million people do not have health insurance, and they are our family and neighbors.

There are 500,000 medical bankruptcies every year. Most of these half million families had health insurance; at least they thought they did because every month they paid for insurance. Millions of people have learned the hard way that for-profit sickness insurance does not prevent financial ruin during a health crisis.

One of the worst lies thrown around every time Congress debates health care is that the U.S. will end up with socialized medicine. Socialized medicine is when the government owns and operates health facilities as well as pays the salaries of the doctors, nurses and the rest of the healthcare work force.

Let me say as clearly as possible — President Obama and the Congress are not discussing, introducing or enacting socialized medicine.

Good old-fashioned U.S. socialized medicine
Today, the U.S. already has socialized medical systems serving more than 20 million people. The current U.S. socialized medicine systems are very popular. The largest in terms of numbers of people is the Military Health System. The largest in terms of numbers of facilities owned and operated is the Veterans Administration health system. Two additional smaller U.S. socialized medical systems are the Indian Health Service and the federal Bureau of Prisons.

Despite being socialized medicine, the VA is ranked the highest in a national survey of patient satisfaction by the University of Michigan. U.S. taxpayers own the 155 VA hospitals and 881 clinics; we employ 289,000 people working in the VA including 16,000 doctors and 42,000 nurses.

Even the bastion of capitalism, Fortune magazine, is impressed by VA health care, stating, “The seamless integration of science, information, and compassion is the dream of modern health care. Scenes like these are not fantasies, however, but daily realities at the Veterans Health Administration.” (Fortune, May 2006.)

Let me repeat, President Obama and the Congress are not discussing, introducing, or enacting socialized medicine. Unlike the socialized system military and veterans enjoy, most health care services are provided through a private delivery system. All reforms will build on the existing private delivery system.

2009 health reform debate
So now that we all agree that the President and Congress are not expanding socialized medicine in the U.S., what are they proposing? There are two basic options and neither creates a nationalized or socialized health care system.

• Medicare for all: The first choice expands Medicare eligibility beyond its current limitation to elderly (over 65) and disabled individuals of any age. This is the most conservative, least-disruptive and cost-effective way to cover more people; it only takes a simple change to an existing, very popular program. Every time the Congressional Budget Office scores the cost of Medicare-for-all type programs, they pay for themselves through two key business principles, the power of bulk purchasing and administrative savings though the elimination of waste in the system.

• Mandated insurance: The second choice forces taxpayers to buy for-profit insurance despite a wasteful administrative cost of $1 billion a day. Yes, a trillion dollars every two and a half years just for paperwork, not a penny of that for health care. As a fiscal conservative, I do not want to pay a secret corporate bailout so that greedy CEOs make bonuses based on how good they are at rationing care to sick people.

In this expansion of the current failed system, the U.S. spends more than twice as much per person than any other country and the excess cost does not result in better outcomes. The U.S. is about 37th in the world for life expectancy, infant mortality, and other indicators of health status.

We have to walk away from corporate rationing to create a seamless system with the highest quality services for the best price. The easiest way to hold down costs is to have the largest purchasing group possible to get bulk prices — this is the single-risk pool.

Especially in this economic downturn it is essential to help people get access to health care. Being creative now gives us the chance to create a brand-new system, an All-American plan.

False conservatives will parrot the corporate line and continue to bail out the failed sickness insurance system. True fiscal conservatives who want to eliminate waste, hold down costs and improve outcomes will support Senate Bill 703 and House Bill 676. All the other bills transfer tax dollars first into needless paperwork and corporate profits and then dole out whatever is left for medical bills.

The choice is clear. We keep our doctors and hospitals in the current private delivery system but let one public insurance plan handle the paperwork and pay the bills.

 Carol Miller is a New Mexico public and rural health expert. She has public service in Washington, D.C., in both Republican and Democratic administrations, including the Clinton White House. In 1994 she was the health reform policy adviser for the National Rural Health Association and the New Mexico Secretary of Health. Miller, a former Commissioned Officer in the US Public Health Service, has used both the uniformed services and veterans health care systems.

http://newmexicofreepress.com/index.php?option=com_content&view=article&id=340:why- fiscal-conservatives-love-medicare-for-all&catid=22:viewpoints&Itemid=64

NEW MEXICO INDEPENDENT ON MILLER IN ROLL CALL

2009-06-20T11:47:00.002-06:00

Ex-congressional candidate Carol Miller opines on health care reform in Roll Call

By MATTHEW REICHBACH 6/9/09 3:49 PM

Ojo Sarco resident and rural health policy guru Carol Miller — who served on the Clinton Health Care Task Force in the ’90s – wrote an op-ed in the influential Washington D.C. paper Roll Call about health care reform.

Miller, who twice ran for Congress in the 3rd Congressional District including last year, pulled no punches in her commentary outlining her thoughts on the need for drastic health care reform, and specifically, advocating the need for a single-payer system.

“In the 15 years since Congress gave up on universal health care, about 300,000 Americans have died from the lack of health coverage alone, using the government’s own data,” Miller began.

She also wrote about the financial toll that the current health care system has on many families.

Miller has a different view of things than President Barack Obama.

In response to a question about the single-payer system at his Rio Rancho credit card reform town hall, Obama responded:

If I were starting a system from scratch, then I think that the idea of moving towards a single-payer system could very well make sense. That’s the kind of system that you have in most industrialized countries around the world. The only problem is that we’re not starting from scratch. We have historically a tradition of employer-based health care. And although there are a lot of people who are not satisfied with their health care, the truth is, is that the vast majority of people currently get health care from their employers and you’ve got this system that’s already in place. We don’t want a huge disruption as we go into health care reform where suddenly we’re trying to completely reinvent one-sixth of the economy.

Miller, who has run for office as a registered Democrat, Green and an independent, says that such an incremental approach is not useful and just plain won’t work.

“By leaving the universal, social insurance option out of the debate, it is easier for the industry, media and some Members of Congress to paint the mixed public-private plan as an extreme rather than what it is — the middle ground,” Miller wrote. “And while not ideal, the mixed plan is a place for Congressional compromise.”
Miller also warned that getting nothing done would be dangerous, writing, “Without real reform, there will be more tinkering at the edges until the tsunami of medical costs finally forces the government to do the right thing.”

http://newmexicoindependent.com/29187/ex-congressional-candidate-carol-miller-opines-on-health-care-reform-in-roll-call

ROLL CALL - CAROL MILLER FOR UNIVERSAL HEALTH CARE

2009-06-20T11:43:00.002-06:00

Miller: U.S. Needs a Holistic, Cradle-to-Grave System of National Health Care

By Carol Miller

Special to Roll Call
June 8, 2009, 12 a.m.

In the 15 years since Congress gave up on universal health care, about 300,000 Americans have died from the lack of health coverage alone, using the government’s own data.

Added to the tragic death toll is the economic toll. More than a half-million individuals and families declare medical bankruptcy every year; most of them have health insurance. Actually, they thought they had health insurance because they pay for insurance. People learn the hard way that when help is really needed for a catastrophic health crisis, private insurance does not protect them from financial ruin.

We stand again as a nation at the same fork in the road on the path to improve access to health care for all of our neighbors and family members.

One choice is the fork that brings us together to weave a safety net. This fork is the Medicare-for-all approach; everybody in, nobody out. Imagine a cradle-to-grave, holistic system based on public health, prevention, wellness, a medical home for everyone and — according to the Congressional Budget Office — doing all of this while saving money. This is the single-payer choice.

Then there is the other fork: forcing everyone to have insurance by building on the current broken system. This is the déjà vu path. Choosing this path continues corporate rationing, procedure-based sickness care, out-of-control costs and obscene CEO and executive compensation. During the last debate on universal health care, Congress fell for industry promises of savings through an expansion of managed care. After a year or so, all voluntary “savings” were gone and the bad old days of skyrocketing costs were back.

Secret Bailout

It’s bailout fever now; every corporation and industry wants theirs. Some are out in the open like Wall Street, American International Group and the automakers. One big corporate bailout is secret, disguised as a uniquely American way of doing business.

I’m talking about the for-profit corporate sickness insurance industry. An industry that takes in money, lots of money, much of it from us, the taxpayers, and in return pays for as little health care as possible to maximize profits for their investors.

It is strange to listen to the Members of Congress criticize the Big Three automakers, when at the same time they not only continue to support, but even propose expanding the for-profit, corporate health insurance industry. At least automakers make something. They have the capability to retool and build better and more efficient cars, light rail, solar panels or even better mousetraps.

Strategy for Passage

There are two issues on the table. First is the fate of the various “reform” bills as they continue to be introduced and move through Congress, and second is the strategy for actually passing reform this year. Watching the same mistakes that killed the Clinton-era reforms being made again — by Democrats and Republicans — is painful.

There are three health reform choices being proposed this year. One choice is the completely public option, universal, single-payer social insurance, which the president and Congress are trying very hard to keep “off the table.” The middle ground has an insurance mandate with an individual choice of either private, likely for-profit, insurance or a public insurance plan, for example, buying in to Medicare. The third option provides the least choice, a mandate to buy private insurance.

This is where strategy matters. By leaving the universal, social insurance option out of the debate, it is easier for the industry, media and some Members of Congress to paint the mixed public-private plan as an extreme rather than what it is — the middle ground. And while not ideal, the mixed plan is a place for Congressional compromise.

Why are powerful people afraid to give us the right to choose a public plan? Are they afraid we will learn that more than $1 billion every day is wasted on insurance overhead? Or that more than a trillion dollars bleeds from the health care system every two and a half years — money not spent on health care but on insurance administration, advertising, marketing and corporate profits?

In surveys of the American people, Medicare is always ranked as the best and most popular government program. If Congress fails to enact a universal social insurance plan, enrolling in Medicare or a new public program must be a choice for the uninsured and underinsured.

If we are lucky, we will see real courage from Congress this year. Every Member knows that sooner or later, because of the economics, the United States will join the rest of the developed world and create a national health plan. This is privately conceded even by the biggest insurance industry boosters on Capitol Hill. Without real reform, there will be more tinkering at the edges until the tsunami of medical costs finally forces the government to do the right thing.

During these challenging economic times, we have the chance to complete the promise of full social insurance. Universal access to health care has been deferred for 74 years since it was stripped from the Social Security Act of 1935 — and that is long enough.

Carol Miller is a rural and public health activist who lives in a small village in Ojo Sarco, N.M. Miller has public service in Washington, D.C., in both Republican and Democratic administrations, including the Clinton Health Care Task Force. In 1994 she was the health reform policy adviser for the National Rural Health Association and the New Mexico secretary of health.

http://www.rollcall.com/features/Mission-Ahead_Health-Care/ma_healthcare/35528-1.html

KUNM COMMENTARY: Who's Stimulus is this Anyway? Part Two - The Surprises

2009-03-08T10:59:00.004-06:00

Here's the disclaimer - yes there are good things in the federal stimulus - but there are also a lot of costly items that have nothing or next to nothing to do with job creation or rebuilding the economy.

This analysis consists of the surprises, items that I was not expecting to find. there were many, but I am just highlighting my worst three.

Surprise Number One - Television: I have to admit, the national effort to convert every household to digital tv is a pet peeve of mine. This is a massive government outreach effort with endless radio and television ads, multiple mailings to every household and news stories. The stimulus adds $650 million for converter boxes to the $3 billion already spent. I don't know about you, but the one I bought was made in China.

Imagine if this scale of national effort was instead sending every home a coupon for a solar water heater or a coupon for a health checkup to the 49 million people without health insurance!

$650 million for tv and only $70 million for helping homeless school children in this stimulus. On any given night in the US, 1.35 million children are homeless. Here is one of the heartbreaking statistics about homeless children, the average age of a homeless person in Michigan is now 8 years old.

Surprise Number Two - Military: The number of military projects was completely unexpected in the stimulus, for operations, maintenance, construction and extra benefits. $100 million for something called "Warrior Transition Complexes."

The bloated military budget is a major factor in the financial crisis and it is unsustainable. Identifiable extra military spending in the stimulus was close to $20 billion, the final number may be higher. With the economy so weak, why are there are two active wars, 440 military installations in the US, nearly 1000 other US bases around the world in 80 countries, and on every continent including Antarctica. I do not believe that bankrupting the country to sustain this madness is a funding priority of the people.

Surprise Number Three - Police State: These are $7 million of unexpected appropriations in this category. A new report this week (March 2, 2009) found that prisons are now the second fastest growing items in state budgets, behind only Medicaid, well ahead of education and everything else.

Despite a 25% reduction in crime in recent years the prison industry has ballooned. There are 7.3 million adults in the system; 1.5 million in prison and nearly 6 million on parole or probation. This function of government needs a total transformation to treating the root causes of street crime; poverty, addictions, and an under-funded - in some places non-existent - mental health system. Private for profit prisons should be banned.

Some items in the stimulus that expand the police state are obvious such as $800 million for federal prisons and $3 billion for additional police. Others are scattered throughout; money for surveillance (also known as spying on Americans), courts, data mining techonology, and detention centers of all types. Together these items add up to billions.

While the people of both Mexico and the US long for a human rights based immigration policy, the militarization of the border and SWAT-military raids and roundups across the country continue. There are large increases to these inhumane policies in the stimulus. $100 million for border fencing and technology, $20 million for "tactical communications" for ICE (Immigration Customs and Enforcement). $300 million for border stations and $420 million for ports of entry.

No more surprises please. What the country deperately needs is a real investment in people - our human capital. Ultimately this is the only capital guaranteed to ge the country back on track!

KUNM COMMENTARY: Who's Stimulus is this Anyway? Part One - Who's Left Behind

2009-03-06T22:51:00.004-07:00

Yes there are good things in the stimulus. But overall, it is so anemic and scattershot that it is already being ignored by the media - now focused on the President's Budget for next year. I am sorry to report that there is very little for the people who need it the most.

While hundreds of billions bail out banks, automakers, high tech and insurance companies, New Mexico and federal safety net programs continue at levels guaranteed to keep millions of people suffering in poverty.

As a tool to show how unfair the help for the most needy really is, I have calculated the equivalent in hourly wages for a year of full time work. Here are a few New Mexico examples:

Unemployment: The average weekly unemployment check in New Mexico is $283, with the payment formula set by the state legislature. This is less than the state minimum wage. So how are people on unemployment helped by the stimulus? They get an extra $25 a week.

Social Security: Thirty-one percent of New Mexicans on Social Security have no other income. These 115, 000 New Mexicans get an average of $11,302 per year, the equivalent of $5.43 an hour. Forty-five thousand blind and disabled New Mexicans receive $603 per month, equal to $3.48 and hour. What do the elderly, blind and disabled get from the stimulus? A one time extra payment of $250, equal to a measly $21 per month.

Temporary Assistance to Needy Families (TANF, formerly known as welfare): In New Mexico a single person gets $266 per month, $1.54 per hour; a family of four gets $539 a month or $3.11 an hour. In December nearly 40,000 New Mexicans were receiving TANF payments and struggling to survive.

What do these people get from the stimulus - nothing! The stimulus gives states more money to cover new cases but it does not increase the level of payments people receive, those are set by the state legislature.

People often say, "yes but poor people get food stamps."

Its the Supplemental Nutrition Assistance Program now or SNAP. As of December, 268,000 New Mexicans were enrolled in SNAP. SNAP is based on what the federal government calls the Thrifty Food Plan. The average amount allowed for food has been $3.35 per person per day.

SNAP benefits are completely outdated and based on the myth that a stay-at-home mom prepares meals "from scratch." Tulane University researchers estimate that following the Thrifty Food Plan takes over 2 hours of food preparation a day.

What is in the stimulus for the SNAP recipient? A small increase of about 45 cents a day per person, not enough for a healthy diet or even an unhealthy diet.

Next time there is a stimulus - a real stimulus that reaches all the way to the most needy New Mexicans - it must include a much larger increase in SNAP. The US Department of Agriculture estimates that a $5 Billion increase in food benefits almost doubles its stimulus effect by creating "increased demand and production in agriculture and food sectors, stablilizing economic activites in these key rural sectors during downturns in the economy."

Increasing SNAP injects stimulus into the economy faster than nearly all other options. By putting benefits directly into the hands of more than 13 million households, they will be spent almost immediately.

Help people buy more food and grow the economy at the same time, now there's a great idea for the next stimulus!

Health Care for All New Mexicans: We Can Make it a Reality with Political Courage

2009-01-11T15:54:00.000-07:00

I want to thank the Santa Fe New Mexican for printing my op-ed on universal health care for all New Mexicans. Please call your legislators and ask them to put the people of New Mexico first.

Opinion – Santa Fe New Mexican

Sunday, January 11, 2009:

We have money for health care, but need courage
Carol Miller

Once again the Legislature is talking about increasing the number of people who have health insurance in New Mexico. The lobbyists will be out in force, money will flow and votes will be cast. There are several things to consider as this annual theater begins:

In 1992, after years of studying the health care system and considering various reforms, the Legislature passed a law calling for universal health care. The studies done in the 1990s, just like the study repeated last year, showed that the state could cover everyone and save money with a universal health care program that is publicly funded and administered (so-called "single payer" financing). Care would continue to be provided by both private fee-for-service and public providers, exactly as it is now.

In 1993, Bill Clinton became president and the Legislature decided to wait for national health reform and not act first. By October 1994, Congress gave up on national health reform and the Legislature let their mandate die. Instead of demonstrating courage, leadership on the national stage and doing the right thing for the people of New Mexico, the Legislature continued to choose the private for-profit insurance industry over the needs of the people of the state.

Using a formula developed by the Institute of Medicine at the National Academy of Sciences adjusted for our state, five New Mexicans a week die from lack of health insurance, 40 during each 60 day Legislative session and 3,584 since the Legislature chose incremental reform over universal health care.

Using this same formula, the national total is 252,000 Americans dead, from the lack of health insurance, since Congress gave up on universal health care in 1994.

The actual numbers would be even greater if they included people who died from bad insurance. Others call this underinsurance; you pay your premium and still can't get care because of unaffordable co-pays, deductibles, insurance denials and delays caused by the business of insurance.

It is impossible to get to universal access to health care through private for-profit health insurance. The United States has been trying to do this for more than 60 years and the dangerous experiment not only kills people, it wastes money. The purpose of private insurance is to collect more money than is spent and keep the money left over as profit. The U.S. spends more per person on health care than any country in the world, leaves nearly 50 million people uninsured, and our health status is not even in the Top 10.

The administrative burdens of private health insurance would take a whole page to list, but here are some as examples:

0. The enrollment/agent/employer bureaucracy
0. Billings for premiums
0. The nightmares related to billing for services delivered
0. Advertising and marketing
0. Tracking deductibles and co-pays
0. Receiving fair and timely payment,
0. Provider credentialing
0. Pre-existing condition exclusions
0. Pre-approval and referral systems that waste time and drive providers crazy.

The administrative waste of private health insurance adds up to 1 of every
3 health care dollars or about $350 billion a year in the United States, or a
$1 trillion every three years. New Mexico health spending is approaching $9 billion a year. Using the national estimate of 31 percent for administration, the cost in New Mexico is $2.6 Billion for administration every year. Public financing and administration could cut this overhead in half, freeing up more than enough money to cover every resident.

Most of the uninsured in New Mexico are hardworking, taxpaying workers and their families. Most New Mexicans with health insurance have their insurance paid for by taxpayers. New Mexico has one of the highest rates of people insured by the public; Medicare, Medicaid, SCHIP, SCI, Indian Health Service, VA, uniformed services, public employees, educators, government-funded programs, grants and contracts, with the largest being Los Alamos and Sandia national labs.

The majority of the health care in New Mexico is already paid for by taxpayers. This makes the hassles and extra costs of private health insurance even more tragic. You are using public money to fund private, mostly for-profit, corporations, that drain money from the health care system while needlessly killing five New Mexicans a week just because they can't afford medical care.

This is the unacknowledged corporate bailout of a non-essential industry, and it has been going on for decades. If Medicare, our national single-payer insurance program, can run the most-popular government program with a 5 percent administrative cost; how can we justify paying the private insurers an extra 25 cents of every health care dollar?

The 2009 Legislature has enough money to cover everyone in New Mexico with a publicly financed and administered system. Money for health care is not the issue. Courage to take on a powerful special interest is the issue.

Carol Miller is a public-health activist and acequia commissioner in Ojo Sarco.

http://www.santafenewmexican.com/Opinion/My-View-We-have-money-for-health-care--but-need-courage

Thoughts on the passing of Emilio Naranjo

2008-11-16T21:18:00.000-07:00

New Mexico was an exciting place in the late 1960’s and 1970’s and nowhere was more exciting than Rio Arriba County. Rio Arriba was the last county in the state to retain a strong and active third party, El Partido de La Raza Unida, birthed out of Chicano political activism that had risen from the civil rights and land grant movements. The momentous Tierra Amarilla Courthouse Raid of 1967 had been a high or low point of this movement, depending on the differing political perspectives dividing the county.

Beginning 1968, many organizations were formed in Tierra Amarilla; La Cooperativa agricultural co-op, La Clinica del Pueblo de Rio Arriba, and El Taller Grafico silkscreen art project to name just a few. While a number of the leaders and workers in these projects were political activists registered in La Raza Unida party, most were not party members.

These self-help community operated programs ran afoul of the patron system of Rio Arriba County, ruled by the iron hand of Emilio Naranjo. In those days, jobs and funding came through Naranjo and before long, the iron fist slammed down on the community activists.

Despite warm farewells to Naranjo, in its heyday this was not a benign system. Its strength came from fear, abuse of power and threats against any perceived enemies of the status quo. False arrests, home searches, an enemies list, planting drugs, and civil rights violations galore maintained the power of the patron.

A brave group of lawyers lead by Richard Rosenstock and Bob Rothstein took on this system in the courts. Our local newspaper, the Rio Grande Sun kept the pressure on local government then as it still does today.

1982 was a watershed year in the battle between the community and Naranjo. La Raza Unida ran a full slate of candidates and although none won, many did very well. I was the candidate for County Treasurer and in June of that year I was hired as Executive Director of La Clinica del Pueblo.

These were heady days, there was hope in the air that the patronage system would be broken at last. Elected in November 1982 was a group that had run against the patron system and because of this they had been supported by La Raza Unida. Bill Richardson was elected the first representative of the new 3rd congressional district, former Attorney General Toney Anaya was elected Governor and former Attorney General Jeff Bingaman won his first term in the US Senate.

Although it took a number of years, more than five federal First Amendment lawsuits were settled or won by members of the community against Naranjo and Rio Arriba County. The federal courts agreed that county jobs, funding and services had been doled out to political supporters and illegally withheld from political opponents. Settling these lawsuits was so expensive that the State of New Mexico Risk Management refused to insure the county and the county had to buy its insurance in the private market.

In 1984, La Raza Unida voted to disband and encouraged its members to register as Democrats to support the presidential campaign of Jesse Jackson. Jackson did quite well in the New Mexico primary and Linda Pedro, La Raza Unida activist, addressed the Democratic Convention in San Francisco. The community activists formed the Rio Arriba Democrats for Progress.

Once Naranjo lost several lawsuits to La Clinica and some of its Board and staff, fences were mended and as state Senator and County Manager he began to provide support to the clinic, and in particular its critically important ambulance service. The relationship had changed.

Naranjo lost his senate seat in a three way Democratic primary in 1996 against Arthur Rodarte, former County Commissioner, and me, Carol Miller, one of the community activists. I received 13% of the vote district wide, winning 68% of the vote of the Los Alamos precincts. Naranjo won Rio Arriba as always, although Rodarte ended up winning the seat by a handful of votes.

Emilio Naranjo had lost his first election and retired from politics.

The final chapter of this story is the primary election of 2006. Emilio Naranjo and I both endorsed Antonio J. Manzanares for Magistrate Judge. Six months later in a gas station in Santa Fe, someone came up to me very excited to shake my hand. He told me he never thought he would live to see the day when Emilio and I were on the same side.

This story would have had a very different ending if people had not stood up for their rights and fought long and hard for justice. The odds seemed overwhelming in the beginning and the penalties were serious. Because of people working together and defeating el patron the story has a happy ending but we must always remember the sad beginning and long awful middle of the story where real people suffered needlessly for the sake of one person maintaining absolute political power over an entire county.

As they eulogize Emilio Naranjo, former state Attorney Generals and other political leaders should not let history be whitewashed. The consistent delivery of Rio Arriba votes, party loyalty and dues paid to el patron should not override respect for the rule of law and the Bill of Rights.

Emilio, you will be missed for showing grace in defeat. For you, once it was over, it was over and you have my respect for that.

Respect New Mexico Voters - Let Us Have a Secret Ballot

2008-11-13T19:47:00.000-07:00

Why is New Mexico one of the few places left in the US that still uses a straight party symbol for voting? Illiteracy was high in the early years of American democracy. Voting for donkeys, elephants, pine trees, bullmoose and grizzly bears was used to help men who could not read vote.

Now men and women can vote - and read. It is time to treat the voters with more respect. Let them read the names of the candidates and select the people they prefer.

And to be honest there is too much coercion with the straight party mark. Everyone knows who votes straight and who doesn't and in the real world of New Mexico, that information has consequences.

In my small precinct in the days with the noisy voting machines, everyone would stop talking when someone entered the voting booth. We could all hear if the person voted straight party, pushing one lever, or selecting each candidate. With our new paper ballots, quickly fill in one circle or go down the line selecting each candidate. We can still tell who is voting straight.

Until New Mexico eliminates the straight party option there is no such thing as a completely secret ballot, guaranteed as one of the basic building blocks of democracy. Just another way New Mexico has less democracy than other states.

A fun list of the many party symbols is at http://www.dcpoliticalreport.com/PartySymbols/.

And the winner is... the Campaign Industrial Complex

2008-11-08T09:43:00.000-07:00

The election night acceptance speech and its mention of the "next term" ignited at lightning speed a seamless transition from campaign-to election-to the next campaign, now underway . As it turns out, the first Obama economic stimulus has been to the Campaign Industrial Complex.

More endless polling, focus groups and spin are already the order of the day. Don't be fooled that a single decision will be made without consideration of its impact on the next election.

Here are a few examples of some principles already swept aside.

Remember promises to reach across the aisle and work in a non-partisan manner? Gone.

While I am not a fan of Joe Lieberman, the Democrats were happy to have him in the caucus when his vote made the difference for them regaining leadership. Lieberman has always been a pro-Iraq-War hawk, but his vote for D leadership was needed so he was allowed to stay in the caucus after being elected as an Independent. To an outside the Beltway observer, the get-Joe movement makes the governing party looks mean and afraid of dissent.

Remember the promise to meet with world leaders - including President Ahmadinejad of Iran - for a dialogue? Gone.

Hillary Clinton called Obama "naive" for even suggesting he would meet with the President of Iran. Now it turns out the voters who crave dialogue and rejection of endless wars are the ones that were naive.

Remember the fierce opposition to unitary government where the checks and balances of government were undermined? Gone.

I have called for legislation to ban the issuance of signing statements by the President. I believe they are unconstitutional since only the Congress can legislate. Now it turns out the opposition was only to unitary government by the R's, and its fine for the D's. So much for balances, and the checks? They are in the mail.

Welcome

2008-11-05T13:26:00.000-07:00

This blog is a way to continue raising the issues and policies that speak to the hopes and dreams of so many in New Mexico, around the nation, and the world. I was honored to be a part of the important 2008 election as an Independent candidate for Congress. As the only New Mexico candidate with experience in the ways of Congress, I was able to articulate clear policy directions and plans for moving forward in a sea of soundbites and focus group tested ideas.

The election yesterday is hopefully a first step for change as promised. Now the work of making change - the right kind of change - begins. That is the job of all of us, holding every single member of Congress and the new administration accountable for their commitments and promises.

I will share that as someone experienced in the ways of Washington, my heart stopped when already, in the midst of his acceptance speech, President-Elect Obama, said that some of the changes we were promised would have to wait for another term. Full of optimism as always, I have chosen to believe that comment was a mistake, not a first step to lowering our expectations.

Throughout the campaign I warned people not to let November 5th be the first day of the next election. We need solutions NOW to the life and death crises facing so many in the country, and especially here en el norte. NOW is the time to address unacceptable rates of poverty, lack of access to health care, failing schools and the other sad statistics that betray the dignity and resiliency of very creative people, who do so much with so little.

Our work is cut out for us so roll up your sleeves and never let up.