A retired physician who volunteers at the Venice Family Clinic and St. Joseph Center and is an advocate of single-payer healthcare, said that the nation has “reached the endgame in our dysfunctional healthcare system and to add another layer of bureaucracy within the public system makes no sense.”

Jerome Helman, M.D., who retired one and a half years ago after 42 years in medical practice, said, “As a physician, I see the need to cover the growing population without health insurance becoming desperate by the day. At the Venice Family Clinic I see first-time patients from middle class homes and families, who require treatment and medication they cannot afford.

“Even just a simple mental health prescription that will prevent further depression or deterioration of a mental health condition is too expensive for most, as it requires a doctor’s office visit or the inappropriate use of a hospital emergency room. The public plan will still leave tens of millions of Americans without health insurance and a legacy of debt we cannot afford.”

Helman said that he has seen a 40 percent increase in the need for services at Venice-based St. Joseph Center, which provides assistance to needy families and individuals on the Westside.

He is affiliated with the California Physicians Alliance (CaPA), a chapter of Physicians for a National Health Program (PNHP).

“As a single-payer advocate representing 17,000 physicians nationally and locally (PNHP, CaPA), single-payer is neutral fiscally, so it will not require new funding or taxes,” said Helman in a letter to Congresswoman Jane Harman, who represents the 36th District. “With the money now sequestered by the health insurance companies in inordinate administrative waste, in delays in authorizing care and in excess profits up to $800 billion is already available to fund a government-sponsored healthcare system that would not deny any citizen or qualified individual from coverage.”

CaPA is a statewide nonprofit organization sharing a goal with PNHP of promoting a single-payer healthcare program and works on incremental reforms to promote justice in healthcare, according to its Web site. PHNP is a nonprofit research and education organization of over 17,000 physicians, medical students and healthcare professionals who support single-payer national health insurance.

“When an individual has to choose between food and medication or has reached the point where neither is possible, no amount of rhetoric will change the reality,” said Helman. “When a working or middle class individual comes for their first visit to the Venice Family Clinic there may be despair and a feeling of failure, but it offers that person a chance to regain the health and dignity that we all deserve.”

“The relentless increase in premiums, co-pays and deductibles by the health insurance industry, as well as the usurious rise in the cost of medications in the past 15 years has brought us to this moment of crisis,” he continued. “Incremental change is the problem. Revolutionary change is the only way out. Healthcare is a human right.

“Physicians really have no serious political force. We are prevented from organizing in any way to protect us financially. Our world has been decimated by legislators and the insurance industry to the point there is nothing left to take away or change. As if punishment has been rendered to a powerless waif until there is no life or sense remaining.

“I talk about the siege physicians are under now. We need advocacy, political power and political will. PNHP has the right understanding and is gaining strength and numbers and has the political will to reach our endpoint. There indeed are many Democrats and Progressives in our midst but also some conservative thinkers and Republicans,” Helman said.

The Veterans Administration has the state-of-the-art information technology that would make electronic medical records (EMR) available to every physician, not only primary care doctors, who are presently “under siege” with their economic burdens, said Helman. With the economic stimulus subsidy of $20 billion already designated for EMR, he said a gift of this technology to physicians would guarantee a transparent and seamless transition without the inefficiencies and excessive charges of those poor systems now available.


The concept of single-payer healthcare is not a new one. California State Senator Mark Leno introduced the California Universal Health Care Act (SB 810) early this year. It carries forward the work of the California Health Insurance Reliability Act (SB 840) a Medicare-like, single-payer program authored by then state Senator Sheila Kuehl in 2005. Kuehl’s bill was passed by both houses of the state legislature in 2006 and again in 2008, and was vetoed both times by Gov. Arnold Schwarzenegger.

“A single payer system for California, as developed in my bills and now, in SB 810, establishes a universal health insurance system that provides every California resident with comprehensive benefits for life; puts your premiums, based on a small percentage of your income, and, for employers, a percentage of payroll, with no co-pays or deductibles, directly into healthcare spending;

It allows you to choose your own doctors, hospitals, dentists, eye care providers, and other medical services, without limiting you to a network; ensures the best use of your money by cutting the current 25 percent private companies now spend for overhead to just five percent; and, through rewarding excellence and sharing efficiencies and best practices, ensures patient-centered, good quality healthcare for all Californians,” Kuehl states on her Web site.

The former senator said, “You can’t lose the insurance if you lose or change your job. You won’t be turned down. The plan is fully funded with the money we already spend on healthcare, which, last year, combining state, federal, local and all premiums, co-pays, deductibles and out-of-pocket expenses, totaled more than $200 billion.

“The bill eliminates wasteful insurance overhead, invests in electronic infrastructure that improves quality while reducing cost, emphasizes prevention and primary healthcare, and utilizes California’s purchasing power to realize savings on prescriptions and durable medical equipment.”

Kuehl, now a member of the California Integrated Waste Management Board, told The Argonaut that the claim of socialized medicine by opponents of single-payer healthcare is “completely false.”

“People don’t understand the difference. Socialized medicine is where the government employs the doctors, all hospitals are public, and the healthcare system is state-run. That would potentially be socialized medicine. In the same way as you might say a socialized police force, with all our public safety employees being employed by the city, county or state. That is not the model for single payer.

“Single payer is more like a Medicare model where everyone pays a premium into a central fund, and out of that fund all of your healthcare services are covered, so that you don’t pay a co-pay or a deductible. You would have a full comprehensive policy based on the premium you pay into a central system like Medicare.”

Asked if SB 840/SB 810 is the same as the United States National Healthcare Act (HR 676), introduced by Congressman John Conyers, Jr. of Michigan, Kuehl said, “I think so, but that bill is not as fully developed as the bill we have in California. We have over a 100-page bill that gets out all of the governance structure, all of the coverage, so that it’s embedded in statute.

“In a sense, we can’t get a bill here with funding in it because it would require a two-thirds vote since it would be considered a tax, even though it would take the place of all the premiums. So it would be less than what you pay now. You would have the ability to choose your own doctors, hospitals, dentists, ophthalmologists and other healthcare providers, and not be limited to a network by insurance companies.”

Asked if the state budget crisis would have an effect on getting Leno’s bill passed, Kuehl answered, “The California budget has nothing to do with it because this is not budget money. If it [Kuehl’s original bill] could have been funded in 2006, a study by The Lewin Group [a national healthcare and human services consulting firm] identified that it would have been about three-and-a-half percent of your income as a yearly premium and about seven percent payroll tax, with all employers having to participate, but that’s about half of what employers pay now to provide health insurance.”

Kuehl said that schools, cities, counties, the state, law enforcement, public employees, unions and retirees who pay for healthcare now would all be participatory in the system. There would be “enormous” savings, a reason why school districts are in favor of single payer healthcare.

“Insurance companies are very, very, very concerned,” she said, “since they make billions of dollars a year just in California, and they would no longer be allowed to operate as health insurance companies except to sell policies for elective surgeries, such as cosmetic surgery.”

“President Barack Obama said that if you like your plan you can keep it. If you don’t, a public option with rules could be created to have an opportunity to buy insurance you can afford,” said Kuehl.

“The reason he said that is because people are very reluctant to let go until they understand the new plan is not going away. It took 35 years for Medicare to be added to social security. It takes a long time to build a movement that will be primarily focused on public education, so that one person at a time comes to realize that this program will be better for them,” she said.

Marcy Winograd, who is opposing Harman in the 2010 election, is a strong proponent of single-payer healthcare. She wrote in an article for LA Progressive, “Single-payers crashing the gates,” saying that she contacted the Congressional Budget Office (CBO) to find out why there are no federal government cost projections for single payer.

She said the communications director replied that the CBO takes its orders from Congress, specifically the leadership (House Speaker and Senate Majority Leader) as well as the chairs of various committees, and that the priorities for the CBO are set by Congress.

In her article, Winograd commented about the charge that the public option is an attempt to “socialize” healthcare. “Please. Last time I checked we had publicly funded the fire department, police department, national parks, libraries, universities and the highways of America.

“Though the government pays the bills for these services, fire departments are still free to purchase equipment made by private vendors and libraries are free to purchase books from for-profit publishing houses. The same would be true under a single-payer system, which though funded by taxpayers, would allow for individual choice; choose any doctor, hospital, lab, or clinic you wish. Ironically, a free-market approach in the delivery of healthcare,” said Winograd.


The new president of the American Medical Association (AMA), J.J. Rohack, M.D., said in his inauguration speech that if the use of federal taxes to significantly pay for healthcare defines a public plan, one already exists, the Federal Employee Health Benefits Plan. He said that individuals whose employer doesn’t provide health insurance coverage could buy into that federal plan with advanceable credits inversely related to their income.

Rohack also said that the AMA wants to build on the good aspects of the healthcare system, not create a brand new system. He called for universal access, freedom of choice, physicians able to practice in an environment of their choice and for the public/private sector to work together.

The Physicians For A National Health Program organization said this federal insurance plan wouldn’t work as a model or template for the nation because the plan is actually a mix of private health insurance plans that carries the same problems of private plans generally; administrative waste, restrictions on healthcare providers, inequities and inadequate cost controls.





(Senator Mark Leno’s site) http://dist03.casen.govoffice.com/