Another reason not to kill the bill

[ProSense]

Want Universal Health Care? Move to Vermont

Source: New York Daily News
By Kenneth R. Bazinet

December 21, 2009

Independent Vermont Sen. Bernie Sanders accomplished what no one else in Washington seems to be able to do: Providing his constituents with affordable universal health care coverage.

In exchange for his vote on the diluted Senate health care bill, Sanders asked for and received just what the doctor ordered — $10 billion to increase the number of community health care centers nationwide, including at least two more for Vermont. It means health care for 25 million Americans nationwide, if the bill passes.

The Green Mountain State already has eight of those centers, which provide primary care, dental and low-cost prescription drugs. Nobody is turned away, since the centers accept as payment Medicare, Medicaid or nothing at all from people who are uninsured. More than 100,000 Vermonters get their primary care at these health care centers.

Sanders, a self-described socialist who by virtue of the fragile Democratic coalition in the Senate finds himself with more clout than ever before, isn’t stopping there. Now he’s pushing to expand by 20,000 the ranks of doctors, dentists, nurses and other medical professionals who are part National Health Service Corps.

Sanders wants to thank those medical professionals for their commitment to providing Americans with quality, affordable health care by forgiving or reducing the obscene debts they face from the cost of attending college and medical school.

“When we more than double in five years the number of people who have access to community health centers — and within that same period of time we add an additional 20,000 primary care doctors, dentists, nurses — we are talking about nothing less than a revolution in primary health care in America — something which we have needed for a long, long time,” Sanders said today on the Senate floor.

The House health care bill includes $14 billion, $4 billion more than the Senate version, to pay for the expanded health care centers and increase in the National Health Service Corps. A well-placed source says there is a very good chance the final House and Senate compromise will match the $14 billion in the House bill.

Sanders’ effort is a tribute to the late Massachusetts Sen. Ted Kennedy, who 40 years ago first proposed the system of community health care centers, formally known as Federally Qualified Health Centers. “Now we’re going to take it a giant step forward,” Sanders promised.

[damntexdem]

1. Why all the posts about 'kill the bill,' for or against?

It's too late. Now it's a question of the conference committee report.

[Clio the Leo]

2. It still has to get past more cloture votes.....

.... we're not done yet.

[karynnj]

5. There are more votes to pass the Senate version - and then more votes if the

conference changes it. Any ideas that there will be radical changes from the Senate bill are really dangerous - as this really is a delicate compromise and they need 60 votes if cloture is not waived (which it won't be) before the final bill on the conference report.

[jenmito]

3. K&R. n/t

[autorank]

4. Claims of more doctors, more coverage GREATLY exaggerated (they're b.s.ing us)

More coverage by Community Health Centers/Federally Qualified Clinics but not nearly enough. Sanders' claims exaggerated

There are Community Health Centers in http://www.nachc.org/client/documents/U.S._Fact_Sheet_2008.pdf">every state already. 1,200 total with 7,000 delivery sites. They are designed to serve the medically disenfranchised, "people with no or inadequate access to a primary care physician due to local shortage of such physicians." Most clients of Community Health Centers Medicaid recipients or the uninsured. This program correlates with lower income, poverty, and unemployment.

The centers serve 19 million people currently on a $9.1 billion budget (2007). The Senate bill ads $10 bil to that amount over six years period. That an annual percentage increase (presuming it's equal and not accounting for inflation) is16% above current budget. So if $9.1 billion covers 20 million “medically disenfranchised citizens then that 16% budget increase has to cover another 30 million.

It won't, of course. Sanders basically pulled off a coup for his state and added funds to a fine program but it's not close to the panacea you describe and that described by the reborn advocate of the insurance company oriented bill. It's just more politics to generate benefits for a legislator's particular state and add fluff to the overall claim that this bill actually addresses the problems of the medically disenfranchised.

Here's a map of the medically disenfranchised. The total for the nation is 20%: 50 million people.



How do you add 16% to a budget to reach the medically disenfranchised and increase that reach by 100%? It's not reasonable to assume that this is a factual claim.

But lets use those higher House numbers of $14 billion over five years. That's a 31% increase in annual budget over five years. In our reasonableness test, we have 20 million served by the Community Health Centers/Federally Qualified clinics now. Ad 31% to the 20 million and what do you get, 26 million medically disenfranchised people covered. There are 50 million of these folks according to the health center association figures presented previously. We're still 24 million short of the 50 million (and growing) medically disenfranchised citizens.

20,000 new doctors - Bernie's nose is growing because that's bull shit



As for 20,000 new doctors, lets be realistic. There are around 16,000 US Medical School graduates per year. This is a result of declining interest in medical school as evidenced by this graph:

That means right now, we're supplementing US M.D.s with graduates of osteopathic programs and foreign doctors.

The American Association of Medical Colleges summed it up nicely: "If we start now (2006), a significant investment of both time and resources will be needed to boost enrollment by 30 percent. It will take at least seven years to see any increase in the number of practicing physicians." American Association of Medical Colleges They didn't start in 2006, so apply that time table to 2010. It's 2017 until we "see any increase" in new MDs.

Where are the 20,000 new doctors going to come from? They're going to come from DO's and foreign doctors, but they don't tell us that.

Once any new doctor become licensed, there will still be shortages across the board, according to the association. Will the new MDs want to serve in rural communities for government wages or will they take advantage of a general shortage of doctors and go to areas where they can earn much more?

It's easy for the leadership or particular Senators/Representatives to make claims but not so easy to produce when confronted with the facts. We have many uncovered citizens and this bill doesn't come close, can't come close, to filling that gap as written and funded.