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PNHP RESOURCES

Keep Your Hands Off Medicare, President Bush

The Hartford Courant
April 13, 2001
by Ramon Castellblanch

"The way to get a Medicare prescription drug benefit that does not risk Medicare hospital benefits is paying for them from the general fund budget surplus, not from the Medicare hospital fund."

"Medicare's problem isn't economic or financial - there's plenty of money in its surplus. The problem is political."

The full article is available at www.ctnow.com, under "Editorials."

Comment: The problem with a "unified" budget, combining Medicare and Social Security taxes with general revenues, is the shift in the source of revenues used to run our government. The excess funds paid into Medicare and Social Security are shifted into the funds for general expenses. But look at who is paying. Unlike income taxes, which are progressive, low income individuals bear the full burden of their portion of these payroll taxes. In fact, the Social Security portion is regressive since high income individuals pay a lower percentage of their total income than do moderate and low income individuals. As Congress tackles tax and budget issues, we must insist that they do not use this patently unfair mechanism of shifting funding of general expenses from our fair, progressive income tax system over to our programs of social insurance that are funded by each participant. To do so would be yet another injustice of the poor funding government services for the rich. Perhaps we should counter with the recommendation that payroll taxes be eliminated and that Medicare and Social Security be funded by general revenues (income taxes), inherently more fair because of the progressive nature. It would certainly bring to attention the real issue involved, and it would strengthen our bargaining position on behalf of preserving Medicare funds.

Don

Message from Don McCanne:

Hoag Memorial Hospital Presbyterian is a first rate hospital that, in fact, does contribute significantly to the unmet medical needs of the community. I still stand by my position that even the best of us must do much more to advance the cause of universal health care, but I sincerely regret using Hoag Hospital as a negative example merely because of a minor blemish in their ethics (using defibrillator gifts to golf courses as a marketing strategy). I feel strongly that the "good guys" have to work together on the cause of health care justice, and, in this instance, I violated my own standards by taking on one of the best.

In fairness, I am presenting the statement of Gwyn Parry, M.D., the Director of Community Medicine at Hoag Memorial Hospital Presbyterian (relayed through Felix Schwarz, Executive Director of the Health Care Council of Orange County).

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Subject: Hoag Hospital Date: 13 Apr 2001 From: Gwyn Parry, M.D. To: Felix Schwarz

Thank you Felix. We always appreciate the critical commentary, and you know that we agree with the need for significant improvement in the provision of health care access. As the only modern industrialized nation without a universal system of health care access and provision, we're going to fall way behind in this competitive world throughout this century unless we bring about some major changes; and we're going to have to speak more aggressively in asking ourselves some very searching questions about our moral and ethical commitment to our society. While I don't engage in rhetorical argument, I would suggest that to be knowledgeable about not-for-profit hospitals, and to be able to make learned commentary, one should review the community benefit legislation: SB697. As you well know, this act of the California legislature provides the motivational standard for programs and initiatives in community benefit provided by not-for-profit hospitals, of which Hoag Memorial Hospital Presbyterian is but one. I'm sure that you can provide your readers with a copy, and a copy of your excellent analysis of hospital programs that you wrote two or three years ago. Additionally, I'd further suggest that your readers access the Community Benefit reports annually filed with the Office of Statewide Health Planning and Development and now accessible via the OSHPD website: http://oshpd.cahwnet.gov/hpp/hcbp/index.htm

Hospitals are listed in alphabetical order; by county; and by bed size. Identify the hospital in which you are interested and e-mail your request to: hppmail@oshpd.state.ca.us

Requests can also be submitted by phone or fax. We are required to annually report our programs provided for the at-risk, underserved, and while we don't advertise them, reports include the dollar expenditures. I think your readers and correspondents might be interested in just how much effort is being put into community outreach for residents that lack resource access and service that we take for granted. On another related topic, I've had an opportunity to talk to several funding sources about the forum on insurance issues that you wish to conduct and you and I need to sit down at your convenience and re visit the proposal. Thanks GP