Michigan Did Not Get Its False Claims Act Together, Again

Pay attention to the whom the review was addressed.  Mike Cox is no longer Attorney General.  It is now Bill Schuette. 


HHS OIG Review of Michigan False Claims Act 2011

Conyers: One Year Later, Affordable Care Act’s Positive Impact Has Already Been Felt by America

Wednesday, March 23, 2011

Conyers:  One Year Later, Affordable Care Act’s Positive Impact Has Already Been Felt by America

Conyers Celebrates the One Year Anniversary of the Affordable Care Act by Praising the Term, “Obamacare”

(Washington)—Congressman John Conyers, Jr. (MI-14)  issued the following statement today celebrating the first anniversary of the comprehensive health care reform law, the Affordable Care Act, that passed last Congress and was signed into law by President Obama on March 23, 2010.

“Not withstanding the unfounded views of the President's political opponents, there is no denying that the Affordable Care Act has already significantly helped the people of Michigan and the rest of the country,” said Conyers.  “Michigan residents will no longer have to worry about their children losing coverage because of a pre-existing condition or a mistake made on an application, and I have yet to meet one parent who would not want their children to stay on their insurance plan until the age of 26.”  

“Contrary to many people’s intentions to use the term, ‘Obamacare’ to derogate the health care reform law, I believe the name does the opposite in praising President Obama for leading the Nation to make the first step towards achieving the goal of affordable health care for all,” said Conyers.  “Who wouldn’t want to get credit for legislation that will reduce the deficit, create more jobs, and ensure access to quality health care?”

Specifically, the Affordable Care Act is already helping the people of Michigan by:

·         Providing New Benefits and Lowering Costs for Medicare Beneficiaries

·         Lowering Taxes for Small Businesses

·         Providing Greater Resources for Michigan

·         Providing New Coverage Options for Young Adults

·         Covering Children with Pre-Existing Conditions

·         Removing Lifetime Limits on Health Benefits

·         Making it Illegal for an Insurance Company to Drop Coverage When You Get Sick

·         Creating New Coverage Options for Individuals with Pre-Existing Conditions

·         Increasing Support for Community Health Centers

#3-23-2011#

REINS Is Literally "Job-Killing"

Oh, this is hilarious.

Here you have a group of individuals who believe regulation is "job killing".  Well, when you are dealing with elected persons who lack administrative sophistication, you must assume their advice comes from their advocates... oops, I mean lobbyists, the same individuals who would significantly benefit from less regulatory mandates.

See, it goes like this, even though all three branches of government have their input into any administrative regulation that comes down, it is actually "job killing" because most of the local governments would not be in operation if they had to be compliant, let alone have to be compliant wtih civil rights policies.  This rings with even more truth when you understand that these "economically significant" new rules that may come down are dealing with privatization, out-sourced by state governments.

If one possessed basic understanding of the legislative process, one would know there currently exists multiple forms of input from the people regarding the formation and adoption of regulations beyond the sole elected official.


There is the Federal Registry which allows for public content.  The elected official who is concerned with having a voice should assist and engage his/her constituents in the opportunities to submit historical comments into federal record.

Then, there is always the role of the elected official to, again, assist and engage his/her constituents on how to contact the administrators of each agency to voice concerns and to provide critical input in the development of any policies.

Alas, it seems here the elected official would prefer to bog down the legislative process in minutia of applying a fifth layer of approval for policies which would virtually shut down governmental functions.  Grandstanding at its finest.

Now, let's examine the counterfactual of a "so-called" removal of regulatory policies.  Let's take EPA for example.

You remove regulation of EPA, people become sick and die.  Sick people tend to cause a soaring costs to overall health care.  Sick people can not work nor be productive to society which means that they will not be able to afford individual private insurance and seek the single payer programs.  The moral hazard kicks in to increase the cost of private insurance placing more individuals at risk of loosing their medical coverage.

As the insurance companies financially benefit with an increase in profits by cherry picking who will be insured, there will be a need to further reduce its work force with fewer clients.
Dead people do not work nor pay taxes.

Now, that is what I call "job-killing", literally.

Beverly Tran
An Original Source

Michigan Senate Resolution To Memorialize Congress For Moritoria On Regulation With REINS Act 2011

San Francisco Endorses Hr-676 Press Conference June 19, 2008

John Conyers Talks about Healthcare

New federal rules are attempt to curb fraud

New federal rules that begin March 25 aim to curb Medicare and Medicaid fraud from the get-go and better police businesses with questionable practices.

Through provisions of federal health reforms, the Centers for Medicare & Medicaid, part of the Department of Health and Human Services, will:

• Classify types of health care businesses as low, moderate and high risk for fraud. Medical equipment supply companies and home health care agencies will be considered at highest risk because of past fraud problems involving those industries. People owning 5% or more of such a business will need to be fingerprinted so their background can be checked more thoroughly.

• Consider health care providers dropped from Medicare and Medicaid programs because of questionable activities to be high risk, regardless of their specialty. The providers will be required to undergo security checks and fingerprinting.

• Prohibit providers terminated from programs in one state from moving elsewhere and billing the programs in another state.

• Conduct unannounced site visits and suspend payments when there are credible fraud allegations.

• Be able to suspend new Medicare applications by providers in areas of health care where suspicious, increasing problems exist.

"We really believe that the combination of our increased screening before people get into the program and the scrutiny they will get once they are in the program ... will improve" prosecution of Medicare and Medicaid fraud, said Peter Budetti, head of the Center for Program Integrity at the federal agency.

Budetti said the new tools address concerns that the federal government does too much pay-and-chase to catch wrongdoing after it's done, not at the time it's planned.

"This is a major shift," he said. Pay-and-chase strategies work with existing providers with established billing records but "when dealing with new threats to the program from scam artists, people doing downright illegal activities, pay-and-chase can't work,'' he said.

"Most of the time the money is gone. That's why the only real solution is to prevent these problems and keep the bad guys out."

Medicare scams infect Detroit as recruiters use poor to steal millions

A security guard walks through the Conner Capuchin Soup Kitchen in Detroit on Thursday. Security has helped keep away the Medicare scam artists who prey on soup kitchen clients. Poor people on the streets and in homeless shelters also are targeted. / ANDRE J. JACKSON/Detroit Free Press

BY PATRICIA ANSTETT
DETROIT FREE PRESS MEDICAL WRITER

• FILED UNDER
• Local News
• City Of Detroit

Fraud conference set

U.S. Attorney General Eric Holder and U.S. Health and Human Services Secretary Kathleen Sebelius will be keynote speakers Tuesday at a conference at Wayne State University on Medicare fraud.

The event will include law enforcement officials, consumer experts, providers and government agencies. The conference is the fifth nationwide to educate the public and others about the problem. Attendance at the conference is by invitation only.

It will be from 9 a.m.-12:30 p.m. Come back to freep.com Tuesday for coverage.

Nine targets

Since 2007, a joint federal task force has cracked down on Medicare fraud in nine U.S. cities.

Besides Detroit, the strike forces operate in Miami; Los Angeles; Baton Rouge, La.; New York (Brooklyn); Houston; Tampa; Chicago, and Dallas.

ZOOM

Dearborn Clinic operators wanted: Clara Guilarte, left, and her sister Caridad Guilarte are wanted on Medicare fraud charges.

ZOOM

How Medicare scam works

The Medicare scams operating in metro Detroit follow a similar pattern. Here’s how the scam worked in one recent Detroit case:

THE CLINIC
Operators pooled money to start a bogus clinic.

THE DOCTORS
The operators put ads in newspapers for medical doctors to run the clinic or used colleagues involved in scams in other states, even if they were not licensed in Michigan.

THE RECRUITERS
Clinic operators hired Medicare recruiters to find Medicare recipients in Detroit, using vans to pick up people at soup kitchens, homeless shelters and on streets in poor neighborhoods and shuttle them to surburban clinics.

PAYOFF
Medicare recipients gave the clinic their information in exchange for money, typically $50 per visit or as much as $150 for return appointments.

SCAM MONEY
Clinics used the information to fraudulently bill Medicare for millions of dollars.

The corner of Third and Martin Luther King Jr. in Detroit is known as an area where Medicare scam artists prey on homeless people. / Photos by ANDRE J. JACKSON/Detroit Free Press

Brother Ed Conlin talks to clients at the Conner Capuchin Soup Kitchen in Detroit on Thursday. Conlin says he has confronted scam artists trying to get Medicare information.

Rosa Genao, 52, of Miami, will serve eight years.

How to report fraud

Medicare fraud: 800-447-8477 or e-mail: HHSTips@oig.hhs.gov

Medicaid fraud: 866-428-0005

Related Links

New federal rules are attempt to curb fraud

New federal rules are attempt to curb fraud

Detroit has become one of the nation's "new frontiers" for Medicare fraud with many scams run by operators fleeing a federal crackdown in Miami.

Authorities say operators use recruiters to target poor men on Detroit streets, at soup kitchens and in homeless shelters. They shuttle them in vans to clinics set up for the scams or run by licensed providers trying to bilk the system for bogus treatments or for care never rendered or needed. Operators take their Medicare information in exchange for $50 or more.

Detroit's unemployment rate makes it a particularly vulnerable target. Authorities have identified at least $120 million in fraudulent billings in metro Detroit.

The businesses investigated include physical therapy clinics, home health care agencies, medical equipment providers and podiatry offices. More regulation and prosecution is needed, some attorneys say.

"It's like banks without an alarm system," said David Haron, a Troy attorney who specializes in Medicare and Medicaid fraud, referring to the ease with which some medical businesses are established.

Since a federal strike force was created in Detroit in 2009, there have been more than 200 arrests, resulting in 60 guilty pleas and eight convictions at trial. Two operators of a Dearborn clinic -- sisters Clara and Caridad Guilarte -- are on a federal most-wanted list after their Dearborn infusion clinic was shut down for fraud.

Yet the recruiters keep coming.

Poor people's Medicare information is being used to bilk the government

A man in white painter's pants and a black parka with a fur-lined hood chatted last week with the poor, mostly homeless men at the Conner Capuchin Soup Kitchen on the east side of Detroit.

It wasn't his first time.

"They are here every day," Marilyn Reyes, assistant manager of the kitchen, said, pointing to the man, one of many Medicare recruiters preying on poor, elderly and frail people in Detroit.

When ordered to leave, the man takes his business to the public sidewalk or to a nearby fast-food restaurant or liquor store, the staff said.

Reyes said one recruiter even threatened her a few months ago when she told him to leave, saying, " 'I'll have you killed.' ''

By the vanloads, these recruiters truck their targets to clinics, doctors' offices or other health care businesses in the suburbs, where their Medicare information is traded for $50 or more. The information is then used to bilk the federal government out of thousands of dollars in fraudulent Medicare billings.

When time doesn't allow for a trip, recruiters take pictures of their targets' red-white-and-blue Medicare cards for use in the scams.

To avoid detection during their recruiting trips, some drivers cover their license plates. Men most often are the targets, as they far outnumber women on the streets and at programs serving homeless people.

These activities continue all over the city, including at both Capuchin Soup Kitchens on the east side. The kitchens serve 1,000 meals a day, mostly to homeless men ranging from recently released prisoners to elderly Medicare beneficiaries.

The Conner Capuchin Soup Kitchen was forced to add a security guard in late February to watch its parking lot, in addition to guards who oversee the kitchen and staff inside. A recruiter mistakenly hit on guard Frank Shannon, a retired Detroit police officer, on his first day on the job, asking for his Medicare information in exchange for $50. He said he gave a bogus number to the man, who left. When he returned another day, he told the man he was a security guard hired to get rid of people like him, saying, "There's a new sheriff in town."

The Meldrum Capuchin Soup Kitchen also employs security guards inside and out, to no avail.

"They were here again today," a guard told Brother Jerry Smith, Capuchin Soup Kitchen executive director, on Thursday.

The aggressiveness and pervasiveness of these soup kitchen recruiters shows the scope of the Medicare fraud problem, despite the nation's biggest effort to end it.

Since March 2007, when the first joint federal task force began investigating Medicare fraud in Miami, 990 people have been charged with filing $2.3 billion in false Medicare billings in nine U.S. cities, including Detroit, where the task force efforts have been expanded. Investigators have identified at least $120 million in fraudulent billings in metro Detroit alone.

Federal officials estimate 3% to 10% of the $3.3 trillion the U.S. will spend on health care in 2012 will be wasted because of fraud and abuse. Cutting fraud and waste is critical to making Medicare solvent for future generations and finding money to offset costs for health reforms.

"In Detroit, and in the eight cities across the nation, our strike forces have been making a real impact," Kathleen Sebelius, secretary of the U.S. Department of Health and Human Services, said in a statement to the Free Press. "We're no longer waiting for criminals to trip up. We're working together ... to identify the bad actors early, tracking the large criminal enterprises and shutting them down.''

As the Miami crackdown intensified, health care providers moved from there to other cities including Detroit, where large populations of poor, elderly and sick people, often with AIDS and other chronic problems, "make a target-rich environment," said Tom Spokaeski, assistant special agent in charge of Detroit's Office of Inspector General, part of the Department of Health and Human Services.

Businesses Spokaeski and others have investigated include home health care clinics, podiatry offices, physical therapy businesses and doctors' offices. Some ordered costly tests and expensive prescription drugs or billed for services never rendered, according to federal court records in Detroit.

Others billed for months of physical therapy or home care for people who didn't need any care or needed much less rehabilitation.

With its high unemployment rate, Detroit is a particularly easy target.

On a tour of the Cass Corridor last week, Spokaeski pointed to an area that federal investigators call "the Beach" near Third and Martin Luther King Drive, where dozens of people mill around some days talking to Medicare recruiters waiting for them on vacant lots, outside an aging hotel and near a homeless shelter.

Spokaeski and others have helped arrest more than 120 people in Medicare fraud scams since May 2009, when the joint task force expanded to Detroit. As of last month, 60 of 120 defendants arrested in Detroit have pleaded guilty and another eight have been convicted at trial, according to the Justice Department.

The average prison sentence in Detroit is 41.4 months, with nine people getting stiffer sentences of as much as 10 years.

"Despite our efforts, there is no shortage of cases," said Barbara McQuade, U.S. Attorney for the Eastern District in Detroit.

"We want providers to know we are scrutinizing billing records, and people will be brought to justice. We are seeing very strong sentences in these cases. People who just think a slap on the wrist are mistaken. The judges in our court have taken a very harsh view to this kind of activity.''

Federal investigators also have arrested and sentenced some of the recruiters but "the problem is rampant" and issues of attempted assault or trespass typically fall to local police, Spokaeski said. The Detroit Police Department did not return calls for comment.

$2.3 million in Medicare billings in four months

Xpress opened in November 2006 in Livonia. It was set up as a drug infusion clinic to administer high-dose prescription drugs by infusion for complications resulting from AIDS and HIV, hepatitis C and other problems.

Xpress lived up to its name.

Bankrolled by several Miami health care providers who later were charged or sentenced in various scams, it billed Medicare $2.3 million before federal agencies shut it down four months later, according to federal court records.

One of the principal owners of the clinic was Juan De Oleo, 51, of Miami, who was licensed as a physician's assistant in Florida, federal court records show.

De Oleo and his partners had run other infusion clinics in Miami before coming to metro Detroit, federal authorities say.

They set up four infusion clinics -- one in Livonia, two in Dearborn and one in Southfield -- between 2006 and 2007, court records show. One of the Dearborn infusion clinics was run by Clara and Caridad Guilarte, who fled the country when their clinic was shut down for fraud. The two are now on a most-wanted list issued by the inspector general's office in the Department of Health and Human Services.

The government focused its case on the Livonia operations, where it obtained the best records to establish fraud.

To help with the scheme, De Oleo needed a doctor willing to write prescriptions and bill Medicare for costly drugs. Through a newspaper ad, he found one. But the doctor usually appeared so stoned or drunk that De Oleo then convinced his wife, Dr. Rosa Genao, a 52-year-old Miami pediatrician, to help. Genao had been involved in questionable clinic billings in Miami, according to federal court records.

Flying in to Detroit on weekends in the dead of winter, Genao directed the falsification of records to bill Medicare for costly drugs at the Livonia clinic, court records show.

The clinics rendered little care and did not even have an adequate supply of medicines for the amount of drugs they allegedly prescribed, the court records show. In all, the four clinics submitted $11 million in billings to Medicare for about six months of operations, records show.

Three homeless people caught up in the Livonia scheme are among 19 Medicare recipients in Detroit charged in the scams, typically with conspiracy to receive health care kickbacks, a felony. Most have gotten probation, according to the Justice Department.

One was Rodney Woods, who received two years of probation for giving his Medicare information to Xpress.

"Rodney Woods was a truly sick individual'' with AIDS, hepatitis C and other medical problems, said his Detroit attorney, S. Allen Early.

Early said the clinic billed Medicare $82,000 for Woods' care, but the government said Woods got mostly sham treatments or, at most, B12 vitamin shots before a van shuttled him back to Detroit.

"He was more a victim than a participant in the scheme," said Early.

Attorneys at the sentencing for De Oleo and Genao portrayed De Oleo as a silent investor in the clinics and his wife as a reluctant participant.

Letters from their pastor, family and colleagues to federal judge Denise Page Hood said the couple served as marriage counselors at their Mennonite church in Miami and Genao was a volunteer for a program in Miami called Virtuous Women that helped women raise their children.

"I can see you were kind of the rising star of your family," Hood said to Genao, referring to Genao's life growing up in Puerto Rico, attending medical school in the Dominican Republic and struggling to get licensed as a doctor in Florida.

Hood didn't buy the couple's pitch, saying both were more like top-of-the-food-chain perpetrators, compared with "the little guys" her court also has sentenced for Medicare fraud.

She sentenced De Oleo to 10 years in prison and Genao to eight and ordered the couple to pay $1.8 million in restitution.

Attorneys for De Oleo have requested a new trial. Both the husband and wife declined to comment.

De Oleo was taken away in handcuffs after his sentencing, kissing his wife on the cheek as he left the court with two U.S. marshals.

Genao awaits a letter from the federal Bureau of Prisons telling her where to surrender to serve her sentence. She threw herself on the ground under the attorney's table in Hood's courtroom after the verdict, sobbing.

New federal rules and fraud office in Michigan

New federal rules going into effect this month are an attempt to increase scrutiny of providers seeking Medicare numbers that allow them to bill the program, and to conduct unannounced inspections.

Michigan also has a newly created Office of Inspector General within its Medicaid division and has increased prosecution of health care providers who falsely bill the state-administered Medicaid program. But some providers, particularly those who bill private insurers, often can be involved in questionable activities that escape detection if the business is not required to be licensed. Such is the case with home health care agencies, imaging centers and outpatient clinics, for example. A bill to require licensing of home health care agencies awaits a hearing by the state Senate Health Policy Committee.

Still, attorneys complain that more scrutiny is needed, particularly before a business is allowed to open, and more resources are needed to prosecute illegal and questionable activities.

"There needs to be more resources to vet the people" before they open any type of health care business in Michigan, said David Haron, a Troy Medicare and Medicaid fraud attorney.

Pay may be hot issue, but other factors push harder on health costs

By Megan Woolhouse

Globe Staff / March 13, 2011

Blue Cross Blue Shield of Massachusetts has captured the public’s attention, although not the way it would have liked, as reports of millions paid to the insurer’s former chief executive and hefty stipends paid to board members sparked outrage.

The outcry grew big enough to force Blue Cross board members to vote to suspend their own payments and to lead the insurer to make promises to curb excessive payouts to executives. There’s just one problem: Those steps will do little to fix soaring health care costs.

“I have the same outrage,’’ Stuart H. Altman, a national health policy professor at Brandeis University, said about Blue Cross’s payments. But, “We need to put executive pay and board salaries in perspective. It is not the major force, or even close to the major force, in driving up health care costs.’’

US health care spending hit $2.5 trillion in 2009, increasing by about $600 billion from 2004, according to the Centers for Medicare and Medicaid Services. Nearly two-thirds of the increase was driven by rising costs in three areas: hospitals, which accounted for 33 percent of the increase; doctors, which accounted for 19 percent; and prescription drugs, which accounted for 10 percent.

Administrative costs, which would include payments to board members, accounted for about 5 percent of overall health care cost increases. Altman said Massachusetts health insurers spend about 10 percent on administrative costs, lower than the national average, which is typically 15 to 20 percent.

In a report last year, Attorney General Martha Coakley concluded that price increases by providers accounted for 90 percent of the growth in Massachusetts health care costs between 2006 and 2009. The report also found that prices varied widely, but the highest prices were charged by the biggest providers with market power to push insurers to pay more. Insurers, in turn, passed at least some of the those costs to consumers.

Health care costs are growing much faster than the economy and wages, the report warned.

“Such increases, if unchecked,’’ the report said, “threaten the financial stability of individuals and businesses, and the future viability of our gains in health care access.’’

Under the state’s universal health care law, about 98 percent of Massachusetts residents have insurance. Blue Cross is the state’s largest insurer, insuring more than 3 million residents.

Health care providers and insurers have long clashed over who was responsible for rising health care costs, leaving Massachusetts employers to deal with double-digit premium increases. Many firms criticized Blue Cross and other insurers for the relentless increases that crimp hiring by raising the costs of adding workers.

But it is the compensation issue that has provoked populist anger, as workers struggle with stagnant wages and rising health insurance costs.Continued...

Massachusetts Investigation of Health Care Cost Trends and Cost Drivers

Massachusetts Investigation of Health Care Cost Trends and Cost Drivers

HHS Inspector General Testimony On Medicaid Fraud

Testimony of Inspector General Levinson before the United States Senate Committee on Homeland Security & G...

Senate Dems Consider Health Care Fix That Could Hit Poor Consumers The Hardest

Senate Dems Consider Health Care Fix That Could Hit Poor Consumers The Hardest

MONDAY, MARCH 7, 2011

Dr. Margaret Flowers, a pediatrician from Maryland who volunteers for Physicians for a National Health Program, knows what it is like to challenge the corporate leviathan. She was blacklisted by the corporate media. She was locked out of the debate on health care reform by the Democratic Party and liberal organizations such as MoveOn. She was abandoned by those in Congress who had once backed calls for a rational health care policy. And when she and seven other activists demanded that the argument for universal health care be considered at the hearings held by Senate Finance Committee Chairman Max Baucus, they were forcibly removed from the hearing room.

“The reform process exposed how broken our system is,” Flowers said when we spoke a few days ago. “The health reform debate was never an actual debate. Those in power were very reluctant to have single-payer advocates testify or come to the table. They would not seriously consider our proposal because it was based on evidence of what works. And they did not want this evidence placed before the public. They needed the reform to be based on what they thought was politically feasible and acceptable to the industries that fund their campaigns.”

“There was nobody in the House or the Senate who held fast on universal health care,” she lamented. “Sen. [Bernie] Sanders from Vermont introduced a single-payer bill, S703. He introduced an amendment that would have substituted S703 for what the Senate was putting together. We had to push pretty hard to get that to the Senate floor, but in the end he was forced by the leadership to withdraw it. He was our strongest person. In the House we saw Chairman John Conyers, who is the lead sponsor for the House single-payer bill, give up pushing for single-payer very early in the process in 2009. Dennis Kucinich pushed to get an amendment that would help give states the ability to pass single-payer. He was not successful in getting that kept in the final House bill. He held out for the longest, but in the end he caved.”

Rally, Hearing for Single Payer in Salem Friday

Dissatisfied with Obamacare, single-payer advocates are taking their message to the state capital

By: 

 David Rosenfeld

March 7, 2011 -- Advocates for single-payer healthcare in Oregon plan to make their voices heard in Salem on Friday.

Supporters of HB 3510, which calls for a universal state health plan, will rally in front of the capital at noon, March 11, followed by a hearing in the House Health Care Committee. 

That could be as far as the bill will likely get, though, according to chief sponsor Rep. Michael Dembrow (D-Portland).

“There is obviously a strong base of support out there for single-payer and clearly a frustration that it hasn’t been a part of the government’s conversation,” Dembrow said. “But this will do that and people will become more educated and organized about it. In the long run I think single payer is where we’re going to end up.”

Dembrow and other supporters point to existing programs such as Medicare, Medicaid and the Veterans Administration, as current examples of single-payer healthcare in America.

Supporters are buoyed, too, in Oregon from a strong turnout in January at a single-payer conference that drew close to 500 people, including national leaders such as Congressman John Conyers (D-Michigan) and Dr. Margaret Flowers, a fellow at Physicians for a National Health Program.

Oregon joins Vermont and California in attempting to pass state-based single-payer laws. The Oregon bill, co-sponsored by six other Democrats, would make a number of sweeping changes to the healthcare system.

• It creates a state health plan with no co-pays, deductibles or cost sharing.
• It bars commercial insurers from competing with the state plan, aside from offering additional coverage.
• It eliminates provider panels and says the plan must accept any qualified provider.
• Providers must too accept what the health plan pays, barring them from billing patients for the remainder.
• It expands certificate of need for hospitals and managed care plans.
• It leaves out the question of funding except to say costs will be based on an individual’s ability to pay.

Dembrow said he hopes Friday’s hearing starts a discussion that could see some of the ideas adopted by the Oregon Health Authority in applying for federal waivers or strengthening a proposal for a state-based public option.

“A lot of people are on board with the notion of trying to create the biggest pool as possible,” Dembrow said. “We just want to go a step further and take the insurance companies out of it and move to a self-insurance of this pool and try and dissociate coverage from employment.”

If the bill were to become reality, Dembrow envisions an exodus of employees from commercial insurers to government employees or government contract employees. Exactly how many people it would require or how much it would cost is unknown.

Rep. Bill Kennemer (R-Oregon City), who sits on the House Health Care Committee, said he’s not prepared to move the bill. “It’s a dramatic change from what we're doing,” he said. “When you're making social change, it's tough to do dramatic change well.”

Supporters would like to at least see the legislature authorize a study to compare the costs of a single-payer system in the state with other options, as other states have done, said Peter Shapiro with Portland Jobs with Justice, who helped write the bill. 

“It will certainly keep single payer in play as something to discuss and be taken seriously,” Shapiro said. “It also might create a better environment for something to fall short of that but advance the cause.”

Portland Jobs With Justice, Physicians for a National Health Program chapters in Corvallis and Portland, Mad as Hell Doctors and Healthcare for All Oregon formed the Oregon Single Payer Campaign to advocate for the bill. 

Oregon March 11, 2011 Single Payer Health Care Leaflet