Health Care Now
As a single-payer advocate who is also a doctor, I was concerned after the Affordable Care Act was passed that it didn’t do enough to combat rising underinsurance. A recent study by the Commonwealth Fund, which used new data to demonstrate that in 2012 some 31.7 million Americans were underinsured (i.e. insured, but still with heavy additional out-of-pocket health care expenses), argued that the burden of underinsurance will likely lessen as the ACA fully unfolds. But is there really reason for such optimism?
This is a complicated issue with many moving parts, so one way to tackle it (before immersing ourselves in the exhilarating policy literature) is to pose a simpler question: if your family is insured, and someone gets seriously sick, can you not worry about going broke?
The short answer: it depends on how much you have in the bank, and on the “out-of-pocket maximum” established by the ACA for your particular plan. The out-of-pocket maximum is the most that you would have to pay (after premiums) on things like co-pays for medications or deductibles for hospitalizations, and it can go as high as $12,700 annually for exchange plans under the ACA. But doesn’t the law provide protection for lower-income individuals, for instance, in the form of reduced out-of-pocket limits? The answer is yes – but to a lesser extent than we initially thought, even though, somehow, no one informed us that things had changed.
Health Care for All – Texas’s Open Journal radio series on healthcare reform was today, Wednesday, April 9th on KPFT 90.1FM (Houston) at 9:30am. Their guest this month was Dr. Gerald Friedman.
Here’s a direct link to the mp3 file (right click to save).
Dr. Gerald Friedman, Professor of Economics at the University of Massachusetts at Amherst was their guest. He is the author of a new study that shows how a nonprofit single-payer system based on the principles of “The Expanded and Improved Medicare for All Act, H.R. 676, would save $1.8 Trillion dollars over the next ten years and still be able to provide high quality health care for everybody.
Email HCFAT your ideas at firstname.lastname@example.org or call in to 713-526-5738 during the next show. They will be on the air every 2nd Wednesday of the month at the same time.
When most liberals hear the words “third party,” they have nasty flashbacks to Ralph Nader’s spoiler campaign in 2000. The history buffs among them might think of the populist Greenback Party’s feckless protests against the gold standard in the 19th century or the five presidential campaigns of the Socialist Eugene V. Debs — the last of which, in 1920, he ran from prison.
Third parties seem out of touch with reality, the refuge of idealists with dreams too fragile for the trenches of major party politics. But Democratic skeptics, at least, shouldn’t be too quick to judge. One state is now on the way to single-payer health care, and a third party deserves much of the credit.
Three years ago, Peter Shumlin, the governor of Vermont, signed a bill creating Green Mountain Care: a single-payer system in which, if all goes according to plan, the state will regulate doctors’ fees and cover Vermonters’ medical bills. Mr. Shumlin is a Democrat, and the bill’s passage is a credit to his party. Yet a small upstart spent years building support for reform and nudging the Democrats left: the Vermont Progressive Party. The Progressives owe much of their success to the oddities of Vermont politics. But their example offers hope that the most frustrating dimensions of our political culture can change, despite obstacles with deep roots in American history.
Green Mountain Care won’t begin until at least 2017, but Vermont liberals are optimistic. “Americans want to see a model that works,” Senator Bernie Sanders told The Atlantic in December. (Mr. Sanders is an independent, but a longtime ally of the Progressives.) “If Vermont can be that model it will have a profound impact on discourse in this country.”
Before you dismiss that prospect as wishful thinking, consider: That’s how national health care happened in Canada. A third party’s provincial experiment paved the way for national reform. In 1946, the social-democratic government of Saskatchewan passed a law providing free hospital care to most residents. The model spread to other provinces, and in 1957 the federal government adopted a cost-sharing measure that evolved into today’s universal single-payer system.
It seems natural that America’s experiment in Canadian-style health care should begin in Vermont, a state with a long history of cross-border contact. In Derby Line, Vt., the border runs through the town library. Decades ago, pregnant women from Quebec often drove to Vermont to give birth, preferring American hospitals. Not anymore. When it comes to health care, two countries that share so much have diverged profoundly.
Between 1870 and the Great Depression, Americans and Canadians both worried about the growing gap between the mega-rich and the poor. Their disillusionment fueled the rise of dissenting parties. In Canada, the most successful of these, the social-democratic Cooperative Commonwealth Federation, won control of Saskatchewan in 1944. Canada never passed reforms to match the New Deal, and the C.C.F. capitalized on voters’ frustration with the federal government’s inaction — just as liberals in Vermont are now doing.
It’s risky to compare 1940s Saskatchewan to Vermont today, but “Vermont has some of the features that Saskatchewan had in the 1940s and 1950s. It’s a rural state in which voices from the left have been more legitimate than in other parts of the country,” said Antonia Maioni, a professor of political science at McGill University in Montreal. “Saskatchewan was the last place where you would have expected to have this bold innovation. It was the poorest, most rural, most sparsely populated province. And yet it was the mouse that roared.”
The Vermont Progressives have only eight seats in the State Legislature, but they played a decisive role in the 2010 gubernatorial election. They promised not to play spoiler if the Democratic candidate supported single-payer health care. “Shumlin was very clear on his stance, and it pulled him through a narrow primary — a lot of Progressives were volunteers on that — and then he narrowly won,” Chris Pearson, a Progressive state representative from Burlington, told me. “He kept his promise.”
What explains the success of the Progressive Party? Vermont is small, and “it was expected that I’d knock on every door in my district,” Mr. Pearson said. “Progressives are dedicated to that style of campaigning. It’s also affordable. You can run a House race for $5,000.”
Despite their urban origins in Burlington, the Progressives have won crucial support from rural, traditionally conservative parts of the state, where lifelong Republicans have responded to the same argument that the Populists once used: Without regulation and a public safety net, capitalism will grind the independent farmer into the ground.
The trouble is that the Progressives have no national colleagues pressuring President Obama from the left. The Saskatchewan social democrats and their national successor, the New Democratic Party, forced the ruling Liberals to move left in the 1950s and 1960s as other provincial governments came to favor national reform.
American third parties face many obstacles in national elections, not least financial disadvantages and the ability of the major parties to co-opt dissenters by forming factions (in Canada, rules requiring tight party discipline mean insurgents like the Tea Partiers would probably have to form their own organizations).
But there is a deeper ideological reason. Canada inherited something else from Britain besides the Westminster system. It retained the full spectrum of English politics. This includes the socialist left and the Tory right — both traditions that, despite their differences, call for a strong central government and the restraint of individual liberty in the interest of the community.
The United States, by contrast, is a revolutionary state. The founders feared both kingly tyranny and the rule of the mob, and they bequeathed to us a political spectrum that is the narrowest in the Western world. With few exceptions, even left-wing dissenters have preached some version of free market ideology. The Vermont Progressives’ promise to “promote cooperative, worker-owned and publicly owned enterprises” is a far cry from Debs’s demand that “the capitalist system must be overthrown.”
In times of crisis — during the Civil War, the Great Depression and World War II — Americans have tolerated a radical expansion of the role of government. Harry Truman tried to seize the moment in 1945 by pushing for universal health care, only to be stymied by conservative opponents and the American Medical Association.
American doctors succeeded where Canadian doctors failed (despite multiple doctors’ strikes) because the American political system left individual politicians vulnerable to lobbying. They capitalized on the rhetoric of the Cold War, insisting that “socialized medicine” was one step short of Soviet tyranny. There is also no denying the ugly role that race played in this story: Too many white Americans have rejected reforms for fear that their tax dollars would help black Americans.
Yet the main lesson that Americans can learn from Canada is that political cultures can change. In 1950 Canada was, in many respects, a more conservative country than America, and each step of reform was hard-won. But as Canadians watched new policies produce results, skeptics became supporters. “Many policies that emerged in postwar Canada have changed Canadians’ conception of their relationship to the state,” Professor Maioni told me. “Policies feed political culture.” If the Vermont experiment works, other states will follow. American pragmatism will trump ideology.
President Obama’s 2015 budget proposal would “involuntarily disenroll” some (fewer than 5,000) undocumented immigrants currently receiving some Medicare benefits–even those who have been paying into Medicare for decades–in order to realize minimal savings that will be offset by the costs to hospitals for treating the elderly uninsured.
It’s unfair. Immigrants–mostly undocumented–contributed $13.8 billion dollars more into Medicare than they received in benefits in 2009, while US-born people generated a $30.9 billion deficit. Immigrants have actually been subsidizing and keeping the Medicare program afloat for US-born residents for decades, and they deserve better not worse coverage than they currently receive for their contributions.
It’s heartless. In order to save only $13 million a year (.0003% of his $3.9 trillion budget) President Obama is willing to put thousands of people’s lives at risk. Imagine losing your health insurance in an instant. How would you pay for your medication or doctor visits? The emergency room will replace the doctor’s office and this could cost us more than it saves.
It’s unnecessary. A national, single-payer healthcare plan, like HR 676, would cover everyone living in the US and save $500 billion a year on healthcare costs. Covering everyone who works and lives here should be our goal–not cutting benefits from hard-working individuals who put more into the system than they take out.
Tell President Obama: “Don’t cut undocumented immigrants’ Medicare coverage. It’s unfair, heartless, and unnecessary. Preserve their right to healthcare and work towards a single-payer healthcare system that would cover everyone living in the US instead.”
By the AP –
Maine’s Democratic-controlled House has given initial approval to a proposal to have the state examine whether to implement a universal health insurance coverage system.
The House voted 91-52 in favor of the bill Tuesday that would direct the state to contract with a consultant who would study options for establishing a single-payer system in Maine and submit a proposal to the Legislature.
Single-payer advocates have long been trying to implement the model in Maine with little success. They say a single-payer system will cut costs by streamlining the health insurance process and eliminating unnecessary paperwork.
But critics say the state should focus its resources on providing care to the elderly and the poor and question how the state could afford universal health care.
It faces further House and Senate votes.
On Saturday, May 17 from 10AM to 4PM in Houston, Health Care for All Texas and Healthcare-NOW! will be hosting the first ‘Everybody INstitute’ in the country. An Everybody INstitute is a one-day training focused on developing skills and strategies for single-payer organizing, messaging, outreach, public education, media, and legislative advocacy.
You can register today to be part of this event, which will re-energize our efforts to take the profit out of health care and guarantee access for all!
There is a suggested registration fee of $25, which will pay for lunch, translation services, and a packet of organizing materials for you to take home. However, no one will be turned away – if the fee would be a financial burden, simply request a scholarship online when you register. If you can make an additional contribution to sponsor a scholarship for someone else, please give generously when you register!
Email email@example.com if you have any questions.
Thursday, May 22 will be the first national single-payer lobby day of the year, supported by Healthcare-NOW!, Physicians for a National Health Program, Public Citizen, the Labor Campaign for Single Payer, and others.
Can you schedule a meeting with your Representative and Senators for May 22? You can visit your legislators’ offices in Washington, D.C. or in your district. Email Ben today so we can coordinate meetings across our different organizations.
Meeting face-to-face and describing why you care so passionately about single-payer is the most effective way to get your legislator on board – better than a hundred emails or phone calls. Even more effective is to bring a group of friends!
This will be a great opportunity to add co-sponsors to John Conyers’s Improved and Expanded Medicare for All legislation, HR 676 and Bernie Sanders’s American Health Security Act, S 1782, which would guarantee comprehensive health care for every resident of the United States while reducing costs.
Don’t know who your legislators are? Go here. Email Ben for lobby materials, help identifying whether your Reps. have supported single-payer reform in the past, and how to schedule a meeting at their office.
From the Real News –
In round two of our debate with Dr. Margaret Flowers and economist Dean Baker, we discuss whether CBO’s prediction that Obamacare will trigger reduction of work hours will negatively affect workers.
The Maine Medical Association recently updated a 2008 poll of their members that asked the question, “When considering the topic of health care reform, would you prefer to make improvements in the current public/private system (or) a single-payer system, such as a ‘Medicare-for-all’ approach?” In 2008, 52.3 percent favored the Medicare-for-all approach. In the updated poll, released last week, that number had risen to 64.3 percent.
It’s pretty unusual for two-thirds of a group of doctors to agree on something as controversial as a single-payer health care system. Until recently, doctors formed the core resistance to “government-run” health insurance in the U.S.
A number of factors account for this impressive change, but the huge administrative burden on practicing physicians created by our plethora of private insurance schemes is certainly near the top of the list.
The other day, I spoke with a Maine physician nearing retirement and looking forward to it. She was recently returning home after a long day in her practice, carrying her “homework,” a pile of administrative paperwork several inches high. Her husband asked her how she got so far behind in her paperwork. “I wasn’t behind at all,” she replied. She did this much paperwork, mostly insurance forms, at least twice a week.
American physicians spend at least three times as much time, money and effort on administrative work related to payment and insurance coverage as our Canadian brethren, with their single-payer system. Administrative hassle is a major factor driving more and more American doctors to sell our practices to large corporations that take care of the back-office work. The Affordable Care Act has only added to that burden. Sixty percent of doctors now work for corporations, and that number is growing.
Working for a corporate provider of health care services is a mixed bag. He who pays the piper calls the tune. As both for-profit and nonprofit health care corporations have become increasingly focused on the bottom line, doctors working for them have come under increasingly subtle and not-so-subtle pressures to generate revenue for their employers.
Some tests and procedures are more profitable than others. Increasingly, doctors’ “productivity” is measured by the amount of profitable revenue we produce rather than by the results we get for our patients. But in health care, profitability is a very unreliable measure of value because doctors’ fees and other health care prices are often set arbitrarily.
When we graduate from medical school, most of us take the Hippocratic Oath, swearing our primary allegiance to our patients. Young doctors tend to take their oath very seriously. Most doctors truly want to do what’s best for patients, not their insurance company or our employers’ bottom line.
But in today’s corporatized and increasingly monetized health care environment, the demands for generation of profit often directly conflict with our clinical judgment. The belief that doctors and other healers act as stewards for our patients’ welfare has long earned us a special place in society and the trust of our patients. That position and that trust, so critical to healing, is now threatened.
This conflict has made many doctors very angry. Practicing a profession that has traditionally been a calling has become a business. Doctors today are caught in a system corrupted by an excessive focus on money that is forcing us to behave in ways that conflict with our professional ethics. We are growing very tired of being told how to practice medicine by insurance company bureaucrats and corporate MBAs.
This is another major cause of the burnout experienced by increasing numbers of doctors. Many older doctors are now simply looking for a way out. Others are calling for systemwide reforms that will allow them to return to focusing on the welfare of their patients. Hence the results of the recent MMA poll.
In an excellent new book called “What Matters In Medicine”, longtime Maine family doctor David Loxterkamp points out that medical care, while often using scientific jargon, methods and tools, is at its core a profession about relationships, not profits. That’s something the bean-counters and policy wonks who have become increasingly influential in determining the nature of our corporatized health care system seem unable to understand.
It’s time to remove corporate profit from the financing of health care, and perverse financial incentives from the direct provision of services. It’s time for improved Medicare-for-all.
Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at firstname.lastname@example.org.
From Healthcare Finance News –
Even as the Affordable Care Act is in its nascent stages, some states are already looking toward 2017 when they can request waivers to opt out of the healthcare exchanges. And a small, but persistent, movement has popped up toward a single payer system as an alternative to participating in the exchanges.
That grassroots movement is taking place in Pennsylvania.
In March, a report exploring the single payer system was created for the state by Gerald Friedman, professor of economics at the University of Massachusetts at Amherst. He found that a single payer system would cost $128 billion in 2014 as opposed to the current system, which costs $144 billion. It would save 11 percent ($16 billion) of healthcare costs in 2014, mainly by lowering spending on administration and reducing drug costs.
But adopting a single payer system would dramatically change the business of healthcare. And the examples to follow are nearly non-existent.
While rumblings of moving to a single payer system have been heard in states such Hawaii, Oregon and New York, only one state – Vermont – has passed legislation to move toward actually creating a single payer system.
Vermont, which already has 93 percent of its population insured, passed Act 48, which allows the state to begin preparing a single payer system. It requires the state to set parameters for minimum benefits, create a finance plan and put out a contract for an administrator of the program, and allows the state’s current insurance regulatory body to create a benefit package.
Robin Lunge, Vermont’s director of healthcare reform, said that Vermont’s goal is to move the issue of healthcare completely away from the employer. Vermont’s single payer system, she said, would be similar to the one state employees are already on. It would be financed through an employer and individual tax as well as the premium tax credits and subsidies provided through the exchanges.
In Pennsylvania, the single payer system Friedman based his report on would be funded through a variety of means, including a 3 percent income tax on individuals, a 10 percent payroll tax for employers and various federal and state funds.
The state’s Medicare, Medicaid and Veteran’s Administration programs would continue to operate as usual under a plan similar to Vermont’s. In Vermont’s potential single payer system, the system would act as a supplement to government insurance and cover everyone who is uninsured or part of the current state health exchanges.
The big losers in a Pennsylvania’s potential single payer system would be insurance companies, Friedman said. They would lose a big chunk of their business and profit.
“Insurance companies are the victims there,” he said.
Drug companies may also stand to lose profits, Friedman said. One of the biggest savings in the Pennsylvania estimate is $8 billion from reduced medication spending. This would happen because there would be one large pool that would have greater negotiating power (much like the VA, which Friedman said spends 41 percent less on medications than other providers).
Some of the bigger hospitals that can now charge monopoly prices in a market would also have a more difficult time doing so under a single payer system.
Primary care providers would come out better in a single payer system, but specialists might fare worse as payments are leveled out among providers.
The biggest winners under a single payer system in Pennsylvania would be employers, said Friedman. Employer-provided insurance currently costs about 13 percent of payroll in Pennsylvania, he noted.
David Steil, president emeritus of HealthCare4AllPA, the nonprofit organization advocating for a single payer system in Pennsylvania, and a business owner, agrees with Friedman’s assessment of the benefits to employers. “Businesses shouldn’t be in healthcare,” he said.
But Steil doesn’t take quite as negative a view of the impact a single payer system would have on insurance companies as Friedman does. Steil, a former Republican house representative in Pennsylvania, said insurers would more likely have to change the way they do business.
There are many services that wouldn’t be covered under a single payer plan, like elective plastic surgeries or private rooms, home health visits and ambulance services. Insurers, Steil said, could move to providing supplemental coverage for these kinds of services.
“I think they will have to look at changing their business model, but they won’t go out of business,” he said.
On Tuesday, March 11, a Senate Subcommittee chaired by Bernie Sanders held an unprecedented hearing on what the U.S. can learn from countries with single-payer healthcare systems.
The evidence was overwhelming: expert after expert from Canada, Denmark, Taiwan, and France showed that single-payer costs less while virtually eliminating financial barriers to care for patients. Right-wing critics at the hearing pulled out every misleading myth about single-payer, only to have them debunked by the experts in real world health policy. Here are the highlights.
Can you please take a moment to write a letter to the editor at your local paper about this important Senate hearing? The rest of the country needs to know that single-payer reform, such as John Conyers’s HR676 in the House and Bernie Sanders’s S1782, is the only solution to our crisis of rising health care costs and poor access to care.
Please email us if you need help or if your letter is published.
Here’s a sample letter:
Subject: Congressional Hearing Shows Single-Payer Reform the Best Option
On Tuesday, a Senate Subcommittee – possibly for the first time in the history of Congress – hosted a long overdue hearing on “What the US Health Care System Can Learn from Other Countries.”
Health policy experts from France, Denmark, Canada, and Taiwan painted a startling picture: even after full implementation of the ACA the United States will spend more than any other developed nation, receive inferior access to care, and see similar or worse quality of care. We are the only wealthy country that does not publicly guarantee access to care through a “single-payer” system of universal coverage.
For me, this testimony highlights the tragic consequences of clinging to a for-profit health care system that the rest of the world has escaped from. Our system, despite the ACA, lets people with illness slip through the cracks with devastating consequences, and costs twice as much. It’s time to take the next step and implement guaranteed healthcare for all.
From the LA Times –
A U.S. politician’s I-don’t-need-no-stinkin’-facts approach to health policy ran smack into some of those troublesome facts Tuesday at a Senate hearing on single-payer healthcare, as it’s practiced in Canada and several other countries.
The countries in question have successful and popular government-sponsored single-payer systems, provide universal coverage and match or outdo the United States on numerous measures of medical outcomes — for far less money than the U.S. spends. To explain this, Sen. Bernie Sanders (I-Vt.) asked seven experts to testify before his subcommittee on primary health and aging.
Those interested in how the U.S. matches up should watch the whole 90-minute session, viewable below. (The official subcommittee hearing record is also available.)
By far the high point of the morning was an exchange between Sen. Richard Burr (R-N.C.) and Danielle Martin, a physician and health policy professor from Toronto. The exchange, in which Martin bats down the myths and misunderstandings about the Canadian system that Burr throws at her, starts at about the 1:00:15 mark.
(The reference to “Premier Williams” is to Newfoundland Premier Danny Williams, whose decision to have a heart valve procedure in Miami, near where he owns a condo, rather than Canada, is widely viewed in Canada as a rich man’s failure to investigate the care available to him closer to home.)
Here’s a lightly edited transcript of the key moments, which start with Burr asking Martin about the observation in her written testimony that wait times for elective surgery in single-payer systems will lengthen as doctors move out of the public system:
BURR: Why are doctors exiting the public system in Canada?
MARTIN: Thank you for your question, Senator. If I didn’t express myself in a way to make myself understood, I apologize. There are no doctors exiting the public system in Canada, and in fact we see a net influx of physicians from the United States into the Canadian system over the last number of years.
What I did say was that the solution to the wait time challenge that we have in Canada — we do have a difficult time with waits for elective medical procedures — does not lie in moving away from our single-payer system toward a multipayer system. And that’s borne out by the experience of Australia. So Australia used to have a single-tier system and did in the 1990s move toward a multiple-payer system where private insurance was permitted. And a very well-known study by Duckett, et al., tracked what took place in terms of wait times in Australia as the multipayer system was put in place.
And what they found was in those areas of Australia where private insurance was being taken up and utilized, waits in the public system became longer.
BURR: What do you say to an elected official who goes to Florida and not the Canadian system to have a heart valve replacement?
MARTIN: It’s actually interesting, because in fact the people who are the pioneers of that particular surgery, which Premier Williams had, and have the best health outcomes in the world for that surgery, are in Toronto, at the Peter Munk Cardiac Center, just down the street from where I work.
So what I say is that sometimes people have a perception, and I believe that actually this is fueled in part by media discourse, that going to where you pay more for something, that that necessarily makes it better, but it’s not actually borne out by the evidence on outcomes from that cardiac surgery or any other.
(The ultimate zinger came at the end of the exchange, when Burr thought he had Martin down for the count about wait times in Canada, and she neatly put the difference between the Canadian and U.S. systems in perspective.)
BURR: On average, how many Canadian patients on a waiting list die each year? Do you know?
MARTIN: I don’t, sir, but I know that there are 45,000 in America who die waiting because they don’t have insurance at all.
Local Lodge 1635 of the International Association of Machinists and Aerospace Workers (IAMAW) has endorsed HR 676, national single payer health care legislation, sponsored by Congressman John Conyers (D MI). The bill is named the “Expanded and Improved Medicare for All Act.”
Jessica Morris, Recording Secretary, reports that the local lodge took this action “because a single payer option is the best way to ensure access for health care for all.” The local is a Transport Lodge representing 450 members who work for a number of airlines in Albuquerque, New Mexico.
Morris says that the union is looking forward to hearing from James Besante, a medical student and member of Physicians for a National Health Program (PNHP), who will speak on single payer at the upcoming meeting on March 13, 2014.
PNHP, an organization of over 19,000 physicians, can provide speakers on single payer health care to union meetings across the country. Just make a request to email@example.com (502) 636-1551, and we will work with your union to set it up.
The cause of universal healthcare is alive and well. Not only is the state of Vermont moving toward a single-payer system, but Vermont’s U.S. Senator Bernie Sanders has introduced a bill and is holding a hearing this week on the benefits other countries enjoy from a single-payer system that would benefit everyone except the profiteering middlemen who’ve rigged the current system.
Click here to ask your senators to cosponsor and support. This is a joint action with RootsAction.
“The United States is the only major nation in the industrialized world that does not guarantee healthcare as a right to its people,” Sanders said. “It is time that we bring about a fundamental transformation of the American healthcare system. It is time for us to end private, for-profit participation in delivering basic coverage.”
The bill, S. 1782, the American Health Security Act, would be a much more significant change to health coverage than those recently implemented. It would create a much simpler, less wasteful system of paying for healthcare, one that’s in fact been tested in every other industrialized nation in the world, every one of which buys more healthcare for less money than we do in the United States.
The current system remains so broken that change must come. The question is how slowly and how piecemeal, and with how much unnecessary suffering along the way.
Please forward this email widely to like-minded friends.
From Unions for Single Payer –
The New York State Alliance for Retired Americans, NYSARA, at its most recent annual meeting, endorsed HR 676, Congressman John Conyers’ national single payer legislation also known as Expanded and Improved Medicare for All.
NYSARA has 440,000 members, many of them retired union members who have maintained affiliation with the retiree group of their union. It is affiliated with the four million member Alliance for Retired Americans, ARA.
HR 676 was brought to NYSARA by New York State United Teachers Retiree Council 12, whose former president July Shultz, co-presidents Sandy Bliss and Jeanne Williams Bennett, and member Bev Alves worked on the resolution.
Alves reports that NYSARA overwhelmingly passed the resolution for HR 676 with one enthusiastic delegate calling out loud “It’s about time.” Alves says that the resolution will be brought to the national ARA this year.
Find more endorsements at unionsforsinglepayer.org.
From the Huffington Post –
Hillary Clinton has confirmed, to a paying audience of 20,000 sellers of electronic health records systems, that she supports Obamacare, and opposes single-payer health insurance.
Speaking to a closed-to-the-press meeting of the “HIMSS14″ (Healthcare Information and Management Systems Conference 2014) in Orlando Florida on February 26th, she condemned the Canadian and other nations’ single-payer healthcare systems by saying, “We don’t have one size fits all; our country is quite diverse. What works in New York City won’t work in Albuquerque.” The presumption is that what works in Canada cannot work here, that local control must trump everything in order to fix what’s wrong with American health care.
The data prove her statement to be false, if not irrelevant. America’s healthcare problems are deeper than that. The latest OECD data on healthcare costs show that the U.S. spends by far the world’s highest percentage of GDP on healthcare, 17.7 percent; and also show that the average U.S. life expectancy is 78.7 years; by contrast, Canada spends 11.2 percent, and their life expectancy is 81.0 years. The OECD average expenditure is 9.3 percent , and life expectancy is 80.0 years. So: the U.S. spends twice as high a percentage of GDP as every other OECD nation, and gets markedly inferior results. This makes the U.S. far less economically competitive than it otherwise would be; but, the healthcare industries finance conservative politicians such as Hillary Clinton, Barack Obama, and all Republicans; so, those politicians don’t like single-payer — it would take much of the excess profits out of exploiting the sick, and those excess profits help to fund their campaigns.
The American people’s financial losses produce exceptional financial gains for the investors in healthcare-related stocks, and also inflate the pay for executives in those firms. This helps to fund lots of what conservatives such as Antonin Scalia lovingly call “free speech” — campaign commercials.
A physician in Canada headlined in the Los Angeles Times on 3 August 2009, “A Canadian doctor diagnoses U.S. healthcare,” and he wrote: “Until 50 years ago, we had similar health systems, healthcare costs and vital statistics.” But this situation ended with Canada’s single-payer system, where, “all Canadians have insurance for hospital and physician services. There are no deductibles or co-pays. Most provinces also provide coverage for programs for home care, long-term care, pharmaceuticals and durable medical equipment, although there are co-pays. On the U.S. side, 46 million people have no insurance, millions are underinsured and healthcare bills bankrupt more than 1 million Americans every year.” Nobody goes bankrupt in Canada to pay for needed care. Their system is shared sacrifice, not all of the downsides dumped onto the poorest and the sickest, who can’t pay their bills and end up in emergency rooms until they die of needless ailments.
The Canadian doctor explained that, in that year: “Canada spends 10% of its economy on healthcare; the U.S. spends 16%. The extra 6% of GDP amounts to more than $800 billion per year. The spending gap between the two nations is almost entirely because of higher overhead. Canadians don’t need thousands of actuaries to set premiums or thousands of lawyers to deny care. Even the U.S. Medicare program has 80% to 90% lower administrative costs than private Medicare Advantage policies. And providers and suppliers can’t charge as much when they have to deal with a single payer.”
So, Hillary received many bursts of applause from her audience of people who profit from other Americans’ being vastly overcharged for inferior healthcare. In fact, the transcriber of her speech headlined “Hillary Clinton wows the HIMSS14 crowd.”
From the New York Times –
Beer bottles clinked and indie-rock classics played overhead at a gallery opening here on a Friday night recently, as one artist after another chatted with Julie Sokolow, a filmmaker and health care advocate who has documented the Pittsburgh scene in detail.
There was Eanna Holton, who makes horror masks and props and recalled spending the last five years paying off a $10,000 surgery bill for her toddler. China Horrell, her co-worker, had a pulmonary embolism that cost more than $100,000 to treat. And Daniel McCloskey, a comic-book artist, told of being uninsured when he smashed his teeth in a bicycle accident last year, at a cost of more than $22,000.
These are among the dozens of stories Ms. Sokolow, 26, has collected over the past two years, showing how the lives of Pittsburgh artists are intertwined with their struggles over the costs of medical coverage. Her online video series, “Healthy Artists,” has chronicled the experiences of more than 40 painters, poets and musicians — talented, ambitious and often with a painful story of medical debt — and drawn the attention of national media figures like Michael Moore.
“Everyone in America has a health care story,” said Ms. Sokolow, whose project has culminated in a new 30-minute documentary, “Healthy Artists: The Movie.”
Ms. Sokolow’s films — made on a shoestring budget and uploaded to YouTube — are also a microcosm of the national health care debate as it relates to the young creative class, a group that is disproportionately underinsured. And while her survey of Pittsburgh’s scene is unusual, it is also an example of grass-roots approaches around the country, like the O+ Festival in Kingston, N.Y., and San Francisco, where performers are paid in free health care.
According to one survey last year, 43 percent of artists lacked health insurance, more than double the national average for the uninsured.
“Julie’s work unearthed what was obvious but hidden at the same time,” said Dan Byers, a curator at the Carnegie Museum of Art in Pittsburgh who helped judge a “Healthy Artists” poster competition that is featured in the documentary. “It brought the more abstract national debate into a very specific, concrete, local context.”
Ms. Sokolow, who grew up in New Jersey and studied psychology and fiction writing at the University of Pittsburgh, said the origins of her project came through her volunteer work at a nonprofit organization, HealthCare 4 All PA. Assigned to film interviews with people who had dire health care problems, she was troubled by a lack of involvement among 20-somethings.
In response, the “Healthy Artists” series was conceived as a kind of “indie ‘Cribs’ for social justice,” profiling young creatives in brief vignettes and getting them talking in a personal way about medical issues. The pieces were collected online and publicized through social media.
The goal, Ms. Sokolow said, was not to dwell on tragedies but to approach the problem with some optimism and use the films to advocate for broad reform through the idea that basic health care is a human right.
“I wanted to take a more positive approach, to not just focus on health care horror stories, but the people who would be empowered by a universal health care system,” Ms. Sokolow said. “Look at the work they are able to do without it. Imagine what they’d be able to do if they had a social safety net.”
Yet part of the power of the vignettes is how they detail the frustrations of freelancers in an economy in which health insurance has historically been tied to employment. In one profile, Jennifer Gooch demonstrated some of her work as a “musician, artist, crafter, maker, doer,” before tearfully recounting how she had declared bankruptcy after getting an $18,000 medical bill that included a colonoscopy.
“The procedure I got would have cost $800 in a socialized-medicine country, and I lost 10 years of credit,” Ms. Gooch, whose work has been covered by National Public Radio and the BBC, said in a recent interview. As a result of the bankruptcy, she had to give up her tailoring business. The $180-a-month plan she recently signed up for through the Affordable Care Act is a big help, she said, but still expensive.
The number of people ages 18 to 34 who have signed up for health coverage through federal and state exchanges grew substantially last month. But Ms. Gooch’s view was echoed by many artists who came out for a gallery crawl in the artsy Garfield section of Pittsburgh, some of whom said they had signed up for plans, while others said they still could not afford one.
Ms. Sokolow said that with the completion of the 30-minute documentary, the “Healthy Artists” project in Pittsburgh was now largely finished, and that she hoped it would be a model for activism in other cities. She is also finishing her first feature film, “Aspie Seeks Love,” another documentary about the dating life of a Pittsburgh man who learned in his 40s that he had Asperger’s syndrome, and in her parallel career as a musician, she is recording her second album.
“Julie’s ability to reach out through social media and connect artists and culture to a critical social policy issue is significant,” said Jim Ferlo, a Pennsylvania state senator who has introduced a single-payer health care bill. “I wish we could multiply her around the country.”
A subtext in the “Healthy Artists” films, and in Ms. Sokolow’s wider advocacy, is a challenge to the notion that artists must suffer outside the basic economic protections of society. A single-payer health care system, offering coverage to all, could solve that problem, at least as far as it applies to health. But an important step, Ms. Sokolow said, is persuading artists simply to stand up for themselves and address a problem that is felt by all but rarely talked about.
“I would like for artists to be advocates for themselves and their own health and not buy into stereotypes,” Ms. Sokolow said. “The people I profiled are working hard and trying to be healthy, and working against a society that’s not allowing that for them.”
From Unions for Single Payer –
“The Eastern Panhandle Central Labor Council is proud to support HR 676,” said Ken Collinson, President. “We believe that health care is a right, not a privilege, and we do everything that we can to support single payer. We are close to DC so we go to rallies whenever they are called.”
The Eastern Panhandle CLC represents workers in the seven counties in eastern West Virginia and is headquartered in Martinsburg. Collinson is also the President of United Auto Workers Local 1590.
The Eastern Panhandle CLC is the 610th labor organization to endorse HR 676, Expanded and Improved Medicare for All, sponsored by Congressman John Conyers. At the end of January, Representative Gloria Negrete McLeod (CA-35) signed on to HR 676, bringing the total of cosponsors in the House, including Conyers, to 55.
“When people do not have health care, it is unimaginable. An injury to one is an injury to all—this is what we feel in our hearts,” said Collinson.
The labor council is taking further action to promote public support for single payer by joining with the Eastern Panhandle chapters of Physicians for a National Health Program and Healthcare-NOW! and the Jefferson County NAACP Branch, the League of Women Voters of Jefferson County, and Shepherd University Lifelong Learning Program to bring a one hour, one man play featuring actor Michael Milligan to six West Virginia cities.
The play is Mercy Killers and admission is free. The schedule is below:
Friday, March 28, 7:00 PM, Ice House, 138 Independence St. Berkeley Springs
Saturday, March 29, 1:30 PM, Fisherman’s Hall, 312 South West St. Charles Town
Sunday, March 30, 2:00 PM, Opera House, 131 W. German St. Shepherdstown
Monday, March 31, 7:00 PM, Calvary Church, 220 W. Burke St. Martinsburg
Tuesday, April 1, 7:00 PM, Baha’i Regional Center, 308 S. Buchannan St. Ranson
Wednesday, April 2, 12:30 PM, Erma Ora Byrd Nursing Hall Auditorium, Shepherd University Shepherdstown
From the Times Union –
Twelve years after he first introduced a bill to promote universal health coverage in New York, Assembly Health Committee Chairman Richard Gottfried thinks Obamacare may give his cause the push it needs in 2014.
Federal officials have made successive fixes to address snags in the health law, formally the Affordable Care Act, which is intended to increase Americans’ access to health care.
“I think we are ready to refocus on real reform and real change and not just patchwork change,” Gottfried said Tuesday at the Capitol.
He stood flanked by state Sen. Bill Perkins, sponsor of a companion bill in the Senate, with a backdrop of representatives from labor unions, medical groups and the Working Families Party, who gave their support for the proposal, which is called New York Health.
While Gottfried could not say how much universal health care would cost state taxpayers, he estimated it could cut 20 percent off the more than $100 billion spent by government, private employers and individuals on services covered by the bill.
“The one thing that is certain is that money that we now spend … is dramatically more than what we would pay through New York Health,” Gottfried said.
An anti-insurance-industry refrain ran through the statements supporting the bill. Proponents of a so-called single-payer health system — under which the government is the sole purchaser of medical services — have decried the insurance industry’s influence in shaping Obamacare. The health exchanges that are at the heart of the law are government-run websites which allow individual consumers to shop for private insurance.
Dr. Frank Proscia, president of Doctors Council SEIU, a physicians union, denounced an insurance system that forces health providers to navigate a “maze of complex and counterintuitive policies” to provide care. “In a true single-payer system, all hospitals, doctors and providers would bill one entity … and the profiteers would be gone,” Proscia said.
Health care benefits have been negotiated by unions at the bargaining table, but labor representatives said they are happy to give up that contract fight to have universal coverage.
Bob Master, director of legalization/political action and mobilization for the Communications Workers of America, said employers have had the upper hand in negotiating health benefits, progressively reducing them or increasing employees’ contribution in recent years.
“All we have done in health care negotiations in the last 15 years is go backwards,” Master said.
From Talking Points Memo –
On his first day as governor of Massachusetts, Donald Berwick promises to set up a commission tasked with finding a way to bring single payer to the Bay State. It’ll have report back to him within a year — ideally sooner.
Having run Medicare and Obamacare in Washington for 17 months, he has concluded that the existing hybrid system is too cumbersome and expensive, and that single payer is the right fix. And he’s the only candidate in this year’s contest who dares to go there.
“The Affordable Care Act is a majestic step forward for this country — for the only nation that hasn’t made health care a human right yet. But luckily I’m in a state that’s able to take even a bigger step,” Berwick told TPM in an interview. “And a single payer option — even if the country is not ready for it, I think Massachusetts is ready and it’s worth exploring.”
A political novice, Berwick is an underdog candidate for the Democratic nomination in the 2014 elections — the most outspoken progressive in the race. A pediatrician, Harvard health policy professor and former health care executive, his talent for — and obsession with — health management caught the eye of President Barack Obama, who in 2010 appointed him to be the Administrator of the Center for Medicare & Medicaid Services, which was tasked with getting Obamacare off the ground in its infancy. Berwick left in December 2011, after his recess appointment expired and Senate Republicans refused to confirm him.
“I’ve been looking hard at the Massachusetts budget and I’ve become more aware than ever of how the rising costs of health care are taking opportunity away from other investments,” he said. “I saw it in Washington, and I see it in Massachusetts. We need to find money for transportation, education, the social safety net. … And so I feel a sense of urgency about getting costs under control without harming patients at all.”
There are huge obstacles, as he acknowledges. Entrenched industry groups who prefer a multi-payer system. Insurance companies who would cease to exist. Conservatives who view such a system as an affront to economic freedom. Questionable support from the state legislature. Even though liberals across the country passionately support the idea, no state has set up a single payer system yet and no president has seriously considered it. Luckily for Berwick, Massachusetts is ahead of the curve on health care: In 2006, Gov. Mitt Romney set up the nation’s first ever state-based universal health care system, which subsequently became the template for Obamacare.
Berwick and three other candidates vying for the Democratic nomination are getting crushed in the polls by Martha Coakley, the attorney general known nationally for her 2010 U.S. Senate campaign that failed spectacularly. She has the support of 56 percent of Democrats, according to a Suffolk University poll out this week. Berwick is a distant fourth place tie, with a measly 1 percent. (Worse yet, he’s polling behind the top Republican candidate, Charlie Baker.) He refused to talk about Coakley, but pointed out that Elizabeth Warren was also relatively unknown early in her Senate campaign, and that Mitt Romney was also a political newbie. The primary is seven months away, on Sept. 9.
So far, his campaign says he’s raised about $847,000 and spent $706,000. He touts endorsements from Massachusetts State Sen. Sonia Chang-Diaz (D) and Mass-Care, the state’s campaign for single payer. Mass-Care’s executive director Ture Turnbull said rising health care costs “are crippling the economy in Massachusetts” and harming families and clinicians. Berwick’s spokesman, Joshua Cohen, predicted that “we’ll start picking up more support soon.”
“I would claim that I’m the boldest progressive in the race,” Berwick told TPM. “We’ve not minced our words. I say what I believe. I’m the only candidate to support single payer. I’m the only candidate opposing that law that allows casinos in the state.” He worries about being seen as the health-care-only candidate when it’s not the top concern of Massachusetts residents — 98 percent of whom have insurance — and insists he’ll also prioritize education reforms and “repairing our very flawed transportation system” if he becomes governor.
Berwick has the scars to show his liberal credentials. Former underlings at CMS lavishly praise him. He had a series of high-profile clashes with congressional Republicans in Washington, who forced him out because he once said nice things about the British health care system. They said it signaled his support for “rationing” — a claim that Berwick vociferously denies.
“What did I learn? People took comments out of context and converted it into basically lies,” he said. “They attributed to me ideas I didn’t have, and they did it for distortion. It happened more than I thought. But it never for a moment changed what I believe.”