Health Care Now
This little Appalachian community that made national news a year ago by passing a Fairness Ordinance did it again tonight. It voted to endorse Single Payer Healthcare, HR 676, joining 54 other American cities, including Chicago, San Francisco, Seattle, Philadelphia, Detroit and Baltimore.
The struggling coal town of 334 people unanimously endorsed Expanded and Improved Medicare for All, HR 676, national single payer legislation sponsored by Congressman John Conyers, Jr. (D-MI). Vicco—established by the Virginia Iron Coal and Coke Company—is now the fourth Kentucky local government to favor Single Payer Healthcare. The others are Metro Louisville, Boyle County, and the City of Morehead. In 2007, the Kentucky House legislators also endorsed the bill.
Vicco was put on the map early last year when the New York Times, USA Today, the LA Times and other national media covered the passage of the town’s new law prohibiting discrimination based on sexual orientation or gender identity. It was the smallest city in America to pass such a law.
Vicco gained further fame last August when Mayor Johnny Cummings and City Commissioners were featured on the Colbert Show on cable television. The Colbert Segment went viral with almost three quarters of a million views.
Since then, Vicco, Mayor Johnny Cummings, and the city commissioners have won further state and national praise. At an event that featured Supreme Court Justice Elena Kagan last September, University of Kentucky President Eli Capilouto referred to Vicco when he described Kentucky as a place “deep in values that show up in unexpected ways and in unexpected places.”
Vicco’s new-found reputation as a progressive and humane community led to a presentation Monday night on health care by Dr. Garrett Adams, past president of Physicians for a National Health Program, and three Louisville colleagues, all representing Kentuckians for Single Payer Healthcare (KSPH).
The KSPH members pointed out that every person in Vicco—and everywhere else in the United States—would be covered by a plan similar to but better than the Medicare system that now serves those over 65 years of age. The HR 676 bill would expand Medicare to all ages and would improve it to include dental, vision, mental health–all medically necessary care. Patients would choose their own doctors and hospitals and there would be no co-pays or deductibles. HR 676 would annually save over $400 billion by ending the profits and waste caused by private insurance companies. The savings would then be used to expand an improved care to everyone in the country.
Kay Tillow, Chair of KSPH, said, “It’s a moral issue. We believe that health care should not depend on ability to pay. We invite other cities to join our grassroots movement.”
The Vicco city commissioners decided to throw the weight of the town government behind this movement.
Text of the Resolution under the seal of the City of Vicco
Whereas: Barriers to quality medical care infringe on the right to life, liberty and the pursuit of happiness, and access to health care is a fundamental human right, and;
Whereas a bill has been introduced in Congress, HR 676, aka The Expanded and Improved Medicare for All Act, that will provide all medically necessary care, including dental and prescription drugs, to everyone in the country from birth to death. There will be no co-pays nor deductibles so that inability to pay will be removed as an impediment to care.
Whereas with HR 676 each person will choose their own physicians, hospitals, and other providers.
Therefore be it resolved that the City of Vicco wholeheartedly endorses HR 676, the Expanded and Improved Medicare for All Act; and
Be it further resolved that we call on our representative in Congress, Representative Harold Rogers, to formally co-sponsor HR 676 so that the people of our city, our state, and our nation can move forward toward the excellent health care we deserve.
Mayor Johnny Cummings
Claude Branson, Commissioner
Lula Regina Gibson, Commissioner
Jimmy Slone, Commissioner
Electronic copy of the resolution available upon request from Kay Tillow, email@example.com.
As the ACA takes effect, an alternative gains ground at the state level.
When Sergio Espana first began talking to people, just over a year ago, about the need for fundamental changes in the U.S. healthcare system, confusion often ensued. Some people didn’t understand why, if the Affordable Care Act (ACA) had passed, people still wanted to reform the system; others thought organizers were trying to sign them up for “Obamacare.”
Healthcare is a Human Right Maryland, the group to which Espana belongs, is in pursuit of something else: a truly universal healthcare system that would cover everyone and eliminate insurance companies once and for all. Espana and many others in the growing movement see opportunity in the renewed discussion around healthcare reform as the ACA’s insurance exchanges go into effect.
They believe that the ACA’s continued reliance on (and subsidies of) private insurance simply aren’t good enough. People are still falling through the cracks, employers are trying to dodge the requirement that they provide insurance for their workers, and many states refused federal subsidies to expand their Medicaid programs. What these activists want is a program that would replace existing insurance programs, cover everyone regardless of their employment status, and be funded by the government, with tax dollars. Such a plan had strong support when the national healthcare overhaul was being crafted in 2009—including initial backing by President Obama—but the president and Congress decided it wasn’t politically possible and passed the ACA as a compromise.
Now, the rocky launch of the healthcare exchanges that form the cornerstone of the Affordable Care Act has helped revive interest in single-payer, says Ida Hellander, director of policy and programs for the advocacy group Physicians for a National Health Program. New York State Assemblymember Richard Gottfried, the author of a 20-year-old single-payer bill that is receiving renewed support, points out that single-payer would avoid many of the issues of the ACA’s launch. “When you don’t have means testing and you don’t have to make guesses about who’s going to cover your doctor or your ailment, it’s very simple.”
While Republicans on the national stage have been grandstanding about “repealing and replacing” the ACA, grassroots activists are on the ground in many states organizing their neighbors around the idea of real universal healthcare. A national program remains the end goal, but Nijmie Dzurinko of Put People First! Pennsylvania believes that state efforts could have a domino effect. “Our job is to change what’s politically possible,” says Drew Christopher Joy of the Southern Maine Workers’ Center, which is leading the effort in that state.
According to Hellander, about 25 states already have solid organizing toward single-payer, often accompanied by pending legislation. Some of these efforts predate the ACA: The California Nurses Association led the charge for single-payer in the mid-2000s, twice getting a bill through the California legislature only to have it vetoed by Gov. Arnold Schwarzenegger. Hellander says that the ACA has slowed down some efforts at state reform, as officials turned to setting up exchanges, but the law spurred others in Minnesota, Washington, Hawaii and Oregon. In New York, Gottfried notes that his bill has support from physicians groups, the nurses union and a majority of the lower house of the legislature. And in Massachusetts, considered the laboratory for the ACA, single-payer is now on the table thanks to gubernatorial candidate Don Berwick, the former administrator of the Centers for Medicare and Medicaid Services under Obama.
The biggest legislative victory to date has come in Vermont. Act 48, signed into law by Gov. Peter Shumlin in May of 2011, would begin to create a “universal and unified” healthcare system for the state. The bill, pioneered by the Vermont Workers’ Center (VWC), is at the cutting edge of national healthcare policy. Its passage resulted from years of on-the-ground organizing around the principle that healthcare is a human right—that it must be universal, equitable, participatory, transparent and accountable.
However, Act 48 marks just the beginning of a lengthy process toward healthcare for all residents of the state, regardless of employment or citizenship. The next steps are to figure out how “Green Mountain Care” will fit into federal requirements set by the ACA and to pass a mechanism by which the program will be financed.
The VWC favors a more progressive income tax on individuals and employers, along with a wealth tax. Mary Gerisch, president of the VWC, says, “Even though new taxes or progressive taxation sounds very scary, in reality it’s going to be cheaper for everybody, just like it is in every other country, for them to pay it in taxation rather than to pay out of pocket at the doctor.”
This growing movement has attracted growing opposition, says Gerisch, who notes that a number of TV ads and websites have popped up to oppose Green Mountain Care. And Vermonters for Health Care Freedom, a new 501(c)4 organization founded by longtime Republican political operative Darcie Johnston, has paid for several ads and robocalling campaigns against the plan.
Small business owners, in particular, are susceptible to the fear that new taxes will put them out of business, Gerisch says. She mentions one example of a small business owner who was worried about a 10 percent tax (even though no tax has been decided upon), only to find out that he was already paying 13 percent of his profits to buy insurance for his employees, which would be unnecessary under a state plan.
Healthcare is a Human Right believes the organizing model pioneered in Vermont represents the best chance for passing universal healthcare, and the group is forging ahead with that model in its Maine, Maryland, and Pennsylvania chapters. Among the key elements are base-building and education. To combat corporate scare tactics, activists focus on arming citizens with good information.
In Maryland, according to Espana, more than 90 percent of the 1,200-plus people the organization has surveyed over the last year believe that healthcare is a right, and more than 86 percent support a publicly funded system. “Maryland has been coming off more and more as a progressive state. We’ve been able to get some version of a DREAM Act through, we got marriage equality last year—those are great victories but, economically, they’re not that transformational,” he says.
Joy sees an opportunity to build a strong community-labor alliance around universal care in Maine, where the state AFL-CIO has gotten on board with the Healthcare is a Human Right campaign, and the Maine State Nurses Association held a free health clinic to provide services and connect people to the campaign.
Dzurinko and Put People First! Pennsylvania have been organizing statewide—not only in Philadelphia and Pittsburgh, but in rural counties where the conventional wisdom has been that progressives can’t win. Dzurinko says that people in those counties frequently suggest, unprompted, that the U.S. should have a national healthcare system “like in Canada.”
“We often limit ourselves tremendously by not talking to people that we fear or that we have been told won’t agree,” Dzurinko says. “We can’t talk about universality unless we really are talking about everyone, and that means organizing in all communities.” Joy agrees: “If you’re not taking the time to really organize from the ground up, we’ll end up with the ACA again.”
For Espana, organizing around single-payer presents an opportunity to begin a broader discussion about economic justice and human rights. “All of these politics of austerity are just lies,” he says. “Through a fight for healthcare reform you can demonstrate that not only is it morally righteous for us to have a universal healthcare system, but it’s actually cheaper.”
Almost 200 supporters have received their “Single-Payer Activist Guide to the Affordable Care Act” as gifts for donations since December, and it is now available at wholesale prices at our online store. You can order your copy for only $5, which includes the cost of shipping, or save by ordering in bulk.
The 30-page, 8.5″ by 11″ Guide is designed for individuals and organizations to identify organizing opportunities to build the single-payer movement as the Affordable Care Act is implemented over the next four years. It is a great way to educate yourself about the new law, and to figure out how to get involved in 2014.
For example, learn how new reporting requirements of the Affordable Care Act can support single-payer advocates’ public education efforts; how single-payer groups in the South are harnessing movements to expand Medicaid to get the single-payer message out; how threats to labor unions’ healthcare plans are creating new opportunities for single-payer activists to engage with the labor movement; and more.
Please email Ben if your group would like to order 100 copies or more so we can discuss special discount rates and co-branding the guide with your organization’s logo.
Doctors must advocate for their patients’ health — with supervisors who approve procedures, for instance, or insurance companies that pay for services.
On Tuesday, dozens of doctors-to-be tried different advocacy skills — lobbying state lawmakers to advance proposals they believe will improve New Yorkers’ health.
“If we are not going to fight for our patients, who will?” Albany Medical College student Xin Guan asked a few dozen young adults in white coats who had stopped in the basement of the Legislative Office Building for coffee, bagels and a press briefing between their morning and afternoon visits to lawmakers.
It was the first Medical Student Advocacy Day, organized by Guan, originally from California, and two other second-year students from Albany Med, Ajay Major of Indiana and Phyllis Ying of Seattle.
Some 60 to 70 students from around the state joined them. A glance at the coats suggested most were from Albany Med, but some had traveled from several downstate schools, including Albert Einstein College of Medicine, SUNY Downstate Medical Center and Mt. Sinai Medical Center.
Guan, Major and Ying had prepped them with some activist training before the event. Lobbying representatives was a new activity for about half the students, they said.
While the group shared a concern for health issues, they spoke with legislators about proposals that interested them as individuals. Small groups organized around a few popular issues, including bills to provide universal health coverage for all New Yorkers, allow marijuana for medical use, and prohibit doctors from participating in the torture and improper treatment of prisoners.
Anti-hunger advocate Mark Dunlea gave the students a pep talk before they headed back out to meet their afternoon slate of legislators. Dunlea’s group, Hunger Action Network of New York State, works with a coalition of organizations that provide aid to low-income people who struggle with the costs of health care.
He told the students that their future profession would carry some weight with legislators. And he reminded them that legislators are public servants.
“Remember, these guys work for you,” he said.
The 2013 Award for Profiteering and Deceit in the Private Health Insurance Industry goes to… UnitedHealth for paying its CEO, Stephen Hemsley, $49 million in 2012.
We want to thank everyone who participated. We’re planning to send the award to UnitedHealth’s world headquarters in Minneapolis, MN soon. We’ll also include all of the reasons you gave us about why they are the worst. Including:
“They never approve anything needed by the patients. They have made the process so cumbersome to jump through for authorization that it is impossible for physician to get appropriate treatment for patients. That is how they make their money is by denying appropriate coverage of their enrollees.”
37% – UnitedHealth
30% – Humana for charging women over 50% more than men for the same insurance plan.
27% – Anthem Blue Cross for predatory premium increases.
6% – Moda Health for paying $40 million for naming rights to the Portland Trailblazers arena.
Among CEOs, healthcare CEOs receive the highest median pay at $11.1 million. There are thousands of insurance companies, but the seven largest publicly traded health plans alone are paid their CEOs a collective $87 million.
Under a single-payer health plan, health coverage would be offered as a public good to all, administered by civil servants who will not siphon millions of dollars meant for patient care into their personal bank accounts. So we could use that $87 million in wasted money on CEOs to pay for as many as 8,700 hip replacements.
While Obamacare Enrollment Continues to Lag, Labor Builds Support for Expanded and Improved Medicare for All
The 113th Congress will likely be remembered as the most unproductive in our history, and with an overall approval rating of 9 perent, it is safe to say that most Americans do not consider this bunch to be a noble group of public servants engaged in good works for the people of this country. It is rare that any member of Congress is honored on any level these days, but one truly worthy exception is Rep. John Conyers (D-MI), who early in December was honored with a breakfast celebration attended by some 40 union representatives at a restaurant on East 29th Street in New York City.
Those present included leaders from Actors Equity, The International Alliance of Theatrical Stage Employees (IATSE) and the New York City Central Labor Council (NYCCLC), whose President, Vincent Alvarez, declared his support for Mr. Conyers’ bill HR 676, The Expanded and Improved Medicare for All Act, and promised to deliver their 1.3 million members to back this cause. This is a very significant development, as the 300 unions under the umbrella of the NYCCLC are made up of truck drivers, teachers, nurses, operating engineers, construction workers, janitors, train operators, electricians, fire fighters, retail workers and many more hardworking Americans who, along with everyone else in our nation, would benefit greatly from this revolutionary healthcare plan. They are the face of American labor today, and Mr. Alvarez spoke of the need for labor and the general public to unite and work together for this imperative cause: providing affordable, quality healthcare to all Americans.
We might recall that it was labor that gave us the middle class during the post World War II years as they worked to indeed lift all boats in that time of unprecedented prosperity. Can they lead our nation once again in this time of unprecedented need? They have been taking quite a beating, and have been decimated in several states by the lackeys of the 1 percent. But their values are America’s values, and it is critical that they remain a vibrant force for change in this country.
Mr. Conyers was introduced by his longtime friend, TV talk show host Phil Donahue, and other speakers that morning included Robert Score, Recording-Corresponding Secretary of Local 1 of IATSE, and Stephen Shaff, speaking on behalf of Progressive Democrats of America. Mr. Conyers himself noted that it took him 15 years to move Congress to declare a national holiday for Dr. Martin Luther King, so he is prepared for a long haul to achieve Medicare For All. He has reintroduced HR 676 in every Congress since 2003, and has now garnered support from 54 other House members, along with an impressive 609 union organizations, including 146 Central Labor Councils/Area Federations and 44 State AFL/CIO’s. Obamacare’s failure to address the Taft Hartley Plans and the operating procedures under which they work could create even more union support for the Single Payer movement. The president must address this issue.
Meanwhile, support from the public also continues to build, as the warts on the ACA become more apparent and the questions about its viability grow louder on almost a daily basis. This will undoubtedly drag into the 2014 election and continue to send shock waves throughout the political world into the 2016 race for the White House, as the Conservatives will remain active in their attacks and continuing efforts to end Obamacare.
Following the breakfast, Mr. Conyers and his policy director Mike Darner met with 15 of his core Single Payer activist leaders from organizations like Physicians For A National Health Program and Healthcare-Now! — as well as some doctors — to discuss strategy and continue building the movement. This group is definitely in it for the long haul, too, as they have supported Mr. Conyers and his bill for years. This is a bill that would deliver all necessary health services at less than half the cost we pay now, eliminating co-pays, deductibles and co-insurance while providing long-term care — including all of those expensive dental specialties. The estimated savings would be in the range of $592 billion a year. Better healthcare at lower costs — what’s not to like? And if you like your doctor, you actually could keep him or her — did you hear that, Mr. President? You can also pick any doctor you like — no more provider networks. These healthcare professionals would be able to become doctors once again, instead of a “provider” or “vendor,” and we could become patients again, ending our dehumanizing role as a “consumer” or “customer.”
Of late, we have been reading about Medicare For All from such luminaries as Robert Reich, Ralph Nader and William Greider in The Nation, among others. Even Bill Clinton mentioned it during President Obama’s second campaign. If Hillary were to acknowledge that Medicare For All is the next logical step after Obamacare, she would gain tremendous support and a second opportunity to get the right healthcare plan in place for her presumed 2016 run for president. Unfortunately, Hillary has proven herself to be far from progressive on many issues in the past, so we will have to wait and hear from her what her healthcare plan actually is if she decides to run.
Meanwhile, in the past few weeks Vermont Senator Bernie Sanders and Rep. James McDermott (D-WA) — who is also a doctor — have both introduced Single Payer bills. Bernie’s bill is a Medicare-for-All proposal known as the American Health Security Act of 2013 (S.1782), which would be administered by the states and transferable between states. The McDermott bill also moves the initiative outside of D.C., leaving it up to the states to develop their own plans based on their diversity and individual needs. As Massachusetts was the template for the ACA, it makes sense to finally introduce Single Payer on a state-by-state level.
Vermont has approval in both of its houses for a Single Payer plan, but it needs a waiver from the ACA to implement it in 2017. Can’t the federal government speed up that process? There are also plans at the ready in New York and in Rep. McDermott’s home state of Washington. And what of California, which has come so close in the past? One state can lead the country toward this monumental goal, the way Massachusetts did with the ACA. We just need to find the will.
In the Greider article in this month’s The Nation, entitled “Reviving The Fight For Single Payer,” he raises the question many of us ask: Can Obamacare deliver what it promised? One of the major problems he notes is that “…the reformed system will also still rely on the market competition of profit-making enterprises, including insurance companies.” Rep. McDermott was interviewed for this article, and he pointed out another major flaw in the ACA: “In the long arc of healthcare reform, I think [the ACA] will ultimately fail, because we are trying to put business-model methods into the healthcare system. We’re not making refrigerators. We’re dealing with human beings, who are way more complicated than refrigerators on an assembly line.”
Rep. McDermott – an advocate for Single Payer for decades – further wondered if hospitals will become “too big to fail” as they continue to merge and buy up private practices, and continue hiring younger doctors as salaried employees. Mr. Greider also made the following revelation: “An AMA survey in 2012 found the majority of doctors under 40 are salaried employees.” Rep. McDermott sees the troubling direction of this trend, noting that many new doctors “…will simply be serfs working for the system,” and Mr. Greider referred to another key point in the AMA research, noting that “…hospitals focus on employing primary-care physicians in order to maintain a strong referral base for high-margin specialty service lines.” Mr. Greider added further insight from Rep. McDermott: “Big hospitals need a feeder system of salaried doctors, McDermott explained, to keep sending them patients in need of surgery or other expensive procedures.” Even so, Rep. McDermott remains optimistic that stronger health care systems resembling Single Payer will spring up moving forward.
The New York Daily News offered a scathing editorial on December 24th entitled “Can This Patient Be Saved?” in which we were given a blow-by-blow analysis of the devastatingly mishandled rollout of the Obamacare exchanges and the problems millions of Americans have been having signing up for them. The situation was so bad that the deadline was extended until Christmas Eve for those to sign up who wanted their insurance to kick in on January 1, 2014. The CBO projects seven million will sign up in 2014, in addition to the about 1.1 million this year — well below the Administration’s projections. Meanwhile, millions will be losing their current plans due to the mandate. The question of more people losing their insurance than gaining it as a result of the president remaking the “healthcare economy” was also raised in this Op Ed piece.
Key provisions of the bill have already been waived in the past three years since its passage, and an additional postponement of the requirement for companies with fifty or more employees to offer health insurance or pay a tax penalty has now been postponed until 2015.
The individual mandate requiring most Americans to find coverage by April is also waiving penalties for those who had insurance and lost it this year. Most glaring in this critical article is the fact that there is “little reliable” information on who is getting what as far as coverage is concerned, and at what cost. The even larger question is, will those younger and healthier people opt in at all? If not, financially this boondoggle will sink. Obamacare is counting on them.
As the tinkering continues on the ACA, a major architect of this mess has just been rewarded by the president with an ambassadorship offer to China. Senator Baucus, do you not know the meaning of the word “retire?”
All good wishes for a (hopefully) healthy and happy New Year!
- with Jonathan Stone
While it was enacted in 2010 without a single Republican vote, the Patient Protection and Affordable Care Act (ACA), a.k.a. “Obamacare,” was built on a model first proposed by the conservative Heritage Foundation in the 1990s and implemented by Republican Governor Mitt Romney in Massachusetts in 2006. The ACA extends the public safety net to more of the working poor but otherwise keeps the private health insurance system intact. Rather than replacing the private system—and far from the “government takeover of health care” its critics claim—it provides subsidies for individuals to buy private health insurance through state-level “exchanges.”
As social policy, the ACA is a qualified failure. The expansion of Medicaid and mandates for individuals to buy subsidized private insurance will expand health insurance to an additional 30 million people. Regulations establishing minimum standards for coverage and barring exclusions for pre-existing conditions will improve coverage for many. On the other hand, by maintaining the existing system of for-profit medicine and private insurance, the ACA does little to rein in out-of-control cost growth while leaving millions without coverage. We can hope that the ACA’s strengths and its failures will soon pave the way for a rational universal system such as single payer health care.
Not Everyone Will Be Insured: While the ACA will provide health insurance to millions of Americans, millions of others will remain uninsured. While over 25 million will gain coverage either through the expansion of Medicaid or by buying subsidized private insurance, somewhat more will remain without coverage. Some are not covered by the act (including undocumented immigrants); others will be excused from the requirement to have insurance because of cost; and others will not comply.
Problems of People with Insurance Will Remain: Because it builds on the existing private health-insurance system, the ACA does little to reduce access problems for people with health insurance. Those with insurance have dramatically fewer problems accessing health care (including seeing doctors, arranging follow-up visits, and filling prescriptions) than those without. But even insured Americans are twice as likely as citizens of countries with public insurance to have trouble getting care (see Figue 2).
States Rejecting Medicaid Expansion and Exchanges Are Lowering Enrollment: The ACA’s Medicaid expansion would cover everyone with incomes up to 133% of the federal poverty level. Half the states, all with Republican governors, rejected expansion, denying coverage to 7.5 million people. States can establish “health exchanges” for people to choose a health plan and sign up for federal subsidies. Republicans refused to establish exchanges in 34 states.
After a slow start, enrollment has picked up states with their own exchanges. Problems with the federal website slowed errollment elsewhere, though it has recently surged as well. Including those newly covered by the Medicaid expansion, the ACA has now extended coverage to about 4% of the uninsured in non-cooperating states, compared to over 15% of those in the cooperating states. If the proportion enrolling were the same in the non-cooperating states as in states with their own websites, an additional 4 million Americans would now have health insurance.
The ACA Is Highly Redistributive: The ACA will reduce out-of-pocket spending on uncovered expenses, deductibles, and copayments. Federal subsidies will reduce premiums while coverage expansion will lower reduce hospital surcharges for the uninsured. Public spending will increase, on Medicaid and subsidies; expenditures paid for with other savings taxes on expensive insurance plans, and increases in the Medicare payroll tax for high-income individuals. Taxing the rich to provide health care for the working poor, the ACA is the largest redistributive program enacted since the 1960s.
The ACA Does Not Control Costs; Single-Payer Would: The ACA does not establish a sustainable health-care finance system in the United States. Under the ACA, health care spending will continue to increase significantly faster than the economy as a whole and the share of the economy going towards health care will rise in the next decade to nearly 20%. By controlling administrative costs and drug prices, a single-payer system can hold healthcare spending to less than 17% of the GDP.
The latest outcry for a single-payer healthcare system comes from a duo of prominent cancer doctors who call on their fellow oncologists to support what they call “an improved Medicare for all” resembling Canada’s healthcare system.
In an article scheduled to be published today in the Journal of Oncology Practice, Drs. Ray Drasga and Lawrence Einhorn remark that, as cancer doctors, they’re challenged by trying to advise the best treatments that a patient can afford. Because underinsurance is becoming the “new normal,” they say, cancer treatment may need to be compromised. And because every insurance plan is different, it’s hard for providers to know whether certain treatments will be covered.
Einhorn is a professor of medicine at Indiana University School of Medicine, a past president of the American Society of Clinical Oncology and the doctor who led treatment of Lance Armstrong. Drasga spearheaded efforts to start a free clinic in Crown Point, Ind.
They proposition that a single-payer system would remove some of the financial barriers to cancer care, make reimbursement simpler and cut down on the burdensome administrative overhead of private insurance companies.
They lay out their case:
“(The single-payer system) would provide universal, comprehensive coverage with free choice of providers. All medical care would be covered, including provider visits, hospital care, prescription drugs and rehabilitation. Copayments, deductibles, insurance premiums and out-of-pocket expenses would be eliminated.”
A public agency would manage a single insurance plan for each region of the country that would be financed by payroll and income taxes.
“The public agency would manage the plan and the health care budget in a transparent way. The allocation of available health resources (ie, rationing) would be guided by medical considerations, not on the basis of meeting corporate requirements for a return on investment or on the basis of a patient’s ability to pay.”
Doesn’t that all sound too good to be true? “We think not,” they write. “Because a single-payer system is a sensible and realistic solution, we believe its achievement is possible with sufficient understanding among the public and their elected representatives.”
It would be a challenging transition, they admit. But state-by-state implementation would lessen the administrative burdens, and ultimately such a plan could save up to $380 billion annually, they write.
From Truthout –
New York State Assemblyman Richard Gottfried, who represents the Chelsea and Hell’s Kitchen sections of Manhattan (D-75th District), has introduced a bill to implement a true single-payer healthcare system in New York State. Although the legislation made it out of the healthcare committee of the Assembly last year, it then was basically stonewalled from going much further.
Gottfried, chair of the health committee, told BuzzFlash at Truthout, the bill was re-introduced at the beginning of this session on January 8th of 2014.
What makes Gottfried’s bill distinct is that it would — if implemented in its ideal configuration — be a true single-payer healthcare system for all New Yorkers (except Veterans, who receive care through a government-administered system of providers employed by the Veterans Administration.)
This differs from what is called the Vermont “single-payer” system, which is a laudable one coming down the pike. But the Vermont healthcare insurance program would more accurately be called a comprehensive coverage system than a true single-payer.
Gottfried’s bill (2078A) would create the New York Health Trust Fund and all New Yorkers — in theory — (except veterans) would eventually receive care through the fund. They would carry a “New York Health” card for all their medical needs. Although still far from being enacted, what would make Gottfried’s bill a near seamless single-payer, if passed and implemented in its ideal form, is that the federal government would (and that is something, alas, unlikely to see for the time being given current DC private insurance control of politicians) pay Medicare and other federal programs directly into the state health insurance program. (Medicaid is already paid to states to administer the program within each state — but Gottfried’s bill would make Medicaid party of the pool of money funding “New York Health.”) There are still some gaps and exceptions that would be closed at a later time were the bill ever to be passed and the feds were to provide waivers, but it puts the first stage of a state single-payer on the map of consideration even if it is a political long shot.
Would you like to jump start single-payer organizing in your area with an Everybody INstitute?
An Everybody INstitute is a one or two day training focused on developing skills and strategies for single-payer organizing, messaging, outreach, public education, media, and legislative advocacy.
Whether it’s starting a new chapter, getting more activists involved, advancing single-payer legislation, organizing creative actions, or dealing with the ACA, Healthcare-NOW! can help.
The prospects for single-payer health care — adored by many liberals, despised by private health insurers and looking better all the time to others — did not die in the Affordable Care Act. It was thrown a lifeline through a little-known provision tucked in the famously long legislation. Single-payer groups in several states are now lining up to make use of Section 1332.
Vermont is way ahead of the pack, but Hawaii, Oregon, New York, Washington, California, Colorado and Maryland have strong single-payer movements.
First, some definitions. Single-payer is a system where the government pays all medical bills. Canada has a single-payer system. By the way, Canada’s system is not socialized medicine but socialized insurance (like Medicare). In Canada, the doctors work for themselves.
Under Section 1332, states may apply for “innovation waivers” starting in 2017. They would let states try paths to health care reform different from those mapped out by the Affordable Care Act — as long as they meet certain of its goals. States must cover as many people and offer coverage as comprehensive and affordable. And they can’t increase the federal deficit. Qualifying states would receive the same federal funding that would have been available under Obamacare.
My conservative friends complain that the innovation waiver requirements would rule out everything but single-payer. No doubt they are diligently working on a more privatized alternative that would cover less, cost more and raise the federal deficit.
“Vermont is the only state where they’re thinking very concretely about using (the waiver) as part of their plan,” Judy Solomon, health care expert at the Center on Budget and Policy Priorities, told me.
Hawaii got close. Its Legislature passed a single-payer bill in 2009, which was vetoed by then-Gov. Linda Lingle, a Republican. Lawmakers overrode the veto, but Lingle refused to implement the law.
The quest remains rocky, Dr. Stephen Kemble, a single-payer advocate and past president of the Hawaii Medical Association, told me. “If Vermont can get things going, that would make things easier for others.”
In Washington state, “our focus is to work on grass-roots support,” says Dr. David McLanahan, Washington coordinator for Physicians for a National Health Program. “We’re laying the groundwork” for legislation and a request for an innovation waiver.
Problems in the Obamacare rollout have energized fans of single-payer. Computer glitches aside, the troubles stem chiefly from the law’s complexity. Single-payer is all about simplicity.
Under the Vermont plan, employers and individuals would no longer have to buy private health coverage.
They would instead pay a tax. The state-run system would also cover more things, like dental. And oh, yes, Vermonters could choose their hospitals and doctors.
William Hsiao, an economist at the Harvard School of Public Health, has projected that Vermont’s annual health care spending could fall 25 percent. The savings would more than pay for the new benefits.
How? Fewer dollars would go to advertising, executive windfalls and payouts to investors. Doctors dealing with one insurer would save on office staff. Fraud and abuse would shrink as a comprehensive database makes crooks easier to spot.
It’s too bad that some liberals have turned single-payer into a religion and are whacking the Vermont plan for not being pure enough. Vermont is permitting continued private coverage for very practical reasons.
Bear in mind that the most acclaimed health care systems — in Germany, in France and our Medicare — combine single-payer for basics with private coverage for the extras.
Vermont intends to use its state health insurance exchange as the structure on which to build its single-payer system. By 2017, the road to an innovation waiver should be clear.
Go forth, Green Mountain State. Show us what you can do.
NO, NO and no: That’s been the Republican Party position on health care reform since the Obama administration’s first months in office. No matter how many pro-industry concessions were made in drafting what came to be called the Affordable Care Act (ACA), Republicans never wavered in their all-out opposition.
But increasingly since its disastrous rollout last fall, the ACA has had critics from the left, too–people who oppose a “reform” that falls far short of universal coverage while threatening harsh financial penalties on those who can afford them least unless they purchase the defective products of the private insurance industry.
Groups that criticized the ACA all along, such as Physicians for a National Health Program and National Nurses United, continue to stand for a “single-payer” program–where the government cuts out the insurers and guarantees health care for all under a system similar to the current Medicare program for the elderly, but much better funded and available to the whole population.
Then there are those among liberals and the left who disagree with both sides. They continue to defend the ACA–on the grounds that it is a step toward universal health care.
An editorial in the Nation magazine last month, for example, acknowledged that the ACA came about because Barack Obama and Democratic leaders in Congress “believed [single-payer] was politically unachievable, so they cobbled together a hybrid of public regulation and private insurance that has come back to haunt them.”
Nevertheless, wrote the Nation’s editors, the left should defend this “hybrid”: “Progressives must step in not only as ardent advocates for better implementation of the ACA–a relatively easy task–but also for structural repairs to the law that will make it a better bridge to the truly universal, truly humane and truly functional health care system that America needs…Indeed, winning [the fight for the ACA's effective implementation] will make future reforms all the more possible.”
The Nation is wrong. The ACA isn’t a bridge to universal health care. It is a cul-de-sac, structured above all else to maintain the central role of the health care industry in general, and private insurance companies in particular.
Achieving universal health coverage and access to care will require dismantling the core of the ACA and replacing it with something else entirely. Making a defense of the ACA in the way the Nation does–as a step in the direction of a single-payer system–cedes ground to the right and is counterproductive to the goal of winning health care as a human right.
Dr. Richard Propp and Alice Brody thought Obamacare might sink their movement.
Instead, based on the interest they say they are getting, the federal Affordable Care Act has buoyed their cause of universal health coverage, or “improved Medicare for all,” they said.
At the heart of the new federal law are government-run online markets that provide one-stop shopping to public and private insurance plans for previously uninsured people. The intent was to improve access to health care.
But confusion over the insurance websites and disappointment with the coverage offered has fueled interest in something the activists say is simpler and better — a national health system supported with tax dollars. On Tuesday, they’re screening a documentary about the issue at the First Unitarian Society in Albany.
Recently joining the ranks of single-payer promoters are young adults and labor unions, they said. Both have been dismayed by the trend toward higher-deductible health plans, whether through the new government-run health exchanges or from private employers.
“We’re really surprised at how much new interest there is in this issue,” said Brody, 69, who is active in Single Payer New York, which has supported a proposed state law that would create universal health coverage for New Yorkers.
Propp, 79, launched the Capital District Alliance for Universal Healthcare in 2005. The group is an affiliate of Healthcare-Now!, a national grass-roots advocate that supports similar federal legislation.
The trouble with the Affordable Care Act, single-payer proponents said, is that lawmakers gave too much weight to the concerns of the industries that profit from an overpriced medical system. The result, they say, was a convoluted law that perhaps no one understands completely.
“The reason Obamacare is so complex is it’s so gerrymandered,” said Dr. David Ray of Albany Medical Center, who is active in CDAUH and heads the local chapter of Physicians for a National Health Program, a Chicago-based advocacy group. “The power of the moneyed interests — specifically the insurance industry and the pharmaceutical industry — was not taken out of the equation.”
By contrast, Medicare is easy to apply for and use, they said.
“You can understand Medicare,” Brody said. “The main problem with Medicare is it only serves the elderly, who are very sick. That’s why costs are high on Medicare.”
Another group whose support of universal health coverage may be surprising is doctors. Close to 60 percent of doctors support a single-payer health system, according to PNHP. Doctors support universal health coverage because it would make their business operations simpler, Ray said. Instead of meeting the requirements of dozens of insurance contracts, they would have to handle just one — with the government.
“Most physicians are dealing with so many masters, in terms of the insurance companies,” Ray said. “Single-payer is the only road to continuation of physician autonomy. And if there’s anything that physicians care about, it’s their autonomy.”
Ray, who has practiced medicine for 35 years at the former Community Health Plan and at the Whitney M. Young Jr. Health Center in Albany, said he has long held a philosophy that doctors should be paid for keeping people healthy, not for treating them only when they’re sick. His work at Whitney Young, an Albany-based clinic serving low-income patients, showed him the need for better health coverage for all people, he said.
Propp founded CDAUH when he retired, shortly after reading a Harvard study that showed uninsured people with diabetes had a 50 percent higher death rate than insured patients.
Brody’s impetus to join the movement came with the understanding in recent years that her childhood had been shaped by her family’s struggle to secure adequate health care. Her mother had multiple sclerosis, and her father worked three jobs to pay the household and medical bills. She and her sisters, Brody said, raised themselves.
“Health care should be a human right,” Brody said. “You have a right to be able to, if you’re sick, go see a doctor. It should be with you from birth to death.”
From the Brattleboro Reformer –
The health care committee of the Vermont House is lining up some of the tasks that will have to be finished before the state rolls out the first-in-the-nation single payer health care system, now scheduled for 2017.
Meeting Friday at the Statehouse, the committee heard from legislative staffers who outlined details that will have to be worked out, such as how to ensure the state gets the maximum amount of federal dollars and who would be covered.
There are details such as what would happen if a person living in Vermont works in another state where their employer offers health insurance or if someone from another state worked in Vermont and their employer didn’t offer insurance.
On Tuesday, Gov. Peter Shumlin recommitted the state to the single payer goal.
From the AP –
A government-run health care system in Maine would provide universal coverage to residents, cut down on administrative costs and free businesses from the complexities of providing insurance for their employees, supporters of a single-payer model said Thursday.
Advocates of a single-payer system have long been trying to implement the model in Maine with little success, but said they are hopeful that the steps Vermont officials have recently made to spearhead the effort there can help make it a reality in Maine.
“Our current health care system is complicated, is inefficient, unfair and pretty much broken,” said Julie Pease, president of Maine AllCare, the group behind the measure, which she said will “return our system to one where … our medical profession treats our patients based on their health care needs not on their ability to pay or what kind of insurance they have.”
The bill, sponsored by Democratic Rep. Charlie Priest of Brunswick, aims to create a single-payer health care system in Maine by 2017, as officials are trying to do in Vermont. Beginning in 2017, Vermont will offer a set package of coverage benefits to every resident under the program.
But the idea in Maine faces fierce opposition from insurance companies and questions remain about how the state could afford such an endeavor.
Dan Bernier, a lobbyist for the Maine Insurance Agents Association, said that government should focus its limited resources on the poor, elderly and disabled instead of those who can afford coverage.
“It is not the role of government to provide someone like myself, a lawyer and lobbyist, free health insurance,” he told the Insurance and Financial Services Committee on Thursday.
Supporters argue it would ultimately save the state as much as $1 billion down the line by eliminating unnecessary paperwork and administrative costs. The program would be paid for through taxes like people already do for Medicare and Medicaid, they said.
But the state first has to make a commitment to universal health care before every single detail can be worked out, said Joe Lendvai, a Brooklin resident who advocates on behalf of the bill with Maine AllCare.
“Unless we conceptually agree that we need to cover everyone, that every Maine resident deserves access to health care without any barriers, we are not going to succeed,” he said.
But any proposal to raise taxes would likely be rejected by Republican Gov. Paul LePage, who has vowed not to do so while he’s in office and vetoed the state budget last year because it included tax increases.
Democratic Sen. Geoff Gratwick of Bangor acknowledged that it will be tough to pass the measure in this political and economic environment, when budgets are especially tight. But he said that Maine lawmakers have long-understood the serious problems with the current health care system and want a change.
“This is going to happen whether or not we get it now, two years from now, 10 years from now,” he said. “It’s inevitable because our current system is broken,” he said.
It’s satisfying to watch rats flee a sinking ship. This is because onlookers knew the ship was doomed long ago, and swimming rats signify that the drawn-out tragedy is nearing an end. A collective sense of relief is a natural response.
The rats who propped up the broken boat of Obamacare are a collection of liberal and labor groups who frittered away their group’s resources—and integrity— to sell a crappy product to the American people.
Those in the deepest denial went “all in” for Obamacare— such as some unions and groups like Moveon.org— while the more conniving groups and individuals—like Michael Moore— playacted “critical” of Obamacare, while nevertheless declaring it “progressive”, in effect adding crucial political support to a project that deserved none.
But of course Obamacare was always more barrier than progress: we’ve wasted the last several years planning, debating, and reconstructing the national health care system, all the while going in the wrong direction— into the pockets of the insurance mega corporations. A couple progressive patches on the sails won’t keep her afloat. It’s shipbuilding time.
It was painful to watch otherwise intelligent people lend support to something that’s such an obviously bad idea. So it’s with immense relief that liberals like Michael Moore, labor groups, and others are finally distancing themselves from Obamacare’s Titanic failure. Now these individuals and groups can stop living in denial and the rest of us can proceed towards a rational discussion about a real health care solution.
The inevitable failure of Obamacare is not due to a bad website, but deeper issues. The hammering of the nails in the coffin has begun: millions of young people are suddenly realizing that Obamacare does not offer affordable health care. It’s a lie, and they aren’t buying it, literally.
The system depends on sufficient young people to opt in and purchase plans, in order to offset the costs of the older, higher-needs population. Poor young people with zero disposable income are being asked to pay monthly premiums of $150 and more, and they’re opting out, inevitably sinking Obamacare in the process.
Those young people who actually do buy Obamacare plans—to avoid the “mandate” fine— will be further enraged when they attempt to actually use their “insurance”. Many of the cheapest plans—the obvious choice for most young people— have $5,000 deductibles before the insurance will pay for anything. For poor young people this is no insurance at all, but a form of extortion.
At the same time millions of union members are being punished under Obamacare: those with decent insurance plans will suffer the “Cadillac” tax, which will push up the cost of their healthcare plans, and employers are already demanding concessions from union members in the form of higher health care premiums, co-pays, deductibles, etc.
Lower paid union workers will suffer as well. Those who are part of the Taft Hartley insurance plans will be pressured to leave the plans and buy their own insurance, since they cannot keep their plans and get the subsidy that the lowest income workers get. This has the potential to bust the whole Taft Hartley health care system that millions of union members benefit from, which is one of the reasons that labor leaders suddenly became outraged at Obamacare, after having wasted millions of union member’s dollars propping it up.
Ultimately, the American working class will collectively cheer Obamacare’s demise. They just need labor and other lefties to cheer lead its destruction a little more fiercely.
Surprisingly, most of the rats are still clinging to Obama’s hopeless vessel, frantically bailing water. Sure they’ve put on their life preservers and anxiously eyeing the lifeboats, but they’re also preaching about how to re-align the deckchairs.
For example, in his “critical” New York Times op-ed piece, Michael Moore called Obamacare “awful”, but also called it a “godsend”, singing his same tired tune. Part of Moore’s solution for Obamacare—which was cheered on in the Daily Kos— is equally ludicrous, and follows his consistently flawed logic that Obamacare is worth saving, since its “progress” that we can build on. Moore writes:
“Those who live in red [Republican dominated] states need the benefit of Medicaid expansion [a provision of Obamacare]…. In blue [Democrat dominated] states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer.”
This is Moore at his absolute worst. He’s neck deep in the flooded hull of the U.S.S Obamacare and giving us advice on how to tread water.
Of course Moore doesn’t criticize the heart of Obamacare, the individual mandate, the most hated component.
Moore also relies on the trump card argument of the pro-Obamacare liberals: there are progressive aspects to the scheme—such as the expansion of Medicaid— and therefore the whole system is worth saving.
Of course it’s untrue that we need Obamacare to expand Medicaid. In fact, the expansion of Medicaid acted more as a Trojan horse to introduce the pro-corporate heart of the system; a horse that Moore and other liberals nauseatingly continue to ride on.
But Moore’s sneakiest argument is his advice to blue states to “…lobby for a public option on the insurance exchange…”
Again, Moore implies that it’s ok if we are “mandated” to buy health insurance, so long is there is a public option. But that aside, the deeper scheme here is that Moore wants us to further waste our energy “reforming” Obamacare, rather than driving it to the bottom of the sea.
Moore surely knows that very few people are going to march in the streets demanding a public option at this point; he therefore knows that even this tiny reform of the system is unachievable. He’s wasting our time. Real change only happens in politics when there is a surge of energy among large sections of the population, and it’s extremely unlikely that more than a handful of people are going to be active towards “fixing” Obamacare— they want to drown it.
Moore’s attempt to funnel people’s outrage at Obamacare towards a “public option” falls laughably short, and this is likely his intention, since his ongoing piecemeal “criticisms” of the system have only served to salvage a sunken ship.
Instead of wasting energy trying to pry Obamacare out of the grip of the corporations, Moore would be better served to focus exclusive energy towards expanding the movement for Medicare For All, which he claims that he also supports, while maintaining that somehow Obamacare will evolve into Single Payer system.
Most developed nations have achieved universal health care through a single payer system, which in the United States can be easily achieved by expanding Medicare to everybody. Once the realities of Obamacare directly affect the majority of the population and exacerbates the crisis of U.S. healthcare, people will inevitably choose to support the movement of Medicare for All, the only real option for a sane health care system.
Today marks the beginning of health care coverage under the Affordable Care Act’s new insurance exchanges, for which two million Americans have signed up. Now that the individual mandate is officially here, let me begin with an admission: Obamacare is awful.
That is the dirty little secret many liberals have avoided saying out loud for fear of aiding the president’s enemies, at a time when the ideal of universal health care needed all the support it could get. Unfortunately, this meant that instead of blaming companies like Novartis, which charges leukemia patients $90,000 annually for the drug Gleevec, or health insurance chief executives like Stephen Hemsley of UnitedHealth Group, who made nearly $102 million in 2009, for the sky-high price of American health care, the president’s Democratic supporters bought into the myth that it was all those people going to get free colonoscopies and chemotherapy for the fun of it.
I believe Obamacare’s rocky start — clueless planning, a lousy website, insurance companies raising rates, and the president’s telling people they could keep their coverage when, in fact, not all could — is a result of one fatal flaw: The Affordable Care Act is a pro-insurance-industry plan implemented by a president who knew in his heart that a single-payer, Medicare-for-all model was the true way to go. When right-wing critics “expose” the fact that President Obama endorsed a single-payer system before 2004, they’re actually telling the truth.
What we now call Obamacare was conceived at the Heritage Foundation, a conservative think tank, and birthed in Massachusetts by Mitt Romney, then the governor. The president took Romneycare, a program designed to keep the private insurance industry intact, and just improved some of its provisions. In effect, the president was simply trying to put lipstick on the dog in the carrier on top of Mitt Romney’s car. And we knew it.
By 2017, we will be funneling over $100 billion annually to private insurance companies. You can be sure they’ll use some of that to try to privatize Medicare.
For many people, the “affordable” part of the Affordable Care Act risks being a cruel joke. The cheapest plan available to a 60-year-old couple making $65,000 a year in Hartford, Conn., will cost $11,800 in annual premiums. And their deductible will be $12,600. If both become seriously ill, they might have to pay almost $25,000 in a single year. (Pre-Obamacare, they could have bought insurance that was cheaper but much worse, potentially with unlimited out-of-pocket costs.)
And yet — I would be remiss if I didn’t say this — Obamacare is a godsend. My friend Donna Smith, who was forced to move into her daughter’s spare room at age 52 because health problems bankrupted her and her husband, Larry, now has cancer again. As she undergoes treatment, at least she won’t be in terror of losing coverage and becoming uninsurable. Under Obamacare, her premium has been cut in half, to $456 per month.
Let’s not take a victory lap yet, but build on what there is to get what we deserve: universal quality health care.
Those who live in red states need the benefit of Medicaid expansion. It may have seemed like smart politics in the short term for Republican governors to grab the opportunity offered by the Supreme Court rulings that made Medicaid expansion optional for states, but it was long-term stupid: If those 20 states hold out, they will eventually lose an estimated total of $20 billion in federal funds per year — money that would be going to hospitals and treatment.
In blue states, let’s lobby for a public option on the insurance exchange — a health plan run by the state government, rather than a private insurer. In Massachusetts, State Senator James B. Eldridge is trying to pass a law that would set one up. Some counties in California are also trying it. Montana came up with another creative solution. Gov. Brian Schweitzer, a Democrat who just completed two terms, set up several health clinics to treat state workers, with no co-pays and no deductibles. The doctors there are salaried employees of the state of Montana; their only goal is their patients’ health. (If this sounds too much like big government to you, you might like to know that Google, Cisco and Pepsi do exactly the same.)
All eyes are on Vermont’s plan for a single-payer system, starting in 2017. If it flies, it will change everything, with many states sure to follow suit by setting up their own versions. That’s why corporate money will soon flood into Vermont to crush it. The legislators who’ll go to the mat for this will need all the support they can get: If you live east of the Mississippi, look up the bus schedule to Montpelier.
So let’s get started. Obamacare can’t be fixed by its namesake. It’s up to us to make it happen.
Michael Moore is a documentary filmmaker whose 2007 film “Sicko” examined the American health care industry.
Buried deep in the health reform law is Section 10323. It amends the Social Security Act to extend Medicare coverage to individuals exposed to environmental health hazards in the region defined by the Emergency Declaration of June 17, 2009. That declaration limits this benefit to the area around Libby, Montana.
Section 10323 of the Affordable Care Act (ACA) calls it “deeming of Individuals as eligible for Medicare benefits.” People do not have to be age 65, or wait two years following disability, or to have paid into the Medicare system. The victims of asbestos in Libby were simply “deemed” to be eligible for Medicare. It was described as “discretionary deeming.”
Senator Max Baucus, Chair of the powerful Senate Finance Committee, who hired insurance executive Liz Fowler to write the health reform act, slipped Section 10323 into the law assuring that all those with asbestos-related conditions in the community around Libby, Montana get into Medicare, our single payer program for all those over 65. Further, for this designated group of Montanans, Baucus arranged additional special benefits not normally available to Medicare patients.
It’s true. Senator Baucus “deemed” single payer off the table during the 2009 health care debate. He had physicians and others arrested for insisting that single payer be included in the nation’s discussion. Baucus effectively locked out any consideration of such a plan. But he gave our country’s single payer program, Medicare, to the people of Libby. And they got free drugs, too.
The victims of asbestos exposure in Libby, regardless of age, are eligible for traditional Medicare, plus, under an additional program that Baucus included in the ACA, the government also pays for services not included under Medicare, such as home care, medical equipment, counseling, help with travel, and medications not covered by Medicare prescription plans.
Coverage of drugs can be crucial. Outrageous drug prices continue to threaten all who depend on costly medications. While the ACA bars health insurance plans from refusing to cover those who are sick, insurance companies have found ways to keep patients with cancer, Multiple Sclerosis, AIDS, and other conditions out of their plans. Some insurance companies have made the co-pays on the drugs needed by such patients as high as $1,000 to $6,000 a month, effectively excluding those with pre-existing conditions.
Goodness knows the people of Libby deserve to have Medicare—with free drugs and home care and medical equipment and help with travel and much more. After all, the W. R. Grace company whose vermiculite mine poisoned their entire region left thousands, not just the miners, suffering and dying.
But the senator who helped Libby also made certain that all the rest of us would be left out—that the nation could not even consider the merits of HR 676, the Expanded and Improved Medicare for All Act, that would free our country from the health insurance companies that continue to hold us hostage.
As health reform rolls into a new stage where some who have been left out find help but millions more, both insured and uninsured, find the costs of care still beyond their means, let us look to the Libby solution, publicly-funded single payer, for the answer.
Medicare spends more than 98 cents of every dollar on actual health care, while insurance companies spend only 80 to 85 cents on health care. Under the ACA insurance companies still victimize all of us as their narrow networks deny us access to the doctors and hospitals we need. The insurance companies retain their power to deny tests, procedures, and treatment making life miserable for both patients and doctors.
The United States spends about twice as much per person on health care as the rest of the industrialized world. Yet our life expectancy, infant mortality and other health outcomes lag far behind. As the policy experts of Dartmouth and MIT search in vain for ways to cut health care costs while retaining the profit makers, let us keep in mind that unless we remove the private for-profit insurance companies from our health care, any cut in costs means a cut in care.
To expand care while cutting costs, we have to go to a single payer plan—like HR 676, Expanded and Improved Medicare for All, a bill introduced into every congress since 2003 by Rep. John Conyers, Jr. (D MI). With HR 676, we could save over $500 billion a year while expanding coverage to everyone and improving care to assure dental and eyeglasses and hearing aids and drugs and long term care and all the things we need that are not normally covered. And this coverage would remove all co-pays and all deductibles.
Health care would be paid for publicly and in advance with no payment at the point of care. Patients will choose their doctors and hospitals. When we seek care, the question will not be “How will you pay?” but “Where does it hurt?”
This simple legislation would fix our damaged health care. Medicare was rolled out in six months with only index cards in the time before computers. No need to ask how much you make—it is available to all. That’s what we need–not the twisted double-dealing that wins something special for a few, but, instead, a magnanimous, simple, bold, inclusive plan that finally will allow all of our people to enjoy the life-giving benefits that a wealthy and compassionate nation can offer.
Let us dedicate this new year to building the single payer movement that will make this plan possible.