It was expected that the Weiner Amendment would get a vote today, but Representative Weiner has withdrawn it:
Washington, DC – Today, Representative Anthony Weiner (D - Brooklyn and Queens), a member of the House Energy and Commerce Health Subcommittee, released the following statement on his decision to withdraw his single payer amendment to H.R. 3962, the House health care reform bill:
"I have decided not to offer a single payer alternative to the health reform bill at this time. Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."
"I am going to continue to press the case for health care reform in every venue I can. And I also will continue to press for a smarter, less-expensive, more-comprehensive alternative to the employer-based health insurance system we have today."
"I've discussed the issue with Speaker Pelosi, Chairman Waxman, and agree with them that the health reform bill is so close it deserves every chance to gain a majority."
Last Night, Representatives Dennis Kucinich and John Conyers, Sponsors of HR-676, the Single-Payer bill that Weiner's amendment was about, posted statements on several blogs and news sites warning about this vote because they feared it would not get the votes needed in the current political landscape and could harm future reform actions by setting a low benchmark.
Tomorrow, the House of Representatives is scheduled to consider a single payer bill. As the two principal co-authors of the Conyers single payer bill, we want to offer a strong note of caution about tomorrow's vote.
The bill presented tomorrow will not be HR676. While we are happy to relinquish authorship of a single payer bill to any member who can do better, we do not want a weak bill brought forward in a hostile climate to unwittingly accomplish what would be interpreted as a defeat for single payer.
Here are the facts: There has been no debate in Congress over HR676. There has not been a single mark-up of the bill. Single payer was "taken off the table" for the entire year by the White House and by congressional leaders. There has been no reasonable period of time to gather support in the Congress for single payer. Many members accepted a "robust public option" as the alternative to single payer and now that has disappeared. The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?
While state single payer movements are already strong, the national single payer movement is still growing. Many progressives in Congress, ourselves included, feel that calling for a vote tomorrow for single payer would be tantamount to driving the movement over a cliff. The thrill of the vote would disappear quickly when the result would be characterized not as a new beginning for single payer but as an end. Such a result would be seen as proof that Congress need not pay attention to efforts to restore in Conference Committee the right of states to pursue single payer without fear of legal attacks by insurance companies.
We are always grateful for your support. We are now asking you to join us in suggesting to congressional leaders that this is not the right time to call the roll on a stand-alone single payer bill. That time will come. And when it does there will not be any doubt of the outcome. This system of health care injustice will not be able to endure forever. We are pledged to make sure of that.
Sincerely,
Congressmen John Conyers and Dennis Kucinich
On Monday October 5th, Drs. Margaret Flowers and Paul Hochfeld led a delegation of 15 physicians and nurses to the White House gate. The occasion was a Rose Garden ceremony with over 100 physicians in white coats invited, a photo-op to showcase support among doctors for the President’s effort at health reform.
Dr. Margaret Flowers, Congressional Fellow of Physicians for a National Health Program, was later contacted by one of the doctors allowed in the gates. The following is her response:
Don’t let the good be the enemy of the perfect
Thank you for inviting me to this conversation. I understand your concern to get some type of reform now. I hear your desperation. I have felt it myself. There is so much suffering that it is tempting to say – we must get something even if we know it is not the solution.
At some point we have to look at the facts that incremental change and compromise when it comes to health reform in this nation have not gotten us anywhere. While SCHIP is great, it has merely held the level of uninsured children at bay, not decreased it. Medicaid expansions have similarly not been able to keep up with the rising uninsured or been able to provide a financially sustainable and high quality solution. Why is this?
It is because the greatest impediment to health reform in this country is that the for profit (and not for profit in some cases, such as BCBS) health industries control the political process. No amount of incremental reform will change that. Regulation of the industry is expensive and has been ineffective. The industry can do an end-run around regulation so fast that it would make your head spin. With the proposed legislation, we will be throwing more money into an already overpriced and dysfunctional situation. We will delay enactment of better reform while we wait to see if this reform works, all the time knowing that it won’t. In the meantime, thousands of people will die unnecessarily, thousands of people will suffer, families will continue to go bankrupt and lose their homes, physicians will continue to leave practice.
Single payer was not supposed to be on the table this year, yet despite having little in the way of funding and no paid organizers (like HCAN has), we were able to move it forward and break through some of the media blackout through perseverance and dedication.
We must ask ourselves, how long are we willing to play the incremental game (knowing that while a few more get access to healthcare, many more continue to be left out)? When will we decide that we’ve reached the tipping point, and like other social justice movements, dig in and do the necessary work to enact change?
I am tired of hearing that we can’t have single payer or that it is not on the table. It will never be on the table and we will never get it until we do the work to put it there. We, as physicians (and the other health professionals), hold a unique position in society. For the most part we are seen as advocates for our patients and acting in the best interest of our patients (although sadly this vision is truer for nurses than for doctors). We are seen as "experts." Thus, I believe that it is our professional responsibility to educate and advocate for effective reform. If we work together we can create real change. But it is harder than showing up for a photo shoot. It takes a lot of time and travel and writing and speaking and money and a willingness to put our bodies on the line.
Until more of us are willng to do this, we will have to continue to settle for crumbs. I am not willing to settle for crumbs. My part in this drama is to be a strong voice for single payer. And I won’t give in until we get there. The stories that I hear from patients and docs keep me going. Nobody should be left out. Everybody should have the same level of care. It is our responsibility to fight for this. Anything less is unacceptable.
My two cents, for what it’s worth.
Respectfully,
Margaret
Additional comments from Dr. Andrew Coates:
Single-payer advocates should take note. Dr. Hochfeld was allowed to attend the ceremony, uninvited and at the last minute, because single payer cannot be ignored. Our persistence has proven effective. The goal of the mainstream discussion, orderly consensus for incremental change, with nary a ripple of discord, as remained elusive. Yet experience proves again and again that single payer swims just below the surface.
All year long it has become more and more clear – to more and more people – that single payer national health insurance is in fact the very least we need when it comes to health care reform that will work to improve our lives. As Dr. Flowers explains, "Anything less is unacceptable."
This just-below-the-surface dynamic, combined with clear and persistent advocacy, that has taken single payer from "off the table" to "on the floor" this year. We now learn that the vote on HR 3200 – and with it, the Weiner amendment that would substitute single payer legislation for the text of the bill – may be imminent. Activists around the nation are pulling out all the stops.
So the single payer presence within the beltway continues, even now, to increase, not diminish. We also recognize that soon we will begin a new chapter in our efforts to educate and advocate for a single-payer national health program.
Join us in Washington D.C. September 24th, 4:30 pm for the 3rd Annual Health Care Justice Vigil
In solidarity with American Patients United's 3nd Annual Health Care Justice Vigil in Washington DC, single-payer/Medicare For All healthcare activists are organizing solidarity vigils from New York City to the state of Washington. Also, the G20 Summit will take place in Pittsburgh on September 24-25, and provides another opportunity for single payer activism.
The events uphold a deeply important time for those who have lost someone to the broken U.S. healthcare system, or who are still fighting the denials of the for-profit health insurance companies.
Healthcare justice activists will join together reaching across the country to support each other and remember those who have been lost. We will post vigil details from around the country as they come in.
Pittsburgh, PA. More than seventy labor organizations have submitted resolutions to the AFL-CIO Convention calling for the labor federation to endorse HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).
Resolutions were submitted by five national and international unions including the International Longshore & Warehouse Union (ILWU), the International Alliance of Theatrical & Stage Employees (IATSE), the California Nurses Association/National Nurses Organizing Committee (CNA/NNOC), California School Employees Association (CSEA), and the International Federation of Professional & Technical Engineers (IFPTE).
Seven state AFL-CIO Federations submitted resolutions including Wisconsin, South Carolina, Maine, Michigan, Kentucky, California and Vermont.
The remaining resolutions were submitted by Central Labor Councils and Area Labor Federations in twenty states.
All resolutions, including one expected to be submitted by the Executive Council, will be referred to the Convention’s Legislative Policy Committee which is chaired by Leo Gerard, President of the United Steelworkers.
Healthcare is expected to be discussed on Tuesday September 15th after President Obama addresses the Convention.
For further information, a list of union endorsers, or a sample endorsement resolution, contact: Kay Tillow All Unions Committee For Single Payer Health Care--HR 676 c/o Nurses Professional Organization (NPO) 1169 Eastern Parkway, Suite 2218 Louisville, KY 40217 (502) 636 1551 Email: nursenpo@aol.com http://unionsforsinglepayerHR676.org
The Weiner amendment would replace Division A of HR 3200 with the text of HR 676, the "U.S. National Health Care Act," sponsored by Rep. John Conyers. This would effectively transform HR 3200 into single-payer legislation. Single-payer is a superior reform to HR 3200 in many ways:
Single payer would provide universal and comprehensive coverage for all medically necessary services. Unamended, HR 3200 would leave millions uninsured or with skimpy coverage.
Single payer allows patients free choice of doctor and hospital. Under HR 3200, insurance companies would continue to deny care and restrict access to services.
Single payer pays for itself by eliminating $400 billion in insurance company administrative waste and redirecting it to care. HR 3200 requires $1 trillion in new revenue in the next decade.
Single payer establishes proven and effective cost-containing mechanisms to ensure that benefits are sustainable over the long run. HR 3200 lacks effective cost controls.
The Weiner amendment presents an historic opportunity for Members to register their support for single-payer national health insurance as the best way to solve the U.S. healthcare crisis. It additionally will provide a vote that Members can stand by when approached by constituents.
At the end of August the Republican Party took the position of “hands off Medicare.” While this would leave in place “Medicare Advantage” (which pays private insurance companies 12 to 17% more than it pays for the costs of care of traditional Medicare), and Medicare Part D (another huge giveaway to the drug and insurance industry), it was striking to see the Republican Party tie itself in knots after decades of calling for the abolition of Medicare.
Also in the name of "keeping the government out of health care" the Republican Party came out in defense of the Veterans Administration, a socialized health care system directly owned and operated by the federal government. In August the Congressional Budget Office released a study that underscored once again evidence of superior quality of care at the VA: better than Medicare, better than private practice and better than managed care.
If we were to engage a truly evidence-based debate over how to pay for health care using a “uniquely American” model, it would be a debate between single payer, the Medicare model, and socialized medicine, like the VA.
From "off the table" to "on the floor"
Single-payer national health insurance, after more than 20 years of accumulating evidence, now accumulates unprecedented popular support. Although polls have shown for decades that a majority, including physicians, favor national health insurance, the depth and passion of grassroots activism for the proposal is something new. For the first time this fall single payer may be voted on on the floor of the House of Representatives.
At the end of July, as the Energy & Commerce committee completed deliberations on HR 3200, Representative Anthony Weiner of New York, with 6 others, put forward an amendment to replace the text of HR 3200 with the text of HR 676. Committee Chair Waxman interrupted to say that House Speaker Nancy Pelosi offered to allow single payer to be voted on by the entire House of Representatives if the amendment were withdrawn from Committee. Weiner accepted.
Perhaps the prospect of defeating single payer on the floor of the House of Representatives seems, to the Democratic Party leadership, a way to at last get single payer off the table.
Single payer activists have welcomed this turn of events, for it was the direct fruit of grassroots mobilization. The proposals before Congress, with the exception of HR 676 and S 703, will simply not work. Whatever happens in Congress this fall, the system will grow more dysfunctional. And with expectations for fundamental reform now raised even higher, excellent prospects to build a movement for single-payer national health insurance will persist.
Dr. Coates practices medicine in Albany, NY, where he is assistant professor in the departments of medicine and psychiatry at Albany Medical College, secretary of the Capital District chapter of Physicians for a National Health Program and co-chair of Single Payer New York.
Since health insurance lobbyists have effectively squelched discussion of single payer bill HR 676 as an option for health care reform in Congress at this time, Rep. Anthony Weiner, a single payer supporter, has filed an amendment to the health reform legislation recently created in the House, HR 3200. Weiner’s amendment would effectively change HR 3200 into a single payer bill.
As President Obama prepares to address the nation about his vision for health care reform, we should not overlook the last, best truly transformative change to our health care system: Medicare. We have been staring so intently at the lessons of 1993 that we may have forgotten the universal rule of successful lawmaking: "keep it simple."
During the eleven town hall meetings I've held around my district, I've had some direct experience with the anxiety this debate has produced. Much of the fear comes from two groups: those who have Medicare and don't want it changed and those who have never had a government-run reimbursement system like Medicare and are worried about the impact it will have on their quality of care.
In both cases, a calm, reasoned and vigorous defense of the American single-payer plan is just what the doctor ordered.
The truth is that the United States already uses single-payer systems to cover over 47% of all medical bills through Medicare, Medicaid, the Veterans Administration, the Department of Defense and the Bureau of Indian Affairs.
Understanding that these single-payer health programs are already a major part of our overall health care system should help us visualize what an actual public plan would look like. These institutions also provide health care to millions of satisfied customers in every community who would heartily agree that the government can build and run programs that work quite well.
Medicare also provides us with a case study in the hypocrisy of our Republican friends who have built their party on a 44-year record of undermining this popular program. And now their Chairman sees no irony in ripping "government run" healthcare while publishing an op-ed opposing changes to Medicare.
If Medicare has been such a success, why not extend it? Why not have single-payer plans for 55 year olds? Why not have one for young citizens who just left their parents or college coverage?
So far, the answers we hear to these questions have simply not been very convincing.
At one town meeting the President responded that that he was worried about its "destructiveness."
Really? Americans would still go to the same doctor and the same neighborhood hospital. Sure, they would be able to delete the 1-800 number of their insurance company from their cell phones. And doctors would have to get rid of all those file cabinets full of paperwork while their assistants who spend time fighting with insurance companies would be able to actually speak to patients.
But everyone would adjust, I'm sure.
The real reason we haven't seen the Democratic Party embrace the obvious and simpler idea is that it boils down to pure beltway politics.
We've been reluctant to tackle the real inefficiency in the current system, namely, the very presence of the private insurance companies. Too many in Washington would rather stay friends with the insurance and drug companies when real reform probably can't be achieved in a way that makes these powerful institutions happy.
That's not to say we should vilify the industry. When they pocket up to 30% in profits and overhead (compared to 4% for Medicare) or when their executives take multimillion dollar salaries, insurance companies are doing what their shareholders want them to do.
But let's leave it to the Republicans to defend those actions. I, and most Democrats, should not join the chorus that sounds like we care more about insurance companies than taxpayers.
The same is true for Big Pharma. If Wal-Mart can pool its customers to be able to offer the $4 prescriptions, why shouldn't the federal government drive the same hard bargain on behalf of the tax payers so they too get the best prices under Medicare? I pose this exact question at every town hall meeting I attend and if my colleagues and the President did the same on Wednesday night, they would mix good policy with good politics. Instead we have watched a puzzling dance as policymakers have effectively limited the savings we would find in the enormous drug expenditures that are a fixture in our current system. Is it any wonder citizens are confused?
I have no delusions about the muscle needed to overcome resistance from the insurance and pharmaceutical industries. But I believe that for every American we may lose to a slash-and-burn TV ad funded by these businesses, we will gain five among those who are looking for a clear rationale for what we are trying to accomplish and an example for what it may look like.
We also achieve something else: realignment of the political universe. Democrats understand the role of government and are proud of our signature achievement: Medicare. The Republicans care most about big business.
I'll take that fight any day. And I'm hoping that the President will tell us on Wednesday that he is willing to do the same.
Four central labor councils in Tennessee, Texas and Minnesota have endorsed HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).
One hundred and thirty four central labor councils and area labor federations have now endorsed HR-676 - Expanded and Improved Medicare For All
In Tennessee, the Central Labor Council of Nashville and Middle Tennessee has endorsed H.R.-676, reports Council President Lewis Beck.
In Texas, the Tarrant County Central Labor Council in North Richland Hills and the Webb County Central Labor Council in Laredo also endorsed HR-676. William Koehn, President of the Webb County Central Labor Council, reports that UTU Local 1670, his own local union, has also endorsed HR-676.
In Minneapolis, Minnesota, the Minneapolis Regional Labor Federation endorsed HR-676 and submitted its resolution to the AFL-CIO Convention.
Both Texas labor councils have also submitted their resolutions to the AFL-CIO Convention.
In the current Congress, HR 676 has 86 co-sponsors in addition to Conyers. Vermont Senator Bernie Sanders has introduced SB 703, a single payer bill in the Senate.
HR-676 has been endorsed by 566 union organizations in 49 states including 134 Central Labor Councils and Area Labor Federations and 39 state AFL-CIO's (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NY, NV & MA).
For more information contact: Kay Tillow All Unions Committee For Single Payer Health Care--HR 676 c/o Nurses Professional Organization (NPO) 1169 Eastern Parkway, Suite 2218 Louisville, KY 40217 (502) 636 1551 Email: nursenpo@aol.com http://unionsforsinglepayerHR676.org
For the first time ever, single-payer legislation will be debated and voted on by Congress in September.
The day after thousands of grassroots activists rallied in Washinton, DC for national healthcare on Medicare's 44th birthday, Rep. Anthony Weiner (NY-9) introduced an amendment to President Obama's healthcare reform bill (HR 3200) to replace it with HR 676, the single-payer bill, and Speaker Pelosi pledged to bring it to a debate and vote on the full House floor in September.
Tell your Representatives that the Obama health plan is NOT enough and we want them to vote YES on single-payer. We need real health reform that will cover every American, provide real choice of doctors, and save the majority of Americans money.
Here's a full list of other ways you can help win single-payer healthcare this September.
Reno, Nevada. The American Federation of Government Employees (AFGE) is the twenty-second international union to endorse HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).
On August 27th the 38th AFGE National Convention passed Resolution #4003, "Endorsing Universal Health Care H.R. 676." The resolution was submitted by Local 2157 which represents workers at the Portland, Oregon, Veterans Administration Medical Center. AFGE represents 600,000 federal and District of Columbia workers in a wide variety of agencies, including Social Security, the Veterans Administration, and the Bureau of Prisons.
Betsy Zucker, RN, FNP, and a convention delegate from Local 2157, said after the vote:
"AFGE members from around the country overwhelmingly endorsed H.R. 676, Single Payer Health Care, on August 27. Federal workers understand that Medicare-for-All will save money, provide health care to all, and start addressing health care as a human right, not a commodity to be bought and sold to the highest bidder. AFGE supports health care for people, not for profits!"
HR 676 would institute a single payer health care system by expanding a greatly improved Medicare system to everyone residing in the U. S.
HR 676 would cover every person for all necessary medical care including prescription drugs, hospital, surgical, outpatient services, primary and preventive care, emergency services, dental, mental health, home health, physical therapy, rehabilitation (including for substance abuse), vision care, hearing services including hearing aids, chiropractic, durable medical equipment, palliative care, and long term care.
HR 676 ends deductibles and co-payments. HR 676 would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.
In the current Congress, HR 676 has 86 co-sponsors in addition to Conyers. Vermont Senator Bernie Sanders has introduced SB 703, a single payer bill in the Senate.
HR 676 has been endorsed by 561 union organizations in 49 states including 130 Central Labor Councils and Area Labor Federations and 39 state AFL-CIO's (KY, PA, CT, OH, DE, ND, WA, SC, WY, VT, FL, WI, WV, SD, NC, MO, MN, ME, AR, MD-DC, TX, IA, AZ, TN, OR, GA, OK, KS, CO, IN, AL, CA, AK, MI, MT, NE, NY, NV & MA).
For further information, a list of union endorsers, or a sample endorsement resolution, contact:
Kay Tillow All Unions Committee For Single Payer Health Care--HR 676 c/o Nurses Professional Organization (NPO) 1169 Eastern Parkway, Suite 2218 Louisville, KY 40217 (502) 636 1551 Email: nursenpo@aol.com http://unionsforsinglepayerHR676.org 09/02/09
He left us a model for Senate action - now that Republicans have walked away.
Until last year, Senator Edward M. Kennedy's health care bill, co-authored with with Cong. John Dingell, was a bill known as Medicare for All. Not expensive private insurance for some, but Medicare [a public insurance plan] for All.
Conyer's bill in the House, HR-676 is Expanded and Improved Medicare for All - a single-payer plan. Let's do it.
Machinists’ organizations in Texas and New Jersey have endorsed HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).
The Texas State Council of Machinists (IAM) has endorsed HR 676, reports Council President Danny T. Cooke. The Texas State Council is the sixth IAM State Council to endorse HR 676. The others are Washington, Connecticut, Ohio, Minnesota and Oregon.
In Newark, New Jersey, IAM Local Lodge 2339N has also endorsed HR 676, report Chris Boelens, Legislative Committee Chair, and Eric Kaufman, Deputy Assistant. They report that Local 2339N also endorsed Bernie Sanders’ single-payer Senate Bill 703 and that copies of both resolutions are being sent to all members of the U.S. Congress, the AFL-CIO, and the print and broadcast media.
HR 676 has been endorsed by 574 union organizations in 49 states. Endorsers include 130 Central Labor Councils and Area Labor Federations and 39 state AFL-CIO's.
McCaine's town hall meeting fostered disinformation and fear until one advocate from the audience explained how HR 676 "Medicare For All" worked. Unbelievable, McCain confessed he's never heard of the Bill but said he would not support it, anyway.
Portland, Oregon- American Federation of Government Employees Local 2157 and Painters Local 10 have endorsed HR 676, single payer healthcare legislation introduced by Congressman John Conyers (D-MI).
AFGE Local 2157 represents 600 employees at the Portland VA Medical Center and outlying clinics in Oregon as well as at the Veterans’ Benefits Administration offices and Willamette National Cemetery. The local endorsed HR 676 following a presentation by member Betsy Zucker and Jobs with Justice activist Peter Shapiro. Local 2157 President Leonard Fearn said: “We are proud to join the growing number of unions who support single payer healthcare. Private insurance adds cost, but no value, to our health care dollars. Single Payer Now.”
AFGE Local 2157 has submitted its resolution to the AFGE International Union Convention which meets this month.
Local 10 of the International Union of Painters and Allied Trades (IUPAT) also endorsed HR 676. Travis Giobbi, a Local 10 apprentice, submitted the resolution and reports that the local forwarded its resolution to their International Union Convention which meets in September.
This is what happens when you begin your negotiations with your "line in the sand" position. Democratic activists, HCAN, MoveOn and others who abandoned Single-Payer (Medicare for All), as being unfeasible will be responsible for our not getting even a strong public option if that is how it plays out.
Apparently ready to abandon the idea, President Barack Obama's health secretary said Sunday a government alternative to private health insurance is "not the essential element" of the administration's health care overhaul.
The White House indicated it could jettison the contentious public option and settle on insurance cooperatives as an acceptable alternative, a move embraced by some Republicans lawmakers who have strongly opposed the administration's approach so far.
If you want to save the Public Option, you need to switch gears right away and start lobbying for Single Payer. HR-676 will be allowed a vote on the floor of the House. It will not pass, but getting a strong vote helps move the debate so that reform might actually help citizens.
Seriously, "grandma's going to be killed by Obama's healthcare plan" (whatever his plan is, even I don't know) wouldn't work on "we're just going to give medicare to everyone".
Just sayin'.
The whole "you can't sell single payer" is turning out to be, well, rather questionable. Because the way things are going it's fairly clear you can't sell some godawful hodgepodge either and all the screaming about "you're going to take away my Medicare" indicates that a lot of the people who oppose Obamacare, love Medicare.
Ruling out "single payer" from the very start was an act of mind-bending incompetence on the level of disbanding Iraq's army during the occupation of Iraq. From a policy point of view "Medicare for all" provides massive savings, and we know it works because the equivalent policies have worked for every other nation in the world who ever implemented then. From a sales point of view it's much harder to demonize Medicare and much easier to explain it. From a negotiation point of view pre-compromising is so stupid that anyone who has spent 5 minutes in a third world bazaar or taken even a single negotiating class knows better.
The current health reform "bills" are turning into a clusterfuck of epic proportions. Scrap them, introduce Medicare for all, target Senators who won't vote for it with bone-crushing ads which ask why they want 22,000 American to die every year who could be saved for less money than the Iraq war cost; explain with nice simple pictures how much money they receive from the insurance industry and note that they are willing to let Americans die in exchange for blood money from the medical industry.
Amen. What is happening now is a disaster. If a bill emerges with a robust, affordable and sustainable public option, it will be a miracle.
If you want to help Americans with real health care reform and maybe save Obama's presidency, then you need to start lobbying House members to push for a CBO rating and to vote for HR-676 when it gets to the floor for a vote. And report the more liberal members of the Senate to support Bernie Sanders single payer bill, S-703. We won't get single payer but it will alter the negotiations and moves real healthcare reform forward.
The original, "Bait and switch: How the “public option” was sold" by Kip Sullivan is linked here.
From Kip's Reply to those who wrote in response to that article:
How many times must universal coverage advocates rush onto the battle field to promote a multiple-payer solution and get slaughtered before they realize they can’t get to universal coverage that way? How many defeats will it take till they know that universal coverage without cost containment is not politically feasible? How many times can they be fooled into thinking that there are ways to cut costs other single-payer?
There are several reasons why the lessons of previous defeats don’t sink in with many universal coverage advocates. I’ll discuss two here: (1) insufficient knowledge of how social change happens; and (2) insufficient knowledge about the role that promoters of market-based solutions to the health care crisis played in marginalizing single-payer legislation in Congress.
This view of social change is often expressed in the mantra quoted above, “Single payer is not within the realm of possibility this term.” The implication is that if single-payer advocates cannot demonstrate that they have at least 51 percent of the votes lined up, they should retreat to the sidelines and watch the “political yes buts” do their thing. It implies that social change must occur within a single session of Congress rather than over the course of many sessions. It implies that movements for social change should, in the event that they do not have a majority vote locked up at the beginning of any given session of Congress, put their campaign in moth balls and forgo the opportunity to educate the public and build their movement through lobbying, testimony, rallies and all the other tools associated with campaigns to move bills in Congress.
In short, it implies an absurd Catch-22. To get the “political yes buts” to join them, single-payer advocates must show proof of having a majority of Congress on their side; but to get a majority of Congress on their side, the single-payer movement must build and wage a campaign relentlessly over many years in the face of active discouragement from the “yes buts” – and without pestering Congress with ideas unfairly characterized as utopian.
These demands, when they are spelled out, are obviously irrational. Universal coverage under a single-payer system is going to be difficult to achieve. The difficulty may be on the order of the difficulty of ensuring voting rights for women and civil rights for black people, to name just two examples of movements that took decades to accomplish their goals. If the leaders and supporters of these movements had accepted the Alice-in-Wonderland rules recommended by the “yes buts,” the women’s suffrage and civil rights movements would never have happened.
There have been three cycles of health care reform in the last half century – 1970-73, 1992-1994, and 2007 to date. At the dawn of each cycle, single-payer legislation had already been introduced. But early in the cycle, single-payer legislation was “taken off the table” (to quote a statement Sen. Max Baucus now wishes he had never made). Each time the Democratic leadership chose instead market-based proposals that had no track record and no evidence to support them. Each time they favored reform deemed more “politically feasible” than single-payer because it left the insurance industry in place. In all three cycles, the alternative, market-based proposal was promoted by one or two policy entrepreneurs (that is to say, it wasn’t an idea that bubbled up from the grassroots).
I am not going to quote all of the history of those first two cycles detailed in this article, but it would be well worth your time to read. On to the thrid one - now...
The cycle we’re in now bears many similarities with the last two cycles. When this cycle began (2007 is as good a year to pick as the first year of this cycle, although that is somewhat arbitrary), single-payer legislation was better positioned than ever before to be taken seriously by Democrats. Single-payer bills had been introduced in several states as well as the US House (Sen. Bernie Sanders would introduce a single-payer bill in the Senate in 2008). Polls were showing that two-thirds of Americans and 60 percent of doctors support single-payer (or “Medicare for all”) legislation.
But once again an articulate policy entrepreneur appeared on the scene to sell a market-based alternative to single-payer that would leave the insurance industry at the top of the health care food chain, and once again the Democratic leadership fell for it. This time the entrepreneur was not Paul Ellwood. This time the policy entrepreneur was Jacob Hacker, a professor of political science at Berkeley. Just as Ellwood and the Jackson Hole Group had before him, Hacker said enhanced “competition” among insurance companies was the solution to the health care crisis. (The name of Hacker’s latest paper is “Healthy competition.”) This time enhanced competition would not come from “managing” competition, but from the creation of a “public option.” This time the coalition that promoted the alternative to single-payer was not the Jackson Hole Group, but HCAN, assisted by a sister coalition called the Herndon Alliance.
The Herndon Alliance was founded in 2005 by many of the same groups that would create HCAN in 2008. The Herndon Alliance paved the way for HCAN’s promotion of the “public option” with some laughable “research” claiming to find that Americans want a “public-private-plan choice” approach and don’t want a single-payer system. I have written elsewhere about the bogus “research” conducted by the Herndon Alliance. Suffice it to say here the Herndon Alliance cooked up a new and more insidious version of the “political feasibility” argument.
Until about 2007, when the Herndon Alliance first began publishing its “research,” there was only one variant of the “political feasibility” argument, the one that said the insurance industry is too powerful to beat. The Herndon Alliance variant claimed single-payer is not feasible because Americans don’t want it. According to this variant, American “values,” not the insurance industry, are actually the greatest impediment to single-payer. According to the Herndon Alliance, Americans “value choice of insurance company” and “they like the insurance they have and want to keep it.” HCAN and Hacker picked up these refrains and promoted them vigorously to the public and to members of Congress. This inexcusable attack on single-payer no doubt helped key committee chairs in Congress (Kennedy, Baucus, Waxman, Rangel and Miller) feel more comfortable taking single-payer off the table and concentrating on the “public option.”
By early 2009, it was clear the Hacker-HCAN-Herndon Alliance propaganda for the “public option” and against single-payer had worked with the Democratic leadership, and that the Democratic leadership would fall once again for a market-based alternative and remove single-payer from the table. The removal of single-payer legislation took place without the firing of a single shot in public by the insurance industry and the right wing. It took place at the request of the “yes but” wing.
In the House, single-payer legislation, HR-676, has been rammed back onto the table, thanks to hell-raising by the single-payer movement, including the arrests of some brave doctors and nurses who disrupted hearings in the Senate Finance Committee last May. Last Friday night, Speaker Nancy Pelosi agreed to allow a floor vote on whether to substitute HR 676 for HR 3200, the Democratic leadership’s “public option” bill. This is a significant victory for the single-payer movement, but it should not have come so late in the 2009 session. If Pelosi and the three committee chairmen who wrote HR 3200 had permitted HR 676 to go through the normal committee hearing process, single-payer advocates would have had more time to educate Congress and the public about why a single-payer system is superior to all other alternatives.
It appears almost certain that the reform cycle we’re in now will end the way the last two did – with the Democrats’ competition-based alternative to single-payer going down in flames. It is extremely important that progressives, especially progressives in the “yes but” camp, understand why this happened. Yes, the ultimate villain in these dramas was the insurance industry and their conservative allies. But universal coverage advocates must understand the role of the “yes buts,” and the policy entrepreneurs they listened to, in splitting the universal coverage movement and in seducing Democrats to support legislation that was no more likely to pass than single-payer legislation and wouldn’t have cut costs if it had passed. If they don’t see this – if they persist in believing the insurance industry is the only force single-payer advocates have to contend with – they will, wittingly or unwittingly, help perpetuate the pattern we have seen in the last three reform cycles. They will, in short, perpetuate the insanity of doing the same thing over and over, seeing it fail, and not learning from failure.
The argument that any “public option” is better than none has rarely been articulated, but I suspect we will hear it more often as the reality sinks in that the “public option” in the Democrats’ bill is a joke. “Public option” advocates who learn for the first time that the “option” in the Democrats’ bill will insure few or zero people have only two choices: to abandon the “public option” movement, which is no doubt emotionally difficult to do for those who have invested heavily in the movement, or to continue to work for the Democrats’ version of the “public option” and rationalize that choice with the argument that a tiny “public option” can always be improved once it is established.
The problem with this argument is that the “public option” is not your typical government program. The “public option” is not like the space program or the various college loan programs, to take a few examples, all of which can be expanded or contracted as the years go by without seriously threatening the very existence of the program. The “public option” will be a business. And this particular government-run business may never get very big; it may not even survive. If it doesn’t get big, or doesn’t survive, it won’t develop the huge public fan base that protects popular programs like Social Security and Medicare. In fact, the reverse could happen. A miserable early performance may cause Americans to turn against the idea of a Medicare-like program for the non-elderly. Unlike public programs, businesses don’t have an indefinite time period to develop a supportive public. Businesses don’t automatically take root and go on living forever. The “public option” must prove its ability to survive and undersell the insurance industry quickly. Moreover, the “public option” will be attempting to break into a business that has been consolidating over the last few years. The insurance industry is extraordinarily difficult to crack.
“Public option” proponents who urge us to support even a token “public option” must remember how much is at stake here. At stake is not only the willingness of the public to believe that government health insurance programs can outperform the insurance industry. At stake as well is whether Congress will give the insurance industry a trillion dollars per decade of taxpayer money.
A well-fed insurance industry is bad news for both single-payer and “public option” advocates. An insurance industry strengthened by a trillion dollars per decade of new tax dollars will not only be in a better position to oppose single-payer legislation, it will also be in a stronger position to lobby Congress and the regulators to ensure the “public option” remains stunted.
“Public option” advocates should start talking about the “public option” as if it were inextricably tied to an insurance industry bailout. They should write the phrase “public-option-insurance-industry-bailout” on a Post-it note and paste it to their bathroom mirror to remind them to be honest with themselves and the public about this fact.
To sum up: “Public option” proponents who claim that any “public option” is better than no “public option” because even a skinny little program can be beefed up later are sadly mistaken. A weak “public option” may not survive to be beefed up later, and whether it survives or not, it will serve as fig leaf that will let Congress justify an insurance industry bailout. A strengthened insurance industry is the last thing either the “public option” or the single-payer wing of the universal coverage movement needs. Please say after me: A weak public option is far worse than none at all.
I am under no illusion that a single-payer bill would have passed Congress in 2009 given the world as it was in December 2008. I do believe, though, that if the “yes but” wing of the universal coverage movement had thrown their considerable weight behind single-payer prior to 2009, say, in 1992 when the last reform cycle began, we would either have a Medicare-for-all style system by now, or we’d be on the verge of enacting one now.
Will HCAN and Hacker put out a call to their followers to do all they can to win the floor vote on HR 676 this fall? Or will they give lip service to HR 676 and sit on their hands? When the 2009 session of Congress ends, will HCAN et al. offer their usual misinterpretations of why reform failed?
How quickly America enacts a single-payer system will depend in part on whether progressives learn the real lessons of the failure of the “public option” movement in 2009. If the “yes but” wing draws the same lessons it drew from the failure of the Clinton bill – that the “base” was not well enough organized, or that the Clintons didn’t “sell” their plan skillfully – unity within the universal coverage movement seems unlikely, and the day we get to a single-payer system will be postponed.
I believe the “yes buts” must confront some inconvenient truths immediately. The “political feasibility” rationale for doing nothing to assist the single-payer movement was never a good one or, at minimum, after two decades of constant use, has become an embarrassment and must be discarded. It is foolish to argue that even the tiniest “public option” will constitute a victory that can be built on later. If the “yes buts” see these truths, then unity within the universal coverage movement should be possible. And if unity comes to the universal coverage movement for the first time in 40 years, single-payer can’t be far behind.
Please read it all here at PNHP's Official Blog and share with your progressive friends. More people will die if we fail. Our Grandchildren will be fighting the same battle in another 20 years.
Although still very much under-recognized and fought against by the medical industrial complex and complicit corporate media, there is only one solution to cost containment of our runaway market-based health care system. H. R. 676, coupled with a private delivery system, is a paygo alternative that assures universal coverage of necessary health care for all Americans. It would save up to $400 billion a year and provide a structure within which to put in place other cost-saving efficiencies.
The private health insurance industry is an impediment to reform, not part of the solution. It has survived to this time only through generous subsidies from the government, whether in the employer-based or individual markets or privatized Medicare and Medicaid programs. Until we recognize this, all of our incremental approaches to build on our multi-payer system will be of no avail.
