by Andrew Coates MD
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Nancy Pelosi offered to allow single payer to be voted on by the entire House of Representatives if the amendment were withdrawn from Committee.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. Read it all at PNHP's blog.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.
From Ian Welsh at Open Left
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.
Well worth watching.
Sen. Sanders discussed his views on health care legislation now being debated in Congress. He is the among the Senate's strongest proponents of a single-payer, government-financed health care system, and has introduced the Senate's only single-payer health care plan. S. 703, The American Health Security Act. C-SPAN Video here
by Chuck Idelson | Guaranteed Healthcare
In Canada, it took the dogged determination of one province, Saskatchewan, and a visionary leader Tommy Douglas, to pave the path to a national health care system, which they call Medicare.
For all the detractors of the Canadian system in the studios of Fox News and the board rooms of rightwing think tanks, consider this one note: In 2004, the Canadian Broadcasting Corporation conducted a national poll to select the greatest Canadian of all time. The winner in a landslide -- Tommy Douglas.
While the federal window remains open for reform, with two national single payer bills, John Conyers' HR 676 in the House and now Bernie Sanders' S 703 in the Senate, many nurses, doctors, and health activists are turning to the states to lead as well. More than a half dozen U.S. states now are considering legislation to establish single payer systems, essentially an expanded and updated form of the U.S. Medicare system to cover everyone in their states. Here's a roundup of some of the state bills:
California
The latest bill SB 810 passed its first legislative test Wednesday in the Senate Health Committee on a party line 7-4 vote before a room packed with nurses, doctors, medical students, California School Employees Association members, and healthcare activists.
In her lead testimony, Malinda Markowitz, RN, co-president of the California Nurses Association/National Nurses Organizing Committee noted that "nurses know insurance companies don't provide any value whatsoever in the delivery of medicine. Under SB 810, we would be free of their interference, their denial of care, their massive bureaucracy, and their waste of healthcare dollars."
UC Irvine medical student Parker Duncan said that he did not want to “be in a world not doing what I was trained to do,” referring to the paperwork that is one of the expensive burdens that undermine the ability of the current system to deliver health care.
Twice this decade California's legislature passed earlier versions of SB 810 (SB 840 carried by now retired Sen. Sheila Kuehl), but the bills were vetoed by Gov. Arnold Schwarzenegger. State activists say they will continue to push single payer in California, even if they need to wait until the next governor, who won't be Schwarzenegger, is elected in 2010.
Colorado
House Bill 1273 by Fort Collins Democrat John Kefalas, passed its first vote in the state House April 6. The bill sets up a 23-member commission to design a universal health-insurance system.
"Our current health-care system is not well," Kefalas said. "Our current health-care system is unsustainable, with the cost of health care and the numbers of the uninsured rising dramatically."
Press reports note a state Blue Ribbon Commission on Health Care Reform two years ago studied single payer and found it was the only approach that saved money compared to what Coloradans now spent on healthcare.
Illinois
HB 311, the Healthcare for All Illinois Act, sponsored by Rep. Mary Flowers, had its first hearing in March. Though no votes have been taken yet, the new Gov. Pat Quinn is a long time supporter of single payer reform.
At an introductory press conference, Brenda Langford, Cook County RN, said that “Illinois can once again be a symbol of hope and progress for our nation. Nurses are tired of watching our patients suffer from denial of care and lack of access to coverage. We see far too much of this at Cook County hospitals—and that’s why we support guaranteed healthcare through a single-payer system.”
Maine
LD 1365, sponsored by Brunswick Rep. Charles Priest, and co-sponsored from legislators from all over the state, had its first hearing April 13.
The hearing came just days after both houses of the Maine legislature passed resolutions calling on President Obama and Congress to enact federal single payer legislation. A poll this winter showed 52 percent of Maine physicians also favor single payer.
As Cathy Herlihy of the Maine State Nurses Association put it in a state forum featuring U.S. Senator Olympia Snowe, a single-payer system is the “the only solution,” she said. “We do not have time to wait. Our health should not be sacrificed for limited reforms.”.
Pennsylvania
Two single payer bills are alive in the state, House Bill 1660, the “Family and Business Healthcare Security Act of 2009,” and Senate Bill 300.
Gov. Ed Rendell has said that if a single payer bill were to make it to his desk, he will sign it, reports Chuck Pennachio of Health Care for All Pennsylvania.
The state Democratic House Caucus is holding a public forum on the bill Friday, April 17 at 10 a.m. at the University of Pennsylvania campus in Philadelphia, featuring speakers from Physicians for a National Health Program, the Pennsylvania Association of Staff Nurses and Allied Professionals, and other single payer supporters..
The hearing comes on the heels of a resolution passed by the Philadelphia City Council calling for both state and federal lawmakers to establish a single-payer health system.
Other states
Single payer bills are also on the docket in Minnesota, Missouri, and Washington.
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