Washington, D.C. – Speaker Nancy Pelosi issued the following statement today on Congressman Anthony Weiner’s single payer alternative:
"Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country.
"Congressman Anthony Weiner has been a forceful and articulate advocate for the single payer approach and our legislation. His decision not to offer a single payer amendment during consideration of H.R. 3962 is a correct one, and helps advance the passage of important health reforms by this Congress. While single payer, like other popular proposals, is not included in the consensus bill we will vote on this week, Congressman Weiner has been a tireless and effective advocate for progress on health care, and his work has been a vital part of achieving health care reform."
Committee on Energy and Commerce
Chairman Henry A. Waxman
November 6, 2009
Today Chairman Henry A. Waxman released a statement in response to Rep. Anthony Weiner's decision not to offer a single-payer amendment to the House Democratic health care legislation.
"Rep. Anthony Weiner has been one of the most tireless and effective advocates for health care reform. His decision not to offer his amendment on the floor was a difficult one for him, and for supporters of the measure. I believe Rep. Weiner's choice will be enormously helpful in passing the health care reform package. His step is a correct and courageous one. I thank Rep. Weiner for it, and look forward to working with him closely. Rep. Weiner deserves a great deal of credit for helping to make quality, affordable health care more available to millions of Americans."
Comment by Ida Hellander, M.D., Executive Director, Physicians for a National Health Program:
Next steps and interpretation -
1) The fact that single payer got so far along in the House is a testament to the strength of our single payer movement. The huge number of calls by single payer advocates in support of single payer and the Weiner amendment in recent days have been noted by several members of Congress.
2) It appears that nobody, particularly the President, expected our single payer option to be alive in the Congress for so long. As you know, they attempted to keep it "off the table" from the very beginning.
3) The President was directly involved in the decision to not hold a vote on the Weiner single payer amendment, and Weiner will be meeting with him later today. Stay tuned.
4) We need to increase pressure on the Congress and the White House for Medicare for All through lobbying, civil disobedience, media outreach, and grassroots organizing. Sen. Sanders will call for a vote on single payer in the Senate - this could come up anytime in the next month. Encourage your Senator to support the Sanders bill and also an amendment he will offer for a state single payer option. The California Nurses Association/NNOC has already started lobbying visits in the Senate in D.C.
5) We have been asked how to tell members to vote on the House bill. Our response is that the bill is "like aspirin for breast cancer."
One of the reasons that I am a strong proponent of a single-payer, Medicare-for-all proposal is that it is much less complicated than what we are going to end up with in Congress. A single-payer approach saves hundreds of billions of dollars a year because you don’t end up with thousands of different health insurance programs appealing to all different kinds of people and costing a fortune to administer. I am going to continue the fight for single-payer. I am cautiously optimistic that we may end up with legislation that will allow states to go forward with single-payer if they want to.
The Weiner amendment [PDF] --will be submitted for a floor vote in the House, in the coming days, - This will be a historic vote - the fist time ever Single-Payer has gotten a floor vote.
The Kucinich amendment, [PDF] which will more easily allow states to implement single-payer plans, is already within the bill and must be retained.
Passing these amendments will be difficult, but the votes on them will help set the benchmarks for the next debates on health care so they really do matter. Win or lose, we’ll know who our friends in Congress are...
Sen. Bernie Sanders is sponsoring a Medicare for All bill in the Senate, S. 703. Tell your Senators to support it; find contact info here. He has said that he will be introducing amendments to the Senate Health Care bill, so keep your eyes and ears open for them.
Why it is important to keep fighting for real Health Care Reform:
The New York Times reported on Saturday, October 17, that Sen. Ron Wyden (D-OR) is warning his constituents that the “public option” is not going to be available to the great majority of Americans. No one who has actually read the Senate health committee’s “reform” bill or the House “reform” bill (HR 3200) disputes this. According to the Congressional Budget Office, the “option” will be available only to about 30 million people, or about one American in ten. As the Times put it (slightly inaccurately), the “option” in the Democrats’ legislation “would be out of bounds to the approximately 160 million people already covered through employers.”
Does the public understand this? According to Wyden, they don’t. Wyden says his constituents are shocked when they are told the "option" will not be available to the vast majority of Americans. When he began informing his constituents about this truth last summer, "They nearly fell out of the bleachers," he said.
Once a bill is passed and signed by President Obama, voters will start to learn just how little help the current reform policies will provide. While it is probable that the reforms will continue to funnel money to the Health Insurance companies to fund their lobbying machines, the relief for citizens maybe too little and/or too complicated and I don't believe anything currently being offered will be sustainable in the long term. So we will come back to this table. And that is why good support for the current Single Payer amendments to H.R. 3200 in the House are critically important.
Kucinich Amendment Grants ERISA Waiver for Single Payer States.
Sanders Senate Amendment Would Expand Support for Single Payer States
The Center for Policy Analysis worked closely with Congressional staff to craft the two amendments to health reform legislation that offer the greatest prospects for single payer supporters.
Summary
Some state and local governments that have attempted to expand health care coverage have been successfully challenged in court under the terms of the Employee Retirement Income Security Act of 1974 (ERISA). ERISA pre-empts states from enacting legislation if it is "related to" employee benefit plans. It reserves that right to the federal government. Section 514 of ERISA states that Title V (Administration and Enforcement) and Title IV (Fiduciary Responsibility) of ERISA “shall supercede any and all State laws insofar as they may… relate to any employee benefit plan.” There is no provision for an administrative waiver of these rules.
The Kucinich amendment to HR 3200, approved by a recorded vote of the House Education and Labor Committee, would remove this barrier for states that have enacted and signed into law a single payer system.
What the Amendment Does
The Secretary of Labor, in consultation with the Secretary of Health and Human Services, would be authorized and required to waive the ERISA pre-emption (Sec. 514) for states that have enacted a state single payer system. In this case, the Secretary could decline to grant the waiver only under extraordinary circumstances. The system would have to meet requirements, and the Secretary could revoke the waiver if it fails to do so.
The state single payer system is defined as a non-profit program of the state for providing health care to all residents. A single state agency would finance and administer the provision of comprehensive benefits that meet or exceed the standards for coverage and quality described in HR 3200, and assure free choice of health care providers. Private insurance that duplicates this coverage would be prohibited. Health maintenance organizations could operate on a non-profit basis if they also own their facilities and provide services directly. The system would not result in greater costs to the federal government. At the same time, the federal government would maintain the equivalent level of support as provided to other states, accounting for variations such as population and demographics. States could seek planning and start-up funds.
What the Amendment Does Not Do
A state single payer amendment was proposed by Senator Sanders. It is more detailed than the Kucinich amendment because it would cover matters beyond the jurisdiction of the House Education and Labor Committee. These include:
Dedicated funding for planning and implementation grants;
Specific allocations of funds from existing federal health programs, and waivers to permit coordination with those programs;
Quality assurance and health professional training programs associated with other federal programs.
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
It has become clear that the function of a private health insurance is to make as much money as possible. Every dollar not paid out in claims is another dollar made in profits for the company. Insurance companies spend millions to hire people to do everything they can to avoid paying out legitimate claims, denying coverage because of "pre-existing conditions" and terminating coverage because of high medical bills.
It is no surprise, therefore, that tens of thousands of doctors support a single-payer health care system, as well as the largest nurses unions in the country. These health care professionals do so not just because they are outraged by the lack of coverage Americans experience, but because they are sick and tired of wasting their valuable time arguing with insurance bureaucrats about how they will treat their patients.
In my view, the fight for universal and comprehensive health care is the civil rights battle of our time. Like the other great struggles in our history that have made us a more democratic and just society, victory will require a strong and united grassroots movement that is prepared to take on the very powerful and wealthy special interests that benefit from this failing health care system.
To read some of the health care horror stories Sen. Sanders has received, click here. [PDF] Please share it with your friends. To follow the health care debate on Capitol Hill, sign up for the Bernie Buzz newsletter here.
Thank you Senators Ron Wyden (D-Ore.) and Bernie Sanders (I-Vt.) Not that we were going to stop. But good of you to speak up. Read it all at Huffington Post
Independent Senator Bernie Sanders has been making a splash on progressive blogs with his very public advocacy for including a strong public plan in health care reform. Sen. Sanders told Ezra Klein that he was going to “try and form a Coalition of the Unwilling. People prepared to stay strong for a strong public option.”
David Waldman at Congressmatters.com doesn't think Sen. Sanders will go so far as to actually filibuster a health care bill if it doesn't include a public option. But thanks to the reconciliation measure adopted as part of this years budget, Sanders' “Coalition of the Unwilling” doesn't need to. If there is no bill by October 15th health care reform must go through reconciliation.
Former Senate majority leader Tom Daschle believes that a health care reform bill that goes through reconciliation will probably contain a “pure public option.”
Bernie Sanders' coalition doesn't need to filibuster health care reform without a public plan. They don't even need to vote against any bill without a public option. All they need to do is slow down the whole process. (a process which is already very much behind schedule) There are only 12 legislative weeks left before reconciliation is triggered. By dragging their feet and delaying the bill until October the "Coalition of the Unwilling" wins.
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.
I fear very much that much of the talk of health-care reform is not getting to the root cause of why we have 46 million uninsured and, at the same time, we pay more for health care per person than any industrialized country on earth. And the reason the discussion is not getting to the root cause of the problem is that the discussion is unwilling to take on the role of private insurance companies that are precisely the reason our system is so wasteful, inefficient and bureaucratic. And not to take on that fact is to ignore the reason we are where we are.
For all the talk of the Congressional Budget Office lately, I haven't seen the CBO taking on your legislation or Rep. Conyer's. Have you submitted it to be scored?
We have not submitted it to be scored. If we can we surely will. It's not clear they would score it.
Why wouldn't they?
These studies don't take five minutes. If I were the chairman of the HELP Committee they'd score it.
Re Single Payer not being part of the Senate Finance Commitee Hearings:
I think the importance of the hearing is not that it will change minds but that the American people -- and Congress -- should hear the facts about the enormous waste and bureaucracy and profiteering associated with private health insurance. Not to deal with that is mind-blowing.
You've implied here that single payer may be the long-term goal. In the shorter-term, what should single payer advocates be looking to get out of the health care process Baucus is running? Are there any concessions that could make that a win?
I am sure that there are some single payer advocates who think the only thing worth fighting for is single payer. What I have also introduced, which we will be fighting for, is a five-state option. That would mean five states would have the option of running pilot programs in universal health care but one would have to be single payer.
I think it's possible this will never happen in DC, but that this country will join the rest of the industrialized world when a state, maybe like Vermont, implements single payer and does it well. And then New Hampshire will be looking over our shoulders, and they will adopt that, and so on through the country. That's in fact how national health care came to Canada, it started in the Saskatchewan province.
The second area of less importance, but important nonetheless, is the fight for a strong public option. In my view, if you had a level playing field and a pubic program and a private insurance program providing the same level of benefits, people would come into the public program because the public program would be substantially more efficient. I think we can make that case, and I will advocate for it in the legislation.
Today’s meeting of the nation’s leading single payer activists with Sen. Max Baucus was historic, and a recognition of the power of the tens of thousands of nurses, doctors, and grassroots activists across the country who have been turning up the heat on the policy makers in Washington.
Make no mistake – your voices are being heard. And, the protests and pressure will continue.
As Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee, told Baucus, 'there is a groundswell' across the country that will continue to press for single payer reform, and Baucus and other policy makers in Washington 'are going to get to know us very well.' In a later press conference, DeMoro blasted the conventional wisdom that single payer is not politically viable. 'Is it politically viable to let people die and suffer from a lack of political will?' Noting the fight for women’s suffrage and the civil rights movement, she emphasized, 'we’re going to have to turn up the heat. Women did not get the right to vote by voting on it.'
While Baucus continued to aver that single payer can not pass the legislature, the nurses and doctors pressed him to: • Hold a hearing in which the merits of single payer can be contrasted with the plans now rapidly advancing in the Senate. While Baucus said the tight timeline made that very difficult, Sanders noted that Sen. Chris Dodd is considering a health committee hearing on single payer, which Baucus could co-sponsor. Baucus said, "let me think about it." • Have the Congressional Budget Office score, do a financial analysis, of single payer legislation in addition to other health bills it scores. • Support legislation to allow federal waivers for individual states to enact single payer systems as national role models (another Sanders bill). • Assist in arranging a similar meeting between single payer leaders and President Obama.
Ultimately, Baucus threw the ball back to the President, citing the demand of the President to Congress to have a bill on his desk by October. "He wants a big win on healthcare reform," Baucus said. But the rush to adopt a flawed bill would hardly serve the Senate or the President well, DeMoro noted. "The President would be putting himself in a very bad position. We don’t want that to happen."
PNHP President Dr. Oliver Fein cited the study last year reported in the Annals of Internal Medicine that 59 percent of physicians support a single-payer type system, and a new study showing doctors waste three to four weeks a year on paperwork that could be spent caring for patients. Sanders later praised the efforts of nurses, doctors and activists who have made single payer an inescapable part of the public discourse. "When you have the nurses and physicians saying the current system is not working," scores of people saying health care is a right and single payer the most cost effective approach, we’re seeing this grassroots movement growing and gaining momentum.
Senator Max Baucus met Wednesday with advocates for single-payer healthcare, including Senator Bernie Sanders, and told them that he might drop criminal charges against 13 people arrested for speaking up in his hearings, but that he would not include any supporters of single-payer health coverage in any future hearings. According to one report, Baucus suggested that he'd been mistaken to exclude single-payer but asserted that the process of creating healthcare reform legislation was too far along now to correct that omission.
Senator Sanders said after the meeting that if healthcare reform did not create a single-payer system it shouldn't be done at all, and that within three or four years we would realize we'd solved nothing. He said that it would be better to increase funding for community health centers and take steps to make it easier for medical students to go into primary care, than to enact major reforms that didn't go to the root of the problem.
On The Ed Show, Vermont Senator Bernie Sanders talks about the Arlen Specter defection to the Democrats, and how the grassroots now has to rise up and demand single-payer universal health care if they want it. 4/28/09
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.
Sen. Bernie Sanders, a Vermont Independent, has just introduced a single-payer health care reform bill into the United States Senate. This legislation stands in sharp contrast to the reform models offered by the White House and Sen. Max Baucus, which are similar to our current Massachusetts reform. Unlike Massachusetts, the Sanders bill would eliminate the many private insurance companies and create a "single payer" to administer health care funds.
Single-payer health care would save American taxpayers $400 billion in administrative costs, says Sanders, which would be enough money to provide health care coverage for everyone in our country. Sanders is a senator who knows how to save money at a time when taxpayers are paying billions to keep AIG afloat.
As we know from our Massachusetts experience with health care reform, preserving the role of private health insurance companies does not lead to universal coverage or contain rising health care costs. The Massachusetts reform program has not been affordable for the individual or for the state, and access to health care continues to be problematic, with nearly a quarter of the state's residents saying they had difficulty getting care in 2008.
The provisions of Senator Sander's bill are: (1) universal coverage; (2) comprehensive benefits, including mental health, dental and prescription drug coverage; (3) patient choice of doctors and hospitals; (4)fully-funded community health centers to provide access to care for the 60 million people living in rural and other underserved areas; and (5) resources for the National Health Service Corps to train 24,000 new health professionals to address the shortage of primary care doctors and dentists.
Massachusetts continues to have a critical shortage of primary care doctors, and providing health insurance for the uninsured through our current program has only made that deficiency more visible. Having health insurance in Massachusetts doesn't guarantee health care if you can't find a doctor when you are sick. Others with insurance can't get care because they can't afford their co-payments and deductibles.
Sanders' program would be paid for by taking the current sources of government health care spending, and combining them with modest new taxes that would be less than people now pay for insurance premiums and other out-of-pocket expenses. Four hundred billion dollars would be saved annually by eliminating insurance company profits and overhead, as well as the paperwork that burdens doctors and hospitals.
Dr. Uwe Reinhardt said at a hearing before the U.S. Senate Finance Committee, "We have 900 billing clerks at Duke (a 900 bed university hospital). I'm not sure we have a nurse per bed, but we have a billing clerk per bed. . . it's obscene."
Doctors and hospitals are sick of the paperwork and the health care dollars that don't go for health care delivery. And everyone hates the intrusion of insurance companies into health care decisions. A poll published in the Archives of Internal Medicine found that 64 percent of doctors in Massachusetts now support single-payer health care.
Sen. Bernie Sanders' legislation is a bold step forward. Five hundred physicians in Massachusetts have signed a letter to Sen. Kennedy, asking him to support a single-payer reform similar to Sanders' bill. Kennedy supports universal coverage, but would leave the current dysfunctional system of multiple insurance company payers intact. Kennedy has said, "Health care is not just a commodity . . . to be rationed based on the ability to pay. It is time to make universal health insurance a national priority, so that the basic right to health care can finally become a reality for every American."
Unfortunately, leaving the current system intact would not save the $400 billion now lost to administrative expenses. We ask Sen. Kennedy to listen to Massachusetts physicians and reject the lobbying forces of the profit-driven insurance industry. We also ask him to join Sen. Sanders in sponsoring the only solution for health care reform that will cover everyone at a cost we can afford.
