Building the Single-Payer Movement
Having just gone through a grueling, frequently raucous debate on health reform, capped by the narrowest of votes to pass the Obama administration's bill, many activists are now tempted to adopt a "wait and see" attitude on how the new law plays out.
A few others are putting their emphasis on helping the administration implement the law, in some cases enthusiastically trumpeting their strange-bedfellow partnership with the profit-hungry health insurers and Big Pharma.
Still others - the hostile, noisy Know-Nothings associated with the Republicans and Tea Party crowd - continue to rail against President Obama's "socialized medicine" plan (a misnomer if there ever was one), and pledge to obstruct or overturn it. Conservatives vow to make political hay out of the law in the run-up to the midterm elections.
Wall Street, on the other hand, is very comfortable with the new legislation. Mutual fund analysts now say it's increasingly clear that the law is beneficial for health industry stocks, particularly for pharmaceutical and medical equipment companies, because there are no "onerous cost controls" in the law. And health insurance company stocks continue to a yearlong trend upward, and the industry's CEO salaries continue to be astronomical.
After all, the health insurers wrote the bill. Sen. Max Baucus was recently caught on tape heaping effusive praise on his aide Elizabeth Fowler for her pivotal role in crafting the legislation. Fowler is a former vice president of WellPoint, the giant health insurer.
Baucus himself, a key actor in this bad movie, was surrounded by health industry lobbyists from the very beginning, and has received over $2.8 million in campaign contributions from these toxic sources over the past few years. That he earned his payoff was demonstrated when Karen Ignagni, the president of America's Health Insurance Plans, congratulated him (during this week's episode of "Frontline") on his handling of the single-payer nonviolent disruption of his Senate Finance Committee hearing after single-payer advocates like Dr. Margaret Flowers were excluded from giving testimony.
Supporters of single-payer national health insurance face several challenges, the chief of which is how to transform the various efforts of single-payer Medicare-for-All activists into a movement for political and legislative success. Among the key tasks are these:
* Educating candidates for political office (and current officeholders) from all political parties about the merits of the single-payer proposal, and offering to advise them on health policy matters.
* Ensuring the reintroduction and largest possible legislative sponsorship for national single-payer bills like Rep. John Conyers' H.R. 676 and Sen. Bernie Sanders' S. 703.
* Supporting efforts (including a change in the new law) to permit states to experiment with their own, independent single-payer models of reform right away.
* Defending Medicare from harmful budget cuts and educating Medicare beneficiaries about their self-interest in improving and expanding the program to cover everyone, i.e. embracing the slogan, "Everybody in, nobody out."
* Continuing our educational work about the merits - nay, the necessity - of adopting a single-payer system. The sooner we initiate a truly universal, egalitarian, humane and efficient system, the sooner the American people will enjoy the high-quality health care our nation and our health professionals are capable of providing.
A major burden the enactment of the new law imposes on single-payer advocates is its timeline. Specifically, major elements in the legislation do not kick in for two, four or even eight years' time.
But "wait and see" is not an option for us. The legislation just passed is completely inadequate to the task at hand.
Under the new law, the suffering and financial hardship imposed on Americans by our private-insurance-based system will largely continue unabated for four more years, and only then be subject to very modest regulation. (Loopholes in the law abound.) Over 50 million people will remain uninsured each year until 2014, which translates into 50,000 preventable deaths annually. A comparable number will remain underinsured, with many vulnerable to medical bankruptcy when serious illness strikes, even after 2014.
Even if the new law works as planned, at least 23 million people will remain uninsured at 2019. So "universal health care" remains a dream deferred.
That spells human misery. This week a new Harvard-based study showed that people with migraine who lack health insurance, or who are on Medicaid, disproportionately suffer from their condition because they can't get access to the standard medications they need to reduce their pain and other symptoms. And that's just one example of the unnecessary suffering that lies in wait.
Meanwhile costs, including for health insurance premiums, will continue to escalate.
The unrelenting advocacy of single payer by Physicians for a National Health Program also stems from a careful study of repeatedly unsuccessful experiments with state-based reforms based on private insurance, including the Massachusetts plan (upon which the new law is modeled). The evidence is clear: incremental reforms of this type - based on the private-insurance model - will not work. They invariably succumb to skyrocketing costs.
Single-payer Medicare for All is the reform that's required. Just like almost all other major areas of progress in American life, fundamental health reform requires a movement based on equity, justice, prudence and science that is free of market greed. That movement today is single payer.
That attitude and set of actions will prepare Americans for the very positive change that is coming in our society. That positive change has already been experienced by some Americans, but those Americans live and work in other countries, not ours. They've written many testimonials about their experiences. They know how it is .... in the other countries, not ours.
http://www.mforall.org/pages/howitis
Yes, indeed, it is possible to focus on the positive and get the following results:
--- Get More, including More Freedoms.
--- Pay Less, including Fewer Hardships.
--- Reduce Government Programs.
--- Cover Everyone.
--- Recover & Add Businesses and Jobs.
--- Have Better Health via Better Access.
Something for everyone, even the Tea Party folks.
Bob the Health and Health Care Advocate
First, what is INCLUDED >>> education about the merits and necessity of establishing an improved Medicare for All via the best solution: single-payer health care.
Next, what is EXCLUDED: health insurance companies. Yeah, Dr. Young! We need to focus on what we want, not on what we don't want. A big question for Americans to consider is this: why do any of us spend even one minute advocating hate for insurance companies?
The numbers do speak for themselves, (as commenter Tompoe observed), so we have plenty of solid ground for spending time educating people and preparing them for a positive change to our society.
By the way, speaking of those health insurance companies, good people work for those insurance companies and will be given great support during the transition from the current complex way to pay for health care to our new simple way to pay for health care.
Know that we can and will have an improved Medicare for All. A Million Citizens: More Power Than Lobbyists. Let's move forward positively to what we want and need. Go to http://www.mforall.org.
- Bob Haiducek, Bob the Health and Health Care Advocate
Dr Young will be speaking on May 18 in Indianapolis, across the street from WellPoint/Anthem's corporate headquarters. For more on the latest shenanigans of that corporate behemoth, please see my recent HuffPosting "WellPoint/Anthem Shareholders Revolt!" http://www.huffingtonpost.com/rob-stone-md/wellpointanthem-sharehold_b_534099.html.
However, short of single-payer, and in preparation for it, there other possibilities that are worth considering, including the “Starr Plan”. Basically, it is:
1) Improve funding, reimbursement levels, and coverage standards for Medicaid.
2) Establish a designated tax to support this.
3) Open enrollment to everyone on a sliding fee scale basis, scaled by income level.
This would bring affordable health-insurance within reach of all; create a specific and predictable funding basis for it; bypass private insurance companies and all of their extra costs and problems; increase the political constituency and participant pool for Medicaid; improve benefits for present participants in the program; utilize an existing administrative and programmatic structure for delivering these services; and use the existing federal-state compromise on funding abortion services. Also, it would be a step towards single-payer, preparing people for that prospect.
Please consider supporting this. Thanks.
--- including the 1991 GAO report and others.
But that's just one example of many of our U.S. Congress to respond to the numbers.
The U.S. Congress failed many times to implement health care for all while the other countries implemented it decades ago. See the activities around the world, including the U.S. failures.
http://www.medicareforall.org/pages/World_View#worldactivity
- Bob Haiducek, Bob the Health and Health Care Advocate
- http://www.mforall.org
No wonder the insurance companies were so well taken care of...Now that we're letting bankers help draft the finance reform bill, I'm sure they'll be heavily punished as well...
We got so screwed on this deal, $1T in cost and NO reform...
For nearly a decade Medicare has been trying to introduce a "Medicare fix" with no success. This is thanks to political pressure generated at the grassroots by doctors. In fact with Single Payer, any attempt to rein in medical costs will be more difficult that reining in the insolvent Social Security system.
Dr. Young's efforts would be better spent by helping his colleagues introduce "Best Practice Patterns" to eliminate the 40% of over-, under- and in-appropriate treatment in the current system.
Newsweek magazine March 15, 2010 has a good article (link below) by Sharon Begley on over-treatment - the why and how to get it under control. It is one of few articles in the general media quoting doctors on how to medically reform the healthcare system. More of such informed articles, holding all stakeholders in healthcare responsible to do their part, will help make REAL CHANGES in the climate and cost. Yet, the big challenge is how to and who will "bell the cat".
http://www.newsweek.com/id/234514
29 million is not good but as a %ercentage.. it not a crisis either.
By 2020, another -80 million people will likely be added to the U.S. population = 405 million.
37 / 310
29 / 390(estimate)
Of this 29 Million most would choose to pay the fine instead providing money to compensate for their non payment of care... some will pay out of pocket --- some folks are just Lost to the system ...
So Yes.... I stand by my statement....
The only thing that would cover ALL Americans is Single Payer... and that ain't happening.
1) Sen. Harry Reid promised a future public option vote to stop the Senate P.O. petition drive. http://www.huffingtonpost.com/2010/03/19/reid-promises-separate-pu_n_506272.html
2) Adopt either Sen. Bernie Sanders' Amendment 2837 or Rep. Alan Grayson's Medicare Buy-in bill H.R. 4789 in both houses. http://www.huffingtonpost.com/2010/03/19/grayson-pushes-public-opt_n_506052.html
3) Amend chosen bill to include Medicare drug price negotiation and drug re-importation.
Hundreds of billions in savings right there.
4) Whip both houses (get medieval), without media or W.H. consultation, to adopt and pass this in reconciliation.
A simple, explainable, Medicare Buy-in could co-opt the elder Tbag/GOP factions, re-engage independents and energize the depressed base, mabe enough to shift attention from the bad law just passed and swing the midterms. Prescription drug prices have got to be dealt with for sheer fiscal commonsense and solvency.
Please Contact:
Speaker Pelosi http://www.speaker.gov/contact/
Majority Leader Reid http://reid.senate.gov/contact/index.cfm
Change Campaign Committee http://boldprogressives.org/home They're actively pushing Grayson's MedicareBuyin.
Yes the AMA, representing less than 20% of all physicians, made a deal with the White House for two reasons: the get a fix to the Medicare SGR (sustainable growth rate) and tort reform. Have either happenned?
I'm an oncologist in private practice - for my bio, go to:
http://doctors-takecharge-healthcare-reform.blogspot.com/
And 20% of everyone in the private market in America has already been rationed to zero with wait times until after it's too late. We win all the Booby Prizes for both rationing and wait times, by FAR.
Powerful constituencies crafted the new law. No one favors the creation of new bureaucracies; as your blog states existing ones should cover functions of those being created. This is why I favor a Medicare buy-in:
Medicare infrastructure already exists. No new bureaucracy.
It should reimburse healthcare providers equitably, with incentives for quality over quantity. Providers should be the last to be squeezed. (I've no skin in this game, but 2 RN ex-wives.) Remove the insurance middleman.
Buy-in policies should be competitive with the private sector and preferably revenue positive to shore up Medicare's longterm solvency. Bringing in a younger cohort might do this?
Prescription drug price negotiation is a free-market no-brainer. Pharma got a lot of goodies in this law.
I realize any government expansion into your field may make your life more susceptible to political tides and governmental intrusion, but you needn't worry about a public option. *There probably won't be one.