Rally for Health Care - Sunday, January 15, 2 PM Benton County Courthouse

The January 15 health care rally at the Benton County Courthouse was a great success! Thank you to all who attended. Photos by Mike Huntington below.


Mid Valley Healthcare Advocates invites you to join a rally on to 2 p.m. Facebook event details here.
Last week members of Congress introduced a bill that if passed will strip away health care for 30 million Americans - over 80 percent of whom are working families.

People already suffering will suffer more if Congress proceeds as planned.  They are our neighbors, our parents and children, our coworkers, our own community.

Before Congress destroys the health care of millions of people they need to show us a plan that helps ALL Americans – not one that pushes more costs onto families, strips health care from them, and rolls back important patient protections.

Come rally with us!  We will have signs, t-shirts, andhospital gowns for you to carry or wear.

Letter: A Health Care Opportunity

Here's a Letter to the Editor to the Corvallis Gazette-Times by MVHCA Vice-Chair Tim Roach

December 01, 2015 5:00 am

Our nation's largest health insurer — UnitedHealth — is seriously considering pulling out of Obamacare as early as 2017 (BloombergBusiness, Nov. 19). The insurer has lost millions and anticipates losses of $500 million in 2016. The word is Anthem and Aetna are in a similar circumstance.

What happened? Insurers agreed to cover 10 categories of health care benefits; accept higher cost individuals; limit excess administrative costs and profits, and submit premium increases to insurance regulators for public scrutiny.

Thus the Affordable Care Act was crafted to keep premiums down and require greater cost sharing by patients. Government subsidies were provided to assist lower-income individuals. And when that was still not enough, insurers leveraged narrow provider networks to contract for cheaper medical services, and increased deductibles, shifting more of the costs to patients.

Guess what? It isn’t working — for insurers or patients! Congress created an administratively complex system that has made it almost impossible for insurers to offer a product that meets the required basic plan and has affordable premiums. Additionally, the combination of premiums and deductibles are pricing many patients out of health care. So now insurers are beginning to back out!

Well, that’s fine, because it offers the opportunity of replacing for-profit insurers with a financing plan designed for patient care, as is the case in almost all other developed countries around the world. A well-designed, publicly funded health care program would restore choices and make health care available to everyone. Health Care for ALL!


You can help MVHCA as we work for publicly funded universal health care like the rest of the developed world by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Universal Healthcare Expert to Visit Oregon, Tout Single Payer Plan

T.R. Reid's Oregon tour is featured in the Lund Report:

Efforts are underway in Colorado and Oregon for universal healthcare.

By Shelby Sebens

T.R Reid is hoping that Colorado is the first state in the nation to provide a healthcare system that covers everyone. But he’d still be happy if Oregon got there first.

“Some state has to get this going and prove that it will work and then it will spread,” Reid said.

An author and chairman of the Colorado Foundation for Universal Health Care, Reid will be in Oregon this weekend touting healthcare for all. Advocates in Colorado will put a measure on the 2016 ballot. Though the Affordable Care Act, better known as Obamacare, was intended to get every American insured, the Congressional Budget Office predicts 31 million people will still be uninsured as of 2025.

“The Obamacare solution doesn’t get us there,” said Reid, who has traveled the world studying universal healthcare in other countries. “It’s a national disgrace that we would have 31 million people uninsured in the world’s richest country.”

Reid said he thinks the way to universal coverage in the United States is through state initiatives.

“Congress can’t do this. This is a proven route to universal coverage,” he said of states adopting it first.

Efforts have been underway toward universal healthcare in Oregon for years and advocates say it’s gaining momentum though most universal healthcare bills that have made their way to hearings in the legislature have yet to pass.

“Each time that the state single payer bill is submitted to the legislature it gets more attention, more support and it becomes more viable,” said Dr. Samuel Metz, a member of Oregon Physicians for a National Health Program.

A bill on its way to Governor Kate Brown’s desk would fund a study that will look at methods for financing universal healthcare, Metz said. “The study in Oregon is necessary but not sufficient. It’s a first step but it doesn’t guarantee that the legislature will take action.”

Colorado’s Purple Plan

Reid thinks universal healthcare has a good shot in Colorado because of the state’s political Make up, divided evenly between Democrats and Republicans. He intends to appeal to Democrats as a way to insure everyone and save money and to Republicans as a way to get out of Obamacare. An opt out clause in the Affordable Care Act allows states to get out of the federal mandates while still receiving Medicaid dollars if they can insure people another way, Reid said.

“That’s why I think we can pass it,” said Reid who expects a fight from insurance companies. He argues the private market can still offer supplemental insurance as well as private insurance for those that don’t want a state run plan similar to parents paying to send their children to private schools.

The Colorado plan would add a 3.3 percent state income tax. Employers would also have to pay into the plan. Reid said studies showed Colorado families typically pay 8 percent of their salaries on healthcare.

Oregon’s efforts

Metz thinks Oregon is uniquely poised to push forward on universal healthcare because many insurance companies are non-profit and might benefit under a universal healthcare plan.

“They would thrive in this new business environment. We don’t see this in other states.”

Reid said Colorado is a little more ahead of the game, with its universal healthcare study completed and a ballot measure ready to go.

“We beat you to marijuana and we’ll beat you to universal healthcare,” he quipped.

Here are the events featuring T.R. Reid:

  • July 24th, Friday Noon, Collaborative Life Sciences Building, OHSU, 2730 SW Moody, South Waterfront, Portland. Open to PSU and OHSU students.
  • July 24th, Friday 6:00 pm in Portland: Health Care for All Oregon fundraiser with Mr. Reid as the featured guest. Please contact Terry Rogers at (503) 756-4273 or ibuterry@gmail.com for more details.
  • July 25th, Saturday 12:00 pm in Salem: “Obamacare: Is it the answer?” Presentation by Mr. Reid to the Salem City Club followed by discussion. Creekside Room, Building D, Salem Hospital Campus, 890 Oak Street SE, Salem. Details will be available at http://salemcityclub.com/page-953771
  • July 25th, Saturday 7:00 pm at the Russell Tripp Theater, Linn-Benton Community College, Albany: Presentation by Mr. Reid followed by discussion: “Our Costly and Troubled Sick Care System: U.S. Health Care, What to Do About It.”
  • July 27th, Monday 6:00 pm at the Multnomah County Building, 501 SE Hawthorne, Portland, Board meeting room: Presentation by Mr. Reid followed by discussion: “Universal Health Care: Why Oregon Won't Be First.” No charge. Registration is encouraged (http://www.pdxcityclub.org/calendar_day.asp?date=7/27/2015&event=294). This event is hosted by the City Club of Portland, Health Care Member-Led Forum. Mr. Reid will be introduced by Mike Marshall, executive director of the Portland City Club.

You can help MVHCA as we work for publicly funded universal health care like the rest of the developed world by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Supreme Court upholds Obamacare's tax subsidies

See the Oregonian for the full article,

WASHINGTON — The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama's health care overhaul, in a ruling that preserves health insurance for millions of Americans.

The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, under the 2010 health care law.

 

Oregon stood on sidelines of Obamacare case

Oregon had less at stake than most states in the U.S. Supreme Court's ruling in King v. Burwell.
The suit targeted subsidies issued by the federal health insurance exchange. Oregon used the federal exchange website to enroll Oregonians in health coverage this year after state officials shelved the homegrown Cover Oregon technology project.
Still, because Oregon had passed a law, insurance tax and regulations to set up a state-based exchange, state officials argued that it should not be considered a federal exchange state. Legal briefs filed by both sides in the case agreed, considering Oregon one of 16 state-based exchanges in addition to that of Washington, D.C..
The Supreme Court majority agreed as well, writing that "At this point, 16 States and the District of Colum­bia have established their own Exchanges; the other 34 States have elected to have (the federal government) do so."
Oregon stood on sidelines of Obamacare caseOregon had less at stake than most states in the U.S. Supreme Court's ruling in King v. Burwell.
The suit targeted subsidies issued by the federal health insurance exchange. Oregon used the federal exchange website to enroll Oregonians in health coverage this year after state officials shelved the homegrown Cover Oregon technology project.
Still, because Oregon had passed a law, insurance tax and regulations to set up a state-based exchange, state officials argued that it should not be considered a federal exchange state. Legal briefs filed by both sides in the case agreed, considering Oregon one of 16 state-based exchanges in addition to that of Washington, D.C..
The Supreme Court majority agreed as well, writing that "At this point, 16 States and the District of Colum­bia have established their own Exchanges; the other 34 States have elected to have (the federal government) do so."

--Nick Budnick

As we breath a sigh of relief for all the people who are able to keep their insurance as a result of this ruling, let's also work to update the ACA so that we have true universal, publicly funded health care!

You can help MVHCA as we work for single payer health care by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Families USA: Forgoing health care because of high out-of-pocket costs

 Families USA recently produced a report showing that many families were forgoing health care because even though they had insurance, the health care was still not affordable. The full report is available here.  These are the main points:

  • Just over one-quarter (25.2 percent) of adults who were insured for a full year went without needed medical care because they could not afford it.
  • Adults with lower to middle incomes were the most likely to forgo needed medical care.
  • Adults with high deductibles were more likely to forgo needed medical care.
  • In 2014, half (50.6 percent) of adults had high deductibles of $1,500 or more, and 30 percent had exceedingly high deductibles of $3,000 or more.

Why are people still struggling with out-of-pocket costs?

  • Premium tax credits are tied to silver plans, which often have cost-sharing that is too high for many consumers to be able to afford.
  • Only a portion of the lower-income consumers who are eligible for subsidies to reduce cost- sharing in silver plans receive substantial help to also reduce their deductibles.
  • Insurers are choosing to design silver plans with upfront cost-sharing that is too high for lower- and middle-income consumers to afford.

Policy Recommendations

  • Health insurers should offer more plans at the silver level that have low or no cost-sharing for primary care, other outpatient services, and prescription drugs.
  • Policymakers at the state and federal levels should require health insurers to sell silver plans with lower cost-sharing for primary care, other outpatient services, and prescription drugs.
  • At the federal level, Congress should: Provide cost-sharing reduction subsidies to middle-income consumers (above 250% FPL) and increase the generosity of this help.
  • At the state level, lawmakers can also strengthen financial assistance.

Don McCanne MD, of Physicians for a National Health Program, comments on this report:

Today Families USA released their report that confirms, once again, that many adults insured with high-deductible health plans are likely to forgo needed medical care, especially if they have lower to middle incomes. So what are their recommendations?

In order to remove financial barriers to care, they recommend that more plans offered at the silver level - the benchmark plans -  have lower or no cost-sharing for primary care, other outpatient services, and prescription drugs. This has the advantage of increasing access to primary care services, which most agree would significantly improve the performance of our health care system.

The problem is that the barely affordable silver plans must have an actuarial value of 70 percent (the patient pays 30 percent of health care costs, up to a given maximum). Higher deductibles are used in most of these plans in order to meet this actuarial value. But in a report that Families USA released last year, they explain that if the deductibles and copayments were reduced to more affordable levels, then the required 30 percent of out-of-pocket costs must be shifted to more expensive services.

So this scheme would help the majority who simply need primary care services, but it would make care less affordable, even catastrophic, for those who have greater health care needs. As long as our benchmark plans are set at an actuarial value of 70 percent, this trade-off cannot be avoided.

Families USA also suggests the obvious. We should increase federal and/or state subsidies for both the purchase of plans and for cost sharing for low and middle income individuals and families.

But if you are going to make care affordable for everyone, why continue with this highly inefficient, administratively complex system that wastes so many of our health care dollars. Surely by now Families USA should acknowledge that our dysfunctional system should be replaced by a much more efficient single payer national health program - an improved Medicare for all. We’ve experimented extensively with their preferred model, and it didn’t work.

You can help MVHCA as we work for single payer health care by donatinghosting a house party, signing up for the newsletter, and attending our monthly meetings. You can also Like us on Facebook, and Follow us on Twitter. Thank you.

Tea Party Patriot May Vote For Hillary

From Rawstory:

A conservative video blogger with over a million views on YouTube said this week that he would likely vote for Democratic presidential candidate Hillary Clinton because he was terrified that a Republican president would take away his affordable health insurance.

James Webb, a 51-year-old YouTube celebrity who devotes his “Hot Lead” channel to topics like his love of guns and ranting about gay men kissing on The Walking Dead, may have shocked his viewers on Monday when he revealed that he was torn over which party to vote for in the 2016 election.

“And I’m serious because I asked myself, ‘Which party has helped me out the most in the last, I don’t know, 15 years, 20?’ And it was the Democrat [SIC] Party,” Webb lamented. “If it wasn’t for Obama and that Obamacare, I would still be working.”

“With Obamacare, I got to retire at age 50 because if it wasn’t for Obamacare, I would have had to work until I was 65 and get on Medicare because health insurance is expensive when you’ve got medical problems,” he continued.

Webb said that he hoped to lose some weight and get in shape by taking advantage of a gym membership that was covered by his health insurance.

“But you know, the Republican Party, they haven’t done nothing for me, man. Nothing,” he remarked. “So, I’m leaning toward voting for Hillary unless something major comes up. I don’t trust the Republicans anymore because they’re wanting to repeal the Obamacare. And I don’t want them to do that, man, because then I’ll have to go to work again. My life’s already planned out.”

“Just a tough decision,” Webb sighed. “I voted for Republicans for 32 years, I’m a charter member of my Tea Party Patriots chapter. I’m also a veteran of the U.S. Army under Reagan, when Reagan was in. That was great when Reagan was in there.”

“Things have changed. So unless the Republicans change with it, I’m probably going to have to swing my vote over toward Hillary.”

Watch the video below from the Hot Lead YouTube channel.

The lesson -- once people get health care, they don't want to give it up. Publicly funded universal health care would cover more people for less money. Help us spread the word by joining MVHCA!


Why Did Swiss Voters Reject Single-Payer Health Care?

Supporters of a single-payer, Medicare-for-all health care system in the U.S. were puzzled September 27 when Swiss voters rejected a reform proposal by 62 percent.

The new law would have replaced the current system, where about 60 insurance companies offer mandatory health coverage, with a single insurer, the government. It would have offered all medically necessary care, paid for by taxes adjusted to each person’s ability to pay.

To Americans who’ve worked for such a system here, nationally and state by state, it was a blow. What’s not to like about single payer?

Swiss and American media, academia, and business sectors rushed to interpret the results. Virtually all crowed that the Swiss people had rejected government-run national health insurance because they preferred private insurers.

But these convenient interpretations rely on false assumptions to justify a model of health insurance that is unraveling—less conspicuously in Switzerland, but dramatically in the U.S.

Let’s look at what’s wrong with these pro-business interpretations, and see what lessons the Swiss referendum has for single-payer advocates here.

Mainstream Answers

Washington Post “policy wonk” Jason Millman wrote that the Swiss rejection shows that single-payer has little chance of gaining popular support in the U.S.

He notes that in 1996, the Swiss voted for an individual mandate that compels everyone to buy a basic package of health services. That law eliminated discrimination for pre-existing conditions, meaning companies have to sell equal plans at equal prices to all customers. The government subsidizes low-income people. In Millman’s view, the resulting Swiss system is very much like Obamacare.

Another policy reporter, Avi Roy from Forbes, asserted that Obamacare (and Romneycare before it) was modeled on the Swiss system: people shopping among competing private plans with little government interference.

Roy says the referendum demonstrates the “political popularity” of universal coverage via private insurance. He concludes that because the Swiss have rejected single payer, there’s good reason to believe Americans will reject it, too.

What’s Wrong with the ‘Official View’?

These interpretations are based more on ideology than on facts. Why?

First, Swiss health care is not a version of Obamacare. The differences are critical to understanding the implications of the Swiss referendum for health care reform here.

Second, Swiss health care, though far superior to ours in terms of access, quality, and equity, has critical problems that threaten the system. Those problems illustrate why, four years after Obama signed the Affordable Care Act into law, health care access, quality, and equity are increasingly threatened here too. The Swiss is a model to reject, not to embrace.

Third, the referendum does not prove that the Swiss don’t want government involvement in health care, nor that they like private insurance companies. Quite the opposite.

Indeed, an analysis of a series of referendums over several years shows that, like the U.S. population, the Swiss are increasingly unhappy with treating health care as a business, rather than a social good.

1) Obamacare is not a version of the Swiss system.

The current National Health Care Law, known as LaMal, requires that everybody living and working in Switzerland carry health insurance—we call this an “individual mandate.” So the Swiss are required to purchase insurance for a uniform, comprehensive package of medical services.

But the national government operates at every level to make everything run smoothly. To more than 50 percent of the population, the government offers full or partial subsidies to purchase insurance. So more than 99 percent of the population is covered.

The government also compels insurers to sell policies to everybody at the same price, irrespective of health status, medical history, gender, age, or location (within each canton, the administrative equivalent of a U.S. state). A 25-year-old and an 80-year-old pay exactly the same premium for the same plan. The only exception: those under 25 pay substantially less.

If your income changes, or job changes, or marital status changes, your doctor need not change.

The government also enforces a “basic” package that is very comprehensive—in the U.S., some call it “Cadillac,” as if only spoilt Americans would dare demand it! Thus basic insurance, Swiss-style, includes outpatient care—essentially whatever a doctor prescribes—hospital care, mental health, all pharmaceuticals on the government’s list, some rehabilitation services, some dental care, some herbal medicine, and acupuncture.

Importantly, the government forbids insurers to make a profit from the sale of the mandatory package, and it compels them to contract with every single health care provider in Switzerland.

The government also imposes a system of risk equalization. It compensates companies that enroll individuals with more expensive medical needs, taking the money from companies that enroll healthier users.

The government also compels mechanisms to deal with prices. Within each canton, prices must be negotiated between associations of providers and insurers, and everybody must abide by them. So providers within a canton are paid equal amounts for equal services, regardless of which plan the patient has.

Finally, the state also enforces limited deductibles (about $300 U.S.) in all plans, and a maximum out-of-pocket cost of about $700.

Users can choose to purchase cheaper policies as a trade-off for higher deductibles (up to 2,500 Swiss francs, or about $2,500 U.S., for adults, and 600 francs, or about $600 U.S., for children). They can also choose policies with restricted provider networks, though few do.

As you can see, this looks nothing like “no government interference.”

Obamacare: A Reality Check

Nor does it look like a version of Obamacare. A few comparative points:

  • Obamacare does not cover 100 percent of the population. In fact, more than 30 million people living in the U.S., the majority of them citizens or legal residents, will remain uninsured by 2024, according to the Congressional Budget Office.
  • Obamacare does not guarantee a homogeneous, generous basic package of services.
  • It does not guarantee equal prices for equal services—hence all these calls for greater transparency of prices so “consumers” can shop more productively! Prices vary according to age—older people pay up to three times as much—geographical location (over 18 different ones only in California!), even gender composition of the workforce insured.
  • Providers under Obamacare are paid differently depending on the patient’s plan—which is unheard of, and would be scandalous, in Switzerland.
  • Obamacare does not guarantee access to every provider in your state—only to providers in your plan, and only as long as your plan does not change.
  • As to maximum out-of-pocket, we’re not even close to the Swiss.
  • As to the celebrated choice of plans, it hardly applies to the 160 million Americans with employer-sponsored coverage (now 60 percent of the non-elderly population; it was close to 70 percent back in 2000), who are stuck with whatever “choices” their employers offer (assuming they offer any).
  • Last and not least, insurers in the U.S. can and do make a profit for selling you insurance for medically necessary care. Which is the only reason they are in the business of selling insurance!

So the belief that Swiss health care and U.S. health care after the ACA are “more or less the same” is quite misguided.

At the center of the ACA is a well-oiled money-making machinery for the medical-industrial complex: insurance companies, Big Pharma, and for-profit (and many non-profit) medical establishments.

2) Over the last decade corporate interests have hijacked the Swiss system, despite the strong government oversight.

This has led to increasing overall and out-of-pocket costs, making the Swiss system the third most expensive in the world.

To control costs, the Swiss government has promoted managed-care options and encouraged users to comparison-shop. So in addition to the classic comprehensive plans, insurers are offering narrower provider networks and higher deductibles and co-pays, and users are prompted to choose plans annually.

However, the Swiss appear not to like all these “new choices” after all, because in a 2012 referendum more than 70 percent voted against a dramatic expansion of managed care, proposed as a key mechanism to “control costs and improve the system.” And only a very small minority chooses to change plans every year.

Last, a growing number find health care unaffordable and are failing to pay their premiums.

Simply put, all the problems the Swiss are grappling with are rooted in the for-profit nature of the companies that participate in the system. As these companies become more financially successful, and hence more powerful, they get harder to tame—and their influence on the politicians who decide health policies grows stronger and stronger.

Clearly, even in the best-case scenario—the highly regulated environment of Swiss private insurers—entrusting them with the provision of health care is assigning a fox to guard the henhouse. The attempt to achieve justice in health care via competing private insurers is a pipe dream.

3) The defeat of the single-payer referendum does not mean the Swiss people reject a government-run system and support private insurance.

The Swiss have rejected almost all referendums since 1891—only 20 out of 191 have succeeded, even when issues were popular.

Critically, one successful referendum was LaMal, the 1996 health insurance law that banned profit from the sale of medically necessary care. It also allowed the government to pass on money from companies spending less on patient care, to those spending more—certainly not an indicator that the Swiss shun “government interference” on behalf of ordinary people, nor that they trust private insurance to do well by them without supervision.

Also worth noting: in 2007 single payer was rejected by 71 percent, but the figure fell to 62 percent in 2014. Maybe the Swiss are beginning to cut through the anti-single-payer propaganda?

Further Reading

For a detailed comparison of the U.S. and Swiss systems, see my article “Is the Swiss Health Care System a Model for the United States?”

For a thorough, albeit ideological (i.e. supportive of “market forces”) review of the current state of the Swiss system, see the 2011 OECD report.

For a full “reality check” of the Affordable Care Act, see “Why do Americans still need single-payer health care after major health reform?”

To understand the single-payer movement’s recent setback in Vermont, and what comes next, read “Vermont Governor Backs Away from Health Care for All.”

Lessons Learned

Why, then, was single payer defeated? What can we learn?

In this article from Labor Notes, Claudia Chaufan  discusses the recent rejection of a single payer referendum in Switzerland and how it relates to the ACA and the campaign for universal coverage in the United States..

First, we need to grant that the state of Swiss health care may be of concern for the Swiss (they seem to have lower tolerance than we do!), but it is still not as bad as in the U.S. People who experience the greatest barriers to care in Switzerland are the most politically disenfranchised—the young, poor, women, immigrants, much like here—so the problem has yet to affect the so-called middle class enough to pass a referendum.

Second, we can see the extraordinary power of corporate propaganda. The scare tactics deployed by corporate interests in Switzerland were quite extraordinary, both in 2007 and this year. Likewise, their interpretation of the results was designed to discourage supporters of public health care—to make us think we’re more alone than we really are.

The Swiss referendum teaches us that:

  • We need to sharpen our understanding of what the ACA is really about, who our enemies are, and what our alternatives could be.
  • We must increase our outreach to the disenfranchised, to those who don’t think their voices make a difference.
  • And we must work on improving our political education of those we wish to reach—rather than watering it down to sound bites that fit within the boundaries of the “politically feasible.”

Claudia Chaufan, MD, PhD, is an associate professor at the University of California San Francisco and a member of Single Payer Now and of Physicians for a National Health Program.

- See more at: http://labornotes.org/blogs/2014/12/why-did-swiss-voters-reject-single-payer-health-care#sthash.xIHxPSzh.rZrJLPE8.dpuf

PNHP Comments about the Wall Street Journal Article on Vermont's Single Payer Effort

The Wall Street Journal
December 22, 2014
Vermont’s Single Payer Washout

Last week, in a reversal that deserves more attention, Democratic Governor
Peter Shumlin announced that Vermont would no longer create America’s first
statewide single-payer health system.
Single payer is the polite term for socialized medicine and the ultimategoal of the political left.
At least the Governor deserves credit for admitting failure. His ideological comrades are rarely dissuaded by the prospect of economic damage, as ObamaCare proves. But Mr. Shumlin has succeeded in making Vermont a national model: By admitting that single payer will make health care both more expensive and less efficient, he has shown other states what not to do.

Vermont
H.202
Bill as Passed by the House and Senate, 2011

“An act relating to a single-payer and unified health system”
changed to
“An act relating to a universal and unified health system”

(H.202 is a 213 page bill. The first 135 pages were deleted and the
remaining pages are a rewrite of the entire bill.)

Sec.2(a)(6):

The director, in collaboration with the agency of human services, shall
obtain waivers, exemptions, agreements, legislation, or a combination
thereof to ensure that, to the extent possible under federal law, all
federal payments provided within the state for health services are paid
directly to Green Mountain Care. Green Mountain Care shall assume
responsibility for the benefits and services previously paid for by the
federal programs, including Medicaid, Medicare, and, after implementation,
the Vermont health benefit exchange.

***

Comment by Don McCanne of PNHP

As was fully expected, the conservative and libertarian pundits are
inundating the Internet and other media vehicles with celebratory
commentaries on the theme that Vermont Gov. Peter Shumlin’s withdrawal of
his single payer proposal is proof that single payer is more expensive and
less efficient than other health care financing systems. The Wall Street
Journal editorial excerpt above is selected as a leading example of these
right-wing responses. The problem with these comments is that H.202, the
Vermont reform legislation, IS NOT A SINGLE PAYER PROPOSAL.

Even many single payer supporters have it wrong. They claim that Gov.
Shumlin gave up for political reasons, and, if he had persevered, he would
have been successful in establishing the first state-level single payer
system in the U.S. Again, the problem is that H.202, the Vermont reform
legislation, IS NOT A SINGLE PAYER PROPOSAL.

Posted above is a link to H.202. During the legislative process, the bill
was renamed, deleting “single-payer” from its title. If you check the
document at the link, you will see that the original bill was red-lined
out, and the bill was entirely rewritten. All references to “single-payer”
were removed.

The crucial phrase in the except above regarding waivers and agreements is
“to the extent possible under federal law.” It was known at the time the
revisions were being made that Sec 1332 ACA waivers, Sec 1115 Medicaid
waivers, the narrowly defined Medicare demonstration waivers, and the ERISA
limitations on employer-sponsored plans were so limited that it would be
impossible to establish a bona fide single payer system through unilateral
state action alone, nor through a cooperative effort with the Obama
administration. Comprehensive federal legislation would have been required,
and that clearly was not forthcoming from this or the next Congress.
Legislating a wish list does not equate with clearing all of the hurdles
that only Congress can effectuate.

The reason that this message is being reemphasized again today is that
there has not been a loud enough voice in unison emphatically rejecting the
claim that Vermont’s experience is proof that single payer cannot work.
Single payer never had a chance, considering the inertia in Congress. This
was not a single payer failure. Do not remain silent when that claim is
made. Single payer has been proven to work well in many other nations.

Despite ObamaCare, US Health System Still a Complete Mess

In this recent article in the Daily Beast by Molly Worthen, the author writes about how difficult it is to find out what medical procedures will cost and how much insurance will pay. She makes the point that single payer health care would be a much simpler system.

“How can we tell how much we’ll have to pay in total, assuming it’s a routine birth?” my husband asked.

“Oh, I couldn’t tell you that,” Tami said. Despite churning through droves of pregnant patients each year—many of whom are, like me, insured by the Blue Cross Blue Shield state employee plan—she had no information on what anything would ultimately cost. “Call your insurance company,” Tami said.

This is the evil genius of the American insurance system. No one has any information, and no one is responsible. I was reminded of the opening scene in Franz Kafka’s The Trial, when the officials who rouse Josef K. from bed to arrest him on an unexplained charge tell him they have no idea why he is under arrest: “We’re lowly employees who can barely make our way through such documents,” one says. 

All are part of the growing economy of people—all very nice people, I’m sure—who have college degrees in medical billing and coding, who make their living feeding the bureaucratic beast that cost consumers $200 billion in excess administrative fees in 2009. Much of that waste would vanish if the United States adopted a public single-payer system of the kind that most developed countries favor.

A truly free market requires all parties to have access to the same information—and the time and expertise to interpret that information. Healthcare, by contrast, is an economy of specialized goods that most lay people don’t fully understand, in which insurance companies and many healthcare providers have a vested interest in concealing prices from consumers. And I’m always surprised by how few doctors seem to know the cost of treatments they prescribe. The Affordable Care Act may be better than no reform at all, but the law subsidizes this broken private insurance system. It also adds over 10,000 pages of regulations to the already byzantine bureaucracy that makes American healthcare one of the least cost-efficient in the world—behind even Venezuela and Iran.

For more information about single payer health care, check out our FAQ page.

Single Payer Rises Again

As the ACA takes effect, an alternative gains ground at the state level

When Sergio Espana first began talking to people, just over a year ago, about the need for fundamental changes in the U.S. healthcare system, confusion often ensued. Some people didn’t understand why, if the Affordable Care Act (ACA) had passed, people still wanted to reform the system; others thought organizers were trying to sign them up for “Obamacare.”

Healthcare is a Human Right Maryland, the group to which Espana belongs, is in pursuit of something else: a truly universal healthcare system that would cover everyone and eliminate insurance companies once and for all. Espana and many others in the growing movement see opportunity in the renewed discussion around healthcare reform as the ACA’s insurance exchanges go into effect.

They believe that the ACA’s continued reliance on (and subsidies of) private insurance simply aren’t good enough. People are still falling through the cracks, employers are trying to dodge the requirement that they provide insurance for their workers, and many states refused federal subsidies to expand their Medicaid programs. What these activists want is a program that would replace existing insurance programs, cover everyone regardless of their employment status, and be funded by the government, with tax dollars. Such a plan had strong support when the national healthcare overhaul was being crafted in 2009—including initial backing by President Obama—but the president and Congress decided it wasn’t politically possible and passed the ACA as a compromise.

More here.

Canadian health care better than Obamacare

 Ralph Nader points to 22 ways the Canadian health-care system is better than Obamacare in the U.S.

No. 22: In Canada, everyone is covered automatically at birth — everybody in, nobody out.

No. 21: In Canada, the health system is designed to put people, not profits, first.

No. 20: In Canada, coverage is not tied to a job or dependent on your income — rich and poor are in the same system, the best guarantee of quality.

No. 19: In Canada, health-care coverage stays with you for your entire life.

No. 18: In Canada, you can freely choose your doctors and hospitals and keep them. There are no lists of “in-network” vendors and no extra hidden charges for going “out of network.”

No. 17: In Canada, the health-care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums.

No. 16: In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill.

No. 15: In Canada, costs are controlled. Canada pays 10 per cent of its GDP for its health-care system, covering everyone. In the United States, under Obamacare, costs continue to skyrocket. The U.S. pays 18 per cent of its GDP and still doesn’t cover tens of millions of people.

No. 14: In Canada, it is unheard of for anyone to go bankrupt due to health-care costs.

No. 13: In Canada, if you lose your job, you don’t lose your health insurance.

No. 12: In Canada, simplicity leads to major savings in administrative costs and overhead.

No. 11: In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?”

No. 10: In Canada, the government negotiates drug prices so they are more affordable.

No. 9: In Canada, government health-care funds are not profitably diverted to the top 1 per cent.

No. 8: In Canada, there are no necessary co-pays or deductibles.

No. 7: In Canada, the health-care system contributes to social solidarity and national pride.

No. 6: In Canada, delays in health care are not due to the cost of insurance.

No. 5: In Canada, nobody dies due to lack of health insurance.

No. 4: In Canada, an increasing majority supports their health-care system, which costs half as much per person as in the United States.

No. 3: In Canada, the tax payments to fund the health-care system are progressive — the lowest 20 per cent pays 6 per cent of income into the system while the highest 20 per cent pays 8 per cent.

No. 2: In Canada, the administration of the system is simple. You get a health card when you are born. And you swipe it when you go to a doctor or hospital. End of story.

No. 1: In Canada, the majority of citizens love their health-care system.

In the United States, the majority of citizens, physicians and nurses prefer the Canadian-type system — single-payer, free choice of doctor and hospital, everybody in, nobody out.

More here.