Posts Tagged ‘Democrats’

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Can a Democratic supermajority boost chances for single payer?

December 7th, 2012

Last month’s election saw California Democrats capturing a supermajority in both houses of the legislature for the first time in more than a century. The supermajority will allow Democrats to exercise taxing powers without Republican support. Now, some on the left are clamoring for the Democrats to use the supermajority to enact broad progressive legislation. Could a new supermajority now mean single payer has a better chance of making it through the legislature after failing to pass both houses earlier this year? That remains to be seen for several reasons.

First, the Democrats won’t really have an effective supermajority for about a year. That’s because a couple of Democratic state Senators won seats in Congress. Those vacant Senate seats will have to now be filled through special elections, and the likely successors will be members from the Assembly, leaving their seats vacant. In addition, another state Senator is running for a Los Angeles City Council seat.

Second, Democratic legislators have signaled that they are in no hurry to start unleashing a host of new spending programs. Despite the fact that a changing California electorate seems more amenable to tax increases – as evidenced by the overwhelming passage of the pro-schools measure, Proposition 30 – the Democratic leadership is still taking a cautious approach when it comes to asking voters for more revenue.

Third, we don’t yet know how many of the 29 incoming Democratic lawmakers can be counted on to support single payer legislation. For these reasons, it is imperative that as many Californians as possible be educated about the benefits of a publicly financed healthcare plan, and how single payer is a much better alternative to the inefficient, profit-based system we currently have. We also need to educate the public that under the Affordable Care Act, California could apply for a federal waiver in 2017 to replace the ACA insurance exchanges with the state-based public system, becoming a laboratory of innovation and setting a great example for the rest of the nation. The movement is going to need an army of citizens to put pressure on their legislators and Gov. Jerry Brown to move forward on providing true universal health care for all Californians.

Sylvia@californiaonecare.org

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Don McCanne, MD: Republicans join Democrats in supporting Medicare as a defined benefit program

September 4th, 2012

Republicans, like Democrats, opposed to cutting Medicare benefits, wary of privatization

Kaiser Health Tracking Poll

August 2012

When it comes to Medicare, one of the most notable aspects of Republicans’ views is how uncharacteristically similar they are to those of Democrats and Independents, according to this month’s Post/Kaiser poll. A large majority of Republicans (69 percent) say they are opposed to reducing Medicare benefits, even in the service of debt reduction. At the same time, roughly six in ten Republicans would support cuts in benefits if they were targeted only at high income seniors. In both cases, these views put Republicans on the same side of the issue as Democrats, a rare occurrence of late.

At the same time, a majority of Republicans (55 percent) currently say they prefer that Medicare continue as a defined benefits program, rather than changing to a system in which seniors are guaranteed a fixed amount of money to be used to buy coverage either from Medicare or from a private plan, an option supported by 39 percent of Republicans. Here again, the balance of opinion among Republicans puts them closer to the views of Democrats and Independents than usual in this area. The issue is set up to be an important one this fall given Representative Ryan’s advocacy of moving toward some sort of premium support model, though both Representative Ryan and Governor Romney have explicitly stated that any such change would not impact today’s seniors but would take effect for younger people when they become eligible for Medicare in the future.

Democrats share with Republicans a preference for keeping Medicare as it is rather than switching to a premium support system (68 percent prefer to keep the current system, compared to 29 percent that would back the change). They are also opposed to cutting Medicare benefits as a way to reduce the federal budget deficit (85 percent oppose), unless those cuts are targeted only at the rich, in which case two in three would be supportive.

http://www.kff.org/kaiserpolls/upload/8342-F.pdf

Comment:  

By Don McCanne, MD

A large majority of Americans, regardless of political affiliation, are supportive of Medicare and do not want to see its benefits reduced, nor do they want it privatized through a defined contribution, premium support, or voucherized program. As dissatisfaction with our current dysfunctional health care financing system increases, it is inevitable that the public will eventually support an improved Medicare for everyone.

One concern in this poll is that Republicans and Democrats alike believe that Medicare benefits should be reduced for the wealthy. That would be a terrible mistake, and not only because of the administrative headache that would be created trying to match benefits with labile incomes. The wealthy will have to contribute more, but that should be done through progressive tax policies that are used to finance the entire system. The full complement of benefits should always be there for all of us, reinforcing the importance of social solidarity that is characteristic of the very successful health care programs in other nations.

Re-posted with permission from pnhp.org.

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Affordable Care Act starts to show its weaknesses

August 28th, 2012

This week, the Republicans are feting their presidential and vice presidential nominees in Florida, and you can be sure there will be a healthy dose of Obamacare bashing. Candidate Mitt Romney has already pledged to repeal the Affordable Care Act if elected to the presidency. He won’t be able to do that without a complete Republican takeover of Congress, but there are plenty of ways he could eviscerate it nevertheless.

The Democrats will be re-nominating President Obama in North Carolina next, and rest assured the accolades for the ACA will be as lofty as the Republicans’ attitude toward the law is hostile. Still, two new reports about the effectiveness of the ACA should give the Democrats pause:

Confusing language in the health care reform law has raised the possibility that millions of Americans living on modest incomes may be unable to afford their employers’ family policies and yet fail to qualify for government subsidies to buy their own insurance. This is a bizarre development that undercuts the basic goal of health care reform — to expand the number of insured people and make their coverage affordable.

Even if the GOP doesn’t succeed in repealing the ACA, the law could start unraveling anyway. Thirty million people will remain uninsured after the ACA completely takes effect in 2014, and the law’s cost controls are inadequate. Meanwhile in Massachusetts, the ancestral home of the ACA, costs have still been spiraling out of control since that state’s own health reform law passed six years ago. Gov. Deval Patrick recently had to salvage reform by signing legislation replacing fee-for-service with a global payments system. Doing away with fee-for-service is a good thing, but I don’t think this move will be enough in the long run. After all, the Massachusetts law, like the ACA, unwisely continues to rely on profit-seeking insurance companies as an integral part of its health system. Insurance companies will still try to find ways to wring more money out of the pockets of the people and into those of overpaid CEOs and shareholders. They will continue to waste dollars on advertising and needless paperwork – dollars that should go into care. Massachusetts is the health reform canary in the coal mine.

If the ACA starts falling apart in the next few years – which is quite possible given its flaws – the United States will be forced to rethink the folly of sticking with free-market health care. The profit-seeking model only serves itself, not the people, because that’s what it’s supposed to do. Instead, we need a healthcare system that serves the people, and only the people. The only logical solution is to improve upon and expand the public health insurance model to everyone, whether through SB 810 in California, or Medicare nationwide.

Sylvia@californiaonecare.org

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Could Adverse SCOTUS Ruling on Obamacare Provide Opening for a Public Option?

June 19th, 2012

As Judgment Day for the Affordable Care Act draws closer – a ruling by the U.S. Supreme Court is expected in the next couple of weeks – legal observers, health experts and pundits are trying to predict what the fallout could be if the law is eviscerated or overturned. Undoing the ACA may not be that simple. Would the horrible consequences of suddenly snatching health care away from millions of Americans be enough to force Congress to open up Medicare to people under 65? Economist and former Clinton labor secretary Robert Reich thinks so.

Reich believes that if the individual mandate is struck down, health insurance companies, arguing that they’ll go bankrupt if they are forced to continue covering people with preexisting conditions, will clamor to get the requirement dropped. The problem for the insurance companies is that the preexisting condition requirement is one of the most popular parts of the ACA and Congress may be hesitant to get rid of it.

This opens the way to a political bargain. Insurers might be let off the hook, for example, only if they support allowing every American, including those with pre-existing conditions, to choose Medicare, or something very much like Medicare. In effect, what was known during the debate over the bill as the “public option.”

I hope Reich is correct, but it may be wishful thinking on his part. Right now, President Obama and the Democrats are still pinning their hopes on a positive ruling from SCOTUS and they don’t seem to be looking at a Plan B – at least, not publicly. And the Republicans seem content to do little or nothing. Some health insurers are even saying that they will voluntarily uphold some of the more popular provisions of the ACA (I don’t believe that for a second). The “sickcare” industry would rather maintain the status quo – and their ill-gotten profits – as long as possible than to see lawmakers open up Medicare. The insurers know that once Medicare is available to more people, the program will be in even more demand, hastening the health insurance industry’s demise. In the meantime, what will the reaction be from the public? Resignation and despair? Or will the sudden disappearance of what little healthcare safety net the ACA provides galvanize the public into demanding Medicare for all? I want to see the latter happen.

Some believe that if SCOTUS deals a death blow to the ACA, that that will spell the end of health reform. This is nonsense. Ignoring the healthcare crisis in this country won’t make it go away. It will get progressively worse. More American workers will see their health coverage dropped. Fewer employers will offer health coverage. Millions more Americans will go bankrupt. Even with the ACA in place, out-of-pocket medical costs continue to explode. Lawmakers can keep their heads in the sand for only so long. As the ranks of the uninsured and bankrupt expand to an ever larger proportion of the population, public outrage will grow. At that point, the din will be impossible to ignore.

Sylvia@CaliforniaOneCare.org

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