Posts Tagged ‘Obama’

Washington is broken. The states are leading the way toward single payer.

March 20th, 2014

Health policy expert and single payer supporter Uwe Reinhardt said in a recent interview with the Washington Post that the United States won’t ever have single payer “because our government is too corrupt.” Reinhardt points the finger at special interest lobbying as the culprit:

“When you go to Taiwan or Canada,” Reinhardt said, “the kind of lobbying we have here is illegal there. You can’t pay money to influence the party the same way. Therefore the bureaucrats who run these systems are pretty much insulated from these pressures. Here you have basically a board of directors in the House Ways and Means Committee that gets money from lobbyists both at the regulatory writing stage and during normal operations. And they can call an administrator and demand they stop something from happening.”

True, money in politics is an underlying factor in America’s failure to enact the kind of not-for-profit, universal healthcare system enjoyed by the rest of the developed world. But Reinhardt only has it half right. The corrupting influence of money in the United States is not the complete picture. The political power imbalances between the majority of the American public who support Medicare for all and those who resist meaningful healthcare reform is equally to blame.

Many liberals have criticized President Obama for not vigorously supporting a single payer system or even the idea of a public option when healthcare reform was being bitterly debated in Congress in 2009-10. Some blame the Republican takeover of the House of Representatives in 2010 on voter disenchantment with the legislative sausage making that produced the Affordable Care Act. But, putting the blame entirely on Obama and the Democrats for the failure of single payer on the federal level is misplaced. The sad fact is, as much as progressive activists wanted to see single payer or a public option enacted at the federal level, the nature of American politics today makes that feat extremely difficult.

Some liberals like to point out that the Democrats had enough votes in Congress in 2009-10 to pass at least a public option. On its face, that’s true. The House had passed the public option, but the problem was in the Senate. Where although a simple majority supported a public option, Senate filibuster rules allowed a determined minority to torpedo more progressive legislation that would minimize or eliminate the role of the health insurance companies in our healthcare system. Combined with a healthy dose of health insurance campaign cash, Senate filibuster rules empowered a minority of legislators from more conservative, sparsely  populated states to thwart the majority. This kind of power imbalance is also evident in battles over other kinds of legislation, from gun control to increasing the minimum wage to expanding unemployment insurance to immigration reform.

The reality is that America’s electoral system creates unique barriers to progressive legislation. Unequal political representation is baked into our system and has gotten worse over time as more Americans have migrated away from rural areas and concentrated themselves into cities where their voting power is diluted. Today, we have the perverse result of red state Wyoming with just under 600,000 people having the same number of votes in the Senate as blue state California with nearly 40 million people. In the House, the 2012 election resulted in Republicans capturing 234 seats although they got fewer votes than Democrats who got only 201 seats. The division of power between the President, who may be from one party, and the Congress, which may be controlled by the other party or split between both parties, creates the likelihood of legislative gridlock. Partisan gerrymandering, Senate malapportionment, entrenched incumbency, the division of power between two ideologically opposing parties, the complete shutout of third parties, combined with the polluting influence of special interest money, all contribute to legislative paralysis or to the passage of legislation that is far from what most Americans want. Further, voter participation rates are far higher in other democracies where access to the ballot box is considerably easier than in the United States. Add to the mix America’s troubled racial history when it comes to the provision of social programs, and you have among the skimpiest social safety nets of any developed nation.

It doesn’t matter that polls have consistently shown that a majority of the American public supports universal Medicare, a legislative minority backed by health industry lobbyist money can take advantage of undemocratic and arcane Congressional rules, as well as Constitutional anachronisms that unfairly magnify the political power of the minority, to get single payer put off the table. I often wonder why many activists hold up the problem of money in politics as the main reason why popular ideas like single payer can’t get passed at the federal level, but gloss over the fact that glaring structural flaws in America’s political system are just as problematic. Perhaps it is due to a particular American loyalty to the ways we do (rather, don’t do) democracy and a nearly religious reverence to a Constitution that is rather shop-worn. Or it may be an ignorance of how other countries practice democracy differently (and perhaps, better) than we do. Or it may have much to do with the extreme difficulty – if not near impossibility – of getting any sort of institutional change in America, let alone remaking the political system altogether to make it fairer. The movement to amend the Constitution to get money out of politics and strip corporate personhood is going full steam ahead, but four years and two general elections after the Supreme Court’s Citizens’ United decision, we’re still a long way from getting 2/3 of Congress and 3/4 of the states to agree to pass an amendment as required.

Since Washington is hopelessly broken, it’s up to the states to take the lead on single payer. States, Supreme Court Justice Louis Brandeis once said, “are laboratories of democracy.” They can also be laboratories of health reform. The states aren’t as legislatively constrained as the federal government. Vermont was the first to  say yes to single payer. There are strong single payer movements in California, New York, Oregon, Pennsylvania, Maine and Maryland. The Affordable Care Act’s flaws and its troubled rollout have led the public to give single payer a second look. Fortunately, the ACA does provide the states with the means to implement single payer on their own. In 2017, states can apply for a waiver enabling them to create healthcare systems apart from the ACA as long as those programs cover as many or more people than the federal law. We already know that single payer will cover everyone in America for less money than our current wasteful for-profit healthcare system. A successful single payer system at the state level will more easily open the doors toward a national universal healthcare system.

Obamacare is a step in the right direction, but not the final destination

June 19th, 2013

by Shockwave

The Affordable Care Act (ACA) will help millions but it is not enough.  If Organizing For Action and other Obamacare supporters want the grassroots to help it get implemented, they need to clearly indicate that it is not the final destination. MLKonhealthcare_zps49508968

Health care represents more than 18% of our GNP according to the WHO ($2.700.000.000.000/year), dwarfing everything else.  Obamacare will not bring this down. Norway, with a single-payer system, spends only 9.7% of GNP and 100% of everyone there is covered with significantly better outcomes.  As a matter of fact, we are #38 in health care according to the WHO. Hopefully, the ACA will improve our ranking, but even with Obamacare, more than 30 million people will not be covered according to a study by the Health Affairs journal.

And I doubt that the bankruptcies caused by medical bills will be reduced. Sixty-two percent of all bankruptcies are due to medical bills and 75% of those happen to people who HAVE insurance.

I was not happy at all when Obama put single payer off the table before the negotiations with the GOP (and Blue Dog Democrats) got started in 2009.  He had supported single payer before 2008, but his bargaining chip for the ACA was the public option.

The ACA was the best Obama could get in the ridiculously polarized and dysfunctional Congress, given Republican shenanigans and Blue Dog timidity. But it is not what is best for the country.

Obama has his hands full implementing the ACA in red states and elsewhere.  The fight for Medicare for all continues now state-by-state.  Vermont leads the way with its single-payer system based on the Taiwanese model, but single payer advocates are not giving up in many other states, including California, where the movement is regrouping after the fiasco in Sacramento last year.

If we are going to reach the final destination people really want, we need to embrace health care as a human right.  Once we do and reject the idea of health care as a privilege, nothing can stop us.

So yes, let’s support Obamacare implementation but let’s keep our eyes on the prize. Polls_zpsd240143b

But if you want to expand Obamacare, as a majority of liberals, progressives and Democrats do, according to Pew and Kaiser, follow below.

SinglePayersmall2-4The fight for Medicare for all will now be held at the state level.  Canada implemented its single-payer system province by province, led by Tommy Douglas, who was voted as the most admired Canadian ever.  If you have any doubts about the Canadian system, or if you want to educate possible supporters about that system vs. ours, I highly recommend that you get a copy of The Healthcare Movie.  Single payer supporters in California use this film to rally the grassroots.  It works.

Last Saturday, I spoke at a Democratic club in California, and the message I stressed is that the ACA is a step in the direction towards Medicare for all and it was very well received.  I will be doing more of this as often as I can.  This gives me hope.

This is one chart that I included in my slides. It shows the increase in the number of healthcare administrators and doctors.  The ACA will not address this issue.  Today, doctors spend about $70,000 a year in administration. ScreenHunter_64Sep011534-1

So what can you do?

If you live in California, consider joining one of these single payer organizations:

California OneCare, Healthcare for All, Physicians for a National Health Plan, Labor United for Universal Healthcare and California Health Professional Student Alliance. We are planning some actions to coincide with the birthday of Medicare around July 30.

If you are a single payer supporter and you are attending Netroots Nation 13, please join me when I attend the only healthcare reform session on Friday at 4:30 in room AC 212.  We can all get together after the session in some public area.  I proposed a single payer panel, but it was turned down.  This is the second year in a row that single payer panels were turned down.

Even if you are not attending, keep an eye on the movement and let us know what you think. I’ll do what I can to keep you informed.

Cross-posted from Daily Kos. Shockwave, a.k.a Al Saavedra, is a board member for California OneCare.

The Fight Goes On

November 5th, 2012

Dear California OneCare Supporters,

Regardless of the outcome of the election tomorrow, there is still an overwhelming need to reform our sick healthcare system. No matter who is elected, we will still have a heartbreaking number of people who suffer and die because of profiteering in healthcare.

Mitt Romney has said that he will act to repeal the Affordable Care Act (ACA—Obamacare). Without the cooperation of Congress, of course, he will not be able to do so. And if he does somehow manage to repeal ACA, that will mean that 7 million Californians will remain without health insurance and we’ll be back where we were in 2010.

Barack Obama has said that millions of people will gain healthcare coverage in 2014 because of ACA. What he has not said is that even after it is fully implemented, there will still be 3 million Californians who won’t be covered. That’s equivalent to the entire populations of San Diego, San José, and San Francisco combined!

But the one provision of the Affordable Care Act that gives us hope says that any state can create its own health care system in 2017 as long as it provides an equivalent amount of access and coverage as the ACA. What we all know is that single payer can do much more than that. It will provide universal access and comprehensive coverage, and do it at half the cost. Full care, for all, for less!

Regardless of who is elected, we have our work cut out for us.

Our goal is simple: Single Payer in California in 2017. We are constructing a comprehensive campaign that involves grassroots, netroots, the entertainment industry, lobbying, and campaigning like you haven’t seen before in the fight for single payer.

So be sure you vote in this election. The outcome will affect many aspects of our lives. But the one thing that won’t change is our relentless pursuit of single payer healthcare. Thanks, of course, for your past support and vital donations. You can be assured, you’ll hear more about our plans soon, so stay with us. With your help, there is no doubt—We Will Win!

Don Schroeder, Chair

On Behalf of Andrew McGuire, Exective Director
and the California OneCare Board of Directors

Are federally sponsored health plans the camel’s nose under the tent?

October 31st, 2012

The Obama administration has just announced that it will offer federally-sponsored health benefits to the public as part of the health exchanges due to open up in 2014:

These multistate plans were included in President Obama’s health care law as a substitute for a pure government-run health insurance program — the public option sought by many liberal Democrats and reviled by Republicans. Supporters of the national plans say they will increase competition in state health insurance markets, many of which are dominated by a handful of companies.

The federal health plans are run by private insurance companies, but the government can negotiate the benefits and premiums. So this move by the Obama administration is a far cry from a public option. But that didn’t stop one conservative from sounding the alarm.

Robert E. Moffit, a senior fellow at the conservative Heritage Foundation, said he worried that “the nationwide health plans, operating under terms and conditions set by the federal government, will become the robust public option that liberals always wanted.”

Although many on the left supported the public option, many single payer advocates vehemently opposed it, preferring instead an automatic expansion of Medicare to all Americans. So it’s telling that something far less than single payer would make Mr. Moffit a bit nervous. Why would he (and perhaps other free-market advocates) be so concerned that these private health benefits, under contract with the federal government, could suddenly morph into an entirely public plan? Maybe the idea of a public health plan has broader appeal than free marketers want to admit. The Government Employees Health Association, the organization that oversees federal employee health benefits, consistently gets high marks for patient satisfaction. And Medicare – a true single payer program – is immensely popular.

If large numbers of Americans end up choosing the federal plans in the health exchanges over other types of plans, that might take the steam out of a lot of anti-government rhetoric. If the majority of Americans find that they like their health benefits regulated by the government, it just might be easier for them to make the mental leap to accepting a system where health care is provided by the government. And that’s a very scary prospect for proponents of profit-driven health care.