01/05 Single-Payer News from the CA Nurses Association

(Shum does a good job diving into the limitations of the proposals that have been leaked. – promoted by juls)

California gets much of the attention in today’s Single-Payer Update, as Schwarzenegger robs Peter to pay Paul in his upcoming health care bill, while bringing back George Bush’s failed Health Savings Account idea.  Also Paul Krugman looks at the inefficiency of health care privatization, the Massachusetts Mandate hits a stumbling block, and blogger Avedon figures out how to make single-payer health care a reality.

Brought to you by the National Nurses Organizing Committee as we organize to make 2007 the Year of Single-Payer Healthcare.

California Schemin’
“Moderate” politicians around the country (meaning those trying to protect their corporate healthcare donors) are hitting on a similar strategy to divert the public’s demands for genuine progress on our healthcare crisis: they are passing laws to force people to purchase health insurance, and sometimes coupling that with nominal expansions in programs that serve a few patients here and there.

None of this will solve the problems in our health care system, but they do raise a whole new set of problems: how to pay for even these “nibbling around the edges” reforms.

In California, the San Francisco Chronicle reports on Schwarzenegger’s scheme to find more money to pay for coverage for poor people: he’s going to take it out of public health funds.

That’s right, Governor Arnold plans on taking $2 billion of money now used to cover care for indigent people at hospitals and instead use it to cover health insurance for many of those same people.

In other words-he’s taking dollars used to directly cover care and feeding them into the Insurance Industry Machine, which will start by disappearing about a third of those dollars into their overhead, marketing, profits, and bureaucracy.

Which means we’ll continue to see out-of-control health care costs, but will have fewer public resources to go around. 

HSA’s are Back??
The same article floats a trial balloon for state “Health Savings Accounts.”  As you recall this idea was proposed by President George Bush as an attempt to privatize health care risk, in the same vein that he wanted to privatize retirement risk by replacing Social Security with private accounts.  There are multiple problems with HSA’s, including: they drive more people into bankruptcy; they do nothing to contain costs; they are much better for the rich than middle class or poor people; they greatly increase administrative costs.

Privatization’s Peril
Paul Krugman in the New York Times (reg. req’d.) gives us historical perspective on the harmful trend of privatizing health services:

One of the main features of the (Medicare part D) legislation was an effort to bring private-sector fragmentation and inefficiency to one of America’s most important public programs….but for the Bush administration and its Congressional allies, privatization isn’t a way to deliver better government services-it’s an end in itself…(now the privatized portion of Medicare) costs 11 percent more per beneficiary that traditional Medicare. 

Massachusetts Mandate Mess
Meanwhile problems with the Massachusetts mandate are continuing.  Massachusetts is one of the more heart-breaking stories in the push for health-care reform.  They were probably closer to single-payer than any other state, until one politician with visions of the Presidency in his eyes moved them towards an “individual mandate” system. This is also known as criminalizing the uninsured, where the entire population becomes a forced market for the insurance industry.

The Boston Globe today reports hospitals are having trouble signing people up for their mandated coverage.  They don’t know they have to sign up, or they don’t understand it, or, in the words of one hospital executive,

even when some people are informed about the plans, they remain wary about signing up for coverage, fearing hidden costs or penalties in the fine print.

Go figure. Are they going to get thrown into the poorhouse?

The Haggle

Avedon over at Atrios has a great idea for how to bring about single-payer: haggle.  Start with a demand for a National Health Service…and single-payer emerges as the reasonable alternative it really is!

Health Care Leaks

cross-posted from Working Californains

All of the major news papers seem to have different details that may or may not be in Arnold’s health care proposal.  There are two proposals that come directly from a one pager the governor’s office released yesterday.  The rest are rumored leaks.  We could wait until he gives his speech Monday at 11 am to figure it all out, but why wait?  Let’s see if we can sort through this, shall we.

Confirmed

  • Employers would be required to offer health savings accounts, otherwise known as Section 125 plans.  The plans let workers save pre-tax dollars to pay for premiums of individual insurance.  This is also part of Nunez’s plan.  From Health Access’s Anthony Wright:

    Similar to a provision of the Massachusetts plan, this would require employers to facilitate (but not fund) Section 125 plans, thus giving workers the ability to save up to 40% of their premium. While this would not help most uninsured who still would find buying insurance as individuals unaffordable, it will help more Californians take advantage of federal tax breaks.

  • Safeway inspired reward system for insured persons to take pro-active steps to improve their health.  Think “health-related goods” (gym memberships etc) for those who lose weight, stop smoking, and keep chronic diseases under control.  Wright again:

    While the governor is careful to say that people who don’t engage in “healthy action plans” will not be penalized, some advocates were concerned with the focus on “personal responsibility” rather than systemic solutions for healthier living.

  • Coverage for all California’s children, including those here illegally.  Price tag: about $380 million to cover 750,000 uninsured children.  The proposal would raise “the eligibility threshold for the state’s Healthy Families Program to 300 percent of the federal poverty level, or $60,000 for a family of four.”

Not Officially Confirmed

  • Shifting of governmental dollars from reimbursing health care providers for indigent care to directly pay for insurance for a portion of that population.  The total may be “up to $2 billion in tax money.”
  • Provider tax:  Currently doctors, hospitals, dentists etc charge the insured a premium to make up for treating those without insurance.  “As more people become insured, costs are reduced, and those savings can be redirected to other parts of the health care system.”

These are all relatively small pieces to the larger puzzle.  There is nothing here that directly addresses how we will reduce the high number of the uninsured who are poor.  Health savings plans will not cut it.

Covering all children is relatively inexpensive.  That is the only new piece of spending that has leaked out.  Despite its relatively small cost, it will face strong opposition from the Republican caucus.  In the end, we should be able to control the debate.  Republicans will not look good in the public eye by trying to deny health care to children.  They should not be punished for things out of their control.

Total Recall: The Courage Campaign Governor Watch UPDATE – Health Care

(Another installment of the Total Recall series. Good work Erik. – promoted by SFBrianCL)

By Erik Love – From The Courage Campaign 

The first installment of Total Recall, the Courage Campaign Governor Watch, focused on perhaps the most pressing issue facing California — health care.  The objective of Total Recall is simple: see whether the Governor fulfills his campaign promises.  Yesterday's LA Times had on its front page a story about early details of Governor Schwarzenegger's latest plan for providing insurance to some of the 6.5 million people in our state without any health coverage.  The plan would provide coverage to nearly all of the children living in California — an important achievement to be sure.  But the Governor's proposal is most surprising because it would include undocumented children in its coverage — a proposal which seems to be at odds with Schwarzenegger's conservative base.  While an official announcement of the Governor's plan will appear next week, it appears that the administration has allowed a trial balloon to hit the papers to gauge reaction to this most controversial aspect of his proposal.

If the Governor's plan remains true to the details seen in yesterday's newspaper article, then progressives will find much to like.  Insuring California's children would be an important, big step forward.  Still, it's important to remember that such a plan would only be the beginning.  Schwarzenegger promised to extend health insurance to as many Californians as possible.  Schwarzenegger's plan to insure children would affect about 760,000 people — still leaving about 6 million Californians with no health insurance.  The pressure would still be on the Governor to finish the job.

Moreover, while the Governor would be lauded for including all children in California in his plan, it will be difficult to forget Schwarzenegger's previous anti-immigration statements, including his now infamous "Close the Border!" speeches.  And, it's important not to forget that the Governor had an excellent, financially sound plan for universal health care on his desk as recently as August 2006.  Despite his insistence that insuring Californians is a priority, Schwarzenegger vetoed that plan because it wasn't politically advantageous for him during his reelection campaign.

Now that health care appears politically advantageous, Schwarzenegger is ready for a bold proposal.  This is good for the hundreds of thousands of children in need of health insurance, unquestionably.  But Schwarzenegger still has a long way to go to prove that he's more than a political opportunist on this issue.  Total Recall will be there when the Governor's health care plan is officially unveiled next week.

Spocko’s War

We’ve mentioned Spocko’s blog in several of our blog roundups (see this google site search).  Spocko has been, as jsw put it, waging a one-Vulcan war against the right-wing hate machine based in San Francisco.  Yup, you know it, you ahem, hate it, it’s KSFO.  You know, the station that brings you such luminaries as Brian Sussman and Melanie Morgan.  Quite a station they’ve got over there. Unfortunately, Spocko’s Brain, the blog in question, is down as of 11 PM Wed. But here’s Google’s Cache

One example that got picked up by Media Matters and, eventually, Olbermann:

ROGERS: Yeah, she’s dreaming, all right. She’s dreaming of personally strangling Melanie Morgan.

MORGAN: Oh. We’ve got a bull’s-eye painted on her big, wide laughing eyes.

Just lovely, eh?  Well, good ol’ Spocko has plenty more where that came from. They’ve got some real bile-spewers over there at KSFO.

Well, anyway, not only has Spocko been waging the one-Vulcan war on the series of tubes, but also sending out letters to advertisers.  And, well, it’s been working. Advertisers including Bank of America and AT&T have pulled their ads from KSFO due to the vitriol emerging from the mouths of chickenhawks at KSFO.  This didn’t make KSFO, ABC Radio and Disney (parent corps) particularly happy.

Well, after some nice back and forth on Spocko’s blog with Spocko (via posting as “Spocko’s Vendetta”) where insinuating that Spocko would soon be arrested by, alternatively, the police or the FBI, KSFO got serious.  First, they posted Spocko’s picture on their website.  After thinking better (?) of that, they lawyered up and sent Spocko a Cease and Desist letter.

Where it goes from here is anybody’s guess, but Spocko wages on.  Illogical, perhaps.  But worthy of praise from all of us, certainly.

Working Californians: Unions’ Quality-of-Life Focus & Positive Public Image

First for the meta: I have a new part-time gig blogging for Working Californians.  Like Todd does here for the Courage Campaigns expect a few cross-posts from me each week over here and at MyDD/dkos.

So what is Working Californians?  Well..here is my first post from yesterday.

You can read more about the WC mission here but, in short, WC is a strategic research and advocacy non-profit focused on quality-of-life issues for working people in LA and California. The co-chairs are Brian D’Arcy and Marvin Kropke, who deserve a lot of credit for thinking about the long-term and investing in strategic research and advocacy. Also, Working Californians was the main independent expenditure campaign that helped elect John Chiang as State Controller last year.)

Let’s kick start the discussion with today’s LAT piece on strategic research memo written by Working Californians’ strategists, using quantitative and qualitative research (ie, polling and focus groups) that Working Californians did in LA last fall. LA Times reporter wrote about it in yesterday’s paper.

Los Angeles unions enjoy a decided “brand advantage” over corporations among city voters, and the labor movement should use that popularity to advance “union-led solutions” to key public policy issues in 2007, a memo written by top labor strategists says.

The two-page memo, which was obtained by The Times, argues for broader, more straightforward engagement on policy issues than many unions have undertaken in the past. Some labor leaders prefer to focus on their own contract issues, and even those who are active in politics often soft-pedal the “union” label.

The document demonstrates labor’s confidence as it heads into a new year of big battles over politics, contracts and organizing.

The bottom line is that unions are a trusted communicator for LA voters and we can use that to advocate effectively on behalf of the working men and women in California.

“There is a significant opportunity for organized labor in Los Angeles,” the memo says. “In particular, we’d highlight these factors: unions’ fundamentally positive image and ‘brand advantage’ over business corporations; the overlap between union priorities and the key concerns of voters across the electorate in L.A., and the opportunity to expand public understanding of the connection between local government and the full range of quality-of-life issues.”

Public support for unions in LA is growing, and that presents a great opportunity for the effectiveness of labor sponsored advocacy campaigns.

Binder’s poll found that unions have more public support in Los Angeles than in other areas of the state and country. Among city voters surveyed, 55% agreed that “without unions, there would be no middle-class left in America.”

Reflecting the labor movement’s influence in city politics, the memo argues for talking up local government’s ability to deal with issues such as the economy, healthcare and the environment, which generally are considered federal and state matters.

The memo calls “for a public education campaign focused on union-led solutions to the quality-of-life issues that Los Angeles voters regard as most important.” The memo suggests that such a campaign be conducted before 2008, when state and national election campaigns will probably consume union energy.

“Los Angeles, against its own history, is a labor town now,” said Cherry, one of the strategists, who was a key figure in the successful effort to defeat Gov. Arnold Schwarzenegger’s slate of ballot initiatives in 2005. “One of the things that comes through in the poll is that people really see the potential of unions to take up the cause of ordinary people on quality-of-life issues.”

That is at the heart of what we do at Working Californians.  Labor campaigns do not just lift up union members, but all those working men and women that are at the heart of what makes California great.  Without a vibrant union movement and solutions to high housing costs, health care, transportation, the environment and other quality of life issues, people will continue to leave this state in droves.  We cannot afford to squeeze out our middle class.

Single-Payer Round-Up

(Shum is the type you want to have in a foxhole with you and CNA rocks! – promoted by blogswarm)

The California Nurses Assocation/National Nurses Organizing Committee will spend 2007 organizing for John Conyers’ “Medicare for All” bill, and Sheily Kuehl’s California Health Insurance Reliability Act.  Thesd kinds of single-payer healthcare plans are the only affordable, just way to provide a single standard of high quality care to all people.

We’re developing our internal blog; below is today’s news on the fight.

LOS ANGELES TIMES-Superstar columnist Patt Morrison notes the problem at the heart of today’s broken health-care system: insurance corporations.  America wastes hundreds of billions of dollars a year to subsidize a private insurance industry that does little but create a middleman between patients and care providers, while frittering away care dollars on marketing, profits, and bureaucrats AND denying coverage to customers it doesn’t like.  Take it away, Patt: 

Business, which has a firm grip on the legislative joystick, hits the panic button at talk of single-payer healthcare or universal healthcare, and it hauls out its own boogeyman phrases, such as “job-killer” and “drag on the economy.”

I’ll tell you what’s a drag on the economy. Healthcare insurance that’s impossibly expensive, or impossible to get. If the United States wants a vital economy of personal enterprise and risk-taking, then it needs to guarantee health coverage, period. Americans are willing to take chances in business and careers, but not with their families’ health, or their own.

She notes that Arnold Schwarzenegger-a 59 year-old cigar smoker-would find it impossible to buy health insurance for himself.

ABC NEWS- Finds great news on the battle for single-payer healthcare.  Rep. Barney Frank, incoming chair of the House Financial Services Committee, will offer the business community a “grand bargain” that includes single-payer healthcare and extension of unionization rights in exchange for pro-business policies on trade, immigration and direct foreign investment.

LOS ANGELES TIMES and SACRAMENTO BEE-Governor Arnold Schwarzenegger today begins a PR blitz for the Monday announcement of his healthcare reform plans.  He had promised “universal” health care, but is dialing that back to just include more coverage of the state’s children.  What about adults and seniors?

The LA Times reports that his plan for securing health insurance of the state’s 763,000 children would cost approximately $400 million, and the Sacramento Bee reports it will apparently be run through a state program known as Healthy Families.  While details of the plan for adults and seniors of his plan remain sketchy, it appears to fall into the “much more of the same” category-extending business-based coverage through private insurers, perhaps with an individual mandate that criminalizes those who don’t purchase insurance.  This is a recipe for continuing the trend of declining quality and exploding healthcare costs, while leaving significant portions of the population without coverage or access to the quality care they need.

NEW YORK TIMES- Governor Eliot Spitzer is proposing legislation that would expand Medicaid and state children’s insurance to cover more New York residents.  Like Schwarzenegger, Spitzer is choosing a “nibbling around the edges” approach that does not resolve the fundamental and tragic problems in our healthcare system that are leading so many of us to pain, heartbreak, financial ruin, and early death.

SAN FRANCISCO CHRONICLE-Reports that 8 out of 10 state residents want the government to assure health coverage.  Do the politicians know this?

THE HEALTHCARE BLOG-Carries an interesting proposal for a partial single-payer system, combining Medicaid, the public health systems and other institutions into a National Health Service for the Uninsured, which could serve as a model for a national health program.

NEW ENGLAND JOURNAL OF MEDICINE- Overviews the Democratic agenda on healthcare.  They’ll start with the feel-good stuff-prescription-drug pricing and embryonic-stem-cell research.  It’s not clear where they go after that. 

  BLACK COMMENTATOR- I just found this excellent article from a couple of months ago in which Marilyn Clement lays out “A Strategy for seeking a national-single payer healthcare system that will cover everyone in the United States.”