( – promoted by Brian Leubitz)

Does passage of a bill that funnels millions of additional Americans into the private insurance system, and the decision of House leaders to shut down debate on one single payer amendment and scuttle another, mean the end of the years of efforts by single payer activists to win the most comprehensive reform of all?

Does it mean the end of SB 810, even once Governor Schwarzenegger has wandered off the stage?

For the nation’s nurses and the many grassroots activists, the answer is clearly no.  And we’ve got work to do.

In discussions and organizing, now occurring coast to coast, including a strategy conference this weekend in St. Louis hosted by Healthcare-NOW, many are charting a new course that turns next to the U.S. Senate, to the Senate-House Conference Committee, and then to state capitols from Sacramento to Harrisburg where vibrant single payer movements and campaigns continue to grow.

Most single payer advocates acknowledge some important reforms in the House bill, especially the expansion of Medicaid to millions of low income adults, increased regulation of the insurance industry, expanded public health funding for community programs for low income families, and a more progressive tax plan than the onerous tax on middle income health benefits proposed in the Senate.

But those who dismiss the weaknesses, coupled with the overhyped rhetoric comparing the bill to the civil rights legislation of the 1960s or passage of Social Security and Medicare, should be wary of the backlash when millions of Americans continue to face health insecurity and potential bankruptcy as their healthcare costs rise largely unabated and continue to experience denials of medical treatment insurance companies don’t want to pay for.  

As California Nurses Association/National Nurses Organizing Committee Executive Director Rose Ann DeMoro has written

Social Security and Medicare were both federal programs guaranteeing respectively pensions and health care for our nation’s seniors, paid for and administered by the federal government with public oversight and public accountability

By contrast, the main provision of the House bill, and its Senate counterpart, is to expand health care coverage by requiring everyone to “have insurance” — mostly buying private insurance (since the public option is open to so few). Ultimately whether some want to admit it or not, a massive bailout worth tens of billions of dollars to the insurance industry.

Further, while Social Security and Medicare were both significant expansions of public protection, the House bill actually reduces public protection for a substantial segment of the population, women, with its unconscionable rollback of reproductive rights in the anti-abortion amendment.

To that end, tempering some of the triumphalism would be advisable. Equally unfathomable is the threat by some liberal groups to target single payer proponents Dennis Kucinich and Eric Massa who voted against the anti-choice amendment as well as the full bill. (Massa, in particular, was elected with active support from the single payer community and took a principled stand in a swing district.)

Those who start down this road would do well to remember the nurses, physicians, and thousands of single payer grassroots activists who have carried the flame of genuine healthcare reform for years, and will certainly continue to make their voices heard, especially as employers continue to shift skyrocketing healthcare costs to workers and out-of-pocket costs eat up, by some accounts, 15 percent to 19 percent of family incomes.  

One of those suggesting that work must continue, even prior to the vote, was House Whip James Clyburn who told the Associated Press November 5:  

“I didn’t want anyone to think that if you don’t get everything you want in this health care bill right now, that’s the end of the game. What we need to do is lay a foundation. Get passed what we can pass that will have a meaningful impact on people’s lives – not put too many of our people in jeopardy – and then build upon it later. It’s a long road.”

For single payer proponents, the construction on that long road begins in the Senate now where Sen. Bernie Sanders plans to introduce single payer language. As he said on Vermont Public Radio this week:

“I believe that a single payer system is the most effective way to provide comprehensive, universal, cost-effective health care. … (Without single payer) that ain’t going to happen. The health insurance industry and the drug companies are too powerful.”

Sanders is also proposing a federal exemption of legal barriers for states that opt to establish single payer systems, similar to the Kucinich amendment that was stripped out of the House bill by House leaders in the hours leading up to its final vote.

The reason for the amendment, Sanders notes:

“So that if states like Vermont or California or Pennsylvania – states that are strong in a single payer movement – want to move in that direction that they will be able to do so. And I think … what you will probably end up seeing is we will move toward a Medicare for all program when one state does it and does it well. And other states say, ‘You know what? That looks like the most cost effective, fairest way to provide quality care to all people.'”

You can help. Contact your Senator, (202) 224-312, and urge them to join Sanders in supporting this important amendment. That’s what a lot of us will be working on next.

What a night! As you may have seen, last night I was the highest vote-getter in the 10th Congressional District special primary election and will now face Republican David Harmer in the November 3rd general election.

I want to thank our incredible team of hard working volunteers. They spent countless hours knocking on doors, making phone calls, and making their presence known at community events throughout the district. Our success would not have been possible without them, and they have my deepest gratitude. Because of their efforts, we won all four counties in the district.

I also want to take a moment to acknowledge my competitors in this election:

To David Harmer: Congratulations on your victory among Republicans. I look forward to two months of dialogue focused on the issues and solutions that matter to the people of the 10th Congressional District. I intend to make it clear that a radical right wing agenda that seeks to stop health care reform, starve the education of our children, fails to finance the transportation and infrastructure systems we need, and advocates more tax breaks for the most wealthy is not in the interests of the people of the 10th Congressional District, California, or America.

To Senator Mark DeSaulnier: Your health care town halls helped establish an important dialogue in the campaign about the need for comprehensive health care reform. You are an institution in Contra Costa County, and you have many admirers. You deserve special acknowledgement for your work seeking a constitutional convention. The two-thirds majority requirement has worsened California’s problems and I look forward to working with you to bring a working democracy and majority rule back to California.

More over the flip…

To Assemblymember Joan Buchanan: Thank you for highlighting the concerns of small businesses in your campaign. I look forward to having a conversation with you about innovative ways we can promote job growth in the region. As a former school board member, you also helped focus the debate on education policy, and I thank you for that. I think you’d agree that in the long term, a sound investment in education is the most important economic stimulus of all.

To Anthony Woods: I’m not the first person to say this and I won’t be the last: you have a bright future in politics should you choose to pursue a political career. I first joined the state legislature around your age, and I quickly fell in love with public policy. You have an intelligence, grace, and resume that is worthy of elected office. Thank you for your service to our nation; and thank you for helping to make the issues facing LGBT people a focus in this campaign. You deserve the freedom to openly serve our country, and I pledge that one of my first acts in Congress will be to co-sponsor legislation to repeal “Don’t Ask Don’t Tell.”

To Adriel Hampton: Thank you for highlighting the importance of online outreach. We followed your use of social networking and Web 2.0 tools, and I look forward to chatting with you about the ways we can use the Internet to better reach out to our constituents. You were an accessible and upfront candidate and have my sincere respect.

It’s been a hard fought campaign, and now that the primary is over, we Democrats must unite. We will not allow radical, regressive right-wingers, with their block-progress-at-all-costs agenda, to get a toehold here is the 10th Congressional District – this is a forward-looking, forward-thinking, progressive Democratic district and I intend to fight for every vote to keep it that way!

I look forward to working with President Obama and the Democrats in Congress to protect Social Security, fix our broken health care system, create jobs, broaden educational opportunity, protect the environment, and bring needed federal money back to the district. This election was truly a wonderful experience. I can’t wait to get to Washington, DC to represent the people of the 10th and begin to tackle the many challenges facing our nation!

Lieutenant Governor John Garamendi is the Democratic nominee for California’s 10th Congressional District. He is a University of California regent, California State University trustee, chair of the California Commission for Economic Development, and chair of the California State Lands Commission. He was a twice elected State Insurance Commissioner, Deputy Interior Secretary under President Bill Clinton, and a Peace Corps volunteer. A special election will be held on November 3rd. For more information, please visit http://www.garamendi.org.

Last night, our country lost one of the most important public servants in U.S. history, Senator Ted Kennedy. My thoughts and prayers go out to his wife Vickie, his children, First Lady Maria Shriver, the Governor and the entire Kennedy family. The nation and the world have lost a leader with unparalleled passion for social justice and equality, and his legacy will live on in the many lives and hearts he touched. They will carry the flame of justice and service forward.

Senator Kennedy fought for health care access for every American. In the 1990s, he was one of the lead architects of S-CHIP, which has provided millions of low-income children with the health care they deserve, and he tirelessly promoted universal coverage throughout his career. As Kennedy said during his riveting address at the Democratic National Convention in Denver last year:

“This is the cause of my life – new hope, that we will break the old gridlock and guarantee that every American – north, south, east, west, young, old – will have decent quality health care as a fundamental right and not as a privilege.”

More over the flip…

To honor Senator Kennedy, Senator Robert Byrd has proposed naming the health care reform package after Kennedy. As we mourn the loss of a great man, we must continue the work that is required to make sure his lifelong cause is accomplished. Senator Kennedy’s passing gives renewed focus to the need to pass meaningful health care reform that includes the public option. If he were still with us today, he would agree that there is no more fitting a tribute to his legacy. As Dr. Howard Dean said today, “When President Obama signs a healthcare reform bill late this year, Ted Kennedy may not be standing there next to him, but his presence will be deeply apparent in the Oval Office as the President’s pen moves across the page.”

John Garamendi is the Lieutenant Governor of California. He was California’s first elected State Insurance Commissioner.

Yesterday I was excited to announce that the SEIU California State Council has endorsed me in my race to represent California’s 10th Congressional District, a Northern California district encompassing parts of Contra Costa, Solano, Alameda, and Sacramento counties. With 700,000 members, SEIU is the largest labor union in California, and their ranks include a broad cross-section of working Californians, including social workers, nurses, classroom aides, security officers, college professors, homecare workers, janitors, and more.

Why I’m motivated to lead on single-payer health care, the Employee Free Choice Act, and green-collar jobs over the flip…

“With health care reform, affordable clean energy, and economic security for our nation’s families at the top of Congress’ agenda, we need leaders in congress who will be a powerful voice for working families in each of these important debates,” said Courtni Pugh, Executive Director of SEIU’s California State Council. “We know that John Garamendi will do just what he’s done in California – be an outspoken champion for people who work hard every day, for the elderly and people with disabilities who need a voice, for parents and their kids who deserve opportunities for a better future. We know John Garamendi won’t compromise our grandparents’ safety or our kids’ future.”

I want to take this opportunity to thank the SEIU California State Council for their important endorsement, and I want to let all of you know that when in Congress, I will continue to fight for progressive legislation that improves the lives of all Americans.

You will hear a lot from me over the coming months and years about the issues that have led me into public service, but given this most recent endorsement, I wanted to cover three issues that matter to working Californians: universal health care, the Employee Free Choice Act (EFCA), and advancing green-collar jobs.

Medicare for All

I support single-payer health care. In 1965 we figured out how to make health care work for everyone – or at least everyone over the age of 65 – it’s called Medicare. Polls have consistently shown that an overwhelming majority of seniors enrolled in Medicare are satisfied with the service provided to them. Medicare provides universal coverage for seniors, is cost-effective, and patients are able to choose their own doctors. Sure, it’s not perfect, but it’s a significant improvement over a profit-driven private health insurance industry that rewards early termination of coverage for patients in need of care and includes excessive overhead for advertising and administrative costs.

I also think healthcare reform this year must include the public option. As I’ve always said, if we don’t yet have the votes for truly comprehensive universal health care reform, we should not stand in the way of incremental health care reform, provided we are clearly heading down a path toward universal Medicare for All access. My longstanding advocacy on these issues as a state legislator, Insurance Commissioner, and Lieutenant Governor also led the California Nurses Association to endorse my run for Congress, and I am humbled to have the support of nurses.

The Right to Organize

I am also a proud supporter of the Employee Free Choice Act (EFCA). As I explained at a labor rally in March:

“It is time for a change, because the working men and women of America and the working men and women of California have taken the short end of the paycheck for too long. In 1965, the CEOs had a ratio of 24:1 on their paycheck. What happened in the ensuing years? In 1980, it went to $42 for the CEO and $1 for working men and women. In 2006, what happened? It went to $364 for every dollar you earn.”

Approximately 60 million non-unionized Americans say they would join a union if given the opportunity, and when in Congress, I will work to make sure that working men and women have the opportunity to join a labor union without undue delay or fear of unjust termination.

What’s Good for the Planet is Good for Labor

I also believe smart government policy can help create new quality jobs, and with the ravages of global warming and pollution more apparent by the year, the time was yesterday to employ Americans in fields that make our economy more sustainable. Weatherizing buildings, constructing public transportation corridors, and installing wind turbines, solar panels, and other alternative energy sources have and will continue to create quality jobs. If our country is to maintain its status as the world’s innovator, if our country is to retain its economic competitiveness, then a robust investment in green-collar jobs must be a priority for our country.

I was happy to see President Barack Obama appoint Van Jones as his green jobs advisor, and I share his conviction that environmental advocates must focus on demonstrating the interconnectedness of environmental protection and job creation for the working class. And believe me, I am no stranger to this issue.

As a state legislator, I was the author of the first legislation proposing high speed rail in California, and under a proposition I authored (Prop 111), California generated billions of dollars for mass transportation. I also authored a bill that offered the first tax credit in the state for wind turbine construction, including the wind turbines that exist near Fairfield in Solano County. These projects represent the best of California, and the future of our economy. In Congress, I will continually stress the importance of an environmental agenda that works for everyone, including inner city and rural communities and communities of color.

As you may know, today we face an important filling deadline where we have to report contributions from supporters. You know where I stand on these issues, and I plan on addressing your additional comments and questions throughout the week. If you could spare even $5, $10, or $25, our campaign would be most appreciative. If you live in the area and would be interested in volunteering for a strong advocate for working and middle class Californians, please sign up on our campaign website. And of course, I’d love to see you follow us on Facebook and Twitter.

Yesterday I was proud to receive the endorsement of SEIU. I would be honored to have your support today.

P.S. I also have a blog post up on Calbuzz about offshore oil drilling with the California Department of Finance’s Tom Sheehy: Calbuzz Face-Off: Drill Baby Drill, Yea or No Way? Check it out and let Calbuzz know what you think.

John Garamendi is the Lieutenant Governor of California and a candidate for California’s 10th Congressional District. He is a University of California Regent and California State University trustee and was California’s first elected State Insurance Commissioner, a former Deputy Interior Secretary under President Bill Clinton, a state legislator, and a Peace Corps volunteer. Please visit http://www.garamendi.org for more information.

I’ve been in our nation’s capital this week meeting with Obama Administration officials and Congressional leaders about national health care reform. Everywhere I go, from the White House to the Department of Labor to the U.S. Senate, I get the same question: can San Francisco’s universal health care program, Healthy San Francisco, be scaled?

The answer is yes.  

Truly, one of the strongest aspects of Healthy San Francisco (HSF) is its simplicity. The program allows participants to select their primary care provider from among dozens of local hospitals and clinics, both public and private. Our local system does not require lengthy HMO paperwork and there is no denial of treatment based on pre-existing medical conditions.

A recent study showed that Healthy San Francisco is dramatically less expensive than traditional insurance. And our experience in San Francisco is proving what most American’s already know – it is much less expensive to keep people well than it is to treat their sickness, particularly when so much treatment for uninsured Americans is provided in costly emergency rooms.

There are currently more than 40,000 participants in HSF. We are enrolling approximately 600 new participants every week. We have already enrolled more than half of the previously uninsured San Franciscans and the vast majority will have access to health care by the end of next year.

I believe that administration and congressional leaders understand that we cannot wait for health care reform. Our health care crisis affects every aspect of our society – from making sure every child receives the health care they need to succeed in school, to decreasing the financial burden on business, both large and small, so our economy can get back on track.

I know there is pressure in Washington to wait until the economy improves before we act on health care reform. I faced many of the same pressures when I was working with allies in San Francisco to forge our universal health care delivery system.

But “waiting” in politics usually means never – and we simply cannot afford to wait any longer. The lessons we are learning in San Francisco shows that investing in health and wellness is its own kind of economic stimulus.

The time is now to tackle this problem and I applaud President Obama for promising to sign a national health care reform bill by October. We cannot wait for change – the President needs your help. Sign the petition to support President Obama’s call for health care reform.

One of the key figures leading the charge in Congress is Iowa Senator Tom Harkin. I spoke with Sen. Harkin on my Green 960 radio show this week about the challenges Congress and the administration face and the possibility of using HSF as a model for a national program. You can listen to the show online or via iTunes.

For my part, I was recently made Chair of the U.S. Conference of Mayors Task Force on Health Care Reform. Cities often have the most pressing health care needs and have had to adapt and innovate in lieu of national health care reform. I am looking forward to working with my fellow Mayor’s to hear what they have learned in their cities and share what we’ve learned in my hometown through Healthy San Francisco.

In the end, the task force will identify urban health care priorities and advise the work of Congress and the Administration to help solve this crucial challenge we all share. As always, please feel free to give me your input and feedback in the comments section below.

Listen to Mayor Newsom’s Green 960 radio show online or subscribe to his weekly policy discussions on iTunes.  Join Mayor Newsom on Facebook. You can also follow him on Twitter.

After years of shredding our public health infrastructure and ill advised minimal preparations for the next great global pandemic, the spreading swine flu threat is at last making clear the very real calamity that could be just around the corner. If not today, surely from the next epidemic.

The Obama administration’s call on Congress Tuesday to allocate $1.5 billion for combating the virus is a start, but only a start. The RNs of the National Nurses Organizing Committee and California Nurses Association (NNOC/CNA) believe that far more is needed in federal action, in regulatory crackdown on insurance practices that potentially inhibit those who are infected from seeking help, and in global coordination.

From SARS to avian flu to the swine influenza, the only question has not been if, but when.

Three years ago, during the advent of an avian flu outbreak, in an article by Conn Hallinan and Carl Bloice in the national magazine of the National Nurses Organizing Committee, we warned that the “firewalls for stopping the next great pandemic are getting thinner.”

If the swine flu or the next pandemic has only the fatality of the 1918-1919 global influenza pandemic — 2.7 percent — it would have a catastrophic effect. That pandemic killed 675,000 Americans and anywhere from 50 to 100 million people at a time when the world’s population was less than a third what it is today, and when populations were far more isolated.

Obviously, there have been medical advances in the past 90 years. But on many other levels, conditions remain as precarious as ever.

In the U.S., public health services are often first on the chopping block when budgets are tight — such as the now evidently foolhardy decision of politicians to slash $870 million from the President’s economic stimulus bill that was allotted to fight pandemics.

And many politicians compete to see who can transfer more resources from the public setting into the pockets of private healthcare corporations — often while harvesting hefty campaign contributions from those same companies.

The result is a virtual decimation of many community clinics, especially in rural and medically underserved communities, and a starving of badly needed funds for public hospitals and services.

Over the past eight years especially, we’ve also seen a rash of hospital and emergency room closures, reductions in available hospital beds, and the type of equipment needed to fight pandemics. For example, in 2005, we noted, there were only 105,000 mechanical ventilators, between 75,000 and 80,000 of which are in constant use. Ventilators are particularly important if a pandemic takes on the characteristics of the 1918-1919 flu in which a major killer was acute respiratory distress syndrome.

Hospital and bed closures are all too often driven by the insatiable lust of healthcare industry corporations for greater profit that can be secured by relocating in wealthier communities or re-allocating resources to more profitable services, such as boutique clinics and surgery centers. Such is curse of our absurd reliance on the privatization of healthcare.

An immediate shift in priorities and thinking is needed, if not for swine flu, for the coming plague. Here’s the first call to action by the national nurses movement (link is a .pdf):

• Recruit and mobilize teams of scientists to create the appropriate effective vaccine for the virus.  

• Cease and desist any reductions in public health programs at federal, state and local levels. Lift any freezes on public health funding currently in place.

• Implement a moratorium on any closures of emergency rooms, layoffs of direct healthcare personnel, and reductions of hospital beds.

• Allocate funding for recruitment and retention of school nurses, public health nurses.

• Expand the network of community clinics, especially in medically underserved areas.

• Add thousands of additional ventilators/respirators, which are critically needed in the event of epidemics.

• Assure the availability of protective equipment for all healthcare personnel.

• Require all insurance companies to suspend or waive all out-of-pocket expenses, including co-pays, deductibles, or co-insurance that discourage individuals from seeking preventive care for early signs of infection.

On the international level, it’s apparent that the World Health Organization is overwhelmed. A global infrastructure similar to what is being discussed for the economic crisis should be formed and sanctioned, at least by the G20.  International cooperation and most importantly, transparency of data from all sources, health care facilities, governments, and individuals, is essential to identify the virus and track its patterns.  The global health community must have the authority to require systematic, uniformly collected information to be reported on influenza cases in order to start formulating an effective vaccine.

Within the U.S., we should learn the lessons of the 1918-1919 flu pandemic, one of which was the enormous mitigating effect on mortality of adequate nursing care. We need to rededicate our nation to expanding the supply of nurses and safe patient care in our hospitals and clinics, which is a central component of the healthcare safety net that is especially vital at times of public health crises.

Finally, in order to promote containment and convention, we must eliminate the greed-driven barriers to care based on ability to pay.

Recent reports have emphasized the growing number of Americans who are skipping routine medical screenings, exams, and general preventive care due to the skyrocketing co-pays, deductibles, and other use charges imposed by insurance companies.

Price gouging by the healthcare industry has already put tens of millions of families in healthcare jeopardy, especially in an economic crisis. At a time when untold numbers are already exposed to a dangerous virus, we need to be removing any barriers to medical care that would exacerbate the spread of contagion. We can not afford to wait.

The updated CNA/NNOC swine flu page is here.

For the past few months I have been holding town hall forums across California and no matter where I go, the issue of health care is front and center. These concerns are getting more pronounced and more passionate as the weeks wear on and unemployment continues to rise. People are losing their employer-based health care and COBRA is a temporary and expensive stopgap measure that is stressing already maxed-out family budgets.

The need for bold programs addressing the health care crisis was brought into focus by a new UC Berkeley report showing that more than 500,000 Californians have lost their health care since the start of the recession.

In the past five years, we have worked hard to provide universal health care in San Francisco through our Healthy San Francisco program. We have now enrolled over 38,000 of our city’s estimated 60,000 uninsured. It’s a great start but there is still much work to do here in San Francisco and across California as the new UC Berkeley report clearly lays out.

On my Green 960 radio show this week I talked with Lloyd Dean, the head of Catholic Healthcare West, Mitch Katz, Director of San Francisco Department of Public Health and Tangerine Brigham, Director of Healthy San Francisco about how to bring the “Healthy SF” model to other cities and towns throughout California.

As we discuss on the show, a critical next step for any city or town looking to replicate Healthy SF is to start organizing their community health clinics. Community clinics have historically provided services to uninsured and underserved populations. It’s important for any health care effort at the local, state or federal level to include these crucial providers.

I hope you will listen to the show and let us know your thoughts and suggestions in the comment section as we work to create better health care service here and universal health care across California. As the President and Congress move to reform the health care system in Washington – the time is now to let your voice be heard.

Listen to Mayor Newsom’s Green 960 radio show online or subscribe to his weekly policy discussions on iTunes.  Join Mayor Newsom on Facebook. You can also follow him on Twitter.