A new Field poll today in California shows voters choosing a single-payer healthcare plan over the insurance-driven proposals supported by Governor Arnold and his Democratic allies.

The finding is in line with past research finding voters way ahead of politicians on the issue of guaranteed healthcare.  The timing on this poll, however, could not have been better for healthcare advocates, as the California budget just got passed and Governor Arnold, his Democratic helpers, and their insurance buddies are about to try to shove a regressive healthcare measure through the legislature.  Their plan just got harder.

We’ll take a look at this and more, cross-posted at the National Nurses Organizing Committee/California Nurses Association’s Breakroom Blog, as we organize to make 2007 the Year of GUARANTEED healthcare on the single-payer model.

Tom Chorneau in the San Francisco Chronicle:

As voter dissatisfaction with the state’s health care system grows, increasing interest is emerging in moving to a state-run, single-payer program, according to a Field Poll released today.

For years, a single-payer system had been the favorite of a small but loyal minority, but the new poll shows that 36 percent of California voters now favor replacing the current employer-based system with one operated by the state – a jump of 12 percent since December.

Meanwhile, the number of voters who want to make reforms within the framework of the current system has dropped from 52 percent in December to 33 percent in August.

Mike Zapler in the Mercury News notes:

Ironically, the drumbeat of attention on health care this year, fueled by Gov. Arnold Schwarzenegger and other would-be reformers, seems to have dampened support for the one approach to change that had majority backing last year: shoring up the current insurer-based system. That solution, which is favored by the governor and calls for shared responsibility among government, employers and individuals, is now favored by just one-third of voters, down from 52 percent in December.

Call it the Michael Moore effect.  Sicko drew unprecedented attention to the problem of for-profit insurers…and now legislators want to expend the reach, customers, revenue, and medical influence of these same movie villains?  Thumbs down!

A Bureau of National Affairs article today (sub. req’d.) updates the latest backroom maneuvering on AB 8, which is the legislative offer to Governor Arnold:

SACRAMENTO, Calif.–“Play or pay” health care legislation authored by California’s Democratic legislative leadership was amended Aug. 20 to move up by one year, to Jan. 1, 2009, the proposed date that employers would be required to offer health coverage or pay 7.5 percent of payroll into a state-run purchasing pool .

The health care bill, A.B. 8, amended the same day lawmakers reconvened after a month-long summer recess, is pending in the Senate Appropriations Committee. It must clear both houses of the Legislature by Sept. 14, the last day of the regular legislative session. 

One problem with making this the centerpiece of a healthcare reform initiative?  It is blatangly, obviously, blindingly illegal-and will be tossed out of by the courts faster than you can say Erisa. 

So why put it in there?  To give the appearance of standing up on behalf of patients-while distracting attention from the other provisions in the law.  The other elements of this plan?  Expanding some public health programs while pushing some half-baked insurance “reforms” that will just lead to more paperwork…and more insurance overhead.

That’s it!

Here is a recent  background column from Sen. Sheila Kuehl’s office about the various proposals being thrown out as road-blocks to her single-payer plan, which has the big advantages of being the only plan that will actually work, as well as being the only one with a solid constituency (of healthcare reformers and a growing number of labor unions) pushing for it.

To join the fight for guaranteed healthcare (with a “Medicare for All” or SinglePayer financing), visit GuaranteedHealthcare.org, a project of the National Nurses Organizing Committee/California Nurses Association.

I’ve been watching the debate in the Congress over expanding S-CHIP (the State Children’s Health Insurance Program) today while waiting for my plane travel to Yearly Kos, and I’m reminded of how dishonest Republicans are on this issue.  They created the block grant program to give states the ability to cover children, and now when it’s become popular and successful, and state governors want to expand it more, they suddenly want to stop it.  And they’re using the familiar “this would let illegal immigrants get free health care” canard to try and submarine the bill (incidentally, it doesn’t).

It’s important to chronicle this, because it’s the opening salvo in the battle to change the health care system in this country.  In California we’re gearing up for health care reform, and today The California Budget Project and the UCLA Center for Health Policy Research released a joint report that ably shows the consequences of maintaining the broken status quo on health care as the Republicans want to do:

…many families spend a substantial amount on health care premiums and out-of-pocket costs, and could face financially devastating medical expenses if they are not adequately protected.  The report, “What Does It Take for a Family to Afford to Pay for Health Care?” (available at www.cbp.org and www.healthpolicy.ucla.edu) recommends that health care reform proposals – such as those proposed by the Governor and Democratic legislative leaders – ensure that families can realistically afford premiums and out-of-pocket costs, such as copayments and deductibles.

The report recommends that proposals fully subsidize health care coverage for those who earn up to 200 percent of the poverty line ($41,300 for a family of four) because the cost of housing, food, and other necessities leaves these families with few or no resources to contribute toward health care costs.  The report also determines that families need incomes near 300 percent of the poverty line ($61,950 for a family of four) just to afford typical health care costs.  Because some families face much higher out-of-pocket health care costs, the report recommends that policymakers consider providing subsidies for families with incomes higher than 300 percent of the poverty line.

This is EXACTLY what the expansion of S-CHIP would do, and yet Roadblock Republicans and the Bush Administration are concerned with defeating it solely on ideological grounds.  They don’t want America to see a health care system managed in a public way that works.  They fear people will see the differences between a system that gives people the choice for affordable care and a private for-profit system that values limiting care above everything, and opt for the former.  They don’t want government to work, and they will do everything in their power to make it malfunction.

(I do take issue with the idea that “the governor’s proposal,” which has no cap on affordability or any floor on coverage, would necessarily help needy families.)

Here are some of the key recommendations of the report:

Limiting families’ out-of-pocket costs.  Some insured families have very high health costs because they have very high copayments, deductibles, or other out-of-pocket costs.  Some of these costs are predictable (for example, if a family member has a chronic illness), but some can be unexpected (for example, as the result of an accident or unexpected illness).  Placing limits on out-of-pocket costs is as important as premium subsidies in ensuring affordable health care.

Taking into account expenses families face, such as housing and child care, when determining how much families can afford to pay for health care.  Because families face very different costs, such as housing and child care, income alone is an imprecise measure of what families can afford to spend on health care.

An average adult with private health coverage pays almost $800 a year on premiums; a family of four spends $1,800.  Poor families cannot cope, and forget about it if they actually want to USE their coverage.  We know that almost half of all bankruptcies are due to health care costs.

Californians need to send a strong message to Congress and the President to wholeheartedly support the continuation of S-CHIP.  And they need to send the message to our Legislature that we need real health care reform that allows working families to have the peace of mind of medical coverage while also being able to survive financially.

With Michael Moore’s SiCKO reaching more and more audiences, the traditional media have begun assessing the film’s criticisms of the collapsing US  health care system. Today the SF Chronicle joins the act with a front-page piece. While it’s far better than CNN’s disreputable hatchet job, the Chron piece still employs some framing of the discussion that leads its readers away from a single-payer solution. 

Because the media retains such a major role in shaping the way we discuss health care policy, it’s important for us to be attentive to the ways even a decent article can repeat misconceptions that might hurt the overall single-payer cause.

The article opens well, with a discussion of how health care polls as the top concern among Americans these days, as studies show that the US spends more money than other comparable countries – and yet receives worse quality in return. Victoria Colliver, the author of the piece, gets some great quotes about the “sick care system” here in the US and the staggering number of uninsured

Clearly, this suggests the public is hungry for reform – but what kind?

Moore’s film has been criticized for showing the positive side of health systems in other countries while glossing over negative aspects.

“There’s almost only positive attributes about the British, the French and Cuban system. Invariably, no system is perfect. I think this sort of detracts from his credibility on these comparisons,” said Stephen Zuckerman, health economist with the Urban Institute in Washington, D.C.

And yet the article does not detail what these supposed “negative aspects” of the French or British universal care systems are. The reader doesn’t get a chance to evaluate the pros and cons, because the cons are never really presented. One that is mentioned is wait times, but only in the context of Moore’s visit to an Ontario ER and hearing the Canadian patients saying they had no concerns about it.

Yet even this is misrepresented. The article notes that US waits for specialists or *elective* surgery (a distinction not made often enough) were the shortest in the world, along with Germany. But that is achieved only by strictly rationing who can have appointments with specialists or receive elective surgeries at all – whether it’s through the outright denial of health coverage, or by insurers keeping patients from those services. The full context of this supposedly positive aspect of US care suggests there’s nothing positive about it at all.

Colliver also repeats the flawed claim that Moore suggests socialized medicine “is free.” In reality SiCKO has a Labour MP reading from the NHS founding statement that says “this is not a charity.” She suggests that French care – whose positive aspects she does not discuss in detail – is accomplished only through crippling taxes and high unemployment.

The author does close the article with quotes from Americans living in France who praise that system. But this matter of taxes and economic activity is fundamental to the success of single-payer care in California and the US and so we should deal with it in some detail.

The impression given is that high taxes make for bad living. Unfortunately, Californians have drank deeply from this well over the last 30 years. If it was as simple as pointing out to Californians that, generally speaking, higher taxes levied in a progressive manner and spent on useful services are better for your wallet, we wouldn’t be in the mess we’re in today. All too few Californians make that kind of calculation – instead they tend toward a knee-jerk “all taxes are bad” view that brings us such joys as Prop 13 and the 2/3 requirement.

Behind this view is, in part, a belief that higher taxes will always cripple economic activity. This might have been true for a few years in the late 1970s. But when it comes to health care it is far from certain. As a recommended diary on Daily Kos today notes, health insurance costs are crippling American businesses. The only way businesses can survive is to make cuts to the coverages – so even though a worker might have some health benefits on the job (and are thus not counted as uninsured) they find that many of their health needs are not included.

The costs to American business and government of private health care are becoming well-known. They eat up an ever-growing chunk of state budgets and cut into corporate profits, leading to either less coverage or less hiring or less investment. The crippling of the American economy by the lack of single-payer health care should be at the core of any discussion of health care in the US, and its absence in this article is a significant omission.

As is the lack of any discussion of the flaws of private health insurance. As those who have seen SiCKO know, one of the powerful aspects of the film is its demonstration of the ways private insurers routinely deny care to people they have insured, often fudging the rules or breaking the law in the process. It’s not just the uninsured who are upset with the US “sick care system” but those who have insurance as well, those who pay high costs and find themselves facing less and less service in return.

Victoria Colliver should be credited for writing a better article than most on the subject, and surely we cannot expect her to write an article calling for single-payer outright. But neither does an incomplete look at the US system or an incomplete comparison with other systems that lacks details provide readers with the useful information they need when judging health care reform proposals. A full airing of the facts suggests single-payer is the best answer. Someday, I hope, the media will provide it. Until they do, we will.

Today’s guaranteed healthcare roundup, cross-posted at  the National Nurses Organizing Committee/California Nurses Associations’s Breakroom Blog, as we organize to make 2007 the Year of GUARANTEED healthcare on the single-payer model.

When Iowans want ethanol, presidential candidates leap to it.  When the state’s largest paper calls for guaranteed healthcare on the single-payer model…well, we’ll just have to see how that riles up the candidates.  The Des Moines Register did just that today.  Momentum is building.  Money quote:

What we hope {Michael Moore’s “SiCKO”} does: Spur Americans, at long last, to demand a system that covers everyone, while providing greater quality and reining in costs.

The best option for doing that: a government-financed system, much like Medicare, which covers America’s senior citizens. That wouldn’t be “socialized medicine.” Under Medicare, seniors still choose their doctors, and doctors don’t work for the government.

Barack Obama is soliciting health care policy ideas.  I’m going to email him the Des Moines register editorial.

Meanwhile the Des Moines Register finds that Blue Cross/Blue Shield literally have no shame.

In today’s New York Times, {sub. req’d} Paul Krugman slams FOX News for implying national healthcare causes terrorism.  If you remember Katrina, you know that our dysfunctional healthcare system is actually a major security vulnerability for this nation.  Krugman sums it up:

The only things standing in the way of universal health care are the fear-mongering and influence-buying of interest groups. If we can’t overcome those forces here, there’s not much hope for America’s future.

The Wall St. Journal finds that state plans to require employers to provide health insurance are illegal.  They’re right.  So why are politicians in California and other states still out there pushing them?

How to make a killing in the healthcare field?  Dr. Prem Reddy found where to start: restrict patient access to care.  Scary.

We should all follow NBC News’ story on Iraq and military medicine.  The U.S. is going to be working with our soldiers for many, many years as a result of the war.

John Conyers is an American hero.

And finally..is SiCKO Psycho?

To join the fight for guaranteed healthcare (with a “Medicare for All” or SinglePayer financing), visit with GuaranteedHealthcare.org, a project of the National Nurses Organizing Committee. 

Thanks to Frank Russo for informing us that Sheila Kuehl’s SB 840, the single-payer health care plan which is the the result of years of work and refining, has passed the California State Senate for the second straight year.  The mostly party-line vote was 22-14, with only Lou Correa voting with the Republicans against the bill.

Speaker Nunez and President Pro Tem Perata have health care bills up for votes, likely tomorrow, that are expected to pass.  Then the other chamber gets a crack at them all, then there will be some process of negotiation and merging of all of these health care-related bills resulting in whatever the Governor and the Legislative leaders decide is an acceptable final product.  It’s great that, by virtue of continuing to push SB 840 and not backing down, Sen. Kuehl will be in that room for those negotiations.  So this is not a fool’s errand, it’s a vital step to continue to push this state toward universal single payer healthcare and show the nation that it can be done.

On the flip for more legislative news…

In other news that really warms my heart, Sen. Gloria Romero’s SB 110, providing for an independent sentencing commission that will have the power to recommend sentencing guidelines, the TRUE way to reform our broken prison system, passed the State Senate.  Better yet, a companion bill passed the Assembly, so it looks like this sentencing commission proposal has a very good chance of winding up on the Governor’s desk.  Lou Correa again was the only Democratic Senator to vote against the bill.  I sense a pattern.  But it passed, and that’s spectacular news.  Hopefully the final bill will give the commission some teeth to actually mandate sentencing reform, and take the process out of the hands of “tough on crime” legislators.

And the Senate also voted to put the nonbinding Out of Iraq resolution on the February 2008 ballot.  I only really appreciate this in the sense that I’d love to see the Governor have to sign it.  Will he protect his party or “let the people decide?”  Other than that, I’m apathetic toward it, and I do believe it’s a stalking horse to get more Democrats to the polls in February, who may be more disposed to approving the term limits initiative that would allow the Democratic leadership to stay in office.

Yesterday I attended an event at the Santa Monica Democratic Club with State Senator Sheila Kuehl, who’s devoted the latter part of her legislative career to promoting and advancing SB 840, the single payer universal health care bill that the Governor vetoed last year.  Kuehl keenly understands the political dynamic of the health care debate in the state this year.  The Governor has vowed to pass a “universal” health care law this year, and he has vowed to veto Kuehl’s bill.  Nobody has brought the Governor’s initial program forward as a bill, and it’s likely that nobody ever will.  Both Senator Perata and Speaker Nunez have bills that are making their way through the relevant committees.  Sen. Kuehl’s bill has passed as well.  The Republican Assembly and Senate have forwarded piecemeal bits of legislation that don’t attempt to deal with health care in any kind of comprehensive way.

over…

Right now the advocates of single payer are continuing to build support.  Apparently there are ongoing talks with some hospitals to get them aboard.  It is likely that SB 840 will get to the Governor’s desk again, and it’s assured that he will veto.  Politically speaking, it’s positive (in my view) to keep advancing the same bill year after year and daring the Governor to betray his constituents and denying them the only comprehensive plan that ties health care to residency, not employment, and that will ensure that everyone in the state is covered with quality care.  If the Governor runs for higher office, that legislative history will be important.  Kuehl said that the Governor is not particularly interested in policy details; he wants to be able to sign something that he can call universal health care, whether the appellation applies or not.  Kuehl has signed on as a co-sponsor on Sen. Perata’s bill so that she can help steer it in a direction closer to universal care.  This is smart.  But the important thing is that any bill that’s passed this year (and there is likely to be something) should be seen as a stepping stone to the ultimate goal of single payer.  Because a “universal” program passes in 2007 does not mean the end of SB 840.  Kuehl, and whoever succeeds her in advancing the bill, will continue to build support, will continue to point to their funding mechanisms and study reports that prove the viability of single payer, and will continue to put forth a bill until there’s a governor who can sign it or a majority of Californians who can vote for it in an initiative form.  That initiative, according to Kuehl, should not be advanced until there is additional support among hospitals and doctors.

I am happy that Kuehl is using 840 as a means to get a better bill passed this year, while keeping focused on the ultimate goal of getting a real health care system passed that covers every single Californian.  The only way to rein in soaring costs is to ensure a baseline of care from a central pool that everybody pays into, with a system that is not based on making money but caring for people. And it’s important to note that Kuehl’s bill is not a pie-in-the-sky idea.  This is a detailed report on the financial structure of the proposal, showing how every single dollar can be accounted for, with every Californian able to access affordable care while saving total medical costs.  It’s a positive thing for the country that a plan of this nature is being offered with maximum seriousness and realism.  If it can be done in California, it can be done across the nation.

(Horray for people power! : ) – promoted by atdleft)

Over 1,000 nurses and patients marched on the California State Capitol today to demand guaranteed healthcare, at an event sponsored by the National Nurse Organizing Committee/California Nurses Association. 

This is why we’re going to have genuine healthcare reform: because we have a beloved, engaged constituency pushing for it.  What do the insurers have? A bunch of mercenary lobbyists.  We’re linking to some pictures here…take a look.

Why are we calling it guaranteed healthcare?  Because today, no matter what insurance  you have, you can be denied care for any reason.  No other nation in the world has their healthcare set up this way, and neither should ours.  State Senator Sheila Kuehl has proposed SB840,  a guaranteed healthcare bill with single-payer financing: patients choose a private caregiver who is paid from a non-profit, statewide fund.  And here’s what a health care hero looks like:

We also debuted a new Web site at this rally, devoted to one simple thing: letting people upload videos telling the story of their mis-treatment at the hands of the healthcare insurance industry.  We all know it’s a crisis-but we need to see the faces behind the crisis to be moved to action.  Go visit GauranteedHealthcare.org and upload your story.

Oh…and those “individual” and “employer mandate” plans pushed from Massachusetts to California?  A Trojan horse for the insurance industry…and more cruel denials of care.

“We expect our government to use our tax dollars to provide us with national security, and I contend that insuring us from illness and injury should be considered national security. Just compare the 3,000 Americans we lost on that dark day, September 11, 2001, with the 18,000 Americans who die every year due to denial of medical care. Private corporations, whose number one responsibility is to turn a profit for their shareholders, have proven themselves spectacularly unsuited for insuring our health, and every other civilized nation has come to the conclusion that health insurance is the proper function of government.”

That was Vern Nelson, local health care activist, giving an amazingly eloquent speech to the Costa Mesa City Council on why they should support SB 840, California’s plan for real universal health care. So what else happened at the city council meeting? Well, follow me after the flip for more…

Vern and his “posse” of people who care about health care access for arrived early for the city council meeting, and they were among the first ones to speak during the “public comments” segment, before the city council began to deliberate on the scheduled agenda. First up was Joe Tyndall, a computer tech writer from Costa Mesa who was concerned about the quality of health care in his own city. And in addition to his speech, he also provided all five council members with information packets on health care and why SB 840 is the only real solution for California.

“Americans pay more than $7,000 per person per year for health care, more than any other nation. Yet, we stand 37th in the quality of health care as measured across a wide range of indices. The cost of health care spirals out of control, while the number of Americans without health insurance continues to grow. Every other industrialized nation has a single-payer, Medicare-like system that leaves no person uninsured and costs roughly half as much per capita as our profit-driven, employer-based insurance system.”

Wait, isn’t Governor Schwarzenegger proposing “health care reform“? Dr. Richard Lara then explained to the council why Arnold’s “reform” doesn’t really change anything for the better.

“You, as a city, and we, as citizens, would save money if the health care crisis were solved. I suggest that you ask the Governor NOT to veto the solution if it comes to him again. He evidently feels guilty about that veto, for he is making a great show of interest in health care. He has admitted that there IS a crisis. He has proposed ten pages of band-aids. His scheme is like solving a transportation crisis by making us own a car. If you can’t afford it, the state will help you out, using tax dollars. The auto makers would love that plan. And the army of bureaucrats who will determine just how much help you need. This, from the man who wanted to shrink government!”

Wow, no wonder why no one likes his “health care reform” plan. But if Arnold-Care doesn’t solve anything, what does? If Arnold can’t solve our health care crisis, then what can?

Allan Beek, an Orange County resident who cares about real health care solutions, gave us the real solution: SB 840.

“SB 840 saves money- about $8 billion a year, according to the best estimate. […]
Medicines are bought at bulk prices… About 40% cheaper than what we pay here. (But the manufacturers won’t mind- they get 10 million new customers.) […]
Emergency rooms will be for emergencies only. Nearby hospitals will share, rather than duplicate, expensive equipment. One simple system of payment will replace 15,000 different insurance plans. Senate Bill 840 will cut administrative overhead from today’s 30% to at MOST 5%. We can all have preventive care and stay as healthy as nature permits. Preventing disease is cheaper than curing it. With all these savings, we can give a top-notch package of benefits to EVERYONE, still spending almost as much money total, so there will still be as may jobs. We don’t cause unemployment, but the jobs will be providing health care.”

After the presentation, Costa Mesa City Council Member Katrina Foley was quite impressed with this presentation. She actually asked the city’s legislative director to put together an analysis of all the current health care proposals in California- including SB 840. Fortunately, there are folks in Costa Mesa who see that city residents need a real solution for their health care problems.

And I guess this proves how SB 840 truly is the best choice for universal health care in California. OK, so all these great speeches still aren’t convincing you? Well, then go analyze SB 840 for yourself at Health Care for All. Here, you can see personal stories of struggle under the current privatized health care industry. And yes, you can find more reasons why we need REAL health care reform soon, and why SB 840 is the best course of action for that.

Don’t we owe it to our fellow Californians to provide them with health care security, once and for all?