(More reporting from the front lines, direct from our own in-house health care advocate – promoted by atdleft)

It’s not just America’s soldiers who are sitting in decrepit rooms begging for healthcare-all of us are in Walter Reed, writes a nurse leader today.  The Bush administration might fire a couple generals, but won’t show the door to the parasitic insurance companies that are hurting the rest of us.  Healthcare is, however, a big issue in the 2008 Presidential race already, writes a Washington Post reporter, but a major study by the American Association of Pediatrics suggests that the most common plans pushed by candidates will end up DECREASING preventive care and sentencing a generation of children to chronic health problems.  Lastly we take a look at anti-patient, right-wing propaganda blaming our true healthcare problem on sick people and Medicare.

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

Deborah Burger, RN, is President of the National Nurses Organizing Committee and has worked in hospitals for 30 years.  Over that time she has seen the criminal neglect of the sick and today writes:

The Bush administration’s attitude toward our wounded veterans parallels its behavior toward the rest of our healthcare system – neglect, inadequate funding, and privatization.
It also illustrates a disturbing pattern of misplaced priorities, record spending on a disastrous war while our healthcare security for veterans and millions of other Americans is left behind…

Since President Bush arrived in Washington, the number of uninsured has ballooned by 11%. It’s not much better for the insured. Nearly half say their insurer has refused to pay a medical bill they received, about a third say they have hesitated seeking needed care due to cost. Today half of all bankruptcies, and a third of credit card debt, is directly linked to medical bills.
Concurrently, the number of public hospitals in America has fallen by 30% the past 30 years, a period in which the combined debt of state and local governments has grown by 852% to nearly $200 billion.
It’s affecting huge proportions of our population. New York is preparing to close or merge dozens of hospitals, and Chicago officials just signed off on plans to shut or downsize 19 community and school based clinics….

The U.S. spends more, far more, on health care than any other nation, but much of it is diverted into the pockets of corporate CEOs, gobbled up in record profits for the healthcare industry, and consumed by administrative waste. Just last week the commission that advises Congress on Medicare reported that Medicare has to spend 12% more for care that is administered through private insurers than through traditional Medicare…

While Bush is unlikely to change his attitude, perhaps the next President will.  Christopher Lee in the Washington Post writes today that health is already a focus, with multiple candidates from both parties campaigning on the issue.

The problem?  The trendy policy prescription of “mandated insurance” does literally NOTHING to contain the healthcare costs that are bankrupting Americans.  As such, there is a huge vacuum for whatever candidate will have the guts to take on the private insurance companies that are the cause-not the fix-of those skyrocketing costs.  Such a SinglePayer system has been proven to work in every other developed nation in the world, but the candidates currently fear a backlash from the insurance lobby.  A real leader would take them on and fight to care for the sick and dying in this country who are living their thousands of “Walter Reed” tragedies.  Lee writes:

Although fixing health care is back in vogue, some analysts worry that the prescriptions of the presidential candidates miss the heart of the problem. All the talk about creating universal coverage has obscured the fact that most voters already have insurance, some analysts say, and what they are most concerned about is curbing costs.

“They want some more active government effort to change the way the insurance system works, and to put some more pressure on doctors and pharmaceuticals and hospitals to give a better deal to working people,” said Robert Blendon, a professor and public opinion expert at the Harvard School of Public Health. “The cost issue is a very important driving issue, and politicians haven’t figured out how to touch that nerve yet.”

Taking on costs is more difficult politically because it generally involves challenging powerful interests with a financial stake in the current system, including hospitals, doctors, and drug and insurance companies, said John Rother, policy director for AARP, the seniors lobby.

Even worse, the American Academy of Pediatrics thinks that the “mandated insurance” plans are a health hazard because they discourage parents from taking their kids to receive medical care.  Many of the plans that families will be mandated to buy are just junk insurance, with high deductibles and co-pays, and low caps.  Reuters:

But the American Academy of Pediatrics has joined a chorus of critics that fear high deductibles in the plans will lead patients to skip preventive care, such as immunizations and annual physicals in children. That could lead to costlier treatment down the road, for example, if a patient winds up in an emergency room.
“Faced with difficult choices, families may seek to ‘load up’ on a scheduled visit to save money or delay care until after the deductible is met,” the group wrote in the March issue of the journal, Pediatrics. The group represents 60,000 physicians in the United States specializing in treating children.

Only a SinglePayer system prioritizes care NOT insurance industry profits.  Policy wonks can read the report here.

Finally the anti-healthcare right-wing continues their jihad against America’s patients.  Their propaganda machine today kicks out lies that that the real problem in healthcare is people in this country use too much of it and that Medicare is too expensive.  Kick those patients and seniors out the door and we won’t have a healthcare problem anymore; plus it will be a boon to the mortuary industry. 

I take this as proof that the healthcare industry is worried by the growing national consensus that it’s time for change.

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Horray for the nurses… And horray for a health care proposal that actually helps real working people! : ) – promoted by atdleft)

State Senator Sheila Kuehl yesterday re-introduced SB 840, her historic bill to move California to a “Medicare for All” health plan.  These kinds of SinglePayer health systems exist in every other developed nation in the world and are the only solution to the problems of access and cost of healthcare-problems caused by the wasteful private insurance bureaucracy.  Schwarzenegger vetoed the bill last year; this year he has promised to bring about healthcare reform and, when SB 840 lands on his desk again, he will have to consider if he is serious about his promise.

The California Nurses Association is the lead sponsor of SB 840, and a strong advocate of H.R.676, the national bill sponsored by Rep. John Conyers.  Nurses are motivated to fight for SinglePayer healthcare because so much of their time is spent fighting insurance corporations on behalf of their patients.  A nurse explains below….

Brought to you by the National Nurses Organizing Committee/California Nurses Association as we organize to make 2007 the Year of SinglePayer Healthcare.

Deborah Burger, RN, President of the California Nurses Association explains why nurses support SinglePayer in her testimony from the SB840 hearing yesterday, and why nurses will continue to fight for it every way they know how, including in a new advertising campaign.  We are at a historic moment in this movement, and California’s progress should provide hope to people across the country that we can cure this healthcare tragedy that is touching so many of us.

Registered Nurses use what’s called the “nursing process” to assess and treat patients.  We are educated to collect objective and subjective data, synthesize that data, and apply our judgment skills to help patients survive both their health problems and the treatment for those problems.  When we ask a patient how they are doing, what their favorite flower is or if they have children, we are not just being pleasant.  We are noting their skin tone, their speech, their pain level, their emotional response and many other indicators of their overall condition.  We are doing a comprehensive assessment of their health, although it may not be apparent to them.

Applying the nursing process to the ailing patient called California, we note symptoms of less access, increasing costs and a less healthy population leading to a diagnosis of healthcare crisis.

The good news is that there is a cure.  It is called SB 840 authored by Senator Sheila Kuehl.

It is probably no accident that the same legislator who fought to protect patients in hospitals and authored California’s historic nurse-to-patient ratios is also the author of SB 840, a SinglePayer, or “Medicare for All” system, where everyone is in, benefits are better, and costs are controlled.  We are very proud, as the principal sponsor of SB 840, to work again with Senator Kuehl.

The California Nurses Association and nurses around the country have  fought insurance companies, HMO’s, patient-care gatekeepers, hospital corporate chains, and everyone else who wants to put us in the position of letting our patients suffer from inadequate care. 

We know one very important fact: a SinglePayer system is the only cure for the current market-based system that has turned our health into a commodity subjected to “insurance products” that cost more and deliver less every year.

Treating these symptoms with more insurance would be like treating a patient with lung cancer or asthma with cigarette smoke.

A SinglePayer plan is the only way to assure genuinely universal care – not universal insurance with a windfall to health plans.

It is the only way to avoid a multi-tiered system, assure better, more comprehensive benefits, and guarantee patient choice of physician and hospital. 

It is the only effective way to adequately control premium and out-of-pocket costs and to end an insurance bureaucracy that wastes 30% of every healthcare dollar because it quite simply takes the insurance middle man out of the middle.

Therefore, CNA RNs are proud to stand with Senator Kuehl, other advocates and other legislators who will fight for the right cure for California’s health crisis.

If you want to join the fight for SinglePayer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(Shiela Kuehl is back, this ought to be interesting. – promoted by dday)

While Schwarzenegger’s healthcare plan languishes, California State Senator Sheila Kuehl will re-introduce her historic SinglePayer bill tomorrow.  It landed on Arnold’s desk last year and it will land there again–except this year he has promised to finally deal with the healthcare crisis.  Elsewhere, Republican and Democratic Governors are fighting Washington for their healthcare dollars, indicative of the national consensus for reform, but the Cook County Board of Supervisors drops the ball by fighting for their patronage jobs instead.  Meanwhile bloggers and editorialists check in on the state of healthcare reform in this country.

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

The battle for genuine healthcare reform is shifting now to California, where tomorrow Sen. Sheila Kuehl, hero of the SinglePayer movement, will re-introduce SB840, the nation’s signature SinglePayer bill.  It was vetoed by Arnold Schwarzenegger last year even though, as Senator Kuehl remarks, 

“SB 840 represents the gold standard for healthcare reform-the plan that will move California into healthcare solvency and security, not only for ourselves, but for the generations that will follow.”

The time for this bill is now:

Universal health care is possible.  Polls are showing that 60% of Californians now support a publicly funded universal health care system over the current system.  The conversation is steering away from whether we need to enact such a system in favor of how.  SB 840, the California Universal Healthcare Act, is a very important step forward in this because it answers the how.

Here’s how it works:

SB 840 is the only proposal that establishes universal, affordable, comprehensive health insurance for all Californians and that guarantees the right of each patient to choose his or her own doctor.  SB 840 replaces insurance companies with a state-wide trust fund that collects premiums paid by employers and individuals, sharing the responsibility for funding.  This reduces the administrative portion of California’s healthcare costs from nearly 30% to under 10%.  With everyone in one risk pool, no one is denied coverage for a so-called pre-existing condition. Consumers are free to change jobs; start a business; go to school or start a family without losing the doctors they trust.

So what about Arnold?  He has promised to bring universal, affordable coverage to California.  His mask briefly slipped off this weekend, when he made a slightly different promise in reference to the insurance companies:  “You must let everyone make their profits.”

Nonetheless, he hopes to make his legacy with healthcare reform.  His problem is that his plan won’t work.  Legally, he won’t be able to mandate employers provide their workers with health care.  Practically, he won’t be able to mandate individuals to purchase insurance they can’t afford.  And financially, the numbers don’t add up. 

It’s interesting to note that Mitt Romney’s plan in Massachusetts is also facing severe problem; he over-promised and under-delivered.  Unfortunately for Schwarzenegger, RomneyCare was his inspiration.  Here’s one of many articles detailing the Massachusetts mess, in which a conservative activist notes “RomneyCare is in the intensive care unit, soon to be wheeled into hospice.” 

This kind of uncertainly is leading to legislative trouble for Schwrazenegger.  He has yet to find a sponsor for his bill, much of the state is still sitting on the sidelines watch the drama unfold, and it is entirely unclear that his plan will even get out of committee.  Moreover, the California Nurses Association today unveils a wide-ranging media campaign to shape public opinion about the Governor’s plan, and spread the word that it is an insurance industry giveaway barely pretending to address the problems of cost and access of healthcare.  The San Francisco Chronicle writes:

The ads are strong and striking in a political arena that so far has treated the governor’s health care plan with kid gloves.
Although a lot of interest groups have expressed doubts about parts of the governor’s plan, there’s been little public criticism. Many groups, like the Service Employees International Union and the California Chamber of Commerce, have said that they are withholding judgment until the legislative process takes it course and at least, so far, are willing to work with the administration. The nurses do not appear interested in being part of that effort.
“We will never be a part of any plan that benefits only the big insurance companies,” said Chuck Idelson, association spokesman.

Schwarzenegger will have to choose between affordable, universal coverage under the SinglePayer system proposed by Senator Kuehl or breaking his promise of healthcare reform.  The movement for SinglePayer healthcare runs through the California legislature for the next few months.

Around the country, despite the strong public mood for an increase in healthcare, much of our public health system is in deep peril.  A bi-partisan coalition of Governors is raising a red flag about underfunding of the State Children’s Health Insurance Program, a stop-gap program which helps millions of families.

The program in question, the State Children’s Health Insurance Program, covers more than six million children in families that have too much income to qualify for Medicaid but not enough to buy private insurance.

Karen A. Smigielski, a spokeswoman for the Minnesota Department of Human Services, said her state had a federal allocation of $48.6 million this year, would run out of money in July and would need $15 million to continue the program as it is.

In a separate letter to Congress, the National Governors Association criticized a Bush administration proposal to cut federal Medicaid payments to public hospitals and nursing homes. The White House says the changes are needed to ensure the “fiscal integrity” of Medicaid and to curb “excessive payments.”

It is extraordinary that Republican governors are forcing a confrontation with a Republican President over a healthcare issue.  Are we seeing healthcare emerge as the new third rail of American politics-the issue that no candidate dares to fail on?

If so, Cook County Board President Todd Stroger in Chicago hasn’t gotten the message.  Many of Cook County’s 5.2 million residents rely on their public health system, which is among the best in the nation.  Not for long, if Stroger has his way-his new budget would cut nearly 10% of the system’s nurses and close half the clinics, while maintaing 400 high-paid patronage jobs doled out by the politicians.

The County’s RNs, represented by the National Nurses Organizing Committee, promises a furious fight-back.  Watch this one.

Finally, the Agonist notes why market-based health insurance simply CANNOT work,  USA Today notes that we are approaching a choice: change the employer-based system of healthcare or junk it, and an insurance corporation executive argues that it’s not his bloated industry driving costs in our healthcare system-it’s those darn, sick patients!

If you want to join the fight for single-payer healthcare, sign up with SinglePayer.com, a project of the National Nurses Organizing Committee.  You can share your story about surviving the healthcare industry here, and start contacting media here.

(wouldn’t you know it, Ezra Klein wrote an almost identical piece, albeit from a slightly different perspective, at TAPPED.  It’s very much worth a read.)

Last night we were treated to a health care “plan” that would reward those who have shitty health insurance, punish the middle-class union workers who’ve bargained for better health insurance, and keep the private insurance industry afloat in the process.  Ruth Marcus thinks that this actual reading of the evidence of the plan is unfair.

If George W. Bush proposes something, it must be bad. Such is the knee-jerk state of partisan suspiciousness that when the president actually endorses a tax increase — a tax increase that would primarily hit the well-off, no less — Democrats still howl.

….Listening to Democratic reaction to Bush’s new health insurance proposal, you get the sense that if Bush picked a plank right out of the Democratic platform — if he introduced Hillarycare itself — and stuck it in his State of the Union address, Democrats would churn out press releases denouncing it.

Kevin Drum and Jonathan Cohn do away with this nonsense so easily that it’s not worth taking an extra swipe, showing that Bush’s plan is actually an attempt to preserve the health insurance industry and allow it to offer less and less services to their customers.  But there is an important issue in here that needs to be addressed, that I seem to keep coming back to in this health care debate. 

Republicans who say the words “universal health care” do have the effect of pushing the debate in a more progressive direction, and setting out universal coverage as the desired goal.  But IT’S NOT ENOUGH for them to be lionized for doing something that human dignity and a basic belief in humanity demands. 

Catherine Siepp of the National Review makes this mistake, and throws in a nose-thumbing at all Democrats for good measure.

But for some reason, the only politicians pushing expanded access to health care right now are Republicans: Gov. Arnold Schwarzenegger of California and former Gov. Mitt Romney of Massachusetts, who’s just left his post to become a (mean old) Republican presidential candidate in 2008.

The name’s Wyden, Ron Wyden.  And Ted Kennedy.  And John Edwards.  And Barack Obama.  And Ed Rendell, who’s moving forward with his own health care plan in Pennsylvania, which (while marginally similar to Schwarzenegger’s in California) actually addresses cost-containment and quality of care, frankly the only issues that are going to make health care more affordable and more desirable.

So if you agree that the broad cross-section of the public, and the broad cross-section of the political spectrum want universal care (though the Democrats have been waiting for the Republicans to get there since 1994), it behooves you to actually take a look at the plans, and not give them a free pass because they kinda sorta seem like they want to help people.  Which is how Mitt Romney got so much praise for getting a plan through in Massachusetts that actually will slowly begin to bankrupt the uninsured:

Uninsured residents will have to shell out a quite a bit more than originally expected to get mandated health-care coverage, according to the group charged with introducing the coverage.
Monthly premiums to meet the state’s minimum coverage under last year’s universal health-care law would cost $380 on average and could cost up to $580 for a 56-year-old.

The plans are meant for roughly 200,000 uninsured Massachusetts residents who aren’t eligible for publicly subsidized insurance programs, said Bob Carey, director of planning and development at the Health Care Connector Authority. The group sent out requests for proposals to health insurance companies asking for the cost if they provided 60 percent of the benefits from an above-average health insurance plan. The cost ended up $100 higher than expected.

“This is bad news,” said member Jon Gruber. “We used to think it was going to cost $260.”

So it’s not enough to come up with some magical way to insure everybody.  Content matters, and some fundamental principles must be preserved.  I believe health care is a right and not a privilege for those who can afford it.  I believe in the importance of covering all children regardless of any other factor because it’s cheap, it promotes wellness throughout life, and it can prevent diseases which are more serious in children than adults.  I believe that trying to partner with the private insurance industry is like making a deal with the devil, and that the only market-oriented solutions that make any sense include things like guaranteed issue and community rating, so nobody is discriminated against for health care based on who they are.  I believe in baseline minimums for basic care that are far above what is typically considered in these plans.  I believe that forcing a marketplace through an individual mandate that doesn’t include a “Medicare for All” option does nothing but subsidize for-profit industry. I believe that health care with a huge deductible and giant co-payments is not health care.  And I believe that single-payer is the best way to keep down costs and keep the system efficient, and that anyone who studies the issue will come to the same conclusion.  Failing that I like Jacob Hacker’s solution from the Agenda for Shared Priorities.

A far better alternative was recently proposed by Yale Professor Jacob Hacker and the Economic Policy Institute. Employers would either have to provide good insurance, or pay a tax of six percent of payroll. People without insurance could buy into a public program much like Medicare, on a sliding scale. That same program would enroll people whose employers elected to pay the tax instead of providing insurance.

Hacker estimates about half of all Americans would soon be in the universal pool. Over time, the superior efficiencies of the public program would attract more people. The private health insurance industry, as a superfluous and inefficient middleman, would gradually dwindle. We’d eventually get universal and public coverage without the fragmentation.

Of course, the people who brought us HMOs will fiercely oppose it, but that’s not necessarily bad. Harry and Louise, the stars of the insurance industry commercials that helped kill the Clinton plan, have a lot less credibility these days. Reformers seeking universal coverage should recognize that the private insurance industry is less a credible partner than the prime obstacle.

For the Beltway punditocracy, their bretheren in the states, and people who don’t pay a lot of attention, having a health care plan means that you are a beneficent soul trying to improve people’s lives.  I don’t begrudge motives, but it’s not enough just to be FOR the general principle.  You have to support something that’ll actually work.

Let’s get the particulars out of the way.  I’m dday, in the real world I answer to Dave Dayen, and I, like hekebolos, am running for CDP (California Democratic Party) delegate this weekend.  In fact, there are over 20 progressive bloggers running for CDP delegate slots all across the state.  My district, AD 41 (the fightin’ 41st), stretches along the coast from Santa Monica all the way up to Oxnard.  There’s a map here.  The 41st AD caucus meeting is on Saturday, January 13th at 10 a.m., at the Malibu Library, located at 23519 Civic Center Way (Mapquest it).  If you or someone you know is a registered Democrat in my district, I’d be honored to have you (or them) vote for me and the entire Progressive Slate.  The full details are at this DFA link.

But what I want to tell you about is my experience last night, where I gave the first campaign speech of my entire life, and how I have the blogging community to thank for the results.

So MoveOn.org is doing this “Mandate for Change” campaign, where members get people in their community to sign “photo petitions”.  Instead of just signing a petition asking for bold leadership on major issues (Iraq, health care, clean energy, restoring democracy through election reform) and sending it to your Congresscritter, in this campaign people are asked to take a picture holding up a personal message for their Congresscritter.  Then we’ll hold personal meetings with the Congresscritters or their staffs and hand-deliver the photos of their constituents asking them for change.  It’s a nice little idea.  Here’s a flickr photo set of hundreds of these photo petitions.

My local MoveOn chapter (yes, they have chapters now) held a meeting yesterday to discuss the photo petition project.  I’ve been fairly active in this campaign and with this particular chapter, so I attended.  I also printed up a bunch of flyers about my election on Saturday to distribute to the group.  We ended up having about 35 people at the meeting.

I actually had a separate role to play at the meeting, to lead the discussion about the latest part of the Mandate for Change campaign, which is a drive to write letters to the editor (not astroturfing, but ACTUAL grassroots action!).  So I went ahead and discussed that, and gave my thoughts on how to get a good LTE published (key point: less use of the phrase “ignorant MSM fuckhead” increases chances of publication).  And right after that, the meeting organizer said, “And Dave also has something exciting that you can get involved in this weekend, and that’s his election for CDP delegate.  Care to tell us about that?”

This wasn’t totally unexpected, but also not expected to the extent that I prepared anything.  But in a way, I’ve been preparing since roughly 2002.  This community and the progressive blogosphere is an incubator for ideas and framing and ways to relate your message.  I knew why I was running (in fact, I wrote about it right here).  The California Democratic Party is an invisible institution that comes around for two weeks every two years and places election ads.  Other than that, they’re a nonentity.  Here’s what I wrote then:

I’ve lived in California for the last eight years.  I’m a fairly active and engaged citizen, one who has attended plenty of Democratic Club meetings, who has lived in the most heavily Democratic areas of the state in both the North and South, who has volunteered and aided the CDP and Democratic candidates from California during election time, who (you would think) would be the most likely candidate for outreach from that party to help them in their efforts to build a lasting majority.  But in actuality, the California Democratic Party means absolutely nothing to me.  Neither do its endorsements.  The amount of people who aren’t online and aren’t in grassroots meetings everyday who share this feeling, I’d peg at about 95% of the electorate. 

I mean, I’m a part of both those worlds, and I have no connection to the state party.  I should be someone that the CDP is reaching out to get involved.  They don’t.  The only time I ever know that the CDP exists is three weeks before the election when they pay for a bunch of ads.  The other 23 months of the year they are a nonentity to the vast majority of the populace.

And this has a tremendous impact.  The state of California is hardly deep blue.  It’s had Republican governors for 80 out of the past 100 years.  The last time the Democratic Party meant anything to California’s citizens was in the time of Alan Cranston and Pat Brown in the 1950s and 1960s, when the Democratic Club movement began, and when the state party was most involved with the grassroots.  At the time, the party was committed to progressive values and offered a real politics of contrast to move the Democratic brand in the state forward.  This has receded in the past 30 years.

But it’s actually worse than all that.  The Republican Governor of this state is getting a lot of publicity this week for submitting a universal health care proposal that essentially says: “I won’t rest until everybody in this state is paying for really crappy coverage!”  The plan doesn’t go far enough in addressing cost containment, forces people to buy insurance without defining what “basic coverage” is, provides a cheap opt-out of providing coverage for employers, and basically maintains the same system where greedy insurers get rich off the backs of the citizens of this state.  Most solid progressives, like my state senator Sheila Kuehl, understand this.  There are only two figures statewide who have had nothing but good things to say about the governor’s proposal.  They are Don Perata, Democratic leader in the Senate, and Fabian Nuñez, Democratic leader in the Assembly.  It’s a curious way to negotiate.

That’s because the state party and its top officials are primarily interested in maintaining the status quo.  They have incumbency protection through redistricting, are slathered with special interest money by being in the majority, and have no desire to upset that apple cart.  This is EXACTLY why membership in the CDP is slipping.  They work around the margins and do generally a decent job, but they have no leadership on the big issues, and no connection to the grassroots progressive movement that attracts ordinary citizens and lets them know that the Democratic Party is working in their interests.

So it’s with this as background, that I began to say a few words about the election.  And it became entirely clear to me that I was actually making a campaign speech.  I was talking about the need to build a movement from the bottom up and not the top-down.  I was talking about how the national agenda is important, but what happens in your own backyard really matters, especially in a state like California, which oftentimes sets the agenda for the rest of the nation to follow.  I was talking about the need for bold, progressive leadership, to make the CDP more responsive, more effective, and more relevant.  I was talking about the Governor’s health care proposal and how we need a credible alternative.  I was talking about how we had to wrest the party away from the narrow-cast, special interest-driven agenda of the current leadership and return it back to the people, about how we have to compete everywhere in the state and not just where we have large majorities.

And I realized that I have written about all of these things at one point or another.  I’ve internalized the concepts and sharpened my dialectic to a knife’s edge.  I’ve tried arguments, seen them rise or fall, seen people agree or disagree, and tried them again.  I’ve been running this speech through in my head since I first discovered blogs in 2002.  It came out so naturally and easily, that I have to conclude that the blogosphere is the greatest primary campaign that any candidate has ever experienced.

Now, this was a friendly audience made up of MoveOn members.  But I’m fairly certain that a bunch of them had about as much of a relationship to the CDP as most of the rest of the state, which is to say none, before that speech.  But before I even got around to saying “I’d like your vote, and I have some flyers here with all the information,” one of them asked, “How can I get involved?”  Then another.  They were really interested in the process and surprised that they didn’t know about the election at all.  I sent around the flyers and got commitments from a bunch of people to come out and vote.

(I’d be remiss if I didn’t mention that one of the people at the meeting was a fellow colleague on the Progressive Slate, Ellis Perlman, a retired political science professor with an incredible array of knowledge about state politics, and a desire to see change.  He spoke as well and he was fantastic on giving the history of grassroots movements in the state, and the need to check runaway executive power – sound familiar? – with a robust legislature committed to offering real alternatives.)

Upon leaving to go to the crappy night job I have this week (I didn’t get home until 5:30AM last night, so forgive me if this is rambling), I reflected on how this speech and this moment changed me.  In a way it was both a culmination and a beginning.  If we’re ever going to change America, all of us need to understand that democracy demands participation.  Online activism of the “I did something for the movement!  I clicked SEND!” variety is nice and all, but it’s ultimately insufficient.  I’m comfortable with public speaking but not necessarily with being a leader.  But what I took away is that we all have the capacity to lead, to call for change, to be a part of this progressive movement all across the country.  All it takes to do so is the will.  You can create the opportunity.

(This is my personal opinion on the subject, others may differ. The Governor’s proposal is so expansive and desperate to be liked that there’s something for everyone to praise and denounce. – promoted by dday)

OK, I think I’ve read every possible news report about the Governor’s health care proposal, and I’m still confused.  Why exactly is this called “universal care”?  It doesn’t ensure that everybody is covered, it demands it.  That’s not universal care, that’s a universal threat.  And while I agree with Ezra Klein that even single-payer health care is a universal mandate in that it uses required taxes to fund health care, applying that mandate without cutting down costs for consumers makes this a fantasy, as Ezra explains.  On the flip…

The question with an individual mandate is subsidization and affordability. If we pass a law levying an individual mandate and subsidizing premiums down to $50 a month, there’ll be few complaints. A mandate with no subsidization, however, is an impossible burden on millions of families. When evaluating an individual mandate, that’s where liberals need to focus: The generosity of the subsidies. The Wyden Plan, for instance, subsidizes up to 400 percent of the poverty line. The Massachusetts plan subsidizes up to 300 percent. The Schwarzenegger plan subsidizes up to 250 percent. That looks too low, and I’ll talk more about it later today.

I look forward to seeing that, Ezra is very good on this issue.

This plan is very reflective of the Governor’s newest persona as a post-partisan.  What makes it ultimately unsatisfying and potentially dangerous is that it lacks the same thing the Governor lacks: core beliefs.  Instead of trying to jerry-rig all of these different ways to find the money so that everyone in the state has a low, vague level of health care (if I read this right, under this plan my premiums would go up and my coverage would go down), why not step back and try to lay out what the end goals are?  I believe that health care is a right and not a privilege.  I believe the money spent on health care today is enough to fund a successful, robust system where people get quality care, doctors and hospitals make money, and the public at large is generally healthier.  If that was the goal, you wouldn’t continue to perpetuate this myth that employers have an obligation to make sure their employees are healthy.  On this score I completely agree with the LA Times editorial board:

The problem is this: It makes no sense to legally and permanently make Californians’ access to healthcare dependent on their employers. Companies hire workers and pay them for their time, talent, muscle and brains. Employers must meet certain standards to do business in the state – complying with workplace safety laws, paying the minimum wage, providing workers’ compensation insurance, etc. But they should not become the primary mechanism for the state to deliver vital services to citizens.

This is more true here than elsewhere because so many Californians who need insurance have only marginal or temporary relationships with employers. Companies, meanwhile, face plenty of challenges just staying in business and keeping up with the dynamics of the modern marketplace without being saddled with a new health insurance tax.

What ends up happening, and would still happen, is that people would stay in dead-end jobs because of their health insurance, because the subsidies wouldn’t be big enough to justify the poor care and the cost of going it alone.  And American companies are less competitive because they stand alone in bearing the burden of health care.  And taxing companies who opt out of paying for employee health care by 4% of profits is a pittance compared to actual health care costs for companies.  You’ll end up with a de facto state-run health care system with no possibility to rein in costs.  The cost-containment strategies, mainly HSAs and telling people to join a gym, are laughable.  Employers can’t provide health care and compete in a global marketplace, and the state cannot fund health care without keeping costs down.  The plan does neither.

(Never mind the fact that a key point of funding this mish-mash is by taking $2 billion out of the public health system.  The funding aspect of this is almost totally ridiculous.)

Another core belief of mine is that no plan should keep in place and largely intact the for-profit insurance system which, through greed and dirty dealing, benefits from its own stinginess in denying care and trying to eliminate the sick from their rolls.  The Governor’s plan would be the greatest thing ever to happen to the private insurance industry.  It would give them four or five million new consumers, who they would be required to provide with care.  That’s a positive step, but it does nothing to contain costs for those consumers based on age or occupation.  Insurance companies can jack up rates that Californians MUST pay.  How’s that for a license to print money? 

The CNA has a very good roundup of this plan which I urge you to read.  And I’m pleased with the reaction of Art Pulaski of CalFed.

“While the Governor’s healthcare proposal includes some positive elements, it is the wrong prescription for California’s health care crisis. This proposal will be a boon to insurance companies, but a bust for most workers. This plan requires all Californians to buy health insurance with no guarantee that it will be affordable or that coverage will be adequate. We are concerned that the plan creates an incentive for employers who currently provide health care to drop coverage and instead pay only a minimal tax.”

That’s it in a nutshell.  And I really hope that Democrats in the Legislature, who were very nearly effusive in their praise of this strategy, wake up and figure this one out.  Perata and Nuñez are pretty much alone in their support.  Is this tactical?  If so, it’s the worst tactical maneuver I’ve ever seen, and calls into question what their goals for health care really are.  It doesn’t seem to be changing a broken system.  It doesn’t seem to be making health care affordable for everyone.  It doesn’t seem to be doing anything but making insurance companies rich.

This is a very Republican program in that it puts the risk and burden of health care, largely, on individuals.  Just like moving pensions to defined contributions from defined benefits, just like proposals to privatize Social Security instead of keeping it protected, just like “free trade” causes job insecurity for the vast amount of America’s workers, the message to individuals is simple: YOYO.  You’re On Your Own.  That’s what this proposal is for Californians. 

As I mentioned yesterday, nyceve has been doing incredible work looking into the crisis of healthcare nationwide.  Today, she highlights a disturbing LA Times story about how insurers in California pretty much refuse to cover potential consumers unless they’re Jack LaLane (and even then, Jack had better not have a pre-existing condition).

Frankly today I don’t know whether to laugh or cry. The stupidity. The abject stupidity. And Americans accept this as “normal”?

Perhaps something is wrong with us, with the citizens of the United States for tolerating this crap.

So without further delay, let’s end the year on a high note.

And once again, ask yourselves, if our elected representatives suffered these indignites, remember they serve us , how quickly the for-profit insurance industry scam might collapse.  Do you think they would tolerate such abuse?

In California, if you are say, self-employed (the backbone of the American economy, per George Bush), and you need to buy an individual health insurance policy, in a word. You. Better. Be. Healthy. Period.

This is what the Los Angeles Times is reporting this morning in a front page story. By the way, the reporter, Lisa Girion, deserves a Pulitzer for her ongoing and  extraordinary coverage of the corrupt, cherry-picking health insurance industry in California.

Scott Svonkin joined the Los Angeles County Commission on Insurance 10 years ago because he was concerned about an emerging problem: people losing health coverage. Since then, the ranks of uninsured Americans have swelled to more than 46 million.

Svonkin almost became one of them.

. . .As it turned out, Svonkin was rejected by not just one but three of California’s biggest health insurers, which cited his history of asthma, among other things.

“I couldn’t buy it at any price,” said Svonkin, 40, who lives in Sherman Oaks. “I remember thinking, ‘This can’t be happening to me.’ “

I want to interject here at this point, because I am in exactly the same position as those in this article.  I’m self-employed, living in California, and I have, in fact, a prior history of asthma.  I had to practically beg Blue Cross to take me in 2004 (when I fully went free-lance, and dropped the coverage I had with my employer), and since I have had Achilles tendon surgery since then, I pretty much have to stay with the greediest, sneakiest, most depraved insurer in the nation.  It seems like it’s only gotten worse since then.  As it is, I have high-deductible coverage that doesn’t cover routine things like MRI’s (which I paid completely out of pocket in the summer of ’04).  I can certainly afford coverage that’s better, but at this point, nobody would cover me.  This is well-known to anyone who has to arrange for their own insurance.  I’ve been turned down before, even by so-called “good guys” like Kaiser.  It’s this knowledge, that any prior history will cause rejection, that pushes people to fib on their forms, which Blue Cross uses to its advantage later by dropping people after they make a claim.  Blue Cross doesn’t mind if you lie a little on your form if you pay them; it’s only when you want something FROM them that they’ll drop you.

Consumer advocates see the practice as cherry-picking – a legal form of discrimination that is no longer tolerated in schools, public accommodations or workplaces – and a way to guarantee profits.

“The idea is to avoid all risk,” said Bryan Liang, executive director of the Institute of Health Law Studies at California Western School of Law in San Diego.

Jerry Flanagan, an advocate with the Foundation for Consumer and Taxpayer Rights, said it wouldn’t take much to be left out of the private-insurance market. “A minor asthma condition or a surgery 10 years ago that requires no further medical care is enough to get you blacklisted forever,” he said.

As a result, some people forgo treatment so as not to tarnish their health records. Others withhold information from doctors or ask them to leave details out of their records. For those who are uninsurable, healthcare often is the chief reason they stay in or take a certain job.

. . .Consumer advocates say out-of-date, ambiguous and even erroneous medical information can render people uninsurable. Sometimes the reasons can seem absurd. In a letter to an otherwise healthy recent college graduate, for instance, Blue Cross listed among the reasons it denied coverage a past bout of jock itch, “successfully treated with cream.”

. . .Blue Shield declined to discuss Svonkin’s case, citing patient privacy laws, as did the other insurers that subsequently rejected him, Blue Cross and PacifiCare. Although the rejection notices pointed to various problems – “expectant fatherhood” and swelling from a spider bite – all three blamed his history of asthma, a condition that affects more than 4.5 million Californians.

This is why we MUST have universal health care to prevent this kind of ruthlessness from happening.  For-profit insurance companies have a responsibility to their shareholders and their corporate boards, and the people have no part in that. 

Few mention this, but the American healthcare system is something of a mistake. It blossomed out of a World War II tax reform meant to guard against corporate war profiteering. Liberals, with their usual combination of good intentions and inadequate foresight, imposed massive marginal tax rates on corporations, effectively freezing their profits at prewar levels. But the law had a loophole: Corporations could funnel their wartime riches into employee benefits, such as healthcare, thus putting the cash to use within their company. And so they did, creating the employer-based healthcare system.

But healthcare was simpler in the 1940s, and far less expensive. In the 21st century, it’s not simple at all. Once a perk of employment, health insurance is now a necessity, and a structure that dumps such power, complexity and cost in the laps of employers is grotesquely unfair to both businesses and individuals. There’s no logic to an auto manufacturer running a multibillion-dollar health insurance plan on the side; it should stick to making cars. There’s no excuse for pricing the self-employed and entrepreneurial out of the market. And there’s no reason the owner of a three-employee start-up should have to go to bed with a heavy conscience because his coffee shop can’t pay for chemotherapy.

But health insurance is not only the inexplicable responsibility of business; it is a big business, which is why the system survives. The medical-industrial complex is a massive, remarkable beast, consuming a full one-ninth of the American economy and offering astonishing profits to many of the participants (indeed, Big Pharma was the most profitable industry in the U.S. from the 1980s until 2003, when energy companies wrested away the top spot). As with any lucrative industry, the winners are resistant to reforms, and they have a formidable army of politically lobbyists, PR specialists and image consultants helping to preserve their position, to preserve a mistake.

It’s unconscionable to keep the system the way it is, and I hope Ezra Klein is right, that change is around the corner.  But to go into the buzzsaw that is the present insurance industry is going to take an enormous amount of political will, as well as a grassroots movement to understand the nature of the problem, and why going single-payer is the most rational alternative.  I think Senator Wyden’s proposal, which uses community rating to ensure everybody pays the same price no matter their expected level of care, deserves serious support and scrutiny.  What will come out of California, which will certainly be a compromise, will go a long way to determining what will be acceptable to the nation at large.  We should not lay down our arms for universal health care before those negotiations even begin.  And we should not allow a system to continue where people who can afford quality care can’t get it – because the insurance companies don’t want to take the risk of paying even a dime to care for them.

(The Money Comes in, The Favors Go Out. It’s time to stop this cycle. So many issues would get a better crack at the apple if we didn’t have all this money flowing into Sacramento. Think about recommending this on Daily Kos. – promoted by SFBrianCL)

Cross-posted at Daily Kos

With the Katrina anniversary, there has been lots of talk about what government needs to do to protect citizens from another disaster. The other day, California Assemblymember John Laird told the Capitol Weekly, “We have less flood protection than they had in New Orleans. Sacramento is really not protected and the thousands of people who live here are at risk.” But this wasn’t a story about the anniversary, this was a report on how flood protection in California died a suspicious death in the legislature:

This week, just as Senate President Pro Tem Don Perata put on hold an eight-bill package of flood-protection legislation, one of his political committees received a $500,000 donation from the California Building Industry Association (CBIA), one of the package’s biggest opponents.

The donation is the single largest that a Perata committee has received since he became Senate leader in 2004.

In response, the California Majority Report noted, “As is the case with many policy areas that the legislature deals with, especially this time of year, eyebrows were raised about the timing of all of this.” In addition being a policy disaster that risks lives, these scandals harm people’s faith in government, decreasing participation in a vicious cycle that gives even more power to the special interests who run Sacramento.

In May, the Public Policy Institute of California polled on the issue (May 14-21, 2000 adult residents, +/- 2% MOE):

Do you think that campaign contributions are currently having a good effect or a bad effect on the public policy decisions made by state elected officials in Sacramento, or are campaign contributions making no difference?”

Good Effect	12%
Bad Effect	56%

The big money that controls Sacramento is so excessive, that it is easy to see why the polls show people realize how it is harming policy. If you check out yesterday’s San Francisco Chronicle, you’ll see an editorial blasting the “nasty moves” that special interests used to kill flood control. It is easy to see why people who pay attention are disgusted by the way Sacramento operates like an auction.

Special Interests Killing Universal Health Care Legislation

Yesterday, the California Assembly passed historic Universal Health Care legislation. This bill would save $8 billion a year and at the same time provide insurance for 6 million Californians. Sounds too good to be true? Well here comes the but…

Insurers have spent $3.7 million in campaign contributions in California since 2005.  Governor Schwarzenegger, who alone has received $765,000 from health insurers, has said he will veto the bill.

The big money has a proven ability to stop sound policy, and so California will waste $8 billion a year so that 6 million less people will have health insurance.

Special Interests New Deregulation

Public safety and health care aren’t the only areas where big money dominates in Sacramento. While lawmakers are holding dozens of fundraisers as they wrap up the legislative session, AT&T lobbyists are hitting the jackpot:

The Public Utilities Commission (PUC) gave AT&T and smaller Verizon permission to raise telephone rates at will, even as a telecommunications deregulation bill — a bonanza for AT&T and a bane to consumers — sped toward passage in the state Senate, jammed with last-minute amendments. […]

AT&T, while publicly billing the deregulation as beneficial competition in the video market, has not promised any rate reductions or other specific consumer benefits. It has poured nearly $18 million into lobbying efforts over the last few months, and $500,000 into direct political contributions during this election cycle, noted FTCR. That does not include contribution pledges made during legislators’ mad dash of fund-raising during the last three weeks of the legislative session, which ends next Thursday. These contributions will not be known until after the hundreds of measures still coming to a vote are passed or killed.

Yes, it sounds exactly like what went on during electrical deregulation, but as with flood protection, government can’t learn from past mistakes when special interests are running the show.

Solution: Proposition 89

Proposition 89 is the Clean Money and Fair Elections initiative that California will vote on this November. Put on the ballot by the California Nurses Association of anti-Arnold fame, the proposal addresses that systematic problems that are holding back good policy on a wide array of issues. Here are the details of Proposition 89.

Strict contribution and expenditure limits
Prop. 89 ends the fundraising madness with constitutional limits so regular voters aren’t drowned out by big money.
* Proposition 89 bans contributions from lobbyists and state contractors
* Proposition 89 limits contributions from corporations, unions, and individuals to state candidates
* Proposition 89 limits corporation donations to initiatives to $10,000

Clean Money public financing of political campaigns
Prop. 89 levels the playing field so new candidates can win on their ideas, not
because of the money they raise.
* With Proposition 89, candidates who agree to spending limits and to take no private contributions qualify for public funding
* Under Proposition 89, $5 contributions from voters required to prove viability
* With Proposition 89, lean candidates receive enough to run competitive campaigns. They can’t raise money beyond public funds

Tough disclosure and enforcement for politicians
Prop. 89 stops candidates from hiding behind negative ads and punishes politicians who violate the law.
* Proposition 89 makes wealthy self-funded candidates disclose the amount of personal funds they will spend
* Under Proposition 89, publicly financed candidates must engage in debates
* Proposition 89 imposes mandatory jail time and provides for removal from office of candidates who break the law.

The Challenge

Of course, the special interests who dominate Sacramento are spending at least as much money to stop Proposition 89 as they spend for each issue where they want to dominate the debate. While we won’t have as much money as the opposition, what we do have is a great initiative, a reality-based argument, lots of supporters, and trusted organizations like the League of Women Voters, Common Cause, California Nurses, the Consumer Federation of California and the Foundation for Taxpayer and Consumer Rights all aggressively and creatively working to pass the initiative.

We would also like to have your support. We have started a campaign blog to keep supporters up-to-date and would appreciate it if supporters would sign up for email updates. Thanks for reading all the way down.