Today’s meeting of the nation’s leading single payer activists with Sen. Max Baucus was historic, and a recognition of the power of the tens of thousands of nurses, doctors, and grassroots activists across the country who have been turning up the heat on the policy makers in Washington.

Make no mistake – your voices are being heard. And, the protests and pressure will continue.

As Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee, told Baucus, “there is a groundswell” across the country that will continue to press for single payer reform, and Baucus and other policy makers in Washington “are going to get to know us very well.”  In a later press conference, DeMoro blasted the conventional wisdom that single payer is not politically viable. “Is it politically viable to let people die and suffer from a lack of political will?” Noting the fight for women’s suffrage and the civil rights movement, she emphasized, “we’re going to have to turn up the heat. Women did not get the right to vote by voting on it.”

Today’s gripping meeting was in itself an important part of that campaign, with leaders of the CNA/NNOC, Physicians for a National Health Program, and Sen. Bernie Sanders, author of a single payer bill in the Senate, S 703, making a forceful, unfiltered case to one of the top power brokers in the Senate, Max Baucus, for single payer as the only reform likely to actually fix our broken healthcare system and effectively control costs.  A couple of photos from the press conference afterwards are here.

For the first time, Baucus, who has been deluged with protests inside his Senate Finance Committee which has been in the forefront of drafting legislation and in town hall meetings at home in Montana, was apologetic. “I made a mistake,” he said, “I should have left it (single payer) on the table, front and center with everything else.”

Baucus talked about his own positive experiences in Canada where he inspected the Canadian healthcare system first hand, “I was very impressed,” during the healthcare debate in the early 1990s, noting the contrast between a Montana hospital which has an “entire floor” of people devoted to billing, and other administrative paper work, and a nearby Canadian hospital which does it all “in one room.”

He agreed to use the power of his office to have charges dropped against the Baucus 13, nurses, doctors, and activists arrested for raising their voices in the committee hearings.

While Baucus continued to aver that single payer can not pass the legislature, the nurses and doctors pressed him to:

•              Hold a hearing in which the merits of single payer can be contrasted with the plans now rapidly advancing in the Senate. While Baucus said the tight timeline made that very difficult, Sanders noted that Sen. Chris Dodd is considering a health committee hearing on single payer, which Baucus could co-sponsor. Baucus said, “let me think about it.”

•              Have the Congressional Budget Office score, do a financial analysis, of single payer legislation in addition to other health bills it scores.

•              Support legislation to allow federal waivers for individual states to enact single payer systems as national role models (another Sanders bill).

•              Assist in arranging a similar meeting between single payer leaders and President Obama.

Ultimately, Baucus threw the ball back to the President, citing the demand of the President to Congress to have a bill on his desk by October. “He wants a big win on healthcare reform,” Baucus said.

But the rush to adopt a flawed bill would hardly serve the Senate or the President well, DeMoro noted. “The President would be putting himself in a very bad position. We don’t want that to happen.”

One after one, the other participants made compelling cases for single payer. Dr. Marcia Angell, former editor of the New England Journal of Medicine, noted that only single payer can achieve effective cost controls. The alternatives being considered are “all unaffordable and unsustainable. Why pour more money into a dysfunctional system.”

PNHP co-founder Dr. David Himmelstein said  “the decision should be made on what’s going to work.” He cited the Massachusetts law, where he lives, which is considered a model for both the Baucus proposal and the pending Kennedy bill. The bill is rapidly “fraying,” said Himmelstein. Some 28,000 state residents are about to be cut off of subsidized coverage because the state can’t afford it, and new studies show conditions for many state residents back to where they were before the bill was passed with inadequate or no coverage, and medical bills they can’t pay.

Geri Jenkins, RN, Co-President of CNA/NNOC, said “we need evidence based policy,” and all the evidence shows that single payer is the best way to contain costs, improve quality, and achieve universality.

PNHP President Dr. Oliver Fein cited the study last year reported in the Annals of Internal Medicine that 59 percent of physicians support a single-payer type system, and a new study showing doctors waste three to four weeks a year on paperwork that could be spent caring for patients.

Sanders later praised the efforts of nurses, doctors and activists who have made single payer an inescapable part of the public discourse. “When you have the nurses and physicians saying the current system is not working,” scores of people saying health care is a right  and single payer the most cost effective approach, we’re seeing this grassroots movement growing and gaining momentum.

If you agree, why don’t you fax Max Baucus, maybe a couple times, and let him know that we need real healthcare reform, not lobbyist-driven pablum and nonsense statements.

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"It would be nice if something made sense for a change." – Alice, from Alice in Wonderland.

Perhaps we live in an alternative universe.

One in which two thirds of Americans want the government to guarantee healthcare for everyone, while the policy makers in Washington labor to craft a reform plan that caters first to the threats and demands of the insurance industry and the minority voices on Capitol Hill.

One in which the Senate Finance Committee plays congenial host to the insurance industry, the drug companies, and right wing think tanks and it's chairman Max Baucus can proclaim all options are on the table while slamming the door on the nurses and doctors — and arresting them when they speak out.   Why? For advocating the most comprehensive, cost effective reform of all, a single-payer/Medicare for all approach.

One in which single payer is considered off the table inside the rarified airs of Congress, but when President Obama ventures into a town hall meeting with regular folks, the first question he is asked is:

"Why have they taken single-payer off the plate?" asked one woman in the audience to great applause. "And why is Senator Baucus on the Finance Committee discussing health care when he has received so much money from the pharmaceutical companies? Isn't it a conflict of interest?"

Watch here:

http://www.youtube.com/watch?v=Q6d45duX_WU

And one in which Drew Altman, CEO of the Kaiser Family Foundation can ponder today about how baffling it is that the "experts" — presumably people like him who was given a seat at the table by Baucus — sees the world so differently than the vast majority of Americans struggling to survive a cruel, inefficient, and inhumane healthcare system:

"Experts believe the health care system is full of unnecessary care and troubling variations in care, … The public has a very different world view: People think that underservice is a bigger problem than overservice. They want relief from the problems they are having now paying for health care and health insurance in very tough economic times. … And many are worried that they will not be able to afford their health insurance in the future or may lose it altogether."

The "experts" say the problem is too much "unnecessary" care. The public thinks too many people are being denied care they need.

The experts think costs are so high because consumers don't have enough "skin in the game" (i.e., we like to go to the doctor, get invasive tests, and endure long waits for care and high out of pocket costs). The public thinks the reason is "because drug and insurance companies make too much money."

The experts think health care information technology is a panacea to improve quality and cut costs. The public thinks it will probably increase costs (the Congressional Budget Office happens to agree) and are concerned about the privacy of their medical records.

The experts think we must have comparative research to limit future costs. The public thinks "insurers should pay even if their doctor recommends a treatment that has not been proven to be more effective than a cheaper one." (Imagine, getting the care you actually paid your insurance company to provide, what a concept)

Either we need to get more in tune with the self-appointed experts, or they ought to listen to what the people actually think. Or perhaps, as Marcia Angell, former editor of the New England Journal of Medicine told the Great Falls Tribune in Baucus' home state of Montana, "Single-payer is simply considered not realistic for a politician. The medical industrial complex just won't permit it."

But at a price, to our health, to the well being and financial security of American families, and to the cause of health care reform.

Or as Michael Lighty, national policy director for the California Nurses Association/National Nurses Organizing Committee put it:

"Hillary Clinton and President Clinton took single payer off the table much more dramatically than Baucus has, yet everyone draws the lesson that because of 1994 we can't do single-payer. They should draw a different lesson from the Clinton-era struggle. The lesson is we didn't fix the problem. We didn't offer a solution that works and so no one wanted it. That's the risk they run this time going down the road they're currently going. They won't solve the problem, it'll ruin their credibility even if it's enacted, and that's much greater risk."

1. Karen Ignani, the president of the insurance industry trade lobby, America's Health Insurance Plans, offers to end the outrageous industry practice of charging women more than men for health coverage, and is widely praised for the concession.

Even though the reprehensible practice of institutionalized gender bias should have been considered out of bounds long ago. The industry was not even shamed by the report last fall by the National Women's Law Center that insurers charged 40-year-old women up to 48 percent more than men of the same age for the same coverage.

And even though the “offer” remains conditional. AHIP continues to demand conditions in health reform proposals now before Congress, including a requirement that all Americans currently without coverage be forced to buy private insurance, and that Congress block any inclusion of a public alternative to private insurance. Now they've increased the ante and want federal pre-emption of state-based public protection regulations on insurers, such as requirements in a number of states that private insurers must cover such critical basics as maternity care or preventive cancer screenings.

Instead of gushing over AHIP for being conciliatory, it's time to demand the insurance industry stop holding our health hostage and end all discriminatory practices, including all higher charges based on age, health status, where you live, or other factors that serve as a financial barrier to access to care.

There can be no more excuses, no more exceptions, no more impediments to care. If anything, the widespread disparities and offensive pricing practices that characterize the private system  are a major reason why so many Americans are fed up with the insurance based system and want real reform, such as a single payer/Medicare for all approach.

Which brings us to Ignani's other remarkable comment yesterday.

2. “We are not asking people to trust us, we are asking people to trust government.”

Yes, Ignani apparently actually said that. And it was presumably not just a Freudian slip. In other words, a tacit admission that the insurance industry has no credibility with the public — and given their legacy of practices such as charging women more because they are of childbearing age they don't deserve it — and have to rely on the government to give them any trust with the public.

Yes, that government. The same government the insurance industry regularly excoriates “government-run” healthcare and is doing its best to provoke fear and loathing of even a public option alternative to private insurance.

3. The very Republicans who the Democratic leadership is bending over backwards to accommodate on the final form of a health plan are making it increasingly clear that they will work to defeat the legislation no matter what it is.

As now reported, GOP strategist Frank Lutz has put together a 26-page memo for the

Republican leadership on how to revive the Harry and Louise ads from 1994 to campaign against the new bill, using almost identical language from that campaign.

So a bill is being crafted to please the Republicans who will oppose it anyway on the assumption that they can use the specter of “government-run” health care, the same government Karen Ignani admits the public trusts more than her insurance industry, to regain political power at the polls.

Which, finally brings us to:

4. The Senate Finance Committee and its chair Sen. Max Baucus held a hearing Tuesday shutting out doctors and nurses and community supporters of single payer while providing a red carpet to AHIP, the Chamber of Commerce, Blue Cross Blue Shield, America's Health Insurance Plans, Business Roundtable, and the rightwing Heritage Foundation.

No wonder that some finally turned to peaceful protest and subjecting themselves to arrest.

The irony or tragedy, if you prefer, is that by trying to silence the voices of doctors, nurses and advocates of broader reform the Democratic leaders have, as the Washington Times put it, “forfeit a crucial bargaining chip with Republicans, meaning that any compromise with Republicans would swing too far toward the center or right” and leave themselves in a position of crafting even more unworkable reform.

“That's why it looks like (Democrats) are moving so far to the Republican position because they're not even considering the advantages” of a single-payer system, said Michael Lighty, national policy director of the California Nurses Association/National Nurses Organizing Committee.