Weekend Reading List

Sunday, June 24th, 2012

For this weekend’s reading list, we have articles on protecting Vermont’s fledgling single payer health insurance system, how progressives can move politics, a debunking of conservative myths about “voter fraud,” how for-profit corporations are making a fortune detaining undocumented immigrants, and the differences in President Obama and Mitt Romney’s plans for the Bush tax cuts.

 

Can Vermonters Win Single Payer? – a report on how corporate interests are working to undermine support for Green Mountain Care, Vermont’s single payer health insurance system that was passed last year but will not take effect for five or six years.   For our previous coverage of Green Mountain Care, see this post.

Progressive Action Can Move the Candidates – an essay arguing that progressive action both within and outside of the electoral system can and already has moved our politics on issues such as economic inequality and immigration

The Voter Fraud Myth Debunked – A good debunking of some of the most popular false stories about voter fraud being peddled by conservatives across the country.

Private Prisons Profit From Immigration Crackdown – a report on how privately owned prison companies now own nearly half of the cells that immigrant detainees are sent to, which means that the industry is profiting heavily off of the GOP’s misguided objection to immigration.

U.S. Taxpayers and the Bush Tax Cuts – details regarding how various groups would fare under the GOP plan versus Obama’s plan for dealing with the impending expiration of the Bush tax cuts.

Single Payer: Moving Forward State-by-State

Monday, June 18th, 2012

(By Joanne Boyer, cross-posted at Wisdom Voices)

Amid all the noise created by the passage of the Affordable Care Act (ACA) and its future now before the U.S. Supreme Court, there are some states who continue to move forward with the only common sense health care solution:  single payer.

First it was Vermont, when Governor Peter Shumlin signed a law in March that sets Vermont on a course to provide health care for all of its citizens through a single payer system called Green Mountain Care. Key components include containing costs by setting reimbursement rates for health care providers and streamlining administration into a single, state-managed system. The ACA reform law would not allow Vermont to enact single payer until 2017; Vermont is asking the administration to grant it a waiver so that it can get there even faster, by 2014.

Could Minnesota be next?

Vermont diligently and patiently worked for years to build the foundation for its law.  So too, is Minnesota under the umbrella of an organization called Health Care for All Minnesota (HCAMn).  Its mission is dedicated to establishing comprehensive single-payer health care for all Minnesotans through advocacy, education, lobbying, and community organizing.  HCAMn, a coalition of member organizations, is an independent, nonpartisan, 501(c)4 non-profit and does not endorse candidates or work on political campaigns.

No matter what the Supreme Court decides, the move to single payer is on in Minnesota.  In 2010, the Minnesota Health Act passed out of both state legislature committees before the November 2010 elections swept in a Republican controlled legislature and a Democratic governor (Mark Dayton). That effectively stalled the legislation even though Dayton is on record as supporting single payer for Minnesota.

“After the 2010 election, we decided our focus would be more to educate people on what single payer is,” said Erin Anderson, Executive Director of HCAMn.  “We are now going state-wide, via forums and meetings, telling people what the benefits are, how it would save money and how everyone would be covered.  We’re focused on education and organizing the general pubic.”

Minnesota is one state actively working to implement a health exchange as part of the ACA.  The governor’s task forces on both health exchanges and health reform offer HCAMn other avenues to turn the conversation toward implementation of single payer.

“We, in an effort spearheaded by the Minnesota chapter of Physicians for a National Health Program, made a commitment to be at task force hearings and to speak during the public forum part of those meetings,” said Lisa Nilles, Vice Chair of HCAMn.  “We’re showing up and making sure the message gets through to the governor.  We’re also present at citizen forums organized by the Citizens League and helping to provide the governor input on what the citizens are saying about health care.  And the message is getting out there that Minnesotans want single payer – that single payer needs to be on the table.”

Some national polls have shown a 2/3 majority in favor of single payer. A 2007 poll of Minnesota physicians indicated a 64 percent approval of single payer.  Also, the majority of physicians (86%) agreed “that it is the responsibility of society, through the government, to ensure that everyone has access to good medical care.”

The HCAMn site provides excellent information on what single payer is and what it is not. It’s a great read for individuals concerned about knowing the facts about single payer.  In summary, single payer provides:

  • One system that covers everyone
  • A uniform and comprehensive benefit set for everyone
  • A single network of health care providers and an end to choice-limiting networks
  • A single insurance pool to spread insurance risk
  • An outlet to delink health care coverage from employment

“There’s so much misinformation about single payer,” Anderson said.  “People think it’s ‘socialized medicine’ when in fact it’s not that at all.  You still have private clinics and private hospitals, but they are paid by one payer and it doesn’t have to be the government.  And people think it has to be so expensive, when all the studies show single payer saves money.”

Despite making sense and saving money, single payer faces an uphill climb with roadblocks thrown up by big insurance company lobbying. So what keeps HCAMn motivated through this long process?

“We have a fragmented health care system that keeps so many people from getting the care they need,” said Anderson, who herself carries the ‘scarlet letter’ of a pre-existing condition. “I had back surgery when I was 13,” she said.  “I’m a pre-existing condition.

“It’s the stories – that’s what keeps us motivated.  Everyone knows someone who has been affected by debt, who isn’t covered by health insurance, someone who has high deductibles or high prescription drug costs.”

For Nilles, a physician who worked in England in the early 1990s before beginning her practice in the U.S., it’s that first-hand knowledge of working in a system in which “everyone’s covered” that has been her motivating factor.

“I lived in a world where it (universal coverage) was just the norm,” Nilles said.  “And then I came back and saw the crazy and chaotic system here.  People here tend to push back and will cite horror stories about health care delivery in other countries, saying there is rationing and long lines.  And they’re not looking at their own country.  I ask: “what about here?’ We ration health care more than anyone, but people somehow think we have it better. I’ve been active in this for the last seven years, and single payer has become a real contender in the conversation – it seems to be more prevalent. People know what it is – even if they are afraid of it.  And, once they hear it explained in some depth, they are not afraid, but often turn into supporters.”

“In this country it tends to be the states have to do it first,” Anderson said.  “The states are like pilot projects and they have to implement it and then it moves to a national level.”

“For a long term view, everything we are doing is building, and when will it break in favor of single payer? I don’t know, but I do know we are making progress and that is what gives us hope, Nilles said”

Single Payer:  Common Sense & Cost Savings

HCAMn points to the recent Lewin Group report on what single payer would mean for Minnesota.  The report once again states the obvious about single payer – it covers everyone and it saves money.  A complete copy of the report is available by clicking here. Below is an excerpt:

 

Using health spending data provided by the Minnesota Department of Health (MDH), we estimate with our models that the single payer plan would achieve universal coverage while reducing total health spending for Minnesota by about $4.1 billion, or 8.8 percent, in 2014. This includes added costs due to reductions in utilization management and increased utilization costs resulting from reduced cost sharing. Additional costs and savings estimates under the single payer plan in 2014 include:

  • A total savings of $35.7 million to state and local governments;
  • An average savings of $1,214 per worker, for employers offering health insurance coverage prior to the ACA;
  • An average additional cost of $1,963 per worker, for employers not offering health insurance coverage prior to the ACA;
  • An average savings of $1,362 for families, including wage effects;
  • A reduction of 42,800 Minnesota jobs for those with insurance-related job functions; and
  • A ten year total statewide savings of $189.5 billion, from 2014-2023.

 

Wendell Potter:  Exposing The Insurance Industry

Perhaps the biggest roadblock to implementation of single payer health care system is the for-profit insurance industry and its lobby.  After all, who stands to lose the most with a health care system designed to take care of individuals rather than line the pockets of executives and shareholder.  The United States remains the only industrialized nation in the world with a for-profit health care system.

HCAMn’s annual single payer summer celebration is Thursday June 21 and will feature Wendell Potter as its guest speaker.  Information on how to purchase tickets can be found by clicking here. Following a 20-year career as a corporate public relations executive, Potter left his position as head of communications for CIGNA, one of the nation’s largest health insurers, to help socially responsible organizations — including those advocating for meaningful health care reform — achieve their goals.

Potter has been a powerful voice in exposing insurance companies and how they put profits before people.  His latest book Deadly Spin provides not just an exposé of health insurers but a stark warning that corporate spin is distorting our democracy.  Visit www.wendellpotter.com for more information on the book and the work Potter does.

 

Weekend Reading List

Saturday, October 29th, 2011

For this weekend’s reading list, we have articles on how Occupy Wall Street rejects the mindless messaging of the media, lessons that we can all learn from the successful effort to get single-payer insurance in Vermont, a review of an interesting new book on our failed criminal justice system, a report about the conservative attack on voting rights, and a new Congressional Budget Office analysis of economic inequality in the US.

If you have any feedback on these articles, or would like to recommend an article for next weekend’s reading list, please let us know at Winning Progressive’s Facebook page

Occupy the No-Spin Zone - Dahlia Lithwick at Slate praises Occupy Wall Street for rejecting the mainstream media’s call to adopt the type of simple-minded messaging that our media lives off of. 

Help Wanted: Lessons From the Single-Payer State - a good overview of the five lessons that the progressive movement could learn from the successful effort to enact single-payer health insurance in Vermont

Our ‘Broken System’ of Criminal Justice - former Supreme Court Justice John Paul Stevens reviews William Stuntz’s interesting new book The Collapse of American Criminal Justice, which discusses how our nation’s criminal justice system is too severe and imposes a disproportionate impact on African Americans 

The Right to Vote Under Attack - a helpful report from People for the American Way explaining the conservative myth of voter fraud, how conservatives are working to suppress voting, and the groups behind the attack on voting rights

Trends in the Distribution of Household Income Between 1979 and 2007 – a Congressional Budget Office report showing how the vast majority of national income growth over the past nearly 30 years has gone to the top 20% and, especially, the top 1%.

Happy Birthday, Romneycare! Vermont’s “Green Mountain Care” is Better

Tuesday, May 31st, 2011

(by Mark McCutchan)

Vermont’s Governor Pete Shumlin signed into law H-202 last Wednesday, a bill that paves the path to a single payer health care system called Green Mountain Care.  As Shumlin said at the signing:

We gather here today to launch the first single payer system in America, to do in Vermont what has taken too long — to have a health care system that is the best in the world, that treats health care as a right and not a privilege, where health care follows the individual not the employer.

Vermont’s health care plan is a large positive step forward for fixing America’s broken health care system.  More on that later, but first some background on employer-based health insurance in America and health care reform success in another state – Massachusetts.

Employer-Based Health Insurance – A Short History

Insurance offered by employers in the early 20th century was limited to loss of wages due to disability.  The link between employers and private health insurance was strengthened by three key government decisions in the 1940s and 1950s. First, during World War II wage and price controls and the lack of male workers at home created worker shortages.  The War Labor Board ruled that wage and price controls did not apply to fringe benefits such as health insurance, leading many employers to offer it to entice additional workers. Second, in the late 1940s the National Labor Relations Board ruled that health insurance and other employee benefit plans were subject to collective bargaining. Third, in 1954 the Internal Revenue Service ruled that health insurance premiums paid by employers were exempt from income taxation.

Employer-based health care insurance worked fine when the employee cost after insurance was affordable, and unemployment was under 5% (as it was for most of the quarter-century after World War II).  However, as discussed in an earlier Winning Progressive column, health care expenses have sky-rocketed to over 16% of our GDP (over $7,400/person), with corresponding increases in cost to the patient.  Rising Medicare costs have motivated Democratic lawmakers to search for methods for “bending the cost curve” to keep coverage sustainable by rationalizing health care spending.  Rising costs have also made Medicare a political target for Republicans, as 40 out of 47 of Republican senators and all but four Republic House members voted in favor of Paul Ryan’s “Path to Poverty” budget proposal that would abolish Medicare.

Economic “structural” changes, technology changes, efficiency improvements, job off-shoring, and ruthless corporate job-cutting have raised unemployment rates and weakened the employee-employer relationship to the stage that Americans can no longer depend on their employment status for their health insurance.

Happy Fifth Birthday, “Romneycare”!

In 2006, Massachusetts became the first state in the nation to enact a comprehensive health care insurance reform law, which the state’s overwhelmingly Democratic legislature passed and then-governor Mitt Romney signed into law.  It mandates that nearly every resident of Massachusetts obtain a minimum level of health care insurance coverage and provides free health insurance for residents earning less than 150% of the federal poverty level (which comes out to $33,000 for a family of 4) and subsidizes health care insurance for those earning up to 300% of the federal poverty level.

Now that “Romneycare” has reached its fifth birthday, it would be natural to ask, “How is it working for Massachusetts?”

The answer: “Romneycare” has been a success!

  • The state has achieved its goal of providing near-universal (98%) coverage of all residents
  • The percentage of employers offering insurance has increased
  • Per capita payments for low-income enrollees rose an average of 5 percent a year over the first four years, well below recent 7 percent annual increases in per capita health care spending in Massachusetts.
  • The average premiums paid by individuals who purchase unsubsidized insurance have dropped substantially, 20 percent to 40 percent by some estimates
  • Health care reform has not yet slowed the rise in health care costs, but bills have been submitted to the legislature that would enhance the state’s powers to reject premium increases, allow the state to limit what hospitals and other providers can be paid by insurers, and promote alternatives to costly fee-for-service medicine.

We progressives should thank Mitt Romney for all he has done for the citizens of Massachusetts, and for preparing the way for the Affordable Care Act of 2010.  We can also thank the GOP for making their de facto 2012 platform so nonsensical that Multiple Choice Mitt is now waffling on whether he supports what the successful legislation he helped pass in Massachusetts and leading Republicans are pushing Mitt to disavow his greatest accomplishment.

Back to Vermont…

After Governor Shumlin signed H.202, he handed the pen to Dr. Deb Richter, an advocate who has lobbied for a single-payer system for 20 years.  In her remarks, Richter noted that health care in Vermont will for the first time be considered a public good rather than a commodity to be sold.  She also prepared us for the backlash that the legislation will face and why we should fight to protect it, noting:

“We’re going to hear all kinds of scare stories – that this is a thoughtless experiment or that this is too bold.  I want to remind you that every other industrialized country does what we are trying to do. They do it for far less money, they live longer and they do it for far better care. So it’s time for Vermont to join the rest of the industrialized world.”

Health care costs have doubled in Vermont over the last decade to roughly $5 billion a year, taking a toll on small businesses and the middle class.   The single payer system promises to reduce such costs while making all of the state’s 620,000 residents eligible for coverage.  As part of an effort to rationalize health care spending, a five-member board appointed by the governor is to determine payment rates for doctors, what benefits to cover and other details.

But many decisions and a lot of organizational structure remain to be worked out — so that even under the best political circumstances, Vermont’s single-payer health care system may not be running until 2017.  The GOP can put out many roadblocks along the way to try to derail progress, but it is the best interests of all Americans to cheer Vermont’s effort to implement a single payer system, which will:

* ensure universal coverage

* reduce health care system costs and waste

* decouple health insurance coverage from employment

*reduce the financial burden for companies that pay for employee health care insurance

Take action to support Vermont’s step toward single payer health insurance by:

* Letting Gov. Shumlin know you support what he has done – you can comment at his Facebook page, call his office at (802) 828-3333, or e-mail him

* Support Dr. Deb Ricther’s organization Vermont for Single Payer by liking them on Facebook, following them on Twitter, or sending a contribution at their website

* Write a letter to your local newspaper editor thanking Gov. Shumlin if you live in Vermont, or calling on your own elected officials to establish a single payer Medicare-for-all system in your state