'Medicare for All' Would Solve California's Budget Deficit

Originally published on Calitics on January 31, 2012. In Canada, the only way to see a doctor is to call one up and make an appointment. Or walk in to their office. In Britain, the only way you'll get surgery is if you actually need it. And yet State Senator Mark Leno and 44 co-sponsors want to bring this kind of healthcare system to everyone in California! Imagine. In fact, the California legislature twice approved such a system, in which private providers carry on as independently as always but the public pays their bills directly (rather than indirectly as it does now, through a patchwork quilt of emergency care, programs to bring healthcare to the poorest and the elderly, and subsidies for insurance premiums.) Both times Governor Arnold Schwarzenegger vetoed the bill. But Senator Leno, a longtime campaigner for single-payer -- a.k.a. "Medicare-for-All" -- has brought the bill back again as SB 810. Last week, the bill fell just two votes shy of passage with a tally of 19-15 in favor. (It needs 21 to pass because it requires more than a simple majority.) Sen. Leno plans to push for another vote under Reconsideration, because several Democratic state senators abstained, but the deadline to win their support is today.

This single-payer bill is championed by Campaign for a Healthy California, a coalition which includes the California Nurses Association, Physicians for a National Health Program, California Alliance for Retired Americans, Progressive Democrats of America, California School Employee Association, Democracy for America, the California Health Professional Student Alliance, and many others. They have put out action alerts to supporters of SB 810 to call on five key state senators to vote Yes: Los Angeles area state senators Alex Padilla, Rod Wright, and Ron Calderon; San Diego area senator Juan Vargas, and Fresno/Bakersfield senator Michael Rubio. If supporters can bring just two of these state senators around in time for a Reconsideration vote today, then patients in California could very soon be able to choose which doctor to see (rather than submitting to a 'network' or their HMO). And the leading cause of bankruptcy for both the insured and uninsured - medical bills - could be eliminated. A lot of people - i.e. all other advanced democracies in the world - think access to healthcare is a basic human right, and that organizing that access is one of the functions of a government and of a civilized society. In fact, in poll after poll, themajority of Americans support a publicly-funded universal health care system as well. But never mind that. This is a time of economic struggle, an overstretched state budget, and financial uncertainty. Giving the government the job of administering health insurance at this particular juncture is above all else...the most fiscally conservative thing to do. SB 810 would eliminate private health insurance entirely. All Californians' healthcare costs would be paid for from one big pool. It's just like the way people get insurance coverage now, except much much simpler, everyone would be covered, and the profit motive would be removed. And making health insurance a government-run program would dramatically reduce a huge portion of health care expenses that are eaten away by needlessly complicated administration costs. It's the exact opposite of what the bill's detractors pretend. Rather than creating more bureaucracy or paperwork, SB 810 would very quickly whittle down the costs of administering healthcare, currently at 33% of California's total healthcare spending, to under 5%. Providers would only have to bill one entity, a new California Healthcare Agency, and would have no need to chase after patients for unpaid balances, or argue with insurers about whether the insured really does need that organ transplant or dialysis. That's how Sen. Leno's site can claim that SB 810 would save California $20 billion in the very first year by reducing administrative costs alone. Moreover, health insurance commissioners would not need to watch over insurers and fight their premium hikes on behalf of consumers (health insurance premiums grow 4 times faster than wages). After SB 810, there would be no premiums. There would be no deductibles. There would be no co-pays. There would be no private health insurance. These companies would still find a way to sell insurance for non-essential services -- just as in Canada insurers offer policies for things like private rooms should the insured be hospitalized. Insurance companies are nothing if not resourceful, and we shouldn't worry about them too much. The big change would be that with a single-payer program, insurance companies could no longer build their business by keeping the whole health system stratified. The U.S. spends twice as much of its GDP on healthcare as other wealthy nations do. It spends more, and gets less. Americans receive less doctor consultations, hospital care, and surgery than people in other industrialized nations, yet our healthcare costs are higher. Insurance companies, by insisting on their privileged position as middlemen between patients and physicians, balloon healthcare costs out of all proportion. Far from delivering medical care more cheaply, these companies take money from patients - and from non-patients, like those who put off getting care because they can't afford their deductibles or co-pays but who keep sending in premiums to ward off catastrophe - and apply it to profit dividends, CEOs' bonuses and even marketing to win over more customers. And all we get in exchange is the 37th best healthcare in the world, according to the WHO. In addition to Big Insurance, we have Big Pharma driving up healthcare costs. Countries like Canada began long ago to use the leverage of government to negotiate down drug prices, but in the U.S., the government behaves as if it is powerless in the face of whatever pharmaceutical companies wish to charge. SB 810 would tackle prescription drug pricing in California by using its bulk purchasing power. Sen. Leno estimates that such savings on medication, as well as equipment, would save the state $5.2 billion. Lack of or inadequate insurance leads many to wait until their health is seriously threatened and then seek care in Emergency wards, rather than getting preventative screenings or catching the problem at the initial symptoms. This is not only costly to the hospital which provides the Emergency services, and to taxpayers who have to make up the costs, but it escalates costs in general, since by the time these patients seek care they are in need of much greater intervention. SB 810 would transfer the emphasis to preventative care and primary care, and thereby save Californians an estimated $3.4 billion. In short, Sen. Leno maintains that SB 810 would be fully funded from the money we already spend on health care, and that, to boot, California would save a total of $29 billion just in the first year. Considering that these cost-cutting measures would completely solve the state's fiscal crisis without either cutting social services or raising taxes, if Republicans really were fiscal conservatives they should have jumped on board with full support for SB 810. But of course insurance and pharmaceutical companies would be pretty unhappy with them, and campaign donations would stop flowing. Since the Republicans' objections to the federal Affordable Healthcare Act was that it would force people to buy private health insurance - the result of the Obama Administration's barring single-payer advocates from all planning sessions - you would think that they would all be in favor of the freedom that SB 810 would bring. But of course it's hardly the freedom of the 99% that matters. SB 810 has strong backing from ordinary, non-radical Californians. Sen. Leno's website lists 172 groups (unions and professional association, religious groups, city governments, Democratic Clubs, etc.) who endorse SB 810 and who have been working hard to make California the 2nd state in the nation to enact single-payer. Single-payer advocates affiliated with the Campaign for a Healthy California include the American Medical Student Association, Consumer Federation of California, League of Women Voters of California, Progressive Caucus of the California Democratic Party, Amnesty International USA, California National Organization of Women, Courage Campaign, California Teachers Association, California Federation of Teachers, and California Faculty Association. The bill's champions expect that Governor Jerry Brown would happily follow in the footsteps of Vermont's Governor Peter Shumlin and sign a single-payer bill. (The passage last spring of a publicly-run health insurance system made Vermont the first state in the U.S. to take this bold step.) If Sacramento fails to pass SB 810 this year because one Democratic senator voted No (Calderon) and four Democrats abstained (Padilla, Wright, Vargas, and Rubio), there will be a lot of very disappointed people in this state. There will also continue to be 7 million Californians without insurance. Even after the federal Affordable Healthcare Act kicks in, 3 million Californians will remain uninsured, says Sen. Leno. Despite the fuss the country went through over health insurance reform, so-called 'Obamacare' would only manage to cover four out of five at best. And it is predicted that many who will still be unable to afford health insurance will choose to pay the fine instead. We will still have a tiered health care system. And we will stay pay more for less.

"If Stephen Hawking Lived in England" and Other Great Points the Left Doesn't Want You to Know

This article was originally published on SmirkingChimp.com on Friday, August 9, 2009:

Fellow Patriots,

Here are some important things to keep in mind when those blood-suckers from the left try to spread their lies about health care!! Print this out so you can bring it to a town hall.

1.) If Stephen Hawking lived in England, he’d be left to die. Thank God he’s safe at the University of Cambridge in Massachusetts.

2.) If the government was capable of ensuring health care for seniors, they would have done it decades ago.

3.) If we didn’t have a free enterprise health care system in America, then we would not be able to achieve all those advances in medicine funded by the National Institutes of Health.

4.) When the people of oppressed countries like Canada, Britain, France, Italy, Germany, Sweden, Denmark, Israel, Australia and New Zealand finally get democracy, they can vote out their socialized health care systems.

5.) England’s capital is the ultimate proof that national health care kills free enterprise. That’s why London has no stock exchange, no banking district, no tabloid newspapers, no big musicals, and no expensive real estate.

6.) Even the World Health Organization agrees that “America has the best health care system in the world”; the WHO ranks the American health care system at the very top part of its list, right after the first part where 36 other countries rank higher.

7.) Free enterprise is the greatest system ever invented and government can’t even come close. What else but private industry could have split the atom, or gotten a man on the moon?

8.) If you drove 100 miles on the interstate freeway you still couldn’t come up with one good thing that government has done.

9.) I’m writing an urgent letter to my Senator about the health-care issue. I’m explaining how the government never does anything right. I’m sure the Post Office will deliver it in a day or so.

10.) The last thing anyone needs is a government official getting involved with health. I look after my own health. For example, I always make sure I eat at restaurants rated “A” in the window.

11.) I really resent the government thinking I need any assistance from them. I buy my FDA-approved medication on my own.

12.) If health care were available to all at government expense, people would over-consume, using it when they don’t really need it. As in the common phrase: “It’s Saturday night, honey. Would you rather go to a movie, or shall we have our gallstones removed?”

13.) For some reason, the lunatic left can’t understand that the most important thing in health care is consumer choice. When you’re in a car accident and you’ve lost pints and pints of blood, what you really want to do is to sit down, think over how much you want to spend and where, and comparison-shop. And if you happen to choose an incompetent surgeon, well, he damn well won’t get your business next time, will he?

A Funny Thing Happened on the Way to the Health Care Forum

This article was originally published on OpEdNews.com on Sunday, August 16, 2009:

I got to witness Advanced-Stage Townhall-ism on August 11^th, when I attended Congressman Adam Schiff's health care panel and forum in the Southern Californian city of Alhambra. Because of high turnout the assembly was relocated to the spacious hillside lawn between the civic center buildings; thankfully, this accommodated the 2500 or so people who showed up. Unfortunately, there were no cordless mikes for the Q & A, so although Schiff's team never faced the criticisms leveled at some other town halls where venue-size was too small to fit everyone who came (thus trampling on their First Amendment rights!), his Q & A required participants to come down to the front of the crowd and yell their question up to the moderator (thus trampling on their First Amendment rights!). Some other devotees of the Anti-Government sect were less paranoid, but had no patience with the staff's failure to find mikes for an outdoor setting that had only been instituted at the last minute.

Crowd at Adam Schiff's Town Hall in California

Supporters and opponents of health reform were all mixed in together, with homemade signs on both perspectives. There were large numbers of posters with slogans from Obama's Organizing for America; their message of "standing together" unappreciated by various stern-faced men defiantly holding a "Pasadena Patriots" banner, a "Don't Tread on Me" flag, and such-like. From the audience response to Congressman Schiff's opening question, the opponents of health reform were matched if not out-numbered by its proponents. (A smaller number were actually undecided.) Dialogue between different sides actually did happen in the crowd, although one side seemed pretty convinced that government as a whole is a consortium of supernatural, un-human demons who stop at nothing to eviscerate democracy and were determined to keep their fingers in their ears against the enemies of democracy (i.e. the Majority, who voted for Obama's promise of health reform at the polls in Nov. 2008, 52.9% to 45.7%.)

One grey-haired couple was convinced that the same federal government which has enabled funding for seniors' health care for the last 44 years was too incompetent or too dangerous to be trusted with funding seniors' health care. The man's sign read: "The Lord will decide how long I live, not the government", and his companion, a woman who sat in a chair and needed a cane, held a sign saying: "The scariest words: I'm here from the government, I'm here to take control of your health."

 

Senior worried about government-funded health care

When I tried to tell them and others that I'd experienced government-financed health care in Canada, where I lived for almost 30 years, and so had my family and relatives, neighbors, teachers, co-workers, and classmates from kindergarten through university, they were not very interested. (The Christian man rolled his eyes at the mere mention of Canada.) I described how my father had a stroke and for the next five years he received all kinds of medical treatment, two and a half years of which were actually in a chronic care hospital where he lived. I was actually told "that's because he was a senior" and "not everyone can get care in Canada." When I tried to make it clear that No, in Canada everyone gets care because it's universal health care, one of my listeners was sure that the waiting times are really long. I tried to get through to him that for 2 years my father received his own wheelchair, X-rays, CAT-scans, MRIs, medication, antibiotics, an oxygen tank, and even a ventilator as soon as he needed it and for free. In fact, his life was saved over and over again. (Moreover, his life was first saved under the much-maligned British National Health Service. He actually had the stroke in London, and went, over a period of about 6 weeks, from being in a coma to being able to walk, talk, and eat again thanks to them.)

I also affirmed that my 83-year-old godmother, who lives in Montreal, has had all kinds of intensive and sophisticated surgeries and other treatments, without long waits. She happens to be someone who reads medical dictionaries for fun and has studied developments in medicine all her life -- taping, quite possibly, every medical show that PBS has ever run and with all that knowledge was very attentive to the quality of care she received. She praised the great skill of many of the procedures she's had. Not all of them -- the doctors in Canada are just as human as those in the U.S. Sometimes there are malpractice suits and bad bedside manners, just like there are here. (I, for example, went to a hospital in the U.S. and they gave me test resultsthat belonged to somebody else.) However, my eye-witness testimony provoked too much cognitive dissonance to be believed. "I've always heard that people in Canada are unhappy with their health care system!", a man said, shaking his head firmly.

I was also told "the health care system in Canada was much better 15 years ago than it is now." Even if that were true it would not be an argument for privately funded health care, since government insurance and universal access came into effect in Saskatchewan 47 years ago, and the rest of Canada has been insuring all their residents for the last 37 years. However, what did happen in the last couple of decades was that those who never wanted publicly-funded health care at all pressed and pressed until health budgets were cut. This was in evidence in Ontario, where ultra-right-wing premier Mike Harris came into power in 1995 and savagely cut government spending while reducing taxes 30%. I was there at the time and I remember general strikes and protests, increases in homeless people freezing to death, and suicides by people cut off of social assistance. The effect of cutbacks was also evident in the middle of my father's tenure in the Ontario hospital, as the nurse-to-patient ratio worsened, and recreational, occupational, and other therapists had their hours reduced. But my father was in and out of intensive care over and over again, on several occasions getting so much care he practically had his own private nurse. And in all my many conversations with his doctors and specialists, there was certainly never any government limitation placed on the kind or extent of care he could receive. He, and I, -- when I had to speak for him -- were the ones making the decisions.

What's extraordinary is how so many of those 'tea-bagger' types at the Alhambra town hall think only Government could possibly cause them harm or limit their health care. Yet insurance companies don't hold town hall meetings and allow you to shout at them hysterically for 2 hours; they don't hold town hall meetings at all. If you try to set up a meeting at your insurance company, they'll laugh in your face, but I've attended meetings at my Congressperson Diane Watson's office with 5 or 6 others, delivered petitions there, and called up many times. (Her aide has even called me back from D.C.) You can't watch insurance companies' shareholders' meetings on C-SPAN like you can the hearings and sessions of Congress, and the media doesn't condense and report the highlights of your insurer's decision-making process for you.

If your insurance company drops you, they no longer have any interest in you, in fact they don't care whether you live or die. The ACLU doesn't sue your insurance company if they infringe on your rights, because there's no Insured's Bill of Rights. They may refuse you coverage because you have a "pre-existing condition", in other words, because you need care. They can reject doctors' requests for the type of treatment you need, even if the person processing the claim is just a bureaucrat with no medical knowledge. You also can't file a Freedom of Information Act request to get memos from your insurance company's board meetings.

Yet several of the anti-reform protesters at the Alhambra town hall were convinced that the Constitution was being violated. I asked "How?" and was told "the Constitution doesn't say anything about health care!!!" When I mentioned that there's an unalienable right to "Life, Liberty and the pursuit of Happiness" the senior who feared government 'takeover' snapped "That's the Preamble!" As if somehow that didn't count, then. (It's actually in The Declaration of Independence, but last time I looked that was a founding document too.) Of course Obama isn't forcing anyone to choose the public option to begin with, so there's nothing to insist on being free from, but even overhauling the whole system and instituting government-funded health insurance would not violate the tea-baggers' constitutional rights.

 

Nattering Nabobs of Negativity

In 1789, there was no UN to declare health care a fundamental human right. That had to wait till 1946, and the World Health Organization's Constitution, and1948, when Eleanor Roosevelt chaired the UN's commission that gave us the Universal Declaration of Human Rights and Article 25, #1. But the Bill of Rights makes a point of trying to prevent the powerful from playing Simon Says with the Constitution in order to restrict Americans' rights and freedoms. When Fox-loving right-wingers wave the Constitution around, do they only read the first twoAmendments? The Ninth Amendment to the Constitution, part of 'the Bill of Rights', explicitly states: "The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people." In other words, they realized that they may not have listed every right by name.

Moreover, that afore-mentioned Preamble to the Constitution makes sure we understand the Founders' intent. When I've asked Anti-Government zealots what government is for, they tend to focus on the clause "provide for the common defence." But the Preamble also declares that some of the Constitution's purposes are to "establish Justice" and "promote the general Welfare." It's impossible to see any 'Justice' in insurance company execs getting rich by denying young children vital treatments. (http://sickforprofit.com/) And I'm sure stumped as to how 'the general Welfare' is served by millions of people being unable to get needed care, not only because they suffer as a result, but also because their exclusion may hamper society's ability to fight the spread of swine flu, bird flu, AIDS, ebola, SARS, or others yet unknown.

Obama is the first to point out that he isn't proposing a nationalized health care program. But the right-wing wants to make it about that. Obama and his people have to spend all their energy defending criticisms that are not only as made-up as something out of Harry Potter but are completely irrelevant to the proposed reform.

Which proves that I was right all along to worry that the Obama Administration was shooting itself in the foot months ago by refusing to even allow discussion of single-payer health care (a publicly-funded, privately-delivered nationalized system like Canada's). Single-payer advocates were most definitely 'not invited' to the forums earlier this year which were supposed to be for public comment. The forums were stage-managed to reflect only the opinions of entrenched health care powers. Doctors and nurses who've been working for single-payer for years were excluded from public debate in ways the bitter townhallers only dream about, so turned to getting arrested for interrupting congressional meetings and protesting at insurance companies. Even Rep. John Conyers, Jr., the author of the single payer bill HR 676,was very nearly kept out of hearings in D.C.

When a plan has a little of this and a little of that, it's convoluted, and the public can be scared off of it. People end up sounding like bureaucrats when they explain how it will work; it doesn't have the impact of a strong vision. It would have been better to defend a principle rather than a compromise.

Though Obama used to support single-payer before his presidential run, he obviously thought he'd face strong opposition if he tried to advance the idea now. The Democrats are perpetually delusional that if they don't rock the boat, maybe the right-wing won't say mean things about them. At the very least Obama could have made it clear to the rumor-gullible that single-payer is one thing, and a public option is something else.