Sunday, December 20, 2009

Why Fight Now? A Single Payer View on the Public Option

Time to say a few things:

Health reform is important. The bills before Congress can make a difference for millions.

The President needs to win this one, soon. If the insurance industry can demoralize progressives over the holidays, the win comes on their terms. If progressives keep up the fight we could win.

The public option is not optional. It is our toe-hold on structural change.

Women and immigrants are more numerous and better organized than the turkeys who think we are wedge issues.

On the other hand, there is no organization that will swoop in and win this for us. Social justice, labor, women’s rights and other groups have been battered by 30 years of neoliberal economics and politics. Progressive political leaders in the Senate – Sanders, Brown and Burris - took their bows for talking up a single payer amendment that failed even more spectacularly than expected, and they ducked last minute appeals to them to cross Harry Reid and the White House by threatening a No vote.

Mike Huckabee is heading to Omaha to rally and revive the teabaggers. It won’t matter right now. Huckabee, like a lot of others, is building his lists and organization for other fights.

For those of us who think the next step toward health reform, however limited, should be at least a step forward and not a wholesale retreat on reproductive and immigrants’ rights, we will have to be enormously creative and persistent this week. Stay tuned..

Tuesday, December 15, 2009

Fight for Real Health Reform!

The President and the Senate are likely to meet on Tuesday regarding health reform. Following is a message to Congress and the President - please add your own, and call or write TODAY!

Also: links to statements below from the Congressional Progressive Caucus and Rekindling Reform

To Congress and the White House:

We need and support real health reform. Stick with us and demand a bill that preserves and expands the strongest points of House and Senate proposals, starting on day one:

1. A public option is critical to advance access, quality, affordability and cost control. A buy-in to the public Medicare program for ages 55-65 must also be affordable.

2. All plans must be affordable, limit out-of-pocket expenses, require fair financing by employers and high-income individuals, end insurance company abuses, and require insurance companies to spend at least 90% of revenues on health care.

The federal government should promote innovations in delivery and financing of health care, including more primary care providers and public health funding.

3. Defeat diversions on wedge issues:
Advance reproductive rights.

Assure that all people who live in the U.S., including immigrants, have access affordable, quality, culturally appropriate care.

4. Promote states’ ability to move to single payer systems.
This historic bill will be an important step forward. States must be empowered to advance to a single payer system.



Statement by Congressional Progressive Caucus:

Statement by Rekindling Reform:


We have won important victories for better access to affordable health care.
Enemies of reform are now out in force.
Progressives must stay informed and engaged to achieve a truly historic victory.

Saturday, December 12, 2009

The Senate Compromise: Does it Help?

The Senate compromise seems to be this:

For the slice of the population age 55 - 64 that would have gone into health exchanges with subsidies – uninsured, self-employed – let them instead buy in to Medicare. Except without subsidies.

The Medicare Part B premium is now means-tested – that is, based on annual income. It covers 25% of the cost of the program. Individuals earning less than $85,000 a year pay no premium; going up from there from about $44 a month to about $353 a month. Buying in to Part B alone could presumably cost 4 times those amounts, or between zero and $1400 a month. Plus the $155 deductible.

Offer the same group, under age 55, the choice of 2 nonprofit health plans, administered by the federal Office of Personnel Management.

No public option.

Til now we’ve heard that Congress would abolish lifetime caps on what the plans would pay. Now we’re hearing the caps may be back. (After which you’re on your own.)

The great thing about Medicare is that it has the clout of 40 million beneficiaries and the federal government when it comes time to negotiate with Sutter Health. So sure, add more folks in over there.

But. If they’re the oldest and sickest, and everyone under 55 is still left to the depredations of the private insurance industry…Well. Perhaps at least a few more of them will be covered.

And rumor has it that the Senate would also require the companies to spend 90% of the premium dollar on actual benefits (a big hike from the 70% or so that some plans spend now).

Ok marginally a little better than nothing. But so diluted from the House bill, in terms of a stepping stone to the future: less public involvement than any proposed public option (so less cost control), less affordability, less coverage. Makes you think that maybe the regular legislative process has some advantages over the Gang of 10 system.

Painful as it may be, and tempting as it is to go for expanding Medicare by any means necessary, it’s looking like getting something through the Senate, to be followed by a conference with the House’s better bill, is our best hope.

Wednesday, December 9, 2009

The Senate: Getting to the Public Option

It is important that health reform continue to move forward through the Senate. The most recent announcement offers some elements that sound attractive. As a whole, though, the package seems to leave a lot of gaping holes, that the Senators will need to address, or that will be resolved in conference.

What the proposal is, as far as we can tell:

Opening up something like the Federal Employees Health Benefits Plan (FEHBP) to the public, through the Office of Personnel Management.
Offering some or all people age 55-64 the chance to buy in to Medicare.
A trigger to create a public option in the future.

Progressives need 3 things:

1. An expanded role for the public sector, in order to effectively control the charges by health care providers: drug companies, hospitals, medical supply companies, hospitals. Doctors too. Private insurance companies have no stake in controlling prices and are often too weak to bargain successfully with organized providers.

2. To the extent there will continue to be private for-profit insurance companies in the mix, they need to be strictly regulated, so that the uninsured will have a fair shake at getting covered, and the insured and underinsured have a fair shake at getting our claims paid.

3. Subsidies to make insurance affordable, and to put some pressure on the government as prices rise.

Increasing enrollment in Medicare for seniors, while expanding coverage for middle age/middle income people, would be a great step forward.

But marginally opening up Medicare selectively to a subset of seniors does not accomplish these objectives. It likely will not increase significantly the number of beneficiaries; and they will be the most expensive to treat.

FEHBP has the same inflationary insurance spiral as any other set of private insurance plans. It does function somewhat like the proposed health insurance exchanges. It is not a public option. A trigger needs to be pulled now.

The Illinois Campaign for Better Health Care proposes this:

"It is NOT an either or - we demand a strong public option, strong insurance reforms, and expanding access to Medicare to all individuals 55 and older. Better yet, let everyone join Medicare."

Call your U.S. Member of Congress at 1-888-801-4426. Tell them:
For Democratic reps: "Stay firm on the public option plan on which you have already voted yes and on expanding Medicare eligibility."

For Republican reps: "Quit playing politics with my and my family's life. Support the American people and support health care reform."

What do you think?