We've had our children, or not. But we remember.
Worried when we were "late." Escaped to New York or California or Mexico where it was legal, if we could, or found lay caregivers through Jane. Mourned our friends, or relatives, or patients, who were not so lucky. The girls who had to quit school; their boyfriends who never did.
We remember when domestic violence didn't have a name. We know that too many still cower in the face of it. We remember when women couldn't get jobs as reporters. We cringe that they are still blamed by some when they are raped on the job.
We fought on the job for decent pay and union rights, and at home for equality and respect. We're so proud of the lives we've created and equally proud of the generations of women and men who are asserting their places in the world.
We're not surprised that Republicans with no solutions for an ailing global economy are going after the rights of individuals to make our own reproductive choices, the rights of workers to a voice on the job, the rights of all of us to public health and health care. We have been startled at how quickly the Democrats will throw us under the bus.
The House's budget bill, HR 1, and the companion HR 3, are the equivalent of a bully's snigger. Their plans to cut health care services including family planning would force more unintended pregnancies on the most vulnerable women. And then deny access to abortions. They have come to push us around and take our money for their own binges, while bellowing about freedom and fiscal responsibility.
So, we need to find each other again, link up as allies, to renew our vision and our voices, to rebuild our power.
The Trust Women/Silver Ribbon Campaign will wear our silver ribbons for reproductive health, rights and justice (www.oursilverribbon.org) at the Walks for Choices this Saturday, Feb. 26 at noon. There's one near you: http://walkforchoice.tumblr.com/
Let's get this party started.
Thursday, February 24, 2011
Saturday, January 22, 2011
The Trust Women/Silver Ribbon Campaign for Reproductive Rights -- Why Now
http://www.huffingtonpost.com/ellen-r-shaffer/the-trust-womensilver-rib_b_810010.html
We've learned a lot this past year.
We learned it is not enough to appoint and elect smart, progressive women and pro-choice men to government. They and we need to mobilize visibly and vocally to advocate for reproductive rights and justice.
As we celebrate the anniversary of Roe v, Wade on Jan. 22, we and our partners are launching the Silver Ribbon Campaign to Trust Women.
Since the beginning of time, women and men have found ways to control when and whether to undertake the joys and responsibilities of becoming parents. Most adults use or have used birth control. However, even the best birth control fails one time in a hundred. Half of all pregnancies are unplanned. At least a third of U.S. women have an abortion during their lives. Most adults believe that abortion care, a legal procedure. should be covered by health insurance as part of reproductive health services. 86% of employer-based health plans currently cover abortion. In these hard economic times, it is crucial that families have the choice whether to bring a child into the world.
But abortion has been stigmatized by a well-organized, well-funded minority movement, including extremists who provoke violent acts. Our reproductive health is used as a wedge issue, seizing on voters' anxieties about the economy and social issues to claim support for the regressive, anti-woman, anti-self-determination ideology of the right.
We saw a pro-choice president sign laws restricting access to abortion in at least three different ways: In the health care reform law, an executive order, and a regulation on state health plans. Despite the obvious fact that contraception is prevention, the Administration felt compelled to convene a panel to determine if contraceptives count as preventive care.
87% of counties now have no abortion providers. The burden falls hardest on the most vulnerable. 1 in 4 Medicaid recipients could not afford an abortion because it is not covered by their state. Medicaid funding restrictions also delay abortions by 2-3 weeks because of the hardship of raising funds to pay for the procedure. Delaying abortion results in higher risk for the health of the women and higher health care costs.
For too long, abortion providers have suffered from domestic terrorism by a violent, tightly-organized fringe. Virtually every clinic in the U.S. that provides abortions has experienced systematic harassment. Doctors who perform abortions have been targeted and murdered. Most recently, in 2009, an anti-reproductive rights zealot shot Dr. George Tiller point blank while Dr. Tiller was serving as a church usher. Each time a doctor murderer was apprehended, the media claimed that the perpetrator was a "lone wolf," a fable unmasked in Ms. Magazine's article by Amanda Robb.
It's up to us, the majority, to demand our rights. We have the right to make decisions about our reproductive health. We have the right to decide whether and when to have children. We have the right to use birth control as prevention. But if we do not stand up and be counted and seen, these rights will be chipped away -- or taken away.
On Jan. 22, on the anniversary of the 1973 Supreme Court decision on Roe v. Wade that made abortion legal, we join with men and women around the U.S. to launch a month in which we wear silver ribbons: the Silver Ribbon Campaign to Trust Women.
It's time to express the true voices of America.
It's time to come together and show our strength and numbers.
We need to stand by each other and claim our rights to the legal health care to which we're entitled.
Join the Silver Ribbon campaign to Trust Women, for Reproductive Rights and Justice.
1. Wear a Trust Women Silver Ribbon, representing science over ideology
2. Spread the word.
- Follow us on Facebook: http://on.fb.me/hmKaES
- Follow us on Twitter: @oursilverribbon
- Get your Twibbon: http://twb.ly/hp1HEG
Tweet and Facebook about the campaign the following lines:
Trust Women! Show your support for reproductive health care and women's rights by @Twibbon http://twb.ly/hp1HEG via @oursilverribbon
3. Take action!
Check out our webpage of events and share your story about reproductive rights and healthcare.
We who proudly wear the silver ribbon:
• Support reproductive rights
• Support free access to birth control
• Support keeping abortion legal and accessible
We Trust Women to make to their own reproductive health decisions and ask you to join us in showing that you Trust Women, too! Please wear a Silver Ribbon on 1/22-2/22 to show that you Trust Women and we (who Trust Women) are the majority.
Get involved! Go to: www.oursilverribbon.org
Co-authored by with Sophia Yen MD, MPH: pediatrician, adolescent medicine specialist, mother, woman, wife.
We've learned a lot this past year.
We learned it is not enough to appoint and elect smart, progressive women and pro-choice men to government. They and we need to mobilize visibly and vocally to advocate for reproductive rights and justice.
As we celebrate the anniversary of Roe v, Wade on Jan. 22, we and our partners are launching the Silver Ribbon Campaign to Trust Women.
Since the beginning of time, women and men have found ways to control when and whether to undertake the joys and responsibilities of becoming parents. Most adults use or have used birth control. However, even the best birth control fails one time in a hundred. Half of all pregnancies are unplanned. At least a third of U.S. women have an abortion during their lives. Most adults believe that abortion care, a legal procedure. should be covered by health insurance as part of reproductive health services. 86% of employer-based health plans currently cover abortion. In these hard economic times, it is crucial that families have the choice whether to bring a child into the world.
But abortion has been stigmatized by a well-organized, well-funded minority movement, including extremists who provoke violent acts. Our reproductive health is used as a wedge issue, seizing on voters' anxieties about the economy and social issues to claim support for the regressive, anti-woman, anti-self-determination ideology of the right.
We saw a pro-choice president sign laws restricting access to abortion in at least three different ways: In the health care reform law, an executive order, and a regulation on state health plans. Despite the obvious fact that contraception is prevention, the Administration felt compelled to convene a panel to determine if contraceptives count as preventive care.
87% of counties now have no abortion providers. The burden falls hardest on the most vulnerable. 1 in 4 Medicaid recipients could not afford an abortion because it is not covered by their state. Medicaid funding restrictions also delay abortions by 2-3 weeks because of the hardship of raising funds to pay for the procedure. Delaying abortion results in higher risk for the health of the women and higher health care costs.
For too long, abortion providers have suffered from domestic terrorism by a violent, tightly-organized fringe. Virtually every clinic in the U.S. that provides abortions has experienced systematic harassment. Doctors who perform abortions have been targeted and murdered. Most recently, in 2009, an anti-reproductive rights zealot shot Dr. George Tiller point blank while Dr. Tiller was serving as a church usher. Each time a doctor murderer was apprehended, the media claimed that the perpetrator was a "lone wolf," a fable unmasked in Ms. Magazine's article by Amanda Robb.
It's up to us, the majority, to demand our rights. We have the right to make decisions about our reproductive health. We have the right to decide whether and when to have children. We have the right to use birth control as prevention. But if we do not stand up and be counted and seen, these rights will be chipped away -- or taken away.
On Jan. 22, on the anniversary of the 1973 Supreme Court decision on Roe v. Wade that made abortion legal, we join with men and women around the U.S. to launch a month in which we wear silver ribbons: the Silver Ribbon Campaign to Trust Women.
It's time to express the true voices of America.
It's time to come together and show our strength and numbers.
We need to stand by each other and claim our rights to the legal health care to which we're entitled.
Join the Silver Ribbon campaign to Trust Women, for Reproductive Rights and Justice.
1. Wear a Trust Women Silver Ribbon, representing science over ideology
2. Spread the word.
- Follow us on Facebook: http://on.fb.me/hmKaES
- Follow us on Twitter: @oursilverribbon
- Get your Twibbon: http://twb.ly/hp1HEG
Tweet and Facebook about the campaign the following lines:
Trust Women! Show your support for reproductive health care and women's rights by @Twibbon http://twb.ly/hp1HEG via @oursilverribbon
3. Take action!
Check out our webpage of events and share your story about reproductive rights and healthcare.
We who proudly wear the silver ribbon:
• Support reproductive rights
• Support free access to birth control
• Support keeping abortion legal and accessible
We Trust Women to make to their own reproductive health decisions and ask you to join us in showing that you Trust Women, too! Please wear a Silver Ribbon on 1/22-2/22 to show that you Trust Women and we (who Trust Women) are the majority.
Get involved! Go to: www.oursilverribbon.org
Co-authored by with Sophia Yen MD, MPH: pediatrician, adolescent medicine specialist, mother, woman, wife.
Saturday, December 18, 2010
Don't Ask Don't Tell Gone; No on DREAM Act
I’d rather no one were in the military.
I’d rather no one had to be married to enjoy full benefits of social and political life.
I hope today’s vote removes another barrier to social inclusion. It was a hard fight; this is a milestone.
Next year we’ll fight for immigrants to claim recognition, to trust women with decisions about their bodies, and for equitable, quality, universal affordable health care.
From Politico:
By SCOTT WONG
12/18/10 11:57 AM EST Updated: 12/18/10 3:52 PM EST
The Senate voted Saturday afternoon to repeal the ban on gays in the military, marking a major victory for gay rights and an end to the 17-year old “don’t ask, don’t tell” policy.
The bill now heads to President Barack Obama, who plans to sign it into law, overturning what repeal advocates believed was a discriminatory policy that unfairly ended the careers of thousands of gay members of the military over the years.
The 65-31 Senate vote marked a historic – and emotional – moment for the gay-rights movement and handed Obama a surprising political victory in the closing days of the 111th Congress. The legislation had been left for dead as recently as last week after Republicans in the Senate blocked efforts to advance it, yet on final passage, the bill won surprising support from eight Republicans.
The repeal, which would not take effect immediately, ushers in a major cultural shift for a military that has operated under the “don’t ask, don’t tell” policy since the first year of Bill Clinton’s presidency.
The Senate vote capped months of uncertainty about whether Congress or the federal courts, where gay-rights advocates are fighting the ban, would act first to repeal the policy.
The real drama had already come a few hours earlier when the repeal bill cleared a crucial procedural hurdle. The 63-33 cloture vote was three more than needed to beat back a Republican filibuster.
With support from all but one member of the Democratic caucus and help from seven Republicans, the bill overcame the 60-vote threshold required to move forward.
The Republican senators voting “yes” with the Democrats were Richard Burr of North Carolina, Mark Kirk of Illinois, John Ensign of Nevada, Scott Brown of Massachusetts, George Voinovich of Ohio, Lisa Murkowski of Alaska – and Olympia Snowe and Susan Collins, both of Maine. Burr, Ensign and Kirk were late surprises, bucking their party on the historic vote.
West Virginia Sen. Joe Manchin, who previously stated he opposes repeal, was the only Democrat to miss the vote, apparently because of a family “holiday gathering,” his spokeswoman said.
President Barack Obama called the procedural vote an “historic step” toward ending a discriminatory policy that weakens America’s national security and violates the ideals troops risk their lives to defend.
“By ending ‘Don’t Ask, Don’t Tell,’ no longer will our nation be denied the service of thousands of patriotic Americans forced to leave the military, despite years of exemplary performance, because they happen to be gay,” Obama said in a statement. “And no longer will many thousands more be asked to live a lie in order to serve the country they love.”
The repeal measure, passed by the Senate Saturday, already cleared the Democratic-controlled House this week along a mostly party-line 250-175 vote. It now goes directly to the president for his promised signature.
The repeal, however, wouldn’t take effect immediately. Obama, Gates and Mullen would have to certify to Congress that they have reviewed the Pentagon report on the impacts of repeal, that the Defense Department is prepared to implement repeal and that doing so would not harm military readiness, troop morale, and recruiting and retention.
The policy would be repealed 60 days after the president submits the document.
Read more: http://www.politico.com/news/stories/1210/46576.html#ixzz18V2i4ifj
I’d rather no one had to be married to enjoy full benefits of social and political life.
I hope today’s vote removes another barrier to social inclusion. It was a hard fight; this is a milestone.
Next year we’ll fight for immigrants to claim recognition, to trust women with decisions about their bodies, and for equitable, quality, universal affordable health care.
From Politico:
By SCOTT WONG
12/18/10 11:57 AM EST Updated: 12/18/10 3:52 PM EST
The Senate voted Saturday afternoon to repeal the ban on gays in the military, marking a major victory for gay rights and an end to the 17-year old “don’t ask, don’t tell” policy.
The bill now heads to President Barack Obama, who plans to sign it into law, overturning what repeal advocates believed was a discriminatory policy that unfairly ended the careers of thousands of gay members of the military over the years.
The 65-31 Senate vote marked a historic – and emotional – moment for the gay-rights movement and handed Obama a surprising political victory in the closing days of the 111th Congress. The legislation had been left for dead as recently as last week after Republicans in the Senate blocked efforts to advance it, yet on final passage, the bill won surprising support from eight Republicans.
The repeal, which would not take effect immediately, ushers in a major cultural shift for a military that has operated under the “don’t ask, don’t tell” policy since the first year of Bill Clinton’s presidency.
The Senate vote capped months of uncertainty about whether Congress or the federal courts, where gay-rights advocates are fighting the ban, would act first to repeal the policy.
The real drama had already come a few hours earlier when the repeal bill cleared a crucial procedural hurdle. The 63-33 cloture vote was three more than needed to beat back a Republican filibuster.
With support from all but one member of the Democratic caucus and help from seven Republicans, the bill overcame the 60-vote threshold required to move forward.
The Republican senators voting “yes” with the Democrats were Richard Burr of North Carolina, Mark Kirk of Illinois, John Ensign of Nevada, Scott Brown of Massachusetts, George Voinovich of Ohio, Lisa Murkowski of Alaska – and Olympia Snowe and Susan Collins, both of Maine. Burr, Ensign and Kirk were late surprises, bucking their party on the historic vote.
West Virginia Sen. Joe Manchin, who previously stated he opposes repeal, was the only Democrat to miss the vote, apparently because of a family “holiday gathering,” his spokeswoman said.
President Barack Obama called the procedural vote an “historic step” toward ending a discriminatory policy that weakens America’s national security and violates the ideals troops risk their lives to defend.
“By ending ‘Don’t Ask, Don’t Tell,’ no longer will our nation be denied the service of thousands of patriotic Americans forced to leave the military, despite years of exemplary performance, because they happen to be gay,” Obama said in a statement. “And no longer will many thousands more be asked to live a lie in order to serve the country they love.”
The repeal measure, passed by the Senate Saturday, already cleared the Democratic-controlled House this week along a mostly party-line 250-175 vote. It now goes directly to the president for his promised signature.
The repeal, however, wouldn’t take effect immediately. Obama, Gates and Mullen would have to certify to Congress that they have reviewed the Pentagon report on the impacts of repeal, that the Defense Department is prepared to implement repeal and that doing so would not harm military readiness, troop morale, and recruiting and retention.
The policy would be repealed 60 days after the president submits the document.
Read more: http://www.politico.com/news/stories/1210/46576.html#ixzz18V2i4ifj
Sunday, November 14, 2010
Acceptance of Dr. Paul Cornely Award for Social Activism from the Physicians' Forum at the American Public Health Association, Nov. 7, 2010
Thank you so much for this award. It is a deep honor to carry on the historic and inspiring work of Dr. Paul Cornely, a lifelong fighter for social justice. Upon his death in 2002, the Washington Post recalled his outstanding lifetime in public health. He was the first black president of the American Public Health Association (1970), the first black person to earn a doctorate in public health (1934), and a founder and first president of the D.C. Public Health Association in 1963 (now the Metropolitan Washington Public Health Association.) Among his landmark struggles was the fight to eliminate segregated health care.
It is especially meaningful to celebrate the traditions those of us gathered together tonight share.
The APHA annual meeting usually follows just on our national elections, and as a result we've shared many historic moments together.
We were together on the eve of the Bush presidency in 2000, and again when we led him to fire Donald Rumsfeld in 2006.
We were together when we elected Barack Obama in 2008.
And this week, of course, the San Francisco Giants have won the World Series for the first time in decades - against the Texas Rangers, I might add.
It has been a difficult week in some other respects but we are so lucky in so many ways - that we do still have the motivation, the means and the wherewithal to speak up for what we believe in.
And especially that we have each other to come together and share it with.
The corporate assault on politics is not new.
There are real historians here so I'll just talk from two of my personal sources of information - my parents and the movies.
I remember my parents telling me about Glenn Beck's precursor, the hate-spewing Father Coughlin, an anti-Semitic, pro Nazi demagogue who dominated the radio airwaves in the 1930s.
And I've been watching re-runs lately of "Mr Smith Goes to Washington." Freshly minted Senator Jimmy Stewart tries to stop a local wheeler dealer from diverting federal funds to build a dam on his property. Jimmy Stewart did everything he could muster. He filibustered on the floor of the Senate to marshal the local press back home - Mr Big confiscated all the newspapers and paid off the radio announcers. Jimmy mobilized the Boy Scouts to hand out fliers, and Mr. Big's goons beat up the Boy Scouts! But he kept at it and kept at it, til Senator Claude Rains couldn't take it any more and handed Jimmy his victory.
Their techniques are more sophisticated today. But the goal is always the same - to keep us ignorant and quiet, so the bullies of the world can get their way.
I think we've had more than one victory this year. We passed health care reform, after a century of failure. It is pock-marked, bullet-ridden and precarious, but it does two things at the heart of the single payer system we are going to win:
It expands the role of government in assuring coverage and payment for health care - something we must start talking about, positively and effectively.
And it targets administrative waste and reform of the delivery system.
These fundamental reforms are in addition to the immediate benefits I hear about every day, in the work of the EQUAL Health Network to educate about, implement and improve the new law, the immediate reason for this honor tonight.
Nothing could give me greater pleasure than to have the chance to share this room with the many of you who've stood here before me, and forged our identity as people who will speak truth to power - and will bend it!
It is especially meaningful to celebrate the traditions those of us gathered together tonight share.
The APHA annual meeting usually follows just on our national elections, and as a result we've shared many historic moments together.
We were together on the eve of the Bush presidency in 2000, and again when we led him to fire Donald Rumsfeld in 2006.
We were together when we elected Barack Obama in 2008.
And this week, of course, the San Francisco Giants have won the World Series for the first time in decades - against the Texas Rangers, I might add.
It has been a difficult week in some other respects but we are so lucky in so many ways - that we do still have the motivation, the means and the wherewithal to speak up for what we believe in.
And especially that we have each other to come together and share it with.
The corporate assault on politics is not new.
There are real historians here so I'll just talk from two of my personal sources of information - my parents and the movies.
I remember my parents telling me about Glenn Beck's precursor, the hate-spewing Father Coughlin, an anti-Semitic, pro Nazi demagogue who dominated the radio airwaves in the 1930s.
And I've been watching re-runs lately of "Mr Smith Goes to Washington." Freshly minted Senator Jimmy Stewart tries to stop a local wheeler dealer from diverting federal funds to build a dam on his property. Jimmy Stewart did everything he could muster. He filibustered on the floor of the Senate to marshal the local press back home - Mr Big confiscated all the newspapers and paid off the radio announcers. Jimmy mobilized the Boy Scouts to hand out fliers, and Mr. Big's goons beat up the Boy Scouts! But he kept at it and kept at it, til Senator Claude Rains couldn't take it any more and handed Jimmy his victory.
Their techniques are more sophisticated today. But the goal is always the same - to keep us ignorant and quiet, so the bullies of the world can get their way.
I think we've had more than one victory this year. We passed health care reform, after a century of failure. It is pock-marked, bullet-ridden and precarious, but it does two things at the heart of the single payer system we are going to win:
It expands the role of government in assuring coverage and payment for health care - something we must start talking about, positively and effectively.
And it targets administrative waste and reform of the delivery system.
These fundamental reforms are in addition to the immediate benefits I hear about every day, in the work of the EQUAL Health Network to educate about, implement and improve the new law, the immediate reason for this honor tonight.
Nothing could give me greater pleasure than to have the chance to share this room with the many of you who've stood here before me, and forged our identity as people who will speak truth to power - and will bend it!
Friday, October 15, 2010
Health Reform: Declaring and Winning Victories on the Way Forward
Invitation to a Discussion
Many are mad as hell this election season, including some progressives. Absent the funding of the madly rich and insanely right-wing Koch brothers, what are we to do?
For one thing, take a sober look at the policy and politics associated with the Affordable Care Act.
This is not the single payer system many staunch health care reform advocates - including me - preferred, but lacked the power to enact. As we continue the campaign for a single payer, it is essential to recognize, vigorously defend and advance the victories we achieved in the Affordable Care Act, in order to preserve the gains for people in need and also to shore up the valuable activists, and activism, we will need for what is going to be a long haul ahead.
Here's what the ACA accomplishes, what single payer systems do, why we're absolutely right to continue to advocate for them, and how we can shape policy to get there from here.
What does the ACA accomplish? The U.S. health care system will do a better job of treating illness and improving health at an affordable cost. The Medicare Trust Fund will be solvent for an additional 12 years, through 2029. There are substantial improvements for lower and middle income people, and immediate benefits for women, younger people, seniors and small businesses. Importantly, the ACA creates policy space to continue efforts to cover everyone while controlling costs, goals that are popular with the public. It accomplishes these objectives in part by imposing new progressive taxes and fees on the wealthiest 2% of the population and on employers.
Politically, the ACA opens opportunities to challenge corporate power at the national level, in the formation of extensive regulations. It throws some leverage to the states, which progressives can use to advance our goals of equitable, quality, universal, affordable health care.
The law includes compromises that call out for revision, particularly on affordability, and on coverage for immigrants and for reproductive health care. And the political process that got us here will be grist for analysis for decades to come.
But it is just not true, as some have characterized it, that the law is primarily a victory for business as usual by the insurance industry. Furthermore, the fight to undermine and defeat the law unquestionably empowers and invigorates the most predatory anti-government political and financial interests in the country. Since the facts don't serve their agenda - to profit by destabilizing our social and financial security, including dismantling Medicare - they rely on hyperbole and distortion to mobilize the public's complicity in opposing our own real best interests. In contrast, we can and must remain critical while carefully examining sweeping generalizations that don't fit.
Single Payer: Getting There from Here
Single payer systems funnel all payments for health care to one collection point - usually a state or national government. This single payer then pays all the health care providers: doctors, hospitals, drug companies. There is overwhelming evidence that single payer systems are more cost-efficient and affordable, along with their many benefits for equity and quality of care.
This is different from our current system in at least two ways that are key to controlling health care costs.
• First, it is administratively efficient. It eliminates the middleman: the proliferation of private insurance companies that take a bite out of every health care dollar for the administrative service of paying the bills. These insurance companies, both for-profit and non-profit, now rake off about 30% or more of our insurance premiums, using ploys that at the same time restrict access to necessary health care and inflict great suffering on ailing humanity. They also add to the administrative burdens of doctors and hospitals.
• Secondly, it moderates prices. It gives a powerful negotiator - the government - the authority to negotiate prices with the health care industry: hospitals, doctors, medical supply companies, drug companies.
Largely for these reasons, single payer proposals are fiercely attacked, maligned and misrepresented and in all manner just blocked in the halls of power by the industry, which profits nicely from this mess.
The state and federal governments are now writing the rules for implementing the Affordable Care Act. Advocates can help to shape these rules to get us closer to administrative efficiency, and to expand the public sector's purview over prices. Some examples:
• In 2014, new insurance Exchanges will standardize health insurance plans. People who buy insurance now as individuals or in small groups will be grouped into much larger pools, sharply reducing cost-shifting. Advocates have the opportunity to craft and support state laws implementing the exchanges that can push limits on standardizing health plans and require financial transparency.
• The law sharply expands the number of people covered by public sector health plans. For the first time Medicaid will cover everyone under 133% of the federal poverty level, regardless of health status. State governments already do negotiate drug prices under Medicaid, in which enrollment will grow by almost half by 2014. State laws to adopt a public option would further expand the number of people who receive health care either paid for or provided directly by the public sector.
• There are numerous opportunities to regulate, review and otherwise limit premiums, depending on the rules adopted by HHS, and state implementation laws. The current policy debate on how to define and enforce the Medical Loss Ratio is an important example.
• The law also draws on the public's control over Medicare to address some of the underlying drivers of increasing health costs through new measures such as comparative effectiveness research and payment reforms to encourage more cost-effective delivery systems. It also expands primary care and public health.
• Finally, as soon as 2017 - maybe sooner - there is a defined process for states to prepare for and enact alternative systems, including single payer.
The corporate media surround us with messages - and messengers - that exhort us to succumb to cynicism (nothing will ever work, they'll always sell us out). Voluntarily taking ourselves out of the real health care fights of the day is tantamount to capitulation. Effective strategies for building the power we need will require and emerge from engagement as well as resistance. Advocates can rebuild public awareness and momentum for single payer systems, and at the same time support legislation and regulations that maximize the progressive aspects of the ACA. If done well, our work on the ACA will build the pathways we need to a single payer system.
Many are mad as hell this election season, including some progressives. Absent the funding of the madly rich and insanely right-wing Koch brothers, what are we to do?
For one thing, take a sober look at the policy and politics associated with the Affordable Care Act.
This is not the single payer system many staunch health care reform advocates - including me - preferred, but lacked the power to enact. As we continue the campaign for a single payer, it is essential to recognize, vigorously defend and advance the victories we achieved in the Affordable Care Act, in order to preserve the gains for people in need and also to shore up the valuable activists, and activism, we will need for what is going to be a long haul ahead.
Here's what the ACA accomplishes, what single payer systems do, why we're absolutely right to continue to advocate for them, and how we can shape policy to get there from here.
What does the ACA accomplish? The U.S. health care system will do a better job of treating illness and improving health at an affordable cost. The Medicare Trust Fund will be solvent for an additional 12 years, through 2029. There are substantial improvements for lower and middle income people, and immediate benefits for women, younger people, seniors and small businesses. Importantly, the ACA creates policy space to continue efforts to cover everyone while controlling costs, goals that are popular with the public. It accomplishes these objectives in part by imposing new progressive taxes and fees on the wealthiest 2% of the population and on employers.
Politically, the ACA opens opportunities to challenge corporate power at the national level, in the formation of extensive regulations. It throws some leverage to the states, which progressives can use to advance our goals of equitable, quality, universal, affordable health care.
The law includes compromises that call out for revision, particularly on affordability, and on coverage for immigrants and for reproductive health care. And the political process that got us here will be grist for analysis for decades to come.
But it is just not true, as some have characterized it, that the law is primarily a victory for business as usual by the insurance industry. Furthermore, the fight to undermine and defeat the law unquestionably empowers and invigorates the most predatory anti-government political and financial interests in the country. Since the facts don't serve their agenda - to profit by destabilizing our social and financial security, including dismantling Medicare - they rely on hyperbole and distortion to mobilize the public's complicity in opposing our own real best interests. In contrast, we can and must remain critical while carefully examining sweeping generalizations that don't fit.
Single Payer: Getting There from Here
Single payer systems funnel all payments for health care to one collection point - usually a state or national government. This single payer then pays all the health care providers: doctors, hospitals, drug companies. There is overwhelming evidence that single payer systems are more cost-efficient and affordable, along with their many benefits for equity and quality of care.
This is different from our current system in at least two ways that are key to controlling health care costs.
• First, it is administratively efficient. It eliminates the middleman: the proliferation of private insurance companies that take a bite out of every health care dollar for the administrative service of paying the bills. These insurance companies, both for-profit and non-profit, now rake off about 30% or more of our insurance premiums, using ploys that at the same time restrict access to necessary health care and inflict great suffering on ailing humanity. They also add to the administrative burdens of doctors and hospitals.
• Secondly, it moderates prices. It gives a powerful negotiator - the government - the authority to negotiate prices with the health care industry: hospitals, doctors, medical supply companies, drug companies.
Largely for these reasons, single payer proposals are fiercely attacked, maligned and misrepresented and in all manner just blocked in the halls of power by the industry, which profits nicely from this mess.
The state and federal governments are now writing the rules for implementing the Affordable Care Act. Advocates can help to shape these rules to get us closer to administrative efficiency, and to expand the public sector's purview over prices. Some examples:
• In 2014, new insurance Exchanges will standardize health insurance plans. People who buy insurance now as individuals or in small groups will be grouped into much larger pools, sharply reducing cost-shifting. Advocates have the opportunity to craft and support state laws implementing the exchanges that can push limits on standardizing health plans and require financial transparency.
• The law sharply expands the number of people covered by public sector health plans. For the first time Medicaid will cover everyone under 133% of the federal poverty level, regardless of health status. State governments already do negotiate drug prices under Medicaid, in which enrollment will grow by almost half by 2014. State laws to adopt a public option would further expand the number of people who receive health care either paid for or provided directly by the public sector.
• There are numerous opportunities to regulate, review and otherwise limit premiums, depending on the rules adopted by HHS, and state implementation laws. The current policy debate on how to define and enforce the Medical Loss Ratio is an important example.
• The law also draws on the public's control over Medicare to address some of the underlying drivers of increasing health costs through new measures such as comparative effectiveness research and payment reforms to encourage more cost-effective delivery systems. It also expands primary care and public health.
• Finally, as soon as 2017 - maybe sooner - there is a defined process for states to prepare for and enact alternative systems, including single payer.
The corporate media surround us with messages - and messengers - that exhort us to succumb to cynicism (nothing will ever work, they'll always sell us out). Voluntarily taking ourselves out of the real health care fights of the day is tantamount to capitulation. Effective strategies for building the power we need will require and emerge from engagement as well as resistance. Advocates can rebuild public awareness and momentum for single payer systems, and at the same time support legislation and regulations that maximize the progressive aspects of the ACA. If done well, our work on the ACA will build the pathways we need to a single payer system.
Monday, October 11, 2010
California’s Health Insurance Exchange Law: Why Does It Matter?
The Affordable Care Act (ACA) has created a new system of health insurance exchanges. States can design and implement the exchanges to offer new opportunities for access to affordable, accountable health insurance. California’s law is the first in the nation..
Under the federal ACA, exchanges will open in 2014 to offer standardized insurance plans to individuals and small businesses, with subsidies available to people earning up to 400% of the federal poverty level. The California law creates a 5- member governing body with two important features. First, it must “take into consideration the cultural, ethnic, and geographical diversity of the state so that the board’s composition reflects the communities of California.” Secondly, its strong conflict of interest provisions exclude participation by active agents of the insurance and health care industries.
In a key provision for affordability, the state will have the right to engage in “selective contracting” with insurance plans, meaning it will be able to negotiate on premium rates. In addition, it has the right to “require carriers to offer additional products within each of” the five levels of coverage specified by the ACA. These could conceivably refer to supplementary dental plans.
The exchanges for individuals and small employers are initially separate. They could be united in the future, pending a study due by 2018.
The exchange must be self-supporting, after repaying an initial loan for administrative start-up, although there is a prospect for General Fund support. Critics have noted that this funding limitation could hamper the exchange’s viability.
The law includes other important features. It requires coordination with existing health programs. The exchange must provide “oral interpretation services in any language for individuals seeking coverage through the Exchange and makes available a toll-free telephone number for the hearing and speech impaired.” And, “The board shall ensure that written information made available by the Exchange is presented in a plainly worded, easily understandable format and made available in prevalent languages.” Further, the Board must “consult with stakeholders relevant to carrying out” its activities, including “health care consumers who are enrolled in health plans, individuals and entities with experience in facilitating enrollment in health plans, representatives of small businesses and self-employed individuals, the State Medi-Cal Director, and advocates for enrolling hard-to-reach populations.”
Read the bills here:
California Exchange Bill AB 1602
CA Exchange Bill – Senate Bill 900 (Governance)
Under the federal ACA, exchanges will open in 2014 to offer standardized insurance plans to individuals and small businesses, with subsidies available to people earning up to 400% of the federal poverty level. The California law creates a 5- member governing body with two important features. First, it must “take into consideration the cultural, ethnic, and geographical diversity of the state so that the board’s composition reflects the communities of California.” Secondly, its strong conflict of interest provisions exclude participation by active agents of the insurance and health care industries.
In a key provision for affordability, the state will have the right to engage in “selective contracting” with insurance plans, meaning it will be able to negotiate on premium rates. In addition, it has the right to “require carriers to offer additional products within each of” the five levels of coverage specified by the ACA. These could conceivably refer to supplementary dental plans.
The exchanges for individuals and small employers are initially separate. They could be united in the future, pending a study due by 2018.
The exchange must be self-supporting, after repaying an initial loan for administrative start-up, although there is a prospect for General Fund support. Critics have noted that this funding limitation could hamper the exchange’s viability.
The law includes other important features. It requires coordination with existing health programs. The exchange must provide “oral interpretation services in any language for individuals seeking coverage through the Exchange and makes available a toll-free telephone number for the hearing and speech impaired.” And, “The board shall ensure that written information made available by the Exchange is presented in a plainly worded, easily understandable format and made available in prevalent languages.” Further, the Board must “consult with stakeholders relevant to carrying out” its activities, including “health care consumers who are enrolled in health plans, individuals and entities with experience in facilitating enrollment in health plans, representatives of small businesses and self-employed individuals, the State Medi-Cal Director, and advocates for enrolling hard-to-reach populations.”
Read the bills here:
California Exchange Bill AB 1602
CA Exchange Bill – Senate Bill 900 (Governance)
Friday, September 17, 2010
Do Men Have Sex? IOM to Study
Today is the deadline for comments on interim federal regulations on what constitutes a preventive health care service. This is relevant because under the new health care reform law, preventive health care services are to be provided without co-payments and deductibles. Which somehow raises the apparently puzzling question as to whether contraception (defined as methods to prevent pregnancy) is preventive.
Or related to health.
The Obama administration isn't sure about this, and so has asked the Institute of Medicine to study it. This isn't really the question.
The question is: Do men have sex?
Based on substantial empirical evidence, though no new primary research, I assert: They do.
I further assert (and this is recent news as of the last few thousand years) that there are statistically zero pregnancies that occur without the involvement of sperm. This is most commonly supplied by a man known to the prospective mother, but could be supplied through artificial insemination.There were about 4.2 million U.S.births in 2009.
I appreciate that it is women who become pregnant. I appreciate and am an active participant in the women's health movement. There are health conditions that actually occur only in women (cervical cancer) or mostly in women (breast cancer), and gender-related factors that determine female well-being, life chances and longevity.
But I submit that contraception, conception and pregnancy are biological events that involve both males and females; and usually, not to be coy about it, sex.
Now here is how the new regulations will work: Every other on-its-face preventive service will be provided without extra cost-sharing. Starting on Sept. 23.
The Department of Health and Human Services was so eager to get this done that it is issuing interim regulations, meaning we can still submit comments on proposed regulations but meanwhile the interim regs will go into effect. But the Institute of Medicine is going to have to determine whether contraception really is preventive, and related to health, and a service. That will take till August 2011. Then, assuming that they do so affirmatively determine, it will be about another year before you get your IUD, birth control pills -- or vasectomy -- without an additional copay.
We in the women's health movement are going about this all wrong. Contraception is not about protecting women, at least not alone. Contraception is about the rights of men to have sex. In fact, contraception should be the corollary of every prescription for Viagra. In fact, that was the argument Jackie Speier used successfully, when she was a state senator, to get contraception covered by Califormia insurance plans.
Men, whatever else you think about health care reform, I think most of you know and like your female partners. (And LGBT adoptive and assisted technology parents generally feel the same.) You share, at least, the financial and emotional expenses of child-rearing, to say nothing of pregnancy; and if you don't, well, we have laws about that, too. So drop a note by clicking here to the EQUAL Health Network, and we'll let HHS know you know where babies come from. They need your help. You're so big and strong.
Or related to health.
The Obama administration isn't sure about this, and so has asked the Institute of Medicine to study it. This isn't really the question.
The question is: Do men have sex?
Based on substantial empirical evidence, though no new primary research, I assert: They do.
I further assert (and this is recent news as of the last few thousand years) that there are statistically zero pregnancies that occur without the involvement of sperm. This is most commonly supplied by a man known to the prospective mother, but could be supplied through artificial insemination.There were about 4.2 million U.S.births in 2009.
I appreciate that it is women who become pregnant. I appreciate and am an active participant in the women's health movement. There are health conditions that actually occur only in women (cervical cancer) or mostly in women (breast cancer), and gender-related factors that determine female well-being, life chances and longevity.
But I submit that contraception, conception and pregnancy are biological events that involve both males and females; and usually, not to be coy about it, sex.
Now here is how the new regulations will work: Every other on-its-face preventive service will be provided without extra cost-sharing. Starting on Sept. 23.
The Department of Health and Human Services was so eager to get this done that it is issuing interim regulations, meaning we can still submit comments on proposed regulations but meanwhile the interim regs will go into effect. But the Institute of Medicine is going to have to determine whether contraception really is preventive, and related to health, and a service. That will take till August 2011. Then, assuming that they do so affirmatively determine, it will be about another year before you get your IUD, birth control pills -- or vasectomy -- without an additional copay.
We in the women's health movement are going about this all wrong. Contraception is not about protecting women, at least not alone. Contraception is about the rights of men to have sex. In fact, contraception should be the corollary of every prescription for Viagra. In fact, that was the argument Jackie Speier used successfully, when she was a state senator, to get contraception covered by Califormia insurance plans.
Men, whatever else you think about health care reform, I think most of you know and like your female partners. (And LGBT adoptive and assisted technology parents generally feel the same.) You share, at least, the financial and emotional expenses of child-rearing, to say nothing of pregnancy; and if you don't, well, we have laws about that, too. So drop a note by clicking here to the EQUAL Health Network, and we'll let HHS know you know where babies come from. They need your help. You're so big and strong.
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