Advocates for Single Payer HealthCare Blog
About the Author
A forum for exchange of views on singple payer healthcare and progress being made toward that goal
I gave the following testimony in front of the Pennsylvania House of Representatives Insurance Committee in public hearings in Pittsburgh on 9/19/06: (The same arguments apply at the National level - but I tailored the discussion to my own state since I was speaking before a State legislative committee)
I am Dr. Barry Tepperman. I have practiced the medical specialty of Radiation Oncology in the United States for 23 years, in a variety of practice and market settings. I was born and raised and trained in my profession in Canada. I am trained in and teach medical ethics, and hold an MBA degree in Health Administration. Currently I am a member of the Department of Radiation Oncology at Allegheny General Hospital and Chief of Radiation Therapy for the Pittsburgh VA Health System, but in these remarks I speak for myself alone and my comments do not represent the views of either organization. I want to thank Representative DeLuca for the opportunity to testify before the House Insurance Committee today.
The Declaration of Independence speaks to â��unalienable rightsâ�� including â��life, liberty, and the pursuit of happinessâ��. The Declaration of Rights of the Pennsylvania Constitution speaks of universal â��inherent and indefeasible rightsâ��, which include enjoying and defending life and liberty, of acquiring, possessing, and protecting property and reputation, and of pursuing their own happiness. One need ask whether there are conditions under which in the daily life of a Pennsylvania resident these rights are compromised or denied. I respond that in the absence of optimal physical, emotional, and psychological health or the opportunity to be as fully as possible restored to such a state, these rights cannot be achieved. If an individual's quality of life is compromised for want of health care, life and liberty are devalued, happiness â�" for him and for those who care for him - is unachievable, property and reputation are meaningless. I maintain that by implication of these sweeping but generally accepted statements this nation grants a fundamental and irrefutable right to health and to health care. In order to meet the constitutional test of equal protection, such care needs to be of equal quality and equally accessible to all residents of the state, in a fashion which does not discriminate according to factors such as financial resources or potential, current employment or future prospects, physical ability, current or prior infirmity, site of residence, or the profit needs of third parties â�" much less the generally regarded criteria of race, religion, ethnicity, or age.
Pennsylvania society differentiates in access to health care between the rural and the urban, between ethnic and racial groups, those housed and those homeless, to create castes of medical untouchables â�" the uninsured, the underinsured, the uninsurable, those who can access the system only after a minimal problem has progressed through neglect and want of access to crisis proportions. Even those who are as fully insured as this system allows are distinguished according to their private insurer and the quality of their insurance. This creates the medically ethically untenable situation where, according to what they will pay for and what employers have contracted for, in the same physicians' practice treating comparable patients different insurers will demand different standards of care â�" a distinction based on the insurers' need for profit and not on any scientific evidence or medical logic. The current canon of medical ethics reasons acceptable behavior from four basic principles â�" one of which is justice - simple fairness and equity in the use and application of resources. Our current system denies care to many and violates that ethical precept in the care of countless more. Only a system that guarantees equal access for all and a single standard of care based on scientific evidence will pass the test of equal protection for all Pennsylvania residents â�" and I would submit to you that only through a single-payer universal health care system can that be achieved.
The link between employment and access to health care can be justified only in a society that accepts that a person's worth is determined by employment and level of income, and that an individual's access to health care and the quality of that care should be determined and proportionate to that measure of worth. The link we have now between employment and health insurance is egregious. It holds employees in positions that would otherwise be undesirable and discourages them from changing employers for advancement, places employees who leave or lose their positions in jeopardy of losing their assets and their lives. It places a disproportionate burden on honorable employers who are attempting to care for their employees to pay the passed-through costs of care for those who are unemployed or employed but uninsured. When this burden is placed on the employers of the state, the economic imperatives of keeping business viable may force them to reduce or eliminate benefits, move jobs offshore... or face closing. The opportunity cost to all of Pennsylvania of such choices is massive. The current system may allow a substantial proportion of the population to be insured in some fashion â�" but for employers, employees, and the rest of the state it creates a lose-lose-lose proposition.
By ensuring universal access and coverage for all residents, the passthrough of the costs of care for the uninsured and underinsured to those holding or paying for insurance is eliminated, and the costs of care are spread equitably in the State. If the for-profit sector is taken out of the health care market and providers work to an evidence-based single standard of care, the obligation of the payor of insurance premiums to fund the profit margins of investors and to pay for predictable overutilization at investor-owned facilities is eliminated. If the administration of health care in the State can approach the administrative efficiencies of the federal Medicare and Medicaid programs, the overhead attributable to administrative costs is reduced from 15-20% of health care related expenditures to 3-5%. This further reduces overhead costs at the level of the individual health care provider by reducing staffing time and overhead devoted to insurer authorizations and denial management. Promoting a single standard of care based on best science reduces the costs inherent in medical malpractice litigation. The costs of prescription drugs and medical equipment would be reduced by aggressive negotiation at a state-wide level. But all of these are paper savings, and achieving this equity demands an actual source of capital. The least regressive sources of taxation to pay for health care would be derived from payroll taxes shared between employer and employee, and a health care surcharge on the earned income taxes of the highest 5% of earners. It has been estimated that for a Pennsylvania-only plan, a payroll tax surcharge of 5% and an earned income health tax surcharge of 10% would meet the cost requirements of a generously comprehensive universal health plan, all at costs to individual employers and residents of the state that in 95% of cases would be less than the insured and employers who provide insurance currently pay.
The Canadian experience with a single-payer system has led to urban legends in these discussions â�" of rationing, waiting lists, denials of care. In the time available I can only inform the Committee that these arose out of lack of provision for funding of new technologies in that system as originally developed in 1964 and were corrected more than a decade ago. In a country where we are overbuilt in advanced technologies we would not face such issues â�" the issue would be more one of making the most appropriate use in the public interest of the technologies in place.
Members of the Committee, achieving universal health care for all Pennsylvania residents is a Constitutional obligation in fulfillment of a fundamental right that has been too long neglected. Our current system is designed neither to be equitable nor universal â�" but it follows the â��golden ruleâ�� â�" those who have the gold make the rules and benefit from them, and is fundamentally undemocratic. It is well beyond broken â�" and must be replaced. Its replacement is not only practical, it represents a fundamental reduction in costs dedicated to health care in Pennsylvania while offering a massive upgrade in access and quality that serves a universal need and right that has been too long ignored. The only question.... is the political will to act.
I am Dr. Barry Tepperman. I have practiced the medical specialty of Radiation Oncology in the United States for 23 years, in a variety of practice and market settings. I was born and raised and trained in my profession in Canada. I am trained in and teach medical ethics, and hold an MBA degree in Health Administration. Currently I am a member of the Department of Radiation Oncology at Allegheny General Hospital and Chief of Radiation Therapy for the Pittsburgh VA Health System, but in these remarks I speak for myself alone and my comments do not represent the views of either organization. I want to thank Representative DeLuca for the opportunity to testify before the House Insurance Committee today.
The Declaration of Independence speaks to â��unalienable rightsâ�� including â��life, liberty, and the pursuit of happinessâ��. The Declaration of Rights of the Pennsylvania Constitution speaks of universal â��inherent and indefeasible rightsâ��, which include enjoying and defending life and liberty, of acquiring, possessing, and protecting property and reputation, and of pursuing their own happiness. One need ask whether there are conditions under which in the daily life of a Pennsylvania resident these rights are compromised or denied. I respond that in the absence of optimal physical, emotional, and psychological health or the opportunity to be as fully as possible restored to such a state, these rights cannot be achieved. If an individual's quality of life is compromised for want of health care, life and liberty are devalued, happiness â�" for him and for those who care for him - is unachievable, property and reputation are meaningless. I maintain that by implication of these sweeping but generally accepted statements this nation grants a fundamental and irrefutable right to health and to health care. In order to meet the constitutional test of equal protection, such care needs to be of equal quality and equally accessible to all residents of the state, in a fashion which does not discriminate according to factors such as financial resources or potential, current employment or future prospects, physical ability, current or prior infirmity, site of residence, or the profit needs of third parties â�" much less the generally regarded criteria of race, religion, ethnicity, or age.
Pennsylvania society differentiates in access to health care between the rural and the urban, between ethnic and racial groups, those housed and those homeless, to create castes of medical untouchables â�" the uninsured, the underinsured, the uninsurable, those who can access the system only after a minimal problem has progressed through neglect and want of access to crisis proportions. Even those who are as fully insured as this system allows are distinguished according to their private insurer and the quality of their insurance. This creates the medically ethically untenable situation where, according to what they will pay for and what employers have contracted for, in the same physicians' practice treating comparable patients different insurers will demand different standards of care â�" a distinction based on the insurers' need for profit and not on any scientific evidence or medical logic. The current canon of medical ethics reasons acceptable behavior from four basic principles â�" one of which is justice - simple fairness and equity in the use and application of resources. Our current system denies care to many and violates that ethical precept in the care of countless more. Only a system that guarantees equal access for all and a single standard of care based on scientific evidence will pass the test of equal protection for all Pennsylvania residents â�" and I would submit to you that only through a single-payer universal health care system can that be achieved.
The link between employment and access to health care can be justified only in a society that accepts that a person's worth is determined by employment and level of income, and that an individual's access to health care and the quality of that care should be determined and proportionate to that measure of worth. The link we have now between employment and health insurance is egregious. It holds employees in positions that would otherwise be undesirable and discourages them from changing employers for advancement, places employees who leave or lose their positions in jeopardy of losing their assets and their lives. It places a disproportionate burden on honorable employers who are attempting to care for their employees to pay the passed-through costs of care for those who are unemployed or employed but uninsured. When this burden is placed on the employers of the state, the economic imperatives of keeping business viable may force them to reduce or eliminate benefits, move jobs offshore... or face closing. The opportunity cost to all of Pennsylvania of such choices is massive. The current system may allow a substantial proportion of the population to be insured in some fashion â�" but for employers, employees, and the rest of the state it creates a lose-lose-lose proposition.
By ensuring universal access and coverage for all residents, the passthrough of the costs of care for the uninsured and underinsured to those holding or paying for insurance is eliminated, and the costs of care are spread equitably in the State. If the for-profit sector is taken out of the health care market and providers work to an evidence-based single standard of care, the obligation of the payor of insurance premiums to fund the profit margins of investors and to pay for predictable overutilization at investor-owned facilities is eliminated. If the administration of health care in the State can approach the administrative efficiencies of the federal Medicare and Medicaid programs, the overhead attributable to administrative costs is reduced from 15-20% of health care related expenditures to 3-5%. This further reduces overhead costs at the level of the individual health care provider by reducing staffing time and overhead devoted to insurer authorizations and denial management. Promoting a single standard of care based on best science reduces the costs inherent in medical malpractice litigation. The costs of prescription drugs and medical equipment would be reduced by aggressive negotiation at a state-wide level. But all of these are paper savings, and achieving this equity demands an actual source of capital. The least regressive sources of taxation to pay for health care would be derived from payroll taxes shared between employer and employee, and a health care surcharge on the earned income taxes of the highest 5% of earners. It has been estimated that for a Pennsylvania-only plan, a payroll tax surcharge of 5% and an earned income health tax surcharge of 10% would meet the cost requirements of a generously comprehensive universal health plan, all at costs to individual employers and residents of the state that in 95% of cases would be less than the insured and employers who provide insurance currently pay.
The Canadian experience with a single-payer system has led to urban legends in these discussions â�" of rationing, waiting lists, denials of care. In the time available I can only inform the Committee that these arose out of lack of provision for funding of new technologies in that system as originally developed in 1964 and were corrected more than a decade ago. In a country where we are overbuilt in advanced technologies we would not face such issues â�" the issue would be more one of making the most appropriate use in the public interest of the technologies in place.
Members of the Committee, achieving universal health care for all Pennsylvania residents is a Constitutional obligation in fulfillment of a fundamental right that has been too long neglected. Our current system is designed neither to be equitable nor universal â�" but it follows the â��golden ruleâ�� â�" those who have the gold make the rules and benefit from them, and is fundamentally undemocratic. It is well beyond broken â�" and must be replaced. Its replacement is not only practical, it represents a fundamental reduction in costs dedicated to health care in Pennsylvania while offering a massive upgrade in access and quality that serves a universal need and right that has been too long ignored. The only question.... is the political will to act.
Earlier today I had the extreme pleasure (or at least the extreme gastric hyperacidity) of hearing outgoing Senator Rick Santorum (at least, that's the way we're planning it - he's more than 10 points behind in the polls) at a community forum with Pittsburgh Interfaith Impact Network, one of my advocacy groups. He was invited - as was his opponent separately - to answer questions on PIIN's key issues, which include single-payer health care. (His Dem opponent, Bob Casey, was rescheduled out of respect for the death this past week of Pittsburgh's mayor.) I have certainly heard the lies about single-payer and Canada before, but never stated so quickly and glibly in such extreme versions - the waiting lists (which went away in about 1995), the lack of technology (correction of which was the reason the waiting lists went away in the early 1990s).... and did you know "the cancer survival rate in Canada is one-third that in the US because people just aren't treated"? TALK ABOUT BASELESS FEAR-MONGERING! (Pardon me... I have treated cancer for 26 years, I have my specialty qualifications on both sides of the border and have stayed in contact with my colleagues there, and I KNOW I can achieve exactly the same standard of care and results there!) And when his questioner rebutted him with statistics from the World Health Organization, Santorum replied that he was using "an unreliable source". Okay - so Santorum aced Lying 101. Even though the rules of engagement were that no audience questions or comments were allowed, about half of us sitting there were screaming "LIAR!"
Why this prolog? Because the grassroots activist looking for support of single-payer will hear the same lies from other sources - including many of our own. This is not the time for a history lesson in Canadian health care... this is a time for a lesson in how to rebut the lies and bring the victim of the Big Lie into our camp.
These arguments are written with the current Pennsylvania legislation in mind. They work with adaptation for the national bill (Rep Conyers' HR676) or any other state legislation seriously proposing a single-payer model.
101 REASONS WHY BALANCED HEALTHCARE REFORM
WORKS FOR PENNSYLVANIA
1. Protect Pennsylvania jobs - by capping the employer contribution to the Health Trust at 10% of payroll. Those Pennsylvania employers currently paying for employee health insurance coverage will enjoy a substantial savings and will no longer be at a competitive disadvantage
to those paying nothing toward the cost of health care coverage. This
also completely eliminates the administrative overhead costs
associated with employer paid health insurance.
2.
Reduce the cost of prescription drugs - by using Pennsylvania’s
12.5 million citizens as a formidable bargaining entity in dealing with
drug companies.
3.
Eliminate uncompensated care - by assuring that health care
providers are paid for all of the services they provide.
4.
Assure comprehensive care for all - through a universal health
care system. Approximately one million out of our 12 million citizens
have no health coverage of any kind.
5.
End wasteful “defensive” medicine - which, according to a recent
survey, 90% of Pennsylvania physicians admit to. We address this by
replacing the fault based malpractice system with a no-fault program
that emphasizes broader availability of compensation, quality
assurance instead of punishment. Those who believe they are better
off retaining their traditional fault based right to sue may opt out of
the no-fault system, but the Balanced Plan adopts the no-fault
approachas the default position and thus the vast majority of
Pennsylvanians will participate in the no-fault program.
6.
Address racial disparity -through universal access and a
commitment to assuring the availability of quality providers in all
communities.
7.
Dramatically reduce wasteful administrative costs - through a
single payer approach that eliminates the unnecessary and redundant
overhead of the existing myriad of public and private payers. Major
studies have agreed that approximately 20% of our health care dollars
are wasted due to the inefficiencies of the current system.
8.
Remove health care as a recurrent union/management issue in
collective bargaining - by providing automatic, comprehensive, and
universal health care independent of the employment relationship.
This legislation does permit unions and employers to opt out of the
Commonwealth Plan so long as the benefits included in the collective
bargaining agreement are at least as comprehensive as the
Commonwealth Plan.
9.
End health care expenses as the leading cause of personal
bankruptcy - thus preserving the dignity and savings of Americans
who already face the burdens directly associated with family illness or
accident.
10.
Preserve the volunteer firefighter and emergency responder
base, especially in rural areas of the Commonwealth - through a
$1,000 per year state tax rebate to active volunteers we encourage
the retention and recruitment of this vital resource.
11.
Reduce the cost of workers’ compensation insurance - with
universal coverage that meets an injured employee’s health care
needs independent of the employer’s workers’ compensation
insurance. By eliminating the health care expense and administrative
overhead workers compensation premiums will drop dramatically.
12.
Eliminate duplication of facilities in over-served communities
by requiring a certification of need communities already adequately
served with high tech diagnostics or surgery centers will not see
another (which would only threaten the financial viability of both) and
instead would-be investors will be encouraged to build in under-served
areas.
13.
Restore the concept of a true “emergency room” - through
universal coverage that assures that all citizens will have ready access
to primary care physicians. Thus ending the wasteful and inefficient
practice of using hospital emergency rooms as primary care centers.
14.
Reduce the cost of automobile insurance for business and
consumers - universal health care access eliminates the need to ever
file suit to cover past and future medical costs thus removing that risk
from the vehicle insurance coverage and leading to dramatically lower
premiums.
15.
Restore and enhance the traditional physician/patient
relationship - by ending the unfortunate and counterproductive
environment where every patient is seen as a potential plaintiff.
16.
Reduce infant mortality through better pre-natal care - and a
universal health access system that assures full and complete prenatal management thus reducing the number of avoidable low weight
and premature deliveries.
17.
Preserve the family farm - by eliminating the need for a farm family
to seek a “city” job that provides health care benefits and by avoiding
financial failures of farm families faced with uninsured or underinsured
health care expenses.
18.
Retain high-risk specialists in the Commonwealth - by
eliminating entirely the burden on providers to fund a dysfunctional
medical malpractice system.
19.
Support the home care model - where a family is willing to provide
a loving environment in a non-institutional setting. A universal health
system committed to emotional wellness as well as physical health will
provide the training and the specialized services required.
20.
Provide sufficient substance abuse treatment facilities - by
including substance abuse as a covered component of the universal
health system we dramatically expand the funding for facilities and
trained personnel.
21.
Preserve our investment in higher education -by separating
health care coverage from employment more economic opportunities
are created. When our college graduates are unable to find worthwhile
employment in the Commonwealth our investment in their training is
wasted and the Commonwealth loses more of its intellectual capital.
Additionally, new graduates will not suffer a gap in health coverage
while they search for that first job.
22.
Encourage early retirement to open opportunities for younger
people - by making it possible for a worker to retire before they
qualify for Medicare at age 65. If a person is otherwise financially able
to retire before age 65, the universal coverage system will make it
possible to do so thus opening an employment position for a younger
person.
23.
Encourage the best and the brightest to enter the health care
professions - through the elimination of the specter of financial ruin
due to a malpractice action, assured payment for all services, and
reduced overhead costs through a simplified and efficient single payer
system, the health care professions become more attractive career
options.
24.
Level the competitive playing field between large and small
businesses - through a universal health care system that moots the
existing health care insurance premium costs between large and small
employers.
25.
Reduce the cost of home-owner’s insurance - by assuring that a
person injured at your home has automatic health coverage and thus
eliminating the need for a homeowner’s insurance policy to insure
against the risk of being sued for medical costs. Lower risk equals
lower premiums.
26.
Permit lawmakers to move on to other critical matters by
finally resolving the health care crisis - since every year the
General Assembly devotes substantial time to debating, again, the
issues surrounding access to health care, Medicaid allowances,
coverage for Commonwealth employees, and medical malpractice
reform. All of which distracts from other critical issues of the day. A
bold move to resolve the health care dilemma through a balanced and
fiscally responsible solution opens the legislative agenda for other
matters.
27.
Allow Pennsylvania manufacturers to compete more fairly
against foreign manufacturers - most of whom have a government
sponsored health care system independent of the employer and thus
manufacturers in those countries do not have the overhead burden of
providing health care to their workers. By capping a Pennsylvania
employer’s contribution to health care at a fully deductible 10% of
payroll, we dramatically reduce the anticompetitive effect of the higher
premiums currently being paid by our hard-pressed manufacturers.
28.
Shift health provider revenues from administrative to clinical
work - an estimated 20% of provider revenue is squandered on billing
and administrative paperwork required by the existing inefficient and
overlapping system of third party reimbursements. Those same
resources could be redirected to clinical care.
29.
Encourage entrepreneurism - through a universal health care
system that eliminates the risk of being without health access for the
aspiring small business person and their family.
30.
End the practice of requiring those in need to spend themselves
into poverty to qualify for long-term care assistance - by
including long term care in the universal health coverage package.
This will end the current humiliating practice of forcing an already sick,
usually elderly, person to spend themselves into poverty before
qualifying for assistance.
31.
Accelerate the transition to a paperless “electronic health care
record” - through a single payer system it becomes easier to track,
document, and access an individual’s health care history. An
electronic health care record would be immediately available to any
authorized health care provider thus eliminating the delays and errors
associated with paper records scattered over a number of offices and
ultimately lost over time.
32.
Enhance a new culture of health awareness and responsibility
by using part of the trust funds to use the media and school system to
teach and encourage better health habits and by creating a sense of
social responsibility not to engage in self destructive or unhealthful
behaviors that add to the common cost of health care.
33.
End the competitive advantage of those businesses which have
refused to provide health care insurance - by requiring all
employers to pay the same 10% of payroll health care levy as a
percentage of payroll. Small employers paying minimum wage would
pay just 52 cents an hour more, less net of taxes, toward a universal
health care plan.
34.
Create a sophisticated health care society - through the creation
of an age appropriate K through 12 curriculum with an emphasis on
health equal to any other area of study.
35.
Establish dedicated funding sources used exclusively for health
care - thus assuring that the Trust will be fully funded and not
endlessly debated year to year. By establishing dedicated funding
sources for health care the interest of health will not have to compete
against other government priorities for funding and taxpayers will be
less resistant to paying the health specific taxes if confident that all of
such revenues will be used exclusively for health care.
36.
Reduce drug related crime - by assuring adequate and effective
drug treatment services for those supporting their addictions through
criminal activity or by becoming drug pushers themselves.
37.
Assure available specialists in all geographic parts of the
Commonwealth - through a single payer system committed to
assuring universal availability of quality coverage through-out the
Commonwealth. For example, Providers who establish practices or
build facilities in underserved areas can be rewarded with bonus
reimbursements.
38.
Reduce employment discrimination based on age and health
through a universal health care system that ends the concern of
employers over the potential increase in group health insurance
premiums should they hire an older person or someone with a
personal or family illness. This resolves the individual underwriting
process now in use which takes the cost savings out of many group
plans.
39.
End the COBRA irony - through a universal health system that
continues regardless of employment status and which ends the
absurdity of requiring a newly unemployed or divorced person to pay
substantial sums to continue health care for themselves and their
families when they are least able to afford it.
40.
Preserve patient choice - by permitting the patient to choose their
physician among any Participating Provider.
41.
Support the ability of charitable organizations to recruit and
retain staff - as all employees will automatically be covered under the
Plan. Non-profit organizations will no longer lose employees and
prospects to private industry solely due to the employee’s need for
health care benefits.
42.
Free up capital for research and development - by capping the
employer contribution to the health care trust at 10% of payroll, thus
assuring employers will have cash available for the research and
development costs that are at the heart of future growth and
competitiveness.
43.
Better coordinate epidemiological data -through a single payer
system that best captures in one database the occurrence of
environmental, viral, or bacteriological illnesses.
44.
Reinforce and support primary care - through a reimbursement
system that emphasizes wellness and preventative medicine primary
care providers will be in greater demand and more appropriately
compensated.
45.
Accelerate the introduction of new technology to improve
diagnostics - by providing a financing means for hospitals and
providers to acquire new technology even where the obsolete
equipment may not have been fully amortized.
46.
Infinite and immediate adjustability of the revenue sources to
meet a disaster -with health care taxes adjustable in tenths of a
percent as needed, in the event of a natural or man-made disaster the
required revenues to meet the urgent medical needs can be instantly
and temporarily raised through a simple adjustment in the percentage.
Similarly, where Trust surpluses accumulate beyond what is required
downward adjustments in the taxes can also be readily and easily
made.
47.
Free the courts from protracted medical negligence litigation
through the introduction of an optional no-fault administrative
mechanism to compensate those injured by their care. We thus
remove from the court dockets the many and complicated medical
malpractice cases that consume a disproportionate share of judicial
resources.
48.
Reduce state, local and school board expense -through the
adoption of a universal health care system whereby governments of all
sizes will be relieved of the annual angst of debating, providing, and
funding health care benefits.
49.
Improve worker productivity - by providing ready access to care
for workers and their families. Less time will be lost from work due to
untreated conditions that ultimately worsen leading to extended
absences.
50.
Improve highway safety -by fully funding substance abuse
treatment. With a reduction in impaired driving the frequency of
motor vehicle accidents will drop and with it the expense related to the
care and treatment of those injured.
51.
Humanitarian treatment for migrant workers - through the
inclusion of critical but under appreciated migrant workers and their
families in the health care system. In doing so we assure the
responsible support of those who otherwise would be at the mercy of
illness and ultimately burden the emergency facilities of our hospitals.
52.
Encourage and support the arts - by assuring that talented
individuals pursuing a career in the arts, or as independent
performers, are covered through a plan of universal health care.
53.
Restore the spirit of joy and service to the health care
professions - through the elimination of the specter of malpractice
suits and the obsessive concern about whether or not a patient has
adequate insurance, health care professionals can again focus on the
patient.
54.
Reduce abusive access to narcotics -through a unified electronic
health record system that immediately identifies situations where a
patient is seeking multiple prescriptions from different physicians.
55.
Increase self reporting of medical errors - by eliminating the fear
of financial ruin. Errors can be more readily reported and thus
corrective action taken to limit the harm and to develop protocols to
eliminate recurrences.
56.
More swiftly identify previously unknown drug side effects or
dangerous combinations of drugs -through a single payer system
that tracks patients and medications as well as the symptoms that are
later reported which may be the clue to adverse chemical reactions.
57.
Eliminate the wasted motion of the specialist referral for
responsible consumers -by granting all patients the right to self
refer to a specialist, and then only limiting that right for those who
abuse it, the Plan assures that access to specialists is not delayed by
procedural barriers that punish the many for the conduct of the few.
58.
End the “same sex” and “domestic” partner health care debate
-by automatically covering everyone under the universal plan.
59.
Eliminate suicides related to the cost of health care - through a
universal health care system that relieves the chronically ill patient of
the guilt associated with potentially bankrupting their family with
health care expenses.
60.
Reduce the incidence of chronic diseases that could have been
avoided or prevented through early intervention - by eliminating
the cost of care barrier, individuals with the early symptoms of a
disease, such as cancer, will more readily seek care and enjoy an
earlier diagnosis and better prognosis.
61.
Reward the development of enhanced skills and experience -by
adopting a reimbursement structure that adds an incentive bonus to
those health care providers who invest in themselves and acquire
enhanced skills and experience.
62.
End the wasted motion and paperwork associated with point of
service deductibles and co-pays - through the elimination of the
ritual of collecting and accounting for these charges.
63.
Eliminate wasted employer management time - by ending forever
the annual dreaded ritual of receiving and analyzing the group health
insurance premium increase, shopping around for a lower premium,
evaluating how much of the premium cost can be shifted to the
employees through premium sharing, a reduction in benefits, an
increase in co-payments and the like.
64.
End the “food or medicine” choice - through the inclusion of a full
prescription drug benefit covering all citizens.
65.
Assure full access to mental health treatment - by fully funding
mental health therapy and treatment.
66.
Maintain the continuity of care -by eliminating constant switching
of providers to accommodate different health plans.
67.
Guarantee divorced spouses and their children have access to
health care - through universal health care marital status is irrelevant
to health care access.
68.
Improve nurse retention -by reallocating funds from malpractice
insurance premiums and administrative overhead. Hospitals will be
able to use those resources to assure a rational patient to nurse ratio,
eliminate mandatory overtime, and enhance training.
69.
Annuitize compensation for persons injured by their medical
treatment -by making compensation payments through monthly
disbursements, rather than by lump sum. This assures that the
money cannot be squandered over a short period of time, which is
often the case, and is more consistent with the concept of replacing
what was lost rather than granting a lottery type pay-off.
70.
Assured coverage for those working multiple part time jobs - by
detaching health care access from employment there is no difference
in coverage based upon whether a person is working one full time, or
two part time, jobs.
71.
Protection for domestic employees - through universal coverage
that assures that housekeepers, cooks, drivers, gardeners and others
working as domestic servants enjoy comprehensive access for
themselves and their families.
72.
More extensive quality assurance review of errors and
complications - because every patient claim will be carefully
investigated for evidence of correctable mistakes and patterns. By
changing the emphasis to care improvement rather than blame all
involved can contribute to a more constructive analysis of what went
wrong, and what can be done to prevent a reoccurrence.
73.
Preserve the free market system while assuring cost
containment - with a Plan that does not contemplate public
ownership of health care facilities or public employment of health care
workers. Rather, the free market system will be allowed to work such
that the providers with the best quality of service will attract the most
patients.
74.
Assured dental coverage -through inclusion of non-cosmetic dental
services in the program.
75.
Eliminate the health care coverage handcuffs that limit
workers’ ability to change jobs - and replace it with the freedom to
offer your services to the highest bidder thanks to universal coverage
that is independent of the employer.
76.
End uncompensated care for providers -and instead assure
Participating Providers that they will be paid for 100% of the services
rendered to program beneficiaries.
77.
Assured vision and optical care -through inclusion of eye health
services as an integrated part of the health care package.
78.
Eliminate the financial insecurity and fear associated with the
aging process - by assuring that gaps in the Medicare program will
be filled through the Plan and no Pennsylvanian will suffer needlessly
simply based upon their ability to pay.
79.
Create tens of thousands of high paying new jobs in health care
and health education - required to provide services to the
approximately one million currently uninsured Pennsylvanians and to
teach a “wellness curriculum” in our schools.
80.
Fully protect the catastrophically ill or injured - through a health
care system that does not have the usual life time caps that are easily
exceeded by those with serious and chronic illnesses or disabilities
requiring intensive skilled care.
81.
Saving Pennsylvania’s share of the 18,000 who die annually in
the United States due to inadequate access to health care
through a universal health care program that assures that every
person who needs care will receive it.
82.
Expand the availability of compensation more equitably to
those injured by their health care providers - through a no-fault
system that does not require a tedious and expensive litigation process
committed to finding someone to blame and which allows only a few to
recover anything at all. Rather, the optional no-fault program assures
expedited claim handling and eligibility with lower attorney fees and
other costs of traditional malpractice litigation.
83.
Encourage the unemployed to accept entry level positions by
removing the fear of losing Medicaid or Adult Blue coverage
with universal care automatic for all, there need no longer be a
concern that by accepting a modest paying entry level position a
worker will disqualify themselves or their families from access to
health care.
84.
Assuring that the newly disabled, but under age 65, have
access to health care while they wait two years for Medicare
eligibility -through a universal coverage approach that does not go
away when the disabled lose their jobs.
85.
Prompt payment of reimbursements to providers - through
electronic billing and electronic fund transfers within one week health
care providers have ready access to their money and avoid borrowing
costs.
86.
End the practice of overcharging the uninsured - which is an
ironic and absurd reality in the current system. Many hospitals and
doctors charge uninsured patients a higher rate than the
reimbursement accepted from private insurers and government
programs. As a result the patients least able to pay have been
charged the most and often are driven into bankruptcy. Universal
coverage through a single payer ends this disparity once and for all.
87.
Eliminate the need for outside billing and collection services
thus saving the average physician up to 5% of their gross collections
otherwise paid to an outside collector.
88.
Pay for Performance incentives -through a reimbursement system
that rewards excellence based upon objective performance criteria.
Providers who adopt best practices and achieve lower complication and
readmission rates will be rewarded and those who do not measure up
will be paid less.
89.
Create millions of qualified first responders - through enhanced
health care education every graduating high school senior can be a
certified first responder ready and able to assist a family member,
friend, or even a total stranger until help arrives. This can mean the
difference between recovery and a lifelong disability or death.
90.
Assure that every injured person is rehabilitated to their
maximum potential - by incorporating full rehabilitation within the
standard program benefits. In addition to being morally right, a
commitment to full rehabilitation will reduce the overall cost of care as
many more patients will be able to return to the workforce or at least
be better able to attend to their own physical needs.
91.
Keep qualified and experienced physicians on the job - by
eliminating the burden of malpractice premiums and by simplifying the
billing and collection system.
92.
Assure well baby care -with comprehensive post-natal care
included in the universal health care program.
93.
Reduce the incidence of sexually transmitted diseases - by
simplifying access to primary and specialist care. STDs can thus be
diagnosed sooner and treatment initiated to reduce the spread of the
disease and to assure proper counseling to the affected patients and
their partner. Enhanced wellness education also leads to reduced
infection transmission.
94. Permit providers to challenge the adequacy of reimbursements
- through an administrative process whereby single providers or
groups can offer evidence in support of higher reimbursements.
95.
Full transparency in the error investigation process - by assuring
that a complaining patient is afforded every opportunity to be heard
and is kept advised of the investigation and any corrective actions that
are ordered in response to an avoidable injury or complication.
96.
Implementation of Pennsylvania Cost Containment Council
recommendations - through a process whereby all such
recommendations are reviewed and where providers are required to
implement necessary reforms.
97.
Humane end-of-life care -by including hospice care within the
comprehensive health care package.
98.
All licensed providers can compete - through a universal system
that does not try to artificially lower prices by freezing out providers
from networks in exchange for lower prices from other providers.
99.
Protect early retirees who were promised health care coverage
by now defunct employers -through a universal health care system
that protects the young retiree from being left out in the cold by a
broken promise of retirement health coverage.
100.
Prepare Pennsylvania for more cuts in Federal health care
support -by preparing our Commonwealth to be more self sufficient
and reliant on its own resources and efficiencies as Congress bit by bit
reduces grants to states for Medicaid and CHIP programs.
101.
No more bake sales to fund health care - instead we embrace
health care as a community responsibility and a communal right
through a system of universal access.
Why this prolog? Because the grassroots activist looking for support of single-payer will hear the same lies from other sources - including many of our own. This is not the time for a history lesson in Canadian health care... this is a time for a lesson in how to rebut the lies and bring the victim of the Big Lie into our camp.
These arguments are written with the current Pennsylvania legislation in mind. They work with adaptation for the national bill (Rep Conyers' HR676) or any other state legislation seriously proposing a single-payer model.
101 REASONS WHY BALANCED HEALTHCARE REFORM
WORKS FOR PENNSYLVANIA
1. Protect Pennsylvania jobs - by capping the employer contribution to the Health Trust at 10% of payroll. Those Pennsylvania employers currently paying for employee health insurance coverage will enjoy a substantial savings and will no longer be at a competitive disadvantage
to those paying nothing toward the cost of health care coverage. This
also completely eliminates the administrative overhead costs
associated with employer paid health insurance.
2.
Reduce the cost of prescription drugs - by using Pennsylvania’s
12.5 million citizens as a formidable bargaining entity in dealing with
drug companies.
3.
Eliminate uncompensated care - by assuring that health care
providers are paid for all of the services they provide.
4.
Assure comprehensive care for all - through a universal health
care system. Approximately one million out of our 12 million citizens
have no health coverage of any kind.
5.
End wasteful “defensive” medicine - which, according to a recent
survey, 90% of Pennsylvania physicians admit to. We address this by
replacing the fault based malpractice system with a no-fault program
that emphasizes broader availability of compensation, quality
assurance instead of punishment. Those who believe they are better
off retaining their traditional fault based right to sue may opt out of
the no-fault system, but the Balanced Plan adopts the no-fault
approachas the default position and thus the vast majority of
Pennsylvanians will participate in the no-fault program.
6.
Address racial disparity -through universal access and a
commitment to assuring the availability of quality providers in all
communities.
7.
Dramatically reduce wasteful administrative costs - through a
single payer approach that eliminates the unnecessary and redundant
overhead of the existing myriad of public and private payers. Major
studies have agreed that approximately 20% of our health care dollars
are wasted due to the inefficiencies of the current system.
8.
Remove health care as a recurrent union/management issue in
collective bargaining - by providing automatic, comprehensive, and
universal health care independent of the employment relationship.
This legislation does permit unions and employers to opt out of the
Commonwealth Plan so long as the benefits included in the collective
bargaining agreement are at least as comprehensive as the
Commonwealth Plan.
9.
End health care expenses as the leading cause of personal
bankruptcy - thus preserving the dignity and savings of Americans
who already face the burdens directly associated with family illness or
accident.
10.
Preserve the volunteer firefighter and emergency responder
base, especially in rural areas of the Commonwealth - through a
$1,000 per year state tax rebate to active volunteers we encourage
the retention and recruitment of this vital resource.
11.
Reduce the cost of workers’ compensation insurance - with
universal coverage that meets an injured employee’s health care
needs independent of the employer’s workers’ compensation
insurance. By eliminating the health care expense and administrative
overhead workers compensation premiums will drop dramatically.
12.
Eliminate duplication of facilities in over-served communities
by requiring a certification of need communities already adequately
served with high tech diagnostics or surgery centers will not see
another (which would only threaten the financial viability of both) and
instead would-be investors will be encouraged to build in under-served
areas.
13.
Restore the concept of a true “emergency room” - through
universal coverage that assures that all citizens will have ready access
to primary care physicians. Thus ending the wasteful and inefficient
practice of using hospital emergency rooms as primary care centers.
14.
Reduce the cost of automobile insurance for business and
consumers - universal health care access eliminates the need to ever
file suit to cover past and future medical costs thus removing that risk
from the vehicle insurance coverage and leading to dramatically lower
premiums.
15.
Restore and enhance the traditional physician/patient
relationship - by ending the unfortunate and counterproductive
environment where every patient is seen as a potential plaintiff.
16.
Reduce infant mortality through better pre-natal care - and a
universal health access system that assures full and complete prenatal management thus reducing the number of avoidable low weight
and premature deliveries.
17.
Preserve the family farm - by eliminating the need for a farm family
to seek a “city” job that provides health care benefits and by avoiding
financial failures of farm families faced with uninsured or underinsured
health care expenses.
18.
Retain high-risk specialists in the Commonwealth - by
eliminating entirely the burden on providers to fund a dysfunctional
medical malpractice system.
19.
Support the home care model - where a family is willing to provide
a loving environment in a non-institutional setting. A universal health
system committed to emotional wellness as well as physical health will
provide the training and the specialized services required.
20.
Provide sufficient substance abuse treatment facilities - by
including substance abuse as a covered component of the universal
health system we dramatically expand the funding for facilities and
trained personnel.
21.
Preserve our investment in higher education -by separating
health care coverage from employment more economic opportunities
are created. When our college graduates are unable to find worthwhile
employment in the Commonwealth our investment in their training is
wasted and the Commonwealth loses more of its intellectual capital.
Additionally, new graduates will not suffer a gap in health coverage
while they search for that first job.
22.
Encourage early retirement to open opportunities for younger
people - by making it possible for a worker to retire before they
qualify for Medicare at age 65. If a person is otherwise financially able
to retire before age 65, the universal coverage system will make it
possible to do so thus opening an employment position for a younger
person.
23.
Encourage the best and the brightest to enter the health care
professions - through the elimination of the specter of financial ruin
due to a malpractice action, assured payment for all services, and
reduced overhead costs through a simplified and efficient single payer
system, the health care professions become more attractive career
options.
24.
Level the competitive playing field between large and small
businesses - through a universal health care system that moots the
existing health care insurance premium costs between large and small
employers.
25.
Reduce the cost of home-owner’s insurance - by assuring that a
person injured at your home has automatic health coverage and thus
eliminating the need for a homeowner’s insurance policy to insure
against the risk of being sued for medical costs. Lower risk equals
lower premiums.
26.
Permit lawmakers to move on to other critical matters by
finally resolving the health care crisis - since every year the
General Assembly devotes substantial time to debating, again, the
issues surrounding access to health care, Medicaid allowances,
coverage for Commonwealth employees, and medical malpractice
reform. All of which distracts from other critical issues of the day. A
bold move to resolve the health care dilemma through a balanced and
fiscally responsible solution opens the legislative agenda for other
matters.
27.
Allow Pennsylvania manufacturers to compete more fairly
against foreign manufacturers - most of whom have a government
sponsored health care system independent of the employer and thus
manufacturers in those countries do not have the overhead burden of
providing health care to their workers. By capping a Pennsylvania
employer’s contribution to health care at a fully deductible 10% of
payroll, we dramatically reduce the anticompetitive effect of the higher
premiums currently being paid by our hard-pressed manufacturers.
28.
Shift health provider revenues from administrative to clinical
work - an estimated 20% of provider revenue is squandered on billing
and administrative paperwork required by the existing inefficient and
overlapping system of third party reimbursements. Those same
resources could be redirected to clinical care.
29.
Encourage entrepreneurism - through a universal health care
system that eliminates the risk of being without health access for the
aspiring small business person and their family.
30.
End the practice of requiring those in need to spend themselves
into poverty to qualify for long-term care assistance - by
including long term care in the universal health coverage package.
This will end the current humiliating practice of forcing an already sick,
usually elderly, person to spend themselves into poverty before
qualifying for assistance.
31.
Accelerate the transition to a paperless “electronic health care
record” - through a single payer system it becomes easier to track,
document, and access an individual’s health care history. An
electronic health care record would be immediately available to any
authorized health care provider thus eliminating the delays and errors
associated with paper records scattered over a number of offices and
ultimately lost over time.
32.
Enhance a new culture of health awareness and responsibility
by using part of the trust funds to use the media and school system to
teach and encourage better health habits and by creating a sense of
social responsibility not to engage in self destructive or unhealthful
behaviors that add to the common cost of health care.
33.
End the competitive advantage of those businesses which have
refused to provide health care insurance - by requiring all
employers to pay the same 10% of payroll health care levy as a
percentage of payroll. Small employers paying minimum wage would
pay just 52 cents an hour more, less net of taxes, toward a universal
health care plan.
34.
Create a sophisticated health care society - through the creation
of an age appropriate K through 12 curriculum with an emphasis on
health equal to any other area of study.
35.
Establish dedicated funding sources used exclusively for health
care - thus assuring that the Trust will be fully funded and not
endlessly debated year to year. By establishing dedicated funding
sources for health care the interest of health will not have to compete
against other government priorities for funding and taxpayers will be
less resistant to paying the health specific taxes if confident that all of
such revenues will be used exclusively for health care.
36.
Reduce drug related crime - by assuring adequate and effective
drug treatment services for those supporting their addictions through
criminal activity or by becoming drug pushers themselves.
37.
Assure available specialists in all geographic parts of the
Commonwealth - through a single payer system committed to
assuring universal availability of quality coverage through-out the
Commonwealth. For example, Providers who establish practices or
build facilities in underserved areas can be rewarded with bonus
reimbursements.
38.
Reduce employment discrimination based on age and health
through a universal health care system that ends the concern of
employers over the potential increase in group health insurance
premiums should they hire an older person or someone with a
personal or family illness. This resolves the individual underwriting
process now in use which takes the cost savings out of many group
plans.
39.
End the COBRA irony - through a universal health system that
continues regardless of employment status and which ends the
absurdity of requiring a newly unemployed or divorced person to pay
substantial sums to continue health care for themselves and their
families when they are least able to afford it.
40.
Preserve patient choice - by permitting the patient to choose their
physician among any Participating Provider.
41.
Support the ability of charitable organizations to recruit and
retain staff - as all employees will automatically be covered under the
Plan. Non-profit organizations will no longer lose employees and
prospects to private industry solely due to the employee’s need for
health care benefits.
42.
Free up capital for research and development - by capping the
employer contribution to the health care trust at 10% of payroll, thus
assuring employers will have cash available for the research and
development costs that are at the heart of future growth and
competitiveness.
43.
Better coordinate epidemiological data -through a single payer
system that best captures in one database the occurrence of
environmental, viral, or bacteriological illnesses.
44.
Reinforce and support primary care - through a reimbursement
system that emphasizes wellness and preventative medicine primary
care providers will be in greater demand and more appropriately
compensated.
45.
Accelerate the introduction of new technology to improve
diagnostics - by providing a financing means for hospitals and
providers to acquire new technology even where the obsolete
equipment may not have been fully amortized.
46.
Infinite and immediate adjustability of the revenue sources to
meet a disaster -with health care taxes adjustable in tenths of a
percent as needed, in the event of a natural or man-made disaster the
required revenues to meet the urgent medical needs can be instantly
and temporarily raised through a simple adjustment in the percentage.
Similarly, where Trust surpluses accumulate beyond what is required
downward adjustments in the taxes can also be readily and easily
made.
47.
Free the courts from protracted medical negligence litigation
through the introduction of an optional no-fault administrative
mechanism to compensate those injured by their care. We thus
remove from the court dockets the many and complicated medical
malpractice cases that consume a disproportionate share of judicial
resources.
48.
Reduce state, local and school board expense -through the
adoption of a universal health care system whereby governments of all
sizes will be relieved of the annual angst of debating, providing, and
funding health care benefits.
49.
Improve worker productivity - by providing ready access to care
for workers and their families. Less time will be lost from work due to
untreated conditions that ultimately worsen leading to extended
absences.
50.
Improve highway safety -by fully funding substance abuse
treatment. With a reduction in impaired driving the frequency of
motor vehicle accidents will drop and with it the expense related to the
care and treatment of those injured.
51.
Humanitarian treatment for migrant workers - through the
inclusion of critical but under appreciated migrant workers and their
families in the health care system. In doing so we assure the
responsible support of those who otherwise would be at the mercy of
illness and ultimately burden the emergency facilities of our hospitals.
52.
Encourage and support the arts - by assuring that talented
individuals pursuing a career in the arts, or as independent
performers, are covered through a plan of universal health care.
53.
Restore the spirit of joy and service to the health care
professions - through the elimination of the specter of malpractice
suits and the obsessive concern about whether or not a patient has
adequate insurance, health care professionals can again focus on the
patient.
54.
Reduce abusive access to narcotics -through a unified electronic
health record system that immediately identifies situations where a
patient is seeking multiple prescriptions from different physicians.
55.
Increase self reporting of medical errors - by eliminating the fear
of financial ruin. Errors can be more readily reported and thus
corrective action taken to limit the harm and to develop protocols to
eliminate recurrences.
56.
More swiftly identify previously unknown drug side effects or
dangerous combinations of drugs -through a single payer system
that tracks patients and medications as well as the symptoms that are
later reported which may be the clue to adverse chemical reactions.
57.
Eliminate the wasted motion of the specialist referral for
responsible consumers -by granting all patients the right to self
refer to a specialist, and then only limiting that right for those who
abuse it, the Plan assures that access to specialists is not delayed by
procedural barriers that punish the many for the conduct of the few.
58.
End the “same sex” and “domestic” partner health care debate
-by automatically covering everyone under the universal plan.
59.
Eliminate suicides related to the cost of health care - through a
universal health care system that relieves the chronically ill patient of
the guilt associated with potentially bankrupting their family with
health care expenses.
60.
Reduce the incidence of chronic diseases that could have been
avoided or prevented through early intervention - by eliminating
the cost of care barrier, individuals with the early symptoms of a
disease, such as cancer, will more readily seek care and enjoy an
earlier diagnosis and better prognosis.
61.
Reward the development of enhanced skills and experience -by
adopting a reimbursement structure that adds an incentive bonus to
those health care providers who invest in themselves and acquire
enhanced skills and experience.
62.
End the wasted motion and paperwork associated with point of
service deductibles and co-pays - through the elimination of the
ritual of collecting and accounting for these charges.
63.
Eliminate wasted employer management time - by ending forever
the annual dreaded ritual of receiving and analyzing the group health
insurance premium increase, shopping around for a lower premium,
evaluating how much of the premium cost can be shifted to the
employees through premium sharing, a reduction in benefits, an
increase in co-payments and the like.
64.
End the “food or medicine” choice - through the inclusion of a full
prescription drug benefit covering all citizens.
65.
Assure full access to mental health treatment - by fully funding
mental health therapy and treatment.
66.
Maintain the continuity of care -by eliminating constant switching
of providers to accommodate different health plans.
67.
Guarantee divorced spouses and their children have access to
health care - through universal health care marital status is irrelevant
to health care access.
68.
Improve nurse retention -by reallocating funds from malpractice
insurance premiums and administrative overhead. Hospitals will be
able to use those resources to assure a rational patient to nurse ratio,
eliminate mandatory overtime, and enhance training.
69.
Annuitize compensation for persons injured by their medical
treatment -by making compensation payments through monthly
disbursements, rather than by lump sum. This assures that the
money cannot be squandered over a short period of time, which is
often the case, and is more consistent with the concept of replacing
what was lost rather than granting a lottery type pay-off.
70.
Assured coverage for those working multiple part time jobs - by
detaching health care access from employment there is no difference
in coverage based upon whether a person is working one full time, or
two part time, jobs.
71.
Protection for domestic employees - through universal coverage
that assures that housekeepers, cooks, drivers, gardeners and others
working as domestic servants enjoy comprehensive access for
themselves and their families.
72.
More extensive quality assurance review of errors and
complications - because every patient claim will be carefully
investigated for evidence of correctable mistakes and patterns. By
changing the emphasis to care improvement rather than blame all
involved can contribute to a more constructive analysis of what went
wrong, and what can be done to prevent a reoccurrence.
73.
Preserve the free market system while assuring cost
containment - with a Plan that does not contemplate public
ownership of health care facilities or public employment of health care
workers. Rather, the free market system will be allowed to work such
that the providers with the best quality of service will attract the most
patients.
74.
Assured dental coverage -through inclusion of non-cosmetic dental
services in the program.
75.
Eliminate the health care coverage handcuffs that limit
workers’ ability to change jobs - and replace it with the freedom to
offer your services to the highest bidder thanks to universal coverage
that is independent of the employer.
76.
End uncompensated care for providers -and instead assure
Participating Providers that they will be paid for 100% of the services
rendered to program beneficiaries.
77.
Assured vision and optical care -through inclusion of eye health
services as an integrated part of the health care package.
78.
Eliminate the financial insecurity and fear associated with the
aging process - by assuring that gaps in the Medicare program will
be filled through the Plan and no Pennsylvanian will suffer needlessly
simply based upon their ability to pay.
79.
Create tens of thousands of high paying new jobs in health care
and health education - required to provide services to the
approximately one million currently uninsured Pennsylvanians and to
teach a “wellness curriculum” in our schools.
80.
Fully protect the catastrophically ill or injured - through a health
care system that does not have the usual life time caps that are easily
exceeded by those with serious and chronic illnesses or disabilities
requiring intensive skilled care.
81.
Saving Pennsylvania’s share of the 18,000 who die annually in
the United States due to inadequate access to health care
through a universal health care program that assures that every
person who needs care will receive it.
82.
Expand the availability of compensation more equitably to
those injured by their health care providers - through a no-fault
system that does not require a tedious and expensive litigation process
committed to finding someone to blame and which allows only a few to
recover anything at all. Rather, the optional no-fault program assures
expedited claim handling and eligibility with lower attorney fees and
other costs of traditional malpractice litigation.
83.
Encourage the unemployed to accept entry level positions by
removing the fear of losing Medicaid or Adult Blue coverage
with universal care automatic for all, there need no longer be a
concern that by accepting a modest paying entry level position a
worker will disqualify themselves or their families from access to
health care.
84.
Assuring that the newly disabled, but under age 65, have
access to health care while they wait two years for Medicare
eligibility -through a universal coverage approach that does not go
away when the disabled lose their jobs.
85.
Prompt payment of reimbursements to providers - through
electronic billing and electronic fund transfers within one week health
care providers have ready access to their money and avoid borrowing
costs.
86.
End the practice of overcharging the uninsured - which is an
ironic and absurd reality in the current system. Many hospitals and
doctors charge uninsured patients a higher rate than the
reimbursement accepted from private insurers and government
programs. As a result the patients least able to pay have been
charged the most and often are driven into bankruptcy. Universal
coverage through a single payer ends this disparity once and for all.
87.
Eliminate the need for outside billing and collection services
thus saving the average physician up to 5% of their gross collections
otherwise paid to an outside collector.
88.
Pay for Performance incentives -through a reimbursement system
that rewards excellence based upon objective performance criteria.
Providers who adopt best practices and achieve lower complication and
readmission rates will be rewarded and those who do not measure up
will be paid less.
89.
Create millions of qualified first responders - through enhanced
health care education every graduating high school senior can be a
certified first responder ready and able to assist a family member,
friend, or even a total stranger until help arrives. This can mean the
difference between recovery and a lifelong disability or death.
90.
Assure that every injured person is rehabilitated to their
maximum potential - by incorporating full rehabilitation within the
standard program benefits. In addition to being morally right, a
commitment to full rehabilitation will reduce the overall cost of care as
many more patients will be able to return to the workforce or at least
be better able to attend to their own physical needs.
91.
Keep qualified and experienced physicians on the job - by
eliminating the burden of malpractice premiums and by simplifying the
billing and collection system.
92.
Assure well baby care -with comprehensive post-natal care
included in the universal health care program.
93.
Reduce the incidence of sexually transmitted diseases - by
simplifying access to primary and specialist care. STDs can thus be
diagnosed sooner and treatment initiated to reduce the spread of the
disease and to assure proper counseling to the affected patients and
their partner. Enhanced wellness education also leads to reduced
infection transmission.
94. Permit providers to challenge the adequacy of reimbursements
- through an administrative process whereby single providers or
groups can offer evidence in support of higher reimbursements.
95.
Full transparency in the error investigation process - by assuring
that a complaining patient is afforded every opportunity to be heard
and is kept advised of the investigation and any corrective actions that
are ordered in response to an avoidable injury or complication.
96.
Implementation of Pennsylvania Cost Containment Council
recommendations - through a process whereby all such
recommendations are reviewed and where providers are required to
implement necessary reforms.
97.
Humane end-of-life care -by including hospice care within the
comprehensive health care package.
98.
All licensed providers can compete - through a universal system
that does not try to artificially lower prices by freezing out providers
from networks in exchange for lower prices from other providers.
99.
Protect early retirees who were promised health care coverage
by now defunct employers -through a universal health care system
that protects the young retiree from being left out in the cold by a
broken promise of retirement health coverage.
100.
Prepare Pennsylvania for more cuts in Federal health care
support -by preparing our Commonwealth to be more self sufficient
and reliant on its own resources and efficiencies as Congress bit by bit
reduces grants to states for Medicaid and CHIP programs.
101.
No more bake sales to fund health care - instead we embrace
health care as a community responsibility and a communal right
through a system of universal access.
Background:
PA CD4 is one of those anomalies - a SW PA district in north suburban Pittsburgh with majority Dem registration that has been held for three terms by a Republican who is running for term #4. At best people thought it would support a conservative Dem. But then PA is an anomaly - it's a majority registration Dem state with both state houses and the Congressional delegation showing solid Republican majorities. The Governor and the 04 Presidential vote was Democratic - but we send Arlen Specter and Rick Santorum (now in the fight of his political career and expected to lose) to Washington.
CD4 is where I live. It's been targeted by "Working Families Win" - an action project of ADA - as a possible key swing district, and I've been working with them to make the change happen. One thing WFW has done through Town Hall Meetings is draw up this document. I thought this was worth sharing through the Blog - it's widely supported in the community, it represents the direction this particular little corner of America thinks we should be going - and it's pretty damned Progressive. Our local Dem candidate against the incumbent has publicly declared his support.
DEMOCRATIC LEADERSHIP - ARE YOU LISTENING? IF YOU WANT TO LEAD THE PARTY OUT OF THE WILDERNESS AND THE COUNTRY OUT OF STAGNATION AND FEAR, THIS IS WHAT YOU NEED TO EMBRACE VIGOROUSLY AND MAKE HAPPEN.
Working Families Community Agenda:
Too many people are not doing well in today's economy. Wages are stagnant, the costs of energy and health care are rising, health care and retirement benefits are being cut, and personal debt is at record levels. Workers are falling behind, and the gap between the rich and poor is growing. The middle class, and even the American Dream itself, is at risk.
We must change our economy so that it rewards work, promotes the well-being of families, gives people enough time for the things that are most important to us, better protects the environment which we leave to our children and grandchildren, and provides the security that every working family deserves.
Such an economy is possible with new rules that reflect the values that our community shares: fairness, responsibility, hard work, and a concern for our neighbors and the next generation.
We need politicians to respond to the needs of the community, not the demands of special interests and corporate lobbyists. We call on all candidates for office to take the following steps toward creating an economy that benefits working families everywhere:
Health Care for All -- Support the U.S. National Health Insurance Act
(H.R. 676) to expand Medicare to cover all U.S. residents, or
comparable legislation to secure comprehensive, high quality, and affordable health care for all Americans including provisions for Medicare to negotiate lower prices on prescription drugs.
Fair Wages -- Support the Fair Minimum Wage Act to increase the
federal minimum wage from its current $5.15 an hour to $7.25 an hour over two years, and also support indexing the minimum wage annually to keep up with the cost of living automatically. Work towards a living wage for all Americans.
Iraq -- Support the Murtha Plan for turning over security to the Iraqi Army. Instead of spending $200 million a day in Iraq, use the money for programs that help working families in this country.
Good Jobs -- Oppose new "fast track" authority for trade agreements like NAFTA and CAFTA. New trade agreements should safeguard workers and the environment by including binding, enforceable measures within the agreements ensuring that all countries protect in domestic law the basic rights established by the International Labor Organization. Labor and environmental provisions should be subject to the same
enforcement mechanisms that apply to other aspects of the agreement. Trade agreements should not cover public services such as education, health care, water supply, and energy.
Workers' Rights -- Support the Employee Free Choice Act which would require certification of a union as the bargaining representative for workers based on authorization cards signed by the majority of workers in the appropriate unit. Oppose so-called "right-to-work" legislation.
Voting Integrity -- Support at the federal level H.R. 550 and H.B.2000 in the Pennsylvania legislature, which would ensure that voting is conducted fairly on machines that are reliable and auditable.
Clean Elections -- Support, at the federal and state levels, publicly financed elections similar to the systems already in place in Arizona and Maine.
And my challenge - for everyone who reads this blog entry - TAKE THIS AGENDA TO YOUR INCUMBENTS AND YOUR CANDIDATES. CHALLENGE THEM TO ENDORSE IT. FIND OUR WHETHER THE PEOPLE WE ARE SENDING TO OFFICE REALLY SUPPORT YOUR INTERESTS AND NEEDS. THE MORE PEOPLE WE SEND TO WASHINGTON WHO SUPPORT THIS AGENDA, THE CLOSER THE DEMOCRATIC PARTY IS TO SHOWING REAL LEADERSHIP WITH A PROACTIVE AGENDA SHOWING REAL VISION FOR 2008.
PA CD4 is one of those anomalies - a SW PA district in north suburban Pittsburgh with majority Dem registration that has been held for three terms by a Republican who is running for term #4. At best people thought it would support a conservative Dem. But then PA is an anomaly - it's a majority registration Dem state with both state houses and the Congressional delegation showing solid Republican majorities. The Governor and the 04 Presidential vote was Democratic - but we send Arlen Specter and Rick Santorum (now in the fight of his political career and expected to lose) to Washington.
CD4 is where I live. It's been targeted by "Working Families Win" - an action project of ADA - as a possible key swing district, and I've been working with them to make the change happen. One thing WFW has done through Town Hall Meetings is draw up this document. I thought this was worth sharing through the Blog - it's widely supported in the community, it represents the direction this particular little corner of America thinks we should be going - and it's pretty damned Progressive. Our local Dem candidate against the incumbent has publicly declared his support.
DEMOCRATIC LEADERSHIP - ARE YOU LISTENING? IF YOU WANT TO LEAD THE PARTY OUT OF THE WILDERNESS AND THE COUNTRY OUT OF STAGNATION AND FEAR, THIS IS WHAT YOU NEED TO EMBRACE VIGOROUSLY AND MAKE HAPPEN.
Working Families Community Agenda:
Too many people are not doing well in today's economy. Wages are stagnant, the costs of energy and health care are rising, health care and retirement benefits are being cut, and personal debt is at record levels. Workers are falling behind, and the gap between the rich and poor is growing. The middle class, and even the American Dream itself, is at risk.
We must change our economy so that it rewards work, promotes the well-being of families, gives people enough time for the things that are most important to us, better protects the environment which we leave to our children and grandchildren, and provides the security that every working family deserves.
Such an economy is possible with new rules that reflect the values that our community shares: fairness, responsibility, hard work, and a concern for our neighbors and the next generation.
We need politicians to respond to the needs of the community, not the demands of special interests and corporate lobbyists. We call on all candidates for office to take the following steps toward creating an economy that benefits working families everywhere:
Health Care for All -- Support the U.S. National Health Insurance Act
(H.R. 676) to expand Medicare to cover all U.S. residents, or
comparable legislation to secure comprehensive, high quality, and affordable health care for all Americans including provisions for Medicare to negotiate lower prices on prescription drugs.
Fair Wages -- Support the Fair Minimum Wage Act to increase the
federal minimum wage from its current $5.15 an hour to $7.25 an hour over two years, and also support indexing the minimum wage annually to keep up with the cost of living automatically. Work towards a living wage for all Americans.
Iraq -- Support the Murtha Plan for turning over security to the Iraqi Army. Instead of spending $200 million a day in Iraq, use the money for programs that help working families in this country.
Good Jobs -- Oppose new "fast track" authority for trade agreements like NAFTA and CAFTA. New trade agreements should safeguard workers and the environment by including binding, enforceable measures within the agreements ensuring that all countries protect in domestic law the basic rights established by the International Labor Organization. Labor and environmental provisions should be subject to the same
enforcement mechanisms that apply to other aspects of the agreement. Trade agreements should not cover public services such as education, health care, water supply, and energy.
Workers' Rights -- Support the Employee Free Choice Act which would require certification of a union as the bargaining representative for workers based on authorization cards signed by the majority of workers in the appropriate unit. Oppose so-called "right-to-work" legislation.
Voting Integrity -- Support at the federal level H.R. 550 and H.B.2000 in the Pennsylvania legislature, which would ensure that voting is conducted fairly on machines that are reliable and auditable.
Clean Elections -- Support, at the federal and state levels, publicly financed elections similar to the systems already in place in Arizona and Maine.
And my challenge - for everyone who reads this blog entry - TAKE THIS AGENDA TO YOUR INCUMBENTS AND YOUR CANDIDATES. CHALLENGE THEM TO ENDORSE IT. FIND OUR WHETHER THE PEOPLE WE ARE SENDING TO OFFICE REALLY SUPPORT YOUR INTERESTS AND NEEDS. THE MORE PEOPLE WE SEND TO WASHINGTON WHO SUPPORT THIS AGENDA, THE CLOSER THE DEMOCRATIC PARTY IS TO SHOWING REAL LEADERSHIP WITH A PROACTIVE AGENDA SHOWING REAL VISION FOR 2008.
Help me assemble Part 2 of the HR676 Hall of Fame - incumbents and candidates who have publicly declared their willingness to become additional co-sponsors.
I have two candidates from my immediate area who have publicly declared that when elected they will co-sponsor HR676. One is in MY district and I'm working directly on his behalf; and I'm supporting the efforts in the adjoining district where the other is running.
Jason Altmire - PA 4
Chad Kluco - PA 18
What I want to do here - is invite reader participation. Which incumbents who had not before signed on as co-sponsors - and which candidates in current Republican congessional seats - have now publicly pledged to sign on to HR676 when the new term begins?
If you SERIOUSLY believe this effort needs to succeed - and needs to become the cornerstone of a new progressive Democratic social platform - then each of us needs to be agitating our conservative Dem incumbents and all our congressional candidates to come aboard - and then working to see each of them elected. And then.... this is one promise they can be SURE we'll hold them to.
So,,,, PLEASE COMMENT. Add to the Hall of Fame. Tell me who among Dem incumbents and candidates are supporing us but have not yet made it public. And.... let's do the Hall of Shame, too. Let's make sure Dem leadership knows that we know who is ducking this hot-button issue - and we're NOT pleased with that.
I have two candidates from my immediate area who have publicly declared that when elected they will co-sponsor HR676. One is in MY district and I'm working directly on his behalf; and I'm supporting the efforts in the adjoining district where the other is running.
Jason Altmire - PA 4
Chad Kluco - PA 18
What I want to do here - is invite reader participation. Which incumbents who had not before signed on as co-sponsors - and which candidates in current Republican congessional seats - have now publicly pledged to sign on to HR676 when the new term begins?
If you SERIOUSLY believe this effort needs to succeed - and needs to become the cornerstone of a new progressive Democratic social platform - then each of us needs to be agitating our conservative Dem incumbents and all our congressional candidates to come aboard - and then working to see each of them elected. And then.... this is one promise they can be SURE we'll hold them to.
So,,,, PLEASE COMMENT. Add to the Hall of Fame. Tell me who among Dem incumbents and candidates are supporing us but have not yet made it public. And.... let's do the Hall of Shame, too. Let's make sure Dem leadership knows that we know who is ducking this hot-button issue - and we're NOT pleased with that.
The standard we need to achieve in our current quest for the Holy Grail of single-payer health care is that incumbents worthy of our continued support have all co-sponsored HR676, which was introduced into the current Congress by Rep Conyers, John, Jr. [MI-14] (introduced 2/8/2005).
This is the most current list of incumbent co-sponsors. Please note that HR676 is STILL acquiring co-sponsors largely as a result of grassroots agitation. Here is - as of today on the THOMAS Web site - the most current list of co-sponsors. ALL are people of whose future we need to be mindful and protective.
Rep Abercrombie, Neil [HI-1] - 5/5/2005
Rep Baldwin, Tammy [WI-2] - 5/10/2005
Rep Becerra, Xavier [CA-31] - 11/17/2005
Rep Bishop, Sanford D., Jr. [GA-2] - 6/14/2006
Rep Brown, Corrine [FL-3] - 11/15/2005
Rep Brown, Sherrod [OH-13] - 2/1/2006
Rep Capuano, Michael E. [MA-8] - 12/13/2005
Rep Carson, Julia [IN-7] - 6/7/2005
Rep Christensen, Donna M. [VI] - 2/8/2005
Rep Clay, Wm. Lacy [MO-1] - 5/10/2005
Rep Cummings, Elijah E. [MD-7] - 5/5/2005
Rep Davis, Danny K. [IL-7] - 5/26/2005
Rep Delahunt, William D. [MA-10] - 12/15/2005
Rep Doyle, Michael F. [PA-14] - 5/22/2006
Rep Engel, Eliot L. [NY-17] - 6/7/2005
Rep Evans, Lane [IL-17] - 6/7/2005
Rep Farr, Sam [CA-17] - 5/5/2005
Rep Fattah, Chaka [PA-2] - 5/17/2005
Rep Filner, Bob [CA-51] - 4/5/2005
Rep Frank, Barney [MA-4] - 5/18/2005
Rep Green, Al [TX-9] - 2/16/2006
Rep Grijalva, Raul M. [AZ-7] - 5/25/2005
Rep Gutierrez, Luis V. [IL-4] - 5/18/2005
Rep Hastings, Alcee L. [FL-23] - 6/13/2005
Rep Hinchey, Maurice D. [NY-22] - 5/5/2005
Rep Honda, Michael M. [CA-15] - 6/22/2005
Rep Jackson, Jesse L., Jr. [IL-2] - 5/25/2005
Rep Jackson-Lee, Sheila [TX-18] - 5/19/2005
Rep Johnson, Eddie Bernice [TX-30] - 7/25/2006
Rep Jones, Stephanie Tubbs [OH-11] - 11/14/2005
Rep Kaptur, Marcy [OH-9] - 2/14/2006
Rep Kilpatrick, Carolyn C. [MI-13] - 5/26/2005
Rep Kucinich, Dennis J. [OH-10] - 2/8/2005
Rep Lantos, Tom [CA-12] - 6/7/2005
Rep Lee, Barbara [CA-9] - 5/5/2005
Rep Lewis, John [GA-5] - 5/25/2005
Rep Lynch, Stephen F. [MA-9] - 11/17/2005
Rep Maloney, Carolyn B. [NY-14] - 5/26/2005
Rep McDermott, Jim [WA-7] - 2/8/2005
Rep McGovern, James P. [MA-3] - 5/10/2005
Rep McKinney, Cynthia A. [GA-4] - 6/16/2005
Rep McNulty, Michael R. [NY-21] - 12/6/2005
Rep Meehan, Martin T. [MA-5] - 5/22/2006
Rep Miller, George [CA-7] - 5/10/2005
Rep Nadler, Jerrold [NY-8] - 5/25/2005
Rep Napolitano, Grace F. [CA-38] - 11/14/2005
Rep Norton, Eleanor Holmes [DC] - 7/25/2006
Rep Olver, John W. [MA-1] - 4/13/2005
Rep Owens, Major R. [NY-11] - 5/10/2005
Rep Pastor, Ed [AZ-4] - 5/18/2005
Rep Payne, Donald M. [NJ-10] - 5/10/2005
Rep Rangel, Charles B. [NY-15] - 4/5/2005
Rep Reyes, Silvestre [TX-16] - 2/14/2006
Rep Roybal-Allard, Lucille [CA-34] - 2/8/2006
Rep Rush, Bobby L. [IL-1] - 12/15/2005
Rep Sanchez, Linda T. [CA-39] - 7/25/2006
Rep Sanders, Bernard [VT] - 6/7/2005
Rep Schakowsky, Janice D. [IL-9] - 12/13/2005
Rep Scott, Robert C. [VA-3] - 5/25/2005
Rep Serrano, Jose E. [NY-16] - 5/12/2005
Rep Solis, Hilda L. [CA-32] - 7/12/2005
Rep Stark, Fortney Pete [CA-13] - 5/5/2005
Rep Thompson, Bennie G. [MS-2] - 5/19/2005
Rep Tierney, John F. [MA-6] - 6/15/2005
Rep Towns, Edolphus [NY-10] - 5/26/2005
Rep Udall, Tom [NM-3] - 5/26/2005
Rep Velazquez, Nydia M. [NY-12] - 12/15/2005
Rep Visclosky, Peter J. [IN-1] - 6/22/2006
Rep Waters, Maxine [CA-35] - 12/15/2005
Rep Watson, Diane E. [CA-33] - 5/5/2005
Rep Waxman, Henry A. [CA-30] - 5/19/2005
Rep Weiner, Anthony D. [NY-9] - 5/25/2005
Rep Wexler, Robert [FL-19] - 2/1/2006
Rep Woolsey, Lynn C. [CA-6] - 5/10/2005
Rep Wynn, Albert Russell [MD-4] - 5/5/2005
Coming next - HELP me assemble Part 2 of the HR676 Hall of Fame - incumbents and candidates who have publicly declared their willingness to become additional co-sponsors.
This is the most current list of incumbent co-sponsors. Please note that HR676 is STILL acquiring co-sponsors largely as a result of grassroots agitation. Here is - as of today on the THOMAS Web site - the most current list of co-sponsors. ALL are people of whose future we need to be mindful and protective.
Rep Abercrombie, Neil [HI-1] - 5/5/2005
Rep Baldwin, Tammy [WI-2] - 5/10/2005
Rep Becerra, Xavier [CA-31] - 11/17/2005
Rep Bishop, Sanford D., Jr. [GA-2] - 6/14/2006
Rep Brown, Corrine [FL-3] - 11/15/2005
Rep Brown, Sherrod [OH-13] - 2/1/2006
Rep Capuano, Michael E. [MA-8] - 12/13/2005
Rep Carson, Julia [IN-7] - 6/7/2005
Rep Christensen, Donna M. [VI] - 2/8/2005
Rep Clay, Wm. Lacy [MO-1] - 5/10/2005
Rep Cummings, Elijah E. [MD-7] - 5/5/2005
Rep Davis, Danny K. [IL-7] - 5/26/2005
Rep Delahunt, William D. [MA-10] - 12/15/2005
Rep Doyle, Michael F. [PA-14] - 5/22/2006
Rep Engel, Eliot L. [NY-17] - 6/7/2005
Rep Evans, Lane [IL-17] - 6/7/2005
Rep Farr, Sam [CA-17] - 5/5/2005
Rep Fattah, Chaka [PA-2] - 5/17/2005
Rep Filner, Bob [CA-51] - 4/5/2005
Rep Frank, Barney [MA-4] - 5/18/2005
Rep Green, Al [TX-9] - 2/16/2006
Rep Grijalva, Raul M. [AZ-7] - 5/25/2005
Rep Gutierrez, Luis V. [IL-4] - 5/18/2005
Rep Hastings, Alcee L. [FL-23] - 6/13/2005
Rep Hinchey, Maurice D. [NY-22] - 5/5/2005
Rep Honda, Michael M. [CA-15] - 6/22/2005
Rep Jackson, Jesse L., Jr. [IL-2] - 5/25/2005
Rep Jackson-Lee, Sheila [TX-18] - 5/19/2005
Rep Johnson, Eddie Bernice [TX-30] - 7/25/2006
Rep Jones, Stephanie Tubbs [OH-11] - 11/14/2005
Rep Kaptur, Marcy [OH-9] - 2/14/2006
Rep Kilpatrick, Carolyn C. [MI-13] - 5/26/2005
Rep Kucinich, Dennis J. [OH-10] - 2/8/2005
Rep Lantos, Tom [CA-12] - 6/7/2005
Rep Lee, Barbara [CA-9] - 5/5/2005
Rep Lewis, John [GA-5] - 5/25/2005
Rep Lynch, Stephen F. [MA-9] - 11/17/2005
Rep Maloney, Carolyn B. [NY-14] - 5/26/2005
Rep McDermott, Jim [WA-7] - 2/8/2005
Rep McGovern, James P. [MA-3] - 5/10/2005
Rep McKinney, Cynthia A. [GA-4] - 6/16/2005
Rep McNulty, Michael R. [NY-21] - 12/6/2005
Rep Meehan, Martin T. [MA-5] - 5/22/2006
Rep Miller, George [CA-7] - 5/10/2005
Rep Nadler, Jerrold [NY-8] - 5/25/2005
Rep Napolitano, Grace F. [CA-38] - 11/14/2005
Rep Norton, Eleanor Holmes [DC] - 7/25/2006
Rep Olver, John W. [MA-1] - 4/13/2005
Rep Owens, Major R. [NY-11] - 5/10/2005
Rep Pastor, Ed [AZ-4] - 5/18/2005
Rep Payne, Donald M. [NJ-10] - 5/10/2005
Rep Rangel, Charles B. [NY-15] - 4/5/2005
Rep Reyes, Silvestre [TX-16] - 2/14/2006
Rep Roybal-Allard, Lucille [CA-34] - 2/8/2006
Rep Rush, Bobby L. [IL-1] - 12/15/2005
Rep Sanchez, Linda T. [CA-39] - 7/25/2006
Rep Sanders, Bernard [VT] - 6/7/2005
Rep Schakowsky, Janice D. [IL-9] - 12/13/2005
Rep Scott, Robert C. [VA-3] - 5/25/2005
Rep Serrano, Jose E. [NY-16] - 5/12/2005
Rep Solis, Hilda L. [CA-32] - 7/12/2005
Rep Stark, Fortney Pete [CA-13] - 5/5/2005
Rep Thompson, Bennie G. [MS-2] - 5/19/2005
Rep Tierney, John F. [MA-6] - 6/15/2005
Rep Towns, Edolphus [NY-10] - 5/26/2005
Rep Udall, Tom [NM-3] - 5/26/2005
Rep Velazquez, Nydia M. [NY-12] - 12/15/2005
Rep Visclosky, Peter J. [IN-1] - 6/22/2006
Rep Waters, Maxine [CA-35] - 12/15/2005
Rep Watson, Diane E. [CA-33] - 5/5/2005
Rep Waxman, Henry A. [CA-30] - 5/19/2005
Rep Weiner, Anthony D. [NY-9] - 5/25/2005
Rep Wexler, Robert [FL-19] - 2/1/2006
Rep Woolsey, Lynn C. [CA-6] - 5/10/2005
Rep Wynn, Albert Russell [MD-4] - 5/5/2005
Coming next - HELP me assemble Part 2 of the HR676 Hall of Fame - incumbents and candidates who have publicly declared their willingness to become additional co-sponsors.
Michael Lemke wrote:
Hi Barry,
>
> sounds great. Only one problem. We have a crisis now, but what you describe could take years.
>
> This group has been set up on the Democratic Party website.
>
> What we really need is the Democratic leadership aggressively promoting universal, comprehensive-coverage single-payer NOW--making it a central issue in any and all elections.
>
> If high-profile leaders educate the public on this issue, they will win majority support and we can be passing legislation as soon as 2008. I am convinced that single-payer, if understood by a disgruntled electorate, is the lever to lift Democrats to control of both Congress and the White House.
>
> So how do we go about convincing the Democratic leadership to do what's right, refuse to compromise with the healthcare cartels, and publically and powerfully embrace single-payer?
>
> After all, if the Democratic leadership is against single-payer--if they too side with the cartels against the middle class--if they too are supporters of the plutocratic agenda--then what good will our advocacy do us? Are you proposing Lamonting every Democrat in Congress through grass-roots advocacy? To say the least: that could take a while.
>
> Thoughts?
Michael:
You are correct. It COULD take years - if we settle for status quo and the candidates we have now. This group is set up on the Democratic Party website only because it seemed a properly prominent podium with an audience this might pay attention. My own advocacy mission in this area is based in my faith (Unitarian Universalist), my understanding of medical ethics (which I teach), and a broad commitment on my part to social justice that is not beholden to any political party. The fact is that of the two major national parties, only Democrats are likely to hear our arguments, so this is a not bad audience in front of whom to have these discussions. However, I am not a member of the "party faithful".
Sitting in a meeting last month with the coordinators of other UU State Legislative Advocacy/Social Justice Networks (there are 15 of us now), securing universal health care was a hot-button issue in every single state represented, and the feeling in many organizations I have spoken to and participated in - advocacy and labor, faith- or issue-based - is that with building grassroots support now and not compromising our principles, this could become a deciding issue in 2008. We need to lay and maintain groundwork now to have that high ground.
How to do this?
Well....
Q:What is the irreducible minimum of our position that allows us to endorse and work with a candidate for election this year?
A: The candidate needs to endorse and commit to publicly supporting and voting for anything that establishes health care as a fundamental human right in this country. It seems to me that "life, liberty, and the pursuit of happiness" is impossible without health and without an underlying social guarantee that every resident's needs with regard to health care will be met timely and well. If we can make THAT point - then adopting any "universal health plan" that keeps private insurers in the system and different classes of care for different groups of individuals can be contested as unconstitutional under equal protection. If nothing else, defining health care as a fundamental human right needs to be a basic plank of a Democratic platform this year and an accepted platform position of any candidate or incumbent worthy of our support. Once we can make that inroad, the stage is set to move progressively forward.
What else defines candidates as being worthy of our support at this time as we seek to set the stage for a major move in 2008? Look at their contributors' lists and their other positions. Those who take money from insurers and pharmaceutical companies will not be our allies. Those who also advocate public funding of elections and full disclosure of contributors are people we can probably work with. Knowing that the timing of "incremental change" in politics is the timing of electoral cycles and term limits, candidates who want more study and time to pursue that approach will have to be persuaded otherwise to be worthy of our votes. The change we demand is fundamental, from the root on up, and cannot be executed on an incremental basis; and it has been well-studied and validated for almost two decades.
If we can get this far with our candidates and incumbents - we need to pressure them to support the Conyers bill (HB676) currently in the House at least to the degree of signing on as co-sponsors. We need to expect and demand the same of state candidates. Implementing single-payer can be done state-by-state, many state legislatures have equivalent bills before them, states are more likely than the federal forum to enact the malpractice reforms that would have to accompany so radical a system reform, and more individual states moving forward absent federal action will simply build pressure at the federal level for something more comprehensive and uniform.
One other thought. Some candidates I've spoken to call for allowing the public to "buy into" Medicare. BRING IT ON! A lesson learned in the Canadian system - except in Saskatchewan - is that that was HOW the system was implemented in every province. If Medicare enrollment is opened to employer groups and the general public, the commercial insurers will find themselves quickly underpriced and outcompeted - and by simple prevalence of market forces they will exit. THAT process took about 5 years in Canada.... but the progress once started is inexorable.
Finally - if, as you say, "the Democratic leadership is against single-payer--if they too side with the cartels against the middle class--if they too are supporters of the plutocratic agenda", then the Democratic party needs a massive transplant of leaders, Democratic leadership needs to grow a backbone, OR America needs a REAL third party to drive the Democrats into obscurity. This is an issue the Democratic party needs to rise to and take up with vigor if it is to remain relevant to American life. Otherwise they join Reform, Federalist, Whig, and BullMoose on the dusty old shelves of political antiquities and curiosities that have outlived their usefulness.
Barry
Hi Barry,
>
> sounds great. Only one problem. We have a crisis now, but what you describe could take years.
>
> This group has been set up on the Democratic Party website.
>
> What we really need is the Democratic leadership aggressively promoting universal, comprehensive-coverage single-payer NOW--making it a central issue in any and all elections.
>
> If high-profile leaders educate the public on this issue, they will win majority support and we can be passing legislation as soon as 2008. I am convinced that single-payer, if understood by a disgruntled electorate, is the lever to lift Democrats to control of both Congress and the White House.
>
> So how do we go about convincing the Democratic leadership to do what's right, refuse to compromise with the healthcare cartels, and publically and powerfully embrace single-payer?
>
> After all, if the Democratic leadership is against single-payer--if they too side with the cartels against the middle class--if they too are supporters of the plutocratic agenda--then what good will our advocacy do us? Are you proposing Lamonting every Democrat in Congress through grass-roots advocacy? To say the least: that could take a while.
>
> Thoughts?
Michael:
You are correct. It COULD take years - if we settle for status quo and the candidates we have now. This group is set up on the Democratic Party website only because it seemed a properly prominent podium with an audience this might pay attention. My own advocacy mission in this area is based in my faith (Unitarian Universalist), my understanding of medical ethics (which I teach), and a broad commitment on my part to social justice that is not beholden to any political party. The fact is that of the two major national parties, only Democrats are likely to hear our arguments, so this is a not bad audience in front of whom to have these discussions. However, I am not a member of the "party faithful".
Sitting in a meeting last month with the coordinators of other UU State Legislative Advocacy/Social Justice Networks (there are 15 of us now), securing universal health care was a hot-button issue in every single state represented, and the feeling in many organizations I have spoken to and participated in - advocacy and labor, faith- or issue-based - is that with building grassroots support now and not compromising our principles, this could become a deciding issue in 2008. We need to lay and maintain groundwork now to have that high ground.
How to do this?
Well....
Q:What is the irreducible minimum of our position that allows us to endorse and work with a candidate for election this year?
A: The candidate needs to endorse and commit to publicly supporting and voting for anything that establishes health care as a fundamental human right in this country. It seems to me that "life, liberty, and the pursuit of happiness" is impossible without health and without an underlying social guarantee that every resident's needs with regard to health care will be met timely and well. If we can make THAT point - then adopting any "universal health plan" that keeps private insurers in the system and different classes of care for different groups of individuals can be contested as unconstitutional under equal protection. If nothing else, defining health care as a fundamental human right needs to be a basic plank of a Democratic platform this year and an accepted platform position of any candidate or incumbent worthy of our support. Once we can make that inroad, the stage is set to move progressively forward.
What else defines candidates as being worthy of our support at this time as we seek to set the stage for a major move in 2008? Look at their contributors' lists and their other positions. Those who take money from insurers and pharmaceutical companies will not be our allies. Those who also advocate public funding of elections and full disclosure of contributors are people we can probably work with. Knowing that the timing of "incremental change" in politics is the timing of electoral cycles and term limits, candidates who want more study and time to pursue that approach will have to be persuaded otherwise to be worthy of our votes. The change we demand is fundamental, from the root on up, and cannot be executed on an incremental basis; and it has been well-studied and validated for almost two decades.
If we can get this far with our candidates and incumbents - we need to pressure them to support the Conyers bill (HB676) currently in the House at least to the degree of signing on as co-sponsors. We need to expect and demand the same of state candidates. Implementing single-payer can be done state-by-state, many state legislatures have equivalent bills before them, states are more likely than the federal forum to enact the malpractice reforms that would have to accompany so radical a system reform, and more individual states moving forward absent federal action will simply build pressure at the federal level for something more comprehensive and uniform.
One other thought. Some candidates I've spoken to call for allowing the public to "buy into" Medicare. BRING IT ON! A lesson learned in the Canadian system - except in Saskatchewan - is that that was HOW the system was implemented in every province. If Medicare enrollment is opened to employer groups and the general public, the commercial insurers will find themselves quickly underpriced and outcompeted - and by simple prevalence of market forces they will exit. THAT process took about 5 years in Canada.... but the progress once started is inexorable.
Finally - if, as you say, "the Democratic leadership is against single-payer--if they too side with the cartels against the middle class--if they too are supporters of the plutocratic agenda", then the Democratic party needs a massive transplant of leaders, Democratic leadership needs to grow a backbone, OR America needs a REAL third party to drive the Democrats into obscurity. This is an issue the Democratic party needs to rise to and take up with vigor if it is to remain relevant to American life. Otherwise they join Reform, Federalist, Whig, and BullMoose on the dusty old shelves of political antiquities and curiosities that have outlived their usefulness.
Barry
This first e-mail exchange on our listserv crystallizes in my mind what this group is about:
from Michael Lemke:
"I've just joined the group.
I support single-payer health care and approve of the PNHP.
So how does this work?
Is there a vision here, or will we be just spinning our wheels?
What is the purpose of this group?
"46.6 million Americans possess no health insurance of any kind. Many more are underinsured. The percentage of employer-insured workers is dropping fast, while prices continue to skyrocket. The system has failed.
We need a single-payer national Health Insurance Program that provides comprehensive coverage to all American citizens with freedom of choice as to provider.
We need to phase out no-value-added private insurers, whose every dollar in expense or profit is a dollar taken away from health care Americans need.
We need to leverage single-payer status to aggressively negotiate fair drug prices with pharmaceuticals companies.
We need to merge Medicare, Medicaid, and the VA into a single universal program with one plan--because good coverage is complete, and complete coverage requires only one plan.
We need to control malpractice insurance prices by regulating jury awards.
We need to pay for the new national Health Insurance Program without raising taxes on the middle class and the poor, and without requiring them to pay for their health care. The program should be paid for through the savings outlined above, with the balance raised by cutting subsidies to elite cartels and progressive taxation of the rich.
It is the only solution that will solve the crisis by fully addressing root causes. It also represents a huge cost savings for American businesses. The boost to the bottom line will mean increased competitiveness, reduced job loss to outsourcing, and higher profits."
Thoughts?"
My response:
First of all - welcome to the list. I've been an active advocate for single-payer health care - and a member of PNHP - in southwest Pennsylvania. By background I'm a Canadian physician who has practiced in the United States for 23 years but has kept abreast of the evolution of the Canadian system, seen the correction of the flaws over which I left it in 1982 (and which our opposition still cite as current fact), and I believe in single-payer as an essential economic reform as well as an ethical and moral stance to promote the well-being of all our people.
You ask if there is a vision. With vision comes mission. You recite a large number of facts.... which are all unfortunately true. As a practicing physician I have major ethical issues with standards of care being dictated by insurers according to their profit needs rather than established medical evidence. As an oncologist, I spend altogether too much time in damage control mode when people at risk of their lives arrive at my office altogether too late.
The vision is this:
To establish universal single-payer health care in the United States through grassroots agitation, political alliance, alliance with advocacy groups, and whatever democratic means are necessary to create the sea change that takes the existing head-shaking and ripples here and there of support and turn it into an irresistable tidal wave at the ballot box, in the states, and in Washington.
The mission is this:
- to replace politically-charged preconceptions (single-payer as "government control" or "socialism") with discussion of facts and meaningful measures that allow a real democratic process to proceed - reframe the discussion to meet our needs rather than respond to profiteers and fear-mongers
- to counter the fear created by the outdated arguments of our opposition (the Canadian waiting list story and tales of outdated technologies was true in 1982 - it's not now) with the current facts of access and costs as implemented in Canada and the European countries and how these lessons could and would be applied for viable finding of single-standard uniform-access care across the country
- to promote commensurate changes in taxation systems and in medical malpractice law to reduce costs, redirect administrative savings to adequate payment for health care supplies and services, and ensure the cooperation and support of the professionals we will need to build and staff the system
- to expose "universal" healthcare executed by coopting insurers, for-profit providers, and phramacetical makers as partners in the system as an alternative unworthy of being discussed or implemented and reveal it for the political concession to existing vested interests it is and always was
- to point out that the needs NOW make incremental bandaid fixes inappropriate, and remind the public that the time frame of incremental change repsonds to political expediency only
- to educate candidates and legislators willing to support any aspect of our agenda, bring them along as long-term partners we can work with and see elected, and gradually move them and with them the overall political environment in the state houses and Washington toward a realistic and sympathetic hearing of the optimal health plan for Americans
- to build working coalitions with other advocacy organizations to further amplify our voice
- to stay in place LONG past the passage of single-payer legislation in any one state or nationally to ensure that the system we want and are working toward is not eviscerated by politically-motivated regulatory changes that redirect the will of Congress, the Legislatures, and the people
- to make sure that the public understands the spin-off benefits - by taking the burden of health insurance off employers, we keep business open, jobs onshore, and see an overall elevation in the quality of life Americans enjoy
In other words this is a long-term, many-faceted project. (I could go on at much greater length - and frequently do.... but for now this suffices.)
And the floor is open for comments.
-Barry
from Michael Lemke:
"I've just joined the group.
I support single-payer health care and approve of the PNHP.
So how does this work?
Is there a vision here, or will we be just spinning our wheels?
What is the purpose of this group?
"46.6 million Americans possess no health insurance of any kind. Many more are underinsured. The percentage of employer-insured workers is dropping fast, while prices continue to skyrocket. The system has failed.
We need a single-payer national Health Insurance Program that provides comprehensive coverage to all American citizens with freedom of choice as to provider.
We need to phase out no-value-added private insurers, whose every dollar in expense or profit is a dollar taken away from health care Americans need.
We need to leverage single-payer status to aggressively negotiate fair drug prices with pharmaceuticals companies.
We need to merge Medicare, Medicaid, and the VA into a single universal program with one plan--because good coverage is complete, and complete coverage requires only one plan.
We need to control malpractice insurance prices by regulating jury awards.
We need to pay for the new national Health Insurance Program without raising taxes on the middle class and the poor, and without requiring them to pay for their health care. The program should be paid for through the savings outlined above, with the balance raised by cutting subsidies to elite cartels and progressive taxation of the rich.
It is the only solution that will solve the crisis by fully addressing root causes. It also represents a huge cost savings for American businesses. The boost to the bottom line will mean increased competitiveness, reduced job loss to outsourcing, and higher profits."
Thoughts?"
My response:
First of all - welcome to the list. I've been an active advocate for single-payer health care - and a member of PNHP - in southwest Pennsylvania. By background I'm a Canadian physician who has practiced in the United States for 23 years but has kept abreast of the evolution of the Canadian system, seen the correction of the flaws over which I left it in 1982 (and which our opposition still cite as current fact), and I believe in single-payer as an essential economic reform as well as an ethical and moral stance to promote the well-being of all our people.
You ask if there is a vision. With vision comes mission. You recite a large number of facts.... which are all unfortunately true. As a practicing physician I have major ethical issues with standards of care being dictated by insurers according to their profit needs rather than established medical evidence. As an oncologist, I spend altogether too much time in damage control mode when people at risk of their lives arrive at my office altogether too late.
The vision is this:
To establish universal single-payer health care in the United States through grassroots agitation, political alliance, alliance with advocacy groups, and whatever democratic means are necessary to create the sea change that takes the existing head-shaking and ripples here and there of support and turn it into an irresistable tidal wave at the ballot box, in the states, and in Washington.
The mission is this:
- to replace politically-charged preconceptions (single-payer as "government control" or "socialism") with discussion of facts and meaningful measures that allow a real democratic process to proceed - reframe the discussion to meet our needs rather than respond to profiteers and fear-mongers
- to counter the fear created by the outdated arguments of our opposition (the Canadian waiting list story and tales of outdated technologies was true in 1982 - it's not now) with the current facts of access and costs as implemented in Canada and the European countries and how these lessons could and would be applied for viable finding of single-standard uniform-access care across the country
- to promote commensurate changes in taxation systems and in medical malpractice law to reduce costs, redirect administrative savings to adequate payment for health care supplies and services, and ensure the cooperation and support of the professionals we will need to build and staff the system
- to expose "universal" healthcare executed by coopting insurers, for-profit providers, and phramacetical makers as partners in the system as an alternative unworthy of being discussed or implemented and reveal it for the political concession to existing vested interests it is and always was
- to point out that the needs NOW make incremental bandaid fixes inappropriate, and remind the public that the time frame of incremental change repsonds to political expediency only
- to educate candidates and legislators willing to support any aspect of our agenda, bring them along as long-term partners we can work with and see elected, and gradually move them and with them the overall political environment in the state houses and Washington toward a realistic and sympathetic hearing of the optimal health plan for Americans
- to build working coalitions with other advocacy organizations to further amplify our voice
- to stay in place LONG past the passage of single-payer legislation in any one state or nationally to ensure that the system we want and are working toward is not eviscerated by politically-motivated regulatory changes that redirect the will of Congress, the Legislatures, and the people
- to make sure that the public understands the spin-off benefits - by taking the burden of health insurance off employers, we keep business open, jobs onshore, and see an overall elevation in the quality of life Americans enjoy
In other words this is a long-term, many-faceted project. (I could go on at much greater length - and frequently do.... but for now this suffices.)
And the floor is open for comments.
-Barry
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