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Posts Tagged ‘Single Payer’

Why Unions Supported a Single-Payer Bill That Passed New York’s State Assembly

Wednesday, August 5th, 2015

mark-dudzicNew York’s State Assembly in May overwhelmingly passed a bill to establish a single-payer-style health care system.

The bill isn’t expected to pass the Senate or be signed into law anytime soon. But getting it through, with unprecedented support from big unions, shows that state-level campaigns are still a fertile ground for health care justice organizing, despite the recent setback in Vermont.

The New York Health Act would eliminate private health insurance and cover all New Yorkers in a publicly financed, universal plan with no patient premiums, deductibles, or co-payments.

“We should be able to go to the doctor when we need to, without worrying whether we can afford it,” said its sponsor, Assembly Member Richard Gottfried. “We should choose our doctors and hospitals without worrying about network restrictions.”

Gottfried has led a decades-long effort in the Assembly for universal care. But the difference this time was the number of major unions actively supporting it. They gave the bill a big boost.

More unions onboard

Traditional single-payer advocates like the New York State Nurses (NYSNA) and the New York City stagehands’ union, IATSE Local 1, have backed Gottfried’s bills before.

This year marked the first time they were joined by such influential statewide unions as Service Employees (SEIU) 1199 and New York State United Teachers (NYSUT/AFT).

Those unions’ lobbying efforts helped convince legislators the bill was politically viable. And their financial support was crucial to hiring community organizers in key regions.

The unions also participated in statewide hearings in January and mobilized members for Albany lobby days in May.

“The employer-based system of providing health care is eroding, covering a smaller percentage of New Yorkers each year,” said 1199 SEIU member Malcolm Olaker, a Poughkeepsie nursing home worker, at a lobby day.

“In a just society, all people are entitled to basic health care. That’s why we are all here today from different walks of life: patients, health care providers, caregivers and community members, supporting single payer health care.”

Advocacy groups Healthcare NOW, Single Payer NY, and Physicians for a National Health Program were able to capitalize on the momentum to play much larger roles than in previous years.

Obamacare didn’t fix it

Labor support for the initiative grew so strong because of how the Affordable Act has panned out. The much-heralded federal law has done little to ease bargaining-table pressures for health care concessions.

“Our members working in schools and college campuses want our state’s poorest students and their families to have access to quality health care services, so they arrive at school each day healthy and equipped to learn,” said Anthony Pallota, NYSUT executive vice president, at the January hearing.

“Our retirees, who tend to be our most medically vulnerable and fragile members, want affordable prescription medication and access to immediate health care.”

Despite the federal mandates, employers are still trying to offer less coverage and shift costs onto the backs of workers and retirees.

Public sector health benefits are a particularly tempting target, as states and municipalities wrestle with budget shortfalls. Politicians exploit a “politics of resentment” among private sector workers who’ve already seen their own benefits cut.

Another factor spurring unions to action is the looming 2018 implementation of the ACA’s “Cadillac tax.” This 40 percent excise tax will apply to all health insurance plan charges over $10,200 per year for individual coverage and $27,500 for family coverage.

These caps are set to rise at a much slower rate than the costs of health insurance, which means nearly all union-negotiated plans will eventually face the choice between radical cuts to coverage or paying the hefty tax.

Already, the tax has been a major issue in recent union negotiations with Boeing, oil refiners, and port operators.

State by state

While most health care justice activists would prefer a national, Medicare-for-All reform along the lines of Rep. John Conyers’ H.R. 676, in recent years the momentum has been growing for single-payer-style reforms at the state level.

At a time when any path to sweeping federal action appears closed, groups like the Labor Campaign for Single Payer and Healthcare NOW have supported state campaigns as a way forward.

The ACA may help facilitate these efforts—because, beginning in 2017, the federal government is authorized to grant states “innovation waivers.”

Such a waiver frees the state from the requirement to establish a private insurance exchange. Instead, it can reallocate federal subsidies for private insurance and Medicaid into funding its own plan.

To be approved, the state’s plan must meet the law’s minimum requirements for coverage and cost-sharing, and cover at least as many residents at a cost no higher than what the federal government would have assumed.

“We believe that a victory for a publicly financed, universal plan in one or more states can provide a powerful impetus to the movement for national health care,” said Ben Day, executive director of Healthcare NOW.

State efforts suffered a setback when Vermont’s governor announced in December that he was suspending plans to implement Green Mountain Care, the single-payer-style program to realize the 2011 law that made health care a right.

Shumlin was scheduled to submit a financing proposal to the legislature in advance of the plan going into effect in 2017. Instead, he announced the health care for all was “just not affordable”—despite the fact that even his own economic estimates showed Vermonters would spend less for health care than they currently do.

Gerald Friedman, a University of Massachusetts economist, called Shumlin’s decision “political, not economic.” Nonetheless, single-payer opponents seized on the Vermont debacle as proof that universal health care at the state level is unworkable.

But the book isn’t closed. The law is still in effect, and hundreds have taken to the streets to demand its implementation.

The Vermont Workers’ Center—which maintains that the state still has an obligation to implement the law—issued its own financing plan, which it submitted to the legislature for consideration.

Strategy conference

All health care justice campaigns, if they get far enough, will be forced to wrestle with the same conundrum Vermonters are facing. The closer they come to victory, the greater the resistance from the medical-industrial complex and free-market fundamentalists who viscerally oppose any form of social insurance.

In California, the legislature twice passed single-payer bills in the 2000s, only to have them vetoed by Republican Governor Arnold Schwarzenegger. Once Democrat Jerry Brown was elected governor, the movement couldn’t even find a bill sponsor.

California activists are gearing up for a multi-year project to muster the substantial funds and organizers it will take to win (and then defend) a single-payer-style system through the state’s initiative process.

Organizers in the strong, labor-backed campaigns in Oregon and Washington are also looking to use the initiative process if pending legislation founders. Oregon passed a bill to fund a study of alternative plans to ensure universal coverage.

New York will surely experience the same political challenges as Vermont and California. Nonetheless, the bill’s passage with such a big majority and the outpouring of labor and community support have given the national movement a welcome shot in the arm.

“This is a great victory, but now the hard work begins,” warned Joel Shufro, a longtime occupational health and safety advocate who worked to recruit unions to support the bill.

“Getting the bill through the Senate and getting the governor to sign it will be a long and difficult struggle. We must keep on building the grassroots movement if we ever hope to win the right to health care for everyone in New York.”

Activists will discuss and debate how to build this movement when they meet in Chicago, October 30-November 1, for thelargest-ever single-payer national strategy conference.

“Our movement continues to grow, as people realize that the Affordable Care Act does not do enough to solve the health care crisis afflicting almost everyone in America,” said NYSNA Vice President Marva Wade. “We need to come together to finish the job and make health care a right for everyone.”

This blog originally appeared in InTheseTimes.com on August 3, 2015. Reprinted with permission.

Mark Dudzic is the national coordinator of the Labor Campaign for Single Payer. He can be reached at mdudzic@igc.org.

Government run health-care, SIGN ME UP!

Monday, August 10th, 2009

“The government can’t run Cash for Clunkers, how can we trust them with health care.” That line was repeated over and over during recent town meetings with Congress-people and Senators.

First, the Cash for Clunkers program was an unqualified success. When was the last time you remember hearing about a government program that was so popular and so successful?

Cash for Clunkers was designed to get gas-guzzlers off the road and to sell new cars. Check and double-check. People loved the program and raced to the dealerships to cash in. Sure the program ran through a lot of money, because people loved it and it more than achieved its goals. Give me more of this kind of government program!

And speaking of government programs, sign me up for a government run health care program. As skeptical as I am of government, I am a thousand times more skeptical of health insurance companies.

I’m writing this not only as a consumer, but as a person who spent time working for two different health insurance companies. I’ve seen the lies and profiteering from the inside and I want another option. We deserve another option.

I wish Congress-people and Senators could see how frustrated we are with pre-existing conditions, treatments being considered experimental and all the other crap that we’ve all been handed by health insurance companies. Crap that we’ve had thrown in our faces even though we paid our dues and were promised the very care we’re having withheld from us.

I’m not suggesting a single-payer model. No, my suggestion is much simpler. Let the government compete with health insurance companies. I’m tired of them having a monopoly in health care. Let’s give them a real run for their money by making them compete.

They hate this idea because they know that far from fearing their government there are millions of people who would rather put their lives in the hands of government bureaucrats than profiteering private companies.

So please keep the public option on the table. Give us real choice.

Funny how corporations talk about the free market but then do everything to keep it very expensive and not free at all.

Based on your experience do you prefer the existing monopoly or would you like to join me in a government run program?

About the Author: Bob Rosner is a best-selling author and award-winning journalist. For free job and work advice, check out the award-winning workplace911.com. If you have a question for Bob, contact him via bob@workplace911.com .

Finding Common Ground Between Public Option Advocates and Single Payer Advocates

Thursday, July 30th, 2009

A heated argument is going on about the right health insurance model between those those who believe in a public option and those who believe in single payer.

Or perhaps I should say between those who are willing to take what they can get: public option; vs. those who want to hold out for what they consider the best option: single payer.

By way of reconciling what differences can be reconciled, let me ask a question of each side.

A Question for Public Option Advocates

Do you want to eventually have a single payer or a comprehensive system like the French have?  If not, why not?

A Question for Single Payer Advocates

Are you willing to fight for a public option which could eventually lead to single payer or a comprehensive system like the French one? If not, why not?

At this point what I'm seeing is both sides retreating into moralistic screaming.

The public option folks are saying: “It is better to save some lives than none, and if you single payer purists don't support a public option which will save even a few lives, you're responsible for those deaths.”

The single payer people are saying: “The public option is so watered down that all it will do is discredit real public reform, aka single payer.  You public option folks are settling for so little that the few lives you might save are outweighed by all the lives you won't save and the damage to the chance at real comprehensive health care reform.”

Both sides are assuming the other side is operating in bad faith.  The public option folks assume the single payer folks just want to be pure rather than saving lives, the single payer that the public option folks are just sell-outs shilling for a bad bill.

But what I'm seeing, as someone with a foot in each camp, is that both sides are (mostly) sincere.

Now there is one group that can't be reconciled.  People who want a public option so weak it either won't survive, or can't be used as the basis for a comprehensive system.  The usual suspects like Insurance company executives, for example.  But also some people in the Obama administration, such as Health Secretary Katherine Sibelius, the health secretary, who said that the plan would be drafted specifically so that it could never become single payer.

But for everyone else, for those acting in good faith, there should be some common ground from which we can work together. Let's start by recognizing that the battle over public option vs single payer is a distraction away from what we could accomplish if we worked together.

United we stand a chance.  Divided, we will lose our chance at health care reform.

(Minor edits made 3 am July 26th for clarity and style)

Ian Welsh: Ian Welsh has been blogging since 2003. He was the Managing Editor of FireDogLake and the Agonist. His work has also appeared at Huffington Post, Alternet, and Truthout, as well as the now defunct Blogging of the President (BOPNews). In Canada his work has appeared in Pogge.ca and BlogsCanada. He is a social media strategy consultant and currently lives in Toronto.

This article was originally posted at Open Left on July 27, 2009 and is reprinted here with permission from the author.

Confusing the Terms of the Health Care Debate

Thursday, July 30th, 2009

Martin Feldstein, a brilliant conservative economist, has his facts wrong on the health care debate in an op-ed he penned today in the Washington Post.

Nate Silver of FiveThirtyEight concisely explains Feldstein’s error:

Take a look at this:
Obama has said that he would favor a British-style “single payer” system in which the government owns the hospitals and the doctors are salaried but that he recognizes that such a shift would be too disruptive to the health-care industry. The Obama plan to have a government insurance provider that can undercut the premiums charged by private insurers would undoubtedly speed the arrival of such a single-payer plan.

Feldstein is simply mistaken here. “Single-payer” has to do with who pays for health care (in the case of single-payer, the federal government does). It has absolutely nothing to do with who provides health care. It’s the difference between the Canadian system, in which private doctors and hospitals are paid by the Canadian government (and indirectly, Canadian taxpayers) to provide health care to its citizenry, and the British system, in which the providers themselves — doctors, nurses, hospital administrators — are actually in the employ of Her Majesty’s Government. For that matter, it’s the difference between Medicare — a single-payer system for American seniors — and the British system. The Canadian system is nationalized health insurance. The British system is nationalized health care — or if you prefer, socialized medicine.

Obama has never expressed or implied any admiration for the British system of socalized medicine. Not that there aren’t admirable elements of it — but I doubt that you’d find even very many self-identified liberals who would suggest that it’s the right system for America. Obama, rather, has expressed admiration for a government-run monopoly on insurance — single-payer — as do about half of Americans in opinion polls.

Got it? Get it? Good.

Paul Secunda:

Paul Secunda joined the Marquette University Law School as an associate professor of law in the summer of 2008. He teaches employment discrimination, employee benefits, labor law, employment law, civil procedure, and seminars in special education law, global issues in employee benefits, and public employment law. Professor Secunda is the author of nearly three dozen books, treatises, articles, and shorter writings. He is also the author, along with Rick Bales and Jeff Hirsch, of the treatise, Understanding Employment Law, along with Sam Estreicher and Rosalind Connor, of the case book, Global Issues in Employee Benefits Law, and of the Teacher’s Manual to the 14th Edition of the Cox, Bok, Gorman & Finkin Labor Law casebook.Professor Secunda is a frequent commentator on labor and employment law issues in the national media and has written numerous columns and op-eds for the National Law Journal and Legal Times. He co-edits with Rick Bales and Jeffrey Hirsch the Workplace Prof Blog, recently named one of the top law professor blogs in the country, which is part of the Law Professors Blog Network.
This article originally appeared at Workplace Prof Blog and is reprinted here with permission from the author.

 

GM, Healthcare, Trade, It's All Related

Wednesday, June 10th, 2009

As I noted yesterday in connection with the bankruptcy of General Motors, I am in favor of spending money on trying to save peoples’ jobs–we are talking about the survival of communities and the lives of thousands of people. But, having now spent the morning reading various media reports about the GM bankruptcy, it’s startling how little, if any, of the dialogue makes broader connections to other parts of the economic system. Put another way, it’s great to spend money to address a crisis but if you don’t see the crisis in a broader way, the money will be wasted. Here is what I mean.

GM, and the rest of the U.S.-based auto industry, arrives at this crisis because of at least four problems. One is mismanagement. So, you have to ask the question–why isn’t there an entire housecleaning, removing every top manager and executive who has had significant role in running the company into the ground? Why would we turn over billions in taxpayer money to people who have shown they are thoroughly incompetent?

Second problem–which would lead me to be a tad less vocal on the first problem. Part of the crisis that led GM to the brink is a worldwide collapse of auto sales brought on by the general economic crisis. So, not to at all excuse the performance among the ranks of pathetically incompetent managers, you can also give a Bronx cheer for this sad situation to the leaders of the financial system (Robert Rubin, please take a bow).

But, you know, the above two problems pale in comparison to my other two points. First, and this is a point I have made countless times over the past number of months when I’ve played the role of TV pundit-talking-head-defender of labor, the crying shame is that we could have avoided the auto industry collapse if we had had a single-payer, “Medicare for All” health care system which would have relieved the auto companies of tens of billions of dollars of costs that have dragged down their balance sheets. Here we have the most prominent example I can think of where stupid ideology (“We can’t have a government-run health care system, that’s socialism”) has triumphed over sound economics. If we don’t learn from that mistake, the GM money goes to waste.

And, finally, if an auto industry job was, thanks to the UAW, a ticket to the “middle-class” or, at least, some promise that you could retire with some dignity, then, you would think someone would say: whoa, so now the auto companies are seeing their future in moving more jobs to Mexico and other countries. Wonder why they are doing that? Huh–could that be because of lower wages? Nah, that’s just “protectionist” talk. Point being: sure, we should be fine with our tax dollars helping people save their jobs BUT where are the leaders who are ready to rethink a trade policy that put us precisely where we are: a world where competition is based on the lowest wage possible.

About the Author: Jonathan Tasini is the executive director of Labor Research Association. Tasini ran for the Democratic nomination for the U.S. Senate in New York. For the past 25 years, Jonathan has been a union leader and organizer, a social activist, and a commentator and writer on work, labor and the economy. From 1990 to April 2003, he served as president of the National Writers Union (United Auto Workers Local 1981).He was the lead plaintiff in Tasini vs. The New York Times, the landmark electronic rights case that took on the corporate media’s assault on the rights of thousands of freelance authors.

This article originally appeared in Working Life on June 3, 2009. Reprinted with permission by the author.

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