www.caprogressreport.org

 

 

Office of California State Senator Sheila Kuehl

"Politically feasible" is just another way of saying that folks are scared to stand up to insurance companies. I don’t accept that. It’s time to take a stand for what we really want. It’s time to have hope. - Senator Sheila Kuehl

SB 840 is alive and well in the Assembly Appropriations committee, much further along in the legislative process than it was in 2006, just before its historical passage out of both houses of the legislature and onto the Governor’s desk. Legislative deadlines for passage out of fiscal committees aren’t until August 15th and, between now and then, grassroots organizing and education efforts are really taking off. Every day, Senator Kuehl and her staff receive requests for presentations regarding SB 840, the truly universal healthcare bill.

On Sunday, January 27th and Monday, January 28th, the American Medical Students’ Association held their hugely successful third annual rally and lobby day in Sacramento, which included a day long training that drew nearly 400 med students from all over the state. The fact that so many overworked medical students spent an entire weekend, even taking a rare day off from school, to advocate for single payer health care shows an unparalleled level of dedication and passion. AMSA students give every single payer supporter hope and inspiration as they push for passage of the bill.

Single payer advocates are also busy preparing for a historical strategy summit taking place in Los Angles later this month that will bring together representatives from the broad coalition of organizations dedicated to bringing single payer to California. The summit demonstrates the unprecedented development of the organized and operational single payer movement necessary to bring universal health care to California. It’s the kind of grassroots movement that has been largely absent in the history of health reform, and it’s just one example of the changing landscape of health care politics.

On that note, my "leisure" reading lately is a book called, One Nation Uninsured: Why the US Has No National Health Insurance. It chronicles the 20th century’s long line of failed attempts at achieving national health insurance. There’s an unmistakable pattern to each major attempt, in that there seems have been an attempt once every decade and, each time national health insurance is within our grasp, it is defeated with a capitulatory "compromise".

I couldn’t help but notice that, historically, the compromises are forged by the exact same powerful interests every time, working like scavengers randomly picking through the ideas of national health insurance, with little consideration given to whether any "reform" was actually going to improve the health care system for the average American.

In fact, a century of such "health care reform" has brought our health care system to the point where it is deeply fragmented, unimaginably costly and the least effective system in the entire developed world at delivering either health or care. I can’t help but wonder where we might have been in terms of universal health care had proponents not forfeited their goal quite so fast.

Most striking? The grassroots role that physicians repeatedly played in defeating national health insurance. The American Medical Association functioned as an exceptionally effective grassroots movement that was embedded in every community across the nation. They organized education and lobbying campaigns against universal health care, labeling their efforts as "protecting the public health". They hired PR consultants who admitted that they were attempting to label national health insurance as "socialized medicine" for the simple reason that Americans were opposed to socialism.

The litmus test for "politically feasible" has historically been largely defined by where doctors, insurers, business and labor stood on the issue. Throughout the last century, there was no grassroots group as singularly focused on the passage of single payer health care as the physicians and insurers were opposed to it. That’s changed considerably, especially in California, as the 500 or so organizations that support SB 840 continue their evolution into an effective coalition that works tirelessly (and largely under the radar of many in Sacramento) to educate and organize Californians on universal health care.

More importantly, groups that traditionally oppose single payer, like physicians, are no longer unified against it. The American College of Physicians made history last year in their endorsement of single payer and the California Medical Association includes a large and growing minority of members that strongly support single payer. The American Medical Students Association has quickly risen to become one of the most passionate and inspired groups advocating for passage of SB 840. Another powerful provider group, the California Nurses Association has gone "all in" for single payer and is working in much the same way for single payer as the American Medical Association once worked to oppose it. Their dedication unites with that of organizations like Health Care for All – California, school employees, the League of Women Voters, retired teachers, and others who are deeply embedded in communities across the state.

 

The lesson that advocates of single payer should take from history is to observe how the AMA was able to defeat national health insurance through steady community education and organizing. This is why single payer has the best shot, politically, as well as on a policy basis, for winning passage. Only single-payer boasts the kind of unified and dedicated grassroots movement for something that makes large reform possible.

 

http://www.amazon.com/One-Nation-Uninsured-National-Insurance/dp/0195160398 

http://insureblog.blogspot.com/2005/10/one-nation-uninsured-review-conclusion.html

excerpt

One Nation, Uninsured: A Review (Conclusion) In Part 1 we learned about Prof Jill Quadagno’s new book setting forth the case for a national health insurance plan

 Forcing Medical Patients To Be Consumers Wreaks Havoc on Our Health System

By Niko Karvounis, Health Beat. Posted February 22, 2008.

http://www.alternet.org/healthwellness/77396/ 

excerpt

The price tag of health care for the uninsured is over $40 billion. Maintaining a market-driven system will only drive that bill higher

One of the most common justifications for consumer-driven medicine is reduced health care costs. The reasoning here is two-fold:

• Since they're high-deductible and low premium, consumer-driven health plans require more out-of-pocket spending. Consumers are more cost-conscious when they have to actively shell out for purchases. As a result, they will user fewer health care services -- and thus overall health care costs will fall.

   

   

• If consumers are in the driver's seat, competition in an open market will drive prices down. For-profit providers will want to offer the best deal to get the most business. Consumers will also have better information thanks to the commoditization of medicine, which will translate medical jargon into universally comprehensible knowledge. Smarter consumers translate into less over-payment for services.

   

This is standard-issue free market orthodoxy at its finest. Unfortunately, this isn't the whole story. In fact, there's an even stronger argument to be made that consumer-driven health plans could lead to higher health care costs.

The Wrong Patients Forgo the Wrong Care

Research by the RAND Corporation's health insurance experiment shows that when you shift costs to the consumer, patients forgo both wasteful and effective care. And this is particularly true of the patients who cost us most in the long run -- those suffering from chronic diseases.

A 2007 paper from the National Bureau of Economic Research looked at retired California public employees on Medicare, and its findings contradict some of the basic assumptions of the consumerist movement.

The study's authors -- from Harvard, MIT, and the University of Oregon -- found that chronically ill patients who are asked to shoulder more of their health care costs deferred, neglected, or opted-out of doctor's visits and drugs when the price got too high. This short-term cost reduction led to long-term catastrophe, as their hospitalization rates were significantly higher than other patients suffering from chronic diseases. Immediate savings ultimately led to a greater -- and otherwise preventable -- use of more expensive care.

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