Surprise In Mass. Primary: 21 Percent For Single-Payer Candidate Berwick

Note to politicians: Backing �Medicare for all� is looking less and less like electoral poison. If, deep in your heart, you believe American health care would be better off with a Canadian-style, single-payer system, you might now consider coming out of the closet. (In Democratic primaries in blue states, at least.)

 

 

That�s my suggested takeaway from the striking Massachusetts Democratic primary showing of Dr. Donald Berwick, who rocketed from near-zero name recognition among general voters to 21 percent at the polls. Catch him saying forcefully in the video above: �Let�s take the step in health care that the rest of the country hasn�t had the guts to take: single payer. Medicare for all.�

Now, Vermont not only has a mainstream politician who backed a single-payer system � Gov. Peter Shumlin � it�s actually translating the idea into practice as we speak. But let�s put it this way: This seems to be the first time that a candidate in a mainstream political party in a state that is not a verdant utopian duchy has run on a single-payer platform. And though he did not defeat the longtime familiar faces, he did surprisingly well.

Of course, we knew that Massachusetts voters tend to like the idea of single payer. As recently as 2010, 14 fairly middle-of-the-road districts voted in favor of a non-binding ballot measure calling for �creating a single payer health insurance system like Medicare that is comprehensive, cost effective, and publicly provided to all residents of Massachusetts.�

Analysts projected that the results meant a statewide majority in support of a single-payer system. The single-payer idea had polled well in non-binding ballot measures before, as well. But now we�ve seen that sentiment translated into support for a candidate.

Other politicians, including President Obama, have backed the general idea of a single-payer system, but they always add a �but,� said Dr. Steffi Woolhandler, who helped found Physicians for a National Health Program.

�And the �but� usually has to do with the political situation,� she said. �But it�s actually important to say what�s the right thing to do and to really work toward the right solution, and that�s what Don [Berwick] has been willing to do, to say, �We need single payer and skip the �but,� let�s just say we need single payer and that we need to start working toward it.��

Will Berwick�s strong showing change the playing field for other candidates? Dr. Woolhandler says yes: �Politicians understand votes. Unfortunately, they also understand money. But they do understand votes, and I think other politicians will see that voters are behind the idea of single payer.�

I asked Dr. Berwick about the reaction to his single-payer position in his many campaign-season travels, and he said the biggest surprise was how positive the response had been from voters who would likely not call themselves progressives. They either already agreed with the idea, he said, or responded instantly after one sentence of explanation with, �That sounds right to me. Let me tell you my story.�

�I remember a carpenter in Hingham,� he said. �I don�t think he would have said he was a progressive � he was a somewhat older carpenter struggling to make ends meet, sitting on a sofa at a gathering, a meet-and-greet, and I started talking about this, and I guess � embarrassingly, to me � I was expecting some pushback. But he immediately said, �I�ve got to tell you a story.� And he told me about his struggle to get health insurance.

�He very carefully went through the policy options, he had picked one that had a maximum deductible that was pretty stiff, and he was ready to swallow it. And he did, he signed up for that plan. And then, the problem was that he had three major illnesses the following year. And he discovered � to his dismay � that the deductible did not apply to the year, it applied to each separate episode. So this guy, who�s working with his hands and trying to just get through and have his family�s ends meet, suddenly found himself tens of thousands of dollars in debt, because of the complexity [of health insurance.] And he said, �Enough of this!� He immediately understood and was fully on board, and that kind of experience has been pretty constant for me.�

Overall, Dr. Berwick said, �The response has been extremely positive beyond anything I would have anticipated. When I took the position, I had no polling information. I did it because I was looking at the state budget and seeing the erosive impact of rising health care costs on everything else we need to do. The numbers were stunning to me. I got briefed by the Mass. Budget Policy Center and they said � as I remember the numbers and have been quoting them � Parks and Recreation were down 25 percent, local aid was down 40 percent, higher education was down 30 percent.

You really can�t find a line item on the state budget that hasn�t been down in real terms in the last decade. Except health care is up 59 percent. That was the number that stuck in my mind when they briefed me. And as I went around the state and began to see what we need to do for schools, for transportation, for affordable housing � the term I�ve used, and it�s a bold term but it�s confiscation. It�s with benign intent, but health care is essentially taking away opportunities from public investment.�

�And then you meet with businesses and you get the same story. Businesses talk about how the continuing increase in health care costs is cutting opportunities for them to grow and develop their businesses. And then when you talk to labor � I remember meeting with the painters� union, and I asked the person who was hosting me to show me their paychecks, and the union wage scales over the past few years � you can see it right there in black letters � the take-home pay per hour has not been going up. What is going up is contributions to health care. So the logic was strong.

�And the reactions have been consonant with those data. People are very frustrated. They don�t understand their health insurance. They can�t read their policy. They know it�s not transparent. And they are suffering from vastly increased costs.�

No anti-Canada, anti-England backlash against what could be seen as an attempt to �nationalize� or �socialize� health care?

Not really, Dr. Berwick said. �Initially, you have to explain it, like, �What exactly do you mean? Medicare is a federal program.� If you say it�s Medicare for all, that doesn�t quite do it. But as I explain it to people, you take all the funds, put them in a single pool, make that pool publicly accountable, constantly subject to scrutiny and redefinition, stop the paperwork, stop the complexity, that could save 10 percent of the total bill over the first couple of years.�

�People do have questions, like, �Is this a government takeover of health care?� And you explain, �No, no, no. It�s the same delivery system, your doctors and hospitals, this is not nationalization or the state taking over care, but it is a single payment system. So I would say, the reaction to this has been stunningly positive. Could this be catalytic? I certainly hope so. I�d hate to see Vermont lap Massachusetts on being the first to show what a rational payment system looks like.�

Neither of the Massachusetts primary winners � Democrat Martha Coakley and Republican Charlie Baker � backs a single-payer system, so it�s actually pretty well guaranteed that Vermont is going to lap Massachusetts in the single-payer realm.

But perhaps the question is whether Vermont and Massachusetts will follow the pattern of gay marriage: The Vermont Supreme Court broke the ice in late 1999 with its decision on �civil unions,� but it was � arguably � the 2003 decision by the highest court of Massachusetts that set gay marriage on the road to the big-time.

Forget Obamacare

Vermont wants to bring single payer to America

Saskatchewan is a vast prairie province in the middle of Canada. It�s home to hockey great Gordie Howe and the world�s first curling museum. But Canadians know it for another reason: it�s the birthplace of the country�s single-payer health-care system.

In 1947, Saskatchewan began doing something very different from the rest of the country: it decided to pay the hospital bills for all residents. The system was popular and effective � and other provinces quickly took notice. Neighboring Alberta started a hospital insurance plan in 1950, and by 1961 all ten Canadian provinces provided hospital care. In 1966, Canada passed a national law that grew hospital insurance to a more comprehensive insurance plan like the one that exists today.

Saskatchewan showed that a single-payer health-care system can start small and scale big. And across the border, six decades later, Vermont wants to pull off something similar. The state is three years deep in the process of building a government-owned and -operated health insurance plan that, if it gets off the ground, will cover Vermont�s 620,000 residents � and maybe, eventually, all 300 million Americans.

“If Vermont gets single-payer health care right, which I believe we will, other states will follow,” Vermont Gov. Peter Shumlin predicted in a recent interview. “If we screw it up, it will set back this effort for a long time. So I know we have a tremendous amount of responsibility, not only to Vermonters.”

When Shumlin ran on a single-payer platform in 2010, it was unprecedented. No statewide candidate � not in Vermont, not anywhere � had campaigned on the issue, and with good political reason. Government-run health insurance is divisive. When the country began debating health reform in 2009, polls showed single-payer to be the least popular option.

Shumlin just barely sold Vermont voters on the plan (he beat his Republican opponent by less than one percentage point). Then, he got the Vermont legislature on board, too. On May 26, 2011, Shumlin signed Act 48, a law passed by the Vermont House and Senate that committed the state to building the country�s first single-payer system.

Now comes the big challenge: paying for it. Act 48 required Vermont to create a single-payer system by 2017. But the state hasn�t drafted a bill that spells out how to raise the approximately $2 billion a year Vermont needs to run the system. The state collects only $2.7 billion in tax revenue each year, so an additional $2 billion is a vexingly large sum to scrape together.

Continue reading…

With Hippocratic Oath, Doctors Pledge Allegiance to Patients, Not Profits

The Maine Medical Association recently updated a 2008 poll of their members that asked the question, �When considering the topic of health care reform, would you prefer to make improvements in the current public/private system (or) a single-payer system, such as a �Medicare-for-all� approach?� In 2008, 52.3 percent favored the Medicare-for-all approach. In the updated poll, released last week, that number had risen to 64.3 percent.

It�s pretty unusual for two-thirds of a group of doctors to agree on something as controversial as a single-payer health care system. Until recently, doctors formed the core resistance to �government-run� health insurance in the U.S.

A number of factors account for this impressive change, but the huge administrative burden on practicing physicians created by our plethora of private insurance schemes is certainly near the top of the list.

The other day, I spoke with a Maine physician nearing retirement and looking forward to it. She was recently returning home after a long day in her practice, carrying her �homework,� a pile of administrative paperwork several inches high. Her husband asked her how she got so far behind in her paperwork. �I wasn�t behind at all,� she replied. She did this much paperwork, mostly insurance forms, at least twice a week.

American physicians spend at least three times as much time, money and effort on administrative work related to payment and insurance coverage as our Canadian brethren, with their single-payer system. Administrative hassle is a major factor driving more and more American doctors to sell our practices to large corporations that take care of the back-office work. The Affordable Care Act has only added to that burden. Sixty percent of doctors now work for corporations, and that number is growing.

Working for a corporate provider of health care services is a mixed bag. He who pays the piper calls the tune. As both for-profit and nonprofit health care corporations have become increasingly focused on the bottom line, doctors working for them have come under increasingly subtle and not-so-subtle pressures to generate revenue for their employers.

Some tests and procedures are more profitable than others. Increasingly, doctors� �productivity� is measured by the amount of profitable revenue we produce rather than by the results we get for our patients. But in health care, profitability is a very unreliable measure of value because doctors� fees and other health care prices are often set arbitrarily.

When we graduate from medical school, most of us take the Hippocratic Oath, swearing our primary allegiance to our patients. Young doctors tend to take their oath very seriously. Most doctors truly want to do what�s best for patients, not their insurance company or our employers� bottom line.

But in today�s corporatized and increasingly monetized health care environment, the demands for generation of profit often directly conflict with our clinical judgment. The belief that doctors and other healers act as stewards for our patients� welfare has long earned us a special place in society and the trust of our patients. That position and that trust, so critical to healing, is now threatened.

This conflict has made many doctors very angry. Practicing a profession that has traditionally been a calling has become a business. Doctors today are caught in a system corrupted by an excessive focus on money that is forcing us to behave in ways that conflict with our professional ethics. We are growing very tired of being told how to practice medicine by insurance company bureaucrats and corporate MBAs.

This is another major cause of the burnout experienced by increasing numbers of doctors. Many older doctors are now simply looking for a way out. Others are calling for systemwide reforms that will allow them to return to focusing on the welfare of their patients. Hence the results of the recent MMA poll.

In an excellent new book called �What Matters In Medicine�, longtime Maine family doctor David Loxterkamp points out that medical care, while often using scientific jargon, methods and tools, is at its core a profession about relationships, not profits. That�s something the bean-counters and policy wonks who have become increasingly influential in determining the nature of our corporatized health care system seem unable to understand.

It�s time to remove corporate profit from the financing of health care, and perverse financial incentives from the direct provision of services. It�s time for improved Medicare-for-all.

Physician Philip Caper of Brooklin is a founding board member of Maine AllCare, a nonpartisan, nonprofit group committed to making health care in Maine universal, accessible and affordable for all. He can be reached at pcpcaper21@gmail.com.

A Crusader on What Ails Artists

From the New York Times –

Beer bottles clinked and indie-rock classics played overhead at a gallery opening here on a Friday night recently, as one artist after another chatted with Julie Sokolow, a filmmaker and health care advocate who has documented the Pittsburgh scene in detail.

There was Eanna Holton, who makes horror masks and props and recalled spending the last five years paying off a $10,000 surgery bill for her toddler. China Horrell, her co-worker, had a pulmonary embolism that cost more than $100,000 to treat. And Daniel McCloskey, a comic-book artist, told of being uninsured when he smashed his teeth in a bicycle accident last year, at a cost of more than $22,000.

These are among the dozens of stories Ms. Sokolow, 26, has collected over the past two years, showing how the lives of Pittsburgh artists are intertwined with their struggles over the costs of medical coverage. Her online video series, �Healthy Artists,� has chronicled the experiences of more than 40 painters, poets and musicians � talented, ambitious and often with a painful story of medical debt � and drawn the attention of national media figures like Michael Moore.

�Everyone in America has a health care story,� said Ms. Sokolow, whose project has culminated in a new 30-minute documentary, �Healthy Artists: The Movie.�

Ms. Sokolow�s films � made on a shoestring budget and uploaded to YouTube � are also a microcosm of the national health care debate as it relates to the young creative class, a group that is disproportionately underinsured. And while her survey of Pittsburgh�s scene is unusual, it is also an example of grass-roots approaches around the country, like the O+ Festival in Kingston, N.Y., and San Francisco, where performers are paid in free health care.

According to one survey last year, 43 percent of artists lacked health insurance, more than double the national average for the uninsured.

�Julie�s work unearthed what was obvious but hidden at the same time,� said Dan Byers, a curator at the Carnegie Museum of Art in Pittsburgh who helped judge a �Healthy Artists� poster competition that is featured in the documentary. �It brought the more abstract national debate into a very specific, concrete, local context.�

Ms. Sokolow, who grew up in New Jersey and studied psychology and fiction writing at the University of Pittsburgh, said the origins of her project came through her volunteer work at a nonprofit organization, HealthCare 4 All PA. Assigned to film interviews with people who had dire health care problems, she was troubled by a lack of involvement among 20-somethings.

In response, the �Healthy Artists� series was conceived as a kind of �indie �Cribs� for social justice,� profiling young creatives in brief vignettes and getting them talking in a personal way about medical issues. The pieces were collected online and publicized through social media.

The goal, Ms. Sokolow said, was not to dwell on tragedies but to approach the problem with some optimism and use the films to advocate for broad reform through the idea that basic health care is a human right.

�I wanted to take a more positive approach, to not just focus on health care horror stories, but the people who would be empowered by a universal health care system,� Ms. Sokolow said. �Look at the work they are able to do without it. Imagine what they�d be able to do if they had a social safety net.�

Yet part of the power of the vignettes is how they detail the frustrations of freelancers in an economy in which health insurance has historically been tied to employment. In one profile, Jennifer Gooch demonstrated some of her work as a �musician, artist, crafter, maker, doer,� before tearfully recounting how she had declared bankruptcy after getting an $18,000 medical bill that included a colonoscopy.

�The procedure I got would have cost $800 in a socialized-medicine country, and I lost 10 years of credit,� Ms. Gooch, whose work has been covered by National Public Radio and the BBC, said in a recent interview. As a result of the bankruptcy, she had to give up her tailoring business. The $180-a-month plan she recently signed up for through the Affordable Care Act is a big help, she said, but still expensive.

The number of people ages 18 to 34 who have signed up for health coverage through federal and state exchanges grew substantially last month. But Ms. Gooch�s view was echoed by many artists who came out for a gallery crawl in the artsy Garfield section of Pittsburgh, some of whom said they had signed up for plans, while others said they still could not afford one.

Ms. Sokolow said that with the completion of the 30-minute documentary, the �Healthy Artists� project in Pittsburgh was now largely finished, and that she hoped it would be a model for activism in other cities. She is also finishing her first feature film, �Aspie Seeks Love,� another documentary about the dating life of a Pittsburgh man who learned in his 40s that he had Asperger�s syndrome, and in her parallel career as a musician, she is recording her second album.

�Julie�s ability to reach out through social media and connect artists and culture to a critical social policy issue is significant,� said Jim Ferlo, a Pennsylvania state senator who has introduced a single-payer health care bill. �I wish we could multiply her around the country.�

A subtext in the �Healthy Artists� films, and in Ms. Sokolow�s wider advocacy, is a challenge to the notion that artists must suffer outside the basic economic protections of society. A single-payer health care system, offering coverage to all, could solve that problem, at least as far as it applies to health. But an important step, Ms. Sokolow said, is persuading artists simply to stand up for themselves and address a problem that is felt by all but rarely talked about.

�I would like for artists to be advocates for themselves and their own health and not buy into stereotypes,� Ms. Sokolow said. �The people I profiled are working hard and trying to be healthy, and working against a society that�s not allowing that for them.�

A Crusader on What Ails Artists

From the New York Times –

Beer bottles clinked and indie-rock classics played overhead at a gallery opening here on a Friday night recently, as one artist after another chatted with Julie Sokolow, a filmmaker and health care advocate who has documented the Pittsburgh scene in detail.

There was Eanna Holton, who makes horror masks and props and recalled spending the last five years paying off a $10,000 surgery bill for her toddler. China Horrell, her co-worker, had a pulmonary embolism that cost more than $100,000 to treat. And Daniel McCloskey, a comic-book artist, told of being uninsured when he smashed his teeth in a bicycle accident last year, at a cost of more than $22,000.

These are among the dozens of stories Ms. Sokolow, 26, has collected over the past two years, showing how the lives of Pittsburgh artists are intertwined with their struggles over the costs of medical coverage. Her online video series, �Healthy Artists,� has chronicled the experiences of more than 40 painters, poets and musicians � talented, ambitious and often with a painful story of medical debt � and drawn the attention of national media figures like Michael Moore.

�Everyone in America has a health care story,� said Ms. Sokolow, whose project has culminated in a new 30-minute documentary, �Healthy Artists: The Movie.�

Ms. Sokolow�s films � made on a shoestring budget and uploaded to YouTube � are also a microcosm of the national health care debate as it relates to the young creative class, a group that is disproportionately underinsured. And while her survey of Pittsburgh�s scene is unusual, it is also an example of grass-roots approaches around the country, like the O+ Festival in Kingston, N.Y., and San Francisco, where performers are paid in free health care.

According to one survey last year, 43 percent of artists lacked health insurance, more than double the national average for the uninsured.

�Julie�s work unearthed what was obvious but hidden at the same time,� said Dan Byers, a curator at the Carnegie Museum of Art in Pittsburgh who helped judge a �Healthy Artists� poster competition that is featured in the documentary. �It brought the more abstract national debate into a very specific, concrete, local context.�

Ms. Sokolow, who grew up in New Jersey and studied psychology and fiction writing at the University of Pittsburgh, said the origins of her project came through her volunteer work at a nonprofit organization, HealthCare 4 All PA. Assigned to film interviews with people who had dire health care problems, she was troubled by a lack of involvement among 20-somethings.

In response, the �Healthy Artists� series was conceived as a kind of �indie �Cribs� for social justice,� profiling young creatives in brief vignettes and getting them talking in a personal way about medical issues. The pieces were collected online and publicized through social media.

The goal, Ms. Sokolow said, was not to dwell on tragedies but to approach the problem with some optimism and use the films to advocate for broad reform through the idea that basic health care is a human right.

�I wanted to take a more positive approach, to not just focus on health care horror stories, but the people who would be empowered by a universal health care system,� Ms. Sokolow said. �Look at the work they are able to do without it. Imagine what they�d be able to do if they had a social safety net.�

Yet part of the power of the vignettes is how they detail the frustrations of freelancers in an economy in which health insurance has historically been tied to employment. In one profile, Jennifer Gooch demonstrated some of her work as a �musician, artist, crafter, maker, doer,� before tearfully recounting how she had declared bankruptcy after getting an $18,000 medical bill that included a colonoscopy.

�The procedure I got would have cost $800 in a socialized-medicine country, and I lost 10 years of credit,� Ms. Gooch, whose work has been covered by National Public Radio and the BBC, said in a recent interview. As a result of the bankruptcy, she had to give up her tailoring business. The $180-a-month plan she recently signed up for through the Affordable Care Act is a big help, she said, but still expensive.

The number of people ages 18 to 34 who have signed up for health coverage through federal and state exchanges grew substantially last month. But Ms. Gooch�s view was echoed by many artists who came out for a gallery crawl in the artsy Garfield section of Pittsburgh, some of whom said they had signed up for plans, while others said they still could not afford one.

Ms. Sokolow said that with the completion of the 30-minute documentary, the �Healthy Artists� project in Pittsburgh was now largely finished, and that she hoped it would be a model for activism in other cities. She is also finishing her first feature film, �Aspie Seeks Love,� another documentary about the dating life of a Pittsburgh man who learned in his 40s that he had Asperger�s syndrome, and in her parallel career as a musician, she is recording her second album.

�Julie�s ability to reach out through social media and connect artists and culture to a critical social policy issue is significant,� said Jim Ferlo, a Pennsylvania state senator who has introduced a single-payer health care bill. �I wish we could multiply her around the country.�

A subtext in the �Healthy Artists� films, and in Ms. Sokolow�s wider advocacy, is a challenge to the notion that artists must suffer outside the basic economic protections of society. A single-payer health care system, offering coverage to all, could solve that problem, at least as far as it applies to health. But an important step, Ms. Sokolow said, is persuading artists simply to stand up for themselves and address a problem that is felt by all but rarely talked about.

�I would like for artists to be advocates for themselves and their own health and not buy into stereotypes,� Ms. Sokolow said. �The people I profiled are working hard and trying to be healthy, and working against a society that�s not allowing that for them.�

Med Students Lobby for New Yorkers’ Health

Doctors must advocate for their patients’ health � with supervisors who approve procedures, for instance, or insurance companies that pay for services.

On Tuesday, dozens of doctors-to-be tried different advocacy skills � lobbying state lawmakers to advance proposals they believe will improve New Yorkers’ health.

“If we are not going to fight for our patients, who will?” Albany Medical College student Xin Guan asked a few dozen young adults in white coats who had stopped in the basement of the Legislative Office Building for coffee, bagels and a press briefing between their morning and afternoon visits to lawmakers.

It was the first Medical Student Advocacy Day, organized by Guan, originally from California, and two other second-year students from Albany Med, Ajay Major of Indiana and Phyllis Ying of Seattle.

Some 60 to 70 students from around the state joined them. A glance at the coats suggested most were from Albany Med, but some had traveled from several downstate schools, including Albert Einstein College of Medicine, SUNY Downstate Medical Center and Mt. Sinai Medical Center.

Guan, Major and Ying had prepped them with some activist training before the event. Lobbying representatives was a new activity for about half the students, they said.

While the group shared a concern for health issues, they spoke with legislators about proposals that interested them as individuals. Small groups organized around a few popular issues, including bills to provide universal health coverage for all New Yorkers, allow marijuana for medical use, and prohibit doctors from participating in the torture and improper treatment of prisoners.

Anti-hunger advocate Mark Dunlea gave the students a pep talk before they headed back out to meet their afternoon slate of legislators. Dunlea’s group, Hunger Action Network of New York State, works with a coalition of organizations that provide aid to low-income people who struggle with the costs of health care.

He told the students that their future profession would carry some weight with legislators. And he reminded them that legislators are public servants.

“Remember, these guys work for you,” he said.

Med Students Lobby for New Yorkers’ Health

Doctors must advocate for their patients’ health � with supervisors who approve procedures, for instance, or insurance companies that pay for services.

On Tuesday, dozens of doctors-to-be tried different advocacy skills � lobbying state lawmakers to advance proposals they believe will improve New Yorkers’ health.

“If we are not going to fight for our patients, who will?” Albany Medical College student Xin Guan asked a few dozen young adults in white coats who had stopped in the basement of the Legislative Office Building for coffee, bagels and a press briefing between their morning and afternoon visits to lawmakers.

It was the first Medical Student Advocacy Day, organized by Guan, originally from California, and two other second-year students from Albany Med, Ajay Major of Indiana and Phyllis Ying of Seattle.

Some 60 to 70 students from around the state joined them. A glance at the coats suggested most were from Albany Med, but some had traveled from several downstate schools, including Albert Einstein College of Medicine, SUNY Downstate Medical Center and Mt. Sinai Medical Center.

Guan, Major and Ying had prepped them with some activist training before the event. Lobbying representatives was a new activity for about half the students, they said.

While the group shared a concern for health issues, they spoke with legislators about proposals that interested them as individuals. Small groups organized around a few popular issues, including bills to provide universal health coverage for all New Yorkers, allow marijuana for medical use, and prohibit doctors from participating in the torture and improper treatment of prisoners.

Anti-hunger advocate Mark Dunlea gave the students a pep talk before they headed back out to meet their afternoon slate of legislators. Dunlea’s group, Hunger Action Network of New York State, works with a coalition of organizations that provide aid to low-income people who struggle with the costs of health care.

He told the students that their future profession would carry some weight with legislators. And he reminded them that legislators are public servants.

“Remember, these guys work for you,” he said.

Single-Payer Activism Gets Boost from Obamacare

Dr. Richard Propp and Alice Brody thought Obamacare might sink their movement.

Instead, based on the interest they say they are getting, the federal Affordable Care Act has buoyed their cause of universal health coverage, or “improved Medicare for all,” they said.

At the heart of the new federal law are government-run online markets that provide one-stop shopping to public and private insurance plans for previously uninsured people. The intent was to improve access to health care.

But confusion over the insurance websites and disappointment with the coverage offered has fueled interest in something the activists say is simpler and better � a national health system supported with tax dollars. On Tuesday, they’re screening a documentary about the issue at the First Unitarian Society in Albany.

Recently joining the ranks of single-payer promoters are young adults and labor unions, they said. Both have been dismayed by the trend toward higher-deductible health plans, whether through the new government-run health exchanges or from private employers.

“We’re really surprised at how much new interest there is in this issue,” said Brody, 69, who is active in Single Payer New York, which has supported a proposed state law that would create universal health coverage for New Yorkers.

Propp, 79, launched the Capital District Alliance for Universal Healthcare in 2005. The group is an affiliate of Healthcare-Now!, a national grass-roots advocate that supports similar federal legislation.

The trouble with the Affordable Care Act, single-payer proponents said, is that lawmakers gave too much weight to the concerns of the industries that profit from an overpriced medical system. The result, they say, was a convoluted law that perhaps no one understands completely.

“The reason Obamacare is so complex is it’s so gerrymandered,” said Dr. David Ray of Albany Medical Center, who is active in CDAUH and heads the local chapter of Physicians for a National Health Program, a Chicago-based advocacy group. “The power of the moneyed interests � specifically the insurance industry and the pharmaceutical industry � was not taken out of the equation.”

By contrast, Medicare is easy to apply for and use, they said.

“You can understand Medicare,” Brody said. “The main problem with Medicare is it only serves the elderly, who are very sick. That’s why costs are high on Medicare.”

Another group whose support of universal health coverage may be surprising is doctors. Close to 60 percent of doctors support a single-payer health system, according to PNHP. Doctors support universal health coverage because it would make their business operations simpler, Ray said. Instead of meeting the requirements of dozens of insurance contracts, they would have to handle just one � with the government.

“Most physicians are dealing with so many masters, in terms of the insurance companies,” Ray said. “Single-payer is the only road to continuation of physician autonomy. And if there’s anything that physicians care about, it’s their autonomy.”

Ray, who has practiced medicine for 35 years at the former Community Health Plan and at the Whitney M. Young Jr. Health Center in Albany, said he has long held a philosophy that doctors should be paid for keeping people healthy, not for treating them only when they’re sick. His work at Whitney Young, an Albany-based clinic serving low-income patients, showed him the need for better health coverage for all people, he said.

Propp founded CDAUH when he retired, shortly after reading a Harvard study that showed uninsured people with diabetes had a 50 percent higher death rate than insured patients.

Brody’s impetus to join the movement came with the understanding in recent years that her childhood had been shaped by her family’s struggle to secure adequate health care. Her mother had multiple sclerosis, and her father worked three jobs to pay the household and medical bills. She and her sisters, Brody said, raised themselves.

“Health care should be a human right,” Brody said. “You have a right to be able to, if you’re sick, go see a doctor. It should be with you from birth to death.”

The Left After the Failure of Obamacare

It�s satisfying to watch rats flee a sinking ship. This is because onlookers knew the ship was doomed long ago, and swimming rats signify that the drawn-out tragedy is nearing an end. A collective sense of relief is a natural response.

The rats who propped up the broken boat of Obamacare are a collection of liberal and labor groups who frittered away their group�s resources�and integrity� to sell a crappy product to the American people.

Those in the deepest denial went �all in� for Obamacare� such as some unions and groups like Moveon.org� while the more conniving groups and individuals�like Michael Moore� playacted �critical� of Obamacare, while nevertheless declaring it �progressive�, in effect adding crucial political support to a project that deserved none.

But of course Obamacare was always more barrier than progress: we�ve wasted the last several years planning, debating, and reconstructing the national health care system, all the while going in the wrong direction� into the pockets of the insurance mega corporations. A couple progressive patches on the sails won�t keep her afloat. It�s shipbuilding time.

It was painful to watch otherwise intelligent people lend support to something that�s such an obviously bad idea. So it�s with immense relief that liberals like Michael Moore, labor groups, and others are finally distancing themselves from Obamacare�s Titanic failure. Now these individuals and groups can stop living in denial and the rest of us can proceed towards a rational discussion about a real health care solution.

The inevitable failure of Obamacare is not due to a bad website, but deeper issues. The hammering of the nails in the coffin has begun: millions of young people are suddenly realizing that Obamacare does not offer affordable health care. It�s a lie, and they aren�t buying it, literally.

The system depends on sufficient young people to opt in and purchase plans, in order to offset the costs of the older, higher-needs population. Poor young people with zero disposable income are being asked to pay monthly premiums of $150 and more, and they�re opting out, inevitably sinking Obamacare in the process.

Those young people who actually do buy Obamacare plans�to avoid the �mandate� fine� will be further enraged when they attempt to actually use their �insurance�. Many of the cheapest plans�the obvious choice for most young people� have $5,000 deductibles before the insurance will pay for anything. For poor young people this is no insurance at all, but a form of extortion.

At the same time millions of union members are being punished under Obamacare: those with decent insurance plans will suffer the �Cadillac� tax, which will push up the cost of their healthcare plans, and employers are already demanding concessions from union members in the form of higher health care premiums, co-pays, deductibles, etc.

Lower paid union workers will suffer as well. Those who are part of the Taft Hartley insurance plans will be pressured to leave the plans and buy their own insurance, since they cannot keep their plans and get the subsidy that the lowest income workers get. This has the potential to bust the whole Taft Hartley health care system that millions of union members benefit from, which is one of the reasons that labor leaders suddenly became outraged at Obamacare, after having wasted millions of union member�s dollars propping it up.

Ultimately, the American working class will collectively cheer Obamacare�s demise. They just need labor and other lefties to cheer lead its destruction a little more fiercely.

Surprisingly, most of the rats are still clinging to Obama�s hopeless vessel, frantically bailing water. Sure they�ve put on their life preservers and anxiously eyeing the lifeboats, but they�re also preaching about how to re-align the deckchairs.

For example, in his �critical� New York Times op-ed piece, Michael Moore called Obamacare �awful�, but also called it a �godsend�, singing his same tired tune. Part of Moore�s solution for Obamacare�which was cheered on in the Daily Kos� is equally ludicrous, and follows his consistently flawed logic that Obamacare is worth saving, since its �progress� that we can build on. Moore writes:

�Those who live in red [Republican dominated] states need the benefit of Medicaid expansion [a provision of Obamacare]�. In blue [Democrat dominated] states, let�s lobby for a public option on the insurance exchange � a health plan run by the state government, rather than a private insurer.�

This is Moore at his absolute worst. He�s neck deep in the flooded hull of the U.S.S Obamacare and giving us advice on how to tread water.

Of course Moore doesn�t criticize the heart of Obamacare, the individual mandate, the most hated component.

Moore also relies on the trump card argument of the pro-Obamacare liberals: there are progressive aspects to the scheme�such as the expansion of Medicaid� and therefore the whole system is worth saving.

Of course it�s untrue that we need Obamacare to expand Medicaid. In fact, the expansion of Medicaid acted more as a Trojan horse to introduce the pro-corporate heart of the system; a horse that Moore and other liberals nauseatingly continue to ride on.

But Moore�s sneakiest argument is his advice to blue states to ��lobby for a public option on the insurance exchange��

Again, Moore implies that it�s ok if we are �mandated� to buy health insurance, so long is there is a public option. But that aside, the deeper scheme here is that Moore wants us to further waste our energy �reforming� Obamacare, rather than driving it to the bottom of the sea.

Moore surely knows that very few people are going to march in the streets demanding a public option at this point; he therefore knows that even this tiny reform of the system is unachievable. He�s wasting our time. Real change only happens in politics when there is a surge of energy among large sections of the population, and it�s extremely unlikely that more than a handful of people are going to be active towards �fixing� Obamacare� they want to drown it.

Moore�s attempt to funnel people�s outrage at Obamacare towards a �public option� falls laughably short, and this is likely his intention, since his ongoing piecemeal �criticisms� of the system have only served to salvage a sunken ship.

Instead of wasting energy trying to pry Obamacare out of the grip of the corporations, Moore would be better served to focus exclusive energy towards expanding the movement for Medicare For All, which he claims that he also supports, while maintaining that somehow Obamacare will evolve into Single Payer system.

Most developed nations have achieved universal health care through a single payer system, which in the United States can be easily achieved by expanding Medicare to everybody. Once the realities of Obamacare directly affect the majority of the population and exacerbates the crisis of U.S. healthcare, people will inevitably choose to support the movement of Medicare for All, the only real option for a sane health care system.