Single-Payer Strategy Conference
Jan. 13 – Jan. 15, 2017
You are invited to join hundreds of activists for a weekend of inspiration and strategy to win single-payer national health insurance! Click here for more info.
Two doctors and a nurse report on the state of America’s healthcare, the Affordable Care Act (Obamacare), and their future under a Trump Administration. First-hand reports from the recent Physicians for a National Health Program national conference in Washington DC.
The Republican Healthcare Plan(s)
Jeff Gee, family physician and chair of the Bay Area chapter of Physicians for a National Health Program, discusses Republican healthcare proposals and what’s likely to come under a Trump Administration.
From L.A. Times California props
Nov. 9, 2016, 12:50 p.m.
Proposition 61, the most expensive statewide initiative on the ballot this November, has been defeated by a 54–46 margin.
The ballot measure sought to lower prescription drug prices by requiring that state agencies pay no more for medicines than the federal Department of Veterans Affairs.
Proponents of the measure, funded almost entirely by the Los Angeles-based AIDS Healthcare Foundation, had argued that Proposition 61 would be a strong voter rebuke of pharmaceutical industry greed. Supporters included Vermont Sen. Bernie Sanders, who campaigned up and down the state for the measure.
Drug companies led the campaign opposing the proposition, raising a record $109 million to defeat the measure. They argued the initiative could lead to higher drug costs for veterans and seniors if the pharmaceutical industry refused to sell the state medicines at lower prices.
Proponents of the measure raised more than $19 million to support it, and fundraising figures for both sides made it one of the priciest ballot measures in California history.
Visit UCLA Site Here. Interview Re-posted to SPN website.
Gerald Kominski is the director of the UCLA Center for Health Policy Research and co-author of a new policy brief on the share of taxpayer dollars that are spent on health care expenditures. In this brief interview, Kominski discusses how tax exemptions for employer-sponsored health insurance premiums benefit the rich more than the poor, why California’s share of Medicaid spending is 10 percentage points higher than the national average, and why a streamlined single-payer system might be preferable to the nation’s current “crazy patchwork” of health care financing.
Q: California spends money on health care in a variety of ways, including through tax exemptions for employer-sponsored health insurance premiums. Can you explain how this works ? or does not work?
The premiums that employers and workers pay for employer-sponsored health insurance (ESI) are exempt from taxation. These “foregone” taxes deduct $10.9 billion annually from the state coffers that could be spent on state programs like Medi-Cal and Healthy Families. Nationally, ESI tax subsidies are the third-largest health care program after Medicare and Medicaid, according to the National Bureau of Economic Research. And the ESI exclusion doesn’t help low-wage workers much — it benefits those with the highest incomes who have the most generous health plans. More than anything, the tax exempt status of ESI seems like an inefficient way to finance employer-based insurance.
Q: California’s share of Medicaid spending is 10 percentage points higher than the national average (27% versus 17%). Why is this?
Almost 33% of the population in California is enrolled in Medicaid, which is notably higher than average enrollment across the U.S. California has done a much better job at enrollment and has embraced the Medicaid expansion under the ACA. The major disadvantage of having a higher share of public spending in California for both Medicaid and total health spending is that there are fewer funds provided by private insurers. This creates pressure on providers to compete more intensely for a smaller share of privately insured patients, because they are generally the most profitable.
When providers select patients based on their profitability, we find greater disparities in access at a time when we are trying to reduce and eliminate disparities by expanding public insurance programs. This isn’t a problem California can solve on its own, unless the state applies for a federal waiver to develop a single-payer system that puts everyone on equal footing.
Q: Does the current system of multiple health care programs and health-related tax incentives make sense?
Despite the great successes of the ACA nationally and in California, our findings focus attention once again on the crazy patchwork of health care financing we have in the U.S. I believe that Sen. Sanders’s campaign pledge of Medicare for All resonated with so many because it acknowledged a simple truth that most people understand intuitively; namely, that not only should everyone have health insurance, we shouldn’t have significantly different health care options for the poor, for seniors, and for the working population. Far from creating “one size fits all” as critics also complain, it is possible to design a single-payer system in the U.S. that provides multiple options, subject to minimum benefit requirements that guarantee a floor for everyone.
Now that we have health insurance exchanges as a result of the ACA, maybe ACA 2.0 should find a way to move ESI, Medicare Part C, and Medicaid eligible populations into those exchanges so that insurers are required to compete for all categories of insurance, not just those they find most profitable.
Or, if insurers like Aetna don’t really want to sell health insurance, it might be time to pull the plug on this grand 87-year “experiment” with trying to make private insurance markets work, and finally admit once and for all, that in this sector of the economy, government really is the best choice for financing everyone’s health care.
Activists in San Francisco greeted Hillary Clinton outside her fundraiser asking for her to join 81% of her fellow Democrats and a majority of Americans, and support Universal, Single Payer, Medicare for All!!
John Geyman, M.D. has just released an excellent new book that analyzes the promises and the reality of the Affordable Care Act, a.k.a. Obamacare. Here a dedicated group of seven professional women present a chapter-by-chapter video summary of the book.
|Chaps. 1–3||Ann Chen|
|Chaps. 4–6||Tara Keir|
|Chaps. 7–12||Makulla Godwin|
|Chaps. 13–15||Mona Cereghino|
|Chaps. 16–17||Eileen Wampole|
|Chaps. 18–19||Susan Cieutat|
|Chap. 20||Carolyn Long|
Click here to listen to Dr. Margaret Flowers interviewed on Feb. 2, 2016 by KPFK journalist Sonali Kohlhatgar on the Uprising Program. Play audio from 8:35 minute mark to 25:25. Margaret discusses the Clinton campaign, recent attacks on single– payer and the Democratic parties lack of attention to the issues.
Both the Wall St Journal and Hillary Clinton are attacking it.
Gerald Friedman, the UMass economist and Board Member of Healthcare Now has been defending single payer.
On January 21, 2016, he spoke on Pacifica radio for 25 minutes. Click here to hear the interview with KPFA host Brian Edwards Tiekert. Professor Friedman begins speaking at the 34:10 minute mark.
Below is Friedman’s September 15, 2015 response to the Wall St Journal’s attack on single-payer.
Gerald Friedman’s research was cited in a Wall Street Journal story about Bernie Sanders’s proposals for government spending. Friedman responds to that story below.
It is said of economists that they know the cost of everything but the value of nothing. In the case of the article “Price Tag of Bernie Sanders’s Proposals: $18 Trillion,” this accusation is a better fit for the Wall Street Journal that published it.
The Journal correctly puts the additional federal spending for health care under HR 676 (a single payer health plan) at $15 trillion over ten years. It neglects to add, however, that by spending these vast sums, we would, as a country, save nearly $5 trillion over ten years in reduced administrative waste, lower pharmaceutical and device prices, and by lowering the rate of medical inflation.
These financial savings would be felt by businesses and by state and local governments who would no longer be paying for health insurance for their employees; and by retirees and working Americans who would no longer have to pay for their health insurance or for co-payments and deductibles. Beyond these financial savings, HR 676 would also save thousands of lives a year by expanding access to health care for the uninsured and the underinsured.
The economic benefits from Senator Sander’s proposal would be even greater than these static estimates suggest because a single-payer plan would create dynamic gains by freeing American businesses to compete without the burden of an inefficient and wasteful health insurance system. As with Senator Sanders’ other proposals, the economic boom created by HR 676, including the productivity boost coming from a more efficient health care system and a healthier population, would raise economic output and provide billions of dollars in additional tax revenues to over-set some of the additional federal spending.
Summary of 10-year projections
Because of the nearly $10 trillion in savings, it is possible to fund over $4.5 trillion in additional services while still reducing national health care spending by over $5 trillion. With these net savings, the additional $14.7 trillion in federal spending brings savings to the private sector (and state and local governments) of over $19.7 trillion.
Projected 10 year impact of HR 676 in billions
10-year estimates of spending with the current system and HR 676 (in $ billions):
Starting in 2018, we will be hiring at least 4 organizers to help us win a single payer health care plan in California. And then a national plan, such as HR 676, the Expanded and Improved Medicare for All Act. These are approximately 5 to 7 year organizing positions. Our goal is to win a California single payer healthcare ballot initiative. Before collecting the one million signatures to be on the ballot, we want to develop a database of 5 million people. We want to be able to communicate directly with voters as we expect corporations, the corporate media, and most politicians to oppose a single payer initiative.
The organizing job description is simple: We are asking organizers to add 100 people a week to our database and to organize 1% of the those people in your area to do something once a month.
Our best tool for talking with people about national healthcare is a postcard supporting the Expanded and Improved Medicare for All Act, HR 676.
As an organizer, you will be asking thousands of people to sign postcards. Let us know if you would like us to send you 10 postcards to see if asking people to sign is comfortable for you.
If this job interests you, you can fill out an application form here.
Please send completed applications to:
Single Payer Now
PO Box 460622
San Francisco, CA 94146
or email to:
The Expanded & Improved for Medicare for All
Summary of HR 676
Introduced by Rep. John Conyers Jr. on February 3, 2015. HR 676 currently has 44 co-sponsors.
The Expanded & Improved Medicare For All Act establishes a unique American national universal health insurance program. The bill would create a publicly financed, privately delivered healthcare system that uses the already existing Medicare program by expanding and improving it to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that everyone will have access, guaranteed by law, to the highest quality and most cost effective healthcare services regardless of their employment, income, or healthcare status. With over 40 million uninsured in the United States, and another 50 million who are under-insured, the time has come to change our inefficient and costly fragmented non-healthcare system.
Who is Eligible?
Every person living or visiting in the United States and the U.S. Territories would receive a United States National Health Insurance Card and ID number once they enroll at the appropriate location. Social Security numbers may not be used when assigning ID cards.
Healthcare Services Covered
This program will cover all medically necessary services, including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long term care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment. Patients have their choice of physicians, providers, hospitals, clinics, and practices. No co-pays or deductibles are permissible under this act.
Conversion To A Non-Profit Healthcare System
Private health insurers shall be prohibited under this act from selling coverage that duplicates the benefits of the USNHI program. Exceptions to this rule include coverage for cosmetic surgery, and other medically unnecessary treatments. Those who are displaced as the result of the transition to a non– profit healthcare system are the first to be hired and retrained under this act.
The conversion to a not-for-profit healthcare system will take place over a 15 year period, through the sale of U.S. treasury bonds.
HR 676 Would Spend Our Resources Wisely
Our fragmented current administration consumes 31.0 percent of U.S. health spending, double the proportion of Canada (16.7 percent). Average overhead among private U.S. insurers was 11.7 percent, compared with 1.3 percent for Canada’s single-payer system and 3.6 percent for Medicare. Streamlined to Canadian levels, enough administrative waste could be saved to provide compressive health insurance to all Americans.
Proposed Funding for HR 676*
Maintain current federal and state funding for existing healthcare programs; employer payroll tax of 3% on incomes less than $53,00, an employer payroll tax of 6% on incomes more than $53,000, in addition to the already existing 1.45% for Medicare; establish a 6% health tax on the top 5% of income earners with incomes > $225,000; and a 1/2 of 1% stock transaction tax,
*This proposal is put forward by single-payer advocates as one example of a funding system, though HR 676 doesn’t propose a funding program.