Healthcare, Not Health Insurance

From Media Mobilizing Project –

Everyone gets sick, but not everyone can access healthcare when they need it. The Affordable Care Act has expanded access, but millions are still left out, and most people with insurance still struggle to afford the care they need. In Pennsylvania and in states across the country, a growing movement is demanding that healthcare become a human right that’s accessible for every person. What will it take to make this happen? Three leaders on the front lines of this struggle share their insights and experiences.

A conversation with Nijmie Dzurinko, a leader of Put People First PA, Mark Dudzic, national organizer with the Labor Campaign for Single Payer, and Marty Harrison, a nurse and member of the Pennsylvania Association of Staff Nurses and Allied Professionals (PASNAP).

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.

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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.

Single Payer Rises Again

As the ACA takes effect, an alternative gains ground at the state level.

When Sergio Espana first began talking to people, just over a year ago, about the need for fundamental changes in the U.S. healthcare system, confusion often ensued. Some people didn�t understand why, if the Affordable Care Act (ACA) had passed, people still wanted to reform the system; others thought organizers were trying to sign them up for �Obamacare.�

Healthcare is a Human Right Maryland, the group to which Espana belongs, is in pursuit of something else: a truly universal healthcare system that would cover everyone and eliminate insurance companies once and for all. Espana and many others in the growing movement see opportunity in the renewed discussion around healthcare reform as the ACA�s insurance exchanges go into effect.

They believe that the ACA�s continued reliance on (and subsidies of) private insurance simply aren�t good enough. People are still falling through the cracks, employers are trying to dodge the requirement that they provide insurance for their workers, and many states refused federal subsidies to expand their Medicaid programs. What these activists want is a program that would replace existing insurance programs, cover everyone regardless of their employment status, and be funded by the government, with tax dollars. Such a plan had strong support when the national healthcare overhaul was being crafted in 2009�including initial backing by President Obama�but the president and Congress decided it wasn�t politically possible and passed the ACA as a compromise.

Now, the rocky launch of the healthcare exchanges that form the cornerstone of the Affordable Care Act has helped revive interest in single-payer, says Ida Hellander, director of policy and programs for the advocacy group Physicians for a National Health Program. New York State Assemblymember Richard Gottfried, the author of a 20-year-old single-payer bill that is receiving renewed support, points out that single-payer would avoid many of the issues of the ACA�s launch. �When you don�t have means testing and you don�t have to make guesses about who�s going to cover your doctor or your ailment, it�s very simple.�

While Republicans on the national stage have been grandstanding about �repealing and replacing� the ACA, grassroots activists are on the ground in many states organizing their neighbors around the idea of real universal healthcare. A national program remains the end goal, but Nijmie Dzurinko of Put People First! Pennsylvania believes that state efforts could have a domino effect. �Our job is to change what�s politically possible,� says Drew Christopher Joy of the Southern Maine Workers� Center, which is leading the effort in that state.

According to Hellander, about 25 states already have solid organizing toward single-payer, often accompanied by pending legislation. Some of these efforts predate the ACA: The California Nurses Association led the charge for single-payer in the mid-2000s, twice getting a bill through the California legislature only to have it vetoed by Gov. Arnold Schwarzenegger. Hellander says that the ACA has slowed down some efforts at state reform, as officials turned to setting up exchanges, but the law spurred others in Minnesota, Washington, Hawaii and Oregon. In New York, Gottfried notes that his bill has support from physicians groups, the nurses union and a majority of the lower house of the legislature. And in Massachusetts, considered the laboratory for the ACA, single-payer is now on the table thanks to gubernatorial candidate Don Berwick, the former administrator of the Centers for Medicare and Medicaid Services under Obama.

The biggest legislative victory to date has come in Vermont. Act 48, signed into law by Gov. Peter Shumlin in May of 2011, would begin to create a �universal and unified� healthcare system for the state. The bill, pioneered by the Vermont Workers� Center (VWC), is at the cutting edge of national healthcare policy. Its passage resulted from years of on-the-ground organizing around the principle that healthcare is a human right�that it must be universal, equitable, participatory, transparent and accountable.

However, Act 48 marks just the beginning of a lengthy process toward healthcare for all residents of the state, regardless of employment or citizenship. The next steps are to figure out how �Green Mountain Care� will fit into federal requirements set by the ACA and to pass a mechanism by which the program will be financed.

The VWC favors a more progressive income tax on individuals and employers, along with a wealth tax. Mary Gerisch, president of the VWC, says, �Even though new taxes or progressive taxation sounds very scary, in reality it�s going to be cheaper for everybody, just like it is in every other country, for them to pay it in taxation rather than to pay out of pocket at the doctor.�

This growing movement has attracted growing opposition, says Gerisch, who notes that a number of TV ads and websites have popped up to oppose Green Mountain Care. And Vermonters for Health Care Freedom, a new 501(c)4 organization founded by longtime Republican political operative Darcie Johnston, has paid for several ads and robocalling campaigns against the plan.

Small business owners, in particular, are susceptible to the fear that new taxes will put them out of business, Gerisch says. She mentions one example of a small business owner who was worried about a 10 percent tax (even though no tax has been decided upon), only to find out that he was already paying 13 percent of his profits to buy insurance for his employees, which would be unnecessary under a state plan.

Healthcare is a Human Right believes the organizing model pioneered in Vermont represents the best chance for passing universal healthcare, and the group is forging ahead with that model in its Maine, Maryland, and Pennsylvania chapters. Among the key elements are base-building and education. To combat corporate scare tactics, activists focus on arming citizens with good information.

In Maryland, according to Espana, more than 90 percent of the 1,200-plus people the organization has surveyed over the last year believe that healthcare is a right, and more than 86 percent support a publicly funded system. �Maryland has been coming off more and more as a progressive state. We�ve been able to get some version of a DREAM Act through, we got marriage equality last year�those are great victories but, economically, they�re not that transformational,� he says.

Joy sees an opportunity to build a strong community-labor alliance around universal care in Maine, where the state AFL-CIO has gotten on board with the Healthcare is a Human Right campaign, and the Maine State Nurses Association held a free health clinic to provide services and connect people to the campaign.

Dzurinko and Put People First! Pennsylvania have been organizing statewide�not only in Philadelphia and Pittsburgh, but in rural counties where the conventional wisdom has been that progressives can�t win. Dzurinko says that people in those counties frequently suggest, unprompted, that the U.S. should have a national healthcare system �like in Canada.�

�We often limit ourselves tremendously by not talking to people that we fear or that we have been told won�t agree,� Dzurinko says. �We can�t talk about universality unless we really are talking about everyone, and that means organizing in all communities.� Joy agrees: �If you�re not taking the time to really organize from the ground up, we�ll end up with the ACA again.�

For Espana, organizing around single-payer presents an opportunity to begin a broader discussion about economic justice and human rights. �All of these politics of austerity are just lies,� he says. �Through a fight for healthcare reform you can demonstrate that not only is it morally righteous for us to have a universal healthcare system, but it�s actually cheaper.�

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.

Labor Builds Support for Medicare for All

While Obamacare Enrollment Continues to Lag, Labor Builds Support for Expanded and Improved Medicare for All

The 113th Congress will likely be remembered as the most unproductive in our history, and with an overall approval rating of 9 perent, it is safe to say that most Americans do not consider this bunch to be a noble group of public servants engaged in good works for the people of this country. It is rare that any member of Congress is honored on any level these days, but one truly worthy exception is Rep. John Conyers (D-MI), who early in December was honored with a breakfast celebration attended by some 40 union representatives at a restaurant on East 29th Street in New York City.

Those present included leaders from Actors Equity, The International Alliance of Theatrical Stage Employees (IATSE) and the New York City Central Labor Council (NYCCLC), whose President, Vincent Alvarez, declared his support for Mr. Conyers’ bill HR 676, The Expanded and Improved Medicare for All Act, and promised to deliver their 1.3 million members to back this cause. This is a very significant development, as the 300 unions under the umbrella of the NYCCLC are made up of truck drivers, teachers, nurses, operating engineers, construction workers, janitors, train operators, electricians, fire fighters, retail workers and many more hardworking Americans who, along with everyone else in our nation, would benefit greatly from this revolutionary healthcare plan. They are the face of American labor today, and Mr. Alvarez spoke of the need for labor and the general public to unite and work together for this imperative cause: providing affordable, quality healthcare to all Americans.

We might recall that it was labor that gave us the middle class during the post World War II years as they worked to indeed lift all boats in that time of unprecedented prosperity. Can they lead our nation once again in this time of unprecedented need? They have been taking quite a beating, and have been decimated in several states by the lackeys of the 1 percent. But their values are America’s values, and it is critical that they remain a vibrant force for change in this country.

Mr. Conyers was introduced by his longtime friend, TV talk show host Phil Donahue, and other speakers that morning included Robert Score, Recording-Corresponding Secretary of Local 1 of IATSE, and Stephen Shaff, speaking on behalf of Progressive Democrats of America. Mr. Conyers himself noted that it took him 15 years to move Congress to declare a national holiday for Dr. Martin Luther King, so he is prepared for a long haul to achieve Medicare For All. He has reintroduced HR 676 in every Congress since 2003, and has now garnered support from 54 other House members, along with an impressive 609 union organizations, including 146 Central Labor Councils/Area Federations and 44 State AFL/CIO’s. Obamacare’s failure to address the Taft Hartley Plans and the operating procedures under which they work could create even more union support for the Single Payer movement. The president must address this issue.

Meanwhile, support from the public also continues to build, as the warts on the ACA become more apparent and the questions about its viability grow louder on almost a daily basis. This will undoubtedly drag into the 2014 election and continue to send shock waves throughout the political world into the 2016 race for the White House, as the Conservatives will remain active in their attacks and continuing efforts to end Obamacare.

Following the breakfast, Mr. Conyers and his policy director Mike Darner met with 15 of his core Single Payer activist leaders from organizations like Physicians For A National Health Program and Healthcare-Now! — as well as some doctors — to discuss strategy and continue building the movement. This group is definitely in it for the long haul, too, as they have supported Mr. Conyers and his bill for years. This is a bill that would deliver all necessary health services at less than half the cost we pay now, eliminating co-pays, deductibles and co-insurance while providing long-term care — including all of those expensive dental specialties. The estimated savings would be in the range of $592 billion a year. Better healthcare at lower costs — what’s not to like? And if you like your doctor, you actually could keep him or her — did you hear that, Mr. President? You can also pick any doctor you like — no more provider networks. These healthcare professionals would be able to become doctors once again, instead of a “provider” or “vendor,” and we could become patients again, ending our dehumanizing role as a “consumer” or “customer.”

Of late, we have been reading about Medicare For All from such luminaries as Robert Reich, Ralph Nader and William Greider in The Nation, among others. Even Bill Clinton mentioned it during President Obama’s second campaign. If Hillary were to acknowledge that Medicare For All is the next logical step after Obamacare, she would gain tremendous support and a second opportunity to get the right healthcare plan in place for her presumed 2016 run for president. Unfortunately, Hillary has proven herself to be far from progressive on many issues in the past, so we will have to wait and hear from her what her healthcare plan actually is if she decides to run.

Meanwhile, in the past few weeks Vermont Senator Bernie Sanders and Rep. James McDermott (D-WA) — who is also a doctor — have both introduced Single Payer bills. Bernie’s bill is a Medicare-for-All proposal known as the American Health Security Act of 2013 (S.1782), which would be administered by the states and transferable between states. The McDermott bill also moves the initiative outside of D.C., leaving it up to the states to develop their own plans based on their diversity and individual needs. As Massachusetts was the template for the ACA, it makes sense to finally introduce Single Payer on a state-by-state level.

Vermont has approval in both of its houses for a Single Payer plan, but it needs a waiver from the ACA to implement it in 2017. Can’t the federal government speed up that process? There are also plans at the ready in New York and in Rep. McDermott’s home state of Washington. And what of California, which has come so close in the past? One state can lead the country toward this monumental goal, the way Massachusetts did with the ACA. We just need to find the will.

In the Greider article in this month’s The Nation, entitled “Reviving The Fight For Single Payer,” he raises the question many of us ask: Can Obamacare deliver what it promised? One of the major problems he notes is that “…the reformed system will also still rely on the market competition of profit-making enterprises, including insurance companies.” Rep. McDermott was interviewed for this article, and he pointed out another major flaw in the ACA: “In the long arc of healthcare reform, I think [the ACA] will ultimately fail, because we are trying to put business-model methods into the healthcare system. We’re not making refrigerators. We’re dealing with human beings, who are way more complicated than refrigerators on an assembly line.”

Rep. McDermott – an advocate for Single Payer for decades – further wondered if hospitals will become “too big to fail” as they continue to merge and buy up private practices, and continue hiring younger doctors as salaried employees. Mr. Greider also made the following revelation: “An AMA survey in 2012 found the majority of doctors under 40 are salaried employees.” Rep. McDermott sees the troubling direction of this trend, noting that many new doctors “…will simply be serfs working for the system,” and Mr. Greider referred to another key point in the AMA research, noting that “…hospitals focus on employing primary-care physicians in order to maintain a strong referral base for high-margin specialty service lines.” Mr. Greider added further insight from Rep. McDermott: “Big hospitals need a feeder system of salaried doctors, McDermott explained, to keep sending them patients in need of surgery or other expensive procedures.” Even so, Rep. McDermott remains optimistic that stronger health care systems resembling Single Payer will spring up moving forward.

The New York Daily News offered a scathing editorial on December 24th entitled “Can This Patient Be Saved?” in which we were given a blow-by-blow analysis of the devastatingly mishandled rollout of the Obamacare exchanges and the problems millions of Americans have been having signing up for them. The situation was so bad that the deadline was extended until Christmas Eve for those to sign up who wanted their insurance to kick in on January 1, 2014. The CBO projects seven million will sign up in 2014, in addition to the about 1.1 million this year — well below the Administration’s projections. Meanwhile, millions will be losing their current plans due to the mandate. The question of more people losing their insurance than gaining it as a result of the president remaking the “healthcare economy” was also raised in this Op Ed piece.

Key provisions of the bill have already been waived in the past three years since its passage, and an additional postponement of the requirement for companies with fifty or more employees to offer health insurance or pay a tax penalty has now been postponed until 2015.

The individual mandate requiring most Americans to find coverage by April is also waiving penalties for those who had insurance and lost it this year. Most glaring in this critical article is the fact that there is “little reliable” information on who is getting what as far as coverage is concerned, and at what cost. The even larger question is, will those younger and healthier people opt in at all? If not, financially this boondoggle will sink. Obamacare is counting on them.

As the tinkering continues on the ACA, a major architect of this mess has just been rewarded by the president with an ambassadorship offer to China. Senator Baucus, do you not know the meaning of the word “retire?”

All good wishes for a (hopefully) healthy and happy New Year!

- with Jonathan Stone

Lance Armstrong’s Doctor Calls for Single-Payer System

The latest outcry for a single-payer healthcare system comes from a duo of prominent cancer doctors who call on their fellow oncologists to support what they call �an improved Medicare for all� resembling Canada�s healthcare system.

In an article scheduled to be published today in the Journal of Oncology Practice, Drs. Ray Drasga and Lawrence Einhorn remark that, as cancer doctors, they�re challenged by trying to advise the best treatments that a patient can afford. Because underinsurance is becoming the �new normal,� they say, cancer treatment may need to be compromised. And because every insurance plan is different, it�s hard for providers to know whether certain treatments will be covered.

Einhorn is a professor of medicine at Indiana University School of Medicine, a past president of the American Society of Clinical Oncology and the doctor who led treatment of Lance Armstrong. Drasga spearheaded efforts to start a free clinic in Crown Point, Ind.

They proposition that a single-payer system would remove some of the financial barriers to cancer care, make reimbursement simpler and cut down on the burdensome administrative overhead of private insurance companies.

They lay out their case:

�(The single-payer system) would provide universal, comprehensive coverage with free choice of providers. All medical care would be covered, including provider visits, hospital care, prescription drugs and rehabilitation. Copayments, deductibles, insurance premiums and out-of-pocket expenses would be eliminated.�

A public agency would manage a single insurance plan for each region of the country that would be financed by payroll and income taxes.

�The public agency would manage the plan and the health care budget in a transparent way. The allocation of available health resources (ie, rationing) would be guided by medical considerations, not on the basis of meeting corporate requirements for a return on investment or on the basis of a patient�s ability to pay.�

Doesn�t that all sound too good to be true? �We think not,� they write. �Because a single-payer system is a sensible and realistic solution, we believe its achievement is possible with sufficient understanding among the public and their elected representatives.�

It would be a challenging transition, they admit. But state-by-state implementation would lessen the administrative burdens, and ultimately such a plan could save up to $380 billion annually, they write.

Maine Advocates Push for Single-Payer Care System

From the AP –

A government-run health care system in Maine would provide universal coverage to residents, cut down on administrative costs and free businesses from the complexities of providing insurance for their employees, supporters of a single-payer model said Thursday.

Advocates of a single-payer system have long been trying to implement the model in Maine with little success, but said they are hopeful that the steps Vermont officials have recently made to spearhead the effort there can help make it a reality in Maine.

“Our current health care system is complicated, is inefficient, unfair and pretty much broken,” said Julie Pease, president of Maine AllCare, the group behind the measure, which she said will “return our system to one where … our medical profession treats our patients based on their health care needs not on their ability to pay or what kind of insurance they have.”

The bill, sponsored by Democratic Rep. Charlie Priest of Brunswick, aims to create a single-payer health care system in Maine by 2017, as officials are trying to do in Vermont. Beginning in 2017, Vermont will offer a set package of coverage benefits to every resident under the program.

But the idea in Maine faces fierce opposition from insurance companies and questions remain about how the state could afford such an endeavor.

Dan Bernier, a lobbyist for the Maine Insurance Agents Association, said that government should focus its limited resources on the poor, elderly and disabled instead of those who can afford coverage.

“It is not the role of government to provide someone like myself, a lawyer and lobbyist, free health insurance,” he told the Insurance and Financial Services Committee on Thursday.

Supporters argue it would ultimately save the state as much as $1 billion down the line by eliminating unnecessary paperwork and administrative costs. The program would be paid for through taxes like people already do for Medicare and Medicaid, they said.

But the state first has to make a commitment to universal health care before every single detail can be worked out, said Joe Lendvai, a Brooklin resident who advocates on behalf of the bill with Maine AllCare.

“Unless we conceptually agree that we need to cover everyone, that every Maine resident deserves access to health care without any barriers, we are not going to succeed,” he said.

But any proposal to raise taxes would likely be rejected by Republican Gov. Paul LePage, who has vowed not to do so while he’s in office and vetoed the state budget last year because it included tax increases.

Democratic Sen. Geoff Gratwick of Bangor acknowledged that it will be tough to pass the measure in this political and economic environment, when budgets are especially tight. But he said that Maine lawmakers have long-understood the serious problems with the current health care system and want a change.

“This is going to happen whether or not we get it now, two years from now, 10 years from now,” he said. “It’s inevitable because our current system is broken,” he said.