Download June 3, 2012 Single Payer Activist Conference Call Notes Thank

June 3, 2012 Single Payer Activist Conference Call Notes
Thank you to everyone who participated in Sunday night's monthly Activist Call. We
would just like to re-emphasize that the state-based healthcare bill being worked on by
McDermott's office that we discussed on the call has not yet been introduced and is
still in development. McDermott has suspended work on the bill at this time and the
discussion was about components of the bill that will likely be included, but are by no
means definite. We will alert you to further developments on the bill as they emerge.
We apologize for any confusion if that wasn't clear on the call.
And, as always, please feel free to contact us at [email protected] with any
suggestions for future Activist Call agenda items. Your input is much desired and
needed!
CNA/NNU Rally in Chicago
The California Nurses Association/National Nurses United held an amazing rally calling
for a financial transaction tax -- or Robin hood tax -- on Wall Street in Chicago two
weeks ago during the NATO summit. Here to tell us about it is Donna Smith,
Community Organizer and Legislative Advocate for CNA/NNU.
Donna: Were having staff nurses' assembly downtown in Chicago that time. A few
weeks before rally Rahm Emanuel (mayor of Chicago) and cohorts at City hall decided
they were uncomfortable with Tom Morello playing at rally, and decided to raise permit
concerns for rally and march at Daley Plaza.
We disputed it. We had been planning on having this event for much time because the
G-8 was supposed to be happening in Chicago. They decided not to, but NATO was still
going forward so we decided to keep it there -- we were also having our Staff Nurses'
Assembly there. The publicity surrounding the permit dispute was massive. We held a
press conference about freedom of speech, etc. The mayor's office wasn't very clear
about why they wanted to withdraw our permit because those of you who know Daley
Plaza know it can fit a lot of people. We felt the concern was more about the message
the nurses were bringing than about the size of the rally.
Agreed we wouldn't hold march through downtown Chicago through the loop, but we
held the rally. The mayor's office making this big stink really helped us because we got
a lot of good press -- AP picked it up, nurses from Boston, LA came.
On the day of the rally we did have to make it from the hotel to the plaza. We did agree
not to march so we have to step off in groups of 25 or less so we couldn't converge in
one large march. But anyone knows you can't keep people that far apart in big cities -street lights, big groups of people get in the way. So we didn't march, we walked, but it
was fun. We actually had press risers because we had so many press people. The city
estimated 6,000 people at the rally, which we think is conservative. There were a ton of
single-payer banners, signs, etc. in the crowd. The front page of The Chicago Tribune
next day had a "Medicare for all" sign in full color above the fold.
There was an awful lot of police presence. We told the police the nurses had no interest
in letting the rally become violent or anything, but we did say we had a strong interest in
asserting our point about our solution to the problem. The Harken-DeFazio bill, that's
not what we're looking at. We're asking for half a penny on a dollar on stocks and
derivatives and such -- which used to be taxed -- but which haven't been in the past 40
years. In any case our feeling is that you and I pay taxes on everything so why shouldn't
Wall Street do the same?
With this tax we could raise $350 billion a year -- and this would go a long way to
alleviating the tragedy we've seen in this country. We don't want to see the austerity
we've seen people all over the world struggle with. We want to protect Social Security,
Medicare, etc. -- we want to protect and strengthen those things. The energy was
fantastic -- the organizing was fantastic. The most exciting thing was that so many
single-payer allies and friends get it and they turned out -- really helped make it a big
message for the city of Chicago and for even wider than that.
The nurses are also -- with the PNHP docs -- going on a bus tour in California to get the
message out there.
Also great interview with RoseAnn Demoro on Bill Moyers show about the financial
transaction tax and the need for single-payer healthcare.
McDermott State Single-Payer Bill in progress
Some of you may have heard that Representative Jim McDermott -- US Rep from
Washington state -- is crafting new legislation called the "State-Based Universal Health
Care Act of 2012." The bill has NOT yet been introduced and McDermott's office
has suspended work on the bill for an undetermined period of time, but I thought it
was still important to create a space to get some feedback from HCN members on what
you all think about the proposal so far. So I'm going to go over a couple key parts of the
bill and then open up the call for discussion.
The bill's stated purpose is to "provide a legal pathway for states that wish to implement
a large publicly financed self-insured plan instead of one based on commercial
insurance." The main features of the bill are as follows:
• once a state makes a "preliminary showing of its projected ability" to create a
universal healthcare system, it will immediately be given permission to use all
ACA money (including money that was supposed to be used to set up an
Exchange) for the new system
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In addition, all federal funds that would be otherwise spent under Medicare,
Medicaid, CHIP, TRICARE, and FEHBP will be paid to the state, as
appropriate, to cover those populations. The funds will be disbursed
quarterly, using the framework established under Medicaid. Funds may
not be used for any purpose other than to finance the health plan.
• automatic eligibility is for "all lawful US residents," but states can choose to cover
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undocumented workers if they so wish
for benefits, "enrollees must receive, at a minimum, the same benefits package as the
most popular plan in the Federal Employees Health Benefits Plan
Patients may not be denied a choice of provider
The state must create "uniform fees for each service" and providers must accept fees
as payment in full.
Plan must be publicly administered.
States individually get to decide 1) Whether and how to include employer
responsibility; 2) Whether and how to include patient responsibility; 3) Structure
of state financing, if any.
Chuck: I have concerns that this might be a sneaky trick to derail the entire program.
We could have two things that we're focusing. I'm afraid that that's the old trick of divide
and conquer -- divide the single-payer movement into two parts.
Francesca: Good concern. Healthcare-NOW! hasn't endorsed this bill -- the bill hasn't
even been finalized or introduced so there's nothing to even endorse or not endorse
right now -- but I think it's helpful for us to discuss what is happening and hear these
concerns.
Lynn: Jim McDermott has always been a supporter of single-payer. He was a co-author
of HR676. McDermott is a retired psychiatrist who's been in the field. I trust him even if
this is an incremental bill. You know in California 6 Democratic senators wouldn't sign
onto our bill so we know how hard this is.
Don: McDermott's office is still working on the details of the bill and it's too early to say
where it's going to be at when it's done. Unfortunately, I released this not knowing it was
under embargo and so more people know about it then McDermott's office really
wanted. They still need to determine if it's going to be a single-payer bill or if it's going to
be a state's rights bill. The positive of a state's rights bill is that you can get
conservatives on board. But we just don't know yet what the final bill will look like.
Kay: I believe that it makes no sense to pull back to trying to implement state bills when
the best example that we have of a single-payer bill that works and is beloved by the
whole country is Medicare. So for some reason that we'd want to bust it up into
state-sized pieces in the hope that some states can create a single-payer plan doesn't
make sense. I think it's a backwards step -- especially at this time when, who knows, the
Supreme Court could throw out the whole ACA. So many people talk about how
Canada did it first in one little province, but the truth is that they didn't have any national
legislation at the time that they needed to get around. It's a backwards step to hand over
Medicare to the states. And the fact is McDermott -- and I do respect him -- I think is a
good person. But I don't think it makes any sense. If we had the power to pass a piece
of legislation that created state single-payer plans, then we would have the power to
pass a national single-payer plan.
Don: PNHP's position nationally is that we support a national single-payer health
program, Medicare-for-all. Our organization thinks the states should each deal with their
issues individually and for some states if this bill works out for them it might be
something for them to look at it, but it's not something PNHP is going to endorse as a
national organization. If you look at what Vermont actually passed it's a promise for
universal healthcare and a wishlist. When you look at states like that and the problems
they're facing as they're trying to come up with a state single-payer model, the
McDermott bill looks really great. The problem is that if we make it -- if it has enough
stipulations in it that really make the state single-payer system, then you're not going to
get the bill passed anyway. However, if you do have enough flexibility that some states
like Kansas can go ahead and set up some kind of voucher system with Medicare and
some of the other horrible plans they're discussing, then they're ruining the system in
those states. And you could muck that up for decades with terrible systems. So either
way it does look like a bad choice.
Delphine: Can someone clarify Bernie Sanders' bill?
Don: Sanders bill was S703 and now it's S915, and then and now it is a state-based bill.
It would create 56 single-payer plans (including DC, the territories, etc.).
Kay: The problem with the Sanders bill is that it specifically excludes undocumented
workers, and includes for-profit hospitals and nursing homes. Unlike HR 676 which
removes the for-profit hospitals and nursing homes, the Sanders bill allows these
monsters like HCA, Tenet, the for-profit dialysis centers, etc. to continue just as
before. All the studies show that the for-profit hospitals have lower quality and higher
costs. If they are left in they will continue to feast on our health care dollars to the
detriment of the patients.
It's a crucial difference that we all have to understand--especially at a time when the
insurance companies are buying up clinics, care centers and other providers. If we do
not close this loophole, we will see the insurance companies morph into hospitals and
other providers to continue their profits.
So the two key problems with the Sanders (S 915) and McDermott bills (HR 1200) are
that they specifically exclude the undocumented from coverage (violating our principle
of everybody, in nobody out) and they do not exclude the for-profit hospitals.
Lynn: The California Bill that we have here -- which I think is one of the strongest -would take Medicare and MediCal (Medicaid) funds. The issue is ERISA.
George: I think Kay has outlined very sound ideas about the McDermott bill, and I
certainly agree. I think the idea of locking up states for many years with complex laws
and seeing that happen is a foolish idea. I think McDermott kind of has an ego problem
and a misunderstanding of single-payer. I would encourage that we oppose the
McDermott bill.
Activist: I think there's some misinformation. Jim McDermott is very familiar with the
single-payer issue and co-sponsored a bill with Wellstone. State based bills allows
states to do a lot things that they couldn't under the Conyers bills. Something I think
people need to look at more is healthcare delivery in rural areas which is something I
think state-based bills might work better for. Either one will work, but the I think the
reason this is gaining traction is because we've seen so little from Conyers in terms of
traction on HR676. We have yet to have Democratic sponsors of the Medicare for all
type system who are moving forward or demanding action.
Don B.: The problem with both the Sanders and McDermott bills that makes them no
gos for me is because of the exclusion of undocumented workers. Back in 1994, our
California bill didn't discriminate, but we released an ad that made it seem like it did, and
we are still trying to heal our relations with the immigrant communities. And I don't think
we can do that.
Conyers bill specifically says all residents and doesn't make a distinction between legal
or illegal residents, and when he was challenged on that -- to his credit -- he said "This
is a healthcare bill, not an immigration bill." The fact that the McDermott bill says that
this is only for citizens with legal document discriminates us and we can't afford that.
Donna: Since we're not at the position of endorsing or not endorsing since the bill has
been suspended for now, I would just like to say that I commend McDermott's office for
reaching out to some folks who work on state-single payer work and others for our
feedback. I want to praise them for doing that since single-payer people weren't even
approached the last time around. And though I hear what people are saying about state
single-payer bills we also have to recognize that some of these state bills -- if passed -would alleviate the suffering of millions of people, and I know I and the nurses would
find that hard to oppose.
National Health Care for the Homeless Council Conference
Francesca: The National Health Care for the Homeless Council held their annual
conference in Kansas City, MO several weeks ago. The conference is a place where
hundreds of health care for the homeless providers and advocates can get together to
share resources and learn from each other. There were about 800 people in
attendance. Myself and Jonathan Kissam from the Vermont Workers' Center were there
and held a workshop on organizing for universal healthcare by using human rights
principles. We had about 20 or 25 people in our workshop.
Individual Updates
Don B: Paul Ryan for some reason decided to come to San Francisco for a fundraiser.
He's a Republican -- wants to create a Constitutional amendment against gay marriage
and is the point person for privatizing Medicare and Social Security so we have no idea
why he came here. He was going to hold a fundraiser at The Gap headquarters. People
called The Gap and said what are you doing and so they threw him out -- wouldn't let
him have his fundraiser there. We had been planning on having a rally outside of the
headquarters, but we couldn't figure out where he went. So we had a press conference
outside The Gap headquarters anyway as his last known whereabouts. We also were at
a big festival in San Francisco today and collected 93 more names for our database.
Betty: Just wanted to let everyone know we now have 48 groups in our new coalition in
Oregon with the mission of creating universal healthcare for everyone in our state and in
the entire United States. We're really moving forward with this coalition.
Kay: We are planning to take action the day after the Supreme Court decision comes
out on the ACA. We have a news release prepared for here in Kentucky, and we're
planning a march and rally for when that decision comes out to say we still need
single-payer healthcare. I encourage everyone to do something because I really think
that decision is a great opportunity to talk about single-payer.
Bev: I'm working with Tom Knoche and doing some Win-Wins up here in NY state for
local school districts, and I hope to bring them to my union and some others. Right now
they are very involved in re-electing Obama, but I'd like to move forward on that in the
future.
Betty K.: I'm really glad McDermott's office isn't moving forward on that new bill yet
because I think it's really important to wait until the Supreme Court decision. I also want
to second what Kay said about being prepared for the decision and taking advantage of
that earned media opportunity. I think on this whole issue of state or national bills,
although I would love for the entire country to have healthcare for all, I think it still needs
to have some local control. I think what could work in California would be very very
different than what will work in New Hampshire or Vermont. I think being able to work
with different cultures, different needs is very important. I mean Europe doesn't have
one continental plan. They all have different plans even though many of their countries
are smaller than many of our states. We may need regional plans or something. I also
don't want to have a national plan held back around the immigration issue if not all
states agree on it.
Bev: I'd like to ask, if you were to talk to Congressman Conyers and give him a
message, what would it be?
Francesca: I think first it'd be encouragement -- that we'd really like to see him move
forward with his bill. It's something that means a lot to a lot of people, and we'd like to
see him supporting it more actively.
Activist: There's a long history of interaction with Conyers and McDermott, and at times
they are helpful and at other times drag their feet. It's a very complicated history over
the years.
Delphine: I am going to the Retirees meeting tomorrow, and Conyers is frequently
there. So I would be happy to relay any message to him. I think he has such extensive
experience that I really trust him as to be very sensitive as to when the time is right, but
if he needs nudging, I think we should do that. And he has 5 people running against him
now because of how they did the redistricting -- and they did that on purpose.
Kay: What could help Conyers so much is if we could get additional co-sponsors. We're
at 76 right now, and if we could get to 100, it'd be incredibly inspiring.
Bev: Some good news is that even conservatives up here -- and I live in the
Adirondacks -- are starting to see the importance of single-payer.
Bob S.: We had a guy from Organizing for America at a UAW meeting recently and he
was talking about Obama, and one of my board members got on there and said we
need to talk about healthcare and single-payer. It's not just us nudging Conyers, but it's
important for us to get out there too. We have to find some way of reaching new people,
younger people. We have to be attuned to building connections to others.
Beth: We have several churches here in Connecticut who are on board with
single-payer. Unitarians, Methodists, reformed Jewish churches, etc. Some of these
churches even have social action clubs.
Bob H.: Just want to emphasize what Kay and Bob said. Two people expressed
concern about Conyers -- this is in our hands. Until there are well over 100 co-sponsors,
Conyers can't do much.
Betty K: My expectation is that if the Supreme Court upholds the whole ACA then we
just keep doing what we're doing. But if they knock down parts of it or the whole thing,
then messaging should really be on full steam ahead to show that single-payer is the
only option left and what we need.
Francesca: Yeah, Healthcare-NOW!'s position has always been that we need
single-payer regardless of the decision.
Bob S.: I've noticed something about these calls. I've been on since the beginning with
Marilyn and I think the point was always dedicated to a national single-payer system,
but now we're talking about state stuff. I think that should be a separate call. This call is
supposed to be about HR676.
Francesca: Well I think this is all related. The strategy has evolved since HCN was
founded. There was no ACA when HCN was founded.
Betty: You might want to survey people who have participated over the past 6 months
since there's different people on the call every month and hear how they want the calls
to be.
Peg: I think this call opens the opportunity to learn strategy from other states. I'm still
blown away that Chicago was able to rally 6,000 people because I don't think that could
ever happen in Houston. And it's nice to know it's happening. After all this is all local.
We're pushing for a national issue, but we're all working locally. I don't know how you
could ever distinguish between what should be on the statewide call or what should be
on the national call if you try and separate it.