Medicare for All

October 2, 2017 Video

Single-Payer Health Care: Debate on Smart Talk

This morning (October 2, 2017), the local public radio station in Harrisburg, PA aired a program on universal health care, often called single-payer health care or Improved Medicare for All.  They presented a debate between insurance industry members, legislators, and advocates for single-payer health care.

Three women holding up posters that say

Advocating for Medicare for All – a universal, single-payer healthcare program. Photo Courtesy of National Nurses United.

The radio clip that I’m embedding below discusses HB 1688, the Pennsylvania Health Care Plan.  This bill was reintroduced in the PA House of Representatives on Friday, September 29. It is a state-based universal health coverage for residents of Pennsylvania via a single-payer health care payment program which redirects Medicare and Medicaid funds into a single state funding program where 9 out of 10 people will have reduced healthcare costs and where you get to select your own doctors, healthcare providers, and hospitals. Decisions about treatment are made between the healthcare provider and the client.

The debate on both the state and federal ideas for universal health care follows Rep. Pam Delissio’s summary of her bill. Here is Part 1 of the debate on SmartTalk:

And here is Part 2 of the debate on universal single-payer healthcare:

Rep. Delissio has been the prime sponsor of HB 1688 for the last three sessions of the PA General Assembly. Here’s a 2016 presentation on the Pennsylvania Healthcare Plan by Representative DeLissio on her bill. FYI, the bill number did not change between the current and last session.  So when she talks about HB 1688, she is presenting essentially the same plan (with some minor tweaks).

Three women holding up posters that say "Love it! Improve it! Medicare for All!"
July 8, 2016

Add Medicare for All to DNC Platform: My Testimony

Three women holding up posters that say "Love it! Improve it! Medicare for All!"

Advocating for Medicare for All – a universal, single-payer healthcare program. Photo Courtesy of National Nurses United.

The full Democratic Platform Committee is meeting this weekend in Orlando, Florida two weeks prior to the Democratic National Convention. I will be attending the National Convention in Philadelphia as a PA-PLEO (Public Leader/Elected Official) delegate.

My biggest issue is access to health care for all. The Affordable Care Act that was passed in 2010 has gained access to healthcare for more people in the US.  But not for everyone.  It’s time to take the next step to build upon what is currently in place.

So as part of my advocacy for access to Universal Health Care, I wrote and sent in testimony to the entire Platform Committee and to the members of the PA members of the committee for whom I had an email address.

Here’s that testimony.  If the Medicare for All amendment isn’t added to the platform this weekend, I will do what I can to get it back in at the Convention in Philadelphia.

nighttime picture of the US Capita

We need Medicare for All/aka Universal or Single Payer Health Care at both the national and state levels. Picture of the US Capital courtesy of Rep. Katherine Clark.

Health Care for All Rally Harrisburg005

Advocates for Single Payer Healthcare Rallying in 2009 in Harrisburg, PA

Friday, July 08, 2016

RE: Adding Medicare for All Amendment to the DNC Platform: My Story

To Whom It May Concern:

I’m writing to ask you to add the Medicare for All amendment language into the Democratic Platform.  As I understand, the amendment language that is being proposed says,

“While making various changes would improve the ACA, the social insurance model, single-payer system, is our goal, and we will continue to fight for it. Health care is a fundamental human right and an important measure of social justice. Achieving universal health care will not come from mandating everyone to buy a health insurance policy from a private insurance company. Instead, we must build on the experience of Medicare, which shows that the most cost-effective and equitable way to provide quality care is through a single-payer system. “Medicare for all” would require updating and expanding the program’s benefits to fit the working population and children, as well as negotiating prices with physicians, providers, and with Pharmaceutical companies for medications that working families–and the country–can afford. Until we achieve a -payer model at the national level states should be allowed to implement universal, publicly financed health care coverage on their own so long as that coverage is affordable and provides a full range of benefits, commensurate with the requirements that apply to all states under the ACA.”

I strongly urge you to add this paragraph into the platform.  FYI, I have read the entire ACA (yes, I’m a glutton for punishment – J ).  I read the entire ACA when it was passed because I wanted to make sure that individuals who have to have a transplant would have both their treatment as well as the treatment of their donor covered without a fight amongst the insurance companies.    I almost died in 1989 because of such a fight – two insurance companies fighting over who would NOT pay for the donor portion of my bone marrow transplant and the hospital refusing to do the transplant until they were guaranteed payment by one or both of the insurance companies.

Here’s an excerpt of my story.  You can read the full story here on my blog — https://civilrightsadvocacy.net/2013/02/20/why-i-support-universal-health-care-a-right-not-a-privilege/.

My life was threatened by the multi-company, private health insurance system we currently have.

I received a bone marrow transplant in 1989 from my identical twin sister. Although I had no problem finding a match, I had to jump through many hoops and barriers put up by the two health insurance companies covering my sister and myself. In the case of my insurance provider, I was refused coverage of the donor portion of the transplant because my twin sister wasn’t on my health insurance plan. In the case of my twin sister’s insurance provider, they refused to cover her portion of the transplant because she “wasn’t sick.” Then the hospital administration said that they would not perform the transplant until this conflict between the two insurance agencies was resolved with a guarantee of payment by either or both companies. And my doctors said that if the resolution did not occur rapidly, I would be dead within the year due to the seriousness of the form of leukemia that I had.

According to Health Care for America, health insurance companies profit by denying–not by providing–healthcare. Health insurance CEOs of the top 10 health insurance companies today typically enjoy an average of $10,000,000 in annual compensation–salary, bonuses, stock options, etc.

Back to my story. I went into battle mode against the insurance companies when I was told that they would let me die because of their bottom line and attempts to deny coverage. Because of the support and advocacy I had through the organization where I self-purchased my health insurance (the National Organization for Women), we were finally able to get me the life-saving transplant that I needed. And I am here today.

This experience is why I became an advocate for a single-payer health care system rather than the current system that allows private companies the ability to deny critical health care to “save” their bottom line for profit only….

Other Reasons why I support a Universal Health Care Plan at Either the National or State Level.

  • It is the ethical and moral to treat all people, regardless of economics or status when they are sick….
  • Some statesare threatening people’s health care and lives based on decisions either by their legislature and/or their governors….
  • A Single Payer, Universal Healthcare program would cover everyone….

As a result of this experience I became actively involved as a member of the board of Healthcare for All PA Education Fund. This non-profit organization is advocating for passage of the Pennsylvania Health Care Plan (HB 1688) (prime sponsor, Pam DeLissio (D-Bucks County).

Thus, given my personal and passionate support for Healthcare for All, and the fact that the US spends 2.5 times the average of other industrialized countries, yet we don’t provide healthcare to everyone; and that Medical outcomes such as infant mortality and life expectancy, and equality of access, are much better in other countries; and that 58% of all Americans support Medicare for All, including 81% of Democrats, we hereby call upon the Democratic Party to adopt this amendment into the Platform of the Democratic Party

Thank you.

Joanne L. Tosti-Vasey, Ph.D.

PA-PLEO Delegate to the Democratic National Convention

Joanne standing in front of a bookcase holding up a sign saying "Rise" to action

Joanne advocating for Medicare for All. Help us advocate for this issue at the national convention through my GoFundMe account. See my PS.

PS. If you’d like to assist me and my friends to attend the Convention in Philadelphia, please check out my GoFundMe site at gofund.me/going2DNCnPhilly. This  will help in my ongoing advocacy for access to healthcare for all.  Thanks.

July 31, 2015

The Federal State-Based Universal Health Care Waiver Act of 2015

banner picture of Universal Healthcare from http://www.healthcareforallcolorado.org/

One Agenda: Universal Health Care.
Picture courtesy of Healthcare for All Colorado

As part of the Affordable Care Act (ACA), states have been given the ability to innovate or create their own form of health care insurance or coverage starting on January 1, 2017 AS LONG AS “benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges,” according to Representative Jim McDermott (D-WA-7).

As a result, at least 14 states—California, Colorado, Hawaii, Illinois, Maine, Maryland, Minnesota, Missouri, , New York, Ohio, Oregon, Pennsylvania, Vermont, and Washington—have community advocates and state legislators working towards implementing a state-level form of universal health care. They have been working for affordable healthcare access for all residents of their states before and since the Affordable Care Act – aka Obamacare – was passed in 2010.

Now that the US Supreme Court has basically settled the fact that the ACA is constitutional both on June 28, 2012 (Florida v. Department of Health and Human Services) and again on June 25, 2015 (King v. Burwell), we can consider ways to improve our healthcare system at both the state and federal level. As a medical doctor and a member of Congress, McDermott voted for the ACA. He also recognizes that “still more needs  to be done to control costs, improve care, and cover everyone.”

One way to further control these costs and improve health care while covering everyone is to create a universal health care system which I’ve previously blogged about (see here, here, here, here, and here). That means we either have the federal government create a federal single payer plan OR we use the waiver clause in the ACA to help states create their own universal single-payer health care program.

Yet even with the waiver currently allowed within the ACA for innovative state-based health care plans, creating a state-based universal care plan that saves funds for states and individuals while providing health care access to all has a big hurdle to overcome. Rep. McDermott explained this issue in a speech on the floor of the House of Representatives on July 28:

One of the many achievements of the Affordable Care Act is its provisions that grant states the authority to innovate in their health care systems. Under Section 1332 of the law, a state may apply for a State Innovation Waiver that will provide it with control of federal dollars that otherwise would have been spent on premium tax credits and cost-sharing reductions for its residents. Through this waiver, a state may design a system to cover its residents, so long as benefits are at least as comprehensive and affordable as those offered by Qualified Health Plans available on the Exchanges.

However, even with this flexibility, numerous barriers limit states’ ability to design true single-payer systems. Existing waivers are narrow in scope, requiring states to seek out imperfect and convoluted solutions to circumvent federal limitations. A sweeping preemption provision in the Employee Retirement Income Security Act (ERISA) denies states authority to regulate employer-sponsored health plans. And, due to the complexities of our existing federal health programs, it is essentially impossible for a state to design a single benefit package that can be administered simply and efficiently on behalf of all of its residents.

This speech was McDermott’s announcement that he was introducing HR 3241, aka the “State-Based Universal Health Care Act of 2015:” If passed, this bill would allow states to apply for a universal health care waiver that would allow them to have access to and authority over federal health care dollars that would otherwise be spent on the residents of that state. More specifically, this additional waiver act goes beyond the ACA to deal with the hurdles mentioned above. The new provisions of this law, according to McDermott, would waive all of the following:

  • The rules governing premium tax credits and cost-sharing reductions, as provided for in existing waiver authority under Section 1332 of the ACA.

  • Provisions necessary for states to pool funds that otherwise would be spent on behalf of residents enrolled in Medicare, Medicaid, CHIP, TRICARE, and the Federal Employee Health Benefits Program.

  • ERISA’s preemption clause, which cur-rently forbids states from enacting legislation relating to employee health benefit program

After the introduction of HR 3241, the House referred this bill to five committees — the Committee on Energy and Commerce, the Committee on Ways and Means, the Committee on Oversight and Government Reform, the Committee on Armed Services, and the Committee on Education and the Workforce. I believe that the large number of committee referrals was done because of the need to review all of the different laws that this waiver would impact.

You can read the bill in its entirety here.

I am pleased that this bill has been introduced. It however needs many co-sponsors and advocates to pressure Congress to actually hear, review, and pass this legislation. Please contact your US Representative and ask her/him to co-sponsor Representative Jim McDermott, MD’s bill HR 3241. Here’s the lookup page to find your US. Representative by zip code.

As this is the summer, your Representative should be in the home district. Call, write, set up a meeting and tell her/him why you want to see a universal health care program in your state and why this bill is so necessary. If your Representative agrees to sign on, have him/her contact Mr. McDermott’s aides that are focusing on this issue. They are Jayme Shoun, located in Seattle at (206) 553-7170 and Daniel Foster, Health Counsel in the DC Office at (202) 225-3106.

Thanks.

March 9, 2015

Universal Health Care: Let’s Do It!

I am not an economist. But I am a strong advocate for universal access to healthcare in the United States. See why here.

A couple of days ago, Thom Hartmann at The Big Picture RT posted a YouTube video on why economists are demanding a universal national healthcare plan. In this video he reports that more than 100 economists sent an open letter to Vermont’s Governor Peter Shumlin (D) after Shumlin “bailed” on implementing Vermont’s state-based single-payer healthcare plan.

Governor Shumlin stated that he was stopping the implementation process because he believes that “This is not the right time” for enacting single payer. He stated that there were too many costs associated with the program and could not go forward with the plan “at this time.”

The economists argued otherwise:

As economists, we understand that universal, publicly financed health care is not only economically feasible but highly preferable to a fragmented market-based insurance system…. Public financing is not a matter of raising new money, but of distributing existing payments more equitably and efficiently. Especially when combined with provider payment reforms, public financing can lower administrative costs, share health care cost much more equitably, and ensure comprehensive care for all.

We support publicly and equitably financed health care at federal and state level, and we encourage the government of the state of Vermont to move forward with implementing a public financing plan for the universal health care system envisioned by state law.

Hartman then goes on to say that part of the economic concerns about Vermont’s single-payer healthcare plan arises from its small population base. He believes that the economy of scale makes it harder for a small state to go it alone in “innovating” new healthcare plans as allowed by the Affordable Care Act starting in 2017. Then he goes on to urge the federal government to expand Medicare to all citizens over a 10-year period of time.

I agree that it would be great to have universal Medicare for All across the United States. But I also believe that the only way that will happen is if some states implement single-payer healthcare at a state level to concretely show that a universal healthcare plan is economically viable and distributes existing healthcare payments more efficiently and equitably while lowering administrative costs WITHOUT raising the overall cost to individuals, businesses or communities. In fact, in many instances, cost would be lower.

Studies on how this might happen have been done by well-known economists across the country. For example, Dr. Gerald  Friedman, Professor of Economics and Department Head at the University of Massachusetts-Amherst has done several of these studies, including one for Pennsylvania, one for Maryland, and one for expanding Medicare to all at the national level. Every economic impact study on implementing universal healthcare plans that I have read indicates that “A single-payer health care finance system would produce substantial health and economic gains” when implemented at either a state or the national level.

At least 14 states—California, Colorado, Hawaii, Illinois, Maine, Maryland, Minnesota, Missouri, New York, Ohio, Oregon, Pennsylvania, Vermont, and Washington—have community advocates and state legislators working towards implementing a state-level form of universal healthcare. And advocates across the nation continue to work for Medicare for All at the national level.

Whichever way comes first is fine with me. We just need to get moving and create healthcare for all in the USA.  Let’s make it sooner rather than later.