PHM-Exch> USA: Health care activists lament single-payer snub

[Claudio Schuftan]

From: Todd Jailer todd.jailer at sbcglobal.net


This article was on the front page of the San Francisco Chronicle
Health care activists lament single-payer snub
Victoria Colliver, Chronicle Staff Writer <mailto:vcolliver at sfchronicle.com>

Saturday, May 30, 2009

Frustrated by the exclusion of government-financed medical care from the
debate to revamp the nation's troubled health system, advocates of a
"single-payer" plan are increasingly turning to demonstrations and civil
disobedience as a way to get their message across.
During Senate Finance Committee hearings May 5 and 12 on health reform, 13
doctors, nurses, lawyers and activists stood up to complain that no
single-payer proponent had been invited to take part and were arrested for
disrupting the proceedings.
On Friday in San Francisco, about 200 single-payer proponents held a rally
in front of the Federal Building and headed in small groups to Rep. Nancy
Pelosi's office to urge the speaker of the House, who was in China, to back
single-payer legislation and give its supporters a seat at the table of the
health reform debate. The public appeals were part of a series of
demonstrations being held in more than 50 U.S. cities over the next few days
to encourage lawmakers to enact a single-payer plan.
Some advocates of a nationalized health plan are calling for activists to
become even more militant.
"It's the only way - direct confrontation with the people who are blocking
what the majority of the American people want," said Russell Mokhiber, the
founder of the newly formed Single Payer Action.
"It's about getting in people's faces and being serious about the fact that
60 Americans are dying every day because of lack of health insurance," said
Mokhiber, who was arrested at the May 5 hearing and arraigned earlier this
week in Washington.
Single payer unlikely
Reforming health care has become a focus of the Obama administration, with
the president urging Congress to get legislation to his desk by the end of
the year that would cover most of the nation's 47 million uninsured. Whether
that will happen remains to be seen, but whatever Congress passes is not
likely to come in the form of a single-payer plan.
In a single-payer system, as envisioned by most advocates, the federal
government would pay for basic medical care delivered by public and private
health professionals. The money would come from taxes, and medical bills
would go directly to a government insurance plan, similar to Medicare.
President Obama and lawmakers have proposed a form of "single-payer lite" -
a government-administered plan people could buy into as an alternative to
purchasing an individual policy offered by insurers. But single-payer
supporters say this option doesn't go far enough. They want private insurers
completely out of the business of covering basic care, which they say could
save nearly 30 percent in administrative costs.
That's clearly not something the health insurance industry supports. Many of
the nation's largest insurers prefer a form of "universal" health care that
would cover all Americans, while keeping them in business. They tend to
avoid discussing the single-payer option largely because it hasn't been
included in the national debate.
Some statistics show the single-payer concept has grown in popularity as
problems in the nation's health care system have worsened. A CBS News/New
York Times poll conducted in January found 59 percent of the 1,112 people
surveyed said they supported government-provided national health insurance.
Physician support
Several groups, including the California Nurses Association and Physicians
for a National Health Program, call for a single-payer option. While not
supported by the American Medical Association, a nationalized health system
got the backing of 59 percent of physicians in a poll published last year in
the Annals of Internal Medicine.
The California Legislature has twice passed a state-level single-payer bill
- in 2006 and 2008 - making it the first state to do so, but both times the
effort was vetoed by Gov. Arnold Schwarzenegger. The legislation, authored
by former state Sen. Sheila Kuehl, D-Santa Monica, has been reintroduced as
by Sen. Mark Leno, D-San Francisco. Leno's version is expected to meet the
same fate as its predecessors.
Still, single payer has been largely dismissed from serious discussion on
the national level as politically infeasible.
"It's off the table in Washington because of the politics," said Laurence
Baker, associate professor of health research and policy at Stanford
University.
Health insurers and drugmakers have contributed millions of dollars to
members of Congress. One of the top recipients of that money, said Consumer
Watchdog, an advocacy group based in Santa Monica, was Sen. Max Baucus,
D-Montana, chairman of the Senate Finance Committee, who was running the
hearings when the arrests took place this month. He accepted $413,000 in
drug and health insurance campaign contributions during that time.
Many single-payer supporters interpret the resistance to the single-payer
idea to be simply the result of a formidable lobbying effort by the health
insurance and pharmaceutical industries, but Stanford's Baker said the
hurdles are more nuanced.
Distrust for government
Americans are clearly frustrated by the health care system. While some polls
indicate that a majority of Americans favor single payer, some polls show a
distrust of government's ability to take over health care, he said. In a
Kaiser Family Foundation poll released in April, just 35 percent of those
surveyed expressed support for a government-run health system like Medicare.
As the debate continues, single-payer supporters have clearly ramped up
their activity and tactics. The 50 demonstrations have been organized by a
variety of groups including Healthcare-NOW!, Progressive Democrats of
America and the Green Party.
But not all single-payer groups promote civil disobedience as a way to draw
attention to the cause. Don Bechler, chairman and founder of Single Payer
Now, a statewide advocacy group in San Francisco that helped organize the
demonstrations, said he is more interested in drawing in more supporters
than seeing people get arrested.
California nurse DeAnn McEwen didn't set out to become one of the "Baucus
13," the 13 arrested at the Senate Finance Committee hearings. She happened
to be in Washington for a nurses' union organizing committee meeting when
she learned about the hearings.
McEwen, of Long Beach, a nurse for 35 years, said she felt compelled to
speak out about the lack of a single-payer voice at the table.
"At that point, I felt I couldn't be silent anymore because it was like I
was seeing a gag, a hand covering the mouth of a victim," McEwen said.
"There's therapy for the broken health care system, and any other reform
that includes the insurance companies is not going to get us where we need
to go in terms of providing equitable and fair coverage."
Health care proposals
A number of health policy proposals are under consideration as lawmakers
work to overhaul the nation's health care system, but a proposal to have the
government pay exclusively for basic health care has largely been left out
of the discussions. Here are some of the ideas on the table:
Public plan: Create a government-financed purchasing pool or "exchange" -
one that people could buy as an alternative to individual health policies
offered by private insurers.
Individual mandate: Require individuals to get health insurance through an
employer, the government or on their own. In exchange, insurers would have
to stop discriminating against people with medical problems.
New taxes: Tax job-based health insurance benefits, a controversial option
that proponents say could help pay for the overhaul estimated to cost some
$1.2 trillion to $1.5 trillion over 10 years. Other taxes would come from
hikes on alcohol, tobacco and soda.
Reduce health costs: Improve efficiency in the delivery system by upgrading
technologies, increasing the availability of generic medications, realigning
provider payments to reward quality of care rather than just quantity, and
funding efforts to figure out which medical treatments work best.
Source: Chronicle research.
E-mail Victoria Colliver at vcolliver at sfchronicle.com.
<http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/05/30/BAVL17TG46.DTL>
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2009/05/30/BAVL17TG46.DTL

This article appeared on page A - 1 of the San Francisco Chronicle



Todd Jailer * 1612 Virginia St. * Berkeley, CA 94703 * 510-540-8474
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