AP Photo/Toby Talbot
(Host) Governor-elect Peter Shumlin says he's optimistic that he can persuade the Obama administration to grant Vermont a special waiver to implement a single payer health care system.
Shumlin says he's already raised this issue with the president, and he'll do it again when he visits the White House early next month.
VPR's Bob Kinzel reports.
(Kinzel) The possibility of Vermont winning a federal waiver to put a single payer health care system in place was a top issue in the gubernatorial campaign.
Republican candidate Brian Dubie said that 2014 is the earliest a waiver could be issued under the new national health care reform law.
But Democrat Peter Shumlin argued that Vermont's congressional delegation could petition the Obama administration to make it happen sooner.
Speaking on VPR's Vermont Edition, Shumlin says he's already spoken to the president about this issue.
(Shumlin) "I had the privilege of talking to the President of the United States earlier today. He called me from Air Force One. A lot of bizarre things have happened to me in the last five days, but that's one of them. You know, you pick up the phone and there's the president at the end of the line. It was a real honor."
(Kinzel) And Shumlin says he doesn't think getting a federal waiver will be the toughest part of implementing a single payer system in Vermont.
(Shumlin) "The waivers is the easy part. The hard part is designing a single payer health care system that works and that delivers quality health care, gets insurers off our providers' backs, has a reimbursement system that makes sense. ... I believe if we design that system, we can sell it."
(Kinzel) The Legislature is expected to receive a special study this winter that will outline several different health care reform plans. One of them will be a single payer approach.
Once that report has been released, Shumlin says he wants to bring together a diverse group of businesspeople, health care providers and consumers to hammer out a workable plan. The governor-elect says it should have 4 specific goals.
(Shumlin) "Delivers quality health care to all Vermonters, where health care is right and not a privilege. Second, is affordable. The current system is going to drown us and will bankrupt us. We can't spend a million dollars more a day than we did the day before. Third, provide outcomes-based medicine so that providers are reimbursed for keeping us healthy, not the number of tests they put us through. And finally, fourth, and perhaps most important, using technology."
(Kinzel) Shumlin admits that making major changes to the state's health care system isn't going to happen overnight. But he's hopeful that significant progress can be made during his first term in office.
For VPR News, I'm Bob Kinzel in Montpelier
Massachusetts voters have, for the second straight election, overwhelmingly affirmed their support for single payer health reform by turning in majority ‘Yes’ votes in all fourteen districts where local single payer ballot questions appeared on November 2. The ballots spanned 80 different cities and towns in a state of 351 municipalities, winning in every city and town reporting results so far except two. Five of the districts backing single payer reform voted for Scott Brown in last year’s special senate election, which was largely seen as a referendum on national health reform, showing that the goal of improved and expanded Medicare for All is supported by a diverse range of communities across the state. It is also striking that in a year of political change, and in a year of drawn-out economic suffering, residents recognize that single payer health reform offers the promise of a more just and humanitarian health care system, which would actually cost us less as a society and lift the burden of sky-rocketing health costs from thousands of households, employers, and taxpayers.
As we celebrate the life and accomplishments of Dr Martin Luther King Jr., it is fitting that we recall his observation about what has become SPAN’s purpose:
“Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane.” Rev Dr Martin Luther King Jr.
It is undeniable that health care is a fundamental human need. Indeed the concept of access to care as an unalienable human right exists in the philosophical tenets of every faith tradition. This fact was reiterated at a health conference hosted at the Vatican in November.
Caring for one another is at the heart of our modern democracy as well. These values are set forth in both the Declaration of Independence and the preamble of the US Constitution. However, without health none of the later enumerated rights are able to be realized. I say the people are losing their freedom due to lack of health care every day.
Dr King understood: “because the arc of the moral universe is long, but it bends toward justice" that no one bill passed or law enacted would achieve justice. We must be always advancing the cause. For as long as one person suffers from the lack of care we all suffer.
Today we recommit to fighting for universally accessible care, for all, without regard to individual economic means or the ability to pay.
Kurt Bateman, Director
Third Biennial Teach-In a Success
On the heels of the introduction of SB 112 by Senator Skindell Ohio SD 23 and co-sponsored by Senator Nina Turner Ohio SD 25 March 10 , 2011, members of the SPAN Ohio Lobby Committee met with members of both houses of the Ohio Legislature March 15th. Those attending for SPAN Ohio were Dr. Johnathon Ross Region 2, Arlene Sheak Region 3, Dr. Donald Rucknagel and Dr. Dick Bozian Region 4, Dr Alice Faryna Bob Krasen and Connie Hammond Region 5, and Debbie Silverstein and Mary Nichols-Rhodes Region 6. Special recognition to our committee co-chairs Debbie and Mary for doing the bulk of the preparation for this event in conjunction with the office of State Representative Robert Hagan and Mike Foley’s offices to arrange the meeting space atop the Riffe Office tower in Columbus.
Throughout the day, in-office meetings were attended by our committee with Ohio Senators and Representatives totaling more than 10% of the entire legislature. At the midday presentation even more legislative staff was in attendance to hear our own Dr. Ross explain the scope of the problem with healthcare access in Ohio and the solution that the Health Care For All Ohioans Act provides. After Dr. Ross completed, Debbie Silverstein presented the economic data that SPAN Ohio has assembled to illustrate the positive effect the HCFAOA would have on state budget conditions. This timely discussion of the cost advantages stood in sharp contrast to the budget machete that, ironically, was being wielded on the other end of the hall by Governor Kasich at the same moment. See the News and Opinion section of this site for an entertaining narrative written by Mary Nichols-Rhodes. In the end we did a great deal of education and outreach to the legislature and citizens there to oppose the Governor’s budget proposal.
PPACA….. Popular support for doing more
Polls conducted this year have consistently shown that though the public is closely split on positive or negative reaction to the Affordable Care Act, solid support is growing that more should be done. Associated Press polls conducted January 5 thru 10 show 43% support for “doing more” vs. 26% for repeal. These results show an 8% increase in support for “doing more” and an 11% decrease in support for repeal from October 2010. Likewise in Public Policy Polling conducted February 3 thru 6 the largest plurality of any category (38%) wanted the federal law changed to make it stronger. 56% of self described Moderates favored no change or making the ACA stronger and even 15% of self described Conservatives felt the same. Finally, a survey of the most important issues among voters, the top four according to Senator Sherrod Brown’s office were, in order of importance: Federal Deficit, Jobs, Protection of Medicare and Affordable Healthcare. As we know the best way to protect Medicare is to enhance and expand it to all! In addition that would enhance economic competitiveness, improve job prospects, and by extension help raise revenues to mitigate the deficit.
Vermont’s Legislature Passes Reform
Pasted below is a link to an article describing the passage of H202 in the Vermont legislature. Ohio can be on its way also through our perseverence!
SPAN Ohio Support Petition
Dave Pavlick, SPAN Ohio board member and intrepid walker for the Health Care For All Ohioans Act, has created an online petition at Change.org. Dave, as many of you know, has walked across Ohio twice to raise awareness about the need for a new approach to the provision of health care in Ohio and indeed America. The PPACA isn’t going to be enough. All of those receiving this message please sign the petition and circulate this link to others. As Vermont demonstrates, we will overcome, there is no doubt!
Debtor’s prison the next battle in healthcare?
The following comment was posted in response to an article regarding collection agencies who swear out warrants for arrest of people who can’t pay bills:
I went to a first time visit in a "Women's Specialty Center". I am covered by an HMO. I had to provide proof of insurance (which they verified ) and my driver's license. I was handed at least 10-12 pgs of paperwork to read and sign. One page was one of the financial responsibility pages. It said if my insurance didn't pay then I was financially responsible for the bill AND if the account went into collections that I agreed to pay collection fees and 53.84 % interest. Nice number huh?! I wrote down that I did not agree and signed the form. The BUSINESS Manager came to the waiting area and called me into the office. We had a discussion and at the end I was told that I would not be seen in their office because I would not re-sign another form removing my comment that I did not agree. And this provider's office is part of the HMO group that I'm insured with!
Letter from Vermont
I wanted to give you a quick rundown of the Vermont single payer rally yesterday. I joined 200 of my fellow medical, nursing, and MPH students as we rallied through Montpelier and the state house with signs, music, and true single payer love. We had two local news channels covering the medical and nursing student speeches as well as speeches from Sen Sanders and Gov Shumlin. Sen Sanders said that our presence there conveyed that: "I want to be the best doctor or healer that I can be, but I can't be that unless we change the system."
I thought the day went swimmingly thanks to amazing efforts from PNHP/AMSA organizers and the Vermont docs like Deb Richter who have been working tirelessly on the ground over the past months.
Video was taken and will be compiled by PNHP NY executive director Laurie Wen soon.
Thanks for all the OPS support! Much love,
Richard Bruno Oregon Health & Science University med student
SPAN Ohio support for Vermont grew out of the OPS (One Payer States) collaboration.
April 21st, 2011 9:51 PM
By Wendell Potter
Rep. Paul Ryan's plan to privatize Medicare would accelerate a trend started several years ago by corporate CEOs and their political allies to shift ever-increasing amounts of risk from Big Business and the government to workers and retirees.
If enacted, the Ryan plan would represent a windfall of unprecedented proportions for insurance corporations and other businesses.
For millions of average Americans, many of whom already are finding it impossible to save for retirement, it would represent financial calamity. The nation's middle class would pay dearly for Ryan's proposed shredding of the social safety net that Medicare currently provides.
Ryan, chairman of the House Budget Committee, wants to dismantle the Medicare program and replace it with a system of vouchers. Starting in 2022, the government would give the average 65-year-old Medicare beneficiary $8,000 a year to buy coverage from a private insurer. That's the amount health care analysts estimate will be what the Medicare program will spend on every 65-year-old in 2022 if the government doesn't turn it over to private insurance companies.
While that might sound fair on the surface, it would actually be a very bad deal for people who turn 65 that year, compared to those who turn 65 in 2021. That's because commercial insurance plans are much more expensive, and operate far less efficiently, than the current Medicare program.
The amount of money commercial plans actually spend to pay medical claims has been declining rapidly over the past several years while the amount they spend on administrative activities such as marketing and underwriting -- and to pay executives and reward shareholders -- has been increasing. That's why Congress included a provision in last year's health care reform law to require insurance firms to spend no more than 20 percent of their policyholders' premiums on overhead. By contrast, the current Medicare program spends just 3 percent of its budget on administration.
The nonpartisan Congressional Budget Office says the $8,000 voucher won't be nearly enough for seniors to buy comparable coverage from private insurers and pay the additional out-of-pocket costs that those insurers would require them to pay. The amount the average 65-year-old would have to shell out to buy private insurance in 2022, according to the CBO, will actually be $20,510. Seniors would have to pay the difference -- $12,510. If Medicare is not privatized, the difference would be $6,150.
Here's why this would be a dream-come-true for the insurance industry: The more health plan enrollees have to pay out of their own pockets, the less insurers have to pay for medical care. The money that insurers avoid paying out in claims goes straight to their bottom line -- and into shareholders' pockets.
Insurers have been shifting more and more of the cost of care to their policyholders over the past several years by enticing -- or pushing -- them into plans with ever increasing deductibles. This trend is part of what Yale professor Jacob S. Hacker called "the personal responsibility crusade" -- making people more responsible for the management and financing of the major economic risks they face -- in his 2006 book, The Great Risk Shift.
This crusade has been led by Republicans and insurance company executives who have been saying for years that the best way to control medical costs is for Americans to have more "skin in the game." That's an expression that former Aetna CEO Jack Rowe used often before he retired in 2005, the year he made $22.2 million. It was also a sound bite favored by the CEO I used to work for, CIGNA's Ed Hanway, before he retired in 2009. Hanway's total compensation that year was almost $111 million.
The problem is, most Americans have far less skin to put in the game than CEOs like Rowe and Hanway or even Rep. Ryan, who makes $174,000 as a member of Congress. The median household income in the United States was just $49,777 in 2009, which was down $335 from 2008.
That decline, by the way, was the continuation of another trend that began as the Clinton era was ending and the George W. Bush era was beginning. Median household income in the United States peaked in 1999 at $52,388 (adjusted for inflation). It fell more than $2,000 during the eight years of the Bush administration.
During that time, health costs rose dramatically. According to the Kaiser Family Foundation, the average annual health insurance premium for family coverage increased from $5,791 in 1999 to $13,770 in 2010. The average amount that workers contributed out of their own pockets for family coverage increased from $1,543 to $3,997.
With household incomes declining, Americans have had far less money to put into retirement. According to a recent survey conducted by Opinion Research Corp. for America Saves and the American Savings Education Council, less than half of current workers are saving enough to have a "desirable standard of living in retirement."
If workers are having this much difficulty saving for retirement, where in the world will they find the money to pay what Rep. Ryan would make them pay for Medicare coverage when they turn 65?
Ryan's "blueprint" is one that will take America back to the pre-1965 days when senior citizens were losing their homes and their farms to pay for medical care. They were becoming destitute -- and dying much earlier than they are today -- because insurers would not sell them coverage because they were too much of a risk to insure, and there was no safety net for them.
That's exactly the same place future senior citizens would find themselves if Ryan's plan to privatize Medicare ever becomes public policy. #
Registration for the 8th annual SPAN Ohio conference should be in by the end of this week.
Final numbers for the meals and conference packets are of concern to our organizers so please go online to www.spanohio.org and secure your registration today. Let’s not make this any harder on the volunteers who work so hard to make our conference a success.
As has been reported, the Ohio Senate version of the Health Care For All Ohioans Act (SB 112) was introduced March 10, 2011. In this past week leadership of SPAN Ohio have been meeting with the staff of Representatives Robert Hagan HD60 and Mike Foley HD14 for the purpose of drafting the Ohio House version of our legislation. It is likely that the new house version will not contain a specific funding formula and will be re-titled to reflect the positive economic impact of a universal single payer health plan for Ohio. Throughout the discussions SPAN Ohio has drawn on the experiences of many colleagues in other states that have been working on health care reform in their respective locales. The OPS (One payer States) collaboration has been an invaluable resource in sharing strategies and tactics that can better lead to humane and sustainable health care provision for Ohio. We look forward to advocating for the house and senate bills simultaneously. The workshop on effective lobbying of state legislators at the annual conference will provide the tools you’ll need to make our case.
News from Vermont
The Vermont Workers Center’s Health Care is a Human Right Campaign and Vermont for Single Payer have passed their House legislation (H202) and hearings are currently underway in the Vermont Senate Health and Welfare Committee for S57. Scores of Vermonters have testified and this past week a group of 200 doctors and medical students rallied in Montpelier in support of the legislation. Those interested in seeing the live hearing focused on testimony from health care providers can do so on Thursday April 7 at 6PM. Just go to www.VPT.org. Vermont Public Television will stream the testimony live and I know our friend and 2010 SPAN Conference speaker Dr. Deborah Richter will be front and center.
Also there has been some national coverage of Vermont’s progress by commentator Rachel Maddow of MSNBC. In this clip http://www.youtube.com/watch?v=dB2ZO1JEs80 from the show aired Friday April 1, Ms Maddow likens President Obama’s challenge of the governor’s association to do better on health care to an “Oh Yeah!?” moment. In discussions with OPS reps from other states its apparent we need to get exposure of the grass roots movements all across America.
Remember get your registration done online at www.spanohio.org
See you at the Ramada on April 16th!
On March 10, 2011 Ohio State Senator Michael Skindell filed SB112 which establishes the Ohio Health Care Plan.
On Saturday April 16th advocates for a universal single payer health care system for Ohio came together in Columbus. At the start of our day attendees were treated to a skit “911….It’s an Emergency” performed by the Not Ready for Prime Time SPANiacs. The premise was that of a call to 911 from a desperate homeowner whose house is being invaded and spouse accosted. Hilarity ensues when the operator must first identify the homeowner’s policy particulars including contract number, level of coverage, deductable and co-pays all while the intruder is threatening life and limb. Let’s hope John Q Public chooses the right network before it’s too late. Stellar performances were turned in by Drew Hellebrand, Debbie Silverstein, John Ross and Mary Nichols-Rhodes.
How preposterous that our disease treatment health care non-system actually functions in this way!
Donna Smith, CNA/NNU national community organizer, and PDA Healthcare not Warfare national co-chair then led the meeting through the torturous way in which too many Americans’ lives are turned inside-out by an insurance/medical complex when they fall ill. Donna’s powerful personal story as depicted in the Michael Moore documentary “Sicko” lays bare the lack of caring and empathy the health care industry shows for us all. Quoting Ms. Smith from a message she sent to the One Payer States collaborative today:
“I had the good fortune to spend the weekend in Columbus, OH, at the SPAN Ohio annual conference. It was an incredible reminder and affirmation of why we all came together in this collaborative effort a year ago in Wayne, PA. Ohio, like so many of our states, has well-informed and passionate advocates for single-payer healthcare, and also like so many of our states faces daunting challenges in moving forward in the current political environment. Yet, through the association with other states and with each other, potential for progress even in this period is made much stronger.”
David Steil, president of healthcare4allpa.org, business owner and former Pennsylvania state representative with the Republican Party made the next presentation which illustrated his realization that the best and most efficient way to make provision of the health care all people need is the single payer concept we all advocate. David’s 35+ years of management experience making products and meeting payroll have left him with no doubt what is needed. He expounded on the precepts that government exists to do what “we cannot do for ourselves”. He even quoted a French philosopher from 1762 who observed “Man is not free when deprived of education and health”. A concept we in SPAN Ohio have endorsed in our recognition of empathy as the soul of democracy. Who said there were none but Democrats that could support such a concept?
The afternoon sessions were dedicated the PPACA vs. HCFAOA, a seminar on lobbying techniques by our lobby committee co-chairs and Mr. Steil’s presentation on how to win the support of business leadership. Mr. Steil expressed his appreciation for the intense questions and stimulating dialog that gave him new energy for the work ahead at home in Pennsylvania. Vann Seawell, SPAN Secretary, and Barb Walden, SPAN Treasurer, did a fantastic job on the entire event.
Today, it is official. Two amazing and courageous elected officials stood with nurses and patients to introduce legislation that moves beyond the current health reform effort and forward to a healthy system for all.
Sen. Bernie Sanders, I-VT, and Rep. Jim McDermott, D-WA, have been allies in the cause for decades. There are not young fellows in terms of legislative or life experience.
Both stood together to introduce the American Health Security Act of 2011 – single-payer, Medicare for All style coverage that would be administered by the states. S915 and HR 1200. Sound policy. Sound thinking. Perfect timing.
Rep. McDermott (D-WA) on the left and Sen. Sanders (I-VT) on the right.
We can all look at the statistics and the motivations of those who offer the numbers, but these two elected officials stand with us —the patients, the nurses, the workers, the people – as surely as night follows day. It is rare to see moments when the people’s business intersects with the political moment. And it is even more rare to see those elected officials who look to the needs of their constituents and the nation and stand up for policy that uplifts – even if some powerful financial interests see things another way.
The work ahead may be daunting, but with advocates like National Nurse United, and co-president Jean Ross, RN, standing in support of AHSA of 2011, S915/HR1200, the path seems navigable, if challenging. Jean was convincing and committed today as she mentioned her own son and his struggle to secure healthcare in the midst of the current for-profit system that often leaves patients left behind and nurses holding hands and hearts. “We hear the stories,” said Ross, “We hear what others do not.”
The American Health Security Act is also backed by the AFL-CIO and its 13 million members. Arlene Holt-Baker, executive vice president, spoke on behalf of the national AFL-CIO at today’s press conference.
Jean Ross, RN, NNU co-president
This was not an effort to criticize or condemn the Patient Protection and Affordable Care Act of 2010, said Sanders and McDermott, but the opportunity to move beyond and to finally realize the goal of workers all over this nation to provide healthcare as a basic human right to all.
As a patient and as someone who went broke (though supposedly fully insured), I watched today’s events with a combination of wonder and worry and praise. I continue to believe – even in the face of all evidence to the contrary – that with the help of the nurses we will achieve healthcare as a human right and we will do so without outright revolution because of lawmakers like Sen. Sanders and Rep. McDermott. We can do it if we stand together with enough clarity and enough solidarity.
My worry related more to the wonderful man I married who is in every way my partner in this struggle and who was at the moment of the press conference in consultation about his own most recent health crisis. Even with full coverage, it is still up to his supplemental insurance carrier to determine if the care his doctor wants to give will be approved. My worry for him would be so very much different if we would change the motivations from profit first to healthcare first. The American Health Security Act of 2011 reaches ever closer to that day.
Finally, I stood with labor leaders – and I am not one of their stature – who have worked so hard to advance anything related to healthcare reform and with whom I have sometimes had differences. But today, we stood as Americans who believe that working class people and our kids and our grandkids deserve the right to healthcare as a human right provided under the social insurance model and not as some privilege granted only to the wealthy and the powerful.
Great day. A celebration of life. The American health Security Act of 2011.
S915/HR1200 – Sen. Bernie Sanders and Rep. Jim McDermott. We can do this.
View Sanders News Conference
Read the AFL-CIO blog
Read about the event in The Nation