Single Payer v. Public Option - Nick Skala

[slipslidingaway]

http://www.singlepayeraction.org/blog/?p=960

Youtube interview link...
http://www.youtube.com/watch?v=dWBZz070m-k

"...In early June, he was invited to speak before the Progressive Caucus of the House of Representatives about single payer health care.

He sent his presentation ahead of time to Bill Goold, the executive director of the Progressive Caucus, and Darcy Burner, executive director of the American Progressive Caucus Foundation. Both were not pleased with Skala.

“Bill Gould emailed me after reading my testimony and materials I was going to present to tell me that they were not acceptable and that there could be no comparison between single payer and the public option with side by side comparison,” Skala told Single Payer Action. “Darcy Burner told me that they would construe talking about the public option — even comparing it to single payer — as an attack on the members of the Progressive Caucus.”


...“The public option preserves all the systemic deficiencies that we see in the current system,” Skala said. “It maintains a finance system that is based on private insurance and private insurers and their drive to fight claims, issue denials, screen out the sick and make a big profit generate tremendous administrative waste — 400 billion dollars a year.”

“Now you can expand coverage by just raising taxes and paying insurers to cover people but that’s not a sustainable system,” Skala said. “But it won’t cover every body and it will fall apart quickly due to rising cost as we’ve seen in Massachusetts, Vermont, Oregon, Tennessee and Minnesota — state after state after state and it hasn’t worked.”

“Now the definition of insanity is to repeat what has gone on in the past and expect a different result. Yet that’s what we’re doing with the public option..."



Hold out for single payer

http://www.pnhp.org/news/2009/june/hold_out_for_single_.php

By Nick Skala

"The following remarks were presented to the Congressional Progressive Caucus on June 4.

Today the Congressional Progressive Caucus faces a choice. That choice is whether Members should maintain their unflinching support for single-payer, or to accede to intense political pressure to support the plan currently being developed in Congress under the direction of President Obama: a mandate for Americans to purchase an insurance plan from a massive new regulatory “exchange,” with one plan potentially being a “public option.” .....


In contrast, the “public option” will require huge new sources of revenue, currently estimated at around $1 trillion over the next decade. Rather than cutting this bloat, the public option adds yet another layer of useless and complicated bureaucracy in the form of an “exchange,” which serves no useful function other than to police and broker private insurance companies...


We’re told that holding out for single-payer is politically unwise, but to compromise and accept a bad plan at precisely the time when popular support and grassroots energy are on the side of true reform is the real political miscalculation.

The history of great social achievement is rife with instances in which the forces of institutionalized power told social movements - as they now tell this one - that what they wanted was too much, or too fast, or too soon. I think, of course, of the abolition of human slavery, the enfranchisement of women, the Civil Rights Movement, Social Security, the minimum wage, an end to child labor. In each of these instances, social movements held fast to their principles and soon discovered that they had been told was “politically unfeasible” one moment was political reality the next.

We currently have a better chance to pass single-payer than Lyndon Johnson had when he passed Medicare. Unlike the public option, single-payer - because it holds the potential to finally realize universal, equitable health care - can be a vehicle to inspire the American people for progressive change..."

[MarjorieG]

1. Holding out for single payer, in the face of great industry lobbying, means no change

I don't see opportunity greater, because public good has never meant a bit in this. Do we just say to insurance, except exotic extras? Didn't work with drugs, either.

[slipslidingaway]

3. "...means no change..." Not necessarilly - as for the insurance

companies they provide nothing in the way of health care.

They move money around, from people to providers and along the way take profits for shareholders. Yet they are given prominent seats in the discussion while actual providers of care are arrested.

:shrug:

[DJ13]

2. K&R

[slipslidingaway]

4. Thanks :) n/t

[bamacrat]

5. This is what they should do.

Obviously set it up as a single payer, I am after all a complete socialist, but... Since most people are already paying premiums and deductibles and copays and what not. Scrap that find out an acceptible tax say 5% on everyone with no income limit. If you want to keep buying your private healthcare and can afford it great keep it, but you pay the tax too. Rich people will not be exempt, which would help provide for lower income people. Everyone is covered.

Also while Im solving problems Ill tell you how to fix social security for the next 100 years without raising the age of eligibility. Remove the income cap, right now a person can only pay social security taxes on the first 108,000 dollars they make. Which may have been fine for the 30s 100,000 a year was unimaginable. But we have way too many multi-million dollars athletes and executive that only pay social security on the 108K not the remaining 10Million. Its called fair.

[slipslidingaway]

6. Have everyone pay into the system...

that would most likely be a better option than the public option. In the UK everyone pays into the system, those who can afford it also purchase private insurance and can use both systems, which means that they could "jump ahead of others" when seeking an appointment for a specialist.

HR 676 does not allow private insurance companies to duplicate the coverage provided by the national system, which is similar to the Canadian system, and makes it more equitable.

http://www.pnhp.org/news/2009/june/hold_out_for_single_.php

"...In contrast, the “public option” will require huge new sources of revenue, currently estimated at around $1 trillion over the next decade. Rather than cutting this bloat, the public option adds yet another layer of useless and complicated bureaucracy in the form of an “exchange,” which serves no useful function other than to police and broker private insurance companies..."


I disagree about SS, it does not need to be fixed anytime soon, boomers have paid in extra to pre-fund a good portion of their retirement. The problem rests with the general budget in the short term, not SS. Plus the amount paid out by SS is capped just as the amount paid in is capped.

Health care is the major problem in the coming years.

[RedEarth]

7. I posted the "hold out" article several weeks ago(glad you posted it again) and agree Single Payer

is the only plan that makes sense...in particular from an economic standpoint. I've been a proponent of single payer for years and strongly urge anyone who wants to find out what single payer is all about to visit(and study) the PNHP site....it has a wealth of information.

http://www.pnhp.org/

BTW ... here is what we're fighting against....

Familiar Players in Health Bill Lobbying (health-care industry spending $1.4 million/day on lobbyists)

The nation's largest insurers, hospitals and medical groups have hired more than 350 former government staff members and retired members of Congress in hopes of influencing their old bosses and colleagues, according to an analysis of lobbying disclosures and other records.

The tactic is so widespread that three of every four major health-care firms have at least one former insider on their lobbying payrolls, according to The Washington Post's analysis.

Nearly half of the insiders previously worked for the key committees and lawmakers, including Sens. Max Baucus (D-Mont.) and Charles E. Grassley (R-Iowa), debating whether to adopt a public insurance option opposed by major industry groups. At least 10 others have been members of Congress, such as former House majority leaders Richard K. Armey (R-Tex.) and Richard A. Gephardt (D-Mo.), both of whom represent a New Jersey pharmaceutical firm.

The hirings are part of a record-breaking influence campaign by the health-care industry, which is spending more than $1.4 million a day on lobbying in the current fight, according to disclosure records. And even in a city where lobbying is a part of life, the scale of the effort has drawn attention. For example, the Pharmaceutical Research and Manufacturers of America (PhRMA) doubled its spending to nearly $7 million in the first quarter of 2009, followed by Pfizer, with more than $6 million.



http://www.washingtonpost.com/wp-dyn/content/article/2009/07/05/AR2009070502770.html?hpid=topnews

[slipslidingaway]

8. "...only plan that makes sense...in particular from an economic standpoint"

"in particular from an economic standpoint"

This is such an important point!

IMO we do not have the luxury of choice at this point, I really wish Obama would come out and use this as explanation, he could even point to the 4 Trillion debt increase under Bush. :)

Now is the time to challenge the insurance companies instead of giving them a seat at the table.


Bush Administration Adds $4 Trillion To National Debt
http://www.cbsnews.com/blogs/2008/09/29/couricandco/entry4486228.shtml

I had not seen the interview (youtube link above) where he talks about being told NOT to compare the two systems when presenting info to the Progressive Caucus...he is working with Conyers at the moment. I'm sure I gave your thread a knr....thanks.

:hi:

Also...

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=389&topic_id=5990169&mesg_id=5991250

Medicare enrollment - from 46 million to 79 million starting in 2010 but somehow we'll be able to cut Medicare costs to partially fund a public option???

IMHO we do not have the luxury of choice and should look to the most cost efficient system that will give basic coverage to everyone instead of keeping the insurance companies in business...

[slipslidingaway]

9. CBO letter to Senator Gregg on cost and coverage of expanding

Medicaid under the draft Affordable Health Choices Act...


Full text
http://www.cbo.gov/ftpdocs/104xx/doc10445/07-07-2009-ExpandingMedicaid.pdf

"In response to your request, the Congressional Budget Office (CBO) has considered the likely effects on federal spending and health insurance coverage of adding a substantial expansion of eligibility for Medicaid to the Affordable Health Choices Act, a draft of which was recently released by the Senate Committee on Health, Education, Labor, and Pensions (HELP).

CBO has not yet had time to produce a full estimate of the cost of incorporating any specific Medicaid expansion in the HELP committee’s legislation. However, our preliminary analysis indicates that such an expansion could increase federal spending for Medicaid by an amount that could vary in a broad range around $500 billion over 10 years. Along with that increase in federal spending would come a substantial increase in Medicaid enrollment, amounting to perhaps 15 million to 20 million people. Such an expansion of Medicaid would also have some impact on the number of people who obtain coverage from other sources (including employers). All told, the number of non-elderly people who would remain uninsured would probably decline to somewhere between 15 million and 20 million. (For comparison, CBO’s analysis of the draft legislation that was released by the HELP committee found that, absent any expansion of Medicaid or other change in the legislation, about 33 million people would ultimately remain uninsured if it were to be enacted.)..."


http://www.pnhp.org/blog/2009/07/08/can-medicaid-fill-the-gap/

Can Medicaid fill the gap?
Posted by Don McCanne, MD on Wednesday, Jul 8, 2009

"From the start it was recognized that insurance exchanges, even if they included a public option, could never provide affordable coverage for low-income individuals. The Medicaid program would have to be expanded to cover this more vulnerable population.

It was also recognized that, even with subsidies, there are many individuals who could not afford to purchase plans through an exchange yet have incomes above the thresholds that would qualify them for Medicaid.

That has led to the new definition of universal coverage as being “close to 95 percent.” This CBO analysis provides support for that view. Leaving only 15 to 20 million people without coverage has become one of the parameters that will define “success” in the reform efforts.

And costs? This Medicaid expansion can be accomplished for only half a trillion dollars (federal component), that is if it is agreed that the program will continue to be chronically underfunded. If it is eventually decided that Medicaid must cover actual health care costs, then add those costs to this half a trillion dollars plus to the funds already obligated for the 60 million people now covered by Medicaid.
Once 75 to 80 million people are on Medicaid - over one-fourth of our population - adequate funding will be essential if there are to be enough willing providers to be there to give care when needed..."

[slipslidingaway]

10. Update on the arrest of Dr. Paris at the Senate Finance Committee

http://www.somdnews.com/stories/07032009/entetop155723_32202.shtml

"Leonardtown psychiatrist Dr. Carol Paris will not be required to complete community service for disrupting a U.S. Senate hearing May 5 on health care reform. So long as she doesn't break any laws for nine months, the charge could be purged from her record.

Paris said Wednesday that the U.S. attorney originally wanted her to do 40 hours of community service, but dropped the demand Tuesday, since Paris lives more than an hour outside of Washington, D.C.

Five of her fellow protesters must complete community service.

"It's a total crock," Paris said of the plea deals. "What those people do for a living is a community service. Their protest was a community service."

Paris and 12 other advocates of a single-payer health care, sometimes known as "Medicare for all," were arrested for disorderly conduct after not being given an official opportunity to speak at the hearing conducted by Sen. Max Baucus (D-Mont.). Paris and seven fellow members of Physicians for a National Health Program, a nonprofit advocacy organization, resorted to making statements from the audience without being recognized. Five other members of the organization were arrested at a subsequent hearing May 12..."