Archive

For November, 2010

EQUAL Health Network: CALL FOR DIRECTION IN 2011

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At a gathering on November 21, 2010, a number of community partners who have been active with the EQUAL Health Network expressed our deep concerns regarding the future of health care reform and the political direction of the country more generally.  Our concerns included:

1. Misguided policies have widened social and economic inequality, eroding the middle class in the U.S. and shredding the financial security of millions.  A decade of the virtual abandonment of government oversight and accountability contributed significantly to the collapse of the financial sector, persistent high unemployment, record rates of home foreclosures and bankruptcies, and uncontrolled health care costs. Corporate-sponsored campaigns and corporate-dominated media attempt to falsely attribute responsibility for the economic crash to an overly intrusive government. This stands reality on its head and must be challenged.

2. Progress requires a political program that recognizes the central role of the government in generating an economic recovery.  Further tax breaks to wealthy individuals will not create jobs. Banks are now sitting on billions that they refuse to invest, while pursuing relentless and questionably legal home foreclosures. Substantial deficit spending is critical to regenerate demand and innovation. Demand will flow from employment in the public sector as well as programs such as extended unemployment benefits that provide cash to lower-income people who will spend it.  Public investment in education, health care and housing will help to renew innovation. It is vital to protect Medicare and Social Security from arbitrary cuts, both to protect people’s financial security and to reorient policy towards a more productive course.

3. The Obama Administration, elected on a wave of voter mobilization, has succeeded in enacting an historic health care reform law, as well as numerous other achievements. But it has yet to generate the momentum for an economic recovery, or the civic engagement that can achieve a political one.

We propose to organize our activities for the near future as follows:

1. We call for leadership at every level- among elected officials. community leaders, and advocacy organizations – to reinvigorate our vision of social justice and to reconnect with and mobilize the American public in our own self-interest, for financial security and the opportunity to improve our lives and communities.

2. We will aim to act as catalysts for the change we believe is necessary, and seek to create alliances with organizations and individuals who ascribe to similar beliefs and goals.

3. In the realm of health care reform, we commit to the following. 

a. Oppose and resist calls to repeal, delay and otherwise undermine the implementation of the Affordable Care Act.

b. Educate the public about the substantial benefits ensuing from the ACA, particularly the expansion of publicly-financed coverage, greater controls over administrative waste and excessive costs, protection from insurance company abuses, and improvements in the quality of care.

c. Implement the law to the benefit of the public, through campaigns on regulations and state laws.

d. Address and improve the shortcomings of the law, most significantly:

  • Cover abortion care and contraception the same as any other medical event.  Defuse the controversy over this issue and destigmatize the conversation.

 

  • Cover undocumented residents and all individuals for the costs of health care, as a matter of human rights, reciprocal fairness for the treatment of Americans abroad, and good public health practice.

 

  • Improve the affordability of health care.

 

  • Recognize and aim to replicate the success of all other economically developed nations and many developing nations at controlling health care costs by invoking the authority of the government to negotiate prices with powerful health care industries including drug companies, hospitals and health care  professionals.  This includes expanding the role of local initiatives to provide publicly-financed and publicly-provided health care services, as well as broader initiatives to create state-based single payer systems.

The EQUAL Health Network’s listserve will continue to disseminate news and opinion consistent with these views, and provide a discussion blog for debate on how best to achieve them.

Moving Forward on Health Reform: Invitation to a Discussion

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Many are mad as hell this election season, including some progressives. Absent the funding of the madly rich and insanely right-wing Koch brothers, what are we to do?

For one thing, take a sober look at the policy and politics associated with the Affordable Care Act.

This is not the single payer system many staunch health care reform advocates – including me – preferred, but lacked the power to enact. As we continue the campaign for a single payer, it is essential to recognize, vigorously defend and advance the victories we achieved in the Affordable Care Act, in order to preserve the gains for people in need and also to shore up the valuable activists, and activism, we will need for what is going to be a long haul ahead.

Here’s what the ACA accomplishes, what single payer systems do, why we’re absolutely right to continue to advocate for them, and how we can shape policy to get there from here.

What does the ACA accomplish? The U.S. health care system will do a better job of treating illness and improving health at an affordable cost. The Medicare Trust Fund will be solvent for an additional 12 years, through 2029. There are substantial improvements for lower and middle income people, and immediate benefits for women, younger people, seniors and small businesses. Importantly, the ACA creates policy space to continue efforts to cover everyone while controlling costs, goals that are popular with the public. It accomplishes these objectives in part by imposing new progressive taxes and fees on the wealthiest 2% of the population and on employers.

Politically, the ACA opens opportunities to challenge corporate power at the national level, in the formation of extensive regulations. It throws some leverage to the states, which progressives can use to advance our goals of equitable, quality, universal, affordable health care.

The law includes compromises that call out for revision, particularly on affordability, and on coverage for immigrants and for reproductive health care. And the political process that got us here will be grist for analysis for decades to come.

But it is just not true, as some have characterized it, that the law is primarily a victory for business as usual by the insurance industry. Furthermore, the fight to undermine and defeat the law unquestionably empowers and invigorates the most predatory anti-government political and financial interests in the country. Since the facts don’t serve their agenda – to profit by destabilizing our social and financial security, including dismantling Medicare – they rely on hyperbole and distortion to mobilize the public’s complicity in opposing our own real best interests. In contrast, we can and must remain critical while carefully examining sweeping generalizations that don’t fit.

Single Payer: Getting There from Here

Single payer systems funnel all payments for health care to one collection point – usually a state or national government. This single payer then pays all the health care providers: doctors, hospitals, drug companies. There is overwhelming evidence that single payer systems are more cost-efficient and affordable, along with their many benefits for equity and quality of care.

This is different from our current system in at least two ways that are key to controlling health care costs.

• First, it is administratively efficient. It eliminates the middleman: the proliferation of private insurance companies that take a bite out of every health care dollar for the administrative service of paying the bills. These insurance companies, both for-profit and non-profit, now rake off about 30% or more of our insurance premiums, using ploys that at the same time restrict access to necessary health care and inflict great suffering on ailing humanity. They also add to the administrative burdens of doctors and hospitals.

• Secondly, it moderates prices. It gives a powerful negotiator – the government – the authority to negotiate prices with the health care industry: hospitals, doctors, medical supply companies, drug companies.

Largely for these reasons, single payer proposals are fiercely attacked, maligned and misrepresented and in all manner just blocked in the halls of power by the industry, which profits nicely from this mess.

The state and federal governments are now writing the rules for implementing the Affordable Care Act. Advocates can help to shape these rules to get us closer to administrative efficiency, and to expand the public sector’s purview over prices. Some examples:

• In 2014, new insurance Exchanges will standardize health insurance plans. People who buy insurance now as individuals or in small groups will be grouped into much larger pools, sharply reducing cost-shifting. Advocates have the opportunity to craft and support state laws implementing the exchanges that can push limits on standardizing health plans and require financial transparency.

• The law sharply expands the number of people covered by public sector health plans. For the first time Medicaid will cover everyone under 133% of the federal poverty level, regardless of health status. State governments already do negotiate drug prices under Medicaid, in which enrollment will grow by almost half by 2014. State laws to adopt a public option would further expand the number of people who receive health care either paid for or provided directly by the public sector.

• There are numerous opportunities to regulate, review and otherwise limit premiums, depending on the rules adopted by HHS, and state implementation laws. The current policy debate on how to define and enforce the Medical Loss Ratio is an important example.

• The law also draws on the public’s control over Medicare to address some of the underlying drivers of increasing health costs through new measures such as comparative effectiveness research and payment reforms to encourage more cost-effective delivery systems. It also expands primary care and public health.

• Finally, as soon as 2017 – maybe sooner – there is a defined process for states to prepare for and enact alternative systems, including single payer.

The corporate media surround us with messages – and messengers – that exhort us to succumb to cynicism (nothing will ever work, they’ll always sell us out). Voluntarily taking ourselves out of the real health care fights of the day is tantamount to capitulation. Effective strategies for building the power we need will require and emerge from engagement as well as resistance. Advocates can rebuild public awareness and momentum for single payer systems, and at the same time support legislation and regulations that maximize the progressive aspects of the ACA. If done well, our work on the ACA will build the pathways we need to a single payer system.

from John Iversen on Pacifica/WBAI

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A response to FB friend Kirsten Thomas of KPFA who asked for my opinion:  AIDS-denialism is part of a larger plot to destroy the Pacifica Network in my humble, shade of gray opinion:
ellen i’m on a mac, hopefully you can translate this to PC so every fourth word is not an asterick or something:)
Kirsten, here are my comments after listening: feel free to disseminate, but correct any typos, I am not perfect!
this is John Iversen, an activist for 40 years who has recieved over 20 community awards including East Bay Express Activist of the year, Bay Guardian Local Hero-1993, first Olympic torch relay carrier with AIDS, social worker of the year , Bsoton 1979, some award from the Episcopal Chruch  Madison WI, member of Minnesota Chippewa Tribe/Bos Forte at Nett Lake, only person to receive a lifetime achievemnet award for AIDS work from Alameda County, Wounded Knee veteran 1973 (inside for 7 weeks) co-founde Berkeley Needle Excahnge, ACT UP East Bay, HealthNet AIDS patients union,Black Panther Party Defense Committee after the murders of Fred Hampton/Mark Clark.  I never earned over $25 K per year.  My Berkeley jobs were Dir of YMCA New Light Senior Center and a PT aide to Maudelle Shirek, former member of SEIU  535, 505, 209 (maybe 219) and Steelworkers 5296.  Recieved a college scolarship from Local 5296 in Silver Bay, Minn. My brother is on the Duluith Labor Council, a former Two Harbors City Councilmember for 20 years and one of Paul Wellstone’s 5 rank n file labor advisors. My brother campaigneed for Wellstone and Wellstone returned the favor. My parents were both active in unions, cooperatives, community health centers–Mom was on the Board of the first community clinic in the country-Two Harbors, Minn (NY times article in 1947)  She was recently honored at age 90 by our tribe-google Alice Iversen, Bois Forte a a page and one-third in our Band’s monthly paper. One opf my grandfathers was in the IWW and even in their marching band in Kellogg Idaho, my other grandfather was a potato farmer from French-Canadian Prince Edward Island who moved to Duluth and became an ironworker.  My indigenous grandmother had six kids and stayed at home in Duluth.  My Norwegian grandmother and my father came to the Duluth when they were 25 and 3 repectivley.
My IWW grandfather died in a plague in 1920. My grandmother supported herself and my dad by going out in a boat by herself with nets, noirth of the Arctic Circle.  Duluth must have seemed like Miami to them.  So my working class roots are deep, part of me has been in Northamerica forever and other parts recently arrived. I also come from a reigiously mixed family, dad a Lutheran, mom a Catholic-almost unheard of in the 50s in my hometown.
I think there ar few who’ve done more on the left on a volunteer basis as I have.  And I was not doing it to pad my resume, like many HIV negative people who now have jobs with AIDS Inc.  If you can top me on voluteering for the left and wanna talk, I am willing to listen, but actions do speak louder than words. I fully support SAVEKPFA.  so replacements (not the great Minneapolis band): Walter Tuner, Davey D, Sasha Lily (sp), bringing back Chris n Philip, Mitch Jesserich (sp), Glenn Reeder, Bonnie Simmons, Eric Larsen from KALW.  Arlene = Surely Mean. silence = Death. kpfa under attack, what do we do? ACT UP Fight Back! and by the way, i’ve only touched on a few of my left actions.  I am an internationally known AIDS actiivst and former board member of HealthGap.
Also it is no coincidence that days after Brian n Aimee were fired, Doug Henwood’s hours were cut at WBAI, and WBAI gave it’s weekday noon to 1 slot to aids denialist and vitamin entreprenuer, Gary Null, who has rich friends who are donating  $$ to cash-strapped WBAI.  As a musician , Pay to Play is an old concept, much hated, now it has come to the air of Pacifica.  Something’s happening here and you don’t know what it is, do you Mr. Jones (btw born in the same hospital, maybe delivered by the same doctor as the man i just quoted.  Arlene if you have the power toi fire Brian and Aimee, you have the pwer to fire ro stop the half-truths of Gary Null at WBAI. I think I’ve made my point!  Kirsten, Mitch and all–DON’T GIVE UP THE SHIP! and everyone else, I urge you to follow Mitch and Kirsten on Facebook because they are the truth tellers and not in it for themselves or to grind a particular political axe. That said, maybe Kirsten and Mitch for morning show hosts, but Brian’s seniority rights seem to have been violated by Arlene who makes $90,000/ year.  I think only real criticism of paid staff can come from those earning their average salary of $24-25K per year.  To have a retired doctor refer to good people like Mitch, Kirsten, Chris and Philip as “exclusivists” is childish nonsense and classist!  My humble opinion that I hope is worth two cents–John Iversen

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