Single Payer State Option Threatened in House

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Donna Smith

Donna Smith, American SiCKO, is executive director of the Health Care for All Colorado Foundation

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October 28th, 2009 9:08 PM

Single Payer State Option Threatened in House

When House Speaker Nancy Pelosi announces the healthcare bill she plans to bring to the floor Thursday, will it still have the amendment that allows individual states the option of bypassing legal barriers to pass state single payer bills?

Apparently not, in the latest concession to the insurance industry, Blue Dog Democrats and other conservative interests who seem to have long held the whip hand on healthcare reform.

In July, the House Labor and Education Committee approved an amendment introduced by Rep. Dennis Kucinich that would exempt states that enact Medicare for all/single payer bills from the onerous limitations contained in the federal ERISA law governing employer sponsored health plans.

Since then a rogues gallery of Fortune 500 corporate interests and insurance lobbyists have put a lot of pressure on the House leadership to strip the Kucinich amendment from final bill going to the House floor.

Obviously these interests, especially the healthcare industry which has topped all others in federal lobbying the past decade, have a lot of sway on Capitol Hill (see the Senator from Aetna, Joe Lieberman).

Your voices are needed now to call the House leaders, Speaker Pelosi, and Reps. George Miller and Henry Waxman, floor managers for health care reform in the House. The message is simple: Keep the Kucinich Amendment!

Here's where to call:

• Speaker Nancy Pelosi: DC (202) 225.4965 - SF (415) 556.4862
• Representative George Miller: DC (202) 225.2095 - Concord (925) 602.1880
• Representative Henry Waxman: DC (202) 225.3976 - LA (323) 651.1040

Why does this amendment matter?

1- Even many progressive proponents of the majority bills coming out of the House and Senate will readily concede that those bills are flawed, at best, and fall short of reigning in the main source of our national healthcare crisis.

Here's California Nurses Association/National Nurses Organizing Committee Executive Director Rose Ann DeMoro on Countdown with Keith Olbermann Tuesday night discussing the genesis of waste and fraud in our healthcare system – the system that profits from patient pain and suffering.

2- Protecting the ability of states which have vibrant single payer movements, including California, Colorado, Illinois, Maine, New Mexico, New York, Pennsylvania, and others to enact single payer bills has been the strongest incentive for many of the thousands of grassroots single payer activists across the nation to continue to support bills that have been steadily watered down to please the healthcare industry and conservatives.

3- Passing the main bill with the Kucinich amendment, especially coupled with a big vote for the amendment by Rep. Anthony Weiner to replace the main bill with a Medicare for all bill, would be the single strongest message the House could send to the insurance industry -- as well as to the White House and Senate in advance of negotiations on the conference committee version of a merged Senate and House bill.

4- How can anyone tout bills to protect the rights of states to opt out or even opt-in on a public option while denying the right or ability of states to opt for more comprehensive reform? Or are the compromises and concessions are only allowed to go in one direction.

Ultimately, a lot of people who have worked for many years for genuine healthcare reform will have to admit that the bills in their present form are not it.

Yes, they do provide subsidies or tax credits for a number of the presently uninsured to buy private health insurance, and put some long overdue restraints on the ability of big insurers to refuse to sell policies to people with pre-existing conditions and rescind coverage for people after they become sick.

But in exchange, the insurers benefit from a massive public bailout in both the subsidies and a new law forcing everyone to buy private insurance, coupled with only limited provisions to contain costs, especially with the many compromises made with the insurance and drug cartels. And no genuinely effective means to stop the disgraceful practice of insurers refusing to authorize needed medical treatment or denying payment for claims for tens of millions of their members.

The result will be fewer uninsured. But insurance premiums, deductibles, co-pays, co-insurance and other fees will continue to skyrocket threatening more people with medical bill-induced bankruptcies and encouraging more people to skip needed medical care because of the cost. And people who are forced to buy insurance will continue to see their urgent appeals for help stamped "denied" when they most need it.

That's the importance of the Kucinich amendment. It provides a vehicle for nurses, doctors, and other grassroots healthcare activists to carry the fight for the reform almost everyone knows is the best option to state capitols, and establish an alternative model that can be copied by other states, and ultimately Washington.

That is, of course, exactly how a national, single payer system was enacted in Canada. First in one province, and when others saw what they could have, the nation.

The Canadian system is under continual attack by the right, and does have problems, especially in adequate funding. But no one is denied care based on ability to pay. In almost all essential patient outcomes Canada surpasses the U.S. Administrative waste and cost is only a fraction of ours. And the founder of Canadian Medicare, Tommy Douglas, was voted the greatest Canadian in their history.

That's why the majority of the nation's hands-on front line nurses and doctors have long supported single payer, and expanded and updated Medicare for all. Tell our representatives not to close that door now.

Donna Smith is a community organizer for the California Nurses Association and National Co-Chair for the Progressive Democrats of America

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