As a next step in health care reform, this looks promising

[ProSense]

Supreme Court Declines Challenge to Healthy SF; Universal Care Program OKd

By: David Dayen

The best money spent in the Affordable Care Act was the $11 billion dollars put toward expanding and maintaining here.[br />
Healthy SF always had one obstacle: getting past the ERISA law. The program has an employer mandate, forcing employers to either provide health care to their workers or pay into a citywide fund. The Golden Gate Restaurant Owners association filed suit over this, arguing that under ERISA, they are not required to provide health care for their workers. Yesterday, the Supreme Court declined to hear the case, meaning Healthy SF will survive.

The U.S. Supreme Court has declined to review San Francisco’s Health Access Law that forces most employers to contribute to a health care plan for their workers. The decision ends a four-year battle to uphold the law’s legality.

When Healthy San Francisco was enacted it was considered groundbreaking; the city offered local health plans to the uninsured with funding through employer contributions.

Now the US Supreme Court has refused to consider a lawsuit filed by the Golden Gate Restaurant Association when the law went in effect. Deputy City Attorney Vince Chabria says this is great news for 53,000 beneficiaries of the program.

It’s great news for lots of Americans. Because the San Francisco program was always viewed as a model for community health centers across the nation. You will probably see other cities adopt their approach. And now, there’s nothing legally standing in the way. As Anthony Wright, executive director of Health Access California, said, “This action by the Supreme Court not only upholds the Healthy San Francisco program that provides care for tens of thousands of California, but it keeps the door open for additional health reforms at the state and local level.”

Healthy SF was the brainchild of then-San Francisco Supervisor Tom Ammiano (now a member of the state Assembly), and he felt vindicated by yesterday’s ruling. “Today’s Supreme Court decision is an affirmation of San Francisco’s landmark efforts to provide affordable health care to the uninsured. With over 50,000 people receiving health care services and prescription drugs, Healthy San Francisco is a national model for what can be accomplished when the public and private sector work in partnership towards a common goal.”

With any luck, universal care programs like Healthy SF will be put together all over the country.

Community health centers, a successful challenge to ERISA and Senator Sanders' single-payer provision.

Sen. Sanders to introduce bill for single payer waiver

Posted by Don McCanne MD on Monday, Aug 2, 2010

Sanders promises to seek health care waiver from Obama for Vermont
By Susan Smallheer
Rutland Herald
August 1, 2010

U.S. Sen. Bernard Sanders, I-Vt., pledged to personally take Vermont’s case for a statewide single-payer health care system to President Obama if the Legislature authorizes it next year.

Sanders, speaking at a health care rally at the Hetty Green Park in downtown Bellows Falls on Saturday afternoon, said that he and other members of Congress would also introduce legislation that would roll back to 2014 the current 2017 restriction for states to apply for a waiver in order to implement their own systems. He said Democratic Reps. Dennis Kucinich of Ohio and John Conyers of Michigan would be co-sponsoring the legislation with him.

http://www.rutlandherald.com/article/20100801/NEWS02/708019832/1003/NEWS02

Although the Patient Protection and Affordable Care Act would allow states to apply for waivers to implement their own systems, they cannot do so until 2017, three years after they are required to implement the private insurance exchanges. Many have asked if Sen. Sanders still intends to introduce legislation to move that date up so that states would not have to set up the exchanges only to replace them soon thereafter with a single payer system. The answer is yes.

A Single-Payer Laboratory in Vermont

Source: The Nation

By Katrina vanden Heuvel

May 14, 2010

The Vermont legislature passed a bill this week mandating the study of three approaches to universal healthcare--a single-payer system, healthcare with a public option, and the current system under the healthcare reform bill passed by Congress. The legislature will choose the best plan in 2011 and plans to begin implementation in 2012.

According to the Vermont Workers' Center, the prospects for passing this legislation looked bleak as recently as January. But thousands of Vermonters--including Senator Bernie Sanders--mobilized for the "Healthcare is a Human Right" campaign and it changed the political climate.

"As a long-time advocate of single-payer I'm glad the state is going to have a study," Senator Sanders told me. "I think the result of it will show that the most cost-effective way to provide universal, comprehensive healthcare to every Vermonter is through a single-payer approach. What the Vermont legislature has done is very important, very positive, and I strongly support their efforts."

Sanders said the bill is also important because it demonstrates that "just because a healthcare reform bill was passed in Washington, does not mean that Vermont and other states should not continue to go forward in the fight for a Medicare for all/single-payer system."

Sanders said that in the event the state legislature chooses a single-payer system, he "will be going right into the President's office, and making the fight on the floor of the Senate that Vermont should be able to become a laboratory and go forward with a single-payer program. And I think if it works in Vermont many other states will want to do the same thing." (It was a single-payer laboratory in Saskatchewan that evolved into the Canadian healthcare system.)

Sanders will indeed have a fight on his hands. During the healthcare debate, he and Senator Ron Wyden pushed for states to have the right to apply for "waivers" so they could implement alternatives to the private insurance market exchanges. Initially, the waiver option was set for 2014--the same year the exchanges take effect. But due to Congressional Budget Office pressure the waiver date was pushed back to 2017. The problem with that is that it requires the states to spend the time, money and attention on creating the exchanges, only to then propose and implement a completely different system three years later.

It's a tough road, and Sanders said he and Wyden are still pushing for the earlier date.

"We are working together on that--and hoping to enlist the support of some governors--who will make the fight to push that up to 2014. We think that states should have the flexibility to go forward with, among other things, the single-payer program, and I intend to work very hard on that."

If Vermonters see this fight through, their state may well serve as the laboratory this country needs to finally achieve quality affordable healthcare for all.

The beauty is that it's already in the law.

[Mimosa]

1. How many people will die waiting for real reform? n/t

[ProSense]

2. How many people will live because of this bill

that you hate so much?

Congressman Grayson said, “I may be in Congress for two years or twenty years, but whenever I leave Congress, I want to be able to say that there is no blood on my hands. I want to know that I did everything I could to save lives. That’s why I voted for health care reform. That’s why I had to vote for health care reform. I am pleased that I voted for life.”

link

[ProSense]

3. Suddenly no one is interested in single payer? n/t

[Jeff In Milwaukee]

5. This is something of a long read there, Prosense!

But very promising stuff. I had heard about Health SF but only knew about the legal challenges. I didn't know anything at all about Vermont and the concept that some states could, on their own, adopt a single payer system under HCR.

[ProSense]

7. Actually, I don't think it takes this long to read this information

LOL!

[flamingdem]

10. Sounds interesting, probably won't happen in CA but at least it will happen nt

[Cleobulus]

11. Shouldn't you be criticizing at least the second 2 articles?

You believe the current law passed in Congress is good enough, so why this rush to replace it?

[ProSense]

12. "You believe the current law passed in Congress is good enough"?

It's a great foundation. What do you believe?

I'm sure people who think this bill sucks would have lambasted FDR for his sucky Social Security Act.

FDR's statement on the 1939 amendments to the Social Security Act of 1935

IT WILL be exactly four years ago on the fourteenth day of this month that I signed the original Social Security Act. As I indicated at that time and on various occasions since that time, we must expect a great program of social legislation, such as is represented in the Social Security Act, to be improved and strengthened in the light of additional experience and understanding. These amendments to the Act represent another tremendous step forward in providing greater security for the people of this country. This is especially true in the case of the federal old age insurance system which has now been converted into a system of old age and survivors' insurance providing life-time family security instead of only individual old age security to the workers in insured occupations. In addition to the worker himself, millions of widows and orphans will now be afforded some degree of protection in the event of his death whether before or after his retirement.

The size of the benefits to be paid during the early years will be far more adequate than under the present law. However, a reasonable relationship is retained between wage loss sustained and benefits received. This is a most important distinguishing characteristic of social insurance as contrasted with any system of flat pensions.

Payment of old age benefits will begin on January 1, 1940, instead of January 1, 1942. Increase in pay-roll taxes, scheduled to take place in January, 1940, is deferred. Benefit payments in the early years are substantially increased.

I am glad that the insurance benefits have been extended to cover workers in some occupations that have previously not been covered. However, workers in other occupations have been excluded. In my opinion, it is imperative that these insurance benefits be extended to workers in all occupations.

The Federal-State system of providing assistance to the needy aged, the needy blind, and dependent children, has also been strengthened by increasing the federal aid. I am particularly gratified that the Federal matching ratio to States for aid to dependent children has been increased from one-third to one-half of the aid granted. I am also happy that greater Federal contributions will be made for public health, maternal and child welfare, crippled children, and vocational rehabilitation. These changes will make still more effective the Federal-State cooperative relationship upon which the Social Security Act is based and which constitutes its great strength. It is important to note in this connection that the increased assistance the States will now be able to give will continue to be furnished on the basis of individual need, thus affording the greatest degree of protection within reasonable financial bounds.

As regards administration, probably the most important change that has been made is to require that State agencies administering any part of the Social Security Act coming within the jurisdiction of the Social Security Board and the Children's Bureau shall set up a merit system for their employees. An essential element of any merit system is that employees shall be selected on a non-political basis and shall function on a non-political basis.

In 1934 I appointed a committee called the Committee on Economic Security made up of Government officials to study the whole problem of economic and social security and to develop a legislative program for the same. The present law is the result of its deliberations. That committee is still in existence and has considered and recommended the present amendments. In order to give reality and coordination to the study of any further developments that appear necessary I am asking the committee to continue its life and to make active study of various proposals which may be made for amendments or developments to the Social Security Act.

link

Some of those excluded:

Most women and minorities were excluded from the benefits of unemployment insurance and old age pensions. Employment definitions reflected typical white male categories and patterns.<11> Job categories that were not covered by the act included workers in agricultural labor, domestic service, government employees, and many teachers, nurses, hospital employees, librarians, and social workers.<12> The act also denied coverage to individuals who worked intermittently.<13> These jobs were dominated by women and minorities. For example, women made up 90% of domestic labor in 1940 and two-thirds of all employed black women were in domestic service.<14> Exclusions exempted nearly half the working population.<13> Nearly two-thirds of all African Americans in the labor force, 70 to 80% in some areas in the South, and just over half of all women employed were not covered by Social Security.<15><16> At the time, the NAACP protested the Social Security Act, describing it as “a sieve with holes just big enough for the majority of Negroes to fall through.”<16>

link

Here is Truman expressing his regret for having failed at health care reform:

<...>

By mid-1951 the AMA was openly claiming victory, and President Truman acknowledged as much when he omitted the proposal from his 1952 state of the Union message. Instead, he announced the establishment of a Commission on the Health Needs of the Nation to study the problem. In the presidential election that year, the Democratic candidate, Adlai E. Stevenson (who replaced the retiring President as the party's standard bearer, skirted the issue of Government health insurance. On the other hand, the winner, Dwight D. Eisenhower, voiced strong opposition to the proposal, ensuring that the new administration would not soon revive it.

In sum, the Wagner-Murray-Dingell bill was the victim of a cautious Congress, massive resistance by a prestigious and vitally affected interest group, sympathy for the AMA's position from an imposing array of nonmedical groups, a lack of wholehearted support from some of the key proponents, considerable antipathy from the press, the rapid growth of private insurance, and, finally, of a hostile political climate. (12)

Years later, President Truman wrote: "I have had some bitter disappointments as President, but the one that has troubled me most, in a personal way, has been the failure to defeat the organized opposition to a National compulsory health insurance program. But this opposition has only delayed and cannot stop the adoption of an indispensable Federal health insurance plan."

link

President Obama ensured that significant legislation passed, and I doubt he believes it will not be improved.

[Cleobulus]

13. I believe it needs to be replaced by a single payer or public option system before it is...

implemented.

ON EDIT: The difference we have is this, after reading the articles you posted, simply put, you think HCR is a foundation for further reform, I don't, indeed, I see it as a step in the wrong direction, the Social Security Act cited above had flaws, a lot of them, and was inadequate in many areas, as pointed out, however it was something to build upon, to increase availability of social security to more people. What does the HCR going to do, force more people into private insurance as time goes on, what is its foundation? Where's the public program that will be greatly expanded later on to cover most, if not all Americans?

[ProSense]

14. Really?

"I see it as a step in the wrong direction, the Social Security Act cited above had flaws, a lot of them, and was inadequate in many areas, as pointed out, however it was something to build upon, to increase availability of social security to more people."

The public option was not a stand-alone program. The reforms enacted do significantly more, than just providing the additional competition of a robust public option.

A public option can always be added. The reforms are the foundation that would make a public option work. Also, the single-payer provision is another foundational element of the plan.

[Cleobulus]

15. As far as I'm aware of the public option is already dead in the water...

at the federal level, it doesn't exist. Right now the best hope is for Bernie Sanders, John Conyers and Dennis Kucinich to push for reform of the recently passed law to allow states to implement public option/single payer plans, and this already requires reforms in the law that already passed. In addition there is no single payer provision in the current law, again it doesn't exist. We would have to wait until 2017 before states can even begin to try to pass such laws, and even now the HCR has to be fixed so it can happen earlier than that.

[Jeff In Milwaukee]

4. There are so many ways to save money....

Something like 10% of all Medicare/Medicaid patients are readmitted to the hospital within 30 days, in part because they haven't seen a doctor since their discharge. It costs BILLIONS in additional costs. Some healthcare providers -- under the gun because the government is going to cut payments for these types of readmissions -- are getting the message and providing post-discharge home health care, including follow-up home visits, regular communications, and enhanced instructions and education for the patient and the patient's family.

Billions. From just a simple change in the procedure that would not have happened unless the government demanded it.

[ProSense]

6. It's going to be interesting

to see the changes roll out. It's only going to get better from here on out.

[Mimosa]

8. What about the people WAITING?

Like me and my partner who can't afford the $895 a month plus co-pays and prescriptions?

There is NOTHING for us, no way out. We may have to quit paying for health insurance p
Tell me it's only going to get better while I'm scared to death. We can't afford it!

[ProSense]

9. What if they had killed the bill?

You are paying for insurance now?

"We may have to quit paying for health insurance"

Is your situation changing?

The bill is being implemented. The high-risk pools and other provisions are for people who currently have no coverage. The fact is that the majority of people who had coverage before reform will not see significant changes until the plan is fully implemented.

[Liberal_Stalwart71]

16. I saw Bernie a few weeks ago on Capitol Hill, stopped him, and thanked him for all the work

he's done for his state and the country. He is a true patriot, and a very nice gentleman!