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Californians like single-payer health care — until they learn taxes must rise to pay for it

0c7b0_920x1240 Californians like single-payer health care — until they learn taxes must rise to pay for it

The single-payer system under consideration by the Legislature would
require the 18 million Californians who have employer-sponsored health
plans to give them up. The 4.5 million Golden State seniors on Medicare —
and 13 million people on Medi-Cal — would have to do the same.

The single-payer system under consideration by the Legislature…


Whether to establish a state-run, single-payer health-care system is shaping up to be one of the main differences among the candidates for governor in California in the run-up to the June primary election. The front-runner, Lt. Gov. Gavin Newsom, says the only thing stopping single-payer in California is a lack of political leadership. The candidate running second in the pack, former Los Angeles Mayor Antonio Villaraigosa, says he supports single-payer but has concerns about how to pay for it.


The cost is more than concerning, it’s catastrophic. Implementing a single-payer system would require tens of billions of dollars in new taxes — and thereby lead the Golden State into financial ruin.

The state Senate has admitted as much. The chamber passed Senate Bill 562 in June to create a system that provides “free” care to all California residents, including undocumented immigrants. The bill would eliminate co-pays, deductibles and all other forms of cost-sharing.

The price tag for the single-payer plan envisioned by SB562, per a Senate Appropriations Committee report, is $400 billion per year. Half of that figure would come from new taxes.

To put those figures in perspective, the state’s total expenditures next year are projected to be about $183 billion. So single-payer would effectively double the state budget.

Californians do not want to shoulder all these extra costs. According to a May survey from the Public Policy Institute of California, two-thirds of Californians backed a single-payer system earlier this year. But support plummeted by more than a third when respondents were told the plan would raise taxes.

Hefty new taxes aren’t the only reason why ordinary Californians are leery of single-payer.

Many voters don’t realize that single-payer means there would be only one health insurance plan statewide — a government-run one. Forty-seven percent of all Americans, and 52 percent of Democrats, mistakenly believe they’d be able to keep their current plans in a single-payer system, according to a Kaiser Family Foundation study.

The single-payer system under consideration by the Legislature would require the 18 million Californians who have employer-sponsored health plans to give them up. The 4.5 million Golden State seniors on Medicare — and 13 million people on Medi-Cal — would have to do the same.

Many patients would lose access to their doctors. Some physicians would retire early to avoid the pay cuts and administrative headaches that a government-run system would no doubt bring. Others would move to other states, where their earning power would be greater. And the most talented medical graduates would think twice before coming to California, where the state could micromanage their practice of medicine — and would pay them less.

Lawmakers on both sides of the aisle have balked at the plan. Assembly Speaker Anthony Rendon, a Democrat from Los Angeles County, shelved the bill this summer, calling it “woefully incomplete” on “financing, delivery of care, cost controls” and more.

“Free” health coverage that covers every service and procedure sounds wonderful. But the single-payer system that’s captivated so many progressives in California would be far from free. It’d impose tens of billions of dollars in new taxes, deprive millions of Californians of the health plans they have and like, and result in rationed care when demand outstrips what the state is willing and able to pay for.

Sally C. Pipes is president and CEO of the Pacific Research Institute and author of “The Way Out of Obamacare” (Encounter 2016). Twitter: @sallypipes

Rockland, Westchester lawmakers push for New York Health Act’s single-payer bill

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NY State of Health opens for enrollment Nov. 1. It has more than 4 million customers.
Joseph Spector, Albany Bureau

Rockland and Westchester lawmakers are backing universal health care movements in New York, despite Trump administration efforts to reduce government’s role in health care.

Rockland County’s Legislature voted recently to support state legislation seeking to provide universal government-run health care. It joined county legislatures in Westchester, Sullivan and Tompkins that previously voted to support the bill, according to New York State Nurses Association, a union representing 40,000 nurses statewide.

“The New York Health Act is a blueprint for the reorganization of health care in New York state,” said Rockland County Legislator Lon M. Hofstein, a Republican and minority leader. “The way care is delivered now is increasingly unsustainable, for individuals, families, businesses and government. We must act before the crisis worsens.”

While the number of counties supporting the bill has grown to four out of 62, it has historically failed to gain traction in Albany.

FED: What would Sen. Bernie Sanders’ ‘Medicare-for-All’ bill mean for you?

STATES: Single-payer plans reignited by Obamacare rollback push

STUDY: Affordable Care Act (Obamacare) far from ‘imploding’ in NY

The single-payer legislation, called the New York Health Act, had passed the Democrat-led Assembly three times before 2017. But it repeatedly stalled in the Republican-leaning Senate, which represents more rural upstate New York versus the urban New York City metro area.

The uncertainty surrounding federal lawmaker’s plans for health care, however, has helped sustain efforts by New York, California and other Democrat-majority states to push universal government-run health care legislation.

Further, the political climate in New York seems poised for drastic changes. Democrats have vowed to unify power in the state Senate in 2018, and the move could boost the chances for the New York Health Act being pushed by the nurses union and other powerful labor groups.

“Too many times I see patients having to fight insurance companies to get the care they absolutely need,” said Chinyere Omwumelo, a union nurse who lives in Rockland.

“With the New York Health Act, medical decisions will be made between the doctor, nurse and patient, not a bureaucrat who has no clinical training and has never even set eyes on the patient,” she said.

In addition to the four county legislatures, the health care bill has been supported by five town boards, two upstate city councils and other political groups, according to the nurses union.

Obamacare debate

Opponents of the New York Health Act, including hospital trade groups, have argued the issue should be addressed at the federal level.

They’ve cited concerns that states would face challenges in securing sufficient federal funding to subsidize health care programs, and pointed to cost concerns killing prior efforts to bring state-run health care to Vermont. 

Meanwhile, the politically charged debate over federal government’s role in health care is already addressing similar issues.

In the wake of failed GOP bids in Congress to overhaul the Affordable Care Act, Vermont Sen. Bernie Sanders has built some momentum for federal legislation to create a single-payer, government-run health care system.

Sixteen Democrats — including potential 2020 presidential candidates — have lined up behind his “Medicare-for-All” bill, which would eliminate the role of private insurers in basic health care coverage, USA TODAY reported.

More than 500,000 people across the country have signed a petition as “citizen co-sponsors” of his bill, which he introduced earlier this year in a packed Senate hearing room.

In the House, a record majority of Democrats — 117 — have signed onto similar legislation.

US Must Move To Single-Payer Health Care

People never really know when they are going to get sick, so why do we punish them when they do?

People want to know that when they get sick they will be able to see a doctor, and for the majority of Americans seeing a doctor regularly is part of their lives. Inability to do so causes immense stress and financial hardships. Moving to a single-payer health care system, in which the government handles payments to private providers, can eliminate these shortfalls. Adequate health care is a worldwide protected right.

In in the United States more than half of Americans live with at least one chronic illness according to the Centers for Disease Control and Prevention. Yet, the health care resources available for people are limited or drive up personal medical bills, plunging people into debt. According to the Kaiser Family Foundation, an estimated 1 in 3 Americans report having difficulty paying their medical bills even with insurance. Evidently, the insurance in our society does not meet the average American’s needs.

The United States voted for the United Declaration of Human Rights in 1948 at the United Nations. Article 25 of the declaration states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”

How exactly would single-payer health care work?

Whether you call it single payer or Medicare for all, the idea of a government-sponsored universal health care system, no matter how contentiously debated, continues to infiltrate the health care discussion.

The idea of universal health care reemerged during the 2016 presidential primary campaign as one of Bernie Sanders’ main platforms. In September, Sanders, I-Vermont, introduced a “Medicare for All” bill into the Senate with the full knowledge it would likely go nowhere — for now. In August, Rep. John Conyers, D-Michigan, reintroduced an expanded and improved Medicare for All bill in the House.  

Both bills would convert the current many-payer system — insurance companies, states, the federal government — into a government-sponsored, tax-supported health care system. As in many other countries, every US citizen would receive health care, and it would essentially be paid for by one source, the government.

In addition to these national legislative moves, which may be more symbolic than realistic, at least three states have been working toward a single-payer system, and those efforts can also help consumers understand how such a plan would work.

The most recent effort toward that goal came from the Massachusetts Senate early in November. Already known for its progressive health care policies, the state approved a broad health care reform bill that seeks to lessen price disparities between hospitals, address rising drug costs and lower the number of patients readmitted for hospital care within 30 days of a discharge.

An important amendment to the bill called for a study of what it would cost Massachusetts to implement a government single-payer health care system. The amendment, introduced by Sen. Julian Cyr, a freshman Democrat, passed by a surprising 33 to 6 vote. “When you consider every other developed nation has single-payer health care, we’ve just got to look at this,” said Cyr. 

In addition, he pointed out that Massachusetts is a state that spends one of the highest amounts per capita on health care. Thus, it only makes sense to find out if that money could be spent more equitably and efficiently with a single-payer system.

Other states grappling with this issue haven’t been entirely successful. Back in 2011 Vermont was the first state to implement a universal health care system of its own, in which all citizens were insured under Green Mountain Care. But by 2014, the state abandoned its efforts, citing unmanageable higher taxes. 

Now Vermont is moving toward an alternative system that offers health care providers lump sum payments that are designed to reward doctors for keeping patients healthy instead of solely treating illness.

California, however, may have had the country’s most ambitious plan for single-payer health care. Such a plan passed the Senate in June but was then stalled in the summer because of the potential increase in taxes and the lack of analysis on how the bill would be funded. The debate continues.

When asked in a recent interview on NPR if state efforts are the shortest way to get to a single-payer system, Linda Blumberg, senior fellow in the Health Policy Center at the Urban Institute, said implementing single-payer health care state-by-state may be far more difficult than a federal system. “High-income states that have a lot of private health care spending … are most likely to be able to do something like this,” she said. But other states without resources can’t just shift costs from one side of the ledger to the other, she added.

In the meantime, pundits such as Drew Altman, president and CEO of the Kaiser Family Foundation, have other warnings about a national single-payer system. Most people worry about the increase in taxes a single-payer system would cause, Altman has written. But also, most people don’t realize they would need to change providers under a single-payer system, something that has always been complicated and uncomfortable for consumers.

For the moment, how single-payer would work is anyone’s guess. It may take months or years to answer these questions. But the earlier consumers can be aware of the issues involved in a big change like this, the better. 

Mass. Senate bill aims to rein in health costs, study single-payer

BOSTON — A sweeping package of reforms supporters said aimed to fix broken elements of the state’s health care system while also saving consumers money passed the Senate on a 33-6 vote at midnight Thursday.

The bill sets a target for reducing hospital re-admissions, imposes new oversight on the pharmaceutical industry, and calls for a study of the costs of shifting to a single-payer system. It aims to cut down on unexpected consumer costs like out-of-network charges and facility fees, and to increase access to telemedicine and mobile integrated health, which involves paramedics performing non-emergency services.

“The bill is really about the consumers and doing everything we can to make health care affordable to consumers,” said Sen. James Welch, who led the working group that wrote the bill.

“Everyone deserves access to high quality health care at a fair price,” said state Sen. Adam Hinds, D-Pittsfield, in a prepared statement. “Massachusetts has always been a leader when it comes to health care, and this legislation is the next step in our efforts to protect and empower consumers, encourage innovative health care and ensure access and affordability.”

Hinds said, “Our goal is to achieve long-term cost savings for the state, without sacrificing our unwavering commitment to high quality coverage for all.”

While senators frequently tout their bipartisan work, Democrats were unable to attract any Republican votes for their bill, which passed on a party line vote with the chamber’s six Republicans dissenting and objecting to solutions they said rely on more bureaucracy.

Whether any provisions actually make their way into law depends on action in the House, where Rep. Peter Kocot, Welch’s co-chairman on the Health Care Financing Committee, said Thursday he hopes to have a bill ready for debate early next year after he wraps up his own meetings and analysis. The Senate bill was developed by a group of senators, outside the traditional joint committee process.

Gov. Charlie Baker on Thursday said the bill “doesn’t save the state any money” and the Senate was “not trying to chase reforms that are going to make” MassHealth more affordable, one of the goals that punctuated the health care debate earlier this year.

“What they’re doing are chasing a variety of initiatives they believe will make the system better,” Baker told reporters.

Senate Ways and Means Chairwoman Karen Spilka, who has said the bill could yield $114 million in savings from MassHealth reforms and $475 million to $525 million from its commercial market reforms by 2020, said after the bill passed that she was “very surprised” and “dumbfounded” by Baker’s characterization.

“I understand the governor’s concerns,” Welch said. “He comes from the health care industry, comes from the insurance industry, and I’m sure obviously still has relationships in the health care industry that would make him concerned or that members of the health care industry might be concerned about. But I think the way we approached this bill is really to focus on the consumer.”

Debate began on Wednesday, and behind-the-scenes discussions both days involved negotiations around contentious measures proposing to automatically enroll MassHealth-eligible consumers participating in the home care program into Senior Care Options, a managed care program that covers services normally paid for through Medicare and MassHealth, with no co-pays. Senior advocacy groups opposed the plan.

During Thursday’s debate, Hinds led a bipartisan effort to secure language updating volunteer ambulance service staffing requirements in rural communities, according to the statement released by his office. Current law and regulations state that when transporting a patient receiving care at either the paramedic level of advanced life support or the non-paramedic level of basic life support an ambulance must be staffed with two emergency medical technicians.

Hinds’ amendment, based on pending legislation he has sponsored with Rep. Paul Mark, D- Peru, allows volunteer ambulance services in rural communities to transport a patient receiving care at the nonparamedic level of basic life support to staff the ambulance with one EMT and one first responder.

Updating this requirement to meet the needs and staffing realities of small rural volunteer ambulance departments is a major priority for many towns in Hinds’ Western Massachusetts district, which includes all of the Berkshires. The senator worked with many local stakeholders, including Rural Commonwealth, volunteer ambulance services, municipal officials, hospital administrators and the Department of Public Health to finalize the amendment language, which was passed unanimously.

 “This is a critical policy update for rural communities,” Hinds said. “It is also a glaring example of how state laws, often passed and implemented with the best intentions, do not always apply fairly across the state. Small, rural towns often have difficulty mobilizing two EMTs in time to help someone in dire need of medical attention. My amendment allows them to move more efficiently, respond to calls more effectively, and hopefully, when implemented, will save lives.”

“We remain fundamentally of a different mind that older people are smart enough to pick their own plans, but the Senate, I give them credit for working hard to come up with language that would protect older people from any kind of dislocation of service and to make sure that the people who arrange their care are not financially at risk,” Mass. Home Care executive director Al Norman told the News Service.

Some of the most heated moments in the two days of debate came as Republicans tried unsuccessfully to beat back an element of the bill they dubbed the “name and shame” list — an annual public report identifying the 50 Massachusetts employers with the highest number of employees “who receive medical assistance, medical benefits or assistance through the Health Safety Net Trust Fund.”

Tarr said the amendment was an attempt to shame people into changing their behavior, while Sen. John Keenan of Quincy said it was a way to gather data to understand how many people with access to employer-sponsored insurance are enrolling in MassHealth, and which employers are not providing coverage that’s accessible to their workers.

In a back-and-forth with Keenan, Tarr said the bill tries to “somehow avoid directly the problem” of increased enrollment and subsequent higher costs at MassHealth. He called the bill “incredibly cumbersome” and repeatedly said it defaults to bureaucracy instead of direct action to try to control costs.

Before passing the bill, senators agreed to modify the way it attempts to shrink the gap between rates paid to the most expensive, larger hospitals and lower-paid community hospitals.

“We view that this is a market failure, and we’re asking the market to correct itself, and if it is unable to do so, then and only then would you turn to government regulation,” Senate President Stanley Rosenberg said.

The bill would raise rates for lower-paid hospitals to 90 percent of the statewide average for the previous year, and set a target rate of growth for total hospital spending.

While senators stopped short of imposing a rate cap at the upper level, they adopted a Sen. Jamie Eldridge amendment specifying that efforts to meet the target “do not directly contribute to increased consumer health care costs.”

The Senate overwhelmingly endorsed studying how the costs of a single-payer health care model would compare to the state’s current health care spending, which the Center for Health Information and Analysis tallied at $59 billion in 2016.

On a 35-3 vote, the Senate adopted an amendment calling for state officials to measure health spending against the estimated costs of providing health care to all residents through a single-payer system. If the single-payer projections prove to be less costly, the Health Policy Commission would need to submit “a proposed single payer health care implementation plan” to the Legislature for potential action.

Sen. Julian Cyr, of Truro, the amendment’s sponsor, compared the current health care system to “one of those rubber band balls you get at Staples,” pointing to interconnected pieces that would be difficult to unwind without an extensive plan. He stressed the amendment would not commit the state to pursuing single-payer but said it would “keep all doors open.”

Tarr voiced concerns about the possible cost of a single-payer system, saying by some estimates it could double the state’s health expenditures, but ultimately voted for the amendment. Republican Sens. Vinny deMacedo, Ryan Fattman and Donald Humason voted against, and Sen. Richard Ross, a Wrentham Republican, voted present.

In 2012, a similar single-payer benchmark proposal failed 15-22 in the Senate.

The Ugly Consequences of Single-Payer Health Care

The late, great Nobel laureate economist Milton Friedman said it best: “There’s no such thing as a free lunch.”

Friedman’s pithy proverb reminds us that there is also no “free health care.” It’s a timely reminder, as Sen. Bernie Sanders, I-Vt., is making a public push for his “Medicare for All” bill.

While liberals have long advocated “single-payer” systems for health care, what’s new this time is that they are coalescing around a plan. Sixteen Senate Democrats are co-sponsoring Sanders’ bill, and 120 Democrats in the House have signed on to a similar approach.

Free Care?

This latest push for “single-payer” features the provision of “free health care” at the point of service from doctors, hospitals, and all other medical institutions.

The Sanders bill provides a comprehensive set of medical benefits and services, combined with “first dollar” coverage and outlaws all patient “cost-sharing,” meaning no deductibles, no co-insurance, no copayments of any kind. Zero.

Sounds great, right? Well, P.J. O’Rourke, a prominent political humorist, improves on Friedman: “If you think health care is expensive now, wait until you see what it costs when it’s free.”

Make no mistake: If Americans were ever foolish enough to take Sanders’ “single-payer” prescription, they would suffer a fiscal fever the likes of which they have never even imagined.

Read the full Heritage Foundation analysis of Sen. Bernie Sanders’ bill.

Last year, two separate analyses—one from the Urban Institute and another from professor Kenneth Thorpe at Emory University—outlined in dreadful detail the fiscal consequences of Sanders’ 2016 proposal.

Though the analysts differed on their assumptions and calculated conclusions based on different models, they both came to the same conclusion: The Sanders “single-payer” bill is going to cost the American people far more than the senator and his academic and congressional allies claim, and the taxes to finance this massive enterprise are going to be huge.

Last year, Sanders estimated that over 10 years (2017 to 2026), new federal spending for his “Medicare for All” proposal would amount to $13.8 trillion.

By getting rid of all private insurance, including the unnecessary marketing and administrative costs and simplifying the system by junking today’s public-private mélange of payment and delivery, ordinary Americans would see big savings compared to their current health care spending.

Well, not quite. Thorpe, a former policy adviser to President Bill Clinton, projected that the full, 10-year cost of the plan would be $24.7 trillion.

Scholars at the Urban Institute, a prominent liberal think tank, estimated a stunning 10-year cost of $32 trillion. According to the Urban analysts, the Sanders plan would come up $16.6 trillion short of the revenues necessary to fully pay for it. Socialism is expensive.

‘Feeling the Bern?’

While the Urban analysts did not model the tax impact of Sanders’ 2016 proposal, Thorpe did. He concluded that the senator’s 6.2 percent payroll tax, plus a 2.2 percent income-based premium tax, plus a whole series of special taxes on investments, dividends, “wealth,” and the hated “rich,” would not be sufficient pay for the program.

There are just not enough rich people to pay for socialized medicine.

Taxes would have to be higher—much higher. So Thorpe concluded that to fully finance Sanders’ plan, as the senator outlined it in 2016, would require a combination of higher payroll and income-based premium taxes, amounting to a 20 percent tax on income.

As for the promised savings for ordinary Americans? Forget it. Taxes on working families would be substantial.

To fully fund Sanders’ single-payer plan, Thorpe estimated, 71 percent of working families would end up paying more than what they pay now under current law.

Loss of Freedom

There are other costs beyond the dollars and cents. As we have noted in a recent Heritage Foundation analysis of Sanders’ updated version of his bill, Americans would lose big chunks of their personal and economic freedom.

Recall that when former President Barack Obama was campaigning relentlessly for Obamacare, he promised—falsely—that, “If you like you like your health plan, you will be able to keep your health plan.”

In fact, under Obamacare, you never really had the freedom to keep what you liked. In 2013, on the eve of the very first year of Obamacare’s full implementation, 4.7 million health insurance policies were cancelled across 30 states, whether enrollees liked them or not.

Over the last three years, Obamacare’s health insurance costs exploded while personal choice and market competition collapsed. By 2016, Americans in 70 percent of U.S. counties were left with only one or two options.

Sanders and his 16 Senate Democratic colleagues deserve applause for their refreshing honesty. They make no pretense whatsoever that you can keep your health plan, regardless of your personal wants, needs, or preferences. You don’t count.

Under the Sanders bill, almost all private health insurance would be outlawed, including your employment-based health coverage. Today, nearly 60 percent of working-age Americans get their health insurance through private, employer-based plans.

Likewise, persons enrolled in existing government health programs—Medicare, Medicaid, and the Children’s Health Insurance Program—would be absorbed into the new government health plan.

The Sanders bill not only abolishes private plans in the Obamacare exchanges, but kills off the popular and successful Federal Employees Health Benefits Program, which provides benefits to over 8 million current and former federal employees. For military dependents, Tricare would also be gone.

Curiously, the scandal-ridden Veterans Administration program and the troubled Indian Health Services would remain. Of course, both are ideologically correct: They are “single-payer” systems.

The Sanders bill would concentrate enormous power in the health and human services secretary, far beyond the already expansive administrative discretion that the secretary exercises today under Obamacare.

The secretary’s power would extend to the establishment of a national health care budget for all health care spending, provider payment, standards for provider participation, and the quality of care delivery.

Taxpayer funding of abortion, among other things, would be compulsory, and, at least from the language of the text, it appears that there would be no traditional conscience protections for doctors and patients opposed to unethical or immoral medical procedures.

The bill would allow for very limited private contracting between doctors and patients for medical care outside of the government system.

If a doctor and a patient wanted to contract privately for medical services, the doctor would have to give up treating all other patients enrolled in the government health plan and receiving reimbursement from the government for one full year.

Curiously, such an absurd restriction on personal freedom does not even exist in Britain’s National Health Service, the granddaddy of socialized medicine, where doctors freely practice in both the government program and the private sector.

Sanders and his colleagues have outlined a clear direction for America’s health policy: a government monopoly with centralized power over American health care financing and delivery; a massive increase in federal spending combined with promised savings that will not materialize; enormous tax increases that will reach deep down into the working class; new restrictions on personal and economic freedom; and, for patients who want or need something new and better, virtually no avenue of escape.

Sanders and his colleagues have put their vision—profoundly authoritarian—into legislative form. It is touted in the media and elsewhere as a viable alternative only in the wake of the Senate Republicans’ monumental failure to come together and enact an alternative to Obamacare.

Sen. John Barrasso, R-Wyo., recently asked the Congressional Budget Office to score the cost of the latest version of Sanders’ plan.

Meanwhile, the president and the Congress should explain to the American people how a patient-centered, market-based set of reforms will reduce health insurance costs, improve access to quality care, and expand their personal freedom.

In short, they should outline their vision—and fight for it.

How Democratic Socialists Convinced a Congressman to Sign Onto Single-Payer Health Care Bill

Michigan Democratic Rep. John Conyers has been introducing his single-payer health care bill for decades. But in the explosion of activism following the Bernie Sanders campaign and the pushback against GOP efforts to repeal parts of the Affordable Care Act, his bill HR 676 has suddenly become much more popular. It now has the support of the majority of the House Democratic caucus.

Last month, a group of activists with the Metro DC Democratic Socialists of America turned its sights to Virginia Rep. Don Beyer, one of the Democrats who had yet to sign onto HR 676.

They started their lobbying by calling Beyer’s office, said James McCormack, an activist with the Northern Virginia chapter of the Metro DC DSA.

“It was never something like ‘we don’t like the bill.’ It was always just, ‘We are looking into it. We’re studying it further,’” McCormack told The Intercept about the response from the congressman’s office.

When that didn’t work, they came up with a plan to directly confront Beyer. Numerous DSA members attended a September 17 town hall Beyer held, sharing their health care horror stories and asking the representative to sponsor the Conyers bill that would establish a universal health care system.

At first, Beyer was hesitant, telling the activists that there are “many problems with the legislation.” But after five activists took turns at the microphone asking Beyer to sponsor the legislation, he relented and announced his intention to sign on. On September 26, he was officially added as a co-sponsor to HR 676.

Beyer has “long supported universal healthcare and the idea of a single payer system,” said Press Secretary Aaron Fritschner, but he has also had some concerns about the Conyers bill, “including the need for greater specificity on how we pay for an expansion of Medicare, the timeline for the transition period, and how much decision-making we leave in the hands of the Secretary of Health and Human Services.”

Still, after hearing “the strong and heartfelt requests from his constituents,” Beyer agreed to cosponsor the bill since he supports its broad objectives, Fritschner told The Intercept, adding that the congressman supports other legislation that expand health care coverage, including the bipartisan Murray-Alexander bill.

The success was a real teaching moment for the DSA.

“It was our first real campaign as a branch together,” McCormack said in an interview. “This is a win for us, unequivocally”

Watch this short documentary about how DSA won Beyer’s support:

Top photo: Nurses and other health care activists rally for the passage of HR 676, single-payer/universal healthcare, in 2009 in Los Angeles.

NH rep proposes statewide single-payer health care

A proposal to create a single-payer health care system in New Hampshire drew mixed reactions in the House on Monday, with some denouncing it as a wayward fantasy and others heralding an opportunity for a conversation on broader reform.

The legislative service request, sponsored by Rep. Peter Schmidt, D-Dover, is titled “establishing a New Hampshire single payor (sic) health care system.”

A single-payer system is a taxpayer-funded health care model through which a government provides health care to its citizens in lieu of private plans. In recent years, the idea of implementing it nationwide has gained sway among the progressive wing of the Democratic Party, while turning away others. New Hampshire Sen. Jeanne Shaheen, a Democrat, endorsed it in September, breaking from Sen. Maggie Hassan, her Democratic junior colleague.

But Schmidt said New Hampshire is ready to try taking action on its own.

“The health care situation is very much in flux, nationally and here in New Hampshire,” he said Monday. “And the bottom line is it’s just utterly irresponsible for the New Hampshire Legislature not to engage in this situation.”

It is unclear exactly how the proposed Granite State single-payer system would work; Schmidt was unable to immediately provide a copy of his draft legislation to the Monitor. But the mere mention of the idea drew a polarized political response.

In an unprompted statement, House Majority Leader Dick Hinch, R-Merrimack, blasted the LSR, pointing to another state’s attempt to do the same: Vermont.

In 2011, the Green Mountain State’s Legislature passed a bill authorizing the creation of a single-payer health care system, giving then-Gov. Peter Shumlin a mandate to devise a plan by 2013. But by 2014, Shumlin, a longtime champion of the effort, backed away over cost concerns.

Following through on the effort would have required a 9.5 percent increase in state income taxes and an 11.5 percent hike to the payroll tax; one analysis estimated a $4.3 billion annual price tag within an annual budget of $4.6 billion. The plan was never set into action.

Hinch said the example should be a sobering one for New Hampshire.

“New Hampshire Democrats just need to look next door to Vermont to realize that single-payer health care is not feasible,” he said. “The fact that we’re seeing legislation to even study the issue baffles me. Vermont studied it, and rejected it because it would have bankrupted their state.”

But Schmidt dismissed the critique.

“That’s like saying that your cousin broke his leg skiing because he doesn’t know what he’s doing so you shouldn’t try skiing, even though you’ve been on the college ski team and you’ve been skiing all your life,” he said. “You can’t go down that hill because he can’t.”

He argued that New Hampshire, with more than twice Vermont’s 624,000 population, is better situated to take on single-payer. And he pointed to a second LSR of his, which would create a commission to study a New England-wide single health care system to pool costs, an approach he called more viable.

Schmidt, 89, was previously involved in the creation of the N.H. Healthy Kids program in 1994, a health care service that eventually transitioned into the state’s Children’s Health Insurance Plan (CHIP) in 1997. A beneficiary of Medicare himself, Schmidt said the present model for both low-income children and seniors can be scaled up for all residents of the state.

“So maybe some of my fellow Democrats will say ‘Oh well, that’s too radical; we can’t do this, we can’t do that,’ ” he said. “And I say: Why not? Because it works just fine for people over 65, and it works just fine in the rest of the world.”

Others on the House Health, Human Services and Elderly Affairs Committee are more reserved. Many, including Chairman Frank Kotowski, R-Hooksett, declined to directly comment on Schmidt’s proposal without seeing the drafted bill first.

Committee member William Marsh, R-Wolfeboro said the same. But speaking on the idea generally, Marsh argued the idea would never work.

To start, he said, the volume of health care services the state of New Hampshire currently outsources to Boston is too vast for the state to pay for or substitute itself. And while Marsh conceded that teaming up with other New England states might be more workable overall, he said the costs would still be prohibitive for the Live Free or Die State.

Meanwhile, Walpole Democrat Lucy Weber, who sits on the committee, said that, while she can’t comment directly on the LSR, she supports the idea of single-payer as a way eliminate wasted money and inefficiencies in the present system.

However, Weber said she doesn’t see it as a feasible approach in the New Hampshire Legislature.

“I tend to look at what’s in the art of the possible,” she said. “With the current makeup of the House and the Senate, I think it’s highly unlikely that we are going anywhere near a single-payer (system).”

But to Schmidt, who said he’d make his draft available later this week, the long political odds are worth it for the discussion the bill would spark.

In that respect, he has one major supporter. House Democratic Leader Steve Shurtleff, D-Penacook, said he also can’t comment on a draft bill he hasn’t seen. But he added that whatever its prospects – or ultimate suitability – the attention the bill would draw to policy reform would justify its submission.

“It’s good to put it on the table because people are talking about it,” he said Monday. “When they’re talking about single-payer, they’re talking about health care.”

(Ethan DeWitt can be reached at edewitt@cmonitor.com, or on Twitter at @edewittNH.)

State Dems say we need single-payer health care

As they make their case for shifting to single-payer health care, two Democrats hoping to seize the Corner Office next year are pointing to soaring premium increases for individuals who purchase insurance through the Massachusetts Health Connector.

After President Donald Trump last week announced he would end subsidies the federal government pays monthly to insurers to defray the costs of some plans — known as cost-sharing reduction payments — the Health Connector on Thursday said it would raise its rates for next year more than originally anticipated, to cover the lost funds.

The decision means some 80,000 people are facing premium increases of about 26 percent.

Jay Gonzalez and Setti Warren, Democrats vying for their party’s gubernatorial nomination in 2018, each said the move highlights affordability problems in the state’s health care system and called for a single-payer model instead.

“Too many people in Massachusetts are already struggling with health insurance they can’t afford to use,” Warren, the mayor of Newton, said in a statement to the News Service. “The political games being playing [sic] in Washington will only make it worse until we recognize that the only way to ensure health care as a basic right is to implement a single-payer system right now. Across the Commonwealth, I’ve talked to too many people who already have to decide between filling a prescription or buying food or between scheduling a doctor’s appointment and making a mortgage payment. That’s wrong. If Health Connector rates shoot up next year, even more Massachusetts families will be left behind.”

A report released last month by the Center for Health Information and Analysis found that health insurance premiums in Massachusetts increased by an average 2.6 percent in 2016, to $464 per member per month, while average regional income increased by 2.9 percent and inflation was 1.5 percent. Health insurance cost-sharing climbed 4.4 percent to $49 per member per month, or $587 annually.

Gonzalez, who was CEO of the health insurer CeltiCare, called Trump’s decision to end the subsidies “terrible” for Massachusetts and the country.

“It’s going to put a real burden on a lot of people, thousands of people in Massachusetts, and possibly make their health insurance unaffordable for them, and that’s a bad outcome,” Gonzalez said. “So we should be doing, and our governor should be doing, everything he possibly can to prevent this from happening in Washington, and advocating as much as we can for Congress to overturn this decision and meanwhile, actually have a plan for how to deal with it here.”

Gov. Baker wrote a letter to the state’s Congressional delegation Thursday, informing them of the higher Connector rates and asking them to “work with your colleagues and with states to make health care reforms that will preserve and expand gains in coverage, while controlling costs for consumers.” In the letter, he said his administration “is committed to taking whatever steps are necessary to protect the stability of the health insurance market for 2017” after Trump ended the cost-sharing subsidies.

Rate shock underscores need for single-payer health care


be4f0_20171020__BREAKINGNEWSShock~p1_200 Rate shock underscores need for single-payer health care

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Sun staff photos can be ordered by visiting our SmugMug site.

By Katie Lannan

STATE HOUSE NEWS SERVICE

BOSTON — As they make their case for shifting to single-payer health care, two Democrats hoping to seize the Corner Office next year are pointing to soaring premium increases for individuals who purchase insurance through the Massachusetts Health Connector.

After President Donald Trump last week announced he would end subsidies the federal government pays monthly to insurers to defray the costs of some plans — known as cost-sharing reduction payments — the Health Connector on Thursday said it would raise its rates for next year more than originally anticipated, to cover the lost funds.

The decision means some 80,000 people are facing premium increases of about 26 percent.

Jay Gonzalez and Setti Warren, Democrats vying for their party’s gubernatorial nomination in 2018, each said the move highlights affordability problems in the state’s health care system and called for a single-payer model instead.

“Too many people in Massachusetts are already struggling with health insurance they can’t afford to use,” Warren, the mayor of Newton, said in a statement to the News Service. “The political games being playing [sic] in Washington will only make it worse until we recognize that the only way to ensure health care as a basic right is to implement a single-payer system right now. Across the Commonwealth, I’ve talked to too many people who already have to decide between filling a prescription or buying food or between scheduling a doctor’s appointment and making a mortgage payment.

That’s wrong. If Health Connector rates shoot up next year, even more Massachusetts families will be left behind.”

A report released last month by the Center for Health Information and Analysis found that health insurance premiums in Massachusetts increased by an average 2.6 percent in 2016, to $464 per member per month, while average regional income increased by 2.9 percent and inflation was 1.5 percent. Health insurance cost-sharing climbed 4.4 percent to $49 per member per month, or $587 annually.

Gonzalez, who was CEO of the health insurer CeltiCare, called Trump’s decision to end the subsidies “terrible” for Massachusetts and the country.

“It’s going to put a real burden on a lot of people, thousands of people in Massachusetts, and possibly make their health insurance unaffordable for them, and that’s a bad outcome,” Gonzalez said. “So we should be doing, and our governor should be doing, everything he possibly can to prevent this from happening in Washington, and advocating as much as we can for Congress to overturn this decision and meanwhile, actually have a plan for how to deal with it here.”

Baker wrote a letter to the state’s Congressional delegation Thursday, informing them of the higher Connector rates and asking them to “work with your colleagues and with states to make health care reforms that will preserve and expand gains in coverage, while controlling costs for consumers.” In the letter, he said his administration “is committed to taking whatever steps are necessary to protect the stability of the health insurance market for 2017” after Trump ended the cost-sharing subsidies.

Baker on Wednesday joined nine other governors on a letter to Congressional leaders, urging them to fund the payments through 2019.

Last month, the Baker administration submitted a waiver request to the federal government, seeking to establish a “premium stabilization fund” in lieu of the cost-sharing reduction payments.

The Swampscott Republican also proposed MassHealth and commercial market reforms this summer, the bulk of which were rejected by lawmakers who said they wanted to develop their own plans. The Legislature did agree to impose new employer assessments to help cover the cost of workers who opt for MassHealth coverage instead of insurance through their employers, and a group of senators this week released a health care bill they hope to debate in November. 

Gonzalez, of Needham, said he wants the state to “implement a single-payer system that actually achieves better outcomes for people, is simpler for people to navigate and is financially sustainable over time,” and that Baker “keeps putting Band-Aids on a system that has gaping wounds.”

“The system we have today is not working for people, and it’s not financially sustainable,” said Gonzalez, who served as Gov. Deval Patrick’s budget chief. “It’s crushing state government in terms of its costs, it’s crushing businesses, and we need leadership on this issue. We need a governor who’s actually going to try to aim higher, try to be proactive about taking us to a place where we reform our system in a way that’s going to work better for people and be sustainable, and that’s what my focus would be as governor.”

While the state Democratic Party includes single-payer health care in its platform, Democrats who have run the Legislature for years have not embraced the idea and changing that dynamic would be a big lift for any governor.

Sen. Jamie Eldridge and Rep. Denise Garlick have filed bills to set up a state-run, “Medicare for all” single-payer system in Massachusetts. Garlick’s bill (H 2987) has 43 cosponsors, and Eldridge’s (S 619) has 37. There are currently 196 people in the Legislature.

Single-payer would drastically change American health care; here’s how it works

As Republican efforts to repeal and replace the Affordable Care Act continue in the background, some Democrats are starting to eye a new health policy goal: implementing a single-payer system. Sen. Bernie Sanders, I-Vt., introduced a single-payer bill in mid-September with 16 Democratic co-sponsors — 16 more than he got when he introduced the bill two years earlier. But how is the health care system funded now, and how would “single-payer” change that?

How health care systems are funded

There are three major components to every health care system, single-payer or not: a patient, a payer (typically an insurance company or the government) and a provider. Here’s how money moves between them:

How multipayer systems work

Congressional Budget Office. That would be partially offset by people no longer needing to pay premiums to private insurers, however, and the government’s monopoly could allow it to implement cost-saving measures.

Medicare (as opposed to Medicare Advantage) operates in the United States. The government pays for a large portion of medical services, but it’s common for people to buy complementary Medigap plans from the private insurance market. And it’s common for people to buy supplementary Medicare Part D plans from private insurers to cover prescription drugs, which are not covered by traditional Medicare.

Countries with universal coverage sit on a spectrum from the least pure to the most pure single-payer — that is, governments that offer the least comprehensive care, where complementary or supplementary insurance is more necessary, to those that offer the most comprehensive health care coverage, with little need for private insurance. (Where one draws the line for “single-payer” vs. merely “universal coverage” is debatable, and largely a semantic problem.)

Some countries, such as Norway, are closer to the “pure” end. They offer such comprehensive coverage that complementary or supplementary private insurance makes up just a small piece of the system. In Canada, by contrast, 29 percent of health care spending comes from the private sector, and about two-thirds of Canadians hold some sort of private supplementary insurance, according to a report from the Commonwealth Fund.

It’s yet to be seen whether Democrats will coalesce around a single-payer plan, and if so, where it will fall on this spectrum.

Icons by The Washington Post’s Aaron Steckelberg.

Among Democrats running for governor, single-payer health care gains support – TwinCities.com

In the midst of the divide and confusion over health insurance’s future, Minnesota Democrats who would be governor are near united in their prescriptions: Universal and single-payer is the way forward.

In a recent debate before a union-member crowd, the half-dozen Democratic-Farmer-Labor candidates gave nods to supporting universal health care, meaning everyone would be covered by health insurance. Four of the six proudly said they supported a single-payer health care model, meaning a publicly financed system. Last week, Democrat Rebecca Otto, the state’s auditor, came out with a lengthy Minnesota-based plan to finance health care.

The leading Democrats to replace DFL Gov. Mark Dayton would give the state a radically different debate than it has ever had on health insurance. The politics of health care have changed dramatically since 2010, when Minnesota had its last gubernatorial election with no incumbent.


RELATED: Who is running to be Minnesota’s next governor?


Since then, the country and state have grappled with the rocky rollout of the ACA, known as Obamacare, seen health insurance costs leap and the number of uninsured decrease. Now, in Washington, D.C., with a new president and Republican-controlled Congress, the debate is how and whether the GOP can repeal the federal health care law. So far, the repeal attempts have failed.

Dayton has long said he supports single-payer health care but on a national level and only this year came out with a public option to allow all Minnesotans to buy into a state system. The Republican Legislature rejected Dayton’s proposal.

If a Democrat wins the 2018 election, he or she may struggle with similar political realities. Earlier this year, deep blue California tabled a measure to bring single-payer health care to that state.

REPUBLICANS WAGING DIFFERENT FIGHT

Minnesota Republicans are having a debate of their own on their equally crowded side of the governor’s race. Among Republicans, the theme is getting distance from MNsure, the health exchange created after the federal government rolled out the Affordable Care Act.

In a flare-up among Republicans last month, former party chair-turned-candidate Keith Downey accused fellow candidate Matt Dean of not working hard enough to rescind MNsure at the Capitol. Dean, a state representative from Dellwood, hit back that he has “devoted my legislative priorities to killing” MNsure and called Downey’s attacks “embarrassing and tragic.”

The GOP Legislature earlier this year approved millions in state spending to subsidize those with skyrocketing increases in their health insurance costs and to fund a multimillion dollar reinsurance plan to keep costs down.

Meanwhile, through executive actions, President Donald Trump has opened the health insurance market to plans that do not meet Obamacare standards and ended certain federal subsidies for health insurance. Minnesota is suing over the latter.

“ObamaCare is a broken mess,” the president said on Twitter. “Piece by piece we will now begin the process of giving America the great HealthCare it deserves.”

National and state Republicans have dismissed Democratic support for single-payer health care as a doomed, budget-busting, big-government takeover of patients’ most crucial rights.

GROWING SINGLE-PAYER SUPPORT

For most Democrats running for governor, however, fighting to keep and improve Obamacare is not enough. That’s a reflection of the growing support for government-paid health care.

“A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a ‘single-payer’ approach to health insurance,” a Pew Research survey found this summer.

5d4f6_ft_17-06-23_healthcare_310px Among Democrats running for governor, single-payer health care gains support - TwinCities.com
Survey results from the Pew Research Center, June 23, 2017 (Courtesy Pew Research Center)

More than half of Democrats in the national survey said they supported health care coverage through “a single national government program.” That support is likely stronger among the Minnesota DFL activists who will winnow the gubernatorial field before next November.

The idea of single-payer health care is not new. More than 40 years ago, a health care prognosticator predicted in the Atlantic Magazine that “national health care,” presumably financed by the federal government, was just a few years away.

But it is getting new life.

“I’d argue on health care, we’ve exhausted every other alternative,” said longtime state Sen. John Marty, DFL-Roseville. Marty, who has run for governor twice, has long pushed for a universal, Minnesota-based health-coverage system. He has introduced measures in the Legislature to make it happen and written a book about what he calls the “Minnesota Health Plan.”

At the DFL candidates forum in Duluth this past week, Otto and state Reps. Erin Murphy and Tina Liebling all said pointedly that they supported single-payer health care.

“I’m a single-payer supporter,” said Rep. Erin Murphy, a nurse who has long represented St. Paul in the Minnesota House. “I don’t want to wait for Congress. I don’t have a lot of faith in Congress.”

State Rep. Paul Thissen, of Minneapolis, said he supported ‘Medicare for all,” a single-payer system being pitched by U.S. Sen. Bernie Sanders, I-VT, and others in Washington.

St. Paul Mayor Chris Coleman said health care should be universal, comprehensive and affordable, and U.S. Rep. Tim Walz of Mankato said he backed “universal access to health care.”

‘A PATH’

Otto, the three-term state auditor now running for governor, has given the most detail on her plan. She proposes to funnel all the current state and federal health care dollars into a single trust fund, bolstered with cash from new taxes, and deliver health care coverage to all Minnesotans.

‘If you are a Minnesota resident, you are covered and that’s it,” she said.

Her proposal would do away with co-pays and deductibles — and much of the role insurance companies play now. Instead, health care providers would be paid quarterly per patient, with incentives to keep people healthy. She said the state would come up with a set of minimum benefits that all residents would receive and businesses or individuals could supplement those if they wished.

The plan still has some blank spaces in it. She said she would work with lawmakers and others to figure out how and on whom to raise taxes. Otto acknowledged that the federal funds Minnesota got for health care in the past may not be there in the future and that political realities at the Minnesota Capitol and in Washington, D.C., might make approval of her plan difficult or impossible.

“What I’m creating here is a path,” she said. “Somebody has to talk about this and I am willing to talk about this.”

Among Democrats, she is not alone in that willingness.

Why business should demand single-payer health care – The San Diego Union

The powerhouse of America’s economy — small business — is being sabotaged. Yes, sabotaged — not by taxes, but by our health care system.

Take it from Warren Buffett, chief executive of Berkshire Hathaway, who referred to our health care system as “the tapeworm of American economic competitiveness.” He asserts that medical costs harm the economy much more than taxes, and he and Berkshire’s vice chairman Charlie Munger (a Republican) favor a single-payer solution, sometimes referred to as “Medicare-for-all.”

Small businesses are a huge sector of the California economy, representing more than 99 percent of all state businesses and providing jobs for 6.8 million, nearly half of all California’s private employees.

Related: Why single-payer health system is too costly

Single-payer health care means you might be denied surgery for being too fat — no, really


Sanders’ single-payer health care: Price tag in perspective

Senator Bernie Sanders’ (I., Vt.) single-payer health care proposal is estimated to cost $32 trillion over a decade. Here’s where else the U.S. could otherwise spend that money.

Do people who are overweight or obese deserve health care? In the United Kingdom’s socialized health care system, the answer appears to be “no.” And if Democrats get their way, the same could be true in the United States.

To save money, the U.K. National Health Service recently announced it will ban obese patients from many surgeries for up to a year. Such rationing is standard in single-payer health care systems. Americans will face the same fate if Democrats can enact Medicare for All here. 

Sen. Bernie Sanders, I-Vt., recently introduced his Medicare for All bill backed by 15 other Democratic senators. His call to create such a single-payer health care system was a major part of his failed campaign for the Democratic presidential nomination last year.

Known as “lifestyle rationing,” the new British policy debunks the myth that single-payer systems deliver truly universal health care.

In addition, Sen. Elizabeth Warren, D-Mass., is urging Democrats to make single-payer a centerpiece of their upcoming campaigns.

Known as “lifestyle rationing,” the new British policy debunks the myth that single-payer systems deliver truly universal health care.

The rule applies to patients with a body mass index of 30 or higher. It would hit a 5-foot-10 man who weighs more than 209 pounds, or a 5-foot-4 woman who weighs more than 174 pounds. These patients will have to wait a year, or lose 10 percent of their weight, before they can receive elective surgeries like hip or knee replacements.

The National Health Service in Britain believes such discriminatory rationing is the “best way of achieving maximum value from the limited resources available.”

Of course, overweight people aren’t the only ones denied care in single-payer systems. The bureaucrats who run them have little choice but to ration care for everyone.

When patients pay virtually nothing for health care, they have little incentive to limit their consumption. If someone feels even slightly under the weather, he or she can immediately go to the doctor and demand medicine, rather than simply rest up and hydrate. So patients flood doctor’s offices and hospitals.

With no market forces at work to regulate demand, the only way for the government to keep costs under control is to forcibly limit the supply of medical services.

Single-payer systems do so by offering doctors and hospitals relatively paltry sums for their services. The average general practitioner in the United Kingdom earns about $130,000 per year. By contrast, a general practitioner in America earns over $200,000 annually, on average.

This combination of lower pay and seemingly limitless demand for care is causing many British doctors to leave the medical field – or go elsewhere to practice. There are 7,000 fewer doctors in the United Kingdom today than in 2005. In just the first month of this year, nearly 300 doctors applied for certificates to work overseas.

In addition, fewer medical students are completing their educations. In 2016, half of junior doctors left the National Health Service after their first two years of training. That is an abrupt increase from 2011, when less than three in ten junior doctors exited.

As a result, the National Health Service is in the midst of an unprecedented staffing shortage. More than 30,600 positions are currently vacant. Almost 40 percent of those openings are for nurses and midwives.

So patients wait. More than 4 million are standing by for surgery – the highest figure in a decade.

The single-payer system in Canada is hardly better, particularly for patients seeking specialist care. According to the Fraser Institute, the median wait time between referral from a general practitioner and treatment by a specialist in 2016 was 20 weeks – the longest on record.

America’s own experiment with single-payer – the Veterans Health Administration in the Department of Veterans Affairs – is a national embarrassment. A federal investigation found that more than 200 veterans died while waiting for care at a Phoenix VA facility in 2015. The same is true of almost 100 veterans at a Los Angeles VA hospital between October 2014 and August 2015.

These horror stories are worth remembering now that the apparent failure of the GOP’s health care reform effort has revived calls for single-payer in the United States.

Some U.S. doctors appear to be falling in line behind liberal icons Bernie Sanders and Elizabeth Warren. According to a new survey from Merritt Hawkins, a physician recruiting firm, 42 percent of doctors strongly support single-payer. Fourteen percent are somewhat supportive.

Supporters of single-payer health care should realize the error of their ways, because single-payer isn’t a shortcut to universal health care. As the experiences of other countries prove, it’s a pathway to grotesque rationing, long waiting lines and needless suffering. 

Bay Area political events: Single-payer health care, Haiti

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Political events in the Bay Area

Single-payer: Peter S. Arno, senior fellow and director of health policy studies at the Political Economy Research Institute, University of Massachusetts, Amherst, will speak on single-payer health coverage for the state and how to pay for universal coverage. 3-5 p.m. Sunday at 1333 Pine St. in Martinez.

Haiti: A screening of a new documentary, “Serenade for Haiti,” at 7 p.m. Wednesday at the Roxie Theater, 3117 16th St. in San Francisco, with a question-and-answer session following. The screening will benefit Engineers Without Borders working in Haiti. http://bit.ly/2hSWieo


Democracy, explained: Learn how to run a campaign and get appointed to a commission from the Lamorinda Democratic Club. 7 to 9 p.m. Thursday at the Lafayette Library and Learning Center, 3401 Mount Diablo Blvd. Features elected officials, campaign managers and consultants. http://bit.ly/2wCoUuI

Civil discourse: The League of Women Voters of North and Central San Mateo County holds an interactive workshop on civil discourse. 1 to 3 p.m. Oct. 24 at the Silicon Valley Community Foundation, 1300 El Camino Real, San Mateo. http://bit.ly/2xo4EfV

Limits of whiteness: Neda Maghbouleh, assistant professor of sociology at University of Toronto, will lecture on how Iranian Americans move across a white not-white color line, discussing race in North America today. The lecture runs from 12:30 to 1:30 p.m. Oct. 26 at the Humanities Auditorium at San Francisco State University. http://bit.ly/2fHvtFF

Black Panther history: Joshua Bloom and Waldo E. Martin Jr., authors of “Black Against Empire: The History and Politics of the Black Panther Party,” discuss their book at the San Francisco Main Library’s Koret Auditorium. 1 p.m. Oct. 29. Information about this event and others noting the book’s selection in the One City One Book program: http://bit.ly/2eTr1mz

To list an event, email Annie Ma at ama@sfchronicle.com

Bay Area political events: Media and single tax-payer health policy

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Political events in the Bay Area

Politics and media: Longtime San Francisco journalist Tim Redmond discusses media coverage and the Trump administration. Event begins at 3 p.m. in the Richmond Meeting Room of the Sen. Milton Marks Branch Library, 351 Ninth Ave., San Francisco. http://bit.ly/2wJub72

Single-payer: Peter S. Arno, senior fellow and director of health policy studies at the Political Economy Research Institute, University of Massachusetts, Amherst, will speak on single-payer health coverage for the state and how to pay for universal coverage. The event will be at 1333 Pine St. in Martinez from 3-5 p.m.


Haiti: A screening of a new documentary “Serenade for Haiti” will be held at 7 p.m. at the Roxie Theater with a question and answer session following. The screening will benefit Engineers Without Borders working in Haiti. http://bit.ly/2hSWieo

Democracy, explained: Learn how to run a campaign and get appointed to a commission from the Lamorinda Democratic Club, from 7-9 p.m. The event will be held from 7 to 9 p.m. at the Lafayette Library and Learning Center, featuring elected officials, campaign managers and consultants. http://bit.ly/2hGwXnJ

Limits of Whiteness: Neda Maghbouleh, assistant professor of sociology at University of Toronto, will lecture on how Iranian Americans move across a white not-white color line, discussing race in North America today. The lecture runs from 12:30 to 1:30 p.m at the Humanities Auditorium at the San Francisco State University. http://bit.ly/2fHvtFF

Black Panther history: Joshua Bloom and Waldo E. Martin Jr., authors of “Black Against Empire: The History and Politics of the Black Panther Party,” discuss their book at the San Francisco Main Library’s Koret Auditorium. 1 p.m. Oct. 29. Information about this event and others noting the book’s selection in the One City One Book program: http://bit.ly/2eTr1mz

To list an event, email Annie Ma at ama@sfchronicle.com

Why single payer health care is a terrible option

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Five lessons from Canada on single-payer health care

The United States is about to debate the merits of Bernie Sanders’ proposal for a single-payer health care system. While cost will be an issue, evidence shows that many countries provide access to quality care for all their citizens through a single-payer model while spending far less than the U.S. does now.

How can this be?

Single-payer systems are often promoted as a means to achieve social justice. But they are also more economically efficient than the private market alternative. Having one payer simplifies the administration of health care by avoiding multiple insurers processing claims.

Costly administration is one reason why the U.S. spends by far the greatest percentage of gross domestic product on health care in the Organization for Economic Co-operation and Development (while having the largest percentage of uninsured).

Poll: Majority supports single-payer health care

A slim majority of Americans support a single-payer health-care system that is funded and administrated by the government and eliminates private insurers, according to a new poll.

The latest Harvard-Harris Poll survey found 52 percent favor a single-payer system against 48 who oppose it. A strong majority of Democrats — 69 percent — back the idea. Republicans oppose single-payer, 65-35, and independents are split, with 51 percent opposing and 49 supporting.

“Given all of the discontent with health care and desire for coverage, single-payer has more support than I have seen in the past, with the country split down the middle,” said Harvard-Harris Poll co-director Mark Penn. “But health-care questions like this are before there has been a public debate on the costs and the effect of a single source for plans and we have often seen support disappear after that kind of debate.”

Sen. Bernie Sanderscdf69_sandersbernie_052317gn2_lead Poll: Majority supports single-payer health careBernard (Bernie) SandersOvernight Defense: Senate passes 0B defense bill | 3,000 US troops heading to Afghanistan | Two more Navy officials fired over ship collisions Senate passes 0B defense bill Dems fear lasting damage from Clinton-Sanders fight MORE (I-Vt.) introduced a “Medicare for all” bill earlier this year to much acclaim from the left.

But the bill has no chance of passing the GOP-controlled Congress and was greeted coolly by Democratic leadership and swing-state Democrats running for reelection in 2018. 

However, the bill attracted support from potential 2020 Democratic presidential contenders, such as Sens. Elizabeth Warrencdf69_sandersbernie_052317gn2_lead Poll: Majority supports single-payer health careElizabeth Ann WarrenSenate Dems hold floor talk-a-thon against latest ObamaCare repeal bill Trump bets base will stick with him on immigration Dems call for action against Cassidy-Graham ObamaCare repeal MORE (Mass.) and Cory Bookercdf69_sandersbernie_052317gn2_lead Poll: Majority supports single-payer health careCory Anthony BookerSenate Dems hold floor talk-a-thon against latest ObamaCare repeal bill Grassley: ‘Good chance’ Senate panel will consider bills to protect Mueller Overnight Finance: GOP plans to unveil tax framework in late September | Critical stretch for Trump tax team | Equifax CEO called to testify | Sanders unveils single-payer bill MORE (N.J.). It was viewed by many on the left as a watershed moment for liberals.

When voters are told that Sanders and Warren are attached to the bill, 33 percent said they support it, 29 percent oppose and 38 said they didn’t have enough information to have an opinion. Knowing who is attached to the bill, most Republicans opposed it, most Democrats supported it and most independents said they didn’t know enough about it.

The best-polling aspect of single-payer is the public’s belief that it will cover more people. Sixty-nine percent said it would provide more coverage, including 54 percent of Republicans.

The public is largely split on every other question, with 51 percent saying the government should provide all health care and 49 saying it should only subsidize health care for the poor and elderly.

“Young people were most supportive of single-payer, while seniors, who use the most health care, reject it by a wide margin,” said Penn.

Fifty-one percent said the single-payer system will lead to runaway government spending and higher taxes, against 49 percent that said it would work out. Fifty-three percent said a single-payer system would restrict people’s choices in medical care.

Fifty-two percent said a government-run system would save the health-care system money, while 48 said it would be more expensive. 

Fifty-two percent said single-payer will improve the efficiency of the health-care system, and 53 percent said they believe they’d be able to keep their current doctor.

The Harvard-Harris Poll online survey of 2,177 registered voters was conducted from Sept. 17 to 20. The partisan breakdown is 37 percent Democrat, 31 percent Republican, 28 percent independent and 4 percent other.

The Harvard-Harris Poll is a collaboration of the Harvard Center for American Political Studies and The Harris Poll. The Hill will be working with Harvard-Harris Poll throughout 2017. 

Full poll results will be posted online later today. The Harvard–Harris Poll survey is an online sample drawn from the Harris Panel and weighted to reflect known demographics. As a representative online sample, it does not report a probability confidence interval.

Newt Gingrich: Health care in America — the single-payer disaster


Look Who’s Talking: Newt Gingrich

Former speaker of the house sounds off on Graham-Cassidy health care bill

A recent poll should worry all Americans who care about the quality and availability of health care in our country.

According to POLITICO/Morning Consult, 49 percent of American voters say they would support a single-payer health care system, where the only provider of health insurance in the United States would be the federal government.

Think about that: The same federal government that runs Medicaid and Medicare – both of which lose an estimated $70 billion to $110 billion annually to fraud – would be the sole option for your family’s health insurance.

Not surprisingly, 67 percent of Democrats said they are in favor of having the government completely take over our health insurance system – a figure that is up from 54 percent in April. This shows the growing influence that Vermont Sen. Bernie Sanders, who recently introduced a “Medicare for All” bill, continues to exert over the Democratic Party. What’s truly alarming though is that even 33 percent of Republicans polled said they support a single-payer health care system.

These results suggest that in the midst of arguing over ObamaCare and the merits of the various “repeal and replace” bills, some basic truths have been forgotten.

It is time to go back to basics. 

The most important principle to understand in the debate over health care is that government-dominated systems lead to scarcity and rationing.  It is why we see the same food lines and starvation in Venezuela today that we saw last century in Soviet-run countries.

In single-payer health care systems, scarcity and rationing often take the form of long wait times. The Red Cross recently declared that Great Britain, which has a single-payer system, faced a “humanitarian crisis” of hospital bed and doctor shortages. Two people recently died at a British hospital after waiting more than 30 hours in a hospital hallway for treatment.

If this situation sounds familiar, it is because the U.S. Department of Veterans Affairs Health Administration, another government-run health care system, faces a similar crisis of long wait times due to years of bureaucratic inefficiency. (Fortunately, under the leadership of President Trump and VA Secretary David Shulkin, this problem is being fixed, in part by offering veterans more non-government health care provider options.)

Other times, scarcity and rationing take the form of government refusing to pay for treatments that you and your doctor think are best for your health.

In Britain’s case, the government – not the patient or doctor – has the final say on what treatments are covered.

According to National Health Service Constitution for England: “You have the right to drugs and treatments that have been recommended by NICE for use in the NHS, if your doctor says they are clinically appropriate for you. You have the right to expect local decisions on funding of other drugs and treatments to be made rationally following a proper consideration of the evidence. If the local NHS decides not to fund a drug or treatment you and your doctor feel would be right for you, they will explain that decision to you.” (Emphasis added).

The British government justifies its decisions through “comparative effectiveness” studies. But in modern medicine, which is becoming increasingly personalized, this is extraordinarily dangerous.

If studies show Drug A is 70 percent effective at treating a disease, while Drug B is only 50 percent effective, the government may decide to cover Drug A over Drug B, regardless of what your doctor recommends. Medicine is rarely one-size-fits-all, and if you are a person for whom Drug A does not work, then you may be paying big for Drug B.

Ultimately, single-payer health care suffers from the same problem that former British Prime Minister Margaret Thatcher identified as the issue with all of socialism: “Eventually you run out of other people’s money.”

In 2014, Vermont tried to pass a single-payer system. The state that gave us Bernie Sanders wanted to be the liberal torchbearer that would show the nation how great a government-run system could be.

Then reality set in.

Democratic Gov. Peter Shumlin realized he would have to raise the state’s payroll tax to 11.5 percent and set premiums at nearly 10 percent of people’s income.

According to The Washington Post, Shumlin determined the plan would be bad for Vermonters, saying “the potential economic disruption and risks would be too great to small businesses, working families and the state’s economy.”

Three years after Vermont’s single-payer effort fell apart, California’s state Senate passed a single-payer health care bill in June of this year.

Even upon passage, the Democrats in the state acknowledged it was an incomplete, wildly expensive piece of legislation that had no hope of going anywhere. The plan would cost $400 billion a year. Lawmakers would have to raise the state’s payroll tax to 15 percent in order to raise the additional $200 billion in annual revenue required to afford the plan.

Republicans must remember these examples – and once again get into the habit of regularly communicating conservative principles and policies.

If we don’t focus on winning the basic arguments about the merits of free markets over socialism, the left will continue to try to convince every new generation of American voters that destructive policies like single-payer health insurance are reasonable.

If we let the left win, America will be fundamentally changed in a matter of decades. That new America would be less healthy, less prosperous and less free.




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