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Thursday, January 8, 2015

Health Care Reform Articles - January 8, 2015

The following article by Adam Gaffney is the best summary and analysis I've yet seen about what's going on in Vermont, and its implications for Single Payer movements elsewhere.

- SPC

Lessons From Vermont

What does Vermont’s failed single-payer plan tell us about future reform efforts?

By A.W. Gaffney, M.D.
Jacobin magazine, Jan. 8, 2015
Has the tide of health care justice turned — in the wrong direction? Last month, Vermont Governor Peter Shumlin announced that he could no longer “responsibly support” a funding plan for his long-awaited “single-payer” plan for the state. It wasn’t long before some on the Right claimed a historic victory.
“As crises of faith go,” the Wall Street Journal editorial board gloated, “this is Mikhail Gorbachev circa 1991 territory.” After all, single-payer health care, according to the Journal, is not merely “the polite term for socialized medicine,” but nothing less than “the ultimate goal of the political left.”
Now, inapt historical analogies aside, it is fair to concede the Journal’s point that universal health care has long been on the left and progressive agenda, from the “[f]ree medical care, including midwifery and medicines” called for by the 1891 Erfurt Program onward.
But the meaning and roots of Vermont’s about-face are more complicated than the dominant narrative now emerging in the mainstream media — as is even characterizing the Vermont plan as “single-payer.” For those of us who see real universal health care as foundational to an egalitarian society, a deeper analysis of the still-evolving events in Vermont is critical. So what has happened in the Green Mountain state, what has changed, and where do we go from here?
http://www.pnhp.org/print/news/2015/january/lessons-from-vermont

Haslam: Moving forward with health care
December 20,2014
This week, we witnessed Gov. Peter Shumlin giving up his role in Vermont’s move to universal health care, as he caved to pressure from big businesses. His misguided decision marks the end of a politician’s ambitious career, but not that of universal, publicly financed health care. The governor’s failure to deliver a common-sense plan for shifting from private to public health care financing reveals the powerful opposition to completing such a shift, as evidenced once again in recent comments by the National Life Group and other big companies. Shumlin’s decision was political, not economic. 

Vermont can and must move forward — with or without Shumlin — to secure the human right to health care for everyone. Without guaranteed access to care, the human rights crisis in our state will continue unabated. Too many people suffer from poor health, financial hardship and agonizing choices between filling their prescriptions, putting food on the table or paying rent. Growing inequity in our state, which leaves one in every five young children in poverty, signals a much deeper problem, yet the market-based health care system has a lot to do with it. An insurance system that sells health care as a commodity to those who can pay exemplifies how our entire economy is set up to make money off underpaid workers and channels profits to corporations that excel in avoiding taxation.

The Health Care is a Human Right Campaign set out in 2008 to build a movement led by people impoverished and excluded by the market insurance and economic system, with a view to changing what is politically possible in our state. When we first met with Peter Shumlin in 2009, he said he believed universal health care was not possible, yet as we succeeded in shifting public discourse, he changed tack to do what was politically expedient. Yet his support for universal health care always rested on a pro-business agenda that sought to maintain and expand an economy benefiting the few. 

As long as universal health care appeared to be aligned with lowering costs for big businesses, Shumlin largely followed the road set out by Act 48. However, he did so without seeking public input or meeting required deadlines, instead discussing his plans primarily with his Business Advisory Council on Health Care Financing. In successive state budgets, he pitted health care against education, social programs, a livable wage and paid sick days, cutting the budget by raising the specter of future health care taxes. When it became apparent that universal health care would only work when equitably financed, with big businesses paying their fair share, Shumlin switched sides again and abandoned his obligations under Act 48.

Universal, publicly financed health care is about economic change — it’s about making our economy work for all people, not the few; it’s about an economy with sustainable businesses that serve the people, not just profit interests, an economy that creates good, livable wage jobs and protects our environment. Shumlin has not been a champion of a people’s economy. Now that he has shown his cards, it’s time for us to show that we can do better.
http://www.rutlandherald.com/article/20141220/OPINION04/712209920/1018/OPINION

The Bill

Steven Brill on how health-care reform went wrong.

BY 

“Working in the White House on a Saturday afternoon had become routine for Zeke Emanuel and Bob Kocher,” Steven Brill tells us at the beginning of Chapter 9 of his ambitious new history of the Affordable Care Act, “America’s Bitter Pill” (Random House):
But they were usually able to leave at a decent hour. However, at 5 p.m. on Saturday, April 25, 2009, they were thrown into a state of near-panic. Emanuel, Kocher, and the rest of the staff from the Office of Management and Budget and the National Economic Council had been blindsided by the domestic policy crew.
At issue was a briefing paper written by the head of the White House health-care-reform effort, Nancy-Ann DeParle. It was early in the planning stages for Obamacare, and DeParle’s memo was a three-thousand-word document, in which she made the political case for a broad expansion of coverage. Kocher and Emanuel were taken aback. They were worried about the cost of the bill. The memo was supposed to go to the President at eight o’clock that night, which gave them just three hours to respond. “Any hopes for an early departure that Saturday evening were gone,” Brill writes.

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