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Baucus Tells Single-Payer Advocates No
By David Swanson
Senator Max Baucus met Wednesday with advocates for single-payer healthcare, including Senator Bernie Sanders, and told them that he might drop criminal charges against 13 people arrested for speaking up in his hearings, but that he would not include any supporters of single-payer health coverage in any future hearings. According to one report, Baucus suggested that he'd been mistaken to exclude single-payer but asserted that the process of creating healthcare reform legislation was too far along now to correct that omission.
Senator Sanders said after the meeting that if healthcare reform did not create a single-payer system it shouldn't be done at all, and that within three or four years we would realize we'd solved nothing. He said that it would be better to increase funding for community health centers and take steps to make it easier for medical students to go into primary care, than to enact major reforms that didn't go to the root of the problem.
Sanders has a bill (S 486) that makes some of the changes he advocates, as well as a bill (S 703) to facilitate the creation by states of single-payer healthcare systems. Congresswoman Tammy Baldwin has introduced resolutions on the same topic in the House. Dr. Margaret Flowers, co-chair of the Maryland chapter of Physicians for a National Health Program (PNHP), attended a press conference following the meeting on Wednesday and filled me in. She said that while states are pursuing single-payer legislation, it would be much easier for them to succeed if they had waivers allowing federal healthcare dollars to go to the states, and if needed changes were made to the Employee Retirement Income Security Act.
Advocates of single-payer emerged from the meeting with Baucus declaring their determination to push ahead with what they see as a fundamental struggle for human rights. Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee and national vice president of the AFL-CIO, said the fight for single-payer is a civil rights movement, and that people "have to turn up the heat." When someone questions the political viability of single payer, she said, we should question "allowing people to die and suffer for lack of political will."
The press conference, in which Baucus did not participate, was attended by the New York Times, Politico, the Associated Press, Pacifica Radio, Congressional Quarterly, and a camera that Flowers believed belonged to CNN. Sanders opened the press conference with a statement on the domination of the private for-profit health insurance companies wasting $350 billion per year in billing, profiteering, and complexity. If we were serious about healthcare reform, he said, we would be having a serious discussion of single-payer.
Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and senior lecturer at Harvard, said that in her diagnosis the disease was market-driven healthcare in which access is based on the ability to pay.
Dr. David Himmelstein, co-founder of PNHP and associate professor medicine at Harvard Medical School, reported that Baucus had said he might be willing to drop charges of unlawful conduct and disruption of Congress against 13 people but had no intention of opening up any hearings to include single-payer. Himmelstein also announced the release of two new studies. The first, being released Wednesday, reportedly finds that some of the largest investors in tobacco stock are private health insurance companies. The second, to be released Thursday, reportedly shows that not only are personal bankruptcies increasing, but 62 percent of them are now due to medical debt.
Geri Jenkins, RN, co-president of the California Nurses Association/National Nurses Organizing Committee and a practicing registered nurse, reported that Baucus had implied he'd made a mistake in not including single-payer but that it was too late now.
And, finally, Dr. Oliver Fein, president of PNHP and associate dean at Weill Medical College of Cornell University, said that he and his colleagues had asked Baucus for a full hearing on the merits of single payer and asked for the Congressional Budget Office to create a comparison of single payer with whatever plan Congress produces that is not single payer. Senator Sanders said that he would continue to push Baucus to hold a hearing.
Dr. Flowers said that in her analysis the single-payer movement is largely inclined to go in the direction that Sanders stated on Wednesday: support for a single-payer bill or nothing. I asked her whether she believed that those pushing for single payer would ever support a public option as doing more good than harm and whether she thought those pushing for a public option would ever advocate allowing states to enact single payer. Flowers acknowledged that there are many (perhaps even most) people in the public option movement who prefer single payer. In fact, it is difficult to find a supporter of the public option who does not claim to "personally" want single payer but to find it "politically unfeasible." But Flowers said that PNHP does not support a public option and backs only single payer. And she said she was unaware of any advocates of a public option also advocating for allowing states to create single payer.
UPDATE: This Just in from the President:
THE WHITE HOUSE
Office of the Press Secretary
For Immediate Release June 3, 2009
TEXT OF A LETTER FROM THE PRESIDENT TO
SENATOR EDWARD M. KENNEDY AND SENATOR MAX BAUCUS
June 2, 2009
The Honorable Edward M. Kennedy
The Honorable Max Baucus
United States Senate
Washington, D.C. 20510
Dear Senator Kennedy and Senator Baucus:
The meeting that we held today was very productive and I want to commend you for
your leadership -- and the hard work your Committees are doing on health care reform, one
of the most urgent and important challenges confronting us as a Nation.
In 2009, health care reform is not a luxury. It's a necessity we cannot defer. Soaring
health care costs make our current course unsustainable. It is unsustainable for our families,
whose spiraling premiums and out-of-pocket expenses are pushing them into bankruptcy and
forcing them to go without the checkups and prescriptions they need. It is unsustainable for
businesses, forcing more and more of them to choose between keeping their doors open or
covering their workers. And the ever-increasing cost of Medicare and Medicaid are among
the main drivers of enormous budget deficits that are threatening our economic future.
In short, the status quo is broken, and pouring money into a broken system only
perpetuates its inefficiencies. Doing nothing would only put our entire health care system at
risk. Without meaningful reform, one fifth of our economy is projected to be tied up in our
health care system in 10 years; millions more Americans are expected to go without insurance;
and outside of what they are receiving for health care, workers are projected to see their
take-home pay actually fall over time.
We simply cannot afford to postpone health care reform any longer. This recognition has
led an unprecedented coalition to emerge on behalf of reform -- hospitals, physicians, and health
insurers, labor and business, Democrats and Republicans. These groups, adversaries in past
efforts, are now standing as partners on the same side of this debate.
At this historic juncture, we share the goal of quality, affordable health care for all
Americans. But I want to stress that reform cannot mean focusing on expanded coverage
alone. Indeed, without a serious, sustained effort to reduce the growth rate of health care costs,
affordable health care coverage will remain out of reach. So we must attack the root causes
of the inflation in health care. That means promoting the best practices, not simply the most
expensive. We should ask why places like the Mayo Clinic in Minnesota, the Cleveland Clinic
in Ohio, and other institutions can offer the highest quality care at costs well below the national
norm. We need to learn from their successes and replicate those best practices across our
country. That's how we can achieve reform that preserves and strengthens what's best about
our health care system, while fixing what is broken.
The plans you are discussing embody my core belief that Americans should have better
choices for health insurance, building on the principle that if they like the coverage they have
now, they can keep it, while seeing their costs lowered as our reforms take hold. But for those
who don't have such options, I agree that we should create a health insurance exchange -- a
market where Americans can one-stop shop for a health care plan, compare benefits and prices,
and choose the plan that's best for them, in the same way that Members of Congress and their
families can. None of these plans should deny coverage on the basis of a preexisting condition,
and all of these plans should include an affordable basic benefit package that includes
prevention, and protection against catastrophic costs. I strongly believe that Americans should
have the choice of a public health insurance option operating alongside private plans. This will
give them a better range of choices, make the health care market more competitive, and keep
insurance companies honest.
I understand the Committees are moving towards a principle of shared responsibility --
making every American responsible for having health insurance coverage, and asking that
employers share in the cost. I share the goal of ending lapses and gaps in coverage that make us
less healthy and drive up everyone's costs, and I am open to your ideas on shared responsibility.
But I believe if we are going to make people responsible for owning health insurance, we must
make health care affordable. If we do end up with a system where people are responsible for
their own insurance, we need to provide a hardship waiver to exempt Americans who cannot
afford it. In addition, while I believe that employers have a responsibility to support health
insurance for their employees, small businesses face a number of special challenges in affording
health benefits and should be exempted.
Health care reform must not add to our deficits over the next 10 years -- it must be at
least deficit neutral and put America on a path to reducing its deficit over time. To fulfill this
promise, I have set aside $635 billion in a health reserve fund as a down payment on reform.
This reserve fund includes a number of proposals to cut spending by $309 billion over
10 years --reducing overpayments to Medicare Advantage private insurers; strengthening
Medicare and Medicaid payment accuracy by cutting waste, fraud and abuse; improving care
for Medicare patients after hospitalizations; and encouraging physicians to form "accountable
care organizations" to improve the quality of care for Medicare patients. The reserve fund also
includes a proposal to limit the tax rate at which high-income taxpayers can take itemized
deductions to 28 percent, which, together with other steps to close loopholes, would raise
$326 billion over 10 years.
I am committed to working with the Congress to fully offset the cost of health care
reform by reducing Medicare and Medicaid spending by another $200 to $300 billion over the
next 10 years, and by enacting appropriate proposals to generate additional revenues. These
savings will come not only by adopting new technologies and addressing the vastly different
costs of care, but from going after the key drivers of skyrocketing health care costs, including
unmanaged chronic diseases, duplicated tests, and unnecessary hospital readmissions.
To identify and achieve additional savings, I am also open to your ideas about giving
special consideration to the recommendations of the Medicare Payment Advisory Commission
(MedPAC), a commission created by a Republican Congress. Under this approach, MedPAC's
recommendations on cost reductions would be adopted unless opposed by a joint resolution
of the Congress. This is similar to a process that has been used effectively by a commission
charged with closing military bases, and could be a valuable tool to help achieve health care
reform in a fiscally responsible way.
These are some of the issues I look forward to discussing with you in greater detail in
the weeks and months ahead. But this year, we must do more than discuss. We must act. The
American people and America's future demand it.
I know that you have reached out to Republican colleagues, as I have, and that you have
worked hard to reach a bipartisan consensus about many of these issues. I remain hopeful that
many Republicans will join us in enacting this historic legislation that will lower health care
costs for families, businesses, and governments, and improve the lives of millions of Americans.
So, I appreciate your efforts, and look forward to working with you so that the Congress can
complete health care reform by October.
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