Empowering Our Say in Health Care Reform

transcript

THE WORLD AS IT IS VERSUS THE WORLD AS IT SHOULD BE

Isn’t that what this whole Health Care Reform initiative is about?

SINGLE PAYERWOULD CALL UPON ALL SECTORS OF OUR SOCIETYTO CO-FINANCE A UNIVERAL HEALTH CARE FUND

FOR ALL AMERICANS

In today’s complex world, no problem has an easy solution.Complexity requires that any reform effort take into account the obvious.

That is the purpose of this document,to walk you though our existing system’s obvious defects

and promote active debate on how to move forward

1. PRIVATE HEALTH INSURANCE (PHI) REPLACE WHAT DOES NOT WORK

IT’S A BUSINESS THAT OPERATES ON A NEGATIVE PREMISE.

We pay . . .

For something they don’t want to do.

We pay . . .

For something they don’t want to do.

That … in and of itself … makes no sense.

IT PROSPERS FROM 2 OPERATIONAL DYSFUNCTIONALITIES: #1 DIVIDE & CONQUER; #2 FEAR

Our Population is divided . . . 1. Between insurers;

Our Population is divided . . . 1. Between insurers; 2. Between policy holders within an insurer;

Our Population is divided . . . 1. Between insurers; 2. Between policy holders within an insurer; 3. In our very lives as we move around and are dropped and added to different insurance policies.

1. We fear the financial consequences of illness;

1. We fear the financial consequences of illness; 2. So we pay for private health insurance;

1. We fear the financial consequences of illness; 2. So we pay for private health insurance; 3. Someone in our policy group gets sick;

1. We fear the financial consequences of illness; 2. So we pay for private health insurance; 3. Someone in our policy group gets sick; 4. Coverage costs more and we pay because …(go to #1 above)

PHI’s two self-reinforcing premises: 1. To act responsibly, Americans must insure their health; 2. Making it mandatory is like your auto or home owner’s insurance obligation.

Premise 1. “Responsibility” or “Right”

Premise 1. “A commodity that is your responsiblity to pay” or

“A basic right”

-- The conclusion to this question will be taken up in Section 3, after taking into account how production, consumption and environmental factors affect our health –

Premise 2. Making it mandatory is like your auto or home owner’s insurance obligation.

Premise 2 – Mandatory Health Insurance : A question of AFFORDABILITY.

Premise 2 – Mandatory Health Insurance : A question of REPLACEABILITY.

Property is not like People

Property is not like People One body per lifetime, whatever it’s health

Car and Home Owner’s Insurance protects us against EVENTUALITIES

Premise 2 – Mandatory Health Insurance : A question of PROBABILITY.

Car and Home Owner’s Insurance protects us against EVENTUALITIES

People’s health needs to be insured against the INEVITABLE. We’re bound to get sick.

2. THE RELATIONSHIP BETWEEN HEALTH AND HOW WE LIVE

Our planet, and our health, are affected by our choices and use of the earth’s resources.

.. the AIR we BREATH (pollution and CO2)

The enormous volume of CO2 emissions released into the atmosphere is upsetting its chemical balance. This imbalance has not only triggered global warming but potentially compromises the very air we breath. Add to this all the other pollutants that affect air quality and our health, and its obvious we have a serious problem.

.. the WATER we DRINK (dumping/sewage)

In a single year, polluters dumped more than 232 million pounds of toxic chemicals into our nation’s rivers and streams. Nationwide, polluters contaminated the drinking water of 23 million Americans. In the last 5 years, industry has violated water pollution laws half a million times. 1 in 10 Americans have been exposed to drinking water that contains dangerous chemicals or fails to meet federal health benchmarks in other ways.

.. the LAND we EXHAUST (overuse/misuse)

Environmental Groups are stepping up their opposition to the coal industries practice of removing the tops of moun-tains with explosives. 500 individual peaks have been removed – the equivalent of 1.2 million acres of land the size of the state of Delaware. In two-thirds of the mountain top removal operations, valley fill is the sister practice of dumping the remaining waste in valleys. In 99% of the valleys some type of water source will be affected.

It was true then (1958 Silent Spring) and it holds true now. We are poisoning the earth with chemicals.

.. the LAND we EXHAUST (overuse/misuse)

.. the FOODS we EAT (processed/empty)

‘You are what you eat’ and in food you find completely synthetic ingredients, quasi-edible substances that ultimately do not come from a corn or soybean field but from a petroleum refinery or chemical plant. These chemicals are what make modern processed foods possible.

Chemicals, sweeteners, hormones … our bodies are exposed to it all, with grave implications for our national health. From premature menstruation in girls, to breast formation in boys. From obesity to alarming levels of diabetes. The dietary health of America is in trouble.

Since 2003, we see a jump in the number of returning Veterans seeking VA health care. How many deserving soldiers have returned home to be denied care? Might there be a relationship between the Iraq War and the rising costs of health care?

3. Heath Care is not a Commoditybut a Basic Right

1. The health issues we face as a Nation are not just a matter of choice, but are intrinsic to our very way of life, which is reflected in how we produce the goods we consume.

2. In the early 1900’s, thousands working in factories and mines were exposed to work-related risks and, through the union movement, labor gained workman’s compensation benefits – the earliest form of American Health Insurance for job related injuries.

3. Over the decades, the risks to health has shifted out of the workplace and into the general environment. The greater risk to our health is through exposure to toxins from resource extraction, agricultural production and chemical processing – making it likely that illness will surface from some non-work related exposure.

4. The American employer-based health insurance system was born out of the congressional defeat of President Truman’s National Health Plan of 1949. The pressures brought to bare by the American Medical Association and Businesses contributed to the plan’s defeat.

5. Today, the Health Insurance Industry that opposes reform. They have everything to lose should Health Care gain its rightful place as a hard-won worker’s right, extended to ‘citizen’s right’ given the generalized risks that threaten our national health.

6. Health Care as a ‘right’ shifts the burden from “individual” to “social” responsibility. But how do we pay for it when the Nation is Broke? Collectively through Single Payer.

6. Health Care as a ‘right’ shifts the burden from “individual” to “social” responsibility. But how do we pay for it when the Nation is Broke?

3. NO TO PUBLIC OPTION WITH PHIYES TO SINGLE PAYER

First we must address “why our Nation is broke”. During President Bush’s term, the National Debt went from President Clinton’s low of 57.7% of GDP to the Bush Era high of 78.1% of GDP in his last year of office (+20 pts).

Don’t perpetuate PHI by obligating Americans to pay Health Care Insurance.Consolidate our Health Care Purchasing Power through Taxes (front-end & back-end).

The Baucus Health Care Reform Price tag is set to $856 billion over a 10 year period, and foresees middle class families paying 13% of their earnings in Health Insurance Premiums (not including cost-sharing concepts like co-payments, deductibles)

The Baucus Plan leaves a back-door penalty that an employer or family must pay if they do not enroll. What happens when most opt out and pay the penalty? Will they still have access to health care? Will the Public Option be viable?

Aren’t we asking those with the least likely ability to pay (i.e., those outside the employer covered health care network) to be one of the legs in the Financing Stool of the Public Option?Do we even know how many legs the stool has?

Don’t perpetuate PHI by obligating Americans to pay Health Care Insurance.Consolidate our Health Care Purchasing Power through Taxes (front-end & back-end).

Obligating Health Insurance at 13% of median income sounds like tax, only its collected by the Private Health Insurance Industry (PHI), not government.

All for what? To sustain and perpetuate the PHI model throughout the whole of American. By default, PHI becomes the “designated driver” of our reformed Health Care System making PHI stronger while we remain weak:

•our risk pool remains fragmented•or contributions (i.e., our purchasing power) remain fragmented.

We don’t have to do it this way.For the welfare of our Nation we must consider

an alternative – Single Payer

The Baucus Health Care Reform Price tag is set to $856 billion over a 10 year period, and foresees middle class families paying 13% of their earnings in Health Insurance Premiums (not including cost-sharing concepts like co-payments, deductibles)

The Baucus Plan leaves a back-door penalty that an employer or family must pay if they do not enroll. What happens when most opt out and pay the penalty? Will they still have access to health care? Will the Public Option be viable?

Aren’t we asking those with the least likely ability to pay (i.e., those outside the employer covered health care network) to be one of the legs in the Financing Stool of the Public Option?Do we even know how many legs the stool has?

Consolidate our Health Care Purchasing Power through Taxes (front-end/back-end).Reference Point: Health Care Costs represent 18% of GDP or $2.5 trillion.

STRATEGICALLY TAXING FRONT-END (INCOME / WEALTH / FLOW OF MONEY)

Place a Health Care Tax on income/wealth across many sectors. Businesses and their employees should not be expected to shoulder the financing of our National Health Care System.

•2% Employee Contribution on Wages Earned•2% Employer Contribution on Wages Paid•5% on earnings above $500,000 a year•5% on Oil, Chemical and Finance Industry profits•1% on money created by the Federal Reserve Bank and lent to Banks (currently @ 0%).•2% on all Government Subcontracting of essential government services•5% on hedge funds and non-traditional high yield trading instruments

STRATEGICALLY TAXING FRONT-END (INCOME / WEALTH / FLOW OF MONEY)

Place a Health Care Tax on income/wealth across many sectors. Businesses and their employees should not be expected to shoulder the financing of our National Health Care System.

•2% Employee Contribution on Wages Earned•2% Employer Contribution on Wages Paid•5% on earnings above $500,000 a year•5% on Oil, Chemical and Finance Industry profits•1% on money created by the Federal Reserve Bank and lent to Banks (currently @ 0%).•2% on all Government Subcontracting of essential government services•5% on hedge funds and non-traditional high yield trading instruments

STRATEGICALLY TAXING BACK-END (CONSUMPTION)

Place a 2% tax on gas, utilities and consumer goods (like food, cigarettes, alcohol, cloths, guns, etc.). By taxing consumption, we cast a wider net for financing Health Care, because:

•The tax not only applies to what we produce in the US (i.e. what’s part of our GDP), but what we import (ex: 60% of the petroleum products we consume comes from oil imports).

•By taxing utilities and gas consumption, industry will make a contribution to Heath Care.

•By taxing food, everyone contributes, even unreported earnings (ex: purchases made w/illicit drug money).

Business will match employee contributions to health care. At 2%, this is lower than the 14% average currently paid on median incomes.

With a 2% Tax on Income and the application of a 2% Tax on Consumer Goods, the cost to Median

Income Households will not exceed 4% of earnings when spending is within means.

Earnings in excess of median incomes will result in higher nominal contributions. It could be

possible to justify a tiered Health Care Tax on income when this adjustment can be offset with sufficient contributions from other taxed sectors.

The taxing of other sectors, that contributed to our systemic crisis, is vital to capturing sufficient

funds for Health Care (oil/industry/banking).

Ideally , the Health Care Tax applied to income and consumer goods can be managed by

State Government. These contributions will represent the States capacity to pay Health Care

Providers for services rendered.

The taxing of other sectors may be a shared strategy between the State and the Federal Government. A formula must be defined for

allocating Federally Collected Health Care Taxes to the States.

With a 2% Tax on Income and the application of a 2% Tax on Consumer Goods, the cost to Median

Income Households will not exceed 4% of earnings when spending is within means.

Earnings in excess of median incomes will result in higher nominal contributions. It could be

possible to justify a tiered Health Care Tax on income when this adjustment can be offset with sufficient contributions from other taxed sectors.

Ideally , the Health Care Tax applied to income and consumer goods can be managed by

State Government. These contributions will represent the States capacity to pay Health Care

Providers for services rendered.

The taxing of other sectors may be a shared strategy between the State and the Federal Government. A formula must be defined for

allocating Federally Collected Health Care Taxes to the States.

Transparency will require that any charging of the Single Payer Tax be an isolated item on the

transaction document, be it Pay Stub, Sales Receipt or any other instrument where the tax

is effectively assessed for collection.

Business will match employees contribution to health care. At 2%, this is lower than the 14% average currently paid on median incomes.

The taxing of other sectors, that contributed to our systemic crisis, is vital to capturing sufficient

funds for Health Care (oil/industry/banking).

The percentages and mix of sectors to be taxed for Health Care is suggestive only.

It is to support the case that there are more ways than one

to approach Health Care Financing.

The most prudent and just approach is to spread the burden.

The more legs to the stool for Health Care Financing, the greater the safety in the event that one leg

or more drop-off or dip in our current crisis.

4. SINGLE PAYER: HOW IT COULD WORK

1. Single Payer Contributions are Pooled by State; 2. Any Citizen can join the Single Payer Risk Pool and is Issued a Health Card;

3. See Your Doctor/Receive Required Preventative Care and Treatment; 4. Health Care Providers Bill the State Directly, and are paid from Pooled Contributions

Conclusion

Whether you agree, disagree or are undecided about the points made here, you must look into what’s at stake, take a position and join the debate.

And for those that do agree, there is some good news!

1. While we do not have what we need in the Senate Finance Committee bill, Congress has the legislation it needs to move Single Payer to the forefront:

• H.R. 676: US National Health Insurance Act (Rep. Conyers, D-MI) • S. 703: American Health Security Act of 2009 (Sen. Sanders, I-VT)

2.To date, H.R. 676 has been endorsed by 20 medical organizations, six faith organizations, over 45 municipalities, and over 465 unions.

3.Talk or write to your elected officials. Urge their support of HR676 & S703.

4.Visit 5.to see what is going on in your city to support single payer.

CONVICTION, ACTION & RESOLVE CAN LEAD TO A SINGLE PAYER VICTORY