CHICAGO—Remote Area Medical (RAM) will be in Chicago to serve the under- and uninsured citizens of Cook County and points beyond. Founded in 1985 to serve “desolate areas of the world,” RAM is a non-profit, volunteer group that delivers on-site health care, dental care, eye care, veterinary services, and technical and educational assistance to people—all free of charge. Their services are available from Friday through Sunday, August 19-21.

To augment the stellar work that RAM does, there will be a press conference comprising activists, legislators, doctors and nurses who are continuing fight for health care justice on the local and national level.

WHO: Aderonke Bamgbose, American Medical Students Association (AMSA); State Representative Mary E. Flowers (D), Sponsor of the single-payer bill HB 311, “The Health Care for All Illinois Act”; Dennis Kosuth, ER Nurse, Stroger Hospital and member of the National Nurses United (NNU); Jim Webster, MD, member of Physicians for a National Health Program (PNHP); Grassroots community activists from ChiSPAN and Illinois Single-Payer Coalition (ISPC)

WHAT: The health care crisis in the United States is deepening with over 50 million people uninsured and many millions more underinsured.

The last reliable data on uninsured rates in Illinois state it very clearly: There are at least 1.75 million uninsured people in the state. But these numbers are before the 2008 bubble burst. And because in the new economy, businesses are increasingly putting the burden of payment back on the workers, that number is very likely higher, possibly 2 million uninsured in the state.

Massive state cuts to the Medicaid Program have left hundreds of thousands without coverage and more cuts to the program are planned. Dr. David Ansell of PNHP and Rush University Medical Center, and author of the new book County: Life,Death and Politics at Chicago’s Public Hospital, says, “The presence of RAM in Chicago is emblematic of the failure of our health care system to take care of the most vulnerable individuals in our society. Each year in Chicago, 3200 black people die because they do not have the same health outcomes as whites. That’s more deaths than on 9/11 and much of it is because of the failings of our public health system. Only with a single-payer health care system, one that provides the same access to care to all Americans regardless of race or income can we begin to turn the tide on this injustice.”

Ms. Flowers and all parties from ChiSPAN, AMSA, NNU, ISPC and PNHP are available for comment. For more information, go to www.ramusa.org or chispan.org.

Many people move to Vermont in search of a slower pace; Dr. Deb Richter came in 1999 to work obsessively toward a far-fetched goal.

She wanted Vermont to become the first state to adopt a single-payer health care system, run and paid for by the government, with every resident eligible for a uniform benefit package. So Dr. Richter, a buoyant primary care doctor from Buffalo who had given up on New York’s embracing such a system, started lining up speaking engagements and meeting with lawmakers, whom she found more accessible than their New York counterparts.

“I wrote a letter to the editor, and the speaker of the House called me up to talk about it,” Dr. Richter, 56, recalled recently. “It was astounding. In New York, I couldn’t even get an appointment with my legislator.”

Twelve years later, Dr. Richter will watch Gov. Peter Shumlin, a Democrat, sign a bill on Thursday that sets Vermont on a path toward a single-payer system — the nation’s first such experiment — thanks in no small part to her persistence. Though scores of people pushed for the bill, she was the most actively involved doctor — “the backbone,” Mr. Shumlin has said, of a grass-roots effort that helped sway the Democratic Legislature to pass it this spring even as other states were suing to block the less ambitious federal health care law.

“We wouldn’t be where we are without Deb,” Mr. Shumlin said in an interview. “She’s made this her passion. And like anyone that’s making significant social change, she has qualities of persuasiveness and leadership and good judgment that are hard to find.”

As in all states, the cost of health care has increased sharply in Vermont in recent years. It has doubled here over the last decade to roughly $5 billion a year, taking a particular toll on small businesses and the middle class. All 620,000 of the state’s residents would be eligible for coverage under the new system, which proponents say would be cheaper over all than the current patchwork of insurers. A five-member board appointed by the governor is to determine payment rates for doctors, what benefits to cover and other details.

But much remains to be worked out — so much that even under the most optimistic projections the plan might not take effect until 2017. Most significantly, Mr. Shumlin still has to figure out how much it will cost and how to pay for it, possibly through a new payroll tax. Whether he will still be in charge by 2017 is among the complicating factors.

“If we had the exact same Legislature and the same governor we could get it done,” Dr. Richter said. “It’s a big if, because the opposition has a ton more money to convince people that the governor is evil and this is socialized medicine and all kinds of other scary stuff.”

The opposition will probably include insurance companies, drug makers and some employers who say there are too many unknowns. Many doctors, too, are wary of the change and what it might mean for their income. Dr. Richter said she believed a “slim majority” of the state’s 1,700 licensed physicians were supportive.

“One of the bigger worries I have is we’ve had all this hoopla and nothing’s going to happen,” she said at a coffee shop here recently on a rare quiet afternoon. “But it might also be helpful to us, because it’s going to be hard for any opposition to be steadily pushing for seven years.”

The federal health care law has complicated Vermont’s plans, requiring the state to first create a health insurance exchange to help residents shop for coverage by 2014. The state would then need a federal waiver to trade its exchange for a government-run system.

Dr. Richter said she embraced the idea of a single-payer system as a young doctor in Buffalo, where many of her patients put off crucial treatments because they were uninsured. As a medical student, she saw a patient with a life-threatening heart infection caused by an infected tooth that had gone untreated because he lacked dental insurance.

“He was in the hospital for six weeks, and I was like, ‘This makes no sense,’ ” she said.

She went to a meeting of Physicians for a National Health Program, a group that advocates for a national single-payer system, and started researching the concept. Before long she became a vocal advocate, even becoming president of the physicians’ group, and moved to Vermont.

John McClaughry, a former Republican state senator who is against the new law, said Dr. Richter meant well but did not understand the “long-term damage” it would wreak. In particular, he said the law would drive away businesses that did not want to help pay for it.

“She’ll tell you that putting in single-payer will attract businesses from all over the place,” said Mr. McClaughry, vice president of the Ethan Allen Institute, a conservative research group. “I don’t think she has any appreciation of business decisions at all.”

Since moving with her husband and two sons to a rambling old house within view of the State House, Dr. Richter has given about 400 talks on the single-payer concept, tutored lawmakers in the State House cafeteria and testified before the Legislature more times than she can remember. Once, she presented a printout of all the insurance companies her small practice in Cambridge had billed over five years.

“It was like 190 pages long,” she said. “Here we were, this tiny rural clinic having to bill all these different addresses. And all of them have different rules and reimbursements; I mean, it’s ridiculous.”

Some supporters of single-payer health care say Vermont’s law does not go far enough, mostly because it would allow at least a handful of private insurers to stay in the market indefinitely. Self-insured businesses like IBM, the state’s largest employer, could continue providing health coverage to workers under the law, though they would have to help finance the new system, possibly through a payroll tax.

Physicians for a National Health Program is among the critics, saying the law “falls well short of the single-payer reform needed.” Allowing private insurers to remain in the state will prevent meaningful savings, the group says.

Dr. Richter acknowledges that the law will not allow for “strict single-payer,” but said it still promised “health care for everybody, for less cost.”

“This is not the top of the mountain, but it’s the first time anyone has headed up the mountain,” she said. “No other place in the country has gotten this far.”

Medical, nursing, and public health students from around the country organized a rally to support universal, single-payer health care in Vermont.

The March 26, 2011 event was led by student members of Physicians for a National Health Program (PNHP) and co-sponsored by the American Medical Student Association (AMSA).

MONTPELIER, Vt. — U.S. Sen. Bernie Sanders and Gov. Peter Shumlin spoke before health profession students who gathered Saturday at the Statehouse in support of single-payer health care.

The Vermont House passed a version of the universal health care bill, which is being championed by Shumlin, with a party-line vote of 92-49 Thursday.

The bill, which will be debated in the Senate, is a critical step toward the creation of a publicly financed medical system that would deliver benefits to every resident of the state.

The students, who came from New England, New York and Pennsylvania, and as far away as Oregon, expressed concerns over the mire of paperwork and bureaucracy that they say would hamper them from practicing medicine in the way they are being trained to.

“I want my future patients to have a comprehensive health care insurance,” said Larry Bodden, a medical student at the University of Vermont.

“Whether or not the single-payer health care reforms are passed could have an effect on where I decide to practice,” Bodden said.

Bodden said he believes having a single-payer system could draw top medical professionals to the state to practice.

Bodden and 38 other medical students at the school have written and signed a letter that lays out what they would like to see in a single-payer health care system that included attracting high-quality health care professionals to the state. The letter, Bodden said, is the students’ way to influence the passing of single-payer health care reforms.

“Our goal is to have a single-payer system that is balanced and sustainable,” Bodden said.

UVM Medical School student Calvin Kegan said he came out for the event because he thinks that, “as Vermont is courageously undertaking the path to universal health care that is more sustainable as a whole, it is important for future health care professionals to express their support for legislation that could affect them throughout their entire practices.”

Kegan said that he believes the current system is frustrating for physicians as the paperwork and bureaucracy can be cumbersome.

A copy of the letter was presented to Sanders, who said that he would submit it to be included in the congressional record.

“It’s inspiring,” said Sanders. “It’s one thing for Vermonters to get behind this cause, but when you see physicians and young people from all over leading the way for health care reform, you begin to see that they are saying that they can’t provide the care they want to with the system we have in place now.”

Sanders said that politicians and lobbyists, including those for drug and insurance companies in Washington, are watching the progress of the Vermont health-care bill very closely.

“If we win here, they know it will spread,” Sanders said.

In his address to the crowd, Sanders said that under the current system patients often wait too long to seek care, and when they finally do, they are much sicker, which leads to more hospitalizations and emergency room visits.

Sanders said that with a new system, patients will be able to seek care before their conditions reach such desperate stages.

Shumlin touted his belief that Vermont can lead the way for health care reform for the nation.

March is Women’s History Month. But this year, for the vast majority of women in America, there is little to celebrate.

Over the past months, “deficit gurus” in the U.S. House of Representatives have unleashed the most devastating assault on women’s health in our nation’s history. If legislation already passed in the House is approved by the Senate and signed into law by President Obama, women’s rights and health will be set back by decades.

Many critical programs are on the chopping block, such as the Public Health Service Act or Title X, providing basic health services, including Pap smears, family planning services, and cancer screenings to more than 5 million low-income people, mainly women.

Slashing Title X will lead to thousands of unnecessary deaths. Maternal and Child Health Block Grants, chiefly benefitting poor women and children, will be cut by $210 million. The Centers for Disease Control and Prevention will be reduced by some $755 million, undermining many public health efforts such as confronting HIV/AIDS. Community health centers providing essential services to millions of women and families across the country will face a brutal $1.3 billion cut.

This onslaught against women joins that against U.S. working people. Look, for example, at the assault on Medicaid, or the drive to cut wages, benefits and collective bargaining rights. Wisconsin is only the most flagrant example of a nationwide phenomenon.

Or consider the chorus that, both from the right and from sectors of the “liberal” left, is calling for “saving” Social Security by reducing benefits, increasing eligibility age or privatizing the program. Yet Social Security is financially sound for at least another 27 years. Whatever problems it may have could be easily fixed by simply raising the cap on the taxable income of the very wealthy. And Medicare and other publicly financed health care programs, favorite targets of the budget cutters, pose a problem only because the U.S. health care system, pre- and post- the federal health law, is built upon a rotten foundation: for-profit health insurance.

Despite subtle differences, both sides of the political aisle convey the same message: “We” must pay for “our excesses” that caused “the deficit” by giving up on our “generous benefits.”

Notably, Wall Street excesses figure nowhere in these arguments, even if its benefits are clear. As President Obama noted candidly in his State of the Union address, “the stock market has come roaring back and corporate profits are up.”

Meanwhile, our “benefits” don’t even include guaranteed access to basic health care, as is the norm in every other wealthy nation. The new federal law has “reformed” the system essentially by mandating us to purchase for-profit insurance increasingly under-insurance under penalty of a fine, and expanding coverage, not necessarily care, through an underfunded Medicaid program. Finally, it leaves at least 23 million people uninsured annually a decade from now.

If this scenario is allowed to stand, women will suffer disproportionately. But in the spirit of International Women’s Day, women’s groups and others are fighting back, and championing the most just and cost-effective solution to our health care woes — single-payer national health insurance, an improved Medicare for All.

As we commemorate those 15,000 brave women who back in 1908 marched through New York City demanding shorter hours, better pay and voting rights, American women and working Americans generally must demand no less.

Claudia Chaufan is an assistant professor at the Institute for Health and Aging at UC San Francisco. She is also vice president of Physicians for a National Health Program — California.

From Physician for a National Health Program –

The percentage of personal bankruptcies linked to medical bills or illness changed little, and the absolute number actually increased in Massachusetts after the implementation of its landmark 2006 law requiring people to buy health insurance, a Harvard study says.

The new study, which appears in today’s American Journal of Medicine, found that between early 2007 and mid-2009, the share of all Massachusetts bankruptcies with a medical cause went from 59.3 percent to 52.9 percent, a non-significant decrease of 6.4 percentage points. Because there was a sharp rise in total bankruptcies during that period, the actual number of medical bankruptcy filings in the state rose from 7,504 in 2007 to 10,093 in 2009.

The findings have national implications because the Obama administration’s health law is largely patterned after the Massachusetts plan, including its individual mandate. One of the administration’s arguments in support of the new federal law was that it would significantly reduce medical bankruptcies nationwide. The findings in Massachusetts cast doubt on that claim.

Moreover, the president’s recent proposal to let states opt out of the national health reform threatens to further weaken the inadequate standards for coverage that were included in the 2010 reform law. The result may well be the growth of skimpier plans nationwide, leading to even higher rates of medical bankruptcy than in Massachusetts.

To explain why medical bankruptcies persist in Massachusetts, the authors of the new study write: “Health costs in the state have risen sharply since reform was enacted. Even before the changes in health care laws, most medical bankruptcies in Massachusetts – as in other states – afflicted middle-class families with health insurance. High premium costs and gaps in coverage – co-payments, deductibles and uncovered services – often left insured families liable for substantial out-of-pocket costs. None of that changed. For example, under Massachusetts’ reform, the least expensive individual coverage available to a 56-year-old Bostonian carries a premium of $5,616, a deductible of $2,000, and covers only 80 percent of the next $15,000 in costs for covered services.”

The study’s lead author, Dr. David Himmelstein, said, “Massachusetts’ health reform, like the national law modeled after it, takes many of the uninsured and makes them underinsured, typically giving them a skimpy, defective private policy that’s like an umbrella that melts in the rain: the protection’s not there when you need it.”

In the case of Massachusetts, “while we can’t completely rule out the possibility that the reform reduced medical bankruptcies, any reduction is certainly small,” he said. Himmelstein conducted the study as associate professor of medicine at Harvard Medical School; he currently is professor of public health at City University of New York.

In 2007, the last year for which national estimates are available, medical issues contributed to 62.1 percent of bankruptcies nationally, according to a 2009 study by the same group of researchers. That study, which was frequently cited by the president and congressional reform advocates, also found that 77.9 percent of those bankrupted were insured at the start of their illness, including 60.3 percent who had private coverage.

The authors note that Massachusetts has historically had fewer medical bankruptcies than the rest of the nation, presumably reflecting, among other things, the state’s more robust social safety net, including public hospitals and a system of free medical care for the poor that predated the recent reform. Massachusetts’ 51 percent increase in total bankruptcies between 2007 and 2009 was slower than the increase in the majority of other federal jurisdictions.

The state’s health law was passed in 2006 and was fully implemented by early 2008. According to the U.S. Census Bureau, the share of state residents who were uninsured fell by 58 percent between 2006 and 2009, from 10.4 percent to 4.4 percent, and remains the lowest rate of any state.

Because bankruptcies lag many months behind a financial shock, the early 2007 and mid-2009 surveys provide a good “before and after” look at the effects of the health reform, the researchers said.

Study co-author Dr. Steffie Woolhandler, a professor of public health at City University of New York who was professor of medicine at Harvard when the research was conducted, said, “American families need the kind of comprehensive coverage that protects people in nations with single-payer national health insurance, such as Canada.” Although recent data are lacking, an older study found few medical bankruptcies in Canada, she said.

*****

“Medical bankruptcy in Massachusetts: Has health reform made a difference?” David U. Himmelstein, M.D., Deborah Thorne, Ph.D., and Steffie Woolhandler, M.D., M.P.H. Deborah Thorne is associate professor of sociology at Ohio University. American Journal of Medicine, March 2011 (print edition).

A copy of the manuscript of the study is available here.

*****

Physicians for a National Health Program (www.pnhp.org) is an 18,000-member organization advocating single-payer national health insurance for the United States. PNHP had no role in funding the study mentioned above. To speak with a physician/spokesperson in your area, visit www.pnhp.org/stateactions or call (312) 782-6006.

By Margaret Flowers, MD for YES! Magazine –

Last month, fulfilling a campaign promise, Republicans in the House of Representatives voted to repeal “Obamacare.” The vote was primarily a symbolic gesture. House leadership knows repeal will not survive a vote in the Senate or a Presidential veto. But the Republican leadership is likely to attempt steps that would lead to a de facto repeal of the health law.

One of the main strategies for weakening the law will be to prevent funding to key elements and programs—particularly of those having to do with enforcing regulations on the insurance industry.
We can also expect Republican members of Congress to promote “triggers,” which change the law if certain goals are not met. These changes will drive employers to stop offering health insurance to employees and instead offer fixed contributions that employees can use to purchase health insurance on the open market. As premiums rise, more people will be forced to purchase skimpier policies, leaving them unprotected in times of need.

Republicans also advocate for the opening of the health insurance market across state lines in the belief that this will create competition that reduces the cost of health insurance. In truth, in order to make a profit, health insurers compete to insure the healthiest patients and to avoid paying for care. The result will be a race to the bottom.

Health insurance regulations—which control, for example, what services insurers must cover, or how many physicians they must allow patients to choose between—were put into place to protect patients. Regulations vary by state, meaning that, just as corporations move their headquarters to states with lower taxes, health insurers will base themselves in states with fewer regulations. Premiums may become cheaper, but at the cost of higher out-of-pocket costs and lower quality benefits that leave patients unable to receive needed care or forced into bankruptcy by an unexpected illness or accident.

Such changes shift more and more of the cost of care onto individual patients—particularly those who have the greatest needs. This is exactly the wrong approach if our goal is the creation of a system that improves the health of our population and controls our soaring health care expenditures.

The United States is the only industrialized nation that does not have a coherent health system and that allows investor-owned corporations to finance and provide health services. As a result, we have the highest health care costs in the world but relatively poor outcomes—not to mention a growing number of people who can’t afford the care they need.

We have the cruelest form of health care rationing in this nation: rationing based on the ability to pay. Except for those in the very highest income brackets, we are all at risk of personal bankruptcy due to a health crisis. In fact, the U.S. is unique in that most personal bankruptcies are due to medical illness or medical costs—and more than three-fourths of those who experienced medical bankruptcy were insured.

The good news is that it doesn’t have to be this way. As the weakening of the federal health care law begins, a nationwide effort for more substantial reform—a national single-payer system, also known as improved Medicare for All—is taking place. Health professionals and advocates around the nation are actively engaged in educating, organizing, and agitating to promote Medicare for All. There are tremendous opportunities at the state and national level to pass a single payer system.

As the current health law falls apart and our national deficit continues to grow, single-payer plans are gaining more and more interest. More than 20 state legislatures have either passed single payer health bills or are in the process of creating such bills. California has passed a single payer bill twice, only to have it vetoed. Advocates are working to pass the law once again this year. Vermont is in the process of putting together legislation setting up a system similar to single-payer; legislators expect to pass their bill this year. At the federal level, single-payer bills will be introduced in both the House and Senate.

Our current health spending is enough to pay for high quality comprehensive care for everyone if we switch to a single risk pool that is transparent and publicly accountable.

Dr. Margaret Flowers wrote this article for YES! Magazine, a national, nonprofit media organization that fuses powerful ideas with practical actions. Dr. Flowers is a congressional fellow with Physicians for a National Health Program and a pediatrician based in Baltimore.

The following remarks were delivered by Dr. Claudia Fegan, past president of Physicians for a National Health Program, to the Louisville (Ky.) Urban League on Jan. 15. 2011

The time is always right to do what’s right: Dr. King and health reform

By Claudia Fegan, M.D.

It is indeed an honor and a privilege for me to stand here today celebrating the life and work of Dr. Martin Luther King Jr.

Dr. Garrett Adams, who gave me such a kind introduction, recently learned that my father was the photographer who took the picture of Emmett Till’s body the night his mother requested the casket be opened so that the public could see what they had done to her baby. That photo became an icon of the civil rights movement.

I was only 7 years old the day my daddy stood behind Dr. King’s right shoulder and photographed the crowd that stood before him on the Washington Mall as he gave his “I Have a Dream” speech. My father, a steelworker, was also a documentary photographer. I brought one of his photographs of Dr. King at that historic rally
with me today.

We learned much from Dr. King, even though he was taken from us too soon. He taught us that “the time is always right to do what’s right.”

As we stand here today, there are 50 million Americans who are uninsured. African Americans are represented disproportionately among the uninsured. I am referring to the fact that while we represent only 12 percent of the population, we are 20 percent of the uninsured. This is our issue.

As a result of not having insurance, we have decreased access to the preventive services that would allow us to live longer, healthier, richer lives. We pay a tremendous price for this.

Our infant mortality rate is about 2.5 times that of whites, our rates of death from heart disease and cancer are 1.5 times that of whites, our rate of death from diabetes is almost 2.5 times that of whites and our rate of death from HIV is 5 times that of whites. African American patients on dialysis are less likely to be referred for evaluation for kidney transplant and therefore, not surprisingly, we are far less likely to get a kidney transplant. This is our issue.

The Institute of Medicine in its 2004 study on “The Consequences of Uninsurance” estimated over 18,000 people a year die as a result of not having access to health insurance:

* Uninsured adults receive fewer and less timely preventive and screening services
* Uninsured cancer patients die sooner due to delayed diagnosis
* The uninsured receive less chronic illness care, poorer hospital care and are more likely to die in the hospital.
* The risk of premature death among uninsured Americans is 25 percent higher than among Americans with health insurance.

This is our reality, the reality of health care for African Americans in this country. We will never get more until we demand more. This is our issue.

Physicians for a National Health Program, PNHP, is an organization of 18,000 physicians. Since 1986 we have been trying to convince physicians, patients and politicians that if we tossed out the private insurance industry and made the government the single payer for health care in this country, we could provide coverage for everyone with same money we are using now to cover only two-thirds of the country poorly.

I have a patient who is 63 years old. Ms. Lenoir has worked all her life, she is active in her church, she cares for her elderly mother and together she and her husband have raised their children to be self-sufficient members of society. Ms. Lenoir does not have health insurance because her employer has never provided that benefit.

The problem is Ms. Lenoir needs a new hip. After more than 20 years of arthritis in her hip, the joint is destroyed. She has bone grinding on bone. No amount of anti-inflammatory medication will relieve her pain. I had to plead with her to consider taking a narcotic to relieve her pain so that maybe she could get a good night’s sleep.

I sent Ms. Lenoir to a pain specialist who injected the joint to provide her with temporary relief and who then called me and said, “This woman needs a new hip.” I told her, I know that, but have you got one you can give her? No one will pay for a hip for her until she turns 65 and Medicare will provide her with coverage.

I wish you could look into this woman’s eyes each time she comes to see me and feel her pain. Will the legislation passed last year provide her with a new hip before she turns 65 in 2013? No probably not. This is our issue.

In the book “The Heart of Power,” David Blumenthal chronicles the efforts of presidents from Franklin Roosevelt through George W. Bush to achieve access to health care for the American public. “Major health reform is virtually impossible: difficult to understand, swarming with interests, powered by money, and resonating with popular anxiety,” he writes.

The congressional veteran and co-chair of the 9/11 Commission, Lee Hamilton, said, “Health care is so difficult because Congress is an incremental body and health care is a non-incremental issue.”

What Barack Obama did with the passage of the Patient Protection and Affordable Care Act (ACA) was nothing short of miraculous, but it was not enough and it will not solve our problems.

Going forward there will not be a fair, open or honest discourse about this legislation. It is a fact that ACA will do nothing to control costs. That is the major flaw of the legislation.

Why are we still talking about single payer? Because single payer will address the issues of cost, access and quality.

Dr. King taught us being right is not enough. We have to win the hearts of the American public.

We didn’t lose the war to gain access to health care for all Americans. We got battered in an ugly skirmish, but we’re not done.

It is time to change our tactics. The opportunity for change is still ahead of us. More recent studies have taught us that actually 45,000 people die each year as a result of not having health insurance which means 180,000 more people will die before implementation of the majority of the ACA legislation. If everything goes exactly as planned, there will still be at least 23 million uninsured once all the changes have taken effect. This is our issue.

Camille Rucks was a security guard for a small company on the South Side of Chicago. In the spring of 2008 she developed breast cancer. She received outstanding care at the University of Chicago and did well. However, in November 2008, which we now know was the beginning of the recession, when her company began to struggle, she was laid off. She thought she was targeted because she had been out sick so much when she was receiving chemo, but it doesn’t matter.

In January 2009, when she had some blood-streaked sputum, her primary care physician (PCP) ordered a chest X-ray that showed a spot that raised the question of maybe her cancer had returned. Her oncologist told her she couldn’t see her because she was no longer insured. Her surgeon never returned her phone calls.

Her PCP called me because she was not able to get the necessary tests done for Camille because she was no longer insured. I told her PCP to have Camille come see me the next day.

I said, sure, of course, this is what we do; we’re the County Hospital. In less than a week she had a CT of her chest, and within two weeks she had been seen by pulmonary and oncology. She did have metastatic cancer and we took care of her. I wish I could tell you this story had a happy ending, but it doesn’t. Camille died last
year, but she told me she had no regrets. We treated her with dignity and respect.

My question is this: Who doesn’t deserve dignity and respect? Why should you have to pass a wallet biopsy before a health care provider determines she can talk to you, order a test, figure out what is wrong or decide how to treat you? This is our issue.

The Affordable Care Act has not made health care a right. Access to care is a profit center controlled by the insurance industry. We pay them to limit access to care. We spend more per capita on healthcare than any country in the world — more than $8,000 per person — and yet we are ranked only 36th in the world by the World Health Organization for the care we provide.

Under the ACA, everyone will be required to carry or purchase private insurance. For those who can’t afford it, we’re requiring states to either cover them under Medicaid or to provide supplements so they can purchase private insurance. This is an industry that has a history of profiteering by retroactively denying coverage to people with illnesses. So now we’re requiring everyone to buy coverage, and yes, we have told the insurance companies they can’t deny coverage to those with illnesses.

My question is why can’t we just pay for the care without having to go through the insurance industry? They are not to be trusted. Ask the state of Massachusetts how it has worked out for them with mandating insurance coverage and paying for those who can’t afford it. The cost of premiums has gone up so high so fast in the first year the governor met with the major companies to request they hold off on their premium increases because the costs had exceeded three times the original projections. The state now teeters on insolvency. This is our issue.

We spend enough money on health care in this country. We just let too many people who aren’t involved in providing care take profit from it.

This is about justice. Health care should be a right to which everyone is entitled. Remember we live in the wealthiest country in the world. We spend more on health care than any other country. It is time we got our money’s worth. It is time we got the health care we deserve, not the care the insurance industry is willing to let us have. It is time we made health care a right and not a privilege.

We have to speak up. We have to speak loudly. We have to make our voices heard.

The Affordable Care Act is an opportunity: It is not going to work!

We have to remind the people — there is still a simpler, easier solution. People want to know, they have questions. They will ask, is this the answer? Will this work? Will this solve the problem?

Multinational Big Pharma charges the American public the highest pharmaceutical prices in the world, while it sells the very same drugs all over the world at prices one-half, one-third or even one-tenth of the price they charge in the United States. They do this because in the rest of the industrialized world, there is legislation that limits profits for medications, while the U.S. allows these companies to charge whatever the market will bear. The Affordable Care Act does not address this issue. This is our issue.

Dr. King said, “When people get caught up with that which is right and they are willing to sacrifice for it, there is no stopping point short of victory.” The Affordable Care Act was not victory. We now have a House of Representatives that thinks the American public will be appeased by political theater instead of substance. They had planned to spent time reading the Constitution omitting the parts about Blacks being only three-fifths of a person, or the prohibition of alcohol; revisionist history at best, trying not to acknowledge the Constitution has been changed repeatedly throughout history.

They had planned to spend time voting to repeal the law when they knew it was an empty gesture. The shootings in Arizona at least gave them pause for that.

What the American public wants is not so different from what African Americans want and deserve. We want guaranteed access to care, freedom of choice of provider, quality health care and two words you don’t hear in association with health care very much anymore: trust and respect.

We know it can be done because every other industrialized country in the world has figured how to do this. Most of them spend less than half what we do and they have better outcomes with more satisfaction.

It is not so complicated what we want: we want a health care system that takes everybody in and leaves nobody out. It is only the phony solutions they are attempting to confuse us with, that are complicated, just so we don’t notice they fail to expand coverage to those who need it and deserve it. That’s why this will be the civil rights struggle of the 21st century, and this is our issue.

I understand people are reluctant to criticize the ACA because our president is under assault from the right and he needs our support. I think Dr. King would tell us it is important to tell the truth. “The time is always right to do what’s right.”

When I think about this struggle I think about a poem my father taught me as a child. It was written by Langston Hughes and is called “Mother to Son.”

*Mother to Son*

Well, son, I’ll tell you:
Life for me ain’t been no crystal stair.
It’s had tacks in it,
And splinters,
And boards torn up,
And places with no carpet on the floor –
Bare.
But all the time
I’se been a-climbin’ on,
And reachin’ landin’s,
And turnin’ corners,
And sometimes goin’ in the dark
Where there ain’t been no light.
So, boy, don’t you turn back.
Don’t you set down on the steps.
‘Cause you finds it’s kinder hard.
Don’t you fall now –
For I’se still goin’, honey,
I’se still climbin’,
And life for me ain’t been no crystal stair.

The issue of guaranteeing access to care for everyone is an issue of social justice. Battles for social justice are never over, because there will always be reactionary forces waiting in the wings to turn back the clock. There are no easy solutions. We have to be willing to fight for what we believe in and keep fighting.

The night before he was assassinated Martin Luther King said: “Let us stand with greater determination. And let us move in these powerful days, these days of challenge to make America what it ought to be. We have an opportunity to make America a better nation.”

I hope you will join me in saying what we expect from any health care program any politician will offer us:

Everybody in, Nobody out!
Everybody in, Nobody out!
Everybody in, Nobody out!

Thank you.

My guest is Dr. Margaret Flowers, congressional fellow of Physicians for a National Health Program [PNHP]. Welcome back to OpEdNews, Margaret. Republican lawmakers, fresh from their November victory, are pledging to move immediately in the new Congress to dismantle the health care law that President Obama gave so much attention to. What’s your take on that?

Thank you for inviting me back, Joan. As you know, Physicians for a National Health Program does not support the new health law. Overall we find that it does more harm than good by further privatizing our health care and failing to address the fundamental problems of rising health care costs and lack of access to care for tens of millions of people. That said, we find the Republican plans to dismantle the health law reprehensible given that they are willing to remove what coverage was gained under the law and offer no effective alternative to our growing health care crisis.

The Republican calls to repeal the law are mere political posturing and will not succeed. In fact the health industries, which contributed more heavily to Republican campaigns in the last election cycle than to Democrats, do not want the full law repealed. The Republicans will more likely succeed in defunding portions of the bill and relaxing regulation of the health insurance industry. This will escalate our health care crisis.

The health law passed in 2010 has already begun to unravel as the Department of Health and Human Services has had to issue multiple waivers excusing businesses and insurance companies from complying with provisions in the law that they refused to meet. A large part of the increase in coverage under the law was based on an expansion of Medicaid, however, states are facing severe budget deficits which will prevent them from implementing the expansion. Republican efforts will likely accelerate the unraveling.

This is why PNHP and the many other organizations which advocate for single payer/improved Medicare for All continue to push forward in educating and building the grassroots voice for single payer. We recognize that our health care problems have not yet been appropriately addressed or solved.

There are millions of us out there who share your concern about the current health care crisis. But this is a little tricky. Those of us who feel that the law passed was less than stellar need to fight back against its repeal, its unraveling or being whittled away altogether by Republicans or strained state budgets. At the same time, we need to be agitating for something that will really do the job. That’s a little complicated. And voters and the public in general have had a notoriously short attention span. How do you channel that very real public distress to bring about meaningful and positive change?

As you are aware, civil unrest in this nation is growing. It is an expression of the very real public distress that you mention. Although information about this unrest is largely censored from the mainstream media, we see that non-union workers and anti-poverty movements are growing as are more organized actions such as the prison protests in Georgia, nurses’ strikes and the veteran-led antiwar civil resistance. This type of unrest is to be expected if we look at what happens historically in nations which experience such severe wealth inequalities as we have in the United States.

Some of the civil unrest is turning to violence. In the absence of constructive and nonviolent avenues for social change and as unemployment, lack of access to health care, homelessness and poverty grow, the level of violence may increase. This is why, now more than ever, we must educate, organize and engage in actions that change the balance of power away from corporate interests and to the needs of people.

There are three important principles that will guide effective action. First, our movements, whatever the issue, must be independent of political parties. The Republican and Democratic parties are both controlled by concentrated corporate power. There are some differences between those parties but overall they serve corporate power and not the people. We must be willing to hold all legislators accountable to act on behalf of people even if that means that they lose a few elections until the shift occurs. And independence also includes the media. We will have to make our own media because mainstream media is also controlled by corporate interests.

Second, we must be clear about what we ask for and that is where education comes in. We have the solutions to all of our problems. For health care it is a national single payer health system. For unemployment and the environment, it is investment in green jobs and ending oil and coal dependence. For the economy, it is developing sustainable local economies and ending Wall Street bailouts. And so on. We must educate the public through local events and independent media about these solutions.

And third, we must be uncompromising in our demands. We are too often willing to accept partial or non-solutions to our problems because we are told that what we want is politically infeasible. When we look at health care, we are constantly told that single payer is not politically feasible. We have heard this for decades. However, the legislation that passes which is politically feasible fails to be feasible from a practical standpoint. It simply doesn’t work. The number of un-insured continues to grow and soaring health care costs are destroying our families and businesses. At some point, we have to realize that we determine what is politically feasible because we hold the power of the vote. We must learn to use that power.

Of course, these are difficult times and many of us are struggling. However, each of us can contribute in some way. We can weaken corporate power by supporting local goods and services. We can educate ourselves and those around us. We can donate to non-profits. We can expose injustice that we see and work with others in our community to end it. We can treat each other with love and respect so that we model what we want to see for others. And for those who are able, we must join together and engage in acts of strategic non-violent resistance.

It is important to realize that work for peace and for social and economic justice is all related. The various movements need to join together in our actions to create a healthy, prosperous and just country. For me, this means that we must organize large acts of non-violent resistance together that focus on weakening corporate power and letting legislators know that business as usual cannot continue. This is why I joined the veterans in their action against war at the White House in December. I believe as we continue to educate, organize and act, more people will join us in any way they can.

Wow, Margaret! This is a lovely, well fleshed-out plan of action, with something for everyone. What can you tell us about specific efforts going on now at the state level for single payer? We don’t hear much about it through the corporate media so it feels like nothing is happening.

Yes, Joan. There is a lot happening at the state level when it comes to single payer. Currently, twenty states have single payer health bills in some phase of the legislative process.

As you may know, California has passed a state single payer bill twice in 2006 and 2008. I just returned from a large health professional student-led march, rally and lobby day at the state capital in Sacramento. The California single payer coalition is continuing to move forward to pass single payer and have it signed by the new Governor. California faces such a serious budget crisis that I was told the legislature will be basing their cuts on what will result in the least number of lives lost.

We are particularly enthusiastic this year about Vermont. They are poised to pass a single payer health bill this legislative session. The state hired Dr. William Hsaio from Harvard to design their health system. He has designed health systems for five countries, the most recent being the single payer system in Taiwan. The new governor of Vermont, Peter Shumlin, ran on a strong single payer platform. And, of course, Vermont has Senator Sanders, who has been a long time proponent of single payer.

Even with all of the stars seeming to be aligned, it is going to be a difficult process to get single payer passed in Vermont. The forces who oppose this, primarily the corporations who profit from the status quo, will be putting tremendous resources into that state to stop single payer. For that reason, many of the organizations that support single payer are working to assist the state single payer movement. Single payer advocates from across the nation are volunteering or helping to raise funds for Vermont.

I encourage your readers to visit www.vermontforsinglepayer.org to learn more about the efforts there and to support them.

Legislation will also be introduced at the national level again in both the House and Senate this year. It is important to work at both the state and national levels because we cannot predict where we will be successful first. Of course, the ultimate goal is a national single payer health program so that all people living in our country will have access to care and so that we can control our health care costs at the national level. Health care costs are a significant cause of our national debt.

Agreed. Tell us about the national deficit and the commission and efforts to cut social insurances like Medicare and Medicaid. How does that fit into the mix?

You are probably aware that the President appointed a commission to look at our national deficit last April. This commission, the National Commission for Fiscal Responsibility and Refom, was composed of 18 people, 14 of whom were fiscal hawks. The commission received support and staff from the Pete Peterson Foundation which has advocated for cuts to our social insurance programs for decades. It was interesting that the President created this commission despite opposition coming from within the Democratic party.

During the summer and fall, there was a considerable effort by the Peterson Foundation and in the media to convince people in America that Social Security and Medicare/Medicaid were to blame for the deficit and that they would need to be changed by either raising the age of eligibility or otherwise placing more of the cost onto the individual.

Members of the single payer community testified before the commission ( read my testimony here ), educated staffers in Congress and built a public education campaign called Handsoffourmedicare.org to counter the misinformation coming from the deficit commission and the media.

The commission was required to vote on recommendations to reduce the deficit by December 1st. They missed the deadline and were not able to gain enough votes to pass a package of recommendations. However, many believe that their proposed actions will turn up in legislation being put together in the coming year.

It is commonly accepted that the rising cost of health care is a fundamental cause of our national deficit, as well as the wars and financial catastrophe. Several members of the commission rightly said that we must deal with the cost of health care in order to effectively resolve the deficit.

Unfortunately, while the commission has made the correct diagnosis, they are ordering the wrong treatment. The commission proposed some initial cuts to Medicare including the Medicare funds that help to pay for the training of doctors, and proposed that more drastic measures be taken if the initial steps are not effective. Of course the initial steps will not be effective because they miss the cause of Medicare’s difficulties.

Medicare and Medicaid are not the causes of our national deficit, they are the victims of a broken health system. As our overall health care costs rise, so do the costs of Medicare and Medicaid. The most effective way to control our health care costs would be to expand and improve Medicare and put everybody in the country on Medicare instead of using hundreds of different health insurances as we do now.

The administrative savings alone of a single payer national health program would be around $400 billion. There are other ways that single payer/Medicare for All controls health care costs such as giving hospitals and other medical institutions a global budget and negotiating for the prices of pharmaceuticals, medical devices and services.

We will need to watch carefully to make sure that Congress does not chip away at Medicare and Medicaid over the next few years. These social insurance programs have been effective in improving the health of the populations they serve and on lifting people out of poverty. It is imperative that we preserve and protect them as we continue to push for improved Medicare for all.

Thanks for bringing us up to date on single payer, Margaret. It was a pleasure talking with you again.