PDF The single payer movement was not invited into the national health reform debate.
But they are not going away.
July 30, 2010 was the 45th anniversary of Medicare. Activists across the country took the opportunity to remind us that Medicare works for older Americans and it can work for the rest of us.
Medicare at 45
The Obama administration took the opportunity to tout improvements in Medicare as a result of the Patient Protection and Affordable Care Act (PPACA):
- More benefits, especially preventative benefits
- More tools to fight fraud and abuse
- Lower drug cots for seniors
- Improved quality of care through pilot programs that encourage more integrated and coordinated care delivery
CMS also issued a report that the savings from the PPACA would extend the life of the Medicare Trust Fund an additional 12 years.
The irony of touting Medicare while its Deficit Commission warns of the need to rein in entitlements seems lost on this administration.
Medicare for All
Meanwhile, three strong congressional proponents of a single payer health care system used Medicare’s birthday anniversary to remind their colleagues in Congress that “Medicare for All is inevitable in the United States.”
In their letter to “friends of health care for all”, Representatives Dennis Kucinich (D-OH), and John Conyers (D-MI) and Senator Bernie Sanders (I-VT) wrote, “We vow to continue to fight along side you for health care justice for all at both the federal and state level.”
States and single payer
It is at the state level that activists hope to make breakthroughs. One of the more promising states appears to be Bernie Sanders’ own state of Vermont. Governor Jim Douglas has allowed a bill to become law without his signature that could challenge the federal health reform law in a very positive direction. Apparently he is passing on the opportunity to have the name Douglas permanently associated with single payer in both Canada and the United States.
The law will create a health reform commission, which has until Feb. 1, 2011, to propose to the governor and general assembly three design options for universal coverage in Vermont. One of those options will be creating a single system of health care in the state.
California has twice passed single payer bills only to be vetoed by the Governor Schwarzenegger.
Other states are actively pushing their legislatures. Maryland has two identical bills in both houses of the Maryland Legislature, called the Maryland Health Security Act”. They have held hearings and have about ¼ of the legislators on board as sponsors. Healthcare-NOW of Maryland is trying to raise money for an economic impact study.
Maryland and Pennsylvania
Across the Mason-Dixon line in Pennsylvania, Governor Rendell has promised to sign a single payer bill if it should reach his desk. Since the Governor will be leaving office in January, that window of opportunity may be closing fast. Nevertheless, activists in Pennsylvania are building a movement that is gathering momentum. In response to grass roots pressure, The State Democratic Committee endorsed single payer and both Democratic candidates for governor and senator have said they would support single payer legislation.
The prospect of two border states enacting single payer health care offers an exciting vision of a regional single payer health care plan network. But there are more than just local challenges that face these activists. And the “Letter to friends of health care for all” certainly highlights that issue.
The PPACA gutted efforts to encourage state initiatives for health care reform. Instead, the law puts up roadblocks for any creative state initiatives to resolve their own health care issues.
More on that topic next week.
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