Who We Are

Single-Payer Action Network Ohio (SPAN Ohio) is a coalition of individuals and organizations in working together to achieve fundamental reform of the health insurance system, first in our state and eventually at the national level, so that every resident is guaranteed full and comprehensive coverage from birth to death. SPAN Ohio is a non-partisan, non-profit 501(c)(4) organization. Contributions to SPAN are not tax deductible.

To join the coalition, please complete the sign-up form, which will add your name to our mailing list and allow us to keep you informed of our progress. Since we are not a membership organization, there is no cost to join. However, voluntary contributions in any amount to help cover the cost of printing and other expenses are greatly appreciated. To make a financial contribution, please CLICK HERE.

"First they ignore you, then they ridicule you, then they fight you, then you win." -- Mahatma Gandhi

News

Keep Medicaid expansion plan in Ohio: editorial

 

By The Plain Dealer Editorial Board on April 09, 2013 at 7:15 PM, updated April 09, 2013 at 7:24 PM

Ohio House Republicans are acting with gross irresponsibility in rejecting Republican Gov. John Kasich's bid to expand Medicaid coverage for poor Ohioans. Even more perplexing is the lack of vocal opposition from some Cleveland-area GOP lawmakers for a decision that -- if it stands -- will gravely damage Greater Cleveland.

Anti-expansion Republicans portray their position as a matter of principle. But their stance is the poisoned fruit of childish partisanship and craven self-interest: They fear primary-election challenges from other Republicans who think that expanding Medicaid in Ohio represents a form of collusion with President Barack Obama, whom they loathe.

For that seamy reason, the Ohio House's GOP caucus, led by Medina's William Batchelder, would deny adequate medical care to hundreds of thousands of Ohioans (many in Greater Cleveland) and reject billions of dollars from the U.S. Treasury. It's mindless and it's pathetic.

Rejecting Medicaid expansion will damage Ohio from Lake Erie to the Ohio River. It will further imperil community hospitals already squeezed by the cost of caring for uninsured patients. It will especially damage Greater Cleveland, which has some of Ohio's greatest concentrations of poverty -- and a nexus of high-tech biomedical companies, including world-renowned hospitals that help shoulder the costs of caring for the uninsured, a burden Medicaid expansion would lighten.

Medicaid expansion also is a smart economic strategy that will underwrite jobs, keep Ohioans' tax dollars in Ohio, improve the health and productivity of our citizens and reduce state outlays for prison health care.

Among those who would benefit are working Ohioans without health insurance who live at or below 138 percent of the poverty level. These men and women, who play by the rules, are the very Ohioans Republicans claim to respect.

What Ohio House Republicans have really decided is that unpaid emergency room charges -- and all other such unpaid medical costs -- will be paid not with help from taxpayers in all 50 states but instead by jacking up the health-insurance premiums or employer-sponsored health plan costs of Ohioans who do have coverage. If that's fair to Ohio employers, the word "fair" has no meaning at the Statehouse.

The House Finance-Appropriations Committee now will affirm or reject House Republicans' refusal of Medicaid expansion. Among the committee's members are Reps. Marlene Anielski of Independence and Mike Dovilla of Berea, both Republicans. Also with a key voice within the House GOP caucus, although she's not on the committee, is Westlake's Nan Baker.

Baker, Anielski and Dovilla have a clear choice. They can stand with the blind partisanship of some of their GOP colleagues. Or they can stand with Greater Clevelanders by fighting for Medicaid expansion.

Medicaid expansion adds up for Ohio

Medicaid expansion adds up for Ohio families, taxpayers: Evelyn Lundberg Stratton

By Plain Dealer guest columnist on March 16, 2013

As a former Ohio Supreme Court justice busily and happily transitioning into my new work on mental health and veterans' issues, I wasn't paying much attention to the discussion about Medicaid expansion. Like Gov. John Kasich and many others, I had issues with Obamacare. Then a friend asked me to "look at the facts" of Medicaid expansion. That triggered 23 years of judicial training, learning how to put aside personal biases and feeling and judge a matter on evidence alone.

This is what I learned:

Medicaid is health insurance for Ohio's most vulnerable citizens -- those earning up to 138 percent of the federal poverty level, or about $15,856 for an individual and $32,499 for a family of four. About 366,000 Ohioans will be covered by the Medicaid expansion for an estimated total cost of $2.6 billion over the biennium.

That cost will be paid entirely by the federal government through 2016, ratcheting down to 90 percent afterward. Ohio can opt out of the expansion if the rules change later.

Rejecting the federal expansion money would send federal money back to Washington and to other states to pay for their Medicaid expansions. Yet Ohio receives billions of dollars every year from the federal government for roads and bridges, education and research grants, and we don't for one minute consider sending that money back to the federal government. After all, we pay good money to the federal government in the form of taxes, and we deserve to get some of it back. How is Medicaid expansion any different?

Besides, state and local governments, employers and taxpayers already pay for the health care of uninsured Ohioans. Our Department of Rehabilitation and Corrections will save $27 million over the biennium on inpatient hospital costs to prisoners under the expansion. In addition, the community behavioral health system will save approximately $105 million over the biennium on services that shift to Medicaid. For example, of the 8,000 individuals in Lucas County now requiring behavioral health services, 7,000 -- or 88 percent -- would be covered by Medicaid, saving $4.6 million and freeing up much-needed local funding for other county needs.

Today, health care for 1.5 million uninsured Ohioans is borne by Ohio's hospitals, employers and 10 million other taxpayers. Hospitals are required to provide medically necessary care, at no cost, to low-income and uninsured individuals. Hospitals make up their losses by charging others more or eliminating services or programs. As a result, the average privately insured individual pays approximately $1,000 per year for costs incurred by uninsured individuals.

Preventive health care for uninsured individuals is virtually nonexistent. They often wait to seek medical treatment -- hoping the condition resolves itself -- until their situation worsens, requiring care in the emergency department. This is a costly scenario for both the individual and the hospital. In 2010, Ohio hospitals provided $1.1 billion in total charity care and incurred $645 million in bad debt.

The Affordable Care Act reduced reimbursement to hospitals that provide a high volume of care to low-income and uninsured individuals with the expectation that the additional Medicaid funds associated with the expansion would offset the loss. The U.S. Supreme Court ruled that the Medicaid expansion is optional for states, but if a state rejects it, its hospitals will still feel the impact of the reimbursement cuts.

My analysis: Why would we turn down these federal funds and instead use local dollars to pay for needs that already exist? Our federal income-tax dollars will go to other states and we still have to come up with the local dollars.

I have used my health insurance many times, including for surgery that I otherwise would never have been able to afford. But so many people have no such insurance. I am particularly concerned about those with serious mental illnesses. I saw many of them in my courtroom, and I know firsthand the ill effects of a lack of insurance and a poorly funded community behavioral health system.

Individuals who do not get needed physical and behavioral health treatment and their families struggle. Extending Medicaid to Ohio's lowest-income uninsured is the right thing to do for them and for all Ohioans.

Evelyn Lundberg Stratton, a former Ohio Supreme Court justice, is a health care adviser and attorney with Vorys, Sater, Seymour and Pease LLP.

A (sarcastic) salute to America's health-care system

The Columbus Dispatch Op Ed, Wednesday August 8, 2012

 By Kevin Horrigan, The St. Louis Post-Dispatch


 “Perhaps not surprisingly in a country where health-care reform is so controversial, it was the high-profile presence of the NHS that stunned many American writers. … Certainly the U.S. equivalent, which would be dancing health insurance corporate executives, was hard to imagine.”

— Paul Harris, in The Guardian , July 28

?Hah, hah, hah. Very funny. It’s not hard at all to imagine what the “U.S. equivalent” to your Olympic Opening Ceremony’s salute to Britain’s National Health Service would look like. I’m already working on it.

Sure, “dancing health-insurance corporate executives” will be part of it. If you’d made that much money last year, you’d want to dance, too.

Picture this: It’s night in Florida. We’re in a darkened Raymond James Stadium in Tampa, jammed with 66,000 delegates to the Republican National Convention and their guests. A spotlight illuminates the stage. The seven top health-care CEOs, carrying canes and dressed in white top hats and tails, prance on stage as the Mormon Tabernacle Choir sings Puttin’ on the Ritz.

Pretty nice, huh?

The spotlight widens to show 94 primary-care doctors, in multi-colored scrub suits, forming a ring around David Cordani, the CEO of Cigna Health Care, bowing and scraping to honor the fact that at $19.1 million, Cordani made more in 2011 than all 94 of them combined.

The orchestra breaks into Gershwin’s It Ain’t Necessarily So as the stadium floor is lighted, revealing 400 actual health-insurance bureaucrats wearing telephone headsets and sitting at small desks. They shake their heads back and forth in our “Salute to Rescission.”

The crowd erupts, because fans know that if Republicans repeal the Affordable Care Act, God will be in his heaven, all will be right with the world and insurance companies once again will be allowed to retroactively cancel coverage when someone needs it.

Lights around the stadium’s upper tier are forming a large donut, signifying the “Medicare donut hole” that will return once “Obamacare” is eliminated, thus ensuring that drugs for anything between basic coverage and catastrophe are not covered. The orchestra swings into Live and Let Die.

Cannons in the end zones fire clouds of pills into the sky. As they fall to the floor, out of the stadium tunnels limp thousands of senior citizens who are allowed to scrounge for the pills. Then, it’s time for our….

Tribute to the ER! Giant video boards flash the image of former President George W. Bush uttering these immortal words in 2007: “I mean, people have access to health care in America. After all, you just go to an emergency room.”

The theme from the TV show ER comes up as sirens wail, ambulances tear around the stadium floor, disgorging patients into the busy “emergency department” on center stage, already jammed with insured adults and children who have no primary-care doctors.

Our ER “treats” them and sends them on their way with big weights (symbolizing hospital bills) strapped to their backs, which they then pass to the people in the crowd — who are delighted to get them!

On wires stretched across the top of the stadium a huge number “17.6” sparkles in lights. It represents the percentage of the gross domestic product devoted to health care — 8 percent higher than the Brits. The music swells into Creed’s Can You Take Me Higher?

The crowd sings along, waving 66,000 foam “We’re No. 1” fingers, signaling America’s status as the nation with the most expensive health care in the world — 2.4 times more expensive than the silly Brits.

KA-BOOM! go the fireworks. We crane our heads skyward to see a giant figure “37,” symbolizing the World Health Organization’s ranking of the American health-care system.

The big finale: With the crowd’s attention diverted skyward, volunteers from health-insurance companies have erected cardboard cutouts of men, women, children and babies around the floor of the stadium. There are so many of them — 45,000 — that they loop around the field in a squiggly line almost a mile long.

They represent the 45,000 Americans whose lack of health insurance contributes to their premature death each year, according to a 2009 study by the Harvard Medical School. Now riding into the stadium atop Rafalca, his wife’s Olympic dressage horse, is Mitt Romney, who will be nominated for president on the following night.

He guides the mare’s nose to the first cardboard figure. A simple nudge and, like dominoes, they topple over in spectacular sequence. The crowd goes wild.

Kevin Horrigan writes for the St. Louis Post-Dispatch.

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Everyone Should Be Entitled to Medicare

By Bill Moyers, Moyers & Company

04 Aug 12

BILL MOYERS: I read a news story this week that sent me on a nostalgic trip down memory lane. This past Monday, July 30th was the 47th anniversary of Medicare, and to celebrate it, the "Raging Grannies," as they’re known, gathered outside the county office building in Rochester, New York to protest rumored cuts to their Medicare coverage.

RAGING GRANNIES: This old grey granny now needs a test or two -

BILL MOYERS: They praised Medicare in song as "the best deal we have in the country," and even called for expanding it Medicare into universal health care for everyone.

It seems the Republican Speaker of the House, John Boehner, was coming up from Washington to raise funds for Republican congressional candidate Maggie Brooks. The "Raging Grannies" wanted to make certain Ms. Brooks didn’t sign on to the GOP budget which includes cuts to Medicare.

For myself, the "Raging Grannies" channeled a familiar voice, the Texas twang of my boss back in 1965, Lyndon Baines Johnson. I was a White House assistant at the time and had been working with the President and others on the team trying to get Medicare through Congress. Even with overwhelming Democratic majorities in the House and Senate, it was one tough fight. Others had tried before us.

In his 1948 State of the Union message, President Harry Truman said:

HARRY TRUMAN: This great Nation cannot afford to allow its citizens to suffer needlessly from the lack of proper medical care. Our ultimate aim must be a comprehensive insurance system to protect all our people equally against insecurity and ill health.

BILL MOYERS: But every time Harry Truman proposed legislation to do just that, Congress refused to budge. In the 1960s, John F. Kennedy took up the cause:

JOHN F. KENNEDY: Our working men and women, instead of being forced to ask for help from public charity, once they are old and ill, should start contributing now to their own retirement health program through the Social Security System…

BILL MOYERS: But his proposal failed in the Senate by just two votes.

On the other side, actor Ronald Reagan, still in private life, had signed on as the American Medical Association’s hired spokesman in their campaign against Medicare. Doctors’ wives organized thousands of small meetings in homes around the country, where guests listened to a phonograph record of Reagan deploring the evils of "socialized medicine":

RONALD REAGAN: Behind it will come other Federal programs that will invade every area of freedom as we have known it in this country […] until one day, as Norman Thomas said […] you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.

BILL MOYERS: But now, it was Lyndon Johnson’s turn. Tragically thrust into the White House by Kennedy’s assassination, LBJ, the son of Franklin Roosevelt’s New Deal and Harry Truman’s Fair Deal, vowed to finish what they had started. He pushed us relentlessly to get it done. Here he is talking to his Vice President, Hubert Humphrey, in early March of 1965:

LYNDON JOHNSON: They are bogged down. The House had nothing this week, all -damn week. Now that’s where you and Moyers and Larry O’Brien have got to find something for them. And the Senate had nothing […] so we just wasted three weeks […] Now we are here in the first week in March, and we have just got to get these things passed […] I want that program carried. And I’ll put every Cabinet officer behind you. I’ll put every banker behind you. I’ll put every organization we got behind you […] I’ll put the labor unions behind you."

BILL MOYERS: About all he had left was the White House kitchen sink, and pretty soon he threw that behind us, too.

Later that March he called me to talk about a retroactive increase in Social Security payments that we were supporting. I had argued for it as a stimulus to the economy. LBJ said okay, but reminded me that social security and Medicare were about a lot more than economics:

LYNDON JOHNSON: My inclination would be […] that it ought to be retroactive as far back as you can get it […] because none of them ever get enough. That they are entitled to it. That that's an obligation of ours. It's just like your mother writing you and saying she wants $20, and I'd always sent mine a $100 when she did. I never did it because I thought it was going to be good for the economy of Austin. I always did it because I thought she was entitled to it. And I think that's a much better reason and a much better cause and I think it can be defended on a hell of a lot better basis […] We do know that it affects the economy […] But that's not the basis to go to the Hill, or the justification. We've just got to say that by God you can't treat grandma this way. She's entitled to it and we promised it to her.

BILL MOYERS: LBJ kept that promise. He pushed and drove and cajoled and traded, until Congress finally said yes. And so it was that 47 years ago, we traveled to Independence, Missouri, the hometown of Harry Truman, and there with the former president at his side, LBJ signed Medicare into law. Turning to Truman, whom he called "the real daddy of Medicare, " Johnson signed him up as its first beneficiary. Harry Truman was 81.

All this was high drama, touched with history, sentimentality, politics, and compromise. A whole lot of compromise. The bill wasn’t all LBJ wanted. It was, in fact, deeply flawed. There were too few cost controls, as some principled conservatives warned, who were then rudely ignored. Co-pays and deductibles remain a problem. And we didn’t anticipate the impact of new technology, or the impact of a burgeoning population.

In fact, even as he signed the bill we still weren’t sure what all was in it. As LBJ himself once told me, never watch hogs slaughtered before breakfast and never, never, never show young children how legislation gets enacted.

But Lyndon Johnson had warned: "We will face a new challenge and that will be what to do within our economy to adjust ourselves to a life span and a work span for the average man or woman of 100 years."

That longevity, and the cost, are what we must now reckon with. As the historian Robert Dallek has written, Medicare and Medicaid, the similar program for the very poor, "…did not solve the problem of care at reasonable cost for all Americans", but "the benefits to the elderly and the indigent…are indisputable." And there’s no going back, current efforts notwithstanding. A new study in the journal Health Affairs finds that Medicare beneficiaries age 65 and older are more satisfied with their health insurance, have better access to care, and are less likely to have problems paying medical bills than working-age adults who get insurance through employers or purchase coverage on their own.

So sing on, Raging Grannies, sing on. The surest way to save so popular and efficient a health care system is to make it available to everyone.

RAGING GRANNIES: Everybody in and nobody out, single-payer Medicare for all.

If only.....

Profits or Patients? Aetna and HCA Answer Without Hesitation

August 7th, 2012

By Donna Smith

My tweet yesterday said I’d write about the three pieces of mail I received from my insurance company, Aetna, this week. All three confirmed it. In their eyes and in every manner of decision they make, I am either a medical loss if a claim must be paid or I am a profit if they can deny me.

If only we had Medicare for all for life…

Read more: If only.....

Targeting Single-Payer Advocates

 

COUNTERPUNCH - July 16, 2012

Liberals Go Dizzy Spinning ObamaCare

Targeting Single-Payer Advocates

by HELEN REDMOND

President Obama’s Patient Protection and Affordable Care Act sucks. It isn’t change in the dysfunctional American health care system that any one should believe in or defend. And yet that is exactly what liberals and progressives are doing. Led by spin doctors at The Nation, they’re spinning ObamaRomneyCare (ORC), and that’s what it should be called, as if it were a step in the right direction. As if it were the only outcome of the national health care reform debate in 2009.

The individual mandate that compels millions of people to purchase unaffordable underinsurance and then punishes them with a fine if they don’t, and the transfer of $447 billion in tax payer money to the health insurers were deal breakers for advocates of a single-payer, national health care system. It doesn’t make sense to give the corporations that cause the health care crisis more profits and power in exchange for a modest expansion of Medicaid and a series of mostly rhetorical reforms that the insurance industry and employers are already undermining. It’s no different than giving the bankers responsible for crashing the world financial system billions of dollars in bail out money. How’s that working for Americans?

Single-payer (SP) supporters opposed the passage of ORC and the Supreme Court decision forcing people to buy expensive, malfunctioning products from corporations that bankrupt, deny care or kill them. Many expressed “relief” at the decision to uphold ORC. That feeling was ephemeral as the implications of the Medicaid decision rippled across the country. The Supreme Court ruled that threatening to withdraw Medicaid funding from states that failed to expand their programs was coercive “economic dragooning.” But why isn’t the individual mandate “economic dragooning?”

Seven Republican governors already said they would opt out and dozens are taking a wait and see approach. The liberals told us we had to support ORC if only because 17 million people would get coverage through Medicaid. Now that reform is being scaled back. The Medicaid debacle illustrates why health care reform has to be federally funded and national in scope.

It’s useful to quote Obama on health care before he was president. He actually got it. Candidate Obama said that forcing the uninsured to buy insurance was like forcing the homeless to buy homes and he added, “I don’t have such a mandate because I don’t think the problem is that people don’t want health insurance, it’s that they can’t afford it.”

Senator Obama in 2005: “I happen to be a proponent of a single-payer, universal health care program. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its gross national product on health care, cannot provide basic health insurance to everybody.”

Any reform that leaves 23 million people uninsured, that proudly excludes undocumented immigrants, and doesn’t cover abortion (watch Obama’s speech on health care to Congress in 2009, it’s sickening) doesn’t deserve one shred of support.

SP activists consistently called out Obama’s hypocrisy and challenged him to do the right thing. Liberal, Democratic astroturf organizations like Health Care for America Now (HCAN) worked overtime to convince people that there was no “political will” in Washington for SP. Groups like HCAN always surface when movements for fundamental reform rise. Their job is to dumb down expectations and channel activist’s energy into incremental reforms that help the fewest people and don’t threaten the power or the profits of the status quo. HCAN wasn’t an ally in the struggle for single-payer, they were a deliberate obstacle to it.

The Nation has published a bevy of articles that blindly and breathlessly spin ORC, gloss over its fatal flaws, and bully those who criticize it. The election fear factor has ramped up their dishonest defense of ORC. Now it’s all about reelecting Obama and who gives a damn that his “signature” legislation is unraveling.

David Cole who calls the uninsured “free-riders,” tied himself into a Gordian knot explaining why it was constitutional to force people to buy private health insurance. Is it a tax or is it a penalty? Who cares? It’s wrong either way. If a Republican president wanted the Supreme Court to uphold the individual mandate (say Bush or Romney) he would’ve argued the opposite. Apoplectic, Cole would have thundered: “How dare those Republicans mandate us to buy health insurance!” Cole constantly derides SP advocates with the nonsensical and irksome phrase, “Don’t make the perfect the enemy of the good.” But a single-payer system is not perfect. It’s simply good because it solves the health care crisis.

Katha Pollitt’s article, “Obamacare (s) for Women” is positively gushing about ORC. She thinks that “Progressive women should be more enthusiastic about Obama.” Pollitt admits upfront, though, that Obama “compromised abortion right out of health care reform.” But somehow that’s okay for one of the nation’s leading feminists. She lists seven ways that ORC will help women but every single one of them is under sustained attack and could be reversed. And gender rating hasn’t ended. In the new insurance exchanges, large group plans with more than 100 employees will be allowed to continue this sexist practice.

Wendell Potter is leading the attack on SP activists. In his article, Health Care Advocates: Time to Bury the Hatchet, he pejoratively calls members of Physicians for a National Health Program (PNHP) and Health Care NOW! “die-hards.” He writes “…we are still furious at the president and the Democrats for their baffling decision not to give single-payer legislation a decent hearing and for compromising too early and too often, in their view, with the special interests.” Damn right single-payer supporters are angry! And so are millions of Americans who don’t support ORC and not because they’re Republicans or Tea Party nut jobs. No doubt many are Democrats. They want a government funded health care system that eliminates the role of private, for-profit insurers.

Potter, whose book Deadly Spin chronicles the chicanery of his former employer Cigna brilliantly, ought to be a leading voice against ORC because as he writes, “It’s a windfall for the insurers.” As an ex-insider who spun PR daily, including the denial of a liver transplant to 17-year-old Nataline Sarkisyan who died, Potter has written some of the most powerful exposes and made compelling arguments for why the insurance industry must be put out of business. Period. He explains how there isn’t one reform these killers can’t gut or get around. And yet there he was on the steps of the Supreme Court providing commentary for Democracy Now! on why ORC had to be upheld. His former bosses at Humana and Cigna must have relished the delicious irony: Potter denounces the insurers and then Potter defends the Supreme Court decision giving the insurers constitutional rights, billions in subsidies and a mandate to rip off millions of new, coerced customers.

Potter charges SP advocates with failing to create a strategy, but that’s not true. For two decades PNHP has been organizing physicians and educating them about single-payer – no easy job given doctor’s vociferous opposition. Because of PNHP’s tireless work and the uncompromising leadership of Dr. Quentin Young, a majority of physicians now support a government financed health care system. That is a huge triumph! PNHP has over 18,000 members and is growing.

Health Care NOW! has a strategy of grassroots, community organizing. Throughout 2009, dozens of chapters across the country organized meetings, marches, demonstrations and “bird dogged” politicians. Hundreds of activists were arrested in a series of sit-ins at insurance company headquarters. Our movement took a quantum leap forward but unfortunately it wasn’t large enough to win single-payer.

This is our die-hard strategy: build a large civil rights movement for health care justice that forces whatever party is in power to enact a single-payer, national health care system. There is no short cut. And there is no compromising on the necessity to abolish the health insurance industry.

And where was Wendell Potter during all this activism? He was working with HCAN for the public option and then for passage of ORC. Potter made our job harder – not only did SP advocates have to fight Obama administration promises and lies, we had to wage a fight against the well funded, toxic influence of HCAN that consistently told people single-payer was off the table, so give it up.

Like President Obama, the health insurance industry has a “kill list.” Nataline Sarkisyan was on it. Currently, 84,000 people die every year because they lack access to health care. They’re on the kill list. We need to sharpen the blade of the hatchet and cut the head off the corporations that kill for profit.

Helen Redmond writes about health care and the war on drugs. She can be reached at: This email address is being protected from spambots. You need JavaScript enabled to view it.

Her new documentary about health care is called: The Vampires of Daylight: Driving a Stake Through the Heart of the Health Insurance corporations. Website: thevampiresofdaylight.com

Transform ACA into Medicare for All?

July 4, 2012

Michael Moore, ACA, and the Single Payer Solution

By Chuck Pennacchio

Michael Moore's SiCKO reunion visit, coupled with Single Payer state-based convention, show the way to transform the Affordable Care Act's enabling provisions into Medicare for All.

Filmmaker and citizen activist Michael Moore (SiCKO, Bowling for Columbine, Roger and Me, Capitalism: A Love Story) graced Philadelphia last Saturday for a five-year reunion of SiCKO's release, the third-highest grossing documentary ever that revealed the tragedy of under-insurance in the United States. Also assembled were seven of the film's health insurance industry victims (including our own Donna Smith), and two industry whistle-blowers who continue to expose the medical-industrial-complex's profit-first methods of maximum money-making.

In addition to the emotional sagas of PREVENTABLE suffering that continue to this day - 9/11 rescue worker with oxygen tank, parentless teen, widowed spouse, morphing cancers, running battles with insurance companies, medical bankruptcies - Wendell Potter (author of "Deadly Spin") shared his crisis-of-conscience journey to 'industry whistle-blower,' beginning with his former company, CIGNA, assigning him, stealthily, to sneak-preview "SiCKO" in Sacramento and plan the public relations attacks on the movie.

Michael Moore then used story, movie-making insights, and outrage over right-wing bullying and Obama-enabling to illustrate, on the one hand, SiCKO's educational and motivational benefit and, on the other hand, the watered-down Affordable Care Act that the Supreme Court validated last week. At the same time, Michael (and Wendell) chastised single payer activists inclined to look past the significance of corporatist Chief Justice Roberts siding with the Court's more liberal members, and permitting ACA's implementation (minus the force of withholding Medicaid funding for states that refuse to accept ACA minimal health standards).

During a pre-event reception at Healthcare-NOW's William Way Center auditorium, the 300-person public event at Plays and Players Theater (sans air-conditioning on a sticky night!) near Rittenhouse Square, and the day following at our 22-member, 'One Payer States' all-day conference, speaker after speaker, discussant after discussant, emphasized the opportunity presented by ACA's continuing implementation. We need to celebrate (Moore), exploit (Michael Lighty, CA Nurses), understand our challenges, challengers, and potential allies (Brigitte Marti, Dr Carol Ritter, Mark Dudzic, Pennacchio), strategize (Potter), and organize (Francesca Lo Basso, Smith).

Specifically, our best opportunity for translating ACA passage and SCOTUS ruling into universal healthcare isembedded in the national legislation itself. That is, ACA contains provisions for state-based healthcare innovation and funding waivers (can you say "Single Payer six times straight"...six times?), already endorsed by President Obama, embraced by numerous Republicans at all levels of government, and led by Independent Senator Bernie Sanders (VT) and Democratic Representative Jim McDermott (WA) in the United States Congress.

So now it's on us, to build on the week's and weekend's successes, energy, inspiration, and more, to turn ACA into state-based Improved Medicare for All as the next step to achieving true, universal single payer healthcare for each and every person in America. Every body in, no body out.

Onward to the Proven Single Payer Solution.

Chuck Pennacchio, PhD
Executive Director
Healthcare4AllPa.org

Co-Founder, One Payer States Network

Submitter’s Website: www.healthcare4allpa.org
Submitter’s Bio:
Chuck Pennacchio, PhD, Executive Director, Healthcare for All Pennsylvania, and History Program Director, The University of the Arts in Philadelphia. BA in history and political science from University of California, and MA and PhD in diplomatic history from University of Colorado. Organizer of 40 years on issues of healthcare, environment, economic justice, war and peace. Former aide to Senators Alan Cranston (CA), Tom Harkin (IA), Tim Wirth (CO), Paul Simon (IL), and Military Personnel Caseworker to Congressman Ronald V. Dellums. Pennsylvania candidate for US Senate in 2006.

Supreme Court Upholds Health Care Law

New York Times

June 28, 2012

Supreme Court Upholds Health Care Law, 5-4, in Victory for Obama

By ADAM LIPTAK

WASHINGTON — The Supreme Court on Thursday upheld President Obama’s health care overhaul law, saying its requirement that most Americans obtain insurance or pay a penalty was authorized by Congress’s power to levy taxes. The vote was 5 to 4, with Chief Justice John G. Roberts Jr. joining the court’s four more liberal members.

The decision was a victory for Mr. Obama and Congressional Democrats, affirming the central legislative achievement of Mr. Obama’s presidency.

“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Chief Justice Roberts wrote in the majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”

At the same time, the court rejected the argument that the administration had pressed most vigorously in support of the law, that its individual mandate was justified by Congress’s power to regulate interstate commerce. The vote was again 5 to 4, but in this instance Chief Justice Roberts and the court’s four more conservative members were in agreement.

The court also substantially limited the law’s expansion of Medicaid, the joint federal-state program that provides health care to poor and disabled people. Seven justices agreed that Congress had exceeded its constitutional authority by coercing states into participating in the expansion by threatening them with the loss of existing federal payments.

Justice Anthony M. Kennedy, who had been thought to be the administration’s best hope to provide a fifth vote to uphold the law, joined three more conservative members in an unusual jointly written dissent that said the court should have struck down the entire law. The majority’s approach, he said from the bench, “amounts to a vast judicial overreaching.”

The court’s ruling was the most significant federalism decision since the New Deal and the most closely watched case since Bush v. Gore in 2000. It was a crucial milestone for the law, the Patient Protection and Affordable Care Act of 2010, allowing almost all — and perhaps, in the end, all — of its far-reaching changes to roll forward.

Mr. Obama welcomed the court’s decision on the health care law, which has inspired fierce protests, legal challenges and vows of repeal since it was passed. “Whatever the politics, today’s decision was a victory for people all over this country whose lives are more secure because of this law,” he said at the White House.

Republicans, though, used the occasion to attack it again.

“Obamacare was bad policy yesterday; it’s bad policy today,” Mitt Romney, the presumptive Republican presidential nominee, said in remarks near the Capitol. “Obamacare was bad law yesterday; it’s bad law today.” He, like Congressional Republicans, renewed his pledge to undo the law.

The historic decision, coming after three days of lively oral arguments in March and in the midst of a presidential campaign, drew intense attention across the nation. Outside the court, more than 1,000 people gathered — packing the sidewalk, playing music, chanting slogans — and a loud cheer went up as word spread that the law had been largely upheld. Chants of “Yes we can!” rang out, but the ruling also provoked disappointment among Tea Party supporters.

In Loudoun County, Va., Angela Laws, 58, the owner of a cleaning service, said she and her fiancé were relieved at the news. “We laughed, and we shouted with joy and hugged each other,” she said, explaining that she had been unable to get insurance because of her diabetes and back problems until a provision in the health care law went into effect.

After months of uncertainty about the law’s fate, the court’s ruling provides some clarity — and perhaps an alert — to states, insurers, employers and consumers about what they are required to do by 2014, when much of the law comes into force.

The Obama administration had argued that the mandate was necessary because it allowed other provisions of the law to function: those overhauling the way insurance is sold and those preventing sick people from being denied or charged extra for insurance. The mandate’s supporters had said it was necessary to ensure that not only sick people but also healthy individuals would sign up for coverage, keeping insurance premiums more affordable.

Conservatives took comfort from two parts of the decision: the new limits it placed on federal regulation of commerce and on the conditions the federal government may impose on money it gives the states.

Five justices accepted the argument that had been at the heart of the challenges brought by 26 states and other plaintiffs: that the federal government is not permitted to force individuals not engaged in commercial activities to buy services they do not want. That was a stunning victory for a theory pressed by a small band of conservative and libertarian lawyers. Most members of the legal academy view the theory as misguided,if not frivolous.

“To an economist, perhaps, there is no difference between activity and inactivity; both have measurable economic effects on commerce,” Chief Justice Roberts wrote. “But the distinction between doing something and doing nothing would not have been lost on the framers, who were practical statesmen, not metaphysical philosophers.”

Justice Ruth Bader Ginsburg, in an opinion joined by Justices Stephen G. Breyer, Sonia Sotomayor and Elena Kagan, dissented on this point, calling the view “stunningly retrogressive.” She wondered why Chief Justice Roberts had seen fit to address it at all in light of his vote to uphold the mandate under the tax power.

Akhil Reed Amar, a Yale law professor and a champion of the health care law, said that it was “important to look at the dark cloud behind the silver lining.”

“Federal power has more restrictions on it,” he said, referring to the new limits on regulating commerce. “Going forward, there may even be laws on the books that have to be re-examined.”

The restrictions placed on the Medicaid expansion may also have significant ripple effects. A splintered group of justices effectively revised the law to allow states to choose between participating in the expansion while receiving additional payments or forgoing the expansion and retaining the existing payments. The law had called for an all-or-nothing choice.

The expansion had been designed to provide coverage to 17 million Americans. While some states have indicated that they will participate in the expansion, others may be resistant, leaving more people outside the safety net than the Obama administration had intended.

Although the decision did not turn on it, the back-and-forth between Justice Ginsburg’s opinion for the four liberals and the joint opinion by the four conservatives — Justice Kennedy and Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. — revisited the by-now-familiar arguments. Broccoli made a dozen appearances.

“Although an individual might buy a car or a crown of broccoli one day, there is no certainty she will ever do so,” Justice Ginsburg wrote. “And if she eventually wants a car or has a craving for broccoli, she will be obliged to pay at the counter before receiving the vehicle or nourishment. She will get no free ride or food, at the expense of another consumer forced to pay an inflated price.”

The conservative dissenters responded that “one day the failure of some of the public to purchase American cars may endanger the existence of domestic automobile manufacturers; or the failure of some to eat broccoli may be found to deprive them of a newly discovered cancer-fighting chemical which only that food contains, producing health care costs that are a burden on the rest of us.”

All of the justices agreed that their review of the health care law was not barred by the Anti-Injunction Act, which allows suits over some sorts of taxes only after they become due. That could have delayed the health care challenge to 2015. The conservative dissenters said that the majority could not have it both ways by calling the mandate a tax for some purposes but not others.

“That carries verbal wizardry too far, deep into the forbidden land of sophists,” they said.

As a general matter, Chief Justice Roberts wrote that the decision in the case, National Federation of Independent Business v. Sebelius, No. 11-393, offered no endorsement of the law’s wisdom.

Some decisions, the chief justice said, “are entrusted to our nation’s elected leaders, who can be thrown out of office if the people disagree with them.”

Justice Ginsburg, speaking to a crowded courtroom that sat rapt for the better part of an hour, drew a different conclusion.

“In the end,” she said, “the Affordable Care Act survives largely unscathed.”

Reporting was contributed by John H. Cushman Jr., Robert Pear, John Schwartz, Ethan Bronner and Sabrina Tavernise.

History & Status of Single-Payer Bills Introduced in Ohio Legislature

Single-Payer Bills Introduced in Ohio General Assembly

For each new session of the General Assembly, bills introduced in previous sessions which have not been acted upon must be reintroduced if action by the new Assembly is desired. Below is the history of SPAN-backed single-payer bills that have been introduced in the Ohio General Assembly, from the latest to the earliest.

In April, 2013, SB No. 104 was introduced in the Senate of the 130th Ohio General Assembly by Senator Michael Skindell, with co-sponsors Edna Brown, Charleta Tavares and Nina Turner. CURRENT STATUS: Assigned to the Senate Medicaid, Health and Human Services Committee.  Members are: Shannon Jones, Chair; Dave Burke, Vice Chair; Capri Cafaro, Ranking Minority Member; Edna Brown, Randy Gardner, Kris Jordan, Peggy Lehner, Scott Oelslager, and Charleta Tavares

In April, 2013, HB No. 121 was introduced in the House of the 130th Ohio General Assembly by Representatives Mike Foley and Robert Hagan, with co-sponsors Nickie Antonio, Barbara Boyd, John Patterson and Dan Ramos. CURRENT STATUS: Assigned to the House Insurance Committee. Members are: Bob Hackett, Chair; Michael Henne, Vice Chair; John Patrick Carney, Ranking Minority Member; John Adams, Michael Ashford, Jim Butler, Anthon DiVitis, Stephanie Kunze, Tracy Maxwell Heard, Ross McGregor, Mark Romanchuk, Barbara Sears, Marilyn Slaby, Richard Sprague, Michael Stinziano, and Fred Strahorn.

In March, 2011, SB No. 112 was introduced in the Senate of the 129th Ohio General Assembly by Senator Michael Skindell (23), with co-sponsor Senator Nina Turner (25).   NO ACTION TAKEN.

On June 29, 2011, HB No. 287 was introduced in the House of the 129th Ohio General Assembly by Representatives Mike Foley and Bob Hagan, with co-sponsors Nickie Antonio (13), Barbara Boyd (09), Tom Letson (64), Clayton Luckie (39), Dale Mallory (32), Dan Ramos (56), Sandra Williams (11) and Kenny Yuko (07). NO ACTION TAKEN.

On April 29, 2009, HB No. 186 was reintroduced as HB 159in the House of the 128th Ohio General Assembly jointly by Representatives Michael Skindelland Robert Hagan and co-sponsors Barbara Boyd, Edna Brown, Michael DeBose, John DomenickMike Foley, Marian Harris, Sandra Stabile Harwood, Joseph Koziura, Tom Letson, Clayton Luckie, Dale Mallory, Peter Ujvagi, W. Carlton Weddington, Sandra Williams, and Kenny Yuko. NO ACTION TAKEN

On April 25, 2007, HB No. 548 was reintroduced as HB 186 in the House of the 127th Ohio General Assembly by Representative Michael Skindell (13) and co-sponsors Jennifer Brady (16), Edna Brown (48), Michael DeBose (12), John Domenick (95), Lorraine Fende (62). Mike Foley (14), Bob Hagan (60), Joseph Koziura (56), Tom Letson (64), Clayton Luckie (39), Dale Mallory (32), Eugene Miller (10), Dan Stewart (25), Peter Ujvagi (47), Sandra Williams (11), and Kenny Yuko (07). NO ACTION TAKEN

On May 15, 2007, SB No. 263 was reintroduced as SB 168 in the Senate of the 127th Ohio General Assembly by Senator Dale Miller (23) and co-sponsors Teresa Fedor (11), Sue Morano (13), Tom Roberts (05), and Shirley Smith (21). NO ACTION TAKEN

On May 17, 2005, HB No. 548 was reintroduced as HB 263 in the House of the 126th Ohio General Assembly by Representative Michael Skindell (13) and co-sponsors Dixie Allen (39), Edna Brown (48), Annie Key (11) Joseph Koziura (56), Dale Miller (14), Sylvester Patton (60), Shirley Smith (10), Barbara Sykes (44), Peter Ujvagi (47), Brian Williams (41), Claudette Woodard (9), and Ken Yuko (7). NO ACTION TAKEN

On September 9, 2004, the day that SPAN Ohio formally announced the kickoff of its petition compaign, bills mirroring the petition were introduced in both chambers of the 125th Ohio General Assembly.

HB No. 548 was introduced in the House by Representative Michael Skindell (13) and co-sponsors Catherine Barrett (32), Joyce Beatty (27), Mary Cirelli (52), Annie Key (11), Joseph Koziura (56), Dale Miller (14), Sylvester Patton (60), Larry Price (26), Dan Sferra (64), Shirley Smith (10), Barbara Sykes (44), and Claudette Woodard (9). NO ACTION TAKEN

SB No. 263 was introduced in the Senate by Senator Bob Hagan (33) and co-sponsors Dan Brady (23), Teresa Fedor (11) and Ray Miller (15). NO ACTION TAKEN

 

 

 

 

 

 

 

 

 

Updated 4/10/13

Supreme Court Wrangling Aside, We Still Need 'Medicare for All'

John Nichols, The Nation, March 27, 2012

It would seem that the majority on the US Supreme Court is conflicted about how to respond to the healthcare reform currently known as "Obamacare."

CNN's legal correspondent Jeffrey Toobin listened to the high court's deliberations this week and concluded that "this was a train wreck for the Obama administration. This law looks like it's going to be struck down."

Not so fast, suggests the Wall Street Journal, which like most media pins the outcome on Justice Anthony "Swing" Kennedy. "Justice Kennedy's early comment that the government carried a 'heavy burden of justification' showed considerable sympathy for the challengers," observed the Journal Tuesday. "But toward the end, one of his questions suggested that people who don’t carry health insurance are still engaged in the healthcare market—which is the central pillar of the government's case."

It's all so confusing. Or maybe not.

It is obvious enough that the barely cloaked political partisans who dominate the court would like very much to whack the Democratic president by declaring that critical components of his Patent Protection and Affordable Care Act—or, to borrow Vice President Biden's technical terminology: Barack Obama's "BFD"—are unconstitutional.

By the same token, the justices know that their conservative movement's paymasters in the insurance and healthcare industries, and on Wall Street, are actually looking foward to the day when the government requires Americans to purchase insurance from for-profit insurance companies, and when Washington steps in as the guarantor of payments to those companies (and to for-profit healthcare concerns) on behalf of low-income Americans.

Tough call, indeed.

It is usually smart when such conflicts arise to bet on the corporate crowd, as they really do call most of the shots.

But on the outside chance that the court goes rogue—as some analysts are suggesting after two days of hearings on the plan that was approved by Congress and signed into law by the president—is that the end of healthcare reform?

Frankly, it could be the beginning.

It is not like a decision by the Supreme Court to scrap all or part of the current plan is going to make the crisis facing America's dysfunctional healthcare "system" go away. In all likelihood, it would cause the crisis to become even more of, well, a crisis.

By the same token, allowing the Obama plan to go forward in its current form—without the protection that would have been afforded by a public option—is not going to solve nearly as many of the plan's problems as its more starry-eyed proponents might imagine. Indeed, one of the selling points for the Obama plan when progressives were gritting their teeth and deciding to support what was clearly a compromise was the understanding that the Patiet Protection and Affordable Care Act was a beginning, not an end.

The end has always, and should always, be the single-payer "Medicare for All" plan that would provide quality care for all Americans—as a right—and cut costs by eliminating the profiteers.

So how, amid all the legal wrangling of the moment, should real reformers think about things?

“Whether the Court overturns part or all of the law, or the Affordable Care Act remains fully intact, we will not have universal coverage, medical bills will still push too many Americans into bankruptcy or prompt them to self-ration care, and insurance companies will continue to have a choke hold on our health,” says Deborah Burger, RN, a co-president of the 170,000-member National Nurses United union.

NNU, a union that represents frontline healthcare providers—and that has taken then lead when it comes to real reform—offers a savvy response to the hyperbole that's coming from in and around the Supreme Court chambers this week:

Despite its name the Affordable Care Act has done little to actually make healthcare affordable. Out of pocket health costs for families continue to soar. Nurses now routinely see patients who have postponed needed care, even when it might be life saving, because of the high co-pays and deductibles.

Delayed dental care illustrates the problem. A February Pew Center report noted a 16 percent jump in the number of Americans heading to emergency rooms for routine dental problems, at a cost of 10 times more than preventive care with fewer treatment options than a dentist's office.

Premiums have jumped 50 percent on average the past seven years, according to a Commonwealth Fund report last November, with more than six in 10 Americans now living in states where their premiums consume a fifth or more of median earnings.

Medical bills for years have been the leading cause of personal bankruptcy. Increasingly they ruin people’s credit as well. Another Commonwealth Fund report earlier this month found that 30 million Americans were contacted by collection agencies in 2010 because of medical bills.

Fifty million still have no health coverage. Another 29 million are under insured with massive holes in their health plans, up 80 percent since 2003, according to the journal Health Affairs.

The percentage of adults with no health insurance at 17.3 percent in the third quarter of 2011 was the highest on record, up from 14.4 percent just three years earlier, Gallup reported.

On quality, the U.S. continues to lag far behind other nations. Two breathtaking examples:

More than 80 percent of U.S. counties trail life expectancy rates of nations with the best life expectancies, the University of Washington found last June. Some U.S. counties are more than 50 years behind their international counterparts.

The U.S. ranks just 41st in the world in death rates for child bearing women, and it has been getting worse, according to the World Health Organization. The average mortality rate within 42 days of childbirth has doubled in two decades, partly due cuts in federal spending for maternal and child health programs the past seven years.

Our economic meltdown has exacerbated the crisis. For the past year, nurses have seen a spike in health woes associated with job loss, high medical bills, poor nutrition and other economic factors. These include stress-induced heart ailments in younger patients, hypertension, anxiety and “gut” disorders.

“More handouts to the private insurers and other healthcare corporations will not improve these dreadful statistics,” says Burger. “The choke hold on our health by the same Wall Street types who tanked our economy is exactly what has caused the falling health barometers on access, quality, and cost.”

"The consequences of the denial of care en masse—now and in the future, with or without the ACA—could not be more ominous, explains NNU co-president Jean Ross." Only more comprehensive reform, Medicare for Life, for all Americans, will finally produce real healthcare security for our country."

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