How to Cover Everyone: Vermont’s Single-Payer Success

The state’s progressive health care model has already bolstered campaigns in more than 20 other places. 

by Amy Gluckman

posted Mar 06, 2012

Original here

The activists who celebrated the passage of Act 48 in Vermont last May will be the first to tell you that there is still a long road ahead. It may be six years before universal, single-payer health care will be fully implemented in the state. That’s plenty of time for likely opponents, including the insurance and pharmaceutical industries, to marshal their forces and try to stop it. But the progress in Vermont has bolstered single-payer campaigns in 20-plus states around the country, and successes elsewhere may in turn help sustain Vermont’s reform campaign.

More articles from 9
Strategies to End Corporate
Rule, the Spring 2012 issue
of YES! Magazine.

Single payer, or “Medicare for all,” is universal health care coverage with the government as insurer. (It’s not “socialized medicine” as in the United Kingdom, where the government runs hospitals and employs doctors directly.)

President Barack Obama’s big push for national health care reform in 2009–2010 left single-payer off the table.

Reform took a different path in Vermont. In 2010, the state hired a Harvard economist to recommend a cost-conscious system of universal coverage. The result, unveiled in early 2011, was a single-payer plan to be run by an independent, quasi-governmental board, with private insurers’ role limited to contracts for claims processing and other administrative tasks.

In the meantime, Vermonters elected a strong single-payer supporter, Peter Shumlin, for governor. But the state had seen good single-payer plans and supportive governors before (think Howard Dean). One difference this time around was a huge popular mobilization. As the legislature deliberated, supporters of single-payer turned out in large numbers, including a “People’s Team” clad in bright red T-shirts that became a fixture at the State House. The Vermont Workers Center, which had been working to build grassroots support on the issue for two decades, can take a lot of the credit. “It would be a shame,” the center’s James Haslam emphasized, “if the lesson people took from Vermont was that the win here was all about having … a sympathetic governor.”

Progressive Party State Rep. Chris Pearson says organizing was critical to convincing “nervous Democrats” to support Act 48, and notes that the campaign also benefited from Vermont’s progressive political climate. Vermont Businesses for Social Responsibility, an influential alternative to the Chamber of Commerce, supported single payer. Vermont’s Blue Cross Blue Shield, the largest insurer in the state and one of the few “Blues” that is still a nonprofit, did not mount an anti-reform campaign. And the presence of the Progressive Party itself made a difference. “While our numbers are small—five out of 150 in the House—our unwavering support for single payer has pulled the debate to the left the way you see the Tea Party pull the debate to the right,” Pearson says. He also claims the Progressive Party influenced the Democrats’ choice of Shumlin in 2010 by promising not to run a Progressive gubernatorial candidate so long as the Democrats nominated a strong single-payer advocate.

The work of implementation is now under way. The Green Mountain Care Board is holding public meetings around the state as it begins designing the new system and proposing how to finance it. Ironically, meeting the mandates of the federal Affordable Care Act will represent a detour on Vermont’s road to universal coverage.

Heavy national players opposed to single payer haven’t been active in Vermont yet, at least not openly. Fierce battles probably lie ahead, but the single-payer camp can already claim one victory. Fletcher Allen Health Care, a nonprofit hospital, wanted to sell five dialysis units to a private corporation, Bio-Medical Applications. Single-payer advocates saw this as a step backward, fought hard to prevent the sale—and won.

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Amy Gluckman wrote this article for 9 Strategies to End Corporate Rule. Amy is a freelance writer and former co-editor of Dollars & Sense magazine.

PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010, 1,900 PAGES: DERIDED BY THE RIGHT AS "OBAMA CARE" AND OFTEN LEAVING MEMBERS OF THE LEFT SKEPTICAL. WANT TO UNDERSTAND IT BETTER? THEN SEE THIS...

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In a Comic Book, Health Care Reform Explained

by JAY LONDON on February 28, 2012

in ALUMNI LIFE,ECONOMICS,HEALTH,IN THE NEWS,RESEARCH

Original here

At about 1,900 pages and 400,000 words, the Patient Protection and Affordable Care Act is a heavy read. Trying to deduce all of the bill’s information can be, at best, time-consuming and, at worst, undecipherable.

Professor Jonathan Gruber ’87 sought to interpret this information for the general public in a straightforward way: through pictures. Using a comic book format, Gruber’s graphic novel, “Health Care Reform: What It Is, Why It’s Necessary, How It Works,” explains and combats some common misconceptions about the new federal health reform law.

A longtime health economist, Gruber has worked with both political parties on health care reform. He worked alongside then-Governor Mitt Romney on the 2006 Massachusetts health care insurance reform law and advised President Barack Obama during the writing of the Affordable Care Act. He told New York’s Inside City Hall he was initially skeptical about doing the book, but quickly realized the comic-style medium was an effective way to translate information.

From Inside City Hall:
“…When you’re on airplane, and you want to know what to do in case of an accident, they hand you a comic. It’s a great way to teach people.
When we polled people and asked them whether they liked the bill, they were sort of skeptical. But when you explained what was in it, they liked it. We realized we needed to explain a very complicated concept clearly.”

In the 152-page book, an illustrated version of Gruber attempts to clarify information and combat misconceptions about the new federal health reform law. The book aims to answer bill-specific issues such as why health-care reform is important, what the individual insurance mandate is, and whether or not people will be required to buy health insurance that they cannot afford.

In the video below, Gruber uses animated illustrations to provide a short summary of points made in Health Care Reform: What It Is, Why It’s Necessary, How It Works.

http://youtu.be/IF8SiN8Bbh0

Michael Collins: "The best news out of 2010 is that the forces in control, The Money Party, have been unable to crush the will of the people to survive and see future opportunities for improvement."

Decline and Fall (Maybe) January 1, 2011

The Happy New Year Edition (with some good news about 2011)

Michael Collins

The best thing about 2010 is that it’s over.  It was a year filled with utter stupidity, mendacity, and greed beyond all bounds on the part of our rulers, also known as The Money Party.  Lots of fiddling while Rome and the rest of the world burned.  Knowledge is power and among the ruling elite in the United States, the power was off.  Somebody forgot to pay the bill or paid with a bad check, no doubt.


A Decade of Job Stagnation In 2000, 135 million citizens were employed.  In 2010 there were 139 million Americans employed.  Given the 9.7% increase in population since 2000, we would expect to see at least 148 million citizens with jobs.  Nobody much wants to talk about this or the true unemployment figures produced by the US Census called “U6″. That measure accounts for, “Total unemployed, plus all persons marginally attached to the labor force, plus total employed part time for economic reasons, as a percent of the civilian labor force plus all persons marginally attached to the labor force.”  Bureau of Labor Statistics

The “U6″ unemployment figure is 17%, well above the official 9.8% we hear all the time.  The official number accounts for 15 million citizens.  But when we use U6, we add 9 million citizens forced by economic conditions to work less than they want in part time jobs and 2.5 million marginally attached to the work force – those who gave up looking and get no benefits. That gives us a real world total of 26.5 million citizens out of work or working part time against their will.

Using more refined, politically neutral measures (closer to those in the Great Depression), the over all unemployment percentage is 22.5%, a total of 34.6 million citizens without employment.  Shadow Government Statistics calculates the real unemployment rate by adding in “long term discouraged workers” (those who stopped looking), a measure the government no longer uses.

If people don’t have jobs they suffer more, have less advantages to offer their children, and drift quickly into poverty.  They face homelessness and risk falling so far behind they’ll never recover. Thanks to the dreadful members Congress who voted for the new bankruptcy bill in 2007, those unemployed will always have their medical bills to pay.  Thoughtful bunch.

The Response – Crackpot Economics You’d think that the government would have the most able hands on deck for this economic storm.  But we’ve got the same old crew, dominated by Wall Street insiders and big bankers without credibility.  These are the folks creating MPD (multiple personality disorder) economics.  They argue that we have to focus on the deficit and get that down (even that policy was disastrous in the Great Depression).  Then they argue that we need to give away $900 billion in tax revenues so the top 1% will have enough wealth to trickle down on the rest of us.  .

They can’t have it both ways.  Lowering the deficit while lowering income at the same time is simply absurd logic.  They think nobody is paying attention.   It’s important to know that the people behind these policies know exactly what they’re doing. They just think we’re stupid, a fatal error.  The key players now include Obama, the Bush Clan, Bill Clinton, and the usual suspects from Wall Street and the big banks.

They have their own media monopoly to crank out the nonsense.  The Fed is doing its part with Quantitative Easing 2 which, as Numerian says, “… is experimental and unprecedented, except when it was used in Weimar Germany with disastrous results, or more recently in the hyperinflationary economy of Zimbabwe.”

Other Major Failings We got health care reform but Congress forgot to do anything for the people.  The elimination of “preexisting conditions” as a means to open up more coverage for adults was postponed until 2014.  The self-employed are totally screwed with their rates doubling and tripling in some cases.  And there was no action to curb the outrageous cost of pharmaceuticals thanks to a major cave in by the president.  Medicare, for example, is barred by law from negotiating discounts from big pharma. That about sums it up.  The only reform was a massive bailout for the health insurance companies.

Nothing has been done to address the rapid increase in citizens in poverty.  That would require jobs.  The only jobs those in power produce are for themselves and their cronies.

The Gulf of Mexico was polluted by the worst oil company by a long shot, BP.  The president surrendered national sovereignty over the 200 mile off shore exclusive economic zone by allowing BP to run the cleanup. That included permission for the use of a highly toxic oil dispersant, one that they knew toxic.  But it did the job required.  It kept the evidence off the surface.  Shame about the rest of the Gulf. They don’t care.  They don’t have to.

Presidential Hit Squads This year saw a radical shift in power from everyone else to the White House.  The president’s national security advisor revealed that the White House had a hit list of US citizens abroad determined to be terrorists.  Never mind the time honored process of arrest, indictment, trial, and sentencing.  If some bureaucrat nominates a “bad guy,” he’s toast.  Shame if that turns out to be one of us.  There’s no reason this needs to be limited to citizens overseas since it’s the ultimate in lawlessness from the start.  Piss off the wrong person and you’re in the cross hairs.

The United States still occupies Iraq and Afghanistan.  While China offers to invest in a top to bottom railroad system from China to the warm water port at  Karachi to distribute their goods, US predator drones bomb villages killing ordinary citizens along with whomever they’re after.   800 military bases worldwide spread ill will.  As economist Michael Hudson points out about the BRIC countries (Brazil, Russia, India, and China):  “When they say we don’t want to hold dollars, by that they mean, we don’t want to finance our military encirclement, which is what the dollar standard has financed.”

The Good News The best news out of 2010 is that the forces in control, The Money Party, have been unable to crush the will of the people to survive and see future opportunities for improvement.  All over the country families are helping each other weather the storm, parents and adult children are opening up their homes to others in need, adjusting their retirement plans, taking extra jobs, and working harder to stay afloat.  Ad hoc communities of care and compassion are emerging to buck the tide of government indifference, malfeasance, and fraud.

The United States has an inverted pyramid of intelligence.  The vast majority have far greater talents, knowledge, and wisdom than the ruling elite, who have failed miserably at every turn over the past year and decade, for that matter.  The goal is to wrench power from the fumblers before they do totally irreparable damage.

Perhaps those in the under thirty generation are the key.  They were told to work hard, go to school, and acquire skills. They were also sold on the magic of the stock market.  All they’ve seen over the past decade is a flat job market, stock manipulations, wasteful wars, and hysteria about terror – all at the expense of rebuilding the nation’s infrastructure (which would spark a real recovery) and producing work worthy of a people who want the best for their families, friends, and the country.
Happy New Year.  Time to throw the bums out.

END

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Why Congress Should Pass a Health-Care Reform Bill with a Robust Public Option

Subsidiary of WellPoint Sues Maine to Raise Insurance Premiums 18.5%
A Brave New Films Video

A wild story out of Maine.

Anthem Health Plans of Maine, a subsidiary of WellPoint, is suing the state because they want to increase premium rates by 18.5% on their 12,000 individual insurance policy holders, so they can guarantee themselves a 3% profit margin. This story shows how silly it would be to solely rely on regulation to rein in insurance industry practices.

Like many other states, Anthem Health Plans hold a monopoly on the individual insurance market in Maine, controlling 79% of all the plans. Also like many other states, they are licensed to sell insurance through the Department of Insurance, who must clear all rate increases prior to implementation. Originally, Anthem Health Plans were a nonprofit Blue Cross and Blue Shield corporation licensed to practice in Maine since 1939. In 1999, Anthem bought the business and began to operate it as a for-profit company. Since that point, Anthem has raised premium rates 10 times, and 8 of those times have been double-digit rate increases.

The average individual Maine rate-payer is paying four times as much for insurance than they did ten years ago.

But this isn’t good enough for Anthem Health Plans. They first proposed a 14.5% rate increase for its individual insurance products, then they revised it up to 18.1% and finally 18.5%. This is an average increase. Some plans would see increase of 24.5%, some 38.4%, and for its Preventive Care and Supplemental Care Accident rider, which is part of 1/3 of all their policies, Anthem proposed a rate increase of 58.2%. This amounts to Maine consumers paying $12 million more in annual premium dollars for the exact same level of benefits.

Anthem isn’t hurting for profit. Their Maine operations have generated an average annual return of $70 million dollars over the last five years. Anthem paid dividends to their parent company, WellPoint, of $75 million dollars last year alone, and $152 million since 2006. Their nine highest-paid employees totaled over $4.3 million in compensation. The individual market, while a smaller portion of their overall business, still generated $5.4 million in profit over the last two years.

The reason Anthem desires these rate raises is because their actuarial charts show they can guarantee a 3% profit through this increase. That’s an estimate, however, and in 8 of the last 10 years the profit margin achieved has actually been higher. The Maine Superintendent of Insurance ruled in May 2009 that the 3% profit and risk margin sought was “excessive and unfairly discriminatory,” as per the laws of the state, and instead approved a rate increase of 10.9% for Anthem. Given the recession, the financial health of the company, and the years of large rate increases, there was no way she could approve anything higher.

So Anthem sued the state. But not after filing revised rates at a 10.9% increase so they could get that going while they litigated for an even higher rate.

The Superintendent of Insurance explained in a court filing that there is no statute mandating that Maine must provide Anthem or any other insurer with a guaranteed profit. Given Anthem’s ability as a large operation to cut costs, just as any family must do during a recession, the Superintendent argued there is nothing preventing them from making a profit with a 10.9% rate of premium increase. But Maine is under no obligation to guarantee one. That would be a “socialized profit,” which Anthem is asserting the right to without any legal basis in fact. Furthermore, policyholders have contributed $17.4 million in profit to Anthem’s bottom line over the past decade, which should be more than enough to cover potential losses from just the individual insurance line this year.

Anthem argued that they were discriminated against relative to other companies in Maine because one other individual insurer was provided a 3% profit and risk margin (that company, MEGA, asked for 2.2% rate increase back in 2007, a far different scenario). This, the corporation said, violated their equal protection rights under the federal and state Constitutions. This is a laughable claim, that the state must guarantee a profit for every insurance company licensed to provide a product. It’s nowhere to be found in the Maine Insurance Code, and the Superintendent of Insurance is allowed under Maine law to consider each company’s situation individually. In this case, she ruled that a 18.5% increase in premiums would be unfair and excessive.

This is a very revealing case. Those arguing against a public option claim that insurance regulations alone will be sufficient to provide an affordable product for everyone. Here’s a case where Maine is attempting to regulate the industry, and the industry sues the state in an effort to grab more profit. While claiming to be on the side of reform, they will fight tooth and nail, and can be expected to do so for every regulation in the national health care bill, right down the line.