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Is America politically mature enough for single payer healthcare?

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Back in 2011, I wrote Single payer to replace Obama health care plan in Vermont? Possibly. In a post of 2012, Rep. Jim McDermott's legislation may enable states to offer single payer healthcare, the L.A. Times ticked off reason after reason why such a plan would be superior to what we have now. Then our own Sherry Howarth asked this back in April: Are the Green Mountain Progressives Going to Pull Off Single Payer?

And now, one of my faves, Michael Hiltzik, has written another thoughtful column for the Los Angeles Times. This one asks if America has the "political maturity" to support single payer healthcare, especially after the dreadful Hobby Lobby decision by the Supreme Corp. Justices.

Hiltzik narrows it all down to the perpetual fight over abortion being the real obstacle to a single payer system. Once we stop our bitter squabbling and resolve that issue (not an easy task), it would open the door to enacting the same successful system so many countries around the world currently use. As Hiltzik notes, "That's not a permanent condition -- sooner or later, the gridlock will have to give, because the public won't stand for total inaction forever."

The entire column is worth a read, so please link over. He begins by responding to something Ezra Klein wrote. He ends this way:

[O]nly a mature system will be able to enact single-payer, so it's pointless to worry about it being hampered by childishness once it's in place.

Let's think again about abortion. There's no point in worrying that a single-payer program would bar abortion -- the thing to worry about is that the abortion debate will be an obstacle to enacting a single-payer plan at all. So clearly, the abortion issue will have to be resolved first.

Ezra Klein is right. Single-payer does have many virtues, and it does have some problems.

But under our current system post-Hobby Lobby, scientifically uninformed employers can interfere in the medical decisions of thousands of their workers. Obviously, that's the worst of all possible worlds.

Single-payer's problems, however, are either resolvable or conjectural, while its virtues are manifest. We should keep our eye on those, and worry about the problems when the time comes.

As we say on Google Plus: +1.

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Are the Green Mountain Progressives Going to Pull Off Single Payer?

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Written by guest contributor, "hardybear" of the wonderful Free Range Talk site:

We elected Bernie and gave the country Ben and Jerry, don't put anything universal past us mule-headed liberal mountain people.

Steve Kornacki highlighted one of the best (and thanks to TeaMania) only positive stories around on single payer prospects in the country on Up over at MSNBC , pulling in Vox's stellar Sarah Kliff, and Vermont State Legislature Rep. Chris Pearson to discuss. Find the full Vox piece here.

 Image courtesy Vox

Image courtesy Vox

Not since we were enjoying the pitched battles and healthcare wars on The Hill leading up to victory in 2010(!) was this Green Mountain gal so excited to see coverage of the Right's expected reaction to real Progressive progress.

It's no sure bet -  Vermont is in full possession of their allotted portion of Tea Party crazy. Yet, when pre-butted by Rep. Pearson of the state's Progressive Party ... listen up and  see if you don't feel some of that vintage, vindicating Hopey Changey Feeling wash over you.  The president might not have spiked the ACA ball to our collective liberal satisfaction quite yet, but here's some interim excitement to re-fire the engines for November.

Peter Shumlin isn't a Howard Dean by personality, but he has been the sleeper gubernatorial hit of the decade up here. He was a leader smart enough to see that a 700% rise in heroin use in the state in two years had an impact on our morale and small but over-worked state hospitals. ER visits now include tragic front row seats to what poverty, addiction and the GOP has brought us to. Not that there's any pressure, as both he and Kliff note.

If Vermont gets single-payer health care right, which I believe we will, other states will follow," Vermont Gov. Peter Shumlin predicted in a recent interview. "If we screw it up, it will set back this effort for a long time. So I know we have a tremendous amount of responsibility, not only to Vermonters.

fearKeep your ears perked about VT Act 48. AKA Green Mountain Care. It's an uphill climb, half the nations that attempt to pioneer this human right fail, repeatedly.

However, in 1777 -- when still a Nation because we declined the invite in '76 -- Vermont abolished slavery. In 2000 we were the state first to acknowledge civil unions, then the 4th to celebrate gay marriage. Two years ago we were Numero Uno to ban fracking and watch this week's news on mandatory GMO food labeling.

And don't underestimate our ability to overcompensate for our size and the patience-drain it takes to abide next to those Live Free or Die maniacs and the buzzards they draw in New Hampshire. So It Is On.  May this be a super sharp contrast to ex-centerfold/ex-Senator Scott Brown and his ubiquitous GD truck.

Kliff chose a doozie of a higher self quote when interviewing the local progressive peeps.

I was the first person I ever heard in politics who was a serious candidate, who said the words ‘single payer,’ and was not using them in an attack ad," recalls Deb Richter, president of Vermont for Single Payer. "It was amazing."

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Democrats have already compromised by abandoning the goal of a single-payer system

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How many times have many of us on the left have openly wished for Medicare for All instead of a health care system centered around Big Insurance?

We get sick, they profit. We don't get sick, they profit. We kvetch, they profit. We vote for Progressives, they profit. We point and laugh at Fox and Friends, they profit. We endure endless Cialis commercials, they profit. We hold our ears and scream "Lalalalala!" they profit. We mock Miley Cyrus, they profit. Miley Cyrus mocks us, they profit. We write inane lists like this one, they profit.

In the Los Angeles Times, there's an op-ed by Jane Mansbridge, a professor at Harvard University's Kennedy School and a member of the Scholars Strategy Network. She reminds us of how much we've already given (given IN):

Fundamentally — and infuriatingly for the Democratic base — Obamacare is inherently a compromise because it is a health insurance reform law rather than an overhaul of the structure of our nation's healthcare system. [...]

Yet the single-payer system had already been compromised away when the final 2009-10 healthcare negotiations began. ... [M]any Democrats compromised, even those who considered the single-payer approach to be by far the best policy.

Instead of pushing for single payer, they rallied around another approach: the "public option." The public option would have preserved the current employer-based system of private health insurance coverage while providing a government-run healthcare insurance alternative as well as a safety net for the uninsured. Importantly, it would have also injected much-needed competition into an environment where private insurance plans are increasingly consolidated.

But even that wasn't good enough for Republicans and some ConservaDems. The most conservative Democrats were the ones who really got my blood boiling, but that's another post for another time.

For many Democrats, these compromises have been hard to swallow... Despite all these compromises and concessions, House Republicans still forced a government shutdown.

Indeed, now we have the Affordable Care Act, a law that is based on Romneycare, a Republican health insurance plan.

But Dems are the ones who aren't compromising. Got it. Jane Mansbridge called it a "shell game." She's right:

The Democrats have compromised over and over again. Now it's the Republicans' turn to play fair.

That last sentence? Great sentiment, impossible demand. Republicans don't know the meaning of the word fair.

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"One day a single-payer system will provide better care at less cost and aggravation."

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Today's L.A. Times letter to the editor, because our voices matter:

Re "Another surgery — while knee-deep in the red tape," Column, Jan. 6

Steve Lopez asks, "Can't we switch to a healthcare system instead of a paper-shuffling, profit-driven, CEO-bonus-building system?" Great question.

There are dozens of for-profit health insurance companies astride the U.S. healthcare "system." Besides profits for their owners, their premiums must pay for exorbitant executive salaries and benefits, lobbyists in Washington, political contributions, marketing programs, lawyers and lawsuits, redundant computer systems and staffs trained to deny claims. These parasitical organizations contribute nothing to actual healthcare.

One day a single-payer system will provide better care at less cost and aggravation. As Winston Churchill said, "Count on Americans to do the right thing — after they've tried everything else."

Ed Carstens

Santa Clarita

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If SCOTUS rules against "Obamacare," California groups plan a single-payer push

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So if the Supreme Court strikes down part, or all, of the Affordable Care Act, then what? Well, here in California, the Courage Campaign will be sending out an email blast about its single-payer plan, but only if ACA falls.

We came close to such a plan in the past, but we still have work to do in order to get single payer passed.

WaPo:

Advocates outside of California have similar plans...  [...]

The state legislature twice passed single-payer bills, in 2006 and 2008, subsequently vetoed by then-Gov. Arnold Schwarzenegger. Now Democrats control the governor’s seat – and think they may have found the “perfect storm” to move a single-payer bill.

Here’s how the thinking goes: If the individual mandate falls, but the rest of the law stands, California still expects to receive a big pile of money to expand insurance coverage. The state has the highest number of uninsured people anywhere, meaning it will get one of the biggest funding boosts. [...]

If California got the necessary waivers from the Obama administration, it could pool those dollars with existing funds to lay a foundation for a single-payer health care system. It’s an approach relatively similar to the one that Vermont is now pursuing.

Please follow the link for more. No guarantees, but it's a start.

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Rep. Jim McDermott's legislation may enable states to offer single payer healthcare

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David Lazarus has a column in the L.A. Times that is very, very, VERY cautiously optimistic about universal coverage making its way to the state level, as long as the federal funding is there. That's a BIG "as long as."

Rep. Jim McDermott (D-Wash.) is drafting a bill that would make this happen, but you know how those Republicans can get all obstructiony and stuff, which tends to spoil all those legislatively smart options that would benefit so many Americans.

So, because a national Medicare-for-all plan would never make it through Congress, it's up to the states to do their own thing, and McDermott's long shot State-Based Universal Healthcare Act would offer the mechanism for each state to ask for federal funding once they establish their own health care programs:

McDermott's bill ... would allow federal funds for California's 4.5 million Medicare beneficiaries and 8 million Medi-Cal recipients to be pooled with state tax money for universal coverage. [...]

People in a statewide Medicare-for-all program would no longer pay annual premiums, deductibles or co-payments for private health insurance. Instead, they would pay a percentage of their income into the system, just as wages are taxed for Social Security and Medicare. [...]

Gerald Friedman, an economist at the University of Massachusetts-Amherst, estimated in a recent paper that a national Medicare-for-all system would cost Americans about $570 billion less annually than the amount spent on private plans.

Moreover, gone would be the problem of private insurers charging higher rates or denying coverage to people with preexisting medical conditions. If you pay taxes in the state, you'd be eligible for coverage.

Also gone would be healthcare as an issue between workers and employers. Businesses would no longer be the primary conduit for health insurance, relieving companies of what has become an increasingly costly obligation.

Does this idea appeal to you? If so, you can email McDermott at his website and let him know. He could use the support and encouragement, which is why Lazarus provided the link.

You can read more here.

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"If putting everyone on Medicare is socialized medicine, sign me up."

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Today's L.A. Times letters to the editor, because our voices matter:

The high cost of healthcare

Re "Healthcare's rising costs," Editorial, Sept. 29

The Times succinctly states that "Americans can't afford to wait long for relief" from rising healthcare costs.

I recently had my carotid arteries scanned. The contractor who performed the procedure said he no longer performs diagnostic procedures outside Orange County because the insurance companies are paying him half of what they used to. In the meantime, my premiums have increased 38% over the last three years, my office co-pays have risen and my deductible has climbed to $1,000. You don't need an MBA to figure out who is receiving the difference.

What amazes me is how many average Americans who, like me, continue to be fleeced by private insurers, are adamantly opposed to a public option for healthcare delivery. Medicare's overhead is a far smaller share of costs than private insurers'. If putting everyone on Medicare is socialized medicine, sign me up.

Matt Giorgi

Brea

Healthcare costs are definitely a severe problem, and the more subtle results are disturbing.

In my case, I am a sole-proprietor small business and an Anthem Blue Cross customer. I have increased my deductible to $5,000 to help reduce my monthly payments. Consequently, in my family of four we rarely visit the doctor unless the problem is life or job threatening. In essence, I am paying for catastrophic care. I am sure mine is not the only insured family that suffers through an illness to save money in this economy.

I am in complete support of our state's and federal government's attempts to rein in these astronomical medical costs.

Bob Bruton

Torrance

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