Single Payer Update and Reading List

The tide is turning my friends. This is becoming an inexorable force that cannot be denied.

New York State Assembly Passes Single Payer Healthcare Bill

The New York Health Act, which previously passed the Assembly three times but stalled in the Senate, would provide no-cost coverage to every New Yorker with no out-of-pocket costs and no network restrictions. It would be paid for through a progressive payroll tax and levies on non-earned income, such as capital gains. A 2015 analysis from Gerald Friedman, professor of economics at the University of Massachusetts at Amherst, showed a potential savings of $45 billion in the first year of implementation

Single Payer healthcare Bill Passes Assembly
Fein notes that a single payer system could significantly reduce costs by negotiating with pharmaceutical companies and health care providers, and drastically cutting hospital-billing costs.

"There was a comparison of Toronto General with Mass. General 'cause they're similarly sized hospitals,” he states. “Toronto General, three people dealing with billing. At the Mass. General, over 350."

Fein adds that while private insurance companies spend about 20 percent on administrative costs, for Medicare that figure is only 3 percent.

Oh, here's a big surprise from the Public News Service article: "Gov. Andrew Cuomo has not taken a position on the bill."

Single Payer healthcare discussed at Nevada County Town Hall
"We have an historic opportunity," said Michael Lighty, the special guest speaker, who is director of public policy for National Nurses United.

Lighty and the panelists who joined him Tuesday believe that California's Senate Bill 562, the Health California Act, could create a unique, state-initiated health care system that provides universal coverage and benefits at lower costs than the current federal health care system.

Note - Nevada County is in California

No, the next one is not a rah-rah article, far from it.

Single Payer Healthcare is the Key To Democratic Victory in 2018
Single-payer health care is exactly the kind of high-concept, visionary goal that the Democrats deliberately shied away from when they chose to support Hillary Clinton’s brand of incrementalist politics, a gamble that paid off poorly in an era of instability and anxiety. Like many big ideas, single-payer is the embodiment of hope — in this case, hope for a healthier and kinder American society in which the worth of a human life is not contingent upon how much capital that human possesses or produces.

If the Democrats won’t stand for that, why should anyone vote for them?

Okay the next one is f-king fascinating - a Republican Congressman from Idaho who says he wouldn't have voted for the Republican abomination if he thought it would pass and then all but endorses single payer in a back-handed sort of squishy way. Think those town halls might have had an impact?

Simpson: Single Payer Could Replace Obamacare

Simpson, who represents the 2nd Congressional District, including most of Boise and everything in Idaho to the east, said “there are no tweaks out there” to make the Affordable Care Act work. He predicted the law will be replaced either by a system that relies less on the federal government or by a single-payer system like Medicare.

“It’s been surprising to me how many people I’ve heard who, five years ago, wouldn’t have said something like that,” he said. “Business people. Who said, ‘Just go to a one-payer system. It’s the simplest thing to do.’ But is it the best thing to do?”

That's just a small sampling of the news coverage out there on single payer. I by-passed countless op-eds and Letters to the Editor from all over the country making eloquent and informed pleas for single-payer in light of what the Republicans are offering up. It would be so incredibly wonderful if their spiteful, homicidal, sociopathic healthcare bill inspired and accomplished the exact opposite of their goals. Oh, there's those laws of motion popping up again - For every action, there is an equal and opposite reaction.

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Phoebe Loosinhouse's picture

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

The Aspie Corner's picture

At least not without federal intervention.

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Phoebe Loosinhouse's picture

@The Aspie Corner
between the ages of 55-65 are exactly the population most burned by both the ACA and the Republican plan and even the Medicaid expansion - the first two due to "age rating" and the last one due to asset stripping property liens if they use Medicaid for plain vanilla healthcare ( I always add when discussing this that is has nothing to do with nursing home care)

I wouldn't be so pessimistic. The private marketplace plans simply do not work unless the insurers are somehow allowed to cherry-pick and exclude people who are ill and actually need care as well as the over 55 population. This is actually the foundation of the republican plan - to put those very people in high risk pools in order to free up the insurers to get back to their profit skimming administrative overheads which is where the exorbitant salaries, bonuses and golden parachutes lurk. And, as an added bonus, by putting the onus of the most expensive healthcare on the states through the riskpools, they get to continue their Starve the Beast Strategy of bankrupting the states in order to soften them up for bankruptcy and privatization of their assets.

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

The Aspie Corner's picture

@Phoebe Loosinhouse From his bullshit drug testing on SNAP recipients which he was able to pocket because he sent people to facilities he owns through Solantic to his slashing disability services to the bone each and every year to the environmental disasters caused by his cronies, it's a real clusterfuck.

And considering the state government is almost entirely Republican with a few right-wing DLC Dems, you can bet your ass this is likely to continue even after Rick Scott leaves office because the elderly population that holds this state by the balls don't know any better. I do pity them, but it sure does piss me off.

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weed, the "leaders" of the democratic party are so far behind the electorate on this issue (and so deep in the pockets of the healthcare-refusal industry) that they cannot ride this obvious vote-winner to nationwide victory.

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Sigh

@UntimelyRippd

"Good" as far as them personally, that is. Lousy as far as the 100%. https://caucus99percent.com/content/base-jonesing-lesson

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detroitmechworks's picture

It was medicine until the 1930's when the propaganda pushback started BIG time.

Assuming the Government doesn't declare "War on Phony Doctors", we'll be fine in about a year or four.

If the Government/Corporate alliance decides on a full court press against Single Payer... we'll be looking at 40 years after Europe does it... oh wait, Britain is trying to Americanize the NHS...

Yep, expect another 40 year fight. I expect single payer about the time I'm 80.

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I don't Blame Christians. I Blame Stupid. Which Sadly, is a much more popular religion these days.

Phoebe Loosinhouse's picture

@detroitmechworks
and patents and Pharma that are zeroing on on the NHS as far as I recall, but I think the citizenry is onto it. Who in their right mind would want to emulate the worst healthcare system in the world with the highest costs and least return and dropping life expectancy?

Our healthcare is like that anti-motivation poster of the Titanic and the iceberg - at least our experience can be a warning to others.

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

ggersh's picture

@Phoebe Loosinhouse " Who in their right mind would want to emulate the worst healthcare system in the world with the highest costs and least return and dropping life expectancy?"

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NO MORE WAR

@detroitmechworks care? That is very different from Medicare for All, which is state-provided health insurance. Truly going American with their system would mean privatizing the system first, then doing some form of half-assed insurance that implodes three years after it goes fully effective.

Exceptionalism!

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that Canada got single payer incrementally with the provinces passing it one at a time.

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@Steve15 @Steve15 @Steve15 Thomas Clement "Tommy" Douglas, PC CC SOM (20 October 1904 – 24 February 1986) was a Canadian social democratic politician and Baptist minister. He was elected to the Canadian House of Commons in 1935 as a member of the Co-operative Commonwealth Federation (CCF). He left federal politics to become the Saskatchewan CCF's leader and then the seventh Premier of Saskatchewan from 1944 to 1961. His government was the first social democratic government in North America, and it introduced the continent's first single-payer, universal health care program.(wiki)

Tommy Douglas is commonly referred to as "the greatest Canadian".

One video I've shared many times around election time is from his famous speech "Mouseland" where the mice keep electing Cats that fail them time an and time again, trying a white cat, then a black cat, a polka dotted cat, a a half white half black cat (like Obama), a striped cat and so on...here is his grandson, the actor, Keifer Sutherland introducing the speech with Tommy Douglas telling the story...

https://www.youtube.com/watch?v=GqgOvzUeiAA

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Thanks Phoebe, there hasn't been very much of it lately.

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native

flowerfarmer's picture

is this....

The care would be paid for by an employment-based premium tied to income with employers paying 80 percent.

So, are they saying there would be a 20% premium, exactly the same as Medicare?
Medicare is unaffordable without supplementary insurance, all of which is unaffordable for very low income and retired people on very low fixed incomes.
What happens with unemployed people?
Just the fact that this conversation is happening around the country could mean closing in on the tipping point.
Thanks for the updates, Phoebe.

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Phoebe Loosinhouse's picture

@flowerfarmer
"It would be paid for through a progressive payroll tax and levies on non-earned income, such as capital gains." My interpretation is that it would be similar to a SS payroll deduction

People who dissed single payer in the past have always used the excuse "it will raise your taxes!" Yes, it will raise your taxes but the tax increase won't even begin to come close to what people are already paying out of pocket for their share of premiums and co-pays so your taxes may go up, but your net income will increase.

I read another proposal for single payer from Maine, (I think)that advocated for employers to turn their current healthcare expenses which would be relieved in her state plan into immediate wage increases for the employees.

I think it's great that some states are tired of waiting for Federal Single payer, although that would be preferable, by plowing ahead on their own.

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

flowerfarmer's picture

@Phoebe Loosinhouse As soon as any state passes true single payer, i will move there in a NY minute!
Some of us do not have the luxury of time.
I would live in my car in a Walmart parking lot in return for real health care.

Hope is the thing with feathers That perches in the soul, And sings the tune without the words, And never stops at all

Hope can also break your heart.

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Phoebe Loosinhouse's picture

@flowerfarmer
So nice to see you flowerfarmer.

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

@Phoebe Loosinhouse

are we talking about? For example, capital gains, stock dividends, royalities and the like don't get paid out of anyone's payroll. Earned income does.

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Phoebe Loosinhouse's picture

@HenryAWallace

"a payroll tax AND levies on unearned income".

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

SnappleBC's picture

@Phoebe Loosinhouse

People who dissed single payer in the past have always used the excuse "it will raise your taxes!"

People like Hillary Clinton and a wide variety of luminaries in the Democratic party? I still remember "20 trillion dollars". That was the first time I caught her in a blatant lie with no other possible interpretation... black and white. It was the end of any possibility whatsoever that I'd vote for her no matter who else was on the ticket. The woman lied about the financials at the cost of the lives of hundreds of thousands of US citizens. I found that monstrous.

lol

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Just to get this out of the way, Yes, I'm a plant from DKOS paid for by the DNC

Shockwave's picture

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The political revolution continues

Phoebe Loosinhouse's picture

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

eyo's picture

@Phoebe Loosinhouse Clinton Ds intend to take the victory lap to regain positions they've lost for their lobbyists, this is key part of their "revolution" grab in CA, wouldn't be shocked if it's same for NY. So they've latched on to a popular product, not worth the win if it means keeping the same lobbyists in charge, that's what I say. System of graft with a single payer is still a system of graft. Good luck.

I just got an email from ngpvan, what the ? The only way npgvan database has my name is through calling for Bernie during the primaries, so either there's been another leak in their "firewall" thingy, or it's been given to other candidates through "normal" procedures. Are Bernie's coalitions using them again? Still? I hope not.

Peace

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On a blog.

dkmich's picture

than they were in 1980, the answer would have to be a resounding no. We were yet to lose our asses, and we didn't know what was coming. I was looking at the map that shows by state what a person must make in order to be able to afford a home/apartment of their own. It was my recollection that every state was over $15.00 hour. There has to be a redistribution of resources from the 1% down in order to have any semblance of a civilized society offering an ounce of opportunity and hope to anyone but the top.

Edited to add: Hope Cuomo doesn't turn this bill into anything even remotely resembling the abomination he alleges is free university.

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orlbucfan's picture

Rec'd!! Thanks, Phoebe☺.

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Right to Work is actually Right to Serf.

@orlbucfan

that was also the year that the head of the DNC wrote Democratic politicians asking them to see if they couldn't get some of the nice corporate donations that Republican politicians were getting. And Democratic politicians went for it and have been going for it ever since.

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Oh Phoebe, I hope you are right about our chances. The insurance monster is sucking all the good energy out of the health care providers. It is a damn crime. People have to rise up above the limiting govt. to make health care a right. It is a fight against greed.

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@QMS

The cost of health care is part of the problem. For example, I was put into a hospital over a weekend from the emergency room because I had presented with severe pain in the gut after abdominal surgery. I had a GI series, but no medical procedure and no other test. I had IV nutrition. Since it was a weekend, I didn't even see a doctor, except for the resident who saw me in the emergency room who gets paid next to nothing. The bill, exclusive of the emergency room, was over $14,000.

Had a similar issue with the Visiting Nurses, only not quite as costly. they ran up a bill of $3000 over about a week and a half just to get me into their system. Sent, I think five people, each of whom interviewed me, asking about the same questions and inputting them into a laptop. I asked if they couldn't just share the info with each other and was told they had "tried that once and it didn't work out too well." Meanwhile, I had healed enough not to need anyone, so I canceled.

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@HenryAWallace
insidious inefficiencies of market-based competition.

depending on the regulatory constraints enacted in the legislation that creates the single payer, the single payer can simply deny certain inefficiencies of competition by limiting the providers of certain services.

in the competition scenario, every hospital in a service area will have a CAT scanner, a PET scanner, and various other unfathomably expensive equipment, regardless of the local demand. and once they have that equipment, they MUST pay for the costs of that equipment, including the amortization, the staffing and the building space, which they will do by two means:
A. Using it in cases where it is of dubious value, so they can bill for the service
and
B. Applying spectacular overhead charges to every single thing the hospital provides -- thus the infamous $N Tylenols.

In the single-payer scenario, the single payer can simply refuse to fund redundant equipment across multiple providers, by insisting that certain services will only be reimbursed at specific providers. Sure, the hospital admins hate it, because as with all technocrats, their income depends directly upon the economic size of their fiefdom ... but fuck 'em.

Never forget: Contrary to the Chicago School mythology, market-based competition is the least efficient form of economic organization.

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SnappleBC's picture

@UntimelyRippd

We don't have "single payer". We have a province run health system. Because of that the things you suggest occur naturally. Expensive services like MRI's are carefully distributed according to (for the most part) logical things like population density and average age. There is no profit motive. There's no reason to try to charge more. The only motive they have is to spend whatever money parliament gave them as wisely as possible.

Honestly, the health care system here was like Alice stepping through the looking glass for us. It isn't just that it's cheaper (by far). It's that you can sense the underlying motives are entirely different. I say that even as I am currently (and have been for the last year and a half) experiencing the dark underbelly of the beast. We lost our primary care physician who retired. We have not been able to replace him. There simply aren't enough. Of course that doesn't cut off our access to health care. We can stroll into any hospital or clinic at will and get seen. We just lose the continuity of experience and the clinics, at least, operate under some constraints (one issue per visit).

My wife and I are living in one of the cherished horror stories that insurance industry funded pundits and politicians like to trot out. But the monsters under my health care bed are like those in Monsters, inc. The ones in the American health care horror story are more like Freddy Kreuger.

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@SnappleBC
at least, all of the provinces I know about use a single-payer system. the single payer in each case is the authority that the provincial government creates to administer the healthcare system, while many/most/all of the providers are privately owned/operated, whether for profit or otherwise -- and quite explicitly, the provincial healthcare authorities use their ability to dictate the terms of reimbursement in order to limit the purchases of high-ticket equipments and so on.

this contrasts with the fully-socialized system in the UK, where the government owns the hospitals/clinics/etc and is the employer of the doctors/nurses/etc.

as far as i know, the term "single-payer" was coined precisely to describe the Canadian system, as opposed to the UK's National Health Service or the more exotic schemes like that in Switzerland.

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SnappleBC's picture

@UntimelyRippd

I did a bit of digging since I work closely with some of the local hospitals. The ones in my neck of the woods are "a publicly funded health care provider". They have a CEO though. I probably got confused simply because however it's structured, it very much looks like a government run thing to the patient. You go in anywhere and tell them what's wrong.

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Just to get this out of the way, Yes, I'm a plant from DKOS paid for by the DNC

@SnappleBC
that could mean almost anything.

there aren't really any rules that limit the nature of the providers under a single-payer system. the government might, for example, own and equip a clinic, but outsource all of the staffing and management. the "provider" might be a non-profit charitable organization, or it might be an old-school family practice, with a doctor, a nurse and an administrative staffer, or it might be a privately-owned for-profit lab processing blood samples.

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Sigh

@HenryAWallace Someone up thread mentioned a 2 hospital comparison. If an American hospital needs 350 specialists to navigate insurance billing, that is over 100 times the comparable cost of a Canadian hospital. General practitioners are dropping out of our system owing to the lack of re-imbursement and restrictive allowed services dictated by insurance companies. Therapies are being denied while rules are changing constantly. I'm seeing health professionals fighting for their patient's services and getting nowhere while billing departments fight denial of coverage from devious insurance obstruction. This is what is sucking the life out of health care and the workers trying to help those in need.

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boriscleto's picture

Through his support of the "Independent Democrats", that this will never even get a vote in the NY Senate.

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" In the beginning, the universe was created. This has made a lot of people very angry, and is generally considered to have been a bad move. -- Douglas Adams, The Hitch Hiker's Guide to the Galaxy "

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Phoebe Loosinhouse's picture

@boriscleto

to call and write their state senators and to produce editorials and letters to the editor, etc. and DEMAND that it be put to a vote in the Senate and to keep at it relentlessly. Every little pebble contributes to the avalanche until one day it hits critical mass and lets loose.

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" “Human kindness has never weakened the stamina or softened the fiber of a free people. A nation does not have to be cruel to be tough.” FDR "

If Cuomo undermines this, I hope he rots. And I don't say or post that kind of thing often.

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TheOtherMaven's picture

@HenryAWallace
New York state politics isn't that corrupt yet, is it?

Do we have any up-and-coming likable Berniecrat types who'd like to oust him?

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There is no justice. There can be no peace.

@TheOtherMaven

Tammany Hall was in NY.

Senator Menendez made his political bones mentored by one of the most corrupt politicians in New Jersey history--and that's going some. I recently learned that people born between certain years in NJ can't use a birth certificate to get a passport because some official was so corrupt. I know the rule is true, but I am not sure what he did. Issue fake birth certificates, maybe? Anyway, imagine having a special rule like that at the federal level because your guy was so corrupt.

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