PeterWK's Periodical

think-progress:

Without Obamacare, families making under $5,000 don’t qualify for Medicaid in five states. They just aren’t poor enough.

Rachel Maddow on healthcare and Romney

I’m becoming a huge Mark Ruffalo fan.  Progressive celebs for the win!

I’ve seen him talk on fracking and the National Nurses United “Robin Hood Tax”.  I also enjoyed him in The Avengers.

Can SEIU Help Vermonters Win Single Payer? ...or screw it all up?

by Steve Early

Steve Early

MONTPELIER, VT.–While the nation waits for an overdue Supreme Court decision that will decide the fate of President Obama’s Affordable Care Act (ACA), another health care drama with wide implications for universal care is just starting in Vermont.

Prodded by a strong grassroots movement, the Vermont legislature voted last year to create a system where every citizen will eventually be eligible for publicly funded health care.

“Green Mountain Care” will take five years to fully implement, however. That’s because of the complexity and difficulty of phasing out existing insurance arrangements, overcoming legal hurdles, choosing a funding mechanism, and dealing with ACA’s unhelpful requirement that Vermont first create a private “insurance exchange”(a speed bump the Supreme Court may eliminate if it strikes down all or part of the ACA).

Meanwhile, the local business community, private insurers, GOP politicians, and right-wing PACs have regrouped and counterattacked, with non-stop advertising. They’re doing their well-funded best to make sure that single payer never happens in this state or any other. They know that a lot can change, politically and in the state budget, between now and 2017, particularly in a place with two-year gubernatorial terms.

Business-Backed Counterattack

Last year’s overhaul was backed by Democratic Governor Peter Shumlin, a multimillionaire businessman who faces re-election this year after narrowly winning office in 2010.

Single payer continues to poll well in the state, despite its lack of concrete benefits for even one Vermonter so far—a weakness that conservative opponents are exploiting in their campaign of disinformation and fear-mongering. A recent poll conducted by several Vermont media found nearly 48 percent of those surveyed still favor single payer; 36 percent are opposed, the rest are undecided.

Shumlin is likely to defeat GOP candidate Randy Brock, whose top adviser is Darcie Johnston, founder of Vermonters for Health Care Freedom, a key conduit for anti-single-payer propaganda, financed by business.

But even if Brock and fellow Shumlin critic Wendy Wilton, who is running for state treasurer, lose this fall, progressives fear they will spread doubt about reform. As a centerpiece of her campaign, Wilton predicts that Vermont will be running budget deficits above $2 billion by 2018 if single-payer becomes a reality. Right-wingers also warn about the new taxes everyone will be required to pay.

‘Air War’ for Single Payer?

To counter conservative attacks, Shumlin and friends are holding a press conference next Thursday to unveil “Vermont Leads: Single Payer Now!,” their own vehicle for advertising and door-to-door canvassing in favor of Green Mountain Care. This new addition to the Vermont political scene will be hiring canvassers and has already raised $100,000 for a six-month drive “to engage and activate Vermonters through media and grassroots organizing.”

According to Peter Sterling, an experienced local political operative who was just named director of the group, Vermonters can expect even more spending on TV ads, when the legislature reconvenes.

Unfortunately, Vermont Leads doesn’t draw on the formidable grassroots network created since 2008 by the Vermont Workers’ Center (VWC)—and seems designed to bypass that group, which is the state’s most influential single-payer advocate. The VWC’s “Health Care Is a Human Right” campaign has been widely credited, both locally and nationally, with spearheading the multi-year community-labor mobilization needed to pass the legislation known as Act 48 last year.

While working closely with Shumlin and key Democratic legislators to achieve that goal, the Workers’ Center has also been willing to sound the alarm and swarm the statehouse when things got off track. In May, 2011, for example, VWC organizers brought more than 1,500 Vermonters to the Capitol to thwart a bid by legislative insiders to exclude undocumented workers from the scope of Act 48.

The VWC has long received strong backing from unions with members who live and work in Vermont—like the United Electrical Workers, Communications Workers, and Vermont Federation of Nurses and Health Professionals, which bargains for most unionized health care workers in the state.

In contrast, Vermont Leads is being funded by just one union—the 1.9 million-member Service Employees, which has no members working in the state and failed to affiliate the still-independent Vermont State Employees Association more than a decade ago.

‘Working with People Who Have Money!’

For Vermont Leads’ volunteer board members, SEIU’s sudden arrival, with a wad of cash large by local standards, is cause for some rejoicing. One new recruit is former state AFL-CIO President Jill Charbonneau, a postal worker, who noted in an email to friends that she is “not used to working with people who have money!”

Another Vermont Leads enthusiast is Middlebury College anthropology professor Ellen Oxfeld, who has previously campaigned under the banner of a small group known as Vermont for Single Payer. SEIU funding is “a gift from heaven,” she told me. “We want to combat the lies, keep up the momentum for single payer, and organize around the financing package” to be adopted by legislators next year.

Deb Richter, leader of Physicians for a National Health Program (PNHP) in Vermont, gave similar reasons for joining Vermont Leads. “We’ve got many more years of fighting to keep this on track,” she said. “We now have the ability to spend more for ad campaigns and literature drops. Instead of using existing groups, it made sense to have this one be a separate entity.”

As for her new funding source, SEIU, Richter asserted that “they have always been single-payer supporters. That’s what I’ve been told.”

Looking a Gift Horse in the Mouth?

Others in single-payer circles wonder whether this particular gift horse could become a Trojan horse that will weaken Vermont’s effort to make health care a human right.

SEIU’s sudden appearance in the state is particularly worrisome to union friends and political allies of the VWC, now in the middle of its own fundraising drive to support an energetic staff of eight who coordinate the work of scores of volunteers around the state.

The VWC is enlisting nationally known figures for a public statement of support titled “Vermont Can Lead the Way.” In an open letter soliciting 1,000 such endorsers, VWC leaders argue that “we will never be able to outspend giant healthcare profiteers and other big money groups in an ‘air war.’ But we can out-organize them on the ground!”

SEIU’s lack of any members on the ground, plus its unhelpful role nationally in health care reform from the Clinton to the Obama eras, has led some labor activists to question its motivation for becoming a single-payer sugar daddy, virtually overnight.

One explanation involves SEIU’s competition with AFSCME to represent personal care attendants in Vermont. Neither union can gain 5,000 new members in that workforce without Shumlin and the legislature agreeing to create a new homecare bargaining unit, plus some sort of card check or election mechanism for union recognition by the state.

And if Shumlin, in the meantime, needs to do some single-payer back-pedaling—under pressure from business interests—SEIU could easily provide political cover for him, local activists fear. For the union, the quid pro quo would be the governor favoring SEIU over AFSCME to represent homecare workers.

Bad Record Elsewhere

Elsewhere in the U.S. and at the federal level, SEIU has frequently undercut other unions’ attempts at single-payer legislation (even though its own affiliates have passed many pro-single payer resolutions over the years).

In California, SEIU refused to join the California Nurses Association (CNA) in working for single-payer coverage. In 2007, then-SEIU President Andy Stern instead cooked up a plan with Governor Arnold Schwarzenegger that would have required all Californians to buy private insurance  but didn’t control its cost  and set no minimum standards for coverage. Included in the bill was a fund for homecare workers’ health benefits—to be administered by SEIU.

“SEIU played the leading advocacy role and ultimately the lead compromise role on that bill,” CNA staffer Michael Lighty told The Nation. “Stern went behind the back of the California State Fed to cut the deal. But it didn’t even pass in the state senate. It lost the backing of labor. It could not withstand the scrutiny.”

In Massachusetts, SEIU affiliates have done little or nothing to build Mass-Care, the main single-payer advocacy organization. Instead, the union worked with Ted Kennedy, then-Governor Mitt Romney, and the coalition known as Health Care for All to enact the state system of mandated private insurance that became the model for Obama’s Affordable Care Act.

As one labor friend of Mass-Care notes, “SEIU has been completely absorbed with ‘Romneycare.’ For them, it’s all about hospital financing, never about changing the system itself.”

Similarly, SEIU helped run interference for the Obama administration when it was working to keep single payer—and ultimately, any public option—off the table in 2009-2010.

Working with liberal foundations and other labor groups, SEIU helped raise $40 million for a group called Health Care for America Now. As David Moberg from In These Times reported, HCAN’s spending swamped that of single-payer groups, while “promoting a strategy closer to Obama’s proposal that would include employer-provided or individually purchased private insurance.”

In 2009, SEIU operatives even intervened at community forums in New Hampshire held to discuss the Affordable Care Act: they tried to prevent local PNHP supporters from distributing pamphlets on single payer.

SEIU’s Man with a Plan

Further fueling suspicion about SEIU’s intentions in Vermont are the multiple hats worn by recently arrived national staffer Matt McDonald. His past assignments have included trying to keep 45,000 Kaiser Permanente hospital workers from fleeing SEIU in California and joining the National Union of Healthcare Workers. In 2010, McDonald was part of the national union organizing team that engaged in so much misconduct at Kaiser that the National Labor Relations Board ordered a re-run of the decertification election, which NUHW lost. (A second vote may be held later this year.)

McDonald set up Vermont Leads from scratch, made himself a board member, and hired Sterling as its director. Meanwhile, he is also masterminding SEIU’s attempt to create the new statewide bargaining unit for personal care attendants, an effort that wisely involves SEIU wooing of advocates for the elderly and disabled who receive such services. For details on AFSCME’s homecare worker organizing in Vermont, which started before SEIU arrived, see http://www.afscme.org/blog/afscme-organizing-home-care-workers-in-vermont.

In response to an email seeking details on SEIU’s won organizing plans and Vermont Leads, McDonald offered to talk, but only off the record. In an email message, he said that the questions posed “don’t deserve a response as far as I’m concerned. I think they even threaten the dual goals of creating a single payer system here in Vt., and the eventual unionization of thousands of workers.”

Scramble for New Members

A slugfest between SEIU and AFSCME in Vermont would be a throwback to their frenzied 2004-5 spending contests in several other states, a struggle over home-based work jurisdiction that I described in my 2011 book, The Civil Wars in U.S. Labor. In the process of obtaining “organizing rights” deals in Illinois for both childcare and homecare workers—and prevailing over AFSCME there—SEIU became labor’s biggest funder of Rod Blagojevich, the corrupt Democratic governor whose “pay to play” schemes landed him in jail for 14 years.

As similar homecare or childcare units unravel in several states under hostile GOP governors, SEIU is now increasingly desperate for new members. A union that was growing by 100,000 annually in 2006-2008 has hit the wall, due to external enemies and the deep internal dysfunction that I reported on in Civil Wars.

In 2011, SEIU registered a net gain of only 7,000 members and agency fee-payers, as compared to 59,000 the previous year. So 5,000 new dues payers in Vermont have become a more tempting prize than before, even if they require a costly brawl with an AFL-CIO union that already represents other public workers in the state.

For budgetary reasons, Vermont’s Democrat-controlled legislature just balked at creating a new statewide bargaining unit for publicly funded day care providers. This was a major, but hopefully not permanent, legislative setback for the Vermont Federation of Teachers (AFT), Vermont’s largest AFL-CIO union.

But Shumlin’s overly passive role and the opposition of key Democratic legislators doesn’t bode well for AFSCME or SEIU doing much better in homecare, as long as the two unions remain divided.

Price of a Relationship

The prospect of a homecare union war is definitely not appealing to others in Vermont labor, for multiple reasons.

“In my opinion, SEIU seems to be cultivating a direct relationship with our governor by loyally supporting his health care plan—including all the expected compromises and retreats that may lie ahead,” says Traven Leyshon, secretary-treasurer of the Vermont AFL-CIO. “This will create real problems for any of us pushing for a stronger, more progressively financed single-payer system than Shumlin favors.”

Ellen David Friedman, a founder of the Vermont Progressive Party and past organizer for the National Education Association in the state, agrees. “SEIU makes very short-term and opportunistic calculations,” David Friedman said. “They will help Shumlin get re-elected in exchange for legislation authorizing homecare unionization. My guess is that his position on single payer really doesn’t matter much to them, since they’ve never really fought for it anywhere else.”

State Senator Anthony Pollina, a Progressive Party leader, worries that the wrong kind of pro-single payer “air war,” funded and directed from out of state, may “encourage right-wing groups to come in and spend even more money.”

According to Pollina, “things could escalate into a media campaign that leaves citizens on the sidelines, just like past single-payer referendum campaigns that were lost in Oregon or California.” Like the Workers’ Center, he believes that “progressive grassroots activists can ‘out-organize’ the opposition on the ground but SEIU’s invasion could end up undermining this good work.”

Richter and Oxfeld both insist they would never let this happen while they served as Vermont Leads board members. “Vermont is a small place,” Richter said. “If it turns out SEIU is trying to push us in a different direction, they won’t have the ground troops to pull it off.” According to Oxfeld, “if they really try to get in the way, I don’t see anyone on the board going along with it.”

Health Care History Repeats?

Three years ago, Mike Lighty from the CNA predicted that creation of a publicly funded model plan, providing universal coverage in any American state, would “move us closer to a single-payer solution” than the “public option” that labor wanted in the Affordable Care Act until President Obama nixed it.

But Lighty warned that “if you pass a plan that’s watered down and bad, you’ve squandered the political moment. You’re going to fuel the cynicism and distrust so many people already have in what can be accomplished in Washington.”

Health care reformers in Vermont are concerned that SEIU will eventually play the same role locally that it did nationally in 2009-2010. If that results in another squandered political opportunity—this time leaving Vermonters cynical and distrustful about what can be accomplished in Montpelier—the repercussions will be felt in every other state where progressives still hope to improve on the ACA.

Steve Early is a labor journalist and lawyer who started writing about Vermont politics when he was a Middlebury College student in 1968. He spent three decades as a New England representative for the Communications Workers, assisting members in Vermont and other states with strikes, contract negotiations, organizing, and health care reform activity. He is the author, most recently, of The Civil Wars in U.S. Labor [2], from Haymarket Books, and a longtime supporter of the Vermont Workers’ Center. This was first posted on Labor Notes (http://labornotes.org) June 22, 2012

The Stunning Truth About Health Care Pricing

A story in today’s LA Times describes in rare detail why US healthcare is insanely expensive.  It’s not due to patients who expect too much, high-tech medicine or burdensome regulations. No, it’s the result of insurance industry bureaucracy and greed. While many consumers have long suspected that, hard evidence has been elusive.  Now, an investigation by the Los Angeles Times has turned up that hard evidence.

Evidence shows that healthcare costs are arbitrary and capricious.

The LA Times article, “Healthcare’s High Cost: Many hospitals, doctors offer cash discount for medical bills,” provides data showing that healthcare costs are neither realistic nor consistent. Americans purchase insurance with the expectation of getting reduced out-of-pocket healthcare costs, but instead pay more than they would if they just paid cash—sometimes, much, much more.  Example:

Los Alamitos Medical Center, for instance, lists a CT scan of the abdomen on a state website for $4,423. Blue Shield says its negotiated rate at the hospital is about $2,400.

When The Times called for a cash price, the hospital said it was $250. [LATimes]

Similar cost disparities exist at other hospitals, according to the Los Angeles Times and Dr. David Belk, MD, and insurance companies pocket the difference.

Healthcare reforms passed in the Obama administration require hospitals to disclose  their standard charges, i.e., list prices.  But, only a sucker pays the list price. The real cost of medical procedures remains hidden to most consumers.

The insurance industry can make exorbitant demands because it has full control of healthcare

Dr. Belk gives free talks around the country about the true costs of healthcare. The following video of one such talk is available on his website, along with a treasure trove of related information.

In his video, Dr. Belk counters insurance industry propaganda with facts and figures, concluding, “Every price is jacked up…we’re looking at 10 times on average.” There is no reason, he says, why a CT scan should cost more than a plane ticket or a transmission overhaul.

“How many of you use your car insurance to pay to fill your gas tank or change your oil?  How many of you use your homeowner’s insurance to pay your electric bill? Why is it that healthcare is the only industry in which we use our insurance for absolutely every expense, no matter how mundane? And, in a sense, we’re forced to because if we say, “I’d rather pay for it myself,” you’re fined…you’re fined ten times the actual value of the service you’re getting.” Moreover, the system limits what the physician can do even when a patient offers to pay cash.

“We’re both stuck in this system where the insurance companies dictate everything we do. They control every dollar that goes into medicine—and not only do they control every dollar that goes into medicine, they can have complete control of the message. They can tell us whatever they want, and who are we to argue with them, because we have no understanding of what these costs are.”

Thus, “They have us all looking in the wrong direction, and all talking about the wrong thing.”  

Overpriced healthcare undermines health and the economy

One of the implications of exorbitantly priced healthcare is that many people do not receive needed care, and some die as a result.  Another implication is that huge expenditures on healthcare reduce our ability to pay for other things.

The average healthcare cost for a family of four is $20,728 a year.  The same amount of money would buy a new, mid-priced car, the LA Times points out—or a year’s college tuition. No wonder many college students rack up massive student loan debt.

Were it not for the high cost of healthcare, the average American could purchase vastly  more non-healthcare goods and services. By co-opting consumer dollars, over-priced healthcaredestroys jobs in other parts of the economy.

Conclusion

With new evidence in hand, consumers are empowered to demand a better healthcare system. That might be a private system combining high-deductible major medical insurance with patient direct pay for routine expenses, or a “single payer” government program, or something else entirely. In any case, the healthcare casino must be shut down. But, that will not happen until Americans demand it, insisting that politicians address it in their campaigns and pass reforms in their terms of office.

The time for change is now.

Good graphic on the cost of healthcare for women and the affordable care act.

(via socialistexan)

Obama Administration Announces New Decision On Birth Control, To Chagrin Of Religious Groups

Nice!  Obama holding his ground! 

via Huff Po:

In a long-anticipated decision that will affect millions of women’s ability to pay for contraception, the Obama administration announced on Friday that it would not allow religiously affiliated employers such as universities and hospitals to deny full birth control coverage to the women they employ.

Under the new rule, set forth by the Affordable Care Act, most women employed in the U.S. will have the cost of their birth control covered with no co-pay. Churches and other places of worship would continue to be exempt from having to cover contraception for their employees if they morally object to the practice, according to Health and Human Services Secretary Kathleen Sebelius, but all other organizations will have a year to comply with the new requirement, regardless of whether or not they are religiously affiliated.

Some women’s rights groups and Democratic women in Congress had begun to lose enthusiasm for President Obama after the controversial decision by HHS to limit access to the morning-after pill. Many of them recently expressed deep concern that he would cave to the powerful Catholic bishop lobby on the birth control issue, but they were pleasantly surprised with his administration’s decision on Friday.

“I am glad that the Obama Administration has taken the sensible path here,” Sen. Jeanne Shaheen (D-N.H.) told HuffPost. “By keeping these provisions strong, the administration is ensuring that millions of women will have access to affordable birth control. That’s good news for them and for the health of our entire country.”

“The bishops pulled out all the stops in their campaign against women’s access to contraception,” said Jon O’Brien, president of Catholics for Choice. “The Obama administration stood with those who support religious liberty and believe in giving women the freedom of conscience to make their own reproductive health decisions.”

The religious organizations that have been lobbying the White House for months to expand the so-called “conscience clause” were deeply upset by the decision, arguing that it includes coverage of the morning-after pill, which they believe causes abortions.

“Freedom of conscience is a sacred gift from God, not a grant from the state,” said Galen Carey, NAE Vice President for Government Relations. “No government has the right to compel its citizens to violate their conscience. The HHS rules trample on our most cherished freedoms and set a dangerous precedent.”

“This is a shameless attempt to kick the can down the road in an election year,” said Hannah Smith, senior legal counsel for The Becket Fund for Religious Liberty. “Religious colleges, universities, and hospitals will never pay for abortion drugs in violation of their religious beliefs — this year or any other year.”

Emergency contraception pills are not, in fact, “abortion drugs.” They can prevent a pregnancy by stopping ovulation or stopping an egg from attaching to the uterine wall, but they cannot end a pregnancy once it starts.

The U.S. Conference of Catholic Bishops, one of the most powerful lobbying groups on the issue of the religious exemption, did not respond to a request for comment on the announcement.

Secretary Sebelius said she had based her decision on “abundant” scientific evidence that birth control has significant health benefits for women and their families.

“This decision was made after very careful consideration, including the important concerns some have raised about religious liberty,” she said. “I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.”

Invade a hospital:  For every person that dies in a terrorist attack globally, 58 people in the US die due to lack of heath care.

(via lolsheviks-deactivated20120831)

The Bomb Buried In Obamacare Explodes Today

I did not know about this.  This could be one of the greatest things about the Affordable Care Act.  It could even bring about the end of big private care and pave the road to true universal healthcare coverage.

http://www.forbes.com/sites/rickungar/2011/12/02/the-bomb-buried-in-obamacare-explodes-today-halleluja/

…That would be the provision of the law, called the medical loss ratio, that requires health insurance companies to spend 80% of the consumers’ premium dollars they collect—85% for large group insurers—on actual medical care rather than overhead, marketing expenses and profit. Failure on the part of insurers to meet this requirement will result in the insurers having to send their customers a rebate check representing the amount in which they underspend on actual medical care.

This is the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time.  Indeed, it is this aspect of the law that represents the true ‘death panel’ found in Obamacare—but not one that is going to lead to the death of American consumers. Rather, the medical loss ratio will, ultimately, lead to the death of large parts of the private, for-profit health insurance industry.

Why? Because there is absolutely no way for-profit health insurers are going to be able to learn how to get by and still make a profit while being forced to spend at least 80 percent of their receipts providing their customers with the coverage for which they paid. If they could, we likely would never have seen the extraordinary efforts made by these companies to avoid paying benefits to their customers at the very moment they need it the most. …

Not a chance-and they know it. Indeed, we are already seeing the parent companies who own these insurance operations fleeing into other types of investments. They know what we should all know – we are now on an inescapable path to a single-payer system for most Americans and thank goodness for it.

Whether you are a believer in the benefits of single-payer health coverage or an opponent, mark this day down on your calendar because this is the day seismic shifts in our health care system finally get under way.

If you thought that the Obama Administration chickened out on pushing the nation in the direction of universal health care for everyone, today is the day you begin to understand that the reality is quite the contrary.

If you believe that the end of private, for-profit health insurance is some type of nefarious step towards a socialist society, then you might want to attend church this Sunday to mourn the loss of health insurers being able to worm out of covering the bills of a cancer patient because she forgot to write down on her application that she had skin acne for three months when she was a teenager.

Of course, those of you who fear the inevitable arrival of universal health care really shouldn’t be too fretful. There will always be a for-profit health insurance industry for those who want to pay for it. The only difference will be that those who cannot afford private coverage will also have an opportunity to get their families the medical care that they need

Everyone wins-except the for-profit health insurers.

I can live with that.