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Medicare For All
Single Payer

Three Parks for Single Payer

Three Parks Independent Democrats has endorsed the Single Payer approach to universal health care. We do not believe that private for-profit insurance should play a role in health care

Majority Support for a Public System

Polls show that more than half of all Americans would support a public system. Many people are less able to afford their private coverage and employers, public and private, are cutting back on health benefits. The old ways are disappearing.

We Can Have the World's Best Health Care

The United States can have the worldís best health care system, or we can have one built on private for-profit insurance companies -- but not both. We now have a patchwork of over 1,300 health insurance companies each with its own rules and procedures. They waste enormous amounts of money just competing with each other, paying executive bonuses, advertising and of course taking a profit out of every premium dollar. Medicare, a public single payer system, does none of these.

Private Insurance - No Basis for a Health System

Health insurance profits come from two sources: collecting more in premiums than are paid in benefits and speculating in the stock market. Neither of these inspires confidence as the foundation of a universal health care system. We have seen it over and over -- if we donít get sick the insurance companies keep our premiums; if we do get sick they keep them anyway and make us fight to get our medical bills paid. Health care providers then hold us individually responsible for what the insurance wonít cover.

Private Insurance - Good Unless You Use It

Insurance is based on the principle of shared risk. The need for health care, however, isnít a risk; in todayís world itís a certainty. Insurance only works if it is never used by the vast majority of people who pay into it. For example automobile theft insurance works because the vast majority of cars are not, in fact, stolen. But, if you live in a neighborhood where a lot of cars are stolen, you either canít get insurance or it is so expensive that you canít afford it. Home owner insurance works because most homes are not destroyed by flood. But if you live within fifty miles of the coast, you canít get insurance and are put in a state sponsored insurance pool. Insurance companies are still refusing to pay for Katrina damage. Insurance only works when most people donít use it.

Single Payer Is a System
We Can Actually Use

Health care is a positive good at every stage of our lives. It isnít a risk or something we might not need. Health care is like education: it's an ongoing necessity. It is something we want everyone to have and to use. We need a system that delivers the most health care at the lowest cost, not one based on the assumption that we wonít use it.

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New York: Gottfried, Perkins introduce universal
health care bill

Our thanks to Physicians for a National Health Program (PNHP) for the following material.

Assemblyman Richard Gottfried and Sen. Bill Perkins have unveiled a bill that, if adopted, would create a new single-payer health plan called New York Health.

The health plan, designed to provide widespread health care for all New Yorkers, would provide health coverage regardless of employment, wealth, age, income or any other factor. The plan would replace private insurance coverage with universal coverage for all New Yorkers.

"Health care should be a right, not a privilege," said Gottfried, the Assembly Health Committee chair. "Coverage should be driven by the needs of patients, not insurance companies and stockholders. You and your doctor work to keep you healthy. New York Health will pay the bill."

Coverage for health care would be publicly funded under the new health plan and would include a benefits package more inclusive than most health plans currently offered. Instead of patients and employers paying deductibles, premiums and co-pays, coverage would be funded through a graduated tax on income, based on ability to pay, according to the sponsors of the legislation.

"There would be two basic sources of revenue; one would be a payroll tax that would be paid primarily by employers that would be on all payroll income and progressively graduated so that higher wage and [salary] earning employees would pay a higher percentage than lower," Gottfried said at a press event announcing the introduction of the bill. "The second revenue source would be a surcharge on the state income tax on taxable interest dividends, capital gains Ö that is important because our wealthiest earners in our society, their wealth doesn't come from a salary, it comes from interest in dividends and capital gains."

Perkins, in a letter advocating for the bill that was sent to fellow Senate members, describes current federal health care as having made improvements over the years but unfortunately still gives insurance companies too much control of "our health and our wallets." He said that currently patients and their doctors are forced to figure out what is covered under insurance companies while trying to get reimbursed.

"Health care should be about health, not profit," Perkins said at the press event. "For some this may be a new issue, but this issue has been around for years and it's time has come. In fact, it has more than come. I have always advocated that your health is your wealth and I am proud to sponsor this bill."

The bill, (A.5389/S.2078) notes that all New Yorkers would be covered for "medically necessary services," such as preventative, specialist and primary care; mental health; dental; reproductive health care; medical supply costs and prescription drugs.

"Right now, five New Yorkers die every day due to lack of health care and many go bankrupt from medical bills. That is unacceptable and inhumane," said Laurie Wen, executive director of Physicians for a National Health Program. "A universal, publicly financed health care system would save lives [and] money. It's a win-win situation for patients, physicians and our economy."

All New Yorkers under the plan would choose a primary care practitioner or other provider of their choice to "provide care coordination." This move is meant to help patients get the care and follow-up attention they need so they can successfully navigate the new health plan system.

"New Yorkers ó as individuals, employers and taxpayers ó have experienced a rapid rise in the cost of health care and coverage in recent years," as stated in a sponsor memo submitted by Perkins. "This increase has resulted in a large number of people without health coverage.

"Businesses have also experienced extraordinary increases in the costs of health care benefits for their employees. An unacceptable number of New Yorkers have no health coverage and many more are severely underinsured."

In 2009, The New York State Department of Health and Department of Insurance, based on a study by the Urban Institute, released a report that declared single-payer plans the "most cost-effective way to provide health care to all New Yorkers."

"Single-payer health care is just, simple, clear and efficient," Dr. Paul Sorum of Albany Medical Center said at the press event. "We ask the state legislature and the governor to save the physicians and patients of New York state to allow the physicians to take care of patients not insurance companies, to be a beacon for the rest of the country, to lead us into universal single-payer health care."

If passed, this bill would be the second of its kind enacted in the United States. Vermont, in 2011, enacted legislation called "Green Mountain Care" that is set to create the first functional single-payer health care system within the next several years.

Gottfried clarified at the event that if the bill is passed it will take a few years for New York to get the proper systems ready to implement the plan ready.

The bill is currently co-sponsored by 83 other legislators.


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Obama Care - Mixed Results
for Year One

An assessment of the
Affordable Care Act
at the end of its first year.

Steve Max

Unlike Single Payer, the Affordable Care Act was never intended to be comprehensive. Rather, it was to provide insurance to the uninsured. That made it essentially a program for lower income people, which is why Republicans hate it and why it hasn't gained majority support. The most recent poll (Rasmussen, October 25th - 26th) showed that 53% of likely voters view it unfavorably, which is consistent with other polls.

In all, the first year seems to have brought only modest improvement in reducing the number of uninsured, and much of the gains that were made came through Medicaid expansion, the public part of the program, according to a New York Times review (10/27). Just how well is the Act providing insurance to the uninsured? Although The Times devoted two full pages to the topic, we still don't exactly know. The Times said, "The number of uninsured Americans has fallen by about 25% this year, or about 8 million to 11 million people." (The range reflects the five different polls from which their data is derived.) The article goes on to say that, "Several million more are expected to sign up in the coming year, but the total number of uninsured is projected to remain around 30 million for years." This is somewhat consistent with the most recent estimate of uninsured people from the Center for Disease Control (CDC) which found that in the first quarter of this year, 41 million people had no health insurance and that 55.5 million had been without insurance for some part of the previous year.

The Census Bureau says that 15.4% of the population had no insurance in 2012, and the CDC says that the uninsured figure was 13.1% in the first quarter of this year. This does not appear to be a tremendous decrease.

More interesting, The Times reports that over half of the newly insured came in through the Medicaid system, the part of the program most like Single Payer. This is astonishing considering that 23 states have refused to expand Medicaid under the Act. Had they done so, the overall record for the year would have been far better with public health care an even greater proportion of the whole.

The number of uninsured young people (19 to 25 years old) has dropped dramatically to the lowest on record (since 1997) which The Times attributes to a change in the law allowing young people to remain on their parents plans until age 26.

When it comes to cost, remember that there is really no one national planóthe situation differs in every state. Recent company surveys indicate that premiums will rise an average of 4% in 2015 according to The Times. CNBC reportsreports, however, that in 38 states where rates have already been approved for 2015, the average increase is 6%. In nine of these states, rates will rise more than 10%.

On the positive side, a Commonwealth Fund poll, reported in July 2014 that 73% of the people who bought insurance through the exchanges and 87% of those who signed up for Medicaid said they were somewhat satisfied to very satisfied with their plans. Even 77% of newly enrolled Republicans liked their plans.

It appears that the major problems in implementing the Act relate to the sale, cost and subsidies of private for-profit insuranceójust as Single Payer Advocates predicted. Despite deliberate Republican sabotage, the Medicaid expansion part seems to be doing well.

Posted 11/02/14

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