UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011 CommonHealth Day of Action November 12th We gathered at Occupy Boston a thousand nurses and their allies demanding a Main Street in Dewey Square to hold a Contract for the American People, including strengthened spirited rally for the real and improved Medicare for all, to be funded by a ﬁnancial healthcare reform which we transaction tax on Wall Street activity. call single payer and against every manner of disparity in Then on September 17th, hundreds of young people moved our existing inadequate sys- into Zuccotti Park in Lower Manhattan, two blocks from tem. Among our dynamic Wall Street and a stone’s throw from Ground Zero. Occupy speakers was Katie Murphy, Wall Street was born, an in-your-face challenge to the 1% RN, Mass-Care secretary (left). that lords it over the 99%. Within weeks, many hundreds of Led by health professional such encampments blossomed across the country and students, members of Mass- Care, Physicians for a National Health Program, allied clini- cians and people from all walks of life then marched through the ﬁnancial district and up Beacon Hill for anequally spirited rally in front of the State House, followedby a parade down to Louisburg Square to remind SenatorJohn Kerry and the debt-deal Committee of Twelve that anyCongressional attack on Medicare, Medicaid or SocialSecurity would be met with righteous anger.We’ve all come to understand that the country is awash inmoney but that it is in the wrong hands and being used alltoo often for nefarious purposes. Our march came towardthe end of a momentous year of mass education. around the world, many near their city’s ﬁnancial hub. Occupy Boston is a prime example. It quickly became the meeting ground for many labor, environmental, peace and healthcare activists, the locus from which sorties moved out to confront corporate exploiters and their political enablers. So our choice to rally there was a natural. (continued on page 2) Mass-Care’s Bea Mikuleckyi & Pat Berger, with Katie Murphy & Marvin Miller behindWe’ve learned from the Arab Spring that arrogance on highmust be confronted and that desperation is no longertolerable. The people found their power. Attacks on therights of public sector workers, especially in the Heartland,provoked the most massive and prolonged battle seen here Universal Health Care Education Fund c/o Mass-Carein decades. Organized nursing brought forward the 33 Harrison Avenue, Fifth Floor, Boston, MA 02111demand: “No cutbacks, no concessions!” In June the US P: 617-723-7001, F: 617-723-7002Chamber of Commerce headquarters in DC was picketed by email@example.com http://www.masscare.org
UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011 Massachusetts Medical Society Day of Action (Continued) 2011 Workforce Survey On a personal note, on October 13th on my way homeFor the past two years the Massachusetts Medical Society from the Greater Boston Labor Council rally at Occupyhas carried out a survey of its members’ attitudes Boston, I received the call that two Massachusetts nursesregarding healthcare reform, as part of its annual were needed the next morning to help New York nursesphysicians workforce survey. The results of the 2011 erect a tent over the ﬁrst aid station at Occupy Wall Street.survey revealed that 41% of members felt that a single- So bright and early, Carlotta Starks and I from the Massa-payer national healthcare system offering universal health chusetts Nurses Association hopped the Acela. A threat bycare to all US residents was their choice of an optimal NYC officials to sweep clean Liberty Plaza (aka Zuccottisystem. This represented a 7% increase since 2010. Park) earlier that morning had been thwarted by thou- sands of trade unionists emerging from the subway at sixThe other choices in this survey were as follows: o’clock to pack the area. NYC ordinances prohibit tents in parks, so we nurses and medics successfully erected the1. Both public and private plans with a public buy-in tent and reorganized the dispensary as an act of civiloption which would allow businesses and individuals to disobedience, despite surrounding police.enroll in a public Medicare-like health-insurance plan thatwould compete with private plans. 23% of physicianschose this option.2. The National Patient Protection and Affordable Care Act(also known as Obama care). This plan does not have apublic option but maintains Medicare and Medicaid. 17%of physicians chose this option.3. Keep the existing mix of private insurance plans,Medicare, Medicaid and the Veterans Administrationcoverage. 15% of physicians chose this option.4. Other plans were chosen by 4% of physicians.These results show that a majority of Massachusettsphysicians support a government-sponsored Medicare-like plan either as a public option (23%) or as a singlepayer approach (41%). There are presently bills in theMassachusetts legislature which address these twooptions. It is time for Massachusetts physicians to maketheir preferences known to move forward a vote whichwould allow Massachusetts to join Vermont in eventuallyestablishing a Medicare for All type of healthcare reform.- Leo Stolbach, MD Nurses & Medics Commit Civil Disobedience Barbeque & Bake-Off for Health Care Justice! Among the youthful occupiers there, the hungry found hot food, the homeless found shelter, the poor found the On October 9th rudiments of health care and children found books to Mass-Care hosted read. Wall Street ﬁnanciers had no interest in nutrition, a contest for decent housing, health care or education unless they mouth-watering could turn a proﬁt. The limits of allowable dissent had b a r b e c u e d been reached, so without notice batons and tear gas were appetizers and brought to bear in the wee hours of November 15th and delectable baked Liberty Plaza was reduced to Zuccotti Park once again. desserts as a The ﬁrst aid station, tent and all, sleeping bags, food and fundraiser at Larz ﬁve thousand books were tossed into garbage trucks and Anderson Park in destroyed. A fascist book-burning couldn’t have been Brookline. The more thorough. In an apparently coordinated effort, Senator Jamie Eldridge & Ben Day grilling competi- similar violent assaults have occurred on occupation sitestors included Ben Day, Executive Director of Mass-Care, across the country, with the wounding of two Iraq MarineRob Hall, waiter at Grille 23, Jennifer Doe, JwJ, and Mike Corps veterans in Oakland and the pepper-spraying ofFiske, owner of Fiske & Co. seated students at the University of California in Davis the most shocking.The bakers were Olivia Alfond, former Mass-Care intern,Judy Deutsch, Chair of Mass-Care’s Legislative And so on Capitol Hill, a partial victory was won onCommittee, Margaret Reeve Panahi, family nurse November 21st as the Committee of Twelve ack-practitioner, and Denise Zwahlen, physician’s assistant. nowledged deadlock. Massive cuts are still slated to take place, but now is the time to plan to turn the 2012The esteemed judges were Jay Murray, Executive Chef at elections into a referendum on the austerity plans of theGrille 23, State Senator Jamie Eldridge and Mohamed 1%. Now is the time to demand no cuts whatsoever to vitalMaenaoui, former Executive Chef at the Barking Crab. Dr. social programs. This is the time to insist on theArnold Relman roused the happy feasters with a lively talk strengthening of Medicare and Social Security. We shallon why we need a single payer system! A great time was forge ahead in the ﬁght to create a just healthcare systemhad by all! - Pat Berger, MD for all! - Sandy Eaton, RN, Editor
UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011 Professor Hsiao Brings Vermont Single Payer The Massachusetts Model of Health Reform in Plan to Massachusetts Legislature Practice & the Future of National Health Reform Professor William Hsiao, If you have forty-ﬁve minutes, read the entire report that PhD, currently the Li was released in November by Mass-Care and Professor of Economics at Massachusetts Physicians for a National Health Program, the Harvard School of Public available at: Health, gave a thought- http://www.masscare.org/massachusetts-health-reform-in-practice provoking brieﬁng to the Massachusetts legislature Youll ﬁnd some surprising and compelling information! If November 14th. Dr. Hsiao you have ﬁve minutes, read the two-page executive has been the architect of summary in the report. In you only have two minutes, read single-payer systems in the following list of some of the ﬁndings: eight countries and is now working with the governor • The state has signiﬁcantly decreased the percentage of and the legislature of uninsured (from 10.4% in 2006 to 5.6% in 2010 Representative Jason Lewis Vermont to plan single payer according to Census Bureaus Current Population Introduces Professor Hsiao reform for Vermont by 2017. Survey). • In order to manage the states portion of the healthcareDr. Hsiao’s strategy speciﬁcally addresses the political as costs, the states Commonwealth Care program has cutwell as the economic issues in the campaign for single enrollment eligibility and reduced beneﬁts (e.g. dentalpayer reform. His team in Vermont had in-depth talks and eyeglass coverage).with all the stakeholders including patients, doctors,hospitals, lawyers, insurance companies, workers and • The changes in reimbursement rates for Medicaid have had a negative effect on our safety net providersemployers to determine what they might all agree on and (community health centers and hospitals serving largehow much they are willing to compromise to win an numbers of the uninsured and publicly insured).agreement. The ﬁnal step in gaining support for singlepayer is to create incentives built into the law to motivate • The increases in health care costs are negativelystakeholders to support the change. affecting the insurance coverage of small business employees. The percentage of total enrollees in smallDr. Hsiao’s team collected data showing how single payer group plans that have high healthcare coverageaddresses the spiraling cost of healthcare, provides (covering more than 80% of medical costs covered byuniversal access, and how it affects different stakeholders. insurance) has decreased dramatically from 78% to 23%.Speciﬁc ﬁndings: • The increased costs have resulted in an unfair burden with some lower income groups paying proportionally• Vermont’s health expenditures as a share of Gross State more. Those with a family income of $20,000 - $41,000 Product (GSP) have risen from 12% in 2000 to 18.5% in (those in the second 20% income range), increased the 2009. percentage of their family income on health care• Vermont’s single payer system projected savings of spending by 4.6%, compared with only a 0.4% increase 25.3% based on an integrated delivery system, reduction for those with family incomes of $111,000 and greater in fraud and abuse, lowering the administrative costs (those in the top 20% income range). generated by the health insurance industry, reduced • A signiﬁcant portion of the increase (estimated as cost of billing by doctors and hospitals and reform of $817,000,000 increase for the year 2009) in cost has medical malpractice. been born by the federal government, which means that• Single payer will increase the number of jobs in Vermont your Federal income tax dollars are paying that portion by increasing the amount of money people will have to of the cost increase. spend because of decreased medical costs. • Many of the ﬁgures quoted in the media for• The Vermont GSP will increase because of the increase Massachusetts healthcare reform are misleading, if not in jobs. inaccurate. • Massachusetts health care reform is unsustainable fromKey to achieving a single payer system, Dr. Hsiao says we a cost perspective.need support of physicians, strong grassroots support,and buy-in from other stakeholders. While we in - Norman Daoust, Cambridge-Somerville for ChangeMassachusetts are waiting to get the support we need, weshould push for a comprehensive all-payer claim database to reduce fraud and reduce total health care CommonHealth, Volume 5, Number 2spending by 5%. We should also push uniform payment Director: Benjamin Day Editor: Sandy Eatonmethods and claim adjudication rules, and develop an Photography: Sandy Eaton, Katie Murphy, NNUintegrated health delivery system. With this kind of single Production: Erin Servaespayer infrastructure we can win when there is an opening Printing compliments of the Massachusetts Nurses Associationin the political climate. - Pat Berger, MD
UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011 Mass-Care Helps Launch ‘Co-Insurance Mass-Care Starts Multi-Year Big is NO Insurance’ Campaign City Campaign for Single PayerStudents must have insurance coverage to enroll in a Mass-Care has voted to expand its grassroots organizingcollege or university program in Massachusetts. efforts into large urban areas of the state including Boston,However, unlike other residents who are required to Worcester and Springﬁeld. This is a multi-year campaign, thepurchase health insurance, they are banned from ﬁrst year of which will reach out to organizations that arereceiving state subsidies no matter how low-income already ﬁghting to preserve health care coverage or arethey are. While many students are enrolled in their struggling because of rising health care costs. Outreach tofamily health plan, 27% are either too old or their these groups will highlight the need for systemic reformparents are uninsured, and must enroll into their while building a more diverse leadership base for the singlecollege’s student health insurance plan (or SHIP). payer movement.For the past few years, colleges and universities havebeen reducing the actual coverage of SHIPs byintroducing an increasingly high-level of co-insurance.Co-insurance means that students must pay 15%, 20%and sometimes 35% of the total cost of care in additionto the yearly insurance premium. For surgeries orother expensive forms of care, students can end up Massachusetts Senior Action Council Leads the Wayowing thousands of dollars. For low-income studentswho can’t afford these cost barriers, co-insuranceeffectively means no insurance, potential insolvency, Mass-Care has already begun working with student groupsmore stress and a constant fear of getting sick. who are protesting the new co-insurance fees being added to their out-of-pocket costs. Other struggling groups include private sector attacks on beneﬁts and bargainingTo stop co-insurance from creating a two-tiered rights (GE, Verizon), attacks on public employees’ health careinsurance coverage system among students, Mass-Care and a network of other organizations have taken (particularly municipal employees), immigrant groups’ access to care, municipal governments that struggle with the risingaction to ban its practice in the state of Massachusetts. cost of employee health care, minority groups that sufferSome of the organizing that has taken place include a from disparities and safety net institutions that are losing‘sick-in’ at UMass, a complaint ﬁled with the Division funding.of Health Care Finance and Policy to investigate thelegality of co-insurance, and a symbolic ‘fundraiser’ The goal is to build an active steering committee in each city,held across the state to raise funds to help cover co- that is committed to supporting each group’s health careinsurance expenses for low-income students in need struggles through solidarity actions, but also committed toof vital medical care. - Ibrahima Sankare, former addressing systemic reform of the health care system. Mass-Massachusetts PNHP Intern Care will need volunteers to develop linguistically and culturally appropriate educational materials, establish con- nections with the targeted groups, and develop a “story- based” speakers’ training program to empower new leaders for single payer. This is an exciting new campaign, so be on the lookout for opportunities to join in!! - Pat Berger, MD You Can Help Mass-Care Mass-Care is hoping to build a vibrant new coalition for single payer in the urban centers of Massachusetts. We need your help! We need funding for producing new educational outreach materials, setting up leadership training con- ferences, and running actions and forums to generate media coverage. We also will need volunteers to help in the organizing effort. To volunteer, please contact the Mass- Care office at 617-723-7001. Please be as generous as you Students & Workers Rally in August for Healthcare Justice can to keep Mass-Care growing!