...A first hand account of Wednesday's vote in the California Senate Committee/Vermont's new health legislation: Will it truly be single payer and if so, when?; Will California follow Vermont's lead?; and What about undocumented immigrant coverage? -Art
California moves Single Payer Bill forward--first hand account of Wednesday's vote in the California Senate Budget Committee (California Healthline); Vermont's new new health legislation that COULD lead to single payer in that state by 2017, but PNHP's Dr. David Himmelstein warns that it's only the first step (Boston Globe); Does Vermont's new health law set a precedent for other states like California and if so, how? (Huffington Post); and Will undocumented workers be covered under Vermont's new health law (Addison County Independent)?
1) A first-hand account of the passage of SB 810 in Sacramento last Wednesday in the Senate Budget Committee (California Healthline,
(
http://www.californiahealthline.org/capitol-desk/2011/5/senate-health-committee-moves-singlepayer-bill.aspx):
excerpts:
"This is a system that will provide California with the best health care in the nation," Leno said, adding, "It will lower premiums, thereby attracting employers. It will simplify paperwork, and that will attract providers."
The state Legislative Analyst's Office estimated that setting up a single-payer system could cost about $200 billion. "But that's the money we're already spending now," Leno said.
Friday, May 06, 2011
Senate Health Committee Moves Single-Payer Bill
by David Gorn
Many dozens of single-payer supporters crammed the Senate Committee on Health chambers on Wednesday for hearing on a bill that would set up a single-payer health system in California.
The supporters were respectful and emphatic as they all stepped, one by one, up to the microphone to voice their support for such a model. After all of the advocates took their turn and returned to their seats, Senate Health Committee Chair Ed Hernandez (D-West Covina) wanted to know if there were any more speakers, so he politely asked if there was anyone else in the audience who was in favor of the bill.
And a sea of hands went up, as nearly everyone in the audience spontaneously and quietly raised their hands.
That has been the history of single-payer legislation in California, with enthusiastic, almost fervid, support of it by many citizens and organizations in the state, but a tepid, almost embarrassed, reception by many lawmakers.
Single-payer legislation passed the Legislature twice before, but then Gov. Arnold Schwarzenegger (R) vetoed both of the bills. Last year, it didn't fare as well, when it languished without a vote on the last day of legislative session, despite being on the floor agenda.
This year it's back as SB 810, by Sen. Mark Leno (D-San Francisco).
"This is a system that will provide California with the best health care in the nation," Leno said, adding, "It will lower premiums, thereby attracting employers. It will simplify paperwork, and that will attract providers."
The state Legislative Analyst's Office estimated that setting up a single-payer system could cost about $200 billion. "But that's the money we're already spending now," Leno said.
Dan Hodges of California Health Care for All said he's been advocating in Sacramento for single-payer health care system for about a decade now, and he has seen a big change occur in the Capitol on his watch.
"The basic argument for single payer has gone from how it might solve the health care problem in California to now being the way to solve the fiscal crisis in California," Hodges said. "That just shows how health costs have gone up so dramatically. So now [single payer] has the chance to solve two of the greatest crises in California -- the health care crisis and the whole financial crisis."
Opposition came, in part, from John Lovell of the California Association of Health Underwriters.
"However interesting this debate is, it is a diversion from making the Affordable Care Act work in this state," Lovell said. "We have to deal with on-the-ground realities of single payer."
That was the sentiment echoed by most of the opposition -- that California is in the middle of a vast health care reform undertaking right now.
Marti Fisher of the California Chamber of Commerce said, "We are opposed to a government-run health care system," adding, "The Legislature is already busy with this. We don't want to be derailed by implementing a new system."
DeAnn McEwen of the California Nurses Association pointed out that Medicare is a government-run health care program that many people seem happy to have. She added that a new single-payer health care system could mesh easily with health care reform tenets since they're so similar.
"Look," McEwen said, "It's not socialized medicine. It is civilized medicine."
The Senate Committee on Health voted 5-3 to pass SB 810 out of committee.
2) Vermont's new new health legislation that COULD lead to single payer in that state by 2017, but PNHP's Dr. David Himmelstein warns that it's only the first step (Boston Globe):
(
http://www.boston.com/news/local/vermont/articles/2011/05/07/vt_seeks_health_insurance_for_most_residents/)
excerpts:
The bill outlines a planning process for implementing what is often referred to as a "single-payer'' system. Called Green Mountain Care, the program would operate in its first few years much like other state health care exchanges established under the federal Affordable Care Act and must begin enrolling individuals and small business in 2014. That's the year the mandate for most Americans to have health insurance takes effect.
Vermont's plan is different, however, because it lays out the state's intention in 2017 to move most people with private and government insurance into a unified system in which their insurance would be paid for through their taxes, not through premiums and copayments.
Anya Rader Wallack, special assistant for health care to Governor Peter Shumlin, said that the bill's passage is a significant step toward a single-payer system, but that supporters have "some real heavy lifting ahead.''...
But:
...Without a funding plan or details about what kind of coverage the state would offer, the bill does not actually do much, said Dr. David Himmelstein, visiting professor at Harvard Medical School and a founder of Physicians for a National Health Program.
"It's an important step, if they take the next one,'' he said. "If this is all they pass then, frankly, it's not.''
3) Does Vermont's new health law set a precedent for other states like California and if so, how? (Linda Bergthold, "Vermont to Go Single Payer--Do I hear a Second?", 5/6/11)
http://www.huffingtonpost.com/linda-bergthold/vermont-to-go-single-paye_b_858718.html. -Art
excerpt:
The single payer community is following this legislation very carefully and urges advocates to stay involved to support the program and strengthen it.... If Vermont can do it, can other states? Is size an important factor in the implementation of single payer? Actually, a little known fact is that single payer style programs for Medicaid (Medi-Cal in California) are already up and running in twelve counties in California, and these programs are incredibly successful, both in terms of their ability to deliver quality care as well as contain costs. They are called "County Organized Health Systems" and they are covering half a million MediCal beneficiaries, with local boards that include doctors, patients, elected officials and others. (The five COHS cover about the same number of members as the State of Vermont.)..
4) And will undocumented workers be covered under the new health law in Vermont? (Addison County Independent, 5/5/11,
http://www.addisonindependent.com/201105health-care-debate-hits-glitch-immigration)excerpt:
MONTPELIER — Following public outcry, a conference committee working to reconcile the House and Senate versions of the recent health care bill on Tuesday announced it had removed language that would bar illegal immigrants from health coverage.
Sen. Claire Ayer, D-Weybridge, a member of the conference committee, said the removal of the amendment doesn't necessarily mean that Vermont will be able to insure non-legal residents under the Green Mountain Care plan, which the law would establish. But new language in the bill urges the federal government to pursue immigration policy reform, and it commissions a study to explore the costs of providing care to illegal workers in the state.
"(Federal law) prohibits us from using federal money to cover illegal immigrants, and yet it says that our hospitals must accept and treat them for free," Ayer said. "That's a cost shift."...
...Under the visa system that exists today, she said, immigrants can come to Addison County to work as apple pickers and turkey pluckers seasonally, and employers must provide health insurance. But since dairy workers are not seasonal, some stay in the county beyond the legal limit, are not covered by health insurance and use the services of the emergency room for any medical issues.
She said the Green Mountain Care board, as part of its report on the costs of providing care to illegal workers, will examine the costs of delayed care for illegal workers who don't have the resources to seek preventative care, and the potential costs of insuring them.
The details of the plan will not be worked out for several years,...
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