Public Option Versus Single Payer

By Candy Marie Bickett, WEAP Mentee
June 18, 2009

June 11th, 2009 ~ Oakland California
WEAP's recent June 2009 Teach-In & Dialogue on ‘Health Care is an Economic Human Right’ covered the newly proposed California budget cuts, current National health care reform plans, Sacramento’s ‘Right to Safe Ground Campaign,’ and other actions, tools, and methodologies needed to build a broad social movement to secure health justice and poverty elimination.  Teach-In presenters included WEAP, California Partnership, the California Nurses Association, CHAM Deliverance Ministry, the Sacramento Homeless Organizing Committee, SEIU 1021, Saint Mary's Center, and Hip Hop Congress, in addition to other members of the community.

California's Health and Human Services ~ Proposed Cuts to Close the $24 Billion Budget Gap:
California Partnership’s, Nancy Berlin (calforniapartnership.org), led the discussion on the recently approved budget package designed to close the $24 billion budget gap proposed by Governor Schwarzenegger.  The proposal includes several already adopted cuts to Alameda County’s social welfare programs and even more potential reductions to essential, life sustaining services.  Some of the most brutal cuts would completely eliminate the CalWORKS program and Healthy Families program and would severely impact In-Home Supportive Services’ (IHSS) payments, affecting 380,000 individuals.

Implications
Who Would be Affected?

Education Funding: K-12 and higher education programs will be impacted by the over $17 million in cumulative budget cuts between now and 2011. Cal Grants will potentially be eliminated all together.  Students at the University of Berkley have already seen a 60% increase in tuition and student housing with further increases to be implemented by the Spring 2010 school year.

CalWORKS: Elimination of CALWORKS cash aid to families resulting in a loss of 3.7 billion in annual federal block grants and a $600 million reduction in California's economic stimulus affecting over one million children.  

Heath Care: Elimination of the Healthy Families Program, including access to breast and cervical cancer treatments for Medi-Cal recipients and emergency medical services available to immigrant families.  Medi-Cal, which currently covers such services, may see a 2.3 billion cut in federal matching funds (affecting Health Families programs under the umbrella of Medi-Cal) as well as a ten percent reduction in Medi-Cal’s payments to private hospitals and substance abuse treatment service funds.  

IHSS: Elimination of In-Home Supportive Services (IHSS) for 90% of current consumers.

Food Assistance: Elimination of California food assistance program and food stamps for illegal immigrants, impacting over 23,000 households.  
Immigrants: Emergency medical care, food assistance, and income assistance offered to lawful immigrants – CUT

Disabled: IHSS’ criteria to qualify for coverage potentially adjusted to exclude services to 380,000 clients; existing services for those who qualify may be significantly reduced

Women and Children: Cal Grants, and Healthy Families - CUT

Elderly: Funding to elder care facilities (IHSS) significantly reduced and OBGYN care offered to women over 65 - CUT

Former Foster Youth and 'aged-out' wards of the state: SSI/SSA and Welfare to Work programs - CUT

Individuals Living with HIV and AIDS: Massive reduction in coverage including preventive services for treatments and essential HIV/AIDs medications - CUT

National Health Care Reform:
Presenting on current National Health Care Reform proposals was Kay McVay from the California Nurses Association ( www.calnurses.org).  This discussion included a deconstruction of the proposed 'Public Option' reform plan supported by President Obama.  As congress and the white house decide the fate of American’s future health care, many individuals find it increasingly difficult to see past the political rhetoric and ambiguity clouding the proposed ‘option’ in order to identify: (1) the implications of each program including cost and benefit for the individual; (2) proposed funding and source of funding (who will be primarily impacted should such a system be implemented?); and (3) the short and long term feasibility (of each proposed health care plan). 

At a Glance: What is ‘Public Option,’ ‘Individual Mandate’ and ‘Just Health Care’ (Universal, Single Payer)?
While most Republicans believe that a Public Option health plan would facilitate the transition to a Single Payer, or federally funded Universal Health Care system, just as many Democrats believe the Public ‘Option’ plan to be an insufficient move and would rather see the push towards an Individual Mandate.  What nobody is talking about, and thus ignoring as usual, is the fact that neither the public option nor an individual mandate would treat health care as a human right.  Only Universal, Single Payer would do this.

Public Option: Not a Human Right
The 'Public Option' is not a universal health care system.  There are numerous aspects of this plan that are problematic, including funding and the percentage of Americans who would actually benefit.

Constructive not Obstructive: This plan simply creates another option for people without eliminating the root problems of our current health system: the profits, costs, poor regulation, and administrative burdens of thousands of insurance companies.

Short term: While millions will receive health insurance, billions will still remain uninsured or underinsured as insurers continue to offer stripped down policies and increased co-pays and deductibles.   It will also add further layers of administrative bloat to our health system through the introduction of a regulator/ broker exchange and will increase health spending by $1 trillion over ten years.                             

Long term: The ‘Public Option’ ensures temporary relief followed by prolonged suffering.  Without regulation, costs will quickly erase any gains in coverage. The government will be forced to hike spending or slash benefits, thus continuing to drain an already burdened economy - the brunt of which will be felt by the very individuals that the system is supposedly designed to benefit.  

In short, since its coverage is not universal, this plan does not offer a solution for all Americans, all the time, which implies only some people are valued some of the time.

Individual Mandate: Not a Human Right
This plan is analogous to laws concerning automobile insurance, which state that every driver must be insured. People are generally aware of the costs associated with automobile insurance when considering factors such as age, driving history, state of residence, etcetera, however; what about those individuals who can’t afford it?  A recent poll done on the nation’s number of insured drivers reported over 25% percent of the country is uninsured and thus, breaking the law every time they start their cars.  Under this mandate, being too poor to purchase health insurance becomes a crime as well  

What people are not being told:
Escalating Costs: The ‘Individual Mandate’ unfairly forces families into buying individual health insurance policies: the most profitable segment of the health insurance business.  This proposal does not create incentives for insurers to reduce costs leaving people instead with the options of either buying health insurance they can’t afford or risking punitive financial penalties.

Insufficient Coverage: Without regulation, insurers will increasingly offer plans, which cover so little; individuals will continue to be faced with huge out of pocket expenses.  Mandates exclude the poor and, as well as lawful immigrants.

In short, we know that individual mandates are bad policy.  By forcing people to buy health insurance, mandates actually act as a subsidy to the insurance industry, enriching profits and CEO salaries while delivering little to the ‘consumer.’  An inefficient and wasteful plan, this proposal would fail to raise the numbers of insured and would increase  the corporatization of our health care: dismantling our economic human right to adequate health care.

Universal, Single Payer: A Human Right!
A Single Payer Universal Health Care system means one payer, the government, for all medical costs: one standard for all.  This plan would extend coverage to every U.S. resident from birth to death.

Constructive and Obstructive: This plan would replace an existing inefficient system - which offers substandard coverage at an unaffordable rate to most people, with a system of quality coverage for ALL.  People should have control over their health care, not corporations.  ‘Single Payer’ eliminates a system, which values the lives of some over others.  

Short term: Single Payer does away with administrative costs that inflate medical bills.  It eliminates potential for corporate profit by removing the corporations that prioritize profits over lives.  Single Payer replaces the existing broken health care system with a universal health plan that eliminates the state and federal burden of absorbing the costs of the uninsured- thus over time, reducing the amount tax payers have to contribute for their own health coverage.  

Long term: People will see a ripple effect if everyone is covered.  Universal coverage translates into fewer sick days and lost jobs due to illnesses, as people will be able to work more efficiently. Homelessness, poverty and bankruptcy, due to overwhelming medical bills, will be eradicated. On the national level, banks will be able to reduce the number of bad loans, meaning more loans will be extended at lower interest rates as Americans loans are paid back on time by Americans no longer at risk of loosing their jobs and homes due to illness.  

In short, Universal Health Care coverage for all people means an overall economic stimulus for the nation.  It also values everyone all of the time.


Members of SHOC, CHAM, & WEAP discussing the need for greater leadership development in the movement for human rights
 Credit: Austin Long Scott

Safe Ground Sacramento: Right to Sleep!
As of June 30, 2009 hundreds of Sacrament County’s shelter beds will be shut down – forcing as many as 350 more homeless people back out onto the street.  The County recently passed a law under the camping ordinance, which states that although it is not illegal to sleep outdoors, to do so while covered with a blanket constitutes camping. “The number of homeless in Sacramento is nearly four hundred; the number of houses which remain unoccupied in the same county is more than two thousand.  “That’s 9 houses to each person living on the street and now we can’t even protect ourselves from the cold and mosquitoes at night because it’s considered camping?” asked John, a homeless organizer with the Sacramento ‘Safe Ground’ campaign.

At WEAP’s June 11th Teach-in and Dialogue, Tracey along with John, Connie and civil rights attorney Cathleen Williams, discussed why people have a basic human right to sleep. They talked not only about how Sacramento needs a safe, legalized campground where homeless folks can have basic services, but also about the importance of cultivating homeless leaders who will fight for this right and for quality and affordable housing. For information about S.H.O.C.’s Safe Ground Campaign and upcoming march, contact SHOC at 916.442.2156 or visit  www.safegroundsac.org.

We Want Viable Options, Not Bad Choices!
Social welfare and educational programs which benefit the public are essential and were created for a reason: all people deserve to have access to basic human necessities: quality and affordable health care, education, housing, food, and living wage jobs.  In fact, these rights are guaranteed by the United Nation’s Universal Declaration of Human Rights, created in 1948 and since replicated in several international and domestic documents.  By cutting the very programs which were put in place to guard against sickness, deficient education, homelessness, malnutrition, and unemployment, California’s increasingly tight budget continues to violate our basic economic human rights, disposing of and hurting those who are in need the most.

Californians want real options, real opportunities, and real change.  The proposed California budget and ‘public option’ national health care reform plan are not “solutions” worth settling for; instead, we must build a broad social movement to secure our basic human rights and eliminate poverty once and for all.  We need to fight for solutions that integrate compassion and justice while including everyone, such as single payer, universal health care.  Quality and affordable health care, a roof over your head, and a safe place to sleep are all rights, not privileges of the few. Near the end of the teach-in & dialogue, successful tools and methodologies in the fight for social justice were shared.  These included putting on a truth commission on economic human rights violations in your community, writing a letter to the editor or to your representative, creating an educational you tube video, using the People’s Tribune as an educating tool, and completing a Health Care is a Human Right training with WEAP. 

Please contact the Women’s Economic Agenda Project at weap@weap.org or 510.986.8620 for more information.