Health Care For All, California  -- Orange County Branch

My Correspondence With State Senator Tom Harman

My Letters to Arnold

When SB840 for Universal Healthcare passed the Assembly and the Senate in late August 2006, Governor Schwarzenegger had 30 days to sign or veto it; I resolved to send him a different letter, by mail AND fax, for every day of September.  I don't know if he ever saw these letters, but other people like them a lot, so here they are on line, starting with #1

I'm currently the chairman of the Orange County chapter of Healthcare for All California (HCA), a grassroots group dedicated to passing Senate Bill 840 (SB840), legislation which would create a universal, single-payer healthcare system in California.  If this passes, we Californians would be joining the civilized world and showing a way forward to the rest of America, as we often do.

Now, a bill like this gets passed in two halves:  a policy half, which only requires a majority vote, and then the finance half entailing taxes, which will require a 2/3 vote.  The policy bill passed in the state senate last May and will probably pass the state assembly in January '06.  It's the funding bill that will be a challenge, as at this point all votes have been on party lines:  i.e., all Republican politicians presently oppose the bill.  (Which doesn't make sense to me, as most Republican citizens I talk to support it.)  So our great challenge, especially here in Orange County, is to get at least two Republican state senators to support it, and six state assemblymen.

Here I will try to make my case for the bill, and at the bottom of this page I'll include links to a lot of supportive and inspirational material.  If you're interested in joining our Orange County chapter, or helpful please contact me by e-mail, or call me at 714-235-VERN.

I don't think I need to belabor the point that our healthcare "system" is in crisis and the current course is unsustainable. So I'll just belabor it very quickly here.

The average American now consumes $6400 of healthcare services a year-that's over $12,000 for the average family. Our "system" with its uniquely obsessive reliance on the private sector, is the most inefficient in all industrial nations.

We spend $1.6 TRILLION a year-that's 15% of our economy-and that's up from 5% in 1962. All other industrial nations spend less than 10% and somehow manage to insure everybody.

We pay more than twice as much per person as other wealthy countries, and our costs are rising at 8% a year, yet we have little to show in terms of results. We rank #37 of all countries in the world on the gold standard of healthcare quality-population-based outcomes. What that means is we have lower life expectancy and immunization rates, and higher infant mortality, than all other industrialized countries.

And we rank even lower, 55th in the world, on equity of healthcare financing, the measure of whether people can afford the care they need and how the society supports those who can't.

Last year nearly 2 million Americans went BANKRUPT due to illness, and ¾ of those people HAD INSURANCE! And now, with the wonderful new Bankruptcy Bill authored by the credit industry, we are doubly screwed.

Okay, let's just focus on California, our little bastion of civilization on the Golden Coast. Nearly 7 million Californians are uninsured, and 10 million have no pharmaceutical coverage. And who are these uninsured Californians, some pampered slackers, uninsured by choice? Some rosy-cheeked yuppies in SUV's gambling that lady illness will never darken their door? NOT. The vast majority-80%-are working families, whose jobs don't offer benefits, and who don't make enough to cover today's exorbitant premiums.

And the uninsured are 25% more likely to die from an illness than the insured. 1800 deaths a year in this state are directly due to lack of insurance.

AND people with no insurance put off getting care until they're sick, wouldn't you? Well, sick care is much more expensive than preventive care. We would save about $3.5 billion just from people getting preventive care.

AND where do the uninsured go when they finally can't put off getting care? Why, to the Emergency Room, which rarely turns them down. Ergo, even those of us with insurance sometimes can't get into the ER when we need to because of the overcrowding. 15% of California ER's have closed since '94 because they can't afford to care for so many uninsured people.

Our estimated economic losses from lack of insurance are somewhere between $65 - $135 billion a year. Now, how big was our deficit again? Healthcare costs are the SECOND LARGEST DRIVER of the budget deficit. Our kids and grandkids will be paying the debt service costs for years to come.

And what else does this mean? It means we all pay with closed parks and libraries, underfunded schools, roads not repaved, less homeland security, decreased public support for nursing education, and more.

There are countless ways this crisis impacts us that we don't even think about. For example, how many folks do you know who stay in a job they don't like, simply for fear of losing their insurance?

Health benefit disputes are the MAIN CAUSE OF LABOR STRIFE today. Wages are depressed as employers pay more and more for health benefits. Last year General Motors spent 5.6 billion on health benefits for workers and retirees. That's more than the company spends on steel for its vehicles - translating to an extra cost of $1500 for every car and truck they make! As their CEO Rick Wagoner said, "This expense is a significant disadvantage versus our foreign competitors, and will make a big difference in our ability to compete in investment and technology."

Employers are increasing the employee share of health care costs, and decreasing benefits. And high healthcare costs are driving jobs overseas! Recently Toyota was scouting out several different American sites for a huge new plant; but they ended up settling on Canada, for two reasons-our lousy education and our lack of healthcare.

And thanks to advances in genetic testing, as Robin Cook warned recently, simple diagnostics are very soon going to allow insurance companies to decide whom they'll cover and whom they won't; anyone with the bad luck to have a risky genetic chart won't be able to get any insurance at all. Tough luck!

I could go on and on, but it's time to ask, how did we come to this sorry pass? There are villains to blame-the health insurance industry and the pharmaceutical companies, "Big Pharma." I name Aetna. I name Merck. I name Humana and Healthnet and Pfizer. I name Blue Cross Blue Shield and Glaxo-Smith-Kline and Bristol-Myers-Squibb.

Of course these companies are full of good and decent people, but that's not the point. They're big corporations, and as corporations they are legally bound to maximize profits for their shareholders in any way they can. Let's look at some of the ways they do that for themselves.

First, let's consider the insurance companies, who treat health insurance as a product. Those who can afford it buy it. Those that can't afford it don't. These corporations have priced millions of Americans and their employers out of the market for health insurance, driving up the ranks of the uninsured. As Nurse Judy Spelman observes, "It's one thing to price people out of the market for a Mercedes Benz or a diamond ring. It's quite another to price people out of the market for health care."

They refuse to sell insurance at any price to people who are sick or have ever been sick, or have a family history-the "pre-existing condition" scam.

And they offer "catastrophic" policies to healthy people and to those who can't afford comprehensive coverage AND they sneak in hidden costs and complicated benefit definitions and limitations in their so-called "comprehensive" policies. They increase their own profits by systematically and intentionally under-insuring illnesses.

Paul Krugman reminds us that a good two or three million Americans are employed by insurers and health care providers not to deliver health care, but to figure out a way to get somebody else to pay the bills. Well, we are paying for that too.

The sins of Big Pharma can fill, and have filled, books. Let's just look at their absurd justifications for their obscene overpricing. They say they can't lower the exorbitant price of drugs in the US because they need that money to support their RESEARCH. Nobody really believes that. We all know that the excessive prices primarily go to marketing and advertising, shareholder dividends and huge executive bonuses, NOT research. Here's the figures, from a recent Boston University study - 31% on marketing, advertising and administration, 16% kept as profits by shareholders and executives, and only 11% on research and development.

Plus, 40% of their so-called "research" is "copycat" research, which means waiting for another company's patent to expire, producing the same drug and trying to get a share of the market. It involves no improvements in the drugs. No medical advances. A lot of new spending on ADVERTISING. Don't you just love all those ads for Viagra, Lipitor, Zoloft, Wellbutrin? That's what we're paying for.

Many feel that the adverstisement of prescription drugs should be made illegal. But until that happens, if we, thru our government, used our purchasing power, we could cut drug prices by 30-50% without even hurting Big Pharma's profits. It's simple economics: the increase in the sales of drugs to the 10 million who now have no drug coverage would offset the price cuts we would get.

These two industries are going to fight tooth and nail to prevent our reforms, as they have before, and they're used to getting what they want in terms of even more deregulation, because they have our various legislatures by the short hairs. Since 1990, PACs representing insurance and pharmaceutical interests have poured hundreds of millions in campaign contributions to national and state politicians, mostly Republican. And if they don't get the results they want, they will threaten to back a challenger. Guess who paid for our governor's trip to the Republican Convention last fall? A consortium of pharmaceutical companies.

But I think it would be hard to disagree that our health, lives, and well-being are too important to be left to the tender mercies of these sorts of unaccountable, impersonal entities, and their inexorable drive for profit.

Now here's a good question: Why do we have a government anyway? What is it for? Why did our forefathers painstakingly cobble together this tripartite representative democracy which has stood us in such good stead for lo these centuries? For that matter why did the cavemen gather together at their sunset councils? The answer of course is: FOR THE COMMON GOOD. And if healthcare doesn't fall under that rubric, I don't know what the hell does.

A stereotype liberal would say all business is bad, government should run everything. A stereotype conservative would say the opposite, that the government can't be trusted to do anything right, and all should be left to businesses and the individual. In reality, all of us are a little more nuanced in this century. We know there is a place for business and a place for government. I contend that health care is an area where business has screwed up royally, and it's time for we the people to take it over, thru our democratic tools.

And always remember, it's up to us citizens to stay vigilant to keep our government honest, efficient, and responsive. It is not some foreign object imposed on us. It is our ongoing creation. Especially this new health plan will be.

And we need Republicans on board with this, because this project is going to entail what can only be fairly described as… TAXES. And bills involving taxes in this tax-shy state need a 2/3 vote. Ah, taxes, the "price we pay to live in a civilized society." Someone recently observed that the reason Americans have become so anti-tax is because more and more they don't see anything good coming from it. That would not be the case here. I aim to show you that under this new plan, individuals, businesses, and the state will all save "BANK".

I'm borrowing from activist Don Bechler this brief description of how SB840 works; the full text of the legislation, details of which are still being worked out, can be downloaded here.

Three years ago the state of California completed a 1.2 million dollar study called the Health Care Options Project. It concluded that by removing the health-insurance industry from the healthcare loop and using a single-payer financing system instead, Californians could save 7.6 billion dollars a year while insuring everyone with better services including prescription drugs.

Last year we conducted another study. Again it was concluded that if we adopted legislation like SB840 we could insure everyone, save 8 billion dollars the first year alone and 343 billion over 10 years.

SB840 passed the senate on May 31 and the Assembly will vote on it early next year. It will cover everyone in California with reliable health care. No longer will we be depending on a job benefit, or an old people's program, or a poor people's program, or something we pay exorbitantly for, or something we have to go without. No longer will anyone be excluded because of a pre-existing condition. Every resident of California will be insured.

SB840 will save Californians money. We would fold in the Medicare, Medicaid, and other government money along with a payroll tax on both the employee and the employer into one public fund. By consolidating these funds, we rid ourselves from the current wasteful bureaucracies caused by the 10,000 insurnace plans and 69 government programs in California. We would pay taxes in lieu of premiums, but they would be a lot less than the premiums we're paying now. This would mean a healthier economy with more money in the pockets of business and working people. This would be the biggest bureaucracy-slasher in history, reducing 10,000 health plans to one.

SB840 will deliver comprehensive care, including full mental health and prescription drugs. It covers dental and vision care. There are no copays or deductibles. We will have full choice of our provider. No longer will an employer or insurance company be able to tell you what doctors you can visit.

Lastly, SB840 will be publicly accountable. Those of you who have insurance, do you know who the CEO of your insurance company is? With SB840 we will elect our health commissioner. We Californians will be in charge of our own health care.

[When the finance bill is finally written, which should be soon, I will include a chart here so that each individual and business can figure out exactly how much they would save.]

Of course we can expect a full-court press to defeat this legislation, given how much big insurance has to lose, and how well-funded they are WITH OUR PREMIUMS. Word is, they've already prepared a $48 million fund just to defeat our measure. We should be expecting a whole new generation of Harry-and-Louise ads, "paid for" by obvious ASTROTURF groups-that is, phony "grass-roots" groups that always turn out to be funded by the threatened corporations. These people are not imaginative, and will try again what worked for them before, thinking Californians don't learn.

And we will again hear endless scare stories about CANADA, using dubious anecdotes, urban legends, and exaggerated waiting-time tales. First of all, most of these stories can be traced back to the Fraser Institute, a 30-year-old misinformation mill dedicated to privatizing Canada's health system. From their controversial big-tobacco-funded conference denying the danger of secondhand smoke, to their notorious Exxon-funded study denying the existence of global warming, the Fraser Institute has more than earned its soubriquet "The Best Little Whorehouse in Canada." Now they've sent us one John R. Graham, who has been gracing the pages of the Orange County Register with his turgid and dishonest tomes against healthcare reform.

Fraser's exaggerations and cherrypicking aside, it is true that Canada has had some problems in certain areas with shortages and waits. This was always due to underfunding, a mistake which we plan to avoid - SB840 will be funded at two to three times the level of the Canadian system.

Plus, how bad could their system be when poll after poll show Canadians overwhelmingly support it? They wouldn't dream of changing their system for ours. One good indication of how far out of the Canadian mainstream privatizers like Fraser are is that the new Conservative Prime Minister Paul Martin won election with a promise to fully fund the healthcare system-a promise he has made good on. So to sum up, the Canadian system is good, and ours will be even better.

Two final points: As a Christian, I see providing Health Care to All as a PRO-LIFE issue. Too often it seems like all we pro-life people care about is stem cells, fetuses, and Terri Schiavo. Here is a chance to show our commitment to improving and preserving the lives of real, living, breathing people; what do you think Jesus would do?

(Actually, given that under the plan we'll get to choose our own doctors and hospitals, the plan is BOTH pro-life and pro-choice!)

And lastly, this issue shouldn't be seen in terms of left vs. right. The question is, do we continue to allow our lives and health to be held hostage by 21st-century robber barons, or do we ALL get together to take control of it ourselves, using the democratic tools at our disposal?

This is a moment like civil rights, when we all unite to do the right thing, and it won't happen without both Democrats and Republicans cooperating to make it happen. It was the great progressive Republican president Teddy Roosevelt who broke up the monopolies a century ago. I would hope Republicans of conscience and goodwill would be prepared to do the same now that it's once again a matter of life and death.

Useful Links

Lots more links coming soon!  -- Vern

(my home page)