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I've been watching the debate on CSpan all day - very busy over on Twitter...

If you were watching and playing a drinking game where you took a drink every time a Republican said "government takeover" or "freedom" or "liberty," you would have had alcohol poisoning early in the day.

If you have not been watching here are some must read about events:

We got off to a bad start when Pelosi gave into a vote on the Stupak Amendment barring funding for abortion.

Late yesterday, the United States Conference of Catholic Bishops met with leaders in the House of Representatives in their bid to eliminate women's access to abortion care under health care reform.

We have just received news that their efforts are working, and Representative Bart Stupak has introduced an amendment to the health care reform bill that will result in women losing health care coverage for abortion.

We urgently need you, and your friends and family, to call your representative. After you call, just reply to this message and let us know how it went.

If the bishops and their anti-choice partners in the House succeed, they'll permanently alter health care in America, even taking away benefits from women that they have today. The bishops want to effectively eliminate abortion coverage in both private plans and the public option. We simply cannot stand for such a discriminatory, mean-spirited attack on women.

This morning, the House began consideration of the rule for debate of the House health care bill. As the Democratic Women’s Caucus took to the microphone on the House floor to offer their arguments for how the bill would benefit women, House Republicans — led by Rep. Tom Price (R-GA) — repeatedly talked over, screamed, and shouted objections. "I object, I object, I object, I object, I object," Price interjected as Rep. Lois Capps (D-CA) tried to hold the floor.

The president, according multiple attendees, played the role of political prognosticator during his roughly 30 minute address before Democratic caucus members on Capitol Hill. Addressing, implicitly, those conservative Democrats who are worried about voting for a nearly trillion dollar health care overhaul, he insisted that they would not be safe from partisan attack even if they opposed the bill.

"He certainly talked about the politics and he said that the Republicans want us to fail and no one should feel if they as a Democrat helped us to fail that they would be [free of their attacks]," said Rep. Henry Waxman, chair of the powerful Ways and Means Committee.

"None of you can expect the Republicans not to go after you if you vote against this bill," Waxman continued, channeling the president. "They want this bill to go down for their own partisan reasons."

Now, no bill can ever contain everything that everybody wants, or please every constituency and every district. That's an impossible task. But what is possible, what's in our grasp right now is the chance to prevent a future where every day 14,000 Americans continue to lose their health insurance, and every year 18,000 Americans die because they don't have it; a future where crushing costs keep small businesses from succeeding and big businesses from competing in the global economy; a future where countless dreams are deferred or scaled back because of a broken system we could have fixed when we had the chance.

What we can do right now is choose a better future and pass a bill that brings us to the very cusp of building what so many generations of Americans have sought to build -- a better health care system for this country.

Millions of Americans are watching right now. Their families and their businesses are counting on us. After all, this is why they sent us here, to finally confront the challenges that Washington had been putting off for decades -- to make their lives better, to leave this country stronger than we found it.

I just came from the Hill where I talked to the members of Congress there, and I reminded them that opportunities like this come around maybe once in a generation. Most public servants pass through their entire careers without a chance to make as important a difference in the lives of their constituents and the life of this country. This is their moment, this is our moment, to live up to the trust that the American people have placed in us -- even when it's hard; especially when it's hard. This is our moment to deliver.

I urge members of Congress to rise to this moment. Answer the call of history, and vote yes for health insurance reform for America.

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MUCH OF the health care debate is focused on whether the country can afford the $850 billion the Congressional Budget Office estimates it will cost. The debate centers on whether the bundle of new taxes, credits, efficiencies, and Medicare spending cuts will be sufficient to offset the new spending so as to deliver health care reform without, in President Obama’s words, “adding a dime to the federal deficit.’’

This debate misses the point. It assumes that doing nothing will cost nothing. It turns out that not expanding health insurance is a pretty costly option, because uninsured people impose big financial and economic costs that are not properly appreciated.

The key question is: what difference does it make if you have health insurance? Several major medical studies have determined that people with health insurance have lower death rates compared to the uninsured, fewer medical ailments, and better all-around health. This means more individuals contribute to the economy for longer. Not having health insurance means these economic benefits are lost.

A number of studies confirm the significance of this impact. For example, a landmark study by the Institute of Medicine estimated that 18,314 Americans between 25 and 64 die each year because of a lack of health insurance. These deaths are largely because of failures to diagnose illness and to limited access to good quality care. However, that study was based on data from 1993. A new study, to be published in the December issue of the American Journal of Public Health, puts the number of deaths among Americans between the ages of 18 and 64 associated with lack of health insurance at 44,789 a year.

The premature death of thousands of Americans can be translated into monetary terms using the economic “value of a statistical life.’’ Government economists use this methodology to help determine whether the cost of new government regulation (stricter pollution controls, for example, or food safety rules) is worth the value of lives saved. Insurance companies also use this approach to help estimate compensation levels for wrongful death. These estimates vary widely, from around $3 million to $12 million.

US government agencies typically use a figure around $7 million to represent the lost economic output from each death. If we conservatively use only half of the government figure, or $3.5 million, it suggests that the annual cost to the US economy of 40,000 deaths is about $140 billion. That adds up to a cost of more than a trillion dollars over a 10-year period - even taking future inflation into account - well above the cost of enacting a health care package.

A second way to estimate the cost of not enacting health care legislation is in terms of life expectancy. US life expectancy - at 78.11 years, ranks around 40th in the world and well below countries with universal health care. If we were to match Canadian life expectancy, for example, that would translate into an extra two years and 1 month of life expectancy for every American.

Economists use another measure for the value of an additional year of life, adjusted for the quality of life. A recent study by Stanford economists has demonstrated that the average economic value of a year of human life is about $129,000. Most insurance companies, and many countries around the world, already use a variant of this concept. They implicitly ascribe the value of an additional year of human life at $50,000 by setting that as the threshold for approving treatments. (Any treatment that costs $50,000 will be reimbursed if it is predicted to add another year of life for the patient).

Without health care reform, the economic cost imposed by premature deaths and avoidable illnesses will continue to grow, to the detriment of the economy. As it enters the final debate on health care reform, Congress needs to weigh carefully the substantial cost of doing nothing.

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Speaker Nancy Pelosi
November 6, 2009
Press Release

Pelosi Statement on Congressman Anthony Weiner’s Single Payer Alternative

Washington, D.C. – Speaker Nancy Pelosi issued the following statement today on Congressman Anthony Weiner’s single payer alternative:

"Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country.

"Congressman Anthony Weiner has been a forceful and articulate advocate for the single payer approach and our legislation. His decision not to offer a single payer amendment during consideration of H.R. 3962 is a correct one, and helps advance the passage of important health reforms by this Congress. While single payer, like other popular proposals, is not included in the consensus bill we will vote on this week, Congressman Weiner has been a tireless and effective advocate for progress on health care, and his work has been a vital part of achieving health care reform."

Today Chairman Henry A. Waxman released a statement in response to Rep. Anthony Weiner's decision not to offer a single-payer amendment to the House Democratic health care legislation.

"Rep. Anthony Weiner has been one of the most tireless and effective advocates for health care reform. His decision not to offer his amendment on the floor was a difficult one for him, and for supporters of the measure. I believe Rep. Weiner's choice will be enormously helpful in passing the health care reform package. His step is a correct and courageous one. I thank Rep. Weiner for it, and look forward to working with him closely. Rep. Weiner deserves a great deal of credit for helping to make quality, affordable health care more available to millions of Americans."

Next steps and interpretation -

1) The fact that single payer got so far along in the House is a testament to the strength of our single payer movement. The huge number of calls by single payer advocates in support of single payer and the Weiner amendment in recent days have been noted by several members of Congress.

2) It appears that nobody, particularly the President, expected our single payer option to be alive in the Congress for so long. As you know, they attempted to keep it "off the table" from the very beginning.

3) The President was directly involved in the decision to not hold a vote on the Weiner single payer amendment, and Weiner will be meeting with him later today. Stay tuned.

4) We need to increase pressure on the Congress and the White House for Medicare for All through lobbying, civil disobedience, media outreach, and grassroots organizing. Sen. Sanders will call for a vote on single payer in the Senate - this could come up anytime in the next month. Encourage your Senator to support the Sanders bill and also an amendment he will offer for a state single payer option. The California Nurses Association/NNOC has already started lobbying visits in the Senate in D.C.

5) We have been asked how to tell members to vote on the House bill. Our response is that the bill is "like aspirin for breast cancer."

Make phone calls or send a fax to the Rules committee members asking them to support re-inclusion of the Kucinich ERISA-waiver for state single payer plans into the House Healthcare Reform Bill.

If amendments passed in the committee process can just be stripped out of bills at the whim of party leaders our whole process, our whole system of government is a farce. I don't think we are there yet - I think the Rules Committee remains capable of operating independently and consistently, and nothing is settled until the votes are counted there this afternoon. Ask the Rules Committee to defend the work accomplished by other committees, especially Ed/Labor on the Kucinich amendment, and not to bow to pressure and disinformation from lobbyists or even the Speaker.

Ask the Rules committee to hear any single-payer amendments brought by Kucinich, Conyers, Weiner or Welch, or any robust public option amendment brought by Grijalva, and to vote for their getting enough time for real debate and votes on the House floor.

• Chair Louise Slaughter Buffalo, NY (202) 225-3615 fax: (202) 225-7822 
• James P. McGovern Worcester, MA (202) 225-6101 fax: (202) 225-5759 
• David Dreier Rancho Cucamonga, CA (202) 225-2305 fax: (202) 225-7018 
• Alcee L. Hastings Fort Lauderdale, FL (202) 225-1313 fax: (202) 225-1171 
• Lincoln Diaz-Balart Hialeah, FL (202) 225-4211 fax: (202) 225-8576 
• Doris O. Matsui Sacramento, CA (202) 225-7163 fax: (202) 225-0566 
• Pete Sessions Richardson, TX (202) 225-2231 fax: (202) 225-5878 
• Dennis Cardoza Stockton, CA (202) 225-6131 fax: (202) 225-0819 
• Virginia Foxx Winston-Salem, NC (202) 225-2071 fax: (202) 225-2995 
• Michael Arcuri Utica, NY (202) 225-3665 fax: (202) 225-1891 
• Ed Perlmutter Aurora, CO (202) 225-2645 fax: (202)225-5278 
• Chellie Pingree Portland, ME (202) 225-6116 fax: (202) 225-5590 
• Jared Polis Boulder, CO (202)225-2161 fax: (202) 226-7840

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It was expected that the Weiner Amendment would get a vote today, but Representative Weiner has withdrawn it:

Washington, DC – Today, Representative Anthony Weiner (D - Brooklyn and Queens), a member of the House Energy and Commerce Health Subcommittee, released the following statement on his decision to withdraw his single payer amendment to H.R. 3962, the House health care reform bill:

"I have decided not to offer a single payer alternative to the health reform bill at this time. Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."

"I am going to continue to press the case for health care reform in every venue I can. And I also will continue to press for a smarter, less-expensive, more-comprehensive alternative to the employer-based health insurance system we have today."

"I've discussed the issue with Speaker Pelosi, Chairman Waxman, and agree with them that the health reform bill is so close it deserves every chance to gain a majority."

###

Tomorrow, the House of Representatives is scheduled to consider a single payer bill. As the two principal co-authors of the Conyers single payer bill, we want to offer a strong note of caution about tomorrow's vote.

The bill presented tomorrow will not be HR676. While we are happy to relinquish authorship of a single payer bill to any member who can do better, we do not want a weak bill brought forward in a hostile climate to unwittingly accomplish what would be interpreted as a defeat for single payer.

Here are the facts: There has been no debate in Congress over HR676. There has not been a single mark-up of the bill. Single payer was "taken off the table" for the entire year by the White House and by congressional leaders. There has been no reasonable period of time to gather support in the Congress for single payer. Many members accepted a "robust public option" as the alternative to single payer and now that has disappeared. The Congressional Budget Office (CBO) has scored the bill scheduled for a vote tomorrow in a manner which is at odds with many credible assumptions, meaning that it will appear to cost way too much even though we know that true single payer saves money since one of every three dollars in the health care system goes to administrative costs caused by the insurance companies. Is this really the climate in which we want a test vote?

While state single payer movements are already strong, the national single payer movement is still growing. Many progressives in Congress, ourselves included, feel that calling for a vote tomorrow for single payer would be tantamount to driving the movement over a cliff. The thrill of the vote would disappear quickly when the result would be characterized not as a new beginning for single payer but as an end. Such a result would be seen as proof that Congress need not pay attention to efforts to restore in Conference Committee the right of states to pursue single payer without fear of legal attacks by insurance companies.

We are always grateful for your support. We are now asking you to join us in suggesting to congressional leaders that this is not the right time to call the roll on a stand-alone single payer bill. That time will come. And when it does there will not be any doubt of the outcome. This system of health care injustice will not be able to endure forever. We are pledged to make sure of that.

Sincerely,
Congressmen John Conyers and Dennis Kucinich

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Andy Cobb has had enough. A former pitchman for BlueCross Blue Shield of Florida, Cobb is breaking with the firm and speaking out in favor of health care reform and a public health insurance option.

"This is the time when Americans have to choose which side we're on," Cobb told HuffPost, quoting Rep. Dennis Kucinich (D-Ohio). "Is it the insurance companies or the American people?"

Cobb calls on what he dubs his fellow "spokes-jerks" -- singling out the FreeCreditReport.com guy -- to stop hawking products that hurt the American people.

Cobb teamed with Brave New Films to create the short video.

"I do know that 19 percent of every dollar of our premiums goes to administrative costs, for executive compensation and people like me. We can't afford people like me any more in this country," he said.

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"Despite spending more than twice as much as other developed countries, the United States still lags behind in terms of access and quality, an international survey said Wednesday," Agence France-Presse reports. The Health Affairs study, which was based on survey responses from thousands of primary care physicians, also found that people in the United States were more likely to struggle to gain access to or pay for treatment than patients in 10 other countries evaluated because of insurance restrictions and high health care costs. "The United States is the only industrialized democracy that does not ensure that all of its citizens have health care coverage, with an estimated 36 million Americans uninsured," the French news agency reports (11/5).

The Seattle Post Intelligencer's travel writer shares the views of some residents of other developed countries on their native health systems. A person from Sweden – one of the countries covered in the Health Affairs survey – says, "The health and medical services have an obligation to strengthen the situation of the patient, for example, by providing individually tailored information, freedom to choose between treatment options, and the right to a second opinion in cases of life-threatening or other particularly serious diseases or injuries. Having lived here all my life and raised my family here in Stockholm, I honestly do not see anything bad with our health care system" (Steves, 11/4).

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As House Democrats prepare to vote Saturday on a bill to overhaul the nation's health care system, they picked up an important endorsement Thursday from the 40-million-member AARP, the nation's largest senior citizens group and the nation's largest doctor group.

AARP, which has been pushing for a health overhaul for more than a year, had withheld a formal endorsement of any of the bills being developed by Democrats. That endorsement was followed by a noon Central time announcement from the Chicago-based American Medical Association in which the nation's largest doctors group voiced its support for the measure.

AARP Executive Vice President Nancy LeaMond said Thursday that the group saw the House Democratic bill as the most promising proposal.

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Congressman Weiner's office is saying that because of our phone calls, faxes, and demonstrations, Speaker Pelosi is keeping her promise to allow the Weiner single-payer amendment a vote on the floor of the House. I am getting conflicting opinions about whether or not a full floor debate is going to be allowed.

After nearly being shut out of the discussion completely, single-payer Medicare for All will get a vote for the very first time in history - probably tomorrow - Friday, Nov. 6th.

This is the one opportunity for your elected officials to go on record as supporting the only universal, comprehensive, cost-effective solution to the health care crisis. There are currently 87 cosponsors of HR 676, but this vote will make it clear to the movement which elected officials are truly with single-payer, Medicare for All.

We need you to call today!

Ask your Representative to vote YES for the plan that most American people, nurses, and physicians want and so desperately need: Medicare for All - Rep. Weiner's single-payer amendment.

If you know who your Rep. is, the Congressional Switchboard number is (202) 224-3121. If not, go here to use the tool provided by Healthcare-NOW!--it's easy and toll free.

NEXT: After you have called your representative, please call Speaker Pelosi and thank her for allowing this promised vote and ask her to make sure it is allowed a full debate. Ask her to release CBO scoring for this amendment. The public deserves to see how much money Single-Payer would save while providing all citizens with affordable, accessible and sustainable access to health care.

Speaker Nancy Pelosi:

• Washington, DC, office (202) 225-4965;
• San Francisco office (415) 556-4862

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The House is moving toward a floor vote Saturday on its big health care overhaul, after Democratic leaders worked to nail down votes from some of their members who want stronger anti-abortion language in the bill.

The House vote is expected at 6 p.m. Saturday. The Rules Committee would have to meet 24 hours before the debate to prepare the bill for floor action, but Slaughter declined to say exactly when Rules would meet.

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