Thursday September 17, 2009, 5:31 am
Thank you Alba.

Thursday September 17, 2009, 5:46 am
'Public Option' Pales Next to Single Payer
by Nicholas Skala

Skala's remarks were published by CommonDreams.org on June 16, 2009, 12 days after he'd delivered them to the Progessive Caucus. He died in his sleep of unknown causes less than 2 months later. I cannot suggest that there might be any connection, but these are the dates, the facts. And I am troubled by the fact that no one knows what he died of.

The interview which is available for watching on the posted page was made on June 12.

His death is considered a devastating loss to everyone who knew him in the Single-Payer healthcare movement, and the author of my post, Donna Smith of the California Nurses Association/National Nurses Organizing Committee, writes: "Nick's influence reached far beyond what most of us will ever achieve."

The following remarks were delivered to a closed-door meeting the Congressional Progressive Caucus on June 4, 2009 :

Today the Congressional Progressive Caucus faces a choice. That choice is whether Members should maintain their unflinching support for single-payer, or to accede to intense political pressure to support the plan currently being developed in Congress under the direction of President Obama: a mandate for Americans to purchase an insurance plan from a massive new regulatory “exchange,” with one plan potentially being a “public option.”

The difference between these choices could not be more stark: single-payer has at its core the elimination of U.S.-style private insurance, using huge administrative savings and inherent cost control mechanisms to provide comprehensive, sustainable universal coverage.

The “public option” preserves all of the systemic defects inherent in reliance on a patchwork of private insurance companies to finance health care, a system which has been a miserable failure both in providing health coverage and controlling costs.

Elimination of U.S.-style private insurance has been a prerequisite to the achievement of universal health care in every other industrialized country in the world. In contrast, public program expansions coupled with mandates have failed everywhere they’ve been tried, both domestically and internationally.

Many progressives accept that the “public option” is inferior to a single-payer system, yet support it because of its perceived political expedience. It is my aim today to convince you that the “public option” program currently being developed is not only bad health policy, but bad health politics.

On two separate occasions last month, physicians and nurses were dragged from the Senate Finance Committee in handcuffs for demanding that single-payer be considered in our nation’s health reform debate. These were American doctors and nurses, people who care for patients, people who want to practice medicine, not protest and disrupt Congress.

But these professionals risked their careers and their freedom. They did this not because they thought that the “public option” was “good” and single-payer “better.” They did it because they are firmly convinced, by well-established health policy science, that the so-called “public option” has no hope of remedying the systemic defects that cause their patients to suffer and die, sometimes before their very eyes.

Millions of dollars have been spent by political advocacy groups to commission polls and statistics “proving” that their health reform is “politically feasible.” Yet political winds do not make good health policy. Careful examination of science and experience do. And it is in the science and experience that we see that single-payer offers the only way to truly comprehensive, universal and sustainable health care, and that “public option” schemes offer only more of the same: tens of millions of uninsured, rapidly deteriorating coverage, an epidemic of medical bankruptcy, and skyrocketing costs that will eventually cripple the system.

First, because the “public option” is built around the retention of private insurance companies, it is unable - in contrast to single-payer - to recapture the $400 billion in administrative waste that private insurers currently generate in their drive to fight claims, issue denials and screen out the sick. A single-payer system would redirect these huge savings back into the system, requiring no net increase in health spending.

In contrast, the “public option” will require huge new sources of revenue, currently estimated at around $1 trillion over the next decade. Rather than cutting this bloat, the public option adds yet another layer of useless and complicated bureaucracy in the form of an “exchange,” which serves no useful function other than to police and broker private insurance companies.

Second, because the “public option” fails to contain the cost control mechanism inherent in single-payer, such as global budgeting, bulk purchasing and planned capital expenditures, any gains in coverage will quickly be erased as costs skyrocket and government is forced to choose between raising revenue and cutting benefits.

Third, because of this inability to control costs or realize administrative savings, the coverage and benefits that can be offered will be of the same type currently offered by private carriers, which cause millions of insured Americans to go without needed care due to costs and have led to an epidemic of medical bankruptcies.

Supporters of incremental reform once again promise us universal coverage without structural reform, but we’ve heard this promise dozens of times before.

Virtually all of the reforms being floated by President Obama and other centrist Democrats have been tried, and have failed repeatedly. Plans that combined mandates to purchase coverage with Medicaid expansions fell apart in Massachusetts (1988), Oregon (1992), and Washington state (1993); the latest iteration (Massachusetts, 2006) is already stumbling, with uninsurance again rising and costs soaring. Tennessee’s experiment with a massive Medicaid expansion and a public plan option worked - for one year, until rising costs sank it.

The Federal Employee Health Benefit Program (the model for a health insurance exchange) leaves hundreds of thousands of federal workers uninsured, and has proven unable to contain costs.

Negative results in a recent series of randomized trials explodes the hope that chronic disease management will cut costs. And the CBO has thrown a wet blanket on the notion that electronic medical records save money.

As Drs. David Himmelstein and Steffie Woolhandler, co-founders of Physicians for a National Health Program, have remarked, a public plan option does not lead toward single-payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan. A quarter-century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry-picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan - which started as a single-payer system for seniors and have now become a funding mechanism for HMOs - and a place to dump the unprofitably ill.

Progressive supporters of the “public option” readily concede that single-payer is a superior system. Indeed, their response to evidence that their plan won’t work is to commission more charts and graphs emphasizing its political feasibility.

The “public option” is truly the embodiment of health policy designed by sound bytes, cobbled together from snippets of information gathered from focus groups and public opinion polls, and centered around well-polling buzzwords such as “choice” and “shared responsibility.”

Such a plan may be enough to excite the political classes in Washington, who care more about what they think can pass the Congress than what will actually deliver universal, comprehensive health care for all. But doctors and nurses, the people who actually work in the health system, see right through it. They are going to jail because they know that this plan won’t work for their patients.

Nobody is going to jail for the “public option,” because the American people cannot be inspired by band-aids and half-measures it is impossible to believe in.

These doctors and nurses are the manifestation of a social movement, millions strong, that is waiting to be mobilized by the leadership of the Members in this room. Polls consistently show that two-thirds of the American people want single-payer. At a recent hearing in Montana convened by Sen. Max Baucus, only 10 people of three hundred said they were happy with the insurance they have. Sixty percent of physicians support single-payer, as do the U.S. Conference of Mayors and 39 state labor federations and hundreds of local unions across the country.

We’re told that holding out for single-payer is politically unwise, but to compromise and accept a bad plan at precisely the time when popular support and grassroots energy are on the side of true reform is the real political miscalculation.

The history of great social achievement is rife with instances in which the forces of institutionalized power told social movements - as they now tell this one - that what they wanted was too much, or too fast, or too soon. I think, of course, of the abolition of human slavery, the enfranchisement of women, the Civil Rights Movement, Social Security, the minimum wage, an end to child labor. In each of these instances, social movements held fast to their principles and soon discovered that they had been told was “politically unfeasible” one moment was political reality the next.

We currently have a better chance to pass single-payer than Lyndon Johnson had when he passed Medicare. Unlike the public option, single-payer - because it holds the potential to finally realize universal, equitable health care - can be a vehicle to inspire the American people for progressive change.

The voices of doctors and nurses can achieve extraordinary resonance when they speak selflessly in their patients’ interest. But your leadership is crucial to inspire the American people. It is my hope that you’ll see fit to provide it.


Besides having been a senior research associate for Physicians for a National Health Program, he was a Juris Doctor candidate and Harry L. Kinser Scholar for Health Law at Northwestern University School of Law.
And had also drafted Illinois' healthcare law.

Thursday September 17, 2009, 7:05 am
There are still single-payer events & rallies taking place, scheduled around the country -- The activists haven't given up -- Why should we ! ? !

Healthcare Justice Week
September 20th – 30th, 2009

The following contains active links @ http://www.healthcare-now.org/

Join us in Washington D.C. September 24th, 4:30pm at Upper Senate Park for the 3rd Annual Health Care Justice Vigil.

Join the Mad as Hell Doctors for their Washington D.C. Rally on September 30th in Lafayette Square Park from 4pm - 7pm.

Don't forget to call Congress! Ask your Rep. to support Rep. Weiner's single-payer healthcare amendment, and to retain Rep. Kucinich's state single-payer amendment. Ask your Senators to support S. 703.

Mark your calendars for Healthcare-NOW!'s National Strategy Conference on November 14th and 15th. Location and information to be announced soon!

■Call your congressional representatives and ask that they cosponsor and actively advocate for HR 676. Call toll free 1-866-338-1015

The number of medical, faith, union, political, state, county & local organizations who Endorse HR 676 is enormous ! See them all !!


Please check out these sites and sign the petitions if you haven't yet:

HEALTHCARE - NOW! -- I Support HR 676

Physicians for a National Health Program: PNHP is at the forefront of research and action for a Single-Payer National Health Insurance

Thursday September 17, 2009, 11:34 am
Thanks for the information links. Much appreciated.

I am in favor and support H. R. 676.

Here is a link for the full bill that you can read for yourself.

http://healthcare.kucinich.us/petition/nhi_bill_final1.pdf

It may come Dennis Kucinich office but it has an official seal and is certified
by Superintendent of Documents , United States
Government Printing Office, certificate issued by GeoTrust CA for Adobe.

The Bill is only 30 pages.

Dennis Kucinich is one of a rare few representatives that I trust. An Honorable Man.

Enjoy reading for yourself. Here it is...

TY, Alba.
.

Thursday September 17, 2009, 1:33 pm
Thank you VERY much. This unexplained death is EXCEEDINGLY troubling. There have been TOO MANY MYSTERIOUS DEATHS: unexplained deaths of prominent 9/11 Truth researchers {just before they were about to testify}; weird almost-simultaneous deaths of Biological researchers who worked in secret govt labs on secret projects {we have no idea what projects they were}.

The people who want to STAY in power, will obviously stop at NOTHING to retain it. Thank goodness for the Internet, or we wouldn't even know of these things!

Who knows what pressures, threats and outright blackmail, President Obama and his lovely family with two beautiful daughters, are subjected to???

This began with the Kennedy assassination, or maybe it had happened before but we just weren't aware of it..... I wouldn't be at all surprised.

Oh, yes, the death of Senator Paul Wellstone and members of his family in an "airplane accident", JUST before he was going to be {for certain!} elected and CHANGE the balance of power in the Senate......

So much easier to fake an "accident" or a "mystery death" by some kind of little-known poison, maybe, than outright taking them out by gunfire..... so crude and so public!

Thursday September 17, 2009, 3:02 pm
Nothing would surprise me in this case. We're talking about an industry which keeps the right people VERY rich.

Friday September 18, 2009, 1:23 am
I'm afraid you're right, Pamylle.

Discovering 27-yr-old Nicholas Skala's unexplained death, I couldn't help thinking of a film with George Clooney & Tilda Swindon, "Michael Clayton," about a biotech company reverting to hit men to get rid of people trying to publicize evidence that the firm's herbicide causes cancer.

Sometimes, real life is more farfetched, more horredous, than fiction.

Monday September 21, 2009, 11:20 am
And to continue with BMutiny's train of thought -- yes, the death of Senator Paul Wellstone and members of his family in an "airplane accident."

And what about Karen Silkwood? On November 13, 1974, she left to meet with a reporter from the New York Times. She never got there.

I think everyone knows her story, thanks to all the books, magazine & newspaper articles, and, of course, the major motion picture. She was a chemical technician at the Kerr-McGee's plutonium fuels production plant in Crescent, Oklahoma...and an activist who was critical of plant safety. During the week prior to her death, Silkwood was reportedly gathering evidence for the Union to support her claim that Kerr-McGee was negligent in maintaining plant safety, and at the same time, was involved in a number of unexplained exposures to plutonium.

Tuesday October 13, 2009, 8:03 pm
I regret to inform those seeking a story that Nicholas did not die because of any kind of conspiracy. He wasn't killed by an insurance company, no one in the government took him out.

Why can't you people just let him rest in peace?? It's absolutely none of your business how he died, and you suppositions are cruel to the people who actually knew and loved him.

Wednesday October 14, 2009, 2:33 am
Dear Adrian,
It was no one's intention here to be cruel: on the contrary, I -who posted this story- was heartsick to find out that such a wonderful, brilliant & very young person, and such a dedicated, talented activist had died. A public person's death of unknown causes sounds very mysterious; it is bound to cause speculation, particularly in a country were extrajudicial murder has occurred on at least several occasions.

But that does not mean there is intent to harm either the person's memory or those who knew and loved him. I am sorry that you have interpreted this post in this way. More important than spreading any possible conspiracy theory is remembering and honoring Nicholas' life and work, which impressed me deeply, even if I found out about him only this past September.

I apologize for any pain I unwittingly caused and thank you for clearing the matter up.

Wednesday October 14, 2009, 2:35 am
Btw, how do we know you really are a former friend of Nicholas Skala and not a lobbyist or just a mischief-maker ?

Wednesday October 14, 2009, 2:41 am
I should add that I feel strongly about health insurance reform and single-payer, so posting this video and all the information I found about Nicholas & his efforts to bring single-payer to victory was my way of giving him a posthumous tribute, celebrating his memory and carrying on the battle.

Saturday November 7, 2009, 9:43 pm
I should be clear that it was not the initial post that offended me, but the subsequent comments. Also, I am not a lobbyist, nor am I a mischief maker, not of the kind you're implying anyway. I understand paying him tribute; he absolutely deserved it. But seeing as how he was, in fact, my dear friend of years, it is very painful to see people speculate on his death. Of course, after typing that last, I realized he probably would have liked to have theories placed on it. Nevertheless, and as prone to believing a good conspiracy theory as I am, there was none here. I hope that at least abates anyone's desire to speak further on his death, and provokes them to focus on what was important: his life.