Wednesday, March 21, 2007

The single-payer solution

Posted on Tue, Mar. 20, 2007 In Philadelphia Inquirer

The single-payer solution
By Linda Hunt Beckman

It is no secret that health care in this country needs a fix. About 47 million people don't have any health insurance, including more than a third of families with incomes of $40,900 or more.

And for those who can get a policy through their jobs, premiums are sky-high, with cutbacks in benefits. Many jobs don't provide health insurance anymore, and the cost of private insurance is prohibitive. Americans pay more for health care than people in any other country, and there is a reason: Administrative expenses, created largely by the many layers of the health-insurance system, and insurance-company profits take one out of every five health-care dollars.

Many Pennsylvanians welcomed Gov. Rendell's announcement in February that he had a health-care plan. What many did not know is that there is another plan our state legislature could pass and that it offers a cheaper, better fix. Senate Bill 300, the Family and Business Health Care Security Act, would provide single-payer universal health care to all Pennsylvanians (there will be a counterpart House bill). The national bill, H.R. 676, providing single-payer coverage for all Americans, has been in Congress for several years; it may be easier to pass the state bill first.

Single-payer health care in Pennsylvania would be much like Medicare for all (but better, because it would cover all costs; offer medications at a fair price; provide dental, optical, and mental-health care, and allow a relatively straightforward and just settlement - within the system - for malpractice). Just as senior citizens get almost all of their health care through a publicly funded, privately delivered system, the Family and Business Act would mean you could go to a doctor or hospital of your own choosing, and these physicians and facilities would not be working for the state or run by it (it would no more fit the negative notion Americans have of "socialized medicine" than does Medicare). The term single payer means that the money for the health-care system would come out of a single tax-supported fund, just as the money for Medicare does. And if we compare Medicare with the administrative expenses created by health-insurance industry, the overhead on our Medicare system is less than 4 percent.

Why don't we know about the option these bills provide? Health care is excellent in countries - including Canada, France, Australia, Denmark and most other developed nations - with single-payer plans. These programs are accessible to everyone, regardless of income; simpler to understand; less troubled by bureaucratic complications and expenses, and, most important, offer affordable care of high quality. We in the United States are unfamiliar with the single-payer option because tremendous amounts of money are spent by the medical-insurance and pharmaceutical industries to keep us in the dark. They would lose big bucks if we chose to go this route.

That health care elsewhere is less expensive is easily established: The United States spent an average of $6,102 a person on it in 2004, according to the Organization for Economic Cooperation and Development, while Canada spent $3,165 a person, France $3,159, Australia $3,120 and Britain just $2,508. Medications offered by those systems are affordable because those governments, unlike ours in running Plan D for those on Medicare, can negotiate with pharmaceutical companies for lower prices.

We could be as healthy and spend as little. S.B. 300 calls for funding by a 3 percent income tax on all citizens and a 10 percent tax on employers. These taxes, unfortunately, cannot be progressive because the Pennsylvania Constitution mandates a flat tax. Still, 3 percent of income is far less than most of us pay now for health insurance (with more spent out of pocket), and the legislation would offer the same services to people who have no income.

The governor's plan would not cover even nearly everybody, would not pay for medications, would not be as comprehensive in kinds of care provided, and would cost the state far more. Rendell's plan, like other supposedly universal health-care plans now in operation in Massachusetts and Maine and proposed in California, would be far more expensive because health-insurance companies, which require costly layers of administration and demand large profits, are the middlemen.

The corporate opposition to single payer exaggerates flaws that some systems have, or had, ignoring the fact that our health care is rationed by income. If you are poor, you may well get inferior health care all of your life. We could learn from problems elsewhere and thus develop the best truly universal health-care system of all.

Linda Hunt Beckman ( is a professor of English at Arcadia University and a coordinator for Neighborhood Networks.

Wednesday, March 14, 2007

Engendering The Mayoral Race

Engendering The Mayoral Race: Report From The Bar Association's Civil Rights Committee Panel On Women's Issues

Cross posted by Jennifer on Young Philly Politics

From what I could tell, no one from the campaigns was anywhere around. I'm not sure why, and not sure how to read the statement that specifically gendered issues have been absent from the race so far. What formal communications and connections are there between the candidates camps and the represented organizations? Is there some concerted plan to engender the race that is failing or are these errors of omission from a field of all-male candidates? Some highlights:


The most interesting conversation involved analysis of the gender dimensions of the crime wave. Crime (from violence to prisons to reentry) has gotten tons of attention, but not so much the question of how it affects women and children, possibly because recent studies have allowed us to pinpoint a specific group of people (who are men) who are statistically most likely to be involved in homicides.

Homicide. Cynthia Figueroa, Executive Director of Women Against Abuse, spoke about the huge proportion of homicides that are domestic violence related. She identified the power the new mayor will have through his commissioners to set an agenda across agency divisions. Specifically, they've been able to identify repeat calls to 911 that are coded as domestic violence, creating an opportunity to target resources to those individuals. there needs to be a coordinated response, including within the court system, where rulings in family and dependency court are often in tension.

Domestic violence. Jennifer Dickson Keith presented data from the Philadelphia Women’s Death Review Team Report (a public/private project released last year). The report examines all women's deaths in Philadelphia, focusing on 2002 - 2003 and describing trends between 1997 and 2003. Among other findings, 27% of female homicide victims had known domestic violence histories. 40% of the total deaths were caused directly by "intimate partner violence." This is another facet of the homicide problem that has maybe been marginalized in the current discussion. That data also suggests that at least some of those deaths could be prevented by effective intervention when the domestic violence problem is identified.

Prisons. Ann Schwartzman, Director of Policy of the Pennsylvania Prison Society, described the huge effect the incarceration rate has on women and their families. Since 70% of women in the city system have children and are heads of household, their incarceration effects those children, the neighborhoods, and the social services system. She advocated a wide range of reforms at all levels, from sentencing alternatives for women (including early release, alternative incarceration in the community, drug treatment programs for those only charged with low-level offenses) to reentry programs helping women with employment and--essentially--housing (many of these women find themselves ineligible for public housing).



JoAnn Fischer, Executive Director of the Maternity Care Coalition, was concerned that the new mayor have a regional approach to issues such as maternity and childbirth, since issues regarding access to care and services often cross city/suburban lines. Worryingly, she observed that there is a significant shortage of both hospitals that provide obstetrics (particularly in the Northeast, where several hospitals have closed those departments as less profitable, way over-burdening others) as well as a shortage of OB/GYN and midwifery students that stay in the area after training. She also discussed the need to deal with the problem of ensuring medical care to undocumented city residents, whose families may cross citizenship lines.


Carol Goertzel, President & CEO of Pathways PA, reviewed their recent report, "Investing in Pennsylvania's Families." She outlined a range of workforce program and legislative and tax reforms, many of them on the state level. They are working on a gender breakdown of the rate of working poor families, and a really wonderful and comprehensive review of the issues and proposed reforms is available in the report, linked above. Maybe I can talk about some of the specifics in comments.


Cynthia Figueroa pleading for a fix, saying how her organization's woman clients "could not sustain any aspect of their lives, much less jobs, if SEPTA becomes more expensive." She said that nonprofits already have to subsidize their clients' getting to services.

Specter is considering sponsoring bill to ensure that college students with drug convictions are not barred from receiving financial aid

Pennsylvania NOW received the following request for support from the Students for Sensible Drug Policy for a bill Sen. Specter is considering sponsoring to ensure that college students with drug convictions are not automatically barred from receiving federal financial aid:


As a Pennsylvania-based organization, Pennsylvania NOW could play a huge
role in making sure that college students with drug convictions are no
longer automaticaly strpped of their federal financial aid.

Sen. Arlen Specter is considering sponsoring a bill to reinstate aid to
affected individuals, but he needs encouragement from organizations like
yours to make this a priority for action.

As you may know, nearly 200,000 aspiring students - including more than
6,000 in Pennsylvania alone - have been affected by the penalty since it was
put into force in 2000.

More than 325 organizations around the country - including national NOW -
have already called on Congress to overturn the aid elimination penalty.

Do you think Pennsylvania NOW could write a short letter to Sen. Specter,
urging him to take a leadership role in removing this harmful roadblock to
education and recovery?

Additionally, it would be incredibly helpful if you could ask your members
to visit where they can easily send
messages to Sen. Specter and other legislators about the penalty.

I'd be more than happy to answer any questions you may have about this issue
and to work with you on putting together a letter to Sen. Specter.

Many thanks for your consideration,
Tom Angell, Government Relations Director
Students for Sensible Drug Policy
1623 Connecticut Ave. NW; Suite 300
Washington, DC 20009
phone: (202) 293-4414
cell: (202) 557-4979
fax: (202) 293-8344
AIM: ThisIsTomAngell

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