On the Struggle for Universal Health Care
DSA reaffirms its support for single-payer health insurance as the most just, cost-effective and rational method for creating a universal health-care system in the United States. In the House of Representatives, John Conyers has introduced H.R.676, the Expanded and Improved Medicare for All Act. This bill has 77 co-sponsors. In the Senate, Bernie Sanders has introduced S.703, the American Health Security Act of 2009, his bill has not yet attracted co-sponsors. These two pieces of legislation take different approaches to universal health insurance, but both take for- profit insurance companies out of the picture. DSA asks our locals to contact their senators and representatives, and encourage them to co-sponsor these bills if they have not already done so.
DSA notes with dismay that the current discussions and hearings in Congress relating to national health insurance have excluded single-payer health insurance from the discussion. The plans under discussion presume a large role for the existing insurance industry; possibly, in competition with a Medicare-like public option. We strongly support single payer over these other alternatives. In particular, we feel it is vitally important to include supporters of single payer in the discussion around all possible plans, and condemn the exclusion of these voices in both President Obama’s Health Care Summit and in the hearings of the Senate Finance Committee. Particularly, in the discussions of the public options, the ideas and experience of health-care professionals committed to the single-payer approach would provide essential input.
Even taking the above into account, the current political situation provides the best opportunity for serious health-care reform in a generation. We do not accept the position that unless we get everything we want, we are willing to see that opportunity disappear. We do believe, however, that the insurance industry is powerful enough that the current political dynamic could result in a “health care reform” that is, in fact, worse than nothing at all, because it would create a public plan that is designed to fail.
Therefore, even while we do everything we can to ensure that single payer gets a fair hearing, we must state our minimum requirements for possible alternatives to single-payer health insurance. Our minimum position is that any plan must include a strong public-provision component, one that can compete with the private insurance options. In evaluating proposed plans, the devil is, unfortunately, in the details. Among the criteria to be considered:
All employers and individuals must be eligible to choose the public plan, possibly during an annual open-enrollment period.
The plan must be government run, operated by the Centers for Medicare & Medicaid Services or by a similar agency.
The public plan must have the ability to negotiate drug prices.
The public plan must be allowed to negotiate reimbursement rates, possibly pegged to Medicare rates.
• The public plan must, like Medicare, allow participants to choose their own doctors. Short of these provisions, whatever comes out of Congress will not be real reform. Health care
is a human right and must be available to all without economic barriers.
DSA recognizes that there is strong support for a single-payer plan in several states. In fact, California would have a single-payer system today if Senate Bill 840 had not been vetoed by Gov. Schwarzenegger. Therefore, DSA insists on an opt-out provision from any national plan that would allow individual states to set up their own single-player plans and to use Medicare, Medicaid and similar federal funds allocated within the state in that state plan.
In summary, DSA asks our locals and activists to engage in the following activities in support of health-care reform:
Urge Senators and Representatives to co-sponsor H.R.676 and S.703.
Support the right of single-payer proponents to have their position heard in the congressional debate.
Insist on the inclusion of a strong public component in any health-care reform legislation.
Insist on the inclusion of a state opt-out so that individual states can enact their own single-payer plans.