Seachange Bulletin #117

August 19, 2003

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Seachange Bulletin #117: Health Crisis & Bush’s Blackout: Solutions Exist

Editorial Comment: What do the recent power outage in eastern North America
and the US healthcare crisis have in common? Too much. Deregulation,
profiteering, corruption, denial are a few words that come to mind. And the anarchy of
capitalism in a country where the lunatic fringe dominates discourse within the
DC Beltway and the son of a Nazi has a real chance of becoming the next
governor of the most populous and diverse state. - SE

Black Caucus urges universal health care
Chicago Tribune, June 9, 2003

National infant death rates are 2 1/2 times higher among blacks than whites,
and inner-city black children are far more likely to suffer from asthma, they
said. Blacks are twice as likely to have diabetes as whites and are 9 1/2
times more likely to get AIDS. ...

Dead on Arrival: The Politics of Health
Care in Twentieth-Century America
By Colin Gordon, Princeton University Press, 316 pages.
A Review by Tom Gallagher, San Francisco Bay Guardian, June 25, 2003

As V.I. Lenin, the leader of the Russian Revolution, said, "Socialized
Medicine is the keystone to the arch of the Socialist State." Actually, Lenin didn't
say that, but the American Medical Association figured that he might as well
have, so they made the quote up for him and used it in their anti-national
health insurance literature of the late 1940s. Such were the politics of health
care in twentieth century America. Since those politics resulted in our nation
ending the century as the world's only wealthy democracy without a national
health insurance system, much of Colin Gordon's "Dead on Arrival" is the story
of how the opponents kept it that way. Certainly the fact that "the AMA ... was
largely successful in making health policy a theater of the cold war" was
important, but the campaign predated that. When World War I-era reformers
suggested that the nearly one-third of enlistees failing military physicals showed
the need to guarantee Americans adequate health care, the status quo's
defenders denounced the idea as "a dangerous device, invented in Germany, announced by
the German emperor from the throne the same year he started plotting and
preparing to conquer the world." One called it a "paternalistic" system like those
found in "king-ridden Europe." Then along did come the Russian Revolution and
kings and emperors were no longer the big problem. For much of the next half
century national health insurance was dealt with as a step on the road to
godless Communism, although there were still interruptions: With the rise of Adolf
Hitler, a Kentucky medical society declared that national health insurance
would "make the Surgeon General of the United States a medical dictator ... as
much so as a Nazi dictator." And the Oklahoma Medical Society believed the
Holocaust "could never have happened if Bismarck had not clandestinely murdered
the free spirit of medicine [with] ... compulsory health insurance." Lest any of
the critiques appear contradictory, the AMA synthesized it all in 1946,
explaining that national health insurance was a "red fascist" idea, a product of
"German-Japanese-Russian philosophy." In other words, everything bad rolled
into one. All of this might be funnier were the problem of lack of access to
health care in America not so serious. ... For fifty years American health care
has been dominated by what Gordon calls the "private welfare state" - the
distinctive American reliance on employment-based health insurance that mushroomed
from covering less than a half million in 1946 to nearly thirty million in
1954. As Gordon, who teaches history at the University of Iowa, describes it, the
system "grew in response to the threat and reality of unionization" which was
at its peak during the post-World War Two years. Among the system's problems
is its tendency to magnify already existing inequities of employment - in other
words, better jobs tend to bring more and better coverage. So when the rate
of civilian employee health coverage dropped from 61 percent to 54 percent in
the 1980s and early 1990s, for low-wage workers it fell from 30 percent to 14
percent. And while overall private health insurance coverage (the self-insured
included) stood at about 70 percent at the end of the century, the rate for
blacks was only 51 percent; for Hispanics just over 40 percent. And women have
always fared worse than men. Nonetheless, all subsequent efforts to broaden
coverage have started with the assumption of this private system as a base. The
last significant change - the 1965 Johnson Administration Great Society
programs - did not touch this base: Medicare "recipients" were elderly and Medicaid
"beneficiaries" were poor. Meanwhile, unions may have been responsible for the
spread of the employee health insurance system, but for the most part
businesses controlled it, which meant that some corporate giants got into the health
care picture. This, in turn, insured that some would try to control the health
care industry. Not a task easily accomplished, but "by the end of 1990s, HMOs
and their variants claimed nearly 80 percent of the health insurance market."
And with so many doctors functioning under Health Maintenance Organizations,
the AMA no longer dominated the debate. ... "[B]etween 1965 and 1990, health
costs swelled from 6 to nearly 15 percent of GDP" and corporate America wanted
to figure out how to cut its costs. So when the Clinton Administration
attempted its system reform in 1993, it took as givens two contradictory elements: the
need to reduce costs and the need to leave the system of private health
insurance in place. Logically, American corporate cost cutters ought to be for
dumping the thicket of health insurance bureaucracies, private and public, not
borne by foreign countries and competitors. Instead, corporate America has viewed
an attack upon one of their sectors as an attack upon all and refused to let
private health insurance go the way of the blacksmith industry. This
commitment to preserve the industry meant that when the Clinton Plan finally appeared,
"at 1,342 pages it was 1,340 pages longer than the Canada Health Plan." The
Canada Health Plan guaranteed Canadians health care; the Clinton Plan resembled
nothing so much as the cartoons of the late Rube Goldberg that showed
preposterously complicated machines performing the simplest of tasks. ... Unlike the
last couple of election campaigns, the idea of universal health care coverage
is again in play in the Democratic primaries with at least Congressman Dennis
Kucinich supporting it. ...

National health insurance is the obvious prescription
Quentin Young, MD, Chicago Tribune, June 29, 2003

Our American system is employment-based, and business and labor unions won't
forgo this arrangement. Well, guess what? Last fall a remarkable statement was
released by the Big Three automakers in Canada. It said, in part, "The
[Canadian] public health-care system significantly reduces total labor costs for
automobile manufacturing firms, compared to the cost of equivalent private
insurance services purchased by US-based automakers ... "

Unspeakable truths no one will admit
Warren Goldstein, Philadelphia Inquirer, June 29, 2003

How do we know the American health-care system is a mess? Because everywhere
you turn, someone is making another proposal to fix it. And unless you're an
expert on these matters, you probably don't even understand the difference
between the latest scheme to "fix Medicare," or "cover the uninsured," or (as
Congress just did) "increase coverage for prescription drugs." That's because no
one in public life (sic) is willing to say, out loud, that there is an obvious
solution to what many people inside and outside the business of health care
are calling a "crisis." That solution is a nationwide program of universal
health care - one that covers every single American - administered by the federal
government. ... The real reason universal health care remains the great
obvious, but unspeakable, solution, is most Americans' gut-level conviction that
competition and the profit motive - the market, in other words - is the only way
to maintain the "best health-care system in the world." The truth of the matter
is quite the contrary. Nearly every problem with American health care is
directly traceable to the market itself, and our deep "faith" that the market
somehow will provide. Why, for instance, does the American health-care system have
the highest overhead (14 percent) among the systems of all other
industrialized countries? Because for-profit corporations run most of the system. The
Canadian system, often characterized here as "inefficient," runs with exactly one
percent overhead. Our own Social Security runs on about 2 percent overhead.
You see these "administrative costs" in person when you go to a medical facility
and spend more time filling out forms than seeing the doctor; when you count
the number of staff talking to insurance companies on the phone, and realize
that they rival the number of medical personnel in the office. You don't see
them, however, in the truly gargantuan salaries of the CEOs of health-related
corporations. In 2000 five top CEOs made annual salaries ranging from $11
million to $54 million; three top execs at pharmaceutical giant Pfizer Inc. made at
least $16 million. We might wonder at the much-vaunted "efficiency" of a
system that simultaneously produces Enron-level salaries (and stock options) for
executives, and pays nurse's aides salaries that do not allow them to live above
the poverty line, or to afford the very health care they are providing. ...
The market has provided great technology and cutting-edge therapies. It has
also produced enormous profits, staggering bureaucracies, and a patchwork of
policies held together with Band-Aids most of us cannot understand. Time to start
over. We can start by saying the unsayable: It's time for a universal,
comprehensive, equitable and affordable health-care system for all Americans.

Health care insurance: Where does it hurt?
Springfield (Massachusetts) Republican, June 29, 2003
<
http://www.masslive.com/search/index.ssf?/base/news-0/1056800713156690.xml?cn
lm>

Today we begin a four-part series about the growing number of local people
who do not have health care insurance, a benefit so important that many
job-seekers now make that, rather than pay, the deciding factor when seeking
employment. We have entered the health care age, and the rising cost of insurance
threatens both businesses and health care providers. The signs of this new era are
everywhere through an array of treatments and medications that is staggering.
When you watched television a few years ago, how often did you see a
commercial for drugs? Rarely. Today, we are inundated with advertisements promoting new
miracle drugs that make parts of our bodies work better. This has resulted in
a significant increase in retail spending on prescription drugs, the
fastest-growing item in the US health care budget. One study showed that 25 of the
most heavily advertised drugs accounted for more than 40 percent of the increase
in retail drug spending in one year. ...

Uninsured and vulnerable
Broken system leaves many on the margins of health care
Marcia Blomberg, Springfield (Massachusetts) Republican, June 29, 2003
<
http://www.masslive.com/search/index.ssf?/base/news-0/105687195947410.xml?nna
e>

Robin C. Veratti, a diabetic for almost 21 of her 22 years, recently suffered
a dangerous hypoglycemic episode because she couldn't afford to test her
blood sugar as often as she needs to. The full-time college student and waitress
has limited insurance, but it doesn't cover the $61 cost of 100 test strips she
needs to check her blood sugar five times a day. Waiting to see a doctor at a
free health-care clinic in East Longmeadow, the Ludlow woman had little
patience for arguments over the nation's fractured health-care system. "There are 4
million Americans with diabetes," she said. "You mean to tell me you can't
give help? Every industrialized country except America has free health care." ...

Safety net struggles to catch the poor
Patricia Norris, Springfield (Massachusetts) Republican, June 30, 2003
<
http://www.masslive.com/search/index.ssf?/base/news-0/1056958356154162.xml?nn
ae>

The calendar is turned to May. But Carole M. Goulet fixates on July. The
62-year-old unemployed, uninsured Northampton woman hopes she can afford a visit
to her pulmonologist. Although Goulet, who suffers from a chronic lung disease,
qualified for a program that offsets doctor fees, the bills remain costly
despite discounts, she said. Down Route 5 and into West Springfield, fresh-faced
Jennifer Parker pulls double shifts at Chi Chi's Mexican restaurant and works
six, sometimes seven days a week to make ends meet. Still, the 19-year-old's
dogged determination doesn't earn her health insurance. Parker thought she'd
qualify for MassHealth, the state's insurance program for the poor. But a
government case worker told her since she wasn't a parent, pregnant or infected with
HIV, her application was denied. ...

Can a cure be found?
Stan Freeman, Springfield (Massachusetts) Republican, July 3, 2003
<
http://www.masslive.com/search/index.ssf?/base/news-0/1057234592113155.xml?nn
ae>

As more join the ranks of the uninsured, calls for alternatives to America's
health-care system are gaining urgency. Is universal health care the answer?
The saying is "if it ain't broke, don't fix it." Every decade or so, the US
health-care system seems to teeter on the brink of collapse, but it has never
quite come to ruin. As a result, there has not been a sustained national will to
reform it. In recent years, though, health-insurance costs have risen without
relief, and an estimated 41 million Americans under age 65 are currently
without insurance, including nearly 365,000 in Massachusetts. In the eyes of many,
what was once the most admired health-care system in the world is finally in
collapse, and the will to reform it is building rapidly. And while hospitals,
physicians, insurers, politicians and patient advocates will all be pushing
their particular agendas - which are often at odds - all agree something needs to
be done. Long a champion of health-care reform, Sen. Edward M. Kennedy,
D-Mass., calls the plight of the uninsured "a national disgrace." The uninsured are
not the poor, though. They are the "working poor," people who make too much
to qualify for Medicaid but too little to afford health insurance, he noted. ...

AIDS budget cuts lamented
Associated Press, July 5, 2003

Worcester - The state's almost 40-percent cut in AIDS spending over the last
few years could lead to a rise in the infection rate and a spike in the death
rate in a few years, warn service providers. The state spent $51.1 million on
AIDS and HIV programs during fiscal 2001. This was reduced to $41.4 million in
2002 and $35.8 million in 2003. Last month, a legislative conference
committee cut Gov. W. Mitt Romney's request for AIDS funding by almost $4 million to
$31.9 million for fiscal 2004, which started on Tuesday. "We're still working
on assessing the impact and the areas we will need to make reductions in,"
Roseanne Pawelec of the state Public Health Department told the Telegram and
Gazette of Worcester. The department is prioritizing counseling and testing
services over some of the client support services that cover child care for people
with HIV and AIDS, as well as respite care for relatives who care for people
with HIV and AIDS. More than 20,000 Massachusetts residents have been diagnosed
with HIV or AIDS, and state officials estimate that 8,000 more are infected. ...

The answer: a national health plan
Allen Giles, Lincoln, Boston Globe, July 17, 2003
<
http://www.boston.com/dailyglobe2/198/letter/The_answer_a_national_health_pla
n+.shtml>

The headline on a front-page article in the July 14 Wall Street Journal
reads: ''To save on health care costs, firms fire disabled workers.'' Workers are
left destitute as companies abandon ''guaranteed'' commitments because it is
inconvenient to stand by their employees. Can we afford to continue depending on
private enterprise to stand by its promises to employees? A national health
plan for everyone underwritten by the government and financed by an expanded
Social Security system is the only answer. Even employers would approve: They
would be off the hook for increasingly expensive health plans. And it would be
less expensive for the country than the health care mess we have now.

The perfect prescription
Everyone has a health care reform plan. But the best
approach to covering the uninsured isn't even on the table.
Jacob S. Hacker, Boston Globe, July 20, 2003
<
http://www.boston.com/dailyglobe2/201/focus/The_perfect_prescription+.shtml>

Still smarting from defeat, a leading activist ruefully explained why
once-promising plans to expand health coverage had failed. Health legislation, he
said, affected ''powerful group interests'' and was easy fodder for scare-tactic
attacks. ''All these fears, some justified, some exaggerated, and some
altogether fanciful,'' he said, ''produced such a confusion of group conflicts that
only a clear recognition of the need ... might have overcome it, and that clear
recognition was lacking.'' All this would be an incisive assessment of the
demise of the Clinton health plan in 1994 - if, that is, it hadn't been offered
in 1930, and if its author, the social reformer Isaac Max Rubinow, hadn't in
fact been talking about the failure of the first campaign for expanded
insurance in the late 1910s. Americans have been fighting over health care for a long
time. Yet the struggle has always ended as it did in the 1910s - with the
failure to achieve universal coverage. ... In the absence of inclusive public
insurance, private employment-based plans have become the first line of defense
for most Americans - and one they are understandably reluctant to give up. As
often noted, the spread of private health coverage was spurred by World War
II-era wage and price controls that capped pay increases but allowed for the
expansion of benefits. But it is often forgotten that there were also massive
lobbying campaigns against public insurance, and that politicians showered immense
tax benefits and favorable regulations on the private sector in order to
forestall a government solution. ... Medicare and Medicaid, enacted in 1965,
created the last major pieces of America's crazy-quilt of coverage. Today, this
jury-rigged system is almost perfectly structured to stymie constructive action.
Begin with a simple fact: Most Americans are insured. While an inexcusable 15
percent lack coverage (and perhaps twice as many were uninsured at least once
in the past two years), most have real, if often inadequate, coverage most of
the time. ... Only one longshot candidate, congressman Dennis Kucinich, has
bucked the trend with a proposal to expand Medicare to all Americans. ... But
it's surprising that Democrats have not revived the single truly original idea
that emerged out of the Clinton-era debate: ''play-or-pay.'' This idea holds
that employers (including self-employed people) must either provide coverage
(''play'') or ''pay'' a payroll tax to fund public coverage. ...

Editorial Comment: "Play-or-pay" was enacted in Massachusetts in 1988 but
never implemented, due to immense opposition from the small business community.
It remained on the books, year to year, as a political club to extort smaller
increments in coverage, until finally being traded away in the mid-ninties.
Below is a letter of rebuttal from long-time single-payer activist Tim Macchio,
sent to the Globe but never printed.

For the life of me, I do not understand why, when people talk about health
care reform, they continue to ignore the real problem in today's system. Jacob
Hacker, in his column "The Perfect Prescription", considers that the best
reform approach is a "pay-or-play" scheme. He wants employers to provide coverage
or pay to fund public coverage. Prof. Hacker may be well intended in his
proposal to provide universal coverage but his proposal will only increase the money
spent for a bad system. A minor point, I believe, is that the public coverage
fund may end up being used by the sickest and neediest people which will make
the coverage more expensive than other coverage. Until reformers tackle the
real problem, any of their proposals will be too expensive. What is the real
problem? Nearly 40% of the health care dollar is not used for health. Why?
Because of the enormous bureaucracy that is needed to handle the maze of our
current system. Until we streamline the administration of our health care system and
get rid of the real waste, well intended proposals are doomed to failure.
People tend to reject the idea of a "single-payer" system as being too radical
and "socialized medicine." First, it is NOT "socialized medicine" because the
health care providers are still independent. Second, it is NOT too radical. If
Prof. Hacker believes that creating a fund to offer public coverage would not
be frightening to the public, why would a single-payer system, which would
create a fund for public coverage, be frightening to the public? Remember that
there is no real change to the current health care delivery system except that
more people could afford to use the system. What a single-payer system does is
reduce the bureaucracy and use the savings to provide health care. Am I missing
something? Cutting waste and providing more care sounds logical to me.

Health care for, by all
Baltimore Sun Editorial, July 22, 2003

Ten years after Bill and Hillary Rodham Clinton launched the fiasco that
began as a bold bid to overhaul the nation's health care system, pressure to
provide medical insurance for all Americans is building again. A return of
double-digit increases in health insurance premiums has shaken business and political
leaders out of the complacency that settled in during the late '90s boom years
when insurers could rely on the stock market for profits. And while insurance
costs are rising, the struggling economy robs employers and individuals of
the wherewithal to pay them. Further, a renewed focus on the forces that drive
up insurance costs highlights the importance of universal coverage as a
financial management tool. Living without health insurance isn't free in a society
that takes all comers in hospital emergency rooms. All premiums include a
built-in surcharge - as much as 20 percent - to pay for those who show up in
hospitals for treatment in the most expensive way possible of ailments that might
have been caught earlier and cheaper through regular medical care. Thus, a new
feature driving the debate this time is the notion of universal health care not
only as a shared privilege but a shared responsibility. Like car insurance,
everyone should have basic medical coverage - subsidized at low income levels -
because that's the cheapest as well as most humane way to provide care that
people almost inevitably need. Of the 41 million or so Americans estimated to be
without health insurance for at least a few months, the vast majority are
workers and their families. The poor, disabled and elderly are covered by
government programs. Nearly half of the uninsured range in age from 19 to 29, usually
students or workers in part-time or entry-level jobs who don't have access to
coverage that fits their budgets, according to a recent study by the
Commonwealth Fund. ... But those who already have good medical coverage should be
leading the charge to make sure everyone else does, too. Either way, we're all
picking up the tab for those without insurance. And in this economy, a sudden
reversal of fate could dispatch almost anyone to their ranks.

'Factory clinics' to cut NHS lists
Critics alarmed at plans for fast-track US surgery
Gaby Hinsliff, The Observer, July 27, 2003
<
http://observer.guardian.co.uk/politics/story/0,6903,1006744,00.html>

An American private healthcare firm will launch the first of a new wave of
'surgery factories' in Britain next month under radical plans to slash NHS
waiting lists. The express clinics will use overseas surgical teams to perform
routine operations such as hip replacements, and are expected to treat patients
faster than an ordinary NHS hospital. They could even perform operations that
currently require an overnight stay as 'day surgery' - meaning patients go home
the same day as having the procedure. The Royal College of Nursing has already
warned against the risk of creating impersonal 'sausage factories' hustling
the patients through to order. But Tony Blair is expected to outline how the
clinics could help reduce waits for treatment in his monthly press conference on
Wednesday, as the Government struggles to resume a domestic policy agenda
overshadowed by David Kelly's death. NHS patients will be treated free in the
Diagnostic and Treatment Centres (DTCs) with the state footing the bill, leaving
firms which run and staff the centres free to reap profits. However, they are
set to be controversial, with Labour MPs who fear a creeping privatisation of
healthcare. ...

State-owned Hospitals in China to Embrace Market
People’s Daily, July 31, 2003
<
http://english.peopledaily.com.cn/200307/31/print20030731_121337.html>

More State-owned hospitals in China are to lose their government support and
will have to adapt to the market as the country's entire health service
undergoes inevitable reform, experts predicted. The unexpected epidemic of severe
acute respiratory syndromes (SARS) has made the central government determined to
take unprecedented action with regard to the country's public health system,
according to Thursday's China Daily. The relevant departments under the State
Council, such as the Ministry of Health and the State Development and Reform
Commission, are making investment plans with huge budgets to improve the
country's public health networks, according to a three-day national working
conference on health that ended Wednesday in Beijing. One of the main tasks in the
coming years will be further development of the health care system so that it can
better prevent and control epidemics such as SARS. The newly added task is
expected to bring new change to the system of providing medical treatment,
another side of the reform campaign, said Cai Renhua, director of the China
National Health Economics Institute. One change to the medical system in China, a
developing country that still can only allocate limited funds to health care, is
that the various levels of government should give up their ownership of and
financial support to many state-owned hospitals, Cai said. ...

Editorial Comment: Sorry, comrades, but we’ve been there and it doesn’t
work. Australians, too, are faced with the threat of loss of healthcare rights as
Bush wannabe PM John Howard tinkers away.

Low paid workers say "NO" to US style health system
Liquor, Hospitality & Miscellaneous Workers Union, July 31, 2003
<
http://www.lhmu.org.au/lhmu/campaigns/medicare/news_1059456441_31212.html>

LHMU members will tell a Senate Inquiry visiting Perth today of the
importance of Medicare to workers with families. A Health Care worker, an Ambulance
Officer and an Enrolled Nurse will give evidence at the inquiry today ... "Our
union's members will also tell the Senators about the effects on the public
health system, and Ambulance Services, with the decrease in bulk billing and the
problems faced by workers in rural and remote areas of Western Australia
accessing good quality bulk billed GP services," Helen Creed the National President
of the LHMU said. "Australian workers do not want a US style health system
where health care is part of workplace enterprise bargaining," Ms Creed said.
"Medicare is part of Australian life; workers supported the introduction of
Medicare in 1984 by giving up a wage increase and continue to support Medicare
through the levy. Workers reject the Howard Government's proposal to undermine a
universal tax funded healthcare system by introducing a co-payment. ... "

Save Medicare hotline
Liquor, Hospitality & Miscellaneous Workers Union, August 3, 2003
<
http://www.lhmu.org.au/lhmu/campaigns/medicare/news_1059699168_9746.html>

The Labor Party has launched a Save Medicare hotline, giving people a channel
to lodge complaints about the health system. Labor hopes people will call the
hotline and give the opposition information it could use to pressure the
government on this important issue for LHMU members. The opposition says the
Howard government had overseen a 12 per cent drop in bulk billing by GPs and the
government is in denial about the Medicare crisis. The Shadow Minister for
Health, Julia Gillard, says Labor is establishing this hotline because, under the
Howard Government, Medicare is in crisis. "Labor is the party that built
Medicare and believes in Medicare. Under Labor, Medicare was not in crisis - it
worked. In 1996, more than 80% of visits to the doctor cost patients nothing
because the doctor bulk billed," Ms Gillard said. "John Howard, in contrast, has
never believed in Medicare and his policies have put Medicare on the critical
list. ... "

Health Care, MCAS & Tolls Added
to List of Possible Ballot Questions
Michael P. Norton, State House News Service, August 6, 2003

Boston - Universal health care proponents are adopting a new strategy -
amending the state constitution - in their bid to force change in Massachusetts.
Rather than proposing a new law, which the Legislature could alter or ignore
even if adopted by voters statewide, a coalition on Wednesday filed a proposed
constitutional amendment with Attorney General Thomas Reilly’s office. ... The
coalition includes lawyers from high-powered Boston firms, doctors from major
hospitals, the head of the state’s Democratic Party and top advocates for
nurses and the homeless. The amendment would make access to health care a
constitutional right. Advocates hope that if it's adopted - the earliest it could
reach the statewide ballot would be 2006 - the amendment would make it the
"obligation and duty" of the Legislature to enact laws to implement it. "This would
be a very exciting thing if we could pull this off and we’re hoping to do
just that," said Dr. John D. Goodson of Newton, a Massachusetts General Hospital
internist and associate professor at Harvard Medical School. "This is a big
deal. It’s a huge challenge." ... Goodson said health coverage these days is
unfairly determined by one’s socio-economic status. "We have public education
because John Adams wrote that into the Constitution," he said. "This is the
next step in that process. We chose the constitutional route because we felt
that this was at that level of social commitment. This is really a major part of
the social contract, so to speak." The amendments calls for passage of laws
that "will ensure that no Massachusetts resident lacks comprehensive,
affordable, equitably financed health insurance coverage for all medically necessary
preventive, acute and chronic health care and mental health care services,
prescription drugs and devices." The amendment is not accompanied by a price tag for
universal care. The cost of health care for most Massachusetts residents is
covered by employer-sponsored insurance plans, taxpayer-funded health care
programs and by surcharges on insurers, hospitals and the state that pay for care
to the uninsured. There are 408,000 people, or more than 7 percent of all
Massachusetts residents, without health insurance in 2002, according to the latest
official state estimate. Many activists believe that number is higher.
Critics of universal care proposals have argued its costs are prohibitive and it’s
never been clear whether the government or employers would be charged with
delivering coverage. Goodson says coverage can be provided to all merely by
shifting billions of dollars away from administration and towards actual care.
Barbara Waters Roop of Boston, a policy analyst, attorney and former general
counsel in the economic affairs secretariat of the Dukakis administration, said the
constitutional amendment addresses concerns of all the stakeholders in the
health care system. Employers and insurers are troubled by rising costs. Those
with insurance face higher costs and fear the loss of benefits. Emergency rooms
are overcrowded. Practitioners are saddled with paperwork. People without
insurance are nervous about getting sick. And health care providers are losing
money. "This is really designed to address the very serious interests of many,
many different interest groups," said Roop. "This is something that government,
both state and federal, have been grappling with for decades. There is a
broad dissatisfaction with the system in its present form. We just seem unable to
come up with a solution. It’s a hard, hard problem to solve and it’s my hope
that this will create momentum to come to some kind of solution that makes our
health care system accessible to everyone and sustainable." To reach the
ballot in 2006, amendment sponsors must gather 65,825 registered voter signatures
by November and then get their amendment approved by 50 of the 200 members of
the state Legislature sitting in a Constitutional Convention both in 2004 and
again in the 2005-2006 session. It’s an intentionally lengthy process. Goodson
said activists are just now gearing up organizationally. ...

Down with the plutocrats
Jim Hightower, Boston Globe, August 10, 2003
<
http://www.boston.com/news/nation/articles/2003/08/10/down_with_the_plutocrat
s_boston_globe>

I come to you as one of America’s rarest species: A progressive optimist in
the age of Bush II. Some would say that this makes me either dumber than a dust
bunny or someone who’s simply not paying attention. After all, the messianic
Bushites have launched an executive war, deleted entire paragraphs from the
Bill of Rights, shoved trillions from our public treasury into the pockets of
their wealthiest backers, and generally romped gaily over labor unions, the
environment, the courts, and everything else that progressives value. Worse,
they’re doing it with impunity, for the Democrats in Congress have metamorphosed
into meekWobblycrats, the media have mostly been cheerleaders, and the polls
have shown Bush to be likeable and popular. How can you watch this mess and feel
optimistic? You can, because I’m here to tell you that the Democratic Party
and the media establishment have been watching the wrong mousehole. The hope is
not in Washington, but at America’s grassroots, where the workaday majority is
way ahead of the politicians and pundits. Any poll that probes an inch
beneath the surface shows that while the affable Bush is personally popular, his
policies decidedly are not. Endless war, executive secrecy, Patriot Acts I and
II, the Homeland Security bully, Ashcroft’s constitutional nuttiness, Bush’s
tax giveaways, shameless corporate welfare, the gutting of environmental laws,
the goosed-up drug war, the FCC’s shilling for media giants, the expansion of
NAFTA and the World Trade Organization, the ideological assault on Social
Security and Medicare - a growing majority of people are opposed to this extremist
agenda. ...

Doctors Push National Health Insurance
Mark Sherman, Associated Press, August 12, 2003
<
http://www.comcast.net/News/HEALTHWELLNESS//XML/1500_Health__medical/aa8bf008
-c1dd-4554-9279-b9872ce4f67e.html>

Washington - Nearly 8,000 US physicians are calling for government-financed
national health insurance, which they say would cover every American while
saving billions of dollars. Ten years after President Clinton's national health
plan died in Congress, tangled in complexity and under fierce assault from the
medical, insurance and pharmaceutical industries, the doctors argue that
private sector solutions have failed. They contend that work in Congress to enact a
prescription drug benefit for the elderly and disabled would shift more
government money to private companies while offering little value to consumers. The
doctors would put in place a single-payer system - essentially an upgraded and
expanded version of Medicare, the government health care program for the
elderly and disabled. "HMOs, launched as health care's bright hope, have raised
Medicare costs by billions and fallen to the basement of public esteem.
Investor-owned hospital chains, born of the promise of efficiency, have been wracked
by scandal," the doctors write. "And drug firms, which have secured the highest
profits and lowest taxes of any industry, price drugs out of reach of those
who need them most." Their proposal was published in Wednesday's Journal of the
American Medical Association. The group of 7,782 physicians is led by Marcia
Angell, former editor of the New England Journal of Medicine, and former
Surgeons General Julius Richmond and David Satcher. "The system cannot continue
much longer the way it is," Angell, a Harvard Medical School lecturer, said in an
interview. "It is clearly imploding. It isn't that single-payer is the best
choice. It's the only choice." ...

Crisis in health care must renew debate
Springfield (Massachusetts) Republican Editorial, August 13, 2003
<
http://www.masslive.com/search/index.ssf?/base/news-0/106076019342981.xml?one
d>

A group that has taken a close look at the nation's health care system and
pronounced it in need of fundamental change - of radical overhaul, in fact -
blames much of the current crisis on HMOs, investor-owned hospitals and
pharmaceutical companies. The group has proposed a form of national health insurance as
the only remedy. Such a proposal might be unremarkable but for one fact: The
group proposing such dramatic changes is made up of nearly 8,000 physicians.
They are, of course, in a position to know better than most what is ailing the
existing system. They are also not prone toward publishing hyperbolic
harangues just to stir up a bit of trouble. The physicians, in short, must be heard.
The proposal appears in today's Journal of the American Medical Association,
and leaves little room for interpretation. A system in which everyone in the
nation is insured as part of one plan - called a single-payer system - is, the
physicians argue, the only solution to the current maladies plaguing health care
in the United States. Their indictment of the current structure isn't subtle.
...

Universal health plan is endorsed
Thousands of doctors back proposal in JAMA
Liz Kowalczyk & Amber Mobley, Boston Globe, August 13, 2003
<
http://www.boston.com/news/nation/articles/2003/08/13/universal_health_plan_i
s_endorsed_boston_globe>

Thousands of US physicians have endorsed a broad proposal that would abolish
for-profit hospitals and insurers and transfer all Americans into an expanded
and improved Medicare program for all ages, reigniting the debate over
universal health care a decade after President Clinton's failed plan. While the four
physicians who wrote the plan - three of whom are affiliated with Harvard
Medical School - are members of a nonprofit organization that has long pushed for
universal health coverage, the new proposal is important for two reasons: It
was published today in one of the country's most prestigious and its most
widely circulated medical journal, the Journal of the American Medical Association,
and because of the large number of doctors - nearly 8,000, including two
former surgeons general - who endorsed it. ...

What will they think of next?
Country getting hit by avalanche of mind-boggling events
Molly Ivins, Creators Syndicate, Chicago Tribune, August 14, 2003
<
http://www.chicagotribune.com/news/opinion/oped/chi-0308140130aug14,1,7439936
.story>

Dublin, NH - What a summer for national credulity fitness. My credulity gets
a lot of exercise, since I cover Texas politics. Like Alice in Wonderland's
White Queen, years of practice have enabled me to believe as many as six
impossible things before breakfast. But here we are with a perfect feast of
mind-bogglers, everyone's credulity stretching and straining in a giant national
workout session. Arnold Schwarzenegger as governor of California. Well, sure, I can
handle that one. Manna from heaven for political humorists of all stripes. I'm
afraid the joke will begin to wear thin, however. I know we all like to make
fun of California as the epicenter of nuttiness, but in fact that big,
beautiful state is in terrible trouble. A $36 billion deficit is not amusing.
Teachers are being fired, programs to help the most helpless - the oldest, the
youngest, the most frail - are being cut. The state's economy took a terrible blow
in the artificially created energy crisis of 2000-2001. Enron and the other
corporate thieves, empowered by years of the Republican mania for deregulation,
drained as much as $45 billion out of the state. It's a mess and, as is often
noticed, Gov. Gray Davis is so uninspiring he makes wet Kleenex look exciting.
But the 200-plus other candidates should realize that no governor can be
popular faced with a mess that size. Now, the fact that our government was
contemplating creating a futures market in terrorism is a bit of a pause-causer.
"They're doing WHAT?" we said, in a rare moment of national unity. This bonkola
endeavor became more understandable when we learned John Poindexter, of
Iran-contra fame, was behind it. Poindexter was up to his neck in Iran-contra, one of
the battiest pieces of illegal cloak-and-dagger fruitcakery ever perpetrated by
a government infested with wannabe James Bonds. You may recall that Adm.
Poindexter, whose streak of insanity is cleverly disguised by a personality that
makes Gray Davis look exciting, was convicted of lying to Congress (his five
felony counts were overturned on appeal). He is the player who came up with the
idea for the now-defunct TIA program. TIA, or Total Information Awareness, was
the loony scheme under which our government would collect every scrap of
information available on each of us - financial records, health, library visits,
etc. - in a mind-boggling exercise of government control that would have made
the old Soviet Union look like a libertarian paradise. ...

Blackout
If Bush Really Wants to Investigate the Cause of the Largest Blackout in
American
History, He Should Start with the Vice-President, Tom DeLay and Himself
A BuzzFlash News Analysis, August 15, 2003
<
http://www.buzzflash.com/analysis/03/08/15_blackout.html>

CLAIM

"We'll have time to look at it and determine whether or not our grid needs to
be modernized. I happen to think it does, and have said so all along." -
George Bush, 8/14/03 <
http://biz.yahoo.com/prnews/030814/lath155_1.html>

San Diego - President Bush said he will order a review of why so many states
were hit by a massive power blackout Thursday and said he suspects the
nation's electrical grid will have to be modernized.
<
http://story.news.yahoo.com/news?tmpl=story&cid=544&e=4&u=/ap/bush_blackout>

FACT

In June of 2001, Bush opposed and the congressional GOP voted down
legislation to provide $350 million worth of loans to modernize the nation's power grid
because of known weaknesses in reliability and capacity. Supporters of the
amendment pointed to studies by the Energy Department showing that the grid was
in desperate need of upgrades as proof that their legislation sponsored by US
Rep. Sam Farr (D-CA) should pass. Unfortunately, the Bush Administration
lobbied against it and the Republicans voted it down three separate times: First, on
a straight party line in the US House Appropriations Committee, then on a
straight party line the US House Rules Committee, and finally on a party line on
the floor of the full House [Roll Call Vote #169, 6/20/01].

As AP reported at the time, the amendment would have amendments that would
have doubled the bill's money for energy assistance for the poor to $600
"provided $350 million to support loans to improve the capacity of transmission
grids. 'It's pure demagoguery,' House Majority Whip Tom DeLay, R-Texas, said in a
brief interview regarding the Democratic amendments. 'If Democrats had an
energy policy, they'd have had one in the last eight years. They have no
credibility on this issue whatsoever. They are responsible for the energy crunch more
than anybody I know.' Spotlighting the high political stakes, House Minority
Leader Dick Gephardt, D-Mo., took the unusual step of issuing a written statement
about the committee's energy votes. He said President Bush and Republicans
are 'committed to helping the Big Energy special interests' and accused them of
obstruction." [AP, 6/14/01]. ...

Power Outage Traced To Dim Bulb In White House
The Tale Of The Brits Who Swiped 800 Jobs From New York,
Carted Off $90 Million, Then Tonight, Turned Off Our Lights
Greg Palast, Z Magazine, August 15, 2003
<
http://www.zmag.org/content/showarticle.cfm?SectionID=10&ItemID=4051>

I can tell you all about the ne're-do-wells that put out our lights tonight.
I came up against these characters - the Niagara Mohawk Power Company - some
years back. You see, before I was a journalist, I worked for a living, as an
investigator of corporate racketeers. In the 1980s, "NiMo" built a nuclear
plant, Nine Mile Point, a brutally costly piece of hot junk for which NiMo and its
partner companies charged billions to New York State's electricity ratepayers.
To pull off this grand theft by kilowatt, the NiMo-led consortium fabricated
cost and schedule reports, then performed a Harry Potter job on the account
books. In 1988, I showed a jury a memo from an executive from one partner, Long
Island Lighting, giving a lesson to a NiMo honcho on how to lie to government
regulators. The jury ordered LILCO to pay $4.3 billion and, ultimately, put
them out of business. And that's why, if you're in the Northeast, you're reading
this by candlelight tonight. Here's what happened. After LILCO was hammered
by the law, after government regulators slammed Niagara Mohawk and dozens of
other book-cooking, document-doctoring utility companies all over America with
fines and penalties totaling in the tens of billions of dollars, the industry
leaders got together to swear never to break the regulations again. Their plan
was not to follow the rules, but to ELIMINATE the rules. They called it
"deregulation." It was like a committee of bank robbers figuring out how to make
safecracking legal. ...

The latest bogus fossil-nuke blackout: this grid should not exist
Harvey Wasserman, The Free Press, August 15, 2003
<
http://www.freepress.org/columns.php?strFunc=display&strID=735&strYear=2003&s
trAuthor=7>

This is the fourth - and worst - completely unnecessary major regional
blackout in this country in forty years, dating back to 1965. Its scope - from
Detroit to Ottawa to New York and New Jersey - is absolutely awesome, especially
since it's due to total stupidity and corruption. This does not count the
blackouts that raged through California in 2000-2001. Those were "blackmails," set
by Enron and the other Bush gas cronies to rip $60 billion out of the state,
leading to, among other things, the impending ouster of Gov. Gray Davis. When
the lights went out, Davis kissed the feet of Southern California Edison's John
Bryson, who engineered a deregulation bill that gouged $30 billion out of the
ratepayers for the state's failed nukes. That opened the gates for the gas
pirates to steal yet another $60 billion. Davis got caught in the backdraft. The
culprits in this latest northeastern disaster are basically the same - the
barons of fossil and nuclear power and their cronies in the electric utility
business. Their "weapon" is an ancient electric grid that's obsolete if not
obscene. It is a massively fragile Rube Goldberg device that dangerously and
inefficiently carts around electricity from expensive, polluting and extremely unsafe
central generating plants to buildings that waste massive amounts of energy
and generate none. That the grid will crash again and again and yet again is
absolutely certain. The only question is who are the real terrorists: errant
crazies who blow things up, or entrenched interests that refuse to change? ...

MNA Continues to Advocate for Single-Payer Health Care
Recent report to JAMA shows growing support by health care
professionals for government-financed health insurance
Massachusetts Nurses Association, August 15, 2003
<
http://www.massnurses.org/News/2003/08/single_payer.htm>

Canton - As the issue of single-payer health care made headlines on Wednesday
following a special report to the Journal of the American Medical Association
(JAMA), the Massachusetts Nurses Association (MNA) again expressed its
support for the creation of a government-financed health insurance system. "Our
22,000 members have long been advocating for a single-payer health care system in
the state of Massachusetts," said Karen Higgins, RN and MNA president. "As
front-line nurses, we are the first to see and care for patients who are
uninsured. And because our current health care system is failing we see far too many
of these patients on a daily basis, patients who wait too long to be treated,
patients who go without prescriptions and patients who can’t take advantage of
proper education and follow-up programs. Our present system of health care
coverage is failing and the MNA applauds the more than 7,500 US doctors who
brought this issue directly to JAMA." The report to JAMA, which was spearheaded by
Marcia Angell, former editor of the New England Journal of Medicine, and
former Surgeons General Julius Richmond and David Satcher, comes at a time when
numerous local and national health care and advocacy organizations have been
rallying around the single-payer movement, including the 22,000 members of the
MNA. In late January of 2002, in response to the Report of the Governor’s Health
Task Force, the MNA issued a special report calling on the state legislature
to adopt a publicly funded, single-payer health care system as proposed under
the Massachusetts Health Care Trust Bill, legislation that is supported by
MASS-CARE, a coalition of more than 70 health care, labor and citizen advocacy
groups. ...

Medicare for all
Donald G. Ross, MD, North Andover, Boston Globe, August 16, 2003
<
http://www.boston.com/news/globe/editorial_opinion/letters/articles/2003/08/1
6/medicare_for_all>

The endorsement by thousands of physicians of a national health insurance
plan (Page A1, Aug. 13) is fueled by the recognition that universal provision of
health care is "the right thing to do." Its absence in our wealthy society is
a national embarrassment. In addition, it has become clear that this goal will
never be reached by a system of private, for-profit insurers and hospitals
motivated primarily by money. Dollars needed to pay for health care are siphoned
off into bureaucratic waste and the pockets of stockholders and overpaid
insurance executives. Contrary to the popular image of government-run programs,
Medicare is a marvel of efficiency compared with private medical insurance
providers. Replacing the patchwork of private insurers with a single government
program would be a major improvement and would yield substantial savings, even
after covering the uninsured. There's plenty of room for debate over just what
form this plan should take, but "Medicare for everyone" is an idea whose time
has come.

The broken grid
Thomas Oliphant, Boston Globe, August 17, 2003
<
http://www.boston.com/news/globe/editorial_opinion/oped/articles/2003/08/17/t
he_broken_grid>

Washington - The largest blackout in American history occurred within a
private-public system that emphasizes the generation of electricity more than its
transmission. More than anything, it should remind people of all political
persuasions that this is why government exists and that the safe, reliable
transmission of electricity is a modern economy imperative that common sense can
provide far better than political ideology. Of all the maddening ironies since the
Northeast shut down on Thursday, none is more infuriating than the fact that
the problem and the most sensible solutions to it have been identified for
years. Worse, giant steps forward via national legislation are not all that
controversial and have moved forward in Congress twice in recent years. They can be
summed up in one word - reliability. That is, reliability in the form of new,
mandatory rules of the electricity road that together with new investment in
transmission and switching equipment and technology can lead to a far better
system than the jerry-built mess that failed last week. ...

Batteries Not Included
Maureen Dowd, New York Times, August 17, 2003
<
http://www.nytimes.com/2003/08/17/opinion/17DOWD.html?th>

Washington - Klaatu barada nikto. I couldn't help but flash on the 50's
sci-fi classic "The Day the Earth Stood Still," watching New York and other cities
plunged into sweaty darkness when the 50's equipment on the power grid gave
out. ... Residents of Iraq and India, interviewed on television, seemed shocked
to learn that the most technologically advanced nation had an electrical
support system so rickety it is "third world," as Bill Richardson put it. (Indians
call their underperforming electricity "bijli," rhymes with "Gigli.") Steamed
Iraqis offered us tips, including: Sleep on the roof and take showers. ...

Time for strong medicine
Boston Globe Editorial, August 19, 2003
<
http://www.boston.com/news/globe/editorial_opinion/editorials/articles/2003/0
8/19/time_for_strong_medicine>

Americans spend more than anyone else in the world on health care, but with
41 million people uninsured, they are paying for a system that is both unjust
and inefficient. It is refreshing that at a time of retrenchment, the
prestigious Journal of the American Medical Association has published an article urging
that the United States adopt a single-payer system that would cover every
American. This approach represents a major contrast with the incrementalism that
has resulted in a few improvements in coverage since the Clinton health plan
died in Congress nine years ago. Now states are cutting back their Medicaid
programs, employers are shifting more health costs directly to workers, and the
Bush administration is showing little interest in expanding coverage. The
article by the Physicians' Working Group for Single-Payer National Health Insurance
asks, in effect, "Why keep paying for a dysfunctional system that costs $1.4
trillion a year?" The physicians propose replacing it with an expanded
Medicare program for every American but adding a drug benefit, which Medicare lacks,
and other improvements. A single-payer plan would affect the interests of
powerful economic lobbies. Private health insurers would not be needed if the
government paid for all care directly to providers. Drug companies would be less
able to charge exorbitant prices if they had to deal with one powerful
customer, the US government. Income for some physicians might go down as more money
was devoted to primary care and less to some procedures that are not as
demonstrably beneficial. ... "Access to comprehensive health care is a human right,"
says the physicians' group. A hodgepodge health care system is failing too many
Americans. It's time for a new approach with a goal of universal coverage.
Single payer is a prominent option.

Big blackout? Imagine life in Iraq
Judith Rich, Natick, Boston Globe, August 19, 2003
<
http://www.boston.com/news/globe/editorial_opinion/letters/articles/2003/08/1
9/big_blackout_imagine_life_in_iraq>

Reading about the biggest blackout in US history, which shut down an area
populated by 50 million people, makes me think about the 23 million Iraqi people
who have endured 13 years of electrical shortages. It makes me wonder about
the war strategy during the 1991 Gulf War that targeted electrical grids and
water treatment plants for destruction. It makes me think about US/UN imposed
sanctions that did not allow Iraq to import parts needed to repair electrical and
water power. It makes me mourn the resulting loss of lives due to unclean
water and inability to provide proper medical care. A country without electrical
power barely functions, as we see from just 24 hours of outage in New York
City. It makes me realize the cruelty of the 2003 Gulf War. It is difficult to
believe that the United States would invade a country that was so weak from
years of sanctions and bombing, and still struggling to regain full electrical
power from the 1991 bombing. And for the past five months, once again, most of
Iraq has no dependable electrical power. I wonder where the heart of America has
gone when this kind of policy is accepted and justified by our government and
moreover by the majority of American people. Could it be time to find less
destructive ways to exert our foreign policy? (sic)

Web Directory:

AARN <
http://www.aarn.org>
Australian Nursing Federation <
http://www.anf.org.au>
California Nurses Association <
http://www.calnurse.org>
Canadian Federation of Nurses Unions <
http://www.nursesunions.ca>
CCDS <
http://www.cofc.org>
Irish Nurses Organisation <
http://www.ino.ie>
Labor Party <
http://www.thelaborparty.org>
LabourStart <
http://www.labourstart.org>
Maine State Nurses Association <
http://www.mainenurse.org>
Massachusetts Ad Hoc Committee <
http://www.massadhoc.org>
Massachusetts Green-Rainbow Party <
http://www.massgreens.org>
Massachusetts Nurses Association <
http://www.massnurses.org>
MASS-CARE <
http://www.masscare.org>
New York Professional Nurses Union <
http://www.nypnu.org>
New Zealand Nurses Organisation <
http://www.nzno.org.nz>
PASNAP <
http://www.pennanurses.org>
PNHP <
http://www.pnhp.org>
Québec Nurses’ Federation <
http://www.fiiq.qc.ca>
Revolution Magazine <
http://www.revolutionmag.com>
Saint Louis Area Nurses Coalition <
http://www.slanc.org>
Seachange Bulletin <
http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition <
http://SAZNC.homestead.com>
Union Web Services <
http://www.unionwebservices.com>

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