Massachusetts Actions:

Senator Steven Tolman & Representative Frank Hynes Sign on as
Lead Sponsors for Massachusetts Single Payer Legislation
Massachusetts Campaign for Single Payer Health Care (MASS-CARE), December 3,
2002

Boston, Mass. - The Massachusetts Campaign for Single Payer Health Care
(MASS-CARE), a coalition of over 80 labor, professional, health care
provider, religious, and advocacy organizations, is proud to announce the new
lead sponsors of a bill that would create a single payer health care system
in Massachusetts. They are Senator Steven Tolman (D-Brighton) and
Representative Frank Hynes (D-Marshfield). Representative Hynes stated, " I
am pleased to have this opportunity to work with those who, for years, have
been committed to the concept of universal health care access at a reasonable
price. Our present health care system is collapsing: costs are rising
exponentially; providers are overworked and underpaid; patients' care is
being limited. The time has come to halt the patchwork financing of this
present system and adopt a new system which will assure all of adequate and
appropriate health care." Entitled "The Massachusetts Health Care Trust", the
bill would guarantee every Massachusetts resident affordable, first class
health care coverage by creating a single public entity called the Health
Care Trust to replace multiple insurance bureaucracies now responsible for
paying for health care. Studies have shown that we already spend enough on
health care in the Commonwealth to provide quality care for all our residents
(including prescription drugs, longterm care, and dental coverage) by
consolidating the funding of health care, thereby capturing a large share of
the 25-30 cents of every dollar that now goes to administrative costs such as
paperwork, marketing and profits and spending it instead on providing care to
the 418,000 Massachusetts residents who now have no insurance at all and to
the many other "underinsured", with inadequate coverage. Financially
distressed health facilities would reap administrative savings and be assured
secure budgets, allowing them to deliver high quality care. This bill would
also restore individuals' freedom to choose the health care professionals and
facilities they prefer. The past lead sponsor in the Senate, Senator Robert
Travaglini, is expected to become the next Senate President. Traditionally,
the Senate President does not act as a lead sponsor on any legislation. The
former lead sponsor in the House, Representative Kevin Fitzgerald, is
retiring at the end of this session. Both Senator Travaglini and
Representative Fitzgerald have been instrumental in building support for
single payer health care in the General Court. Two weeks ago, the single
payer movement was given a boost when former Vice President Al Gore said that
he believed the only way to solve the crisis in health care was with a single
payer system. As happened with the Children's Health Insurance Plan (CHIP),
once again Massachusetts can lead the nation in instituting needed health
care reform. The Massachusetts Health Care Trust bill will be filed in the
Senate on December 4, 2002.

Contact: Margaret O'Malley, RN (978-283-9911)
Richard Mason (781-736-0644 or 781-398-0001)
Senator Steven Tolman (D-Brighton) (617-722-1280)
Representative Frank Hynes (D-Marshfield) (617-722-2552)

The MassHealth Defense group is holding a rally and vigil on December 4th to
protest the many recent cuts to MassHealth programs. Consumers on the
MassHealth HIV waiver will be affected by the service cuts (eyeglasses,
prosthetics, etc.) scheduled to go into effect on January 1 and those with
incomes over 150% of poverty will begin paying premiums also on January 1. In
addition, prescription co-pays will increase from $.50 to $2.00 and there
will be co-payment increases on other services as well. A rally in which
impacted consumers will speak about the importance of MassHealth will take
place on Wednesday, Dec. 4th from 12 noon to 2 pm at the State House Grand
Staircase (2nd Floor). People will be invited to visit their representatives
and senators to encourage their support for MassHealth. Then, from 2:00 pm
until midnight, consumers and their supporters will hold a peaceful vigil
until Governor-elect Romney or a key representative meet with the group to
explain how the new administration will ensure MassHealth is restored and
protected.

Thanks!
Alison

Alison Kirchgasser
Public Policy Specialist
AIDS Action Committee
617-450-1203 (phone)
617-262-6185 (fax)
akirchgasser@aac.org

A Resolution on HEALTH CARE FOR ALL passed unanimously
by the North Shore Labor Council at its general meeting in October 2002

Massachusetts' working men and women and families want universal health care
and asks the Commonwealth's General Court to act without delay to pass
publicly funded universal health care guaranteeing coverage for all
Massachusetts inhabitants.

WHEREAS, every person residing or employed in the United States is entitled,
as a matter of right, to accessible, affordable and quality health care; and

WHEREAS, health care is not a product or commodity, but a fundamental human
right of all citizens and residents of Massachusetts, without regard to sex,
age, race, income, place of employment or any other circumstance; and

WHEREAS, hearth care premiums increased an average of 11% in 2001 and are
projected to increase by 14% or more in 2002. Double digit increases in
overall premiums are expected to continue for several more years; and

WHEREAS, state and local governments are caught between major revenue
shortfalls and escalating health care costs for their employees as well as
for Medicaid and other public program recipients. Health care providers such
as hospitals, clinics and nursing homes are caught between higher health care
costs and reimbursements which all too often do not cover their real costs;
and

WHEREAS, public and private employers try to shift the cost increase onto
employees and retirees who are hit especially hard with thousands losing
health care coverage at a time in their lives when they are most in need of
coverage; and

WHEREAS, it is estimated that the complex and redundant bureaucracy arising
from the existence of multiple, for -profit insurance plans, each with its
own distinct program of coverage and benefits, its own costly administrative
and executive structure, and its own system of processing managed care
approvals and payment of benefits and/or reimbursements, wastes up to 30% of
medical coverage premiums paid for by employers and private citizens;
resources that have been handed back to employers from the wages of workers
to cover higher health care costs, or that could be used to provide benefits;
and

WHEREAS, the world Health Organization ranks the United States 37th in the
world in the overall quality of health care behind such nations as Colombia,
Cyprus, Saudi Arabia, Morocco and Costa Rica; and

WHEREAS, a growing number of Massachusetts residents, including doctors and
medical professionals and advocates such as Physicians for a National Health
Program-Massachusetts; MASS-CARE, Health Care for All, Neighbor to Neighbor,
Mass Senior Action, Jobs with Justice, political leaders, city councils,
trade and local unions like SEIU Local 509, SEIU Local 285, UAW, MNA, CWA
District 1, MTA, AFSCME Council 93, UE District 2 have called upon the
Massachusetts General Court to act without delay to pass the Massachusetts
Health Care Trust which would create publicly funded universal health care
for all Massachusetts residents, and

WHEREAS, the Bush Administration and Congress have walked away from any
effort and fundamental health care reform; and

WHEREAS, the Massachusetts AFL-CIO recognizes that there is a growing crisis
in health care in the United States, manifested by massive layoffs, a steep
increase in premiums, co-payments and deductibles, and the closing of many
health care facilities serving low-to-middle income residents, thereby,
constituting a need for swift action.

THEREFORE BE IT RESOLVED, that the Massachusetts AFL-CIO continues to work
towards affordable health coverage to all people by supporting House
Concurrent Resolution 99, directing Congress to enact legislation providing
for access to comprehensive health care for all Americans; and

BE IT FURTHER RESOLVED, that the Massachusetts AFL-CIO will urge Congress to
consider proposals for a single-payer, publicly-funded, not -for-profit
health plan; and

BE IT FURTHER RESOLVED, that the Massachusetts' AFL-CIO will make health care
reform a central issue in the 2003-2004 legislative session by calling upon
Massachusetts' General Court, to act without delay, to pass publicly funded
universal health care guaranteeing coverage for all Massachusetts inhabitants
(Massachusetts Health Care Trust legislation).

BE IT FURTHER RESOLVED, that the Massachusetts AFL-CIO support the efforts of
Congressman John Tierney, and other members of the Massachusetts
Congressional delegation, and will help the delegation to get the legislation
passed that would provide the waivers that would enable states to improvise
in order to provide universal health care to their residents.

Submitted to your Labor Council for consideration for passage by the North
Shore Labor Council

Canada - the challenge: to preserve, protect & improve a just healthcare
system:

Nurses demand Hansen stop hospital user fees for seniors
The daily charge for in-patient rehabilitation care is a clear violation of
the Canada Health Act
<http://www.bcnu.org/News_Releases/nr096_2002.htm>
British Columbia Nurses' Union, November 14, 2002

Nurses are demanding that Health Services Minister Colin Hansen order the
Interior Health Authority to stop charging user fees to seniors for
rehabilitation care, following surgery or when recovering from strokes or
other acute illnesses. In a letter to Hansen yesterday, Debra McPherson,
president of the BC Nurses' Union says the fees are a blatant violation of
the Canada Health Act. On Nov. 1 the Health Authority began charging seniors
a user fee of $27.10 a day after they are sent to rehabilitation beds at the
Cottonwoods extended care facility at Kelowna General Hospital. "This is a
medically-necessary service normally provided in acute care hospitals," says
McPherson in her letter to Hansen. "Such a user fee is prohibited under the
Act. Before the IHA closed rehabilitation beds at Kelowna General this year,
patients received the service in the hospital. There is absolutely no
justification for charging a user fee when rehabilitation care is provided in
the hospital's extended care wing." ...

Speaking out works!
Health Authority backs off on seniors' user fee, after nurses protest in the
news media
<http://www.bcnu.org/Bulletins_2002/bull079_2002.htm>
British Columbia Nurses' Union, November 15, 2002

It's a great lesson for nurses that speaking out against health care cuts can
pay off. Less than one day after BCNU demanded the government stop a user fee
on seniors' receiving rehabilitation care, the Interior Health Authority
announced Nov. 14 it is suspending the fee. In a letter to Health Services
Minister Colin Hansen Nov. 13 - which was released to the news media and
copied to federal Health Minister Anne McLellan - BCNU president Debra
McPherson called the fee a blatant violation of the Canada Health Act. ...

Creating a National Health Care System for Canadians
<http://www.healthcarecommission.ca/default.asp?DN=cn=1380,cn=17,cn=3,cn=2,ou=

Stories,ou=Suite247,o=HCC>
Roy Romanow, Commissioner,Commission on the Future of Health Care in Canada
The Canadian Club of Winnipeg, November 20, 2002

Friends, early in my mandate, I challenged those advocating radical "private"
solutions for reforming health care - user-fees, medical savings accounts,
de-listing services, greater privatisation, a parallel private system - to
come forward with evidence that these approaches would improve and strengthen
our health care system. The evidence has not been forthcoming. I have also
carefully explored the experiences of other jurisdictions with co-payment
models and with public-private partnerships, and have found these lacking.
There is no evidence these solutions will deliver better or cheaper care, or
improve access (except, perhaps, for those who can afford to pay for care out
of their own pockets). More to the point, the principles on which these
solutions rest cannot be reconciled with the values at the heart of medicare
or with the tenets of the Canada Health Act that Canadians overwhelmingly
support. ...

CFNU Tells Ottawa: Enforce the Canadian Health Act or Face Lawsuit
<http://www.nursesunions.ca/lawsuit.shtml>
Canadian Federation of Nurses Unions, November 22, 2002

Ottawa - In a letter to the Federal Health Minister Anne McLellan, a group of
health activists, including the Canadian Federation of Nurses Unions, have
stated their intentions to take Ottawa to court, saying it has failed to
enforce the Canada Health Act (CHA). The letter was presented at a press
conference in Ottawa. "The Auditor General has found over two consecutive
reports that the Health Minister doesn't collect the information required to
know if provinces are complying with the act," said CFNU President Kathleen
Connors, RN. "It's time for Ottawa to act." ... Civil society organizations
involved in the lawsuit include the Canadian Health Coalition, Canadian Union
of Public Employees, The Council of Canadians and Communications, Energy and
Paperworkers Union of Canada. ...

Groups take Feds to court for failure to enforce Canada Health Act
<http://www.cupe.ca/mediaroom/newsreleases/showitem.asp?id=6992&cl=1>
Canadian Union of Public Employees, November 22, 2002

Ottawa - Fed up with federal inaction in defence of our public health care
system, a coalition of social groups is taking the Chrétien government to
court for its failure to comply with the Canada Health Act. ... Last year
CUPE and CEP successfully blocked the privatization of Hydro One with a court
challenge. "Clearly this government acts only when it's forced to, so we're
taking them to court," said CUPE National President Judy Darcy. "Their
inaction is jeopardizing our ability as Canadians to get health care when and
where we need it. We can't let this negligence continue." ...

Allowing healthcare privatization in Ontario may be illegal
Groups take Feds to court for failure to enforce the Canada Health Act
<http://www.newswire.ca/releases/November2002/22/c5371.html>
Canadian Union of Public Employees, November 22, 2002

Toronto - A court case to be brought against the Chrétien government for its
failure to comply with the Canada Health Act may force the Eves government's
drive to privatize healthcare into reverse. ... "The Ontario government is
plowing ahead with privatization of health services in this province, even
though the public and health care workers strongly support public health
care," said Barb Wahl, President of the 46,000-member Ontario Nurses'
Association. "It's up to the federal government to hold the provinces
accountable under the Canada Health Act and ensure our national public health
care system remains intact. The health of Canadians depends on it." ...

Statement by Roy J. Romanow, Q.C, Commissioner
On the release of the final report of the Commission
on the Future of Health Care in Canada
<http://finalreport.healthcarecommission.ca/pdf/HCC_Speech.pdf>
November 28, 2002

In completing this report, I am acutely aware that the support of Canadians
for their health care system is not given freely. It is given in exchange for
a commitment that their governments will ensure that high quality care is
there for them when they need it. If Canadians come to believe that their
governments will not honour their part of the bargain, they will look
elsewhere for answers. And the grave risk we will face is pressure for access
to private, parallel services - one set of services for the well off, another
for those who are not. Canadians do not want this. Our reform agenda is an
ambitious one, but at a time when one of our most cherished national programs
is at a crossroads, Canadians expect no less than an ambitious plan. I am
always mindful of the lineage of Canada's medicare system. It began with the
CCF party in my home province of Saskatchewan. It was a Conservative Prime
Minister who appointed Emmett Hall. And that it was a Liberal government that
introduced legislation to create modern Medicare. And it was politicians of
all stripes, and from all regions, that joined together to UNANIMOUSLY
approve it. ...

The entire report is now available at
<http://finalreport.healthcarecommission.ca>.

"Romanow is right. Reforms will shorten waiting time and improve care,"
CFNU's Kathleen Connors, RN
<http://www.nursesunions.ca/cfnu-pr.shtml>
Canadian Federation of Nurses Unions, November 28, 2002

Ottawa - The President of the largest organization of nurses in Canada
predicted that Health Care Commissioner Roy Romanow's report would lead to a
genuinely revitalized Medicare. She also praised Prime Minister Jean Chrétien
and urged him to follow through on his intention to fully fund the Romanow
reforms. "The Commissioner's reforms to Primary Health care will particularly
improve patient care by giving nurses the opportunity to use their skills and
knowledge more fully," said Connors. "Nurses, doctors and other health care
providers working in teams will cut waiting times and patients' frustrations.
By the way, nurses have called for this since I was in nursing school.
"Through this report, Medicare could take a giant step forward. The
Commissioner has called for including the following in the Canada Health Act:
Home Care, Diagnostic Services, Pharmacare, and a mechanism for
Accountability. He has also recommended adequate additional funding.
"Medicare's founder, Tommy Douglas, said long ago that Medicare needs to grow
beyond the services his Medicare covered. In this sense, Roy Romanow has
offered Canada Tommy Douglas II. It will greatly improve the quality of care
in our public system. ...

USA - the challenge: to create a just healthcare system:

Steelworkers Union calls for single payer healthcare

The 31st Constitutional Convention of the United Steelworkers of America
(USWA) held in Las Vegas August 5-8, attended by 2,500 union leaders from
across the US and Canada, was convened under the banner "Fighting to Win." It
took up issues connected with collective bargaining, organizing, global
justice and political activism. The convention adopted a special resolution
calling for a new universal and comprehensive healthcare system. The
resolution, titled "For a Single Payer Healthcare, Publicly-Funded,
Not-for-Profit Health Plan" and passed as an "emergency measure," was
referred to the convention by action of USWA Local 1375.

The resolution reads in part:

WHEREAS, every person residing or employed in the United States is entitled,
as a matter of right, to accessible, affordable and quality health care; and

WHEREAS, this Union, the United Steelworkers of America recognizes that there
is a growing crisis in health care in the United States of America manifested
by massive layoffs, a steep increase in premiums, co-payments and
deductibles, and the closing of many health care facilities serving
low-to-middle income residents; and

WHEREAS, 44 million people in the United States have no health insurance
coverage and that number is increasing rapidly; and

WHEREAS, 42 million people having only limited insurance are one catastrophic
illness away from bankruptcy; and

WHEREAS, insured persons now commonly experience unacceptable and sometimes
life-threatening delays in obtaining approval for needed health care services
by private, for-profit health insurers; and

WHEREAS, it is estimated that the complex and redundant bureaucracy arising
from the existence of multiple, for-profit insurance plans, each with its own
distinct program of coverage and benefits, its own costly administrative and
executive structure, and its own system of processing managed care approvals,
and payments of benefits and/or reimbursements, wastes up to 30% of medical
coverage premiums paid for by employers and private citizens; resources which
otherwise could be used to provide benefits; and

WHEREAS, the bureaucratic structure and its inefficiencies distract health
care providers from providing efficient and effective medical services to
patients and places a drain on the financial resources of taxpayers; and

WHEREAS, this Union contends that a single-payer, publicly-funded,
not-for-profit health plan will: eliminate the redundant bureaucracy caused
by numerous insurers; greatly reduce administrative costs associated with
providing medical care; free-up additional financial resources; allow medical
providers to focus their efforts on providing quality care; and reduce the
cost of health care coverage for residents and employers; and

WHEREAS, this resolution constitutes an emergency measure providing for the
immediate preservation of the public health; now therefore,

BE IT RESOLVED BY THE UNITED STEELWORKERS OF AMERICA:

Section 1. That the Delegates to the Thirty-First Constitutional Convention
of the United Steelworkers of America urges the United States House and
Senate to commit to enact a comprehensive, publicly funded, not-for-profit
health insurance program covering: (a) all residents of the United States of
America as well as all dependents of United States residents, whether
residing within the United States or elsewhere; and (b) all persons employed
in the United States, regardless of residence within or outside of the United
States, as well as their dependents.

Section 2. That this Thirty-First Constitutional Convention urges the prompt
passage of Single Payer Health Insurance System so that upon its effective
date:

i. Health insurance will be provided to all persons employed in the
United States and their dependents by or through their federal, state and
local public and private employers, including all health insurance previously
provided by the federal, state and local government to its employees, thereby
relieving these employers of the cost and administrative burden of providing
health insurance coverage; and
ii. Every person will be covered by one uniform program of health
insurance benefits, including prescription drug coverage, dental care, vision
care, long-term care and coverage for mental illness on full parity with
coverage for all other types of illnesses; and
iii. A Commission will be created, as an independent agency of the
federal government, to implement and administer the Single Payer Health
Insurance program; and
iv. The Single Payer Health Insurance benefit program will be designed
and maintained so as to guarantee health care services of excellent quality,
timely delivered and accessible to all; full support for ongoing medical
research, medical education and training; full choice of providers; and
access to comprehensive, preventive and long-term care; and
v. All federal, state and local funds allocated for health care purposes
by Medicare, Medicaid, Veterans Administration, and other programs will be
directed to the Single Payer Health Insurance benefit program, after
obtaining the necessary waivers; and
vi. Any person who while covered by the Single Payer Health Insurance
benefit program requires health care services anywhere in the world will be
entitled to Single Payer Health Insurance program benefits to pay for such
services to the extent payment has not otherwise been provided; and
vii. Any resident displaced from employment by the private health
insurance industry in this United States as a direct result of the enactment
of Single Payer Health Insurance benefit program will be eligible to receive,
at state expense, retraining and temporary financial assistance to facilitate
reemployment without significant loss of income, and will receive preference
for hiring for employment by the Single Payer Health Insurance benefit
program Commission in any position for which the displaced resident is
qualified; and
viii. Single Payer Health Insurance benefit program will be funded by
utilizing federal, state and local monies that currently are used to fund
existing federal, state and local health care programs, and any additional
funding mechanism deemed necessary to ensure that Single Payer Health
Insurance benefit program is fully funded with adequate reserves.

Section 3. That the Secretary-Treasurer of the United Steelworkers of America
is hereby requested to forward a copy of this resolution to the members of
the United States House and Senate.

Woolhandler demands nationalized health care in US
<http://www.pnhp.org/news/archives/001550.php>
Momoko Hirose, The Brown Daily Herald, November 5, 2002

Dr. Steffie Woolhandler advocated a centralized, government-regulated system
of national health insurance, urging members of the academic medical
community to lend their support at a lecture Monday night at the BioMed
Center. Woolhandler is a co-founder of Physicians for a National Health
Program and is also a member of the advisory board to MASS-CARE, the
grassroots initiative for single-payer healthcare in Massachusetts. Under the
current US health care system, numerous for-profit insurance companies
operate with few regulations and little regard for patients, Woolhandler
said. Regulating and centralizing the system would help cut costs and provide
adequate care for most citizens, she added. "The key conundrum in American
health care and American health policy is allegedly the conflict between
access and cost," said Woolhandler. "It's really illusory and, in fact, a
single-payer health care system provides a mechanism through which we can
improve access. We can improve quality and simultaneously control costs." ...

ACTION ALERT: NBC Slams Universal Health Care
FAIR - Fairness & Accuracy In Reporting, 112 W. 27th Street, New York, NY
November 12, 2002

On Election Day, Oregon voters rejected a ballot proposition called Measure
23 that would have instituted universal healthcare in the state. Outspent
more than 30 to 1 by a coalition of insurance companies that blanketed the
airwaves with negative ads, the only hope for proponents of the measure was
fair coverage in the media. Unfortunately, some of the coverage was as
slanted as the insurance industry's advertisements. On NBC Nightly News's
election night broadcast - which aired before polls closed in Oregon - anchor
Tom Brokaw previewed a report on Measure 23 this way: "Is universal health
care a good idea? It's on the ballot in Oregon." Brokaw set the tone from the
start, saying the plan "is called free health care. But is it?" Correspondent
Roger O'Neil echoes this framing in the first line of his report: "If it
sounds too good to be true, the saying goes ... Oregon voters will decide if
universal free health care is free." Actually, Measure 23 supporters did not
promise "free" healthcare; they promoted their plan as affordable healthcare.
"Eliminating the costs incurred for insurance premiums, co-payments,
prescription medications, deductibles and all other health care costs, most
people will spend less than they do now," the Yes on 23 website said - never
suggesting that their tax-supported plan would cost nothing. O'Neil prefaces
his criticism of Measure 23 with an odd assertion: "With insurance companies
raising premiums, with co-pays for prescription drugs going up all the time,
with HMOs telling doctors they can't use the stethoscope on some people
anymore and be paid for it, you'd think the industry would welcome the
spotlight on universal health care. But Oregon's big three health insurers
are pouring money into the campaign against." Actually, the healthcare
industry - with the exception of many doctors and nurses - has traditionally
opposed universal healthcare plans; a key premise of such proposals is that
government funding for health could lower costs - and therefore profits. The
insurance industry in particular has strenuously opposed so-called
"single-payer" plans for the simple reason that they would eliminate private
insurance in favor of government coverage. Yet O'Neil presents predictable
industry opposition to Measure 23 as a damning criticism of the proposal.
O'Neil then finds the catch: Insurance companies say "Oregon could go
bankrupt, too, since the devil is in the details, spelled T-A-X-E-S. More
payroll taxes on business, more taxes on personal income, as much as $25,000
for top wage earners." Since government-funded healthcare proposals all rely
on taxes for funding, it's hard to see how this is a "detail." Furthermore,
O'Neil distorts the personal tax issue by selecting the $25,000 figure, which
is a ceiling that the initiative would have placed on taxes paid by the
wealthiest households; these would have to earn at least $300,000, and
probably much more than that. To be fair, O'Neil could have noted that poor
families would be exempt from the personal income tax. A serious journalist
would investigate whether tax-funded healthcare would be more or less
expensive than a system that is largely privately funded. But O'Neil never
even mentions that the current system costs money. Another detail missing
from O'Neil's report is the disclosure that NBC is owned by General Electric,
which is heavily invested in the insurance and medical industries. O'Neil
concluded his slanted presentation by dismissing a ballot measure that people
were still voting on: "This dose of medicine apparently too strong for what
most agree is an ailing patient."
<http://www.fair.org/activism/nbc-oregon.html>

ACTION: Please contact NBC about Roger O'Neil's election night report on the
Oregon universal healthcare ballot measure.

CONTACT:

NBC Nightly News with Tom Brokaw
Phone: 212-664-4971
Fax: 212-664-6045
nightly@msnbc.com

Early Lessons from Oregon's 2002 Measure 23 Campaign
<http://www.pnhp.org/news/archives/001536.php>
Mark Lindgren, Chair, Health Care for All-Oregon, November 14, 2002

Our experience in Oregon provides both a positive example of how much an
under-funded, volunteer-based health care campaign can achieve, as well as
the limitations of this approach. Volunteers collected most of the 98,000
signatures needed to place the initiative on the ballot (we did pay for
signatures at the end of the signature-gathering phase, to ensure its
success). After an October 11 poll showed a virtually dead heat, the
insurance industry tripled its spending to at least $1.2 million, some from
out of state; our campaign, by contrast, raised and spent about $90,000,
$55,000 to qualify the measure for the ballot (about half of that to pay
signature gatherers), and $35,000 for the subsequent campaign. The final yes
vote was only 21%, just over a quarter of a million votes. ... A degree of
blame for the defeat of Measure 23 lies with the language itself, which was
written by a small language committee with insufficient input from
stakeholders, none of whom took our campaign seriously enough at its start to
choose to become involved. The initiative represented a broad policy outline,
and several details that were left for the plan's Administrative Board to
resolve drew criticism. ... The cap on the health care tax that the very rich
would pay was capped at $25,000 annually. Opponents seized on this number,
claiming that many people would pay this much. ... The refusal of AFL-CIO
leadership to become involved in the drafting of the language and its
subsequent opposition to the measure scared off endorsement by many
office-holders and lowered our fundraising effectiveness. Labor's bottom line
was that they did not want more than 20% of the new funding for the plan to
come from income taxes (under the plan this number was about 43%). In Oregon,
labor has an electoral machine at least as powerful as the Democratic
Party's, so labor's opposition was devastating. In addition, as we approached
many civic groups, labor usually had preceded us, spreading negativity about
the initiative. ... Notable endorsers included the Democratic Party of
Oregon, Consumers Union (publisher of Consumer Reports), Ecumenical
Ministries of Oregon, National Organization for Women (Oregon), a handful of
courageous politicians, the Pacific Green Party, PNHP, and, of course, UHCAN.
As noted above, we were disappointed by the opposition of much of organized
labor, but a handful of individual unions did endorse and support our
efforts. ... The Oregon Nurses Association remained neutral. Most of the
medical organizations opposed the measure, though a good number of individual
physicians endorsed it. ...

Ida Hellander, MD, Executive Director of Physicians for a National Health
Program, forwarded these additional insights into the Oregon campaign:

excerpt from the "Voter's Guide, 2002" by Walter Brown, attorney:

By law, [the explanatory statement for Meaure 23 on the ballot] should have
been an "impartial, simple and understandable statement explaining the
measure". (ORS 251.345) In fact, it flunks all three tests! Why? The
Explanatory Committee's majority were all high-paid employees of Oregon's
so-called "health industry". Each had his employer's special interests in
mind, not yours!

Mike Becker, registered lobbyist, Vice President for Public Policy &
Community Affairs, Regence BlueCross BlueShield of Oregon

Kevin Earls, registered lobbyist, Vice President for Finance, Oregon
Association of Hospitals & Health Systems

Fred Bachofner, until recently Chief Executive Officer, National Kidney
Foundation-Oregon

The two consumers members who tried to speak for you - Max Wilkins, retired
David Douglas High School counselor, and Betty Johnson, retired Director of
Senior Services for Linn, Benton & Lincoln counties - were simply outgunned
and outmaneuvered. Five important items should have been included in this
so-called "impartial, simple and understandable statement" but were voted
down ... 2) There are no co-pays, deductibles, or premiums under this Plan;
3) The dedicated, progressive personal income tax imposed to help fund the
Plan would tax between 0% and 8% of an individual's taxable income. Note: The
Committee merely mentions "8%".

second excerpt, "Voter's Guide" - actual proposed financing of the Oregon
plan:

Financing: This plan will have three sources of financing:

1) Current expenditures by federal, state, and local governments will provide
more than a third of what will be needed.

2) A progressive payment on employers' payroll will replace current insurance
premiums paid by employers. The percentage ranging from 3 to 11.5% will
depend on the size of the payroll, with only the largest corporations paying
the highest percentages. Self-employed individuals will be exempt.

3) A progressive personal income payment will replace most personal health
care spending: premiums, co-pays, deductibles, and out-of-pocket expenses for
such items as prescription drugs, glasses, mental health, and alternative
care. The rate will be between 0 and 8% of taxable income, with most families
paying less than 5%. Families at or below 150% of the federal poverty level
are exempt.

Endorsement by Consumers Union - excerpted from the "Voter's Guide":

Measure 23 is Good Medicine for Consumers Consumers Union of US Inc.'s goal
for health care reform developed over the past 64 years is: Every person must
have access to quality health care at an affordable price, with the right to
choose providers and the right to have complaints resolved fairly. We endorse
Measure 23 because we believe it meets this goal and the average consumer
will get more health coverage for less money.

If consumers do not have employer based insurance, have any type of illness,
or are too young (for Medicare), too rich (for Medicaid), or too broke (to
pay steep premiums), they might be shut out of the health insurance market
altogether. Consider the case of one consumer, who bought a policy in 1992
that cost $1,665 a year and had a $500 deductible; it excluded coverage for
arthritis because a blood test suggested she was at risk. Shortly after, the
company hiked her premium by 64%. Premiums kept rising, and the consumer had
to increase her deductible to $5,000. Nonetheless, this year the annual
premium had reached $18,500.

Our patchwork system of paying for health insurance leaves millions of
families in financial crisis when serious illness strikes. The working poor
are priced out of health insurance. 423,000 Oregonians, many of them working
families and including 70,000 children, lack any coverage.

Piecemeal reforms will not solve the problem. What's needed is coverage for
everyone in a pool that spreads the risk, with each person paying a fair
share, and every person enjoying quality coverage.

Consumers Union of US Inc. strongly supports Measure 23. No Oregonian, and no
American should have to choose between health care and food or paying the
rent. Consumers Union of US Inc., publisher of Consumer Reports, is an
independent, nonprofit testing and information organization serving only
consumers. We are a comprehensive source for unbiased advice about products
and services, personal finance, health and nutrition, and other consumer
concerns. (This information furnished by Sarah Charlesworth, Health Care for
All - Oregon; Elizabeth M. Imholz, Consumers Union of US Inc.)

Federal Advisory Panel Warns of a Crisis in Health Care
Robert Pear, New York Times, November 19, 2002

Washington - The National Academy of Sciences said today that the health care
system in the United States was in crisis and that the Bush administration
should immediately test possible solutions, including universal insurance
coverage and no-fault payment for medical malpractice in a handful of states.
Administration officials said the report would probably become a blueprint
for demonstration projects to be proposed by President Bush and Tommy G.
Thompson, the secretary of health and human services, who requested the
study. "The American health care system is confronting a crisis," said the
report, from a panel of experts appointed by the academy's Institute of
Medicine. "The health care delivery system is incapable of meeting the
present, let alone the future, needs of the American public." The tone
recalled the alarm and urgency of President Bill Clinton in 1993 and 1994,
but the panel proposed a more modest agenda, using states as laboratories to
attack "disturbing trends" that have worsened in the last two years. Members
of the panel acknowledged that health care was not a top priority at the
moment, as officials worry about the economy, terrorism and the possibility
of war in Iraq. But they predicted that health care would soon move back to
the top of the nation's agenda, and they proposed ambitious demonstration
projects in five areas. The 16-member panel said, for example, that the
federal government should provide federal money to three to five states to
help them make health insurance available to all or virtually all of their
residents. States could take either of two approaches: providing tax credits
to the uninsured, to help cover the cost of premiums, or expanding Medicaid
and the Children's Health Insurance Program. The number of uninsured has been
climbing for more than a decade and now stands at 41.2 million, or 14.5
percent of the population, the report noted. The panel also said that four or
five states should test alternatives to medical malpractice lawsuits to
compensate patients injured by doctors and hospitals. Under the proposal,
doctors and hospitals would have to inform patients and state agencies of
errors that cause medical injuries. Patients would receive "faster, fairer,
surer compensation" if they agreed to surrender the right to a jury trial.
"For the first time in 20 years," the panel said, the United States is facing
a broad-based crisis in the availability and affordability of malpractice
liability insurance for physicians, hospitals and other health care
providers. Most instances of negligence do not give rise to lawsuits, and
most legal claims do not relate to negligent care." The panel acknowledged
that there might be constitutional problems in compelling consumers to accept
these arrangements, but it said that patients might be allowed to opt out
when they enroll in a health plan or enter a hospital. Other demonstration
projects would test getting rid of paperwork and test a "paperless health
care system," increasing the use of computers; beef up 40 of the nation's
community health centers, with sophisticated equipment; and upgrade treatment
of chronic conditions like diabetes.

Gore Supports Single-Payer
And an exclusive excerpt from Barbara Walters' 20/20 interview with the
former Vice President.
<http://abcnews.go.com/sections/politics/DailyNews/TheNote_Special2.html>
Mark Halperin, Elizabeth Wilner & Marc Ambinder, ABC News, November 14, 2002

Washington - Al Gore now supports a single-payer national health care system.
On a stage in a synagogue on New York's Upper West Side Wednesday night, Gore
made this stunning announcement to several hundred people in response to a
question from the event's host. Gore suggested he was hesitant to reveal his
position at this forum - but then declared that he had come "reluctantly" to
the conclusion that single-payer is the best solution to the nation's health
insurance crisis. He offered no details for what kind of system he would
favor, or how he would propose transitioning to such a massive change.
Afterward, a Gore spokesman said that the former Vice President would offer
more specifics in the future for what kind of plan he envisions. Long
supported by the left, single-payer plans involve all money spent on health
care being collected by some public agency or trust fund, which then pays for
comprehensive coverage, delivered privately and publicly, for all citizens.
...

The slippery senator
<http://www.boston.com/dailyglobe2/325/oped/The_slippery_senatorP.shtml>
Jeff Jacoby, Boston Globe, November 21, 2002

Al Gore took another step to the left last week, telling an audience in New
York that he now favors a national single-payer health insurance system. He
offered no details, but a spokesman says a speech on the subject is in the
works. A Canada-style single-payer scheme would mean a major decline in US
health care - just ask a Canadian who has had to wait weeks for the results
of an AIDS test, or months for cancer radiation therapy, or more than a year
for a hip replacement - and I doubt that Americans are any keener on the idea
now than they were when Hillary Clinton was peddling it eight years ago. A
single-payer plan was on the ballot in Oregon this month; voters crushed it
in a landslide. The fact that Gore thinks it would be a good idea is one more
reason to steer clear of Gore in '04. But give the former vice president
credit for taking a concrete stand - for openly embracing a policy that he
knows many voters reject, for not hiding behind a cloud of cliches and being
careful to say nothing unpopular. For not being, that is, more like Senator
John Kerry. ...

Single-Payer Is Not A Dirty Word
Submitted to the Boston Globe
Andre Guillemin, Executive Director
Massachusetts Ad Hoc Committee to Defend Health Care

While attacking Senator Kerry in his Nov 21st article, The slippery senator,
Jeff Jacoby took a couple of shots at national health insurance that were
examples of trite and stale rhetoric. We all know that right here in
Massachusetts we have some of the best health care in the world, but stop
trying to convince us we have the best health care system; we don't. In 2000,
the World Health Organization rated the overall performance of health care
systems around the world. The US did not come in 1st. We didn't come in 2nd
or even 3rd. We ranked 39th in the world. That's nine places behind Canada,
Mr. Jacoby. Our hospitals and our health care providers are world renown, but
we rank low in performance for two reasons, we have an expensive and wasteful
system that leaves 42 million people hanging out to dry. I'm not saying do as
the Canadians do, but we have a problem that needs fixing. We are the only
industrialized country in the world that does not consider health care a
right for all its citizens, like education or police and fire protection. We
may have some of the best health care in the world, but until we contain
costs and cover everyone we will never have the best health care system.

Ann Eldridge Malone, a member of Ad Hoc's board, wrote a letter in response
to Jeff Jacoby's article as well. I bet the Globe is swamped with angry
responses from the activist crowd!! Here is a copy of what Ann wrote:

November 21, 2002

Dear Boston Globe Editor,

What a disservice to readers Jeff Jacoby does with his misleading comments on
single-payer health care. Has he taken on work as a spokesman for the
insurance industry? One might think so because it is the usual source for
this type of misinformation and fear mongering about consolidated health
financing known as "single-payer" reform. What facts are his comments based
on? I have been a nurse for 10 years, have worked in health care and studied
health policy for 10 years before that and know very well the realities of
health care financing and delivery in the US. I am proud to be a part of the
great things that access to quality health care can do for people, and yet I
also am ashamed to be a part of the most over-priced, dysfunctional,
unethical and often ineffective health care system in the world. I think Mr.
Jacoby needs to spend some time with front line care givers and a few of the
41-plus million uninsured in this country to better understand and write res
ponsibly about health policy. He might also want to take a look at the World
Health Organization report that ranks the US 37th worldwide in quality and
cost-effectiveness of our health care system - this despite the fact that we
spend 1/3 to 1/2 MORE per capita on health care than any other industrialized
country. To best improve access, quality and cost, the facts support
single-payer, universal access reform. Who would readers trust more on this
issue, the arguments put forth by Mr. Jacoby and the insurance industry which
by the way spends millions of our health insurance premium dollars on
fighting single-payer? Or the health care professionals of the Massachusetts
Nurses Association, the American Association of Registered Nurses, Physicians
for a National Health Program and the countless citizen advocacy groups such
as MASS-CARE who are working to spread the truth about single-payer reform?

Ann Eldridge Malone, RN, MSN

Gore's health plan idea
Bruce G. Levitta, Phoenix, USA Today, November 22, 2002

While sitting down for a bite of lunch recently, I read a newspaper report
about Al Gore that was intriguing ("Gore wants feds to run health care for
all," News, Nov. 15). While certainly not a Gore fan, I'm impressed with his
idea to have all Americans covered for health insurance under a single-payer,
government-sponsored plan. As a middle-class, self-employed professional with
a wife newly diagnosed with a lifelong disease, I face numerous challenges in
the years to come. The irony here is that shortly after lunch, I opened my
mail to discover that my current health-insurance carrier is planning to
increase premiums nearly 50% next year, along with doubling the co-pay and
quadrupling the prescription co-pay. You can imagine what happened to my
lunch.

Al Gore on Single-Payer
<http://www.pnhp.org/news/archives/001551.php>
Jonathan Cohn, The New Republic, November 25, 2002

It looks like Al Gore wasn't kidding two weeks ago when he let slip his
intentions to propose a single-payer health care system for the United
States. In a piece about Gore published earlier this week, Ron Brownstein of
the Los Angeles Times reports that Gore told him the very same thing - and in
considerably more detail. Specifically, Gore told Brownstein that he would
unveil his plan early next year, and that the plan would observe three
principles: The actual practice of medicine would still be done through the
private sector; Americans would have "choices"; and the plan would reduce
spending by streamlining bureaucracy. "The system as a whole has reached a
point of no return," Gore said. "It is collapsing. It is beyond saving in its
current design." Is Gore nuts? Not on policy grounds. In a single-payer
system, the government becomes the nation's health insurance company. Instead
of paying premiums to an insurer (either directly or through an employer),
each American would pay that money to the government; in turn, the government
would pay the providers of medical care - ie, mostly private doctors and
hospitals - in the same way insurance companies now do. Make no mistake: It's
a radical overhaul. But single-payer also has clear virtues: As a general
rule, the more people who belong to an insurance pool, the more thinly you
spread the financial burden of illness, which can be devastating if you face
it alone or within a small group. By definition, single-payer spreads the
risk pool across the largest number of people possible--namely, everyone in
the country. In addition, while people may associate government with
excessive bureaucracy, single-payer systems devote far less money to
administrative overhead than private insurance. (Among other things,
insurance companies spend a ton of money on advertising.) Typically,
opponents of single-payer insist it's better to have a private insurance
system that promotes more "choice." But one of the chief advantages of
single-payer is that it gives patients the kind of choice that matters - not
choice of insurance plan, but choice of doctor. For example, if you switch
plans today, you may discover your favorite physician doesn't take your new
insurance. But in a single-payer system, virtually every physician would take
government insurance, so that would no longer be an issue. And, of course,
single-payer systems by definition make coverage universal - ie, they give
insurance to every citizen as a birthright, regardless of employment status.
This isn't just fair: It may also be more efficient, since it would allow
people more freedom to change jobs and pursue better opportunities. ...

Single-payer vs. nothing at all
<http://www.boston.com/dailyglobe2/330/letter/Single_payer_vs_nothing_at_allP.

shtml>
Allen Giles, Lincoln, November 26, 2002

Jeff Jacoby's statements in his column on John Kerry and single-payer health
insurance (op ed, Nov. 21) must be challenged. He writes: ''Just ask a
Canadian who who has had to wait weeks for the results of an AIDS test or
months for cancer radiation therapy or more than a year for a hip
replacement'' as examples of ''a major decline in US health care'' that
single-payer health insurance would bring about. I suspect that the
increasing millions of Americans who are unable to afford any health
insurance of any sort and the increasing hundreds of thousands more whose
''managed care'' turns them down for the care they need and whose policies
make needed medications unaffordable would find that only having to wait a
bit is a dramatic improvement over their present situations.

The battle lines on health care
<http://www.boston.com/dailyglobe2/330/oped/The_battle_lines_on_health_careP.s

html>
Thomas Oliphant, Boston Globe, November 26, 2002

Washington - For those who like their politics dished out in oversimplified
images, there's an interesting dichotomy in the supposedly moribund
Democratic Party. Where the country's health care crisis is concerned, we
have on the left that famous, wacky liberal dreamer, Al Gore, now pushing
what is most accurately called national health insurance. In the center,
there is a more famous apostle of moderate and mixed-bag policy wonkery who
relies heavily on the private sector for his latest proposal - Edward
Kennedy. On the right, there is the familiarity that ought to breed contempt
- President Bush, still trying to fit the square peg of tax credits into the
round hole of immense gaps in basic coverage for working families. Bush is
the easiest to dismiss. As usual, the right's approach to a major domestic
problem is to focus on those least affected by it. Tax credits primarily help
those already insured or able to pay for it up front; even if made
refundable, they are a false promise because the majority of the 41 million
uninsured work full time for incomes too low to generate the cash. Worse, the
tax credits' proposed ''value'' wouldn't pay half the costs of a decent plan
and ignores the reality of skyrocketing costs. Indeed, the president is so
far out of step that his own secretary of health and human services, Tommy
Thompson, requested a National Academy of Sciences report that recommended a
series of state-level pilot projects to, among other things, test ways of
actually achieving full coverage. ...

Strong medicine
Health care reform is back in the news. This time, does it stand a chance?
<http://www.boston.com/dailyglobe2/335/focus/Strong_medicineP.shtml>
Jonathan Cohn, Boston Globe, December 1, 2002

When Senator Edward Kennedy announced on Nov. 21 that he would soon propose a
plan for universal health insurance, it barely qualified as news. Kennedy has
been a member of Congress for 40 years now, and in that time he's introduced
major health care bills at least a dozen, maybe two dozen times. But for
once, Kennedy's timing seemed exquisite. In the past, the senator has been a
lonely champion of health care reform, fighting not only Republicans but even
more cautious members of his own party. This time around, Kennedy has company
in his crusade. And lots of it. Just days before Kennedy made his
announcement, Al Gore surprised reporters with his announcement that he will
call for the creation of a ''single-payer'' health insurance system in the
United States - that is, a system in which the government provides every
citizen with health insurance directly, just as it does in Canada. Almost
immediately, two of Gore's would-be rivals for the 2004 Democratic
presidential nomination, Senators John Edwards and John Kerry, indicated
they'd soon be unveiling health care plans of their own. Assuming all three
men make good on their promises, they'll be following the lead of a fourth
Democratic presidential contender, Vermont Governor Howard Dean, who long ago
made universal health insurance the centerpiece of his upstart candidacy. And
Democrats running for president aren't the only ones talking about big
changes in health care. The National Academy of Sciences has placed a starkly
worded report on the desk of President Bush. ''The American health care
system is confronting a crisis,'' it reads. ''The health care delivery system
is incapable of meeting the present, let alone the future, needs of the
American public.'' The academy went on to recommend that the federal
government allow a handful of states to experiment with different schemes for
achieving universal coverage, a message the Bush administration said it would
take to heart. ...

Editorial Comment: In the early 70s in the United States, a broad movement
for national health insurance began to grow, spearheaded by the United Auto
Workers and even including at one point General Motors Corporation. Ted
Kennedy jumped on board and the boat sank. It's tempting to rely on knights
in shining armor, but there's no substitute for good old-fashioned grassroots
organizing. - SE

Web Directory:

AARN <http://www.aarn.org>
Australian Nursing Federation <http://www.anf.org.au>
California Nurses Association <http://www.calnurses.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 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>
Revolution Magazine <http://www.revolutionmag.com>
Seachange Bulletin <http://www.seachangebulletin.org>
Southern Arizona Nurses Coalition <http://SAZNC.homestead.com>
Union Web Services <http://www.unionwebservices.com>
United Health Care Workers <http://www.uhcw.org>

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