Friday, February 15, 2013

Fwd: qotd: "Expanded & Improved Medicare For All Act" provides renewal for the movement

Quote-of-the-day mailing list

-------- Original Message --------
Subject: qotd: "Expanded & Improved Medicare For All Act" provides
renewal for the movement
Date: Fri, 15 Feb 2013 08:21:05 -0800
From: Don McCanne <>
To: Quote-of-the-Day <>

113th Congress
H.R. 676
"Expanded & Improved Medicare For All Act"
Sponsor: Rep. John Conyers, Jr., plus 40 Cosponsors (2/14/13)

To provide for comprehensive health insurance coverage for all United
States residents, improved health care delivery, and for other purposes.

The Library of Congress
Thomas (Select "Bill Number" and enter H.R. 676)

As of 2/15/13 the text of the legislation has not been received from the
Government Printing Office, but a draft is available at this link:

Comment: Congressman John Conyers has reintroduced his bill for a
single payer national health program: H.R. 676, "Expanded & Improved
Medicare For All Act." Some perspective is warranted.

Our government stewards are intensely involved in implementation of the
Affordable Care Act (ACA), and thus tend to dismiss any consideration of
single payer reform as being irrelevant in today's political climate.
Such an attitude is decidedly unwise.

We know that a decade from now 30 million people will still be without
any health insurance, and tens of millions more may be exposed to
excessive medical debt because of the inadequate coverage of the health
plans - the standard silver plan having an actuarial value of only 70
percent. We also know that the ACA model of reform will not be capable
of adequately controlling costs and will fail to provide much needed
reform such as the reduction or elimination of profound administrative

Many understandably do not want to wait the years it will take to see
that ACA is a failure. They are turning to their states to try to
achieve single payer reform. But state efforts not only face the
"political feasibility" hurdle, they also face the federal gridlock of
existing programs, laws and regulations that place barriers in the way
of state reform.

For example, Vermont's highly touted single payer legislation has not
enabled adequate federal flexibility with Medicare, Medicaid, and
employer self-insured (ERISA) funds. Although state activists talk about
obtaining federal waivers to free up these funds, without comprehensive
federal legislation, the existing waiver programs cannot possibly open
the gates for state-level single payer. Considering the complexity of
existing federal laws and regulations, the federal legislation required
to enable state single payer systems likely would be as complex, if not
more so, than enacting a national single payer program. The latter
simply would displace our dysfunctional financing system, whereas the
former would have to negotiate the the extremely complex maze that has
been constructed over many decades, most recently compounded by ACA.

The California legislature has twice passed a bill that they labeled
"single payer," but only with the promise of the Republican governor
that it would be vetoed. Now that California has a Democratic governor
and a two-thirds super-majority in each house of the state legislature,
with only one week left to file bills for the current two year session,
no state legislator has been willing to sponsor the single payer bill.
They insist that all attention must now be devoted to implementation of ACA.

This is why H.R. 676 is so important. Even if Congressional barriers
succeed in blocking the legislation, the Expanded and Improved Medicare
for All Act serves as a very important vehicle for education and
advocacy. The bill was introduced two days ago with 37 cosponsors, and
yesterday, 3 more were added. That is more than they began with in the
last session of Congress. We should build on this.

State efforts should be encouraged, but with a dose of reality. We need
to be working on a national movement - all of us, including the state
activists. We can support each other in our state efforts, but all of us
must pull all stops in support of the national efforts.

Perhaps around 2017 the picture will finally emerge that the fragmented
and dysfunctional model of a multitude of private plans and public
programs cannot be repaired, and that a public program such as single
payer or a national health service will be essential. Until then, we
must continue to spread the message that there is a model that will
work. People need to know that, when ACA fails, there is a place to
where we can turn.

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