And the "U" stands for uncompromising. Gandhi is quoted as saying that one cannot compromise on fundamentals because it is all give and no take. When it comes to the healthcare crisis, the smallest incremental step is National Improved Medicare for All. That will create the system and the cost savings needed to provide universal comprehensive coverage. Throughout history, every movement for social transformation has been told that it is asking for too much. When the single payer movement is told that it must compromise, that is no different. The movement is demanding a proven solution to the healthcare crisis, and anything less will not work.
The momentum is on the side of the movement for National Improved Medicare for All. Act now to push Sanders to amend his bill so that it matches HR 676. Sign and share the petition tool, and read the letter below to understand the concerns about Sanders' bill.
CLICK HERE TO SEND AN EMAIL TO SENATOR SANDERS.
Dear Senator Sanders,
For almost fifteen years the movement for National Improved Medicare for All has organized around HR 676: The Expanded and Improved Medicare for All Act, introduced each session since 2003 by Congressman John Conyers. As you know, HR 676 has 117 co-sponsors so far this year. This legislation is considered by the movement to be the gold standard framework for a universal healthcare system in the United States.
We appreciate your support for Improved Medicare for All and the work that you have done to elevate the national dialogue on Improved Medicare for All. We hope to continue to work with you to make this a reality in the near future.
To that end, we are writing to share our concerns about the legislation that you are planning to introduce. These concerns are based on what we have learned about your legislation without having the benefit of reading a draft of it.
In order to maintain the cohesion and strength of the movement for Improved Medicare for All, the legislation in the senate must be in alignment with HR 676. This is important so that the movement is unified and so that the process begins from a position of asking for what we want and need, rather than starting from a position of compromise. It is the task of the movement to build political support for the legislation in Congress.
Here is a list of our concerns:
- We oppose the inclusion of copayments and deductibles in an Improved Medicare for All bill.
As outlined in the recent letter to you from Physicians for a National Health Program, including copayments adds administrative complexity and creates a barrier to care, which leads to delay or avoidance of necessary care. Economic analyses indicate that the administrative and other savings inherent in a well-planned single payer system offset the added expense of eliminating copayments and deductibles. HR 676 does not include copayments. The movement for Improved Medicare for All has coalesced around the elimination of these financial barriers to care.
- We support a rapid transition to National Improved Medicare for All. The Medicare system was implemented within a year of passage without using computers. Unlike when Medicare became law, the United States now has basic infrastructure in place for a national health insurance based on Medicare. We urge you to utilize the timeline in HR 676, which would start the universal system in less than two years, rather than delaying or phasing it in by age group over time. Beginning with a universal system allows savings and cost controls that can be used to provide comprehensive benefits without cost sharing.
- We support a single payer healthcare system. We understand that your legislation will allow employers to continue to provide employee health insurance that duplicates what the national health insurance covers to avoid conflict with the Employee Retirement and Income Security Act (ERISA). We urge you to include a carve out of ERISA for national health insurance so that the new system is a single payer system. Without doing so, your bill will be a multi-payer system. This is required to achieve administrative simplicity and significant cost savings. HR 676 allows private insurance that does not duplicate the benefits of the system. Employers and unions would be able to provide extra benefits beyond what the system covers.
- We support a universal system. We understand that your legislation will allow health providers to opt out of the national health insurance system. This would create a parallel health system for the wealthy and undermine the quality of the public system. Universal systems are of higher quality than tiered systems because they create a social solidarity in which everyone has an interest in making the system the best it can be. We urge you to reject a tiered healthcare system as healthcare is a human right and should not be based on wealth.
- We oppose inclusion of investor-owned health facilities. Investor-owned health facilities treat health care, which is a necessary public service, as a commodity for profit. These facilities have an incentive to cut corners, under and over treat and charge higher prices. The result is higher cost and lower quality. We urge you to reject profiteering in the healthcare system so that the bottom line is improving the health of our population, not profits for Wall Street.
The above concerns are based on what we know about your legislation at present. We do not know if they are warranted because we have not read the text. Upon reading it, there may be additional concerns.
We hope that you will share the draft text of your legislation with us and address the above concerns before it is introduced. Our support for your Improved Medicare for All legislation will depend upon whether or not it will serve as a companion to HR 676. If it is, we are ready to work in our states to build political support for it. If the above concerns are not addressed, then your bill will not be a single payer Improved Medicare for All bill and we believe it will undermine the movement for HR 676.
We recognize that legislators tend to compromise from the start to build political support for legislation. This has served as a failed strategy because the final legislation is too weak to accomplish its goals. We suggest a different approach of beginning from a position of what is required to solve the healthcare crisis. We have organized for too long to concede from the start on these fundamental principles.
Signed,
Vanessa Beck, Health Over Profit for Everyone Steering Committee
Claudia Chaufan, MD, California Physicians for a National Health Program*
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