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Amid all the noise created by the passage of the Affordable Health Care Act (ACA) and its future now before the U.S. Supreme Court, there are some states who continue to move forward with the only common sense health care solution: single payer.
First it was Vermont, when Governor Peter Shumlin signed a law in March that sets Vermont on a course to provide health care for all of its citizens through a single payer system called Green Mountain Care. Key components include containing costs by setting reimbursement rates for health care providers and streamlining administration into a single, state-managed system. The ACA reform law would not allow Vermont to enact single payer until 2017; Vermont is asking the administration to grant it a waiver so that it can get there even faster, by 2014.
Could Minnesota be next?
Vermont diligently and patiently worked for years to build the foundation for its law. So too, is Minnesota under the umbrella of an organization called Health Care for All Minnesota (HCAMn). Its mission is dedicated to establishing comprehensive single-payer health care for all Minnesotans through advocacy, education, lobbying, and community organizing. HCAMn, an independent organization that strategically partners with other organizations, is a nonpartisan, 501(c)4 non-profit and does not endorse candidates or work on political campaigns.
No matter what the Supreme Court decides, the move to single payer is on in Minnesota. In 2010, the Minnesota Health Act passed out of both state legislature committees before the November 2010 elections swept in a Republican controlled legislature and a Democratic governor (Mark Dayton). That effectively stalled the legislation even though Dayton is on record as supporting single payer for Minnesota.
"After the 2010 election, we decided our focus would be more to educate people on what single payer is," said Erin Anderson, Executive Director of HCAMn. "We are now going state-wide, via forums and meetings, telling people what the benefits are, how it would save money and how everyone would be covered. We're focused on education and organizing the general pubic."
Minnesota is one state actively working to implement a health exchange as part of the ACA. The governor's task forces on both health exchanges and health reform offer HCAMn other avenues to turn the conversation toward implementation of single payer.
"We, in an effort spearheaded by the Minnesota chapter of Physicians for a National Health Program, made a commitment to be at task force hearings and to speak during the public forum part of those meetings," said Lisa Nilles, Vice Chair of HCAMn. "We're showing up and making sure the message gets through to the governor. We're also present at citizen forums organized by the Citizens League and helping to provide the governor input on what the citizens are saying about health care. And the message is getting out there that Minnesotans want single payer -- that single payer needs to be on the table."
Some national polls have shown a 2/3 majority in favor of single payer. A 2007 poll of Minnesota physicians indicated a 64 percent approval of single payer. Also, the majority of physicians (86%) agreed "that it is the responsibility of society, through the government, to ensure that everyone has access to good medical care."
The HCAMn site provides excellent information on what single payer is and what it is not. It's a great read for individuals concerned about knowing the facts about single payer. In summary, single payer provides:
- One system that covers everyone
- A uniform and comprehensive benefit set for everyone
- A single network of health care providers and an end to choice-limiting networks
- A single insurance pool to spread insurance risk
- An outlet to delink health care coverage from employment
"There's so much misinformation about single payer," Anderson said. "People think it's "socialized medicine' when in fact it's not that at all. You still have private clinics and private hospitals, but they are paid by one payer and it doesn't have to be the government. And people think it has to be so expensive, when all the studies show single payer saves money."
Despite making sense and saving money, single payer faces an uphill climb with roadblocks thrown up by big insurance company lobbying. So what keeps HCAMn motivated through this long process?
"We have a fragmented health care system that keeps so many people from getting the care they need," said Anderson, who herself carries the "scarlet letter' of a pre-existing condition. "I had back surgery when I was 13," she said. "I'm a pre-existing condition.
"It's the stories -- that's what keeps us motivated. Everyone knows someone who has been affected by debt, who isn't covered by health insurance, someone who has high deductibles or high prescription drug costs."
For Nilles, a physician who worked in England in the early 1990s before beginning her practice in the U.S., it's that first-hand knowledge of working in a system in which "everyone's covered" that has been her motivating factor.
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