(Bankruptcy as a step towards Medicare For All? Let us find a better path! – promoted by eli_beckerman)

I made a statement before the Joint Committee on Health Care Finance at a public hearing on Friday, June 24, 2011 at 11 am in Pittsfield.  The Committee was hearing testimony on H1849, “An Act Improving the Quality of Health Care and Controlling Costs …” .  My statement was in opposition to the bill.  The Chair of the committee asked me several questions afterwards.  A transcript is posted below.

I was happy to meet with fellow health care advocates from around the state, most of whom are strong supporters of Single Payer Health Care (aka Medicare For All), which is one of my major campaign issues as a Green-Rainbow Party candidate.  The issue is also one of the major policy initiatives behind the party’s mobilization around the Commonwealth.

Joining me at the hearing were fellow Green-Rainbow Party members Patrick Burke, Mark Miller, Jeff Turner, Jeff Wheeler.  Mark Miller, a candidate for 3rd Berkshire District, also provided testimony.

Here is a transcription of my prepared notes for the talk, as well as a summary of the follow-up questions to me by the Co-Chair Rep. Steven M. Walsh, (D-Lynn).

Good afternoon.  My name is Scott Laugenour.  I live in Lenox.  I am a representatives of Berkshire County on the State Committee of the Green-Rainbow Party.  Our party is mobilizing politically on the issues of Tax Fairness, Secure Local Green Jobs, Peace, and Single Payer Health Care.   Thank you for traveling out west in order to hold this hearing, and welcome to the Berkshires.

When I first learned of the hearing and the name of this bill – An Act To Increase Health Care Quality and Control Costs – I thought that the name described Single Payer Health Care very well.  I know that some of you on the committee are also co-sponsors of the single payer bill, but as one reads through the bill being considered today one sees that it is not promoting a single payer solution.  It’s very different.

This is not about expanding Medicare For All, which is what Single Payer would do, but about introducing something called ACO’s “Accountable Care Organizations.”  The thinking behind establishing ACO’s is that it is patient and provider choices that have been most responsible for our high costs.   I would highly question this premise.

Last year I was the contact person in the 4th Berkshire District to place a policy question for Medicare For All on the ballot.  The question was was drafted by Mass Care.  We took the question to the people and found it was one of the easiest signature-gathering we ever conducted.  In the 4th Berkshire District well over 70% of voters responded YES to the question.  It was the second-highest percentage of YES votes of the 14 districts in the Commonwealth where it was asked.

Somehow I think if I attempted to take this ACO bill to the people for their signature and support I’d be laughed off the street.  There’s a tired ‘been there done that’ ring to this bill.  Weren’t HMO’s supposed to similarly increase quality and control costs?

The evidence is clear that introducing Medicare in the 1960’s to people 65 and over was the strongest step towards higher health care quality and lowest cost.  We’ve stumbled terribly since.

Gosh!  We’re tired of this!

– tired of being told that we have Cadillac policies, when on a global scale we’re stuck with lemons (Cadillac is an accurate description only of the price);

– tired of 3-letter acronyms;

– tired of convoluted schemes;

– tired of policy elites who wax poetic in the op-ed pieces of the NY Times and the Boston Globe, lavishing praise on these programs and schemes in which they themselves, and you legislators, do not partake;

– we’re tired of being told that you are being ground-breaking, pioneering, and progressive in adopting these schemes;

– tired of elected officials who join us in protest in Madison, but whose votes in Boston put us on the Wisconsin express;

– tired of polarized town meetings, where those who are further down the spiral of paying more while getting less are compelled to cast votes to bring fellow community members down; and

– tired of the drain on our communities and local businesses.

The drain is immense.  Health care costs are nearly half of the state budget.

Costs that burden some, however are revenues that strengthen others.  There seems a clear inverse relationship between the health and solvency of our people and communities with the top-lines and clout of insurance companies and non-profits that benefit from the status quo.

Other systems around the world, which deliver a medicare-like program to all at higher quality and lower cost than we, do not have these public and private brokers to public infrastructure that we have set up here.   During my years as an executive with Marriott Hotels I’ve lived and done business in some of them.  Business people understand that a strong and expanding public health insurance system is good for any business environment in any marketplace (except, of course, a private insurance marketplace).

While other countries’ medicare-like systems have expanded – NHS in Britain has sustained and expanded services for over 60 years – our Medicare system has been stripped.

Medicare for all is popular when it is understood.  Many supporters of it are here before you today.  We’re not only tired of the re-hashing of old ideas and the dismantling of cost-effective public programs.  We’re also tired of traditional advocacy:

– tired of writing letters to the editor and op-eds

– tired of demonstrations and even of hearings like this one

We don’t believe that the next steps of advocacy are in trying to make an ever-more reasoned argument for medicare for all, as if the best argument in the competition for ideas will win.

More of us know that the issue is about playing power in politics, a combination of money, votes, and affiliations.

Health care costs have crippled many people and communities, but they haven’t crippled the campaign contributions that the industry lavishes to you and to your parties.

Rather than countering the power of their money over you, our votes and affiliations with your institutions strengthen the harmful effect of their money.

Withdrawing totally from engagement in the process (as many have through fatigue, dispiritedness, and cynicism) does not challenge your power.  One woman from the Berkshires, sounding resigned, was quoted in the paper a couple days ago that she is “used to being ping-ponged around” by the system.  ACO’s will not change that, however cleverly they are packaged.  ACO’s are not the solution.

Our activism for Medicare For All is bolstered when activists and voters affiliate with a party like ours that does not take the money, and reminds politicians what it is that voters want and our communities need.

Following the statement, Rep. Walsh said that he hoped that his committee and I could continue the discussion in the future, a sentiment which I reciprocated in offering.  He let me know that he was one of the co-sponsors of the Medicare For All bill, which I thanked him for.  (I might have pointed out to him that the number of his fellow co-sponsors on Beacon Hill has been declining since at least 2006.)  While I remained at the podium another five or six minutes elapsed in follow-up questions from him and answers from me.

Q:  Thank you for your statement, Scott.  What answer do you have for people who point out that many single payer health care systems have waiting periods for some procedures?

A:  We have waits here, too.  My experience and observation has been that when other countries find solutions to occurrences of unacceptable waits, for example, it is not reported or discussed here.  We’re misled to believe that waits are a necessary component of a public plan.  For voters in these other countries an advantage of having a public health insurance system is that voters are in a better position to demand improved conditions and vote out any party or candidates who do not deliver the solutions.  I know of no country with a public health insurance system whose voters would swap places with us.  To the rest of the world, we are the example whose system and horror stories are to be avoided.

Q:  Many of us think that the steps we are taking in Massachusetts are steps towards Medicare For All.  Are we going in the right direction?

A:  I think the most logical steps towards Medicare For All is to bring more people into Medicare until it is available to all.  We first made it available to people 65 and over and it was very popular, offered good quality, and was cost effective.  A better step is to make it available to people 60 and over, and then 55 and over, and then 50 and over, etc.  The only way I would acknowledge the legislation you have passed in Massachusetts so far, and what you are considering today, as a step towards Medicare For All is if one considers bankruptcy a step towards Medicare For All.  Weakening existing public health insurance programs is not the way to arrive at Medicare For All.

Q:  Don’t you think that the most important relationship is between the patient and the doctor?

A:  Yes, we definitely agree on that.  Medicare patients in this country and in other countries spend more time with their doctors and less time with the insurance bureaucracy.  This is another argument for Medicare For All.

Q:  I hope you’re willing to partner with us in making progress.

A:  Absolutely, I would love to continue engaging in this dialogue.  Rep. Pignatelli, who ran for the same State Representative seat as I last year, is another co-sponsor of Medicare For All.  During the campaign we both spoke about our support for Medicare For All.  I’m sure that he joined me in encouraging the many people who voted for it last year to do so.

Thanks to Nat Fortune for help with following the money.  It’s also helpful in preparing for public statements such as this to research campaign contributions that the committee members hearing the testimony receive, particularly in this case the financial reports from chairs Senator Richard T. Moore and Representative Steven M. Walsh.

A blog from Ben Day and a posting on CommonHealth provided insight on Accountable Care Organizations and why they will not work towards improved health care quality and increased cost control.

Candidate Mark Miller’s journal entries from Friday June 24 and Saturday June 25 offer a reflection on  his testimony.

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