Report on One Payer States conference held in Philadelphia

One Payer States Conference
William Way Center Auditorium, Philadelphia, PA
June 30-July1, 2012

Healthcare-NOW rented the William Way Center (Philadelphia LGBT center) auditorium for a reception for Michael Moore on Saturday night and for the all-day One Payer States workshop on Sunday.

On Saturday, following the reception, there was a 300-person public event at Plays and Players Theater (sans air-conditioning at 90o and 85% humidity!). The five-year reunion celebrated SiCKO's release. Besides Moore, seven of the film's health insurance industry victims (including Donna Smith), and two industry whistle-blowers attended.

There were emotional sagas of preventable suffering that continue to this day, from a 9/11 rescue worker with an oxygen tank, a parentless teen, a widowed spouse, morphing cancers, running battles with insurance companies and medical bankruptcies. Wendell Potter (author of Deadly Spin) shared his crisis-of-conscience journey from PR corporate enabler to industry whistle-blower, beginning with his former company, CIGNA, assigning him to sneak-preview SiCKO in Sacramento and plan the public relations attacks on the movie.

Moore said that humor is one of the most effective ways of exposing the amoral for-profit insurance industry. Having fun is also an outstanding motivator for staying active. He recommended making full use of social media as well, pointing out that in the space of a single weekend, Twitter was able to mobilize thousands in defense of the Michigan state legislator who was expelled from the floor for saying the word “vagina.” Eve Ensler heard about the incident, and offered to have a performance of her program The Vagina Monologues to benefit feminist groups there.

In the morning session, Michael Lighty (from the California Nurses) offered a review of single payer health care in California. The health care bus, travelling all over the state, has been very successful in building organizational capacity at a local level. They arrange for leaflet distribution in communities before the bus arrives. Volunteers on the bus do health care screening, mainly blood pressure and glucose. The project has built up a regionally based data base for single payer health care supporters.

Lighty recommended going to the ballot with something simple rather than something complicated. California is politically important because of its size, with a population approximately equal to that of France. Like many other states, California needs a 2/3 majority for any bill requiring taxation. Immigration status will come up in health care; however, there is a great deal support in the Latino community for PPACA despite the fact that it leaves undocumented immigrants out. The fiscal case needs to be made to the business community, in addition to having a values-based campaign emphasizing caring and community.

The state labor federation in California strongly supports single payer. People in the labor movement are realizing more and more that the labor movement can’t survive on its own. They will not be able preserve their own benefits while others lose out.

Andrew Adair from Jim McDermott’s office reported on the bill to help states get to single payer. Sanders will be introducing companion legislation in the Senate. This will be a way to use PPACA to promote state single payer.

In the afternoon, there were brief summaries of what is going on in other states.

Colorado
Senator Irene Aguilar has been a key leader in promoting legislation providing health care for all. Two groups working on two different pieces of legislation; the state could some help in coalition building.

One plan would set up a co-op with a board of directors to self-insure the whole state insofar as possible. All of the residents of the state would belong. It will probably have to be put on the ballot. They are raising money for an actuarial study of the plan, and just acquired office space. The campaign will feature the slogan “No to insurance companies”

Hawaii
Dr. Steven Kemble is making sure that Hawaii’s PPACA committee is populated with single payer supporters. Governor Abercrombie was a very strong single payer supporter while in Congress.

Illinois
The state constitution, like that of Washington, prohibits progressive taxation. A single payer bill has been around since 2005, but has lost many cosponsors to implementing PPACA. There was no testimony in the last legislative session. There aren’t the resources to fund an economic study.

Maine
The state government has been taken over by Tea Party Republicans, who are cutting off as many people from Medicaid as they possibly can. State legislation has not gone anywhere. There is a new organization promoting single payer which has gotten a lot of support from medical students.

Maryland
Single payer legislation has been introduced in both the house and the senate, but has stalled out.

Minnesota
Minnesota Nurses, Health Care for All Minnesota, and PNHP have been active in promoting single payer. In the 2009-2010 legislative session, state single payer was supported by about 1/3 of the senate and house members. Both houses are currently held by Republicans. The governor is pro-single payer. The health care assessment for a single payer plan would amount to 4% of income, with the first $12K being exempt.

Missouri
Missourians for Single payer started in 1990. There was a hearing last year on the bill which was televised and uploaded to YouTube. A member has written a 300 page history of the single payer movement nationally. There is a new PNHP chapter in St Louis, which has had good success among students. The Post-Dispatch has come around to endorsing single payer. The chapter got an interview with Charles Jaco of Fox2 news—with no editing out of pro-single payer views. http://fox2now.com/author/ktvicjaco/

New Mexico
The state single payer organization has been around since the 1990s. The supporting coalition has 147 members, including building trades, farmers, ranching, with a lot of geographically diversity. 33 cities and counties have endorsed the specific legislation, including the city of Roswell (a state center of Tea Party activism).

They have done the math and created questions about the economic viability of the PPACA exchange, a matter of special concern to Democratic legislators, who do not want failure to put their party in a bad place.

New York
A single payer bill was written 20 years ago, but there has not been much of a push to get it enacted until recently. Single Payer NY has started the 100 by 100 campaign, in which 100 people agree to get 100 single payer petitions signed. This strategy has been a good organizing tool for building our database.

NY can do better than PPACA, but people have different levels of response to it. Health Care Now NYC and Occupy Albany are involved in outreach to unions, many of which prioritize PPACA (also backed by Working Families Party). The new president of a major union is a single payer supporter. There have been 50 meetings with legislators, and the bill has been moved out of a couple of committees.

Ohio
Many years have been devoted to getting support for a ballot petition. Unfortunately, a reactionary conservative “Health Care Freedom” Amendment—which will prevent regulation of health care by the state, passed. The African American community voted for it because they thought it supported Obama. We are setting up a rapid response committee to counter opponents of single paper.

Oregon
After years of having legislation be introduced but go nowhere, we are moving to a campaign based on the idea of health care as a human right. Mad as Hell Doctors are active, and there is a very active single payer community in Portland.

Pennsylvania
Single payer has bipartisan support here, very helpful since Republicans control all three branches of government. A 16-year Republican legislator (retired) is a member of our coalition. A bill to do a fiscal study was presented before the banking and insurance committee. 68% of the senate wants an economic study done.

Vermont
Vermonters are working on a public option for the exchange. They would like to include dental, vision, mental health, and figure out ways of paying for these features. They have had challenges with coalition building, but it has been functioning. The human rights model is not the only possible one - there should be different messages for different audiences. Think creatively about how art and music can be used to mobilize support. They are asking people to sign the Vermont Workers Center petition (and offer financial support) at http://www.workerscenter.org/vermontcanleadtheway

Washington
Martha Koester reported on HCFA-WA action teams contacting both legislators and candidates requesting them to support our single payer legislation, which has been introduced every year since 2003. She mentioned that a number of groups working on universal health care in different parts of the state have decided to affiliate with HCFA-WA, and that training of a speakers bureau is underway. Les Pittle (WA StatePNHP representative) described the PNHPWW outreach to doctors on the national mailing list, and the hugely successful annual public meeting featuring Amy Goodman.

Neoliberalism
There was a very good presentation by Brigitte Marti and Dr. Carol Ritter on the worldwide neoliberal attack on all public goods, including health care. The NY Times (and other media) typically have separate editions for the US and the rest of the world. The latter include pieces discussing neoliberalism; the former don’t.

Finding allies outside of health care activism
Chuck Pennachio provided a list of all the various corporate complexes that now effectively run our society. Besides the medical-industrial complex, there is the military-industrial complex, the prison-industrial complex, etc. In politics, there is the “bully-wimp” complex. We should not be acting alone, but finding allies among those who are fighting corporatization of other aspects or our lives.

Wendell Potter
He began by quoting Sun Tzu on strategy vs tactics: “Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat,” saying that this is a distinction not widely understood among activists.

The insurance industry has been effective in defining single payer, agreeing on strategy and tactics despite conflicting interests among its stakeholders. They capitalize on the fact that not all share our value that health care is a human right, and have framed it as “a government takeover of health care.” He predicted an all out attack on Medicare and such consumer protections as are now available in PPACA on the grounds that they are too expensive.

Given the unified approach of the opposition, those who hold single payer as a goal need to be united despite the divisions between those who see PPACA as a way to promote single payer and those who see it as a diversion away from single payer. Our best opportunity for translating PPACA passage and the recent SCOTUS ruling into universal healthcare is embedded in the national legislation itself: PPACA contains provisions for both state-based healthcare innovation and funding waivers. These are already endorsed by President Obama and embraced by numerous Republicans at all levels of government. More explicit enabling legislation is being introduced by Independent Senator Bernie Sanders (VT) and Democratic Representative Jim McDermott (WA) in the United States Congress.

Summary session
Led by Francesca Lo Basso (Health Care NOW) and Donna Smith, the attendees discussed and commented on the day’s presentations. Francesca will be compiling contact information for the attendees, to be shared among ourselves. She was the person who handled all the operational details (food, conference space, scheduling) that made the conference flow so smoothly.