Thursday, March 29, 2007

Queer Democrats Endorse Universal Health Care


Copyright © 2007 by Mark Gabrish Conlan for Zenger’s Newsmagazine • All rights reserved

The predominantly Queer San Diego Democratic Club unanimously endorsed California OneCare, the latest version of state senator Sheila Kuehl’s health reform plan, at its March 22 meeting after hearing an impassioned presentation in support of the plan from Scripps nurse Hugh Moore. Representing Health Care for All, an organization formed both to lobby for the plan in the legislature and to put it on the ballot as an initiative, Moore showed a DVD promoting the plan and then spoke on the main point made by its backers; that as long as most health insurance in California is provided by profit-making companies with an incentive to pay for as little care as possible, it won’t be possible either to insure the estimated six million Californians who aren’t covered now or improve the health care available to those who are.

“We don’t have universal health care in California now because of one person: Arnold Schwarzenegger,” Moore said, noting that the state legislature passed Kuehl’s bill last year and the governor vetoed it. Now before the legislature as SB 840, Kuehl’s is a classic single-payer health care system in which private health insurance would cease to exist. Instead, the money now paid to the private insurance system and the money government now spends on the health care system through Medicare and Medi-Cal would all go into a fund from which doctors, hospitals and other health care providers would be paid. The bill provides that employers will kick in 8 percent of their total payroll for coverage and employees will pay 3 percent of their salaries.

By contrast, he said the plan Schwarzenegger has proposed would only charge employers of 50 or more people 4 percent of their total payroll for a plan that, because it retains the private health insurance industry and its huge profit margins, is likely to be more expensive. Moore called the Schwarzenegger plan “a giant HMO … expensive and not sustainable,” and said that Scripps, which employs him as a nurse, pays 12 percent of their payroll to an insurance company which in turn pays Scripps to provide care to their own employees.

Moore’s bitterest scorn was reserved for the insurance companies, who according to the film he showed pay about 70 percent of the premiums they collect for client care and keep 30 percent as so-called “administrative costs.” Administrative costs include the salaries of their own staff members — including the reviewers who go over doctors’ bills and requests for care and decide what care they’ll pay for and what they won’t — plus the expensive ad campaigns and the all-important profits for their shareholders.

What Moore finds particularly galling is that the insurers call the 70 percent of their income they have to pay out again for patient care “medical losses.” ”The sickest thing I can imagine is a doctor who says, ‘I can’t treat you unless you pay me first,’” Moore said. “In the current system, the insurance companies just do that for them, and they think they’re right to do that because they’re making profit.” According to Moore, health care simply shouldn’t be a for-profit business because when you need it you have to buy it. You can decide to do without a luxury item or to eat cheaper food, but when you have a health problem — when you break your arm or you get cancer or you contract a rare infection — you need the care right away and you don’t have the ability to shop around.

Moore also said that the current U.S. health care system is as harmful to people in the medical profession as it is to those they care for. “A lot of doctors in the U.S. are leaving the profession because at the end of every day they have to do four hours of paperwork just to get paid,” he said. “The system is so broken it can’t be fixed.” He compared the struggle for single-payer health care to the Social Security system, which was enacted in California on a one-state basis before it was passed nationwide.

He’s also well aware of what he and his colleagues at California OneCare are up against. “Health insurance is a $100 million business, and it’s not going to go quietly,” he said. “You saw a few doctors speaking out for health care for all in the video, but that’s not the position for most doctors. The San Diego County Medical Association calls OneCare Now ‘the black hole of health care’ even though nothing about it will change how they get paid. If OneCare becomes law, Scripps will bill the state of California instead of billing Aetna. Also, the OneCare system will have the ability to negotiate lower rates for services, including prescription drugs. The only thing that will change is insurance companies will go away.”

The questions and comments from club members basically fell into two groups: people asking Moore to clarify how the plan would work, and people pointing out pitfalls in the political strategy behind it and warning how the health insurance companies and their allies in the business community are likely to campaign against it. Freelance journalist Ernie Barrera, whose brother Richard ran against Republican incumbent Ron Roberts for the San Diego County Board of Supervisors last year but got only 27 percent of the vote after basing his campaign largely on the board’s failure to expand access to health care for San Diego County’s working poor, said he fully supported the plan ideologically but added that the Right has so poisoned the majority of Americans against anything that would raise their taxes or increase government’s role in a major sector of the economy that passing such a plan is an uphill battle.

“’Taxes’ has been a dirty word ever since Nixon and Reagan,” Barrera said. “The mood of the video is profit is awful. The guy who’s making a good living working 100 hours a week running a small business is going to say, ‘I’m working my ass off and these people who don’t work at all will benefit.’ We have to recognize that we won’t get everything at once. The carping from the Left that President Clinton’s health plan wasn’t good enough, wasn’t pure enough, opened the door for the Right. The basic message is not being sold because Democrats don’t know how to fight within an American psyche that doesn’t want to see themselves as ‘losers’ and defines people who get help from the government as ‘losers.’ It’s not about the issues; it’s about the message.”

“That’s why each of you has to tell your friends about this,” replied Moore, who had previously acknowledged that OneCare is relying on a grass-roots marketing strategy to overcome the millions of dollars the insurance industry, medical associations and most business organizations will spend to campaign against any such plan. “For years, the Republicans have managed the issue better. We have to say what the message is and we have got to stop being afraid of being beaten by a crazy message. Let’s stop pretending to be middle-of-the-road and go out and say what we believe.”

One club member noted that Right-wing talk-radio hosts are already bashing the Schwarzenegger plan because it would cover so-called “illegal aliens,” and predicted OneCare would be attacked on the same grounds. Moore replied that under federal law, undocumented immigrants — like everyone else — have an absolute right to be cared for in emergency room (though the film he showed featured at least one woman who had been turned away at an ER), and that the health care system has to care for everybody regardless of their citizenship or resident status because bacteria and viruses don’t respect national borders or immigration laws.

“Right now there’s a TB epidemic in San Diego County and it’s from illegal aliens,” Moore said. “We hear all this talk about illegal aliens crowding people out of the emergency rooms. They’re not; the people taking up all the space in the ER’s are our own citizens who don’t have health insurance.” Moore said that undocumented immigrants wouldn’t be official members of the OneCare plan — the state ID cards needed to access the system would be issued to U.S. citizens and legal residents only — but they’d still be entitled to emergency care, while OneCare would eliminate the need for citizens and legal immigrants to use ER’s for basic care because they’d have access to the entire health care system.

According to Moore, the current California workers’ compensation system would be folded into the OneCare plan — which, one club member suggested, might be a wedge to pick off support from some business owners who are being crushed by workers’ comp premiums and might save a great deal of money if that system were replaced by single-payer. Moore also said that organizations like Kaiser, which is essentially an insurance company and a health-care provider in one, would be covered under OneCare just like any other provider — and would save money because they wouldn’t need to buy the expensive advertisements they take out now to build up their business.

After unanimously endorsing the California OneCare plan, the club also took up a less far-reaching health resolution sponsored by the Service Employees International Union (SEIU), which listed a series of principles they want to see in any health reform but shied away from endorsing a specific plan. After a club member pointed out that they had already taken a more far-reaching position on health care, the club unanimously endorsed the SEIU resolution as well without further debate.