Tag: NNU

A Labor-Based Movement For Medicare For All

Healthcare is the crossroads where the assault on workers meets the juggernaut of “crony capitalism.” That’s the term used by the mainstream neo-classical and Nobel prize-winning economist Angus Deaton to describe the coziness between the healthcare industry and its government “regulators.” In fact, Deaton argues, how healthcare is financed and delivered is a driver of inequality. 

Registered Nurses see that inequity everyday in hospitals and clinics, where the standard of care patients receive depends on the quality (and cost) of the health plan they buy. Not only the benefits but access to treatments, prescription drugs, certain facilities, the latest technologies, all depend on what you can pay. And guess who has the money to buy the best: the wealthy. So for the first time, after the Great Recession two unprecedented trends occurred: the 1% increased their share of income spent on healthcare, and the average life expectancy people in the US declined.

“So for the first time, after the Great Recession two unprecedented trends occurred: the 1% increased their share of income spent on healthcare, and the average life expectancy of people living in the US declined.”

Historically, the labor movement has stepped into this breach of injustice and inequality. Yet in 2017, the union membership rate overall in the US was just 10.7%. In the private sector it was 6.5% and in the public sector it was 34.4%. Unions established the system of job-based health benefits after World War II, in part to provide better coverage to encourage new memberships, and now employers run it for the benefit of the insurance industry’s bottom line.

“Controlling” healthcare costs for businesses has meant a huge cost shift to workers. Rather than pay the annual double-digit insurance premium increases out of their profits – soon to go up under the tax bill – companies raise the workers’ share, increase deductibles and co-pays, and promote employee-funded health savings accounts. Though it expanded coverage for low-wage workers, the ACA also lessened the “union advantage” in health benefits, established new taxes on union plans and created incentives via an excise tax to lessen benefits.

“Historically, the labor movement has stepped into this breach of injustice and inequality. Yet today only 7% of all workers belong to a union.”

The decades of incremental erosion of health benefits, escalating costs, deferring wages in favor of funding benefits, and the thousands of strikes over just keeping the health plans workers have fought to win, has taken a huge toll on the quality of those plans and on attitude toward unions. In short, “unions have become the bearers of bad news,” unable to stem the tide of concessions. And the incremental progress – expansions of insurance for kids, limits on the worst abuses by HMO’s, expanded private coverage under Medicare for prescription drugs, the ACA itself – none has slowed the increasing costs or the decreasing numbers of employers providing benefits, or the decline in membership of unions.

A defensive posture and incremental demands have not worked. Let’s play offense instead. In the face of existential threats to unions’ ability to fund their operations, and the continuing assault on health benefits, let’s unite with the growing public demand for Medicare for All. We don’t need insurance, we need healthcare.  This is the strategy that can turn the tide:  building a broad movement of workers to demand economic and health justice. That’s not an alliance with insurers and employers to “fix” the system in order to stabilize the healthcare industry. Rather, based on the economic interests of workers, we need to make healthcare a public good. Only if it is not compromised by high premiums, deductibles, and co-pays, without narrow networks and “gatekeeping” that restrict access, can we guarantee healthcare as a human right. Parsing out healthcare through insurance based on ability to pay simply means we’ll only get the healthcare we can afford.

“A defensive posture and incremental demands have not worked. Let’s play offense instead.”

The labor movement exists to stop money from being the metric of value and power. Healthcare is exhibit A for money as the metric (see Elizabeth Rosenthal’s book, “American Sickness”). Unions derive power from members, engaged in fights to win a better life at work, home and in society. Medicare for All enjoys strong majority support among the general public, and overwhelming support among union members and Democrats (70-80% in recent polls). Medicare works and is popular. A movement led by labor, inspired like the Fight for 15 by a broad, popular demand for fairness and security, can build the solidarity we need. A movement positioned as the 99%, can assert that all workers are part of the labor movement.

Let’s understand this movement moment: the uprising in Wisconsin, Occupy Wall Street, Black Lives Matter and now #MeToo have created social movements and a political/ideological context  that infused the Sanders campaign for President, and provides the well-spring for a broader health justice demand, linked to and reinforcing the demands for social and economic justice. Medicare for All can be the health wing of the broader justice movements.

“A movement led by labor, inspired like the Fight for 15 by a broad, popular demand for fairness and security, can build the solidarity we need.”

In the most personal area of public policy – whether we will get the healthcare we need – Registered Nurses, who are predominantly women, bring the values of caring, compassion and community to work and to their advocacy. Let that inspire others to join this movement for guaranteed healthcare based on our shared humanity. Promoting these values combined with organizing workers for health and economic security can overcome the deep pockets of the healthcare industry; it is only through mobilizing public opinion that people have overcome politically powerful economic forces.

In demanding guaranteed healthcare through Medicare for All, we are demanding a more just and humane society. Socio-economic status is the major factor in determining health status, and disparities based on race are rampant in healthcare access and outcomes. Here we see the confluence of addressing race-specific barriers to equality in healthcare and in society and the need for economic and health justice.  Addressing the causes of poverty, overcoming structural racism, establishing $15/hour as the minimum wage, building more affordable housing and winning guaranteed healthcare are necessarily linked – we cannot achieve them individually  in isolation.  A fighting labor movement – that encompasses the broadly defined working class – is in the best position to make those connections and organize on a multi-racial basis to win. Medicare for All not only motivates millions to organize for justice, but winning it would help win justice for all.

Pivotal Moment In American History: Sen. Bernie Sanders Unveils Medicare-For-All Bill With 15 Co-Sponsors

On September 13, 2017, Senator Bernard Sanders introduced S.1804 – a bill to establish a Medicare-for-all health insurance program, with 15 co-sponsors. Sanders Institute Fellow and Director of Public Policy for National Nurses United spoke with Amy Goodman of Democracy Now! on the pivotal piece of legislation. According to a June poll by the Kaiser Family Foundation, some 53% of Americans support a national health care plan.

UPDATE: As of September 14, 2017, there are now 16 co-sponsors for S.1804.

 

 

Vermont Senator Bernie Sanders is slated to introduce universal healthcare legislation today, aimed at expanding Medicare coverage to include every American. In a New York Times op-ed published today, Sanders wrote, “This is a pivotal moment in American history. Do we, as a nation, join the rest of the industrialized world and guarantee comprehensive health care to every person as a human right? Or do we maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximize profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?” Fifteen senators have already signed on as co-sponsors. The introduction of the Medicare for All Act comes after Republicans repeatedly failed to push through their legislation to repeal and replace the Affordable Care Act. The Republicans’ efforts sparked sustained grassroots protests, led by disability activists and healthcare professionals. We speak with Michael Lighty, director of public policy for National Nurses United and the California Nurses Association. National Nurses United has long advocated for a Medicare-for-all system.

Transcript

AMY GOODMAN: We begin today’s show in Washington, D.C., where Vermont Senator Bernie Sanders is slated to introduce universal healthcare legislation today aimed at expanding Medicare coverage to include every American. In a New York Times op-ed piece published today, Sanders writes, quote, “This is a pivotal moment in American history. Do we, as a nation, join the rest of the industrialized world and guarantee comprehensive health care to every person as a human right? Or do we maintain a system that is enormously expensive, wasteful and bureaucratic, and is designed to maximize profits for big insurance companies, the pharmaceutical industry, Wall Street and medical equipment suppliers?” unquote.

Under Sanders’ legislation, all children under 18 and all adults 55 and older would qualify for Medicare during the program’s first year. The remainder of adults would be phased in over four years, until everyone is covered by Medicare. Fifteen senators have so far signed on as co-sponsors, including New Jersey Senator Cory Booker, Massachusetts Senator Elizabeth Warren, California Senator Kamala Harris. This is Senator Sanders speaking at the People’s Summit in Chicago in July.

SENBERNIE SANDERS: Think back five years ago. There was, at that point, widespread belief that the Affordable Care Act, so-called Obamacare, was about as far as we could go as a nation in healthcare. That’s about it. Past Obamacare, can’t do any more. Today, as you know, that view is radically changing. Nurses, thank you for your help on this. Today, all over our country, the American people understand that there is something profoundly wrong when we remain the only major country on Earth not to guarantee healthcare to all people as a right, not a privilege. And there is also something profoundly wrong when millions of Americans cannot afford the prescription drugs that their doctors prescribe. And what the American people from coast to coast are catching onto is the function of healthcare is to provide quality care to all people, not to make billions in profits for the insurance companies or the drug companies.

AMY GOODMAN: The introduction of the Medicare for All Act comes after Republicans repeatedly failed to push through their legislation to repeal and replace the Affordable Care Act. The Republicans’ efforts sparked sustained grassroots protests, led by disability activists and healthcare professionals.

For more, we go to Washington, D.C., where we’re joined by Michael Lighty, director of public policy for National Nurses United and the California Nurses Association. National Nurses United has long advocated for a Medicare-for-all system.

Michael, welcome to Democracy Now! Talk about what has happened just in the last two weeks, from zero senators co-sponsoring to—what are we at now? Fifteen and counting?

MICHAEL LIGHTY: Fifteen and counting, Amy. And it’s a beautiful day. It’s an exciting day for this movement to guarantee healthcare for all. We have literally seen, in the last two weeks, the ascension of this movement for improved Medicare for all. It’s something we haven’t really seen, even going back to the Hillarycare days, where this groundswell is organic. It’s a prairie fire across the country. We’ve seen, just one example, 2 million impressions on Twitter on RoseAnn DeMoro, our executive director’s demand for these senators to sign on to Senator Sanders’ bill. So, this groundswell—we had town halls in California this week. We’ve had hundreds of people come out demanding this reform. It is extraordinarily popular.

And I think we have overcome an amazing amount. The political establishment on the Democratic side, and certainly on the Republican side, did not want this to happen, and yet here we are. And it reflects the fact that Medicare for all, an improved Medicare for all, is more popular than the Affordable Care Act and more popular than the repeal of the Affordable Care Act. It works. Medicare works. And so, here we are. I think it’s really an amazing day. Americans should have a lot of hope, I think.

AMY GOODMAN: I wanted to go to just who is supporting this. Senator Sanders introduced single-payer healthcare three times before. This is the first time he’s had any co-sponsors. California Senator Kamala Harris was the first to sign on. That seemed to break the ice. And at last count, 15 Senate Democrats co-sponsored, including New Jersey’s Cory Booker, New York’s Kirsten Gillibrand, Richard Blumenthal and Chris Murphy of Connecticut, Jeff Merkley of Oregon, Elizabeth Warren and Ed Markey of Massachusetts, Al Franken of Minnesota, Tammy Baldwin of Wisconsin, Sheldon Whitehouse of Rhode Island, Brian Schatz and Mazie Hirono of Hawaii. However, Democratic leadership has yet to jump on board. Senate Minority Leader Chuck Schumer, House Minority Leader Nancy Pelosi have both declined to support the bill. So, talk about the significance and whether it matters whether the leadership leads or simply follows and gets on board if it gets support.

MICHAEL LIGHTY: Well, I think what’s extraordinary is that the majority of the Democratic caucus in the House has signed on to HR 676. Seventy percent of Minority Leader Pelosi’s constituents support improved Medicare for all. I think she just doesn’t get it. The only way to maintain the gains of the Affordable Care Act is to extend and build on that foundation by eliminating the insurance company premiums, deductibles and copays, and really guarantee healthcare for all through the Medicare system. That and the fact that she hasn’t signed on yet, I think it’s a matter of time.

AMY GOODMAN: So, Michael Lighty, lay out what you understand—and have you spoken to Bernie Sanders?—what you understand he’s doing today, what exactly this bill calls for.

MICHAEL LIGHTY: Well, this bill calls for a system where we literally take the healthcare industry model of revenue and profit and transform our healthcare into a system based on the morality of caregiving. And that is a fundamental difference, where, as he said in the clip that you showed, Amy, these healthcare players—the pharmaceutical companies, the insurance companies, hospital corporations, medical device manufacturers and, behind them all, Wall Street—are profiting on human suffering. And that is going to end, because we’re going to guarantee healthcare regardless of one’s ability to pay. Yes, everyone contributes, but the patient care that you get will be based upon what you need, not what you can afford. And that’s a fundamental transformation in the healthcare system in this country. And people are desperate for that security. Frankly, a third of the country or more has deductibles of greater than $2,000 a year. This bill eliminates that. The cost sharing that’s endemic to Medicare will be gone. And those are barriers to care. The insurance companies looking over your shoulder, if you’re a doctor or a nurse, when you’re caring for a patient or deciding how long they should stay in the hospital, that’s gone, that kind of interference. Doctors and nurses put in charge of healthcare, patients getting the care they need, people having real health security, that’s what Senator Sanders is doing today.

AMY GOODMAN: So, talk about the phasing in. I mean, we’re talking about Medicare for all, the idea that this extremely popular program of people 65 years and older have Medicare, just dropping that age to zero to include the entire population. But it’s not happening all at once.

MICHAEL LIGHTY: Well, it is important to recognize that part of the issue within healthcare is that we have a lot of people concentrated in Medicare who, of course, need a lot of services. So it’s a very good idea to include young people, who have less intense healthcare needs. So, putting zero—that is, at birth—to 18-year-olds in the plan is a really good thing to kind of stabilize the system initially, and then also cover those who are 55 and older. Those are the ones with the greatest need, who have the hardest time finding insurance that can actually cover what they need as healthcare. So those two things make sense. And that’s a huge chunk of the population. Then, when you get to between 18 and 55, you’re really dealing with the employer-based insurance system. And it’s appropriate to take some time to unwind that. We hear a lot about how invested people are or how complicated that might be. I don’t think it’s necessarily complicated, but it does take some time to unwind that system, that has been the basis of healthcare since World War II. So I think a few years to do that is perfectly reasonable.

AMY GOODMAN: I want to turn to President Trump speaking about healthcare in July during a lunch with Senate Republicans.

PRESIDENT DONALD TRUMP: We have no Democrat help. They’re obstructionists. That’s all they’re good at, is obstruction. They have no ideas. They’ve gone so far left, they’re looking for single payer. That’s what they want. But single payer will bankrupt our country, because it’s more than we take in, for just healthcare. So single payer is never going to work. But that’s what they’d like to do. They have no idea what the consequence will be. And it will be horrible, horrible healthcare, where you wait on line for weeks to even see a doctor.

AMY GOODMAN: Michael Lighty, your response? Michael, your response? We’re talking to Michael Lighty, director of public policy for the National Nurses United and the California Nurses Association. I’m going to give it one more try to see if Michael can hear us. Michael, can you hear me?

MICHAEL LIGHTY: Yes, I can. Sorry.

AMY GOODMAN: Can you respond to President Trump?

MICHAEL LIGHTY: I can hear you, Amy, yes.

AMY GOODMAN: Can you respond to President Trump? We’ll go to break. We’ll come back to you. Michael Lighty is—

MICHAEL LIGHTY: Well, respond to President Trump—

AMY GOODMAN: Yes, to respond to what he’s saying.

MICHAEL LIGHTY: Basically, President Trump has said he likes Australia. Well, this is very similar to the Australian system—no cost sharing, guaranteed healthcare for all, elimination of the role of the insurance companies. So, this is something that, in fact, President Trump should welcome. This is not the Affordable Care Act. This is not something that we’ve, obviously, instituted before, so it’s an opportunity for him to do something actually positive for the country and for everyone, as a whole. So I think that the—really, the opportunity here is to bring folks together. This is a publicly financed, privately delivered reform that actually represents kind of the best of what we can bring to this issue, because we’re going to be putting doctors and nurses in charge. That’s what we hear from the right all the time: We need doctors and nurses, clinicians in charge, and we need patient-centered care. Well, this is exactly it. This is the kind of great healthcare system that we could create in the U.S.

AMY GOODMAN: Michael Lighty, I want to thank you for being with us. Of course, we’ll follow up on this tomorrow, because Senator Bernie Sanders, the former presidential candidate, is introducing Medicare for all today, at least expected to. A couple of weeks ago, as usual, he had no co-sponsors. He’s introduced it a few times before. But today, just in the last few weeks, begun with Kamala Harris, the senator from California, one after another, Democratic senators signed on. And at last count, it’s 15 Democratic senators supporting the Medicare-for-all bill. Michael Lighty, director of public policy for National Nurses United and the California Nurses Association, thanks so much for joining us.

When we come back, the second meeting of the so-called election integrity commission takes place at Saint Anselm College in New Hampshire. We’ll get the latest. Stay with us.