Position Statements
ISPC People with Disabilities Committee - Letter in Support of Home and Community-based services for Long-term Care
ISPC Resolution Opposing War
statement on Police Violence and Black Lives Matter
Position Statement on House Bill 1384: Medicare for All Act of 2019
Position Statement on Senate Bill 1129: Medicare for All Act of 2019
2019 Community, Parent, and Neighborhood Groups Statement of Support for Chicago Teachers and Staff
Public Comment In Opposition To The Proposed Federal "Public Charge" Rule
ISPC Position Statement On National Single-Payer Legislation
Statement On Personal Needs Allowance (HB 2513 And SB 1405)
ISPC CHICAGO STATEMENT ON A CHICAGO TASK FORCE ON EMPLOYMENT OF PEOPLE WITH DISABILITIES
ISPC Position Statement On Fair Taxation And Just Fiscal Policy
Statement From ISPC Chicago To Chicago Public Schools Re Special Education Budget Cuts
Position Statement: Single-Payer Health Care And Public Health Care Delivery
ISPC Position Statement On The Trans Pacific Partnership
Petition: Governor Pat Quinn: Don't Cut Illinois' Medicaid Budget.
Joint Statement Supporting Home And Community Based Services
Letter From ISPC Chicago In Support Of Unite Here
Position Statement By ISPC Chicago On South Side Trauma Center
Testimony To Illinois House Special Committee On Medicaid Reform (January 13, 2011)
ISPC Position Statement On The Affordable Care Act Of 2010
ISPC Position Statement On Medicaid Managed Care And Racial Disparities In Muscular Dystrophy Survival
Action Alert: Support Illinois HB 5113
Originally drafted June 2020, updated and published April 2021
ISPC People with Disabilities Committee - Letter in Support of Home and Community-based services for Long-term Care
January 2024
Dear Medicare for All Supporters:
The People with Disabilities Committee of the Illinois Single Payer Coalition is sharing our concerns by circulating this open letter to the supporters of Medicare for All.
We have been very vocal about the need for all universal single-payer bills to include the universal support of all necessary long-term care services. To be clear, we strongly advocate for a preference for Home and Community-Based Services as the best option to serve most seniors and people with disabilities who need long-term care over institutional placement. Home Care is the preferred option for a high percentage of seniors and people with disabilities who need personal care.
We see significant differences in what the current House of Representatives bill [1] and the Senate bill [2] cover in long-term care. The Senate bill leaves out funding for most nursing home care. It gives that responsibility to state-operated Medicaid programs to fund this care. All other Medicaid services would be moved to the national Medicare for All program with this glaring exception. Medicaid does not have a good history of quality care in nursing homes. Medicaid has gaps in long-term care coverage that vary by state. We believe all long-term care needs must be included in a Medicare for All bill. We support the House bill as the one that will address all long-term care needs and that recognizes long-term care as essential health care.
Here are some reasons that our universal health care system should cover all medically necessary care.
1. Aging population: The United States has an aging population, with the number of elderly individuals projected to nearly double by 2050. There are large gaps in the provision of adequate paid home care services for people with disabilities by states. As people age, they usually require more long-term care services, such as assistance with daily living activities, home health visits, or community health care. Universal coverage for long-term care ensures that the growing elderly population and people with disabilities have access to the care they need without facing financial hardships.
2. Financial burden: Long-term care services are extremely expensive, particularly for lower-income individuals or those without sufficient insurance coverage. Many Americans have exhausted their savings to pay for long-term care services, leaving them financially vulnerable. Universal coverage mitigates this burden by ensuring that everyone has access to these services without facing exorbitant costs.
3. Improved quality of life: Long-term care services play a crucial role in supporting individuals' health and overall quality of life. By providing universal coverage you provide consumer choice to meet the diverse needs that may fall under long-term care and thus better meet individual needs. We know many people have died due to low quality of care and abuse particularly in for-profit nursing homes before and during COVID. Federal funding could be a way to better regulate and monitor these settings. We know that a significant majority of individuals support home and community services and independent living over institutions but we see the need to cover the entire spectrum of care needs.
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1. The Medicare for All Act 2023, House, H.R. 3421;
2. The Medicare for All Act 2023, Senate, S. 1655.
ISPC Resolution Opposing War
January 2024
WHEREAS Illinois Single Payer Coalition’s mission is to promote healthcare justice; and
WHEREAS, Illinois Single Payer Coalition is an organization dedicated to upholding the dignity of all humans; and
WHEREAS, Illinois Single Payer Coalition believes human beings everywhere have a right to safe environments that provide necessary human rights of food, water, clean air, housing, and healthcare; and
WHEREAS, economic violence, including sanctions, denial of workers' rights and safety, and the transfer of wealth, by any means, from the poor to the rich, kills people; and
WHEREAS, the weapons industry shares with the health insurance industry and the fossil fuel industry the sacrifice of people's health and lives in the interest of profit; and
WHEREAS, Illinois Single Payer Coalition works toward a world in which the manufacture and sale of weapons designed to kill people, individually or en masse, will be abolished; and
WHEREAS, the war in Gaza has caused death of over 24,000 human beings in 2023 as well as over countless humans wounded ; and
WHEREAS, the war in Ukraine has resulted in the injury or death of over a half a million human beings since 2022 with no end in sight; and
WHEREAS, war and economic violence are causing the displacement of millions of people, with great damage to their communities and their health; and
WHEREAS, war is a horrific assault to human life and the environments that sustain human life;
THEREFORE BE IT RESOLVED, THAT Illinois Single Payer Coalition, in solidarity with the international community, demands that the US Congress and the President immediately broker a ceasefire in Gaza
THEREFORE BE IT RESOLVED, that Illinois Single Payer Coalition, in solidarity with the international community demands that the US Congress and the President immediately broker a ceasefire in Ukraine
THEREFORE BE IT RESOLVED, that Illinois Single Payer Coalition supports the immediate cessation of the manufacture, sale, and export of all weapons
THEREFORE BE IT RESOLVED, that Illinois Single Payer Coalition demands that the US engage with the international community to provide food, water, health care, safety, and other necessities to prevent further displacement of people and to support those already displaced
BE IT FURTHER RESOLVED, that Illinois Single Payer Coalition will oppose the violence of war in all its forms.
Statement on Police Violence and Black Lives Matter
Originally drafted June 2020; updated and approved April 2021
The Illinois Single-Payer Coalition recognizes racism and police violence as a public health crisis. Police violence is a leading cause of death for young men of color. Black men in particular are 2.5 times more likely to be killed by police than white men. We were appalled, dismayed, and angered by the murders of Ahmaud Arbery, Breonna Taylor, and George Floyd last year. In Illinois, police officers killed 19-year-old Marcellis Stinnette of Waukegan and 13-year-old Adam Toledo of Little Village.
We are an organization which supports Medicare for all regardless of race or economic background. We recognize and condemn not only the racism inherent in our policing system but also in our healthcare system.
Medical apartheid, as coined by Harriet Washington, has existed in this country since white settlement. During slavery, medical care was provided infrequently and only at the inclination of the slaveowner. Black people were used for medical research and experimentation through the late 20th century. Today, medical apartheid continues with our employer and profit-based insurance system. Until Medicare eligibility age is reached at 65, Black people are more likely to not have insurance than their white counterparts. Because of this, Black people are more likely to suffer and die from preventable health conditions including diabetes, heart disease, and cancer. This inequity has worsened with the COVID crisis.
We fight and advocate for a universal single-payer system where all residents are guaranteed to have health insurance coverage from birth until death. We believe this is the first step in establishing a fair and just health system. It will eliminate the colossal barrier of cost to accessing care.
As we fight for single payer, we support those who are fighting for racial justice outside the health system. We support the restructuring of the police forces in our nation to hold police officers accountable when laws are broken and any other instances of police misconduct just as any other citizens are held accountable. Some of the funding that is used for policing communities of color can easily be diverted towards healthcare and other social services. We believe Black Lives Matter and we believe that public funds should prioritize the care – not policing – of its people.
Position Statement on House Bill 1384: Medicare for All Act of 2019
The Illinois Single-Payer Coalition is thrilled to see the introduction of House Bill 1384, the Medicare for All Act of 2019. We believe the House Bill, if enacted, would be a tremendous step forward in securing accessible, quality care to everyone living in the United States. The bill embodies the key principles of a single-payer system:
Universal coverage. Every resident of the United States is entitled to benefits.
Comprehensive services. Covered services include hospital services, primary care, specialty care, prescription drugs, mental health and substance abuse treatment, reproductive care, dental, vision, audiology, emergency services and transportation, and long-term care.
No cost-sharing. There are no co-payments, no deductibles, no premiums.
Freedom of choice. You go to the qualified provider and hospital of your choosing.
We are especially pleased with these facets of the bill:
It includes long-term care.
We believe long-term care is healthcare and any single-payer bill should cover it. The house bill prioritizes home and community-based services over institutionalization. It mandates services and supports be provided in the least restrictive environment and maximizes individual autonomy.
It excludes value-based payments.
Value-based (pay-for-performance) payments became popular with the Affordable Care Act. They reward providers for better patient outcomes, with the intention of improving outcomes. However, they have shown no improvement in patient outcomes; instead, they have resulted in discrimination towards the poor and sick and an increase in provider burnout and administrative load.
It mandates safe nurse-to-patient staffing ratios.
Good staffing ratios result in safer patient care. This is the first single-payer bill to establish mandatory minimum safe nurse-to-patient staffing ratios.
It allows the override of drug patents.
In the event a drug manufacturer will not agree to a reasonable price, the Medicare program will be able to override a patent so that another manufacturer can produce the drug at a reasonable price.
It eliminates the dominant role of investor-owned insurance companies.
Much of the bloated costs, barriers to care, and emotional stress associated with the current U.S. system for financing healthcare is due to the system-wide control exercised by private health insurance companies. They offer no value to health care or health care financing, yet they skim off vast sums from the system and impose themselves continually in the doctor-patient relationship. Eliminating their role, will make U.S. health care financing more efficient and improve health outcomes.It includes global budgets which will result in substantial savings for hospitals.
Our current system of itemized billing requires huge expenditures on billing staff and technology. Global budgets will reduce hospital operating costs and let them concentrate on delivering care.It prioritizes health equity.
The House bill requires that capital expenditures be allocated first to medically underserved and rural areas. It mandates ongoing assessments of healthcare disparities and recommendations to improve disparities.
Excellent though it is, the House bill could be improved with these changes:
Ban investor-owned facilities.
With this legislation, healthcare facilities could still be owned by for-profit entities. While the bill states that payments to providers cannot be spent on marketing, profits, union-busting, or political contributions, it is unclear how these restrictions will be monitored or enforced. We expect that investor-owned facilities, as we see in so many cases, will bend the rules and regulations to their advantage, and patient care and staff working conditions will be compromised.
Simplify and shorten the transition.
The bill outlines a two-year transition. One year after passage of the bill, Medicare is expanded to include those 55 and over and 18 and under. During this year, a Medicare Transition plan would be created with new premiums and cost-sharing subsidies dependent upon age, tobacco status, type of coverage, and income. This transition would require significant time and resources to create a plan that will exist for only one year.
The transition delays coverage for those of child-bearing age: the U.S. has egregious racial inequities in maternal and infant morbidity and mortality. We argue that everyone be included in the program from day one! We advocate for a bill that improves the Medicare program, and expands to include everyone at the same time. Everybody in, nobody out!
Position Statement on Senate Bill 1129: Medicare for All Act of 2019
The Illinois Single-Payer Coalition welcomes the introduction of Senate Bill 1129 the Medicare for All Act of 2019. We believe this bill takes important steps towards creating the kind of single-payer system we support. However, there are areas for improvement. We would:
Simplify and shorten the transition.
The bill outlines a four-year transition. Each year it decreases the age threshold at which people become eligible for Medicare (the first year, those over 55 are eligible; the second year, those over 45 are eligible, etc). A Medicare transition plan with varying premiums and cost-sharing subsidies would be created. The time and resources required to create and implement this transition could instead be spent on setting up the actual single-payer plan.
Furthermore, in the transition phase, individuals will be allowed to purchase corporate-based Medicare Advantage plans. This is worrisome. Private insurance companies are currently investing heavily in Medicare Advantage. Given the four-year transition, they would flood the market and attempt to embed themselves in the Medicare market permanently, even post-transition. Of course, that is not what we want. It is not necessary for a transition to single payer to be drawn out over four years. Original Medicare was implemented within one year in 1965.
Most importantly: the legislation will be vulnerable to repeal over the four-year period. Political opposition could smear the name of single payer before we even have it.
Ban investor-owned facilities.
With the Senate legislation, healthcare facilities could still be owned by for-profit entities. While the bill states that payments to providers cannot be spent on marketing, profits, union-busting, or political contributions, it is unclear how these restrictions will be monitored or enforced. We expect that investor-owned facilities, as we see in so many cases, will bend the rules and regulations to their advantage, and patient care and staff working conditions will be compromised.
Include institutional care.
This bill covers home and community-based services, which includes home health, caregivers, and case management. This is a huge improvement over the previous Senate bill, which did not include these services. However, long-term institutional care (i.e. nursing homes) is not covered. Institutional care would remain under state Medicaid programs. There are no care standards or funding minimums (other than to receive current federal funding) established in this bill. Institutional care is severely underfunded in many states, and as a result, poor patient care and abuse are rampant. We believe institutional care should be part of a strong federal program to secure stable funding and appropriate, standardized care.
End value-based payment systems.
Value-based (pay-for-performance) payments were introduced largely with the Affordable Care Act. They reward providers for better patient outcomes, with the intention of improving outcomes. However, they have shown no improvement in patient outcomes; instead they have resulted in discrimination towards the poor and sick and an increase in provider burnout and administrative load.
Adjust how hospitals are funded.
The bill does not include global budgets and does not separate out capital expenditures. Global budgets pay hospitals a lump sum of money on a regular basis to cover operating expenses, which eliminates extremely wasteful per-patient billing. Capital expenditures are funds used to make improvements to hospitals, such as construction projects and equipment purchases. Capital expenditures should be separate from operating expenses to prevent hospitals from becoming over-resourced or under-resourced. Hospitals should be designed to meet the needs of the community.
Eliminate cost-sharing on pharmaceuticals.
The bill includes no cost-sharing (no co-payments, premiums, nor deductibles) on covered services with the exception of some pharmaceuticals, up to a $200 maximum a year. We know that any cost-sharing will deter people from using that service. We want individuals to be able to take care of their health, including taking prescription drugs as necessary and appropriate.
2019 Community, Parent, and Neighborhood Groups Statement of Support for Chicago Teachers and Staff
It appears likely that the Chicago Public Schools (CPS) administration’s irresponsible delays in meaningful negotiations will again force the 23,000 members of the Chicago Teachers Union (CTU) out on strike. Teachers have been working without a contract since June 30 and have been negotiating in good faith with CPS for the last nine months with little progress. That is why 94 percent of teachers voted at the end of September to authorize a strike.
Seven thousand members of Service Employees International Union (SEIU) Local 73, which represents school security guards, special education assistants, engineers, and other school staff, have been working without a contract for over a year and 97 percent of members voting in July authorized a strike.
We, community, parent, and neighborhood groups throughout the city of Chicago, support the CTU's demands for lower classroom sizes; a nurse, librarian and caseworker in every school; social workers, counselors and other clinicians at professionally recommended staffing levels; sanctuary protections for students and families; creation of 75 sustainable community schools; and a fair raise for educators and paraprofessionals, who are some of the lowest paid staff in our school district.
We also support SEIU's contract proposals for higher pay, better working conditions and work schedules, and an end to the privatization of engineers that has left our school buildings filthy.
During the campaign, then candidate Lightfoot supported many of the teachers' proposals to improve our schools. But, as mayor, she has refused to put those promises in writing in a legally binding contract with our educators. We call on the Mayor to direct the CPS Board she controls to put in writing her campaign promises for more school investments and reach a fair agreement with CTU and SEIU that improves the teaching and learning conditions in our schools.
We pledge to stand in solidarity with CTU and SEIU members on the picket lines and in the streets if CPS forces them to strike.
Public Comment in Opposition to the Proposed Federal “Public Charge” Rule
November 17, 2018
The Illinois Single-Payer Coalition (ISPC) opposes the "public charge" rule.
ISPC organizes for a health care system in which every person who lives in this country is guaranteed access to high quality health care with no financial barriers or burdens; a health care system in which all of us together take care of one another, using the capacities of government of, by, and for the people to accomplish that purpose. We work to expand, not decrease, guarantees of public benefits and their use.
No human being is a "public charge." We are sisters, brothers, and siblings. Thus we say, "Everybody in, nobody out!"
No human being is self-sufficient. Attempts at self-sufficiency result not only in inefficiency, but in the abuse of other people and of the planet. Inclusiveness, sharing, and collaboration are the route to a society and a planet that will be here for our children and many generations of grandchildren.
We submit this comment in solidarity for the health and well-being of all people.
ISPC Position Statement on National Single Payer Legislation
December 4, 2017
ISPC, in order to promote the health and welfare of all people in Illinois and the US, educates and works with people and organizations in all parts of our society toward a national single-payer system for financing health care.The system we work for will be universal, equitable, not-for-profit, publicly funded, publicly administered, privately and publicly delivered, subject to strong civic and governmental oversight in its operations, and accountable to "we the people." ISPC pursues and encourages active engagement by single-payer advocates in all steps toward the achievement of these ends.In the present, such engagement includes informing ourselves and others about the two national single-payer bills, HR 676, the Expanded and Improved Medicare for All Act (first introduced in 2003), and S 1804, the Medicare for All Act of 2017, including the strengths and weaknesses of each.It includes open, respectful and forthright discussion, debate, negotiation, and advocacy around the bills as they are improved and refined.It includes working sometimes together and sometimes differently toward the vision of health care justice that we share.
Such active engagement will serve as the foundation for the public oversight and accountability necessary, once single-payer legislation is enacted, for the continuing development of a health care system that truly serves the needs of all of us.
Statement on Personal Needs Allowance (HB 2513 and SB 1405)
May 11, 2017
The Illinois Single-Payer Coalition (ISPC) Chicago supports HB 2513 and SB 1405 in the Illinois General Assembly. These bills would increase from $30 per month to $100 per month the portion of nursing home residents' social security income that would be retained by the residents for their personal use instead of going to the nursing home.
We support these bills for two reasons: reports from people who have spent time in nursing homes show us that they are needed; they are consistent with the principles and goals of the single-payer movement.
ISPC Chicago members have heard from former nursing home residents that $30 per month is inadequate to allow them to purchase essential items that the nursing homes do not include in their services, such as toiletries, clothes, and transportation for shopping and social activities. Inadequate financial resources for self-care keep residents in a vicious cycle of having to purchase over-priced items from the nursing homes, further diminishing the value of their income. This enforced poverty is an assault on residents' dignity; it damages social bonds; and it directly impairs their ability to move from institutions into the community.
By contrast, ISPC struggles for a health care system that values the dignity of each human life; and that also favors community over institutional living whenever possible, both because it is less expensive and because it's what people want.
ISPC Chicago is concerned that many Illinois nursing homes are investor-owned for-profit. We object to residents being impoverished in order to increase profits for investors. We note, further, that investor-owned institutions have an inherent conflict of interest, since they are legally required to serve the interests of their shareholders, when the goal of all health care should be to serve patients; that for-profit institutions on average provide poorer care for greater cost; and that the nursing home industry diverts millions of dollars per year from safe staffing levels, just worker compensation, high quality food, and other resident needs to lobbying elected officials for their own financial benefit.
The United States should save money on health care by passing and implementing a single-payer health care program, thus eliminating billions of dollars per year in wasteful bureaucracy and corporate profit. Meanwhile, nursing home residents who rely on social security benefits should retain $100 per month that they can use according to their own judgment, to provide for their personal needs and to transition to the setting of their choice.
ISPC Chicago Statement on a Chicago Task Force on Employment of People with Disabilities
March 9, 2017
The Illinois Single-Payer Coalition Chicago supports the Chicago City Council resolution to create a Task Force on Employment of People with Disabilities.
People with disabilities have the same desire as those without disabilities to participate fully in our communities, which in our society includes having access to paid employment.
But In 2015, according to the Bureau of Labor Statistics, only 17.5% of people with a disability were employed, compared to 65% of those without a disability.
Therefore, the Task Force should seek ways to make employment more accessible and workable for people with disabilities.
One critical aspect of doing that is to ensure that the costs of health insurance and health care do not present a barrier for either workers or employers.
To that end, we urge that the Task Force, when created, endorse Improved Medicare for all, also called single-payer health care, as an important step in facilitating employment of people with disabilities, improving the efficiency of all businesses, and expanding opportunities for entrepreneurship by people with and without disabilities.
Under this system:
Everyone who lives in the United States will be automatically enrolled in the national health plan, relieving all employers of the burden of administering health care as an employee benefit.
No small employer will have to worry about a rise in health insurance premiums due to one or two employees' or their family members' disability or serious illness.
No person will go into debt or be otherwise impoverished by out-of-pocket health care costs.
No one will have to choose to live in severe poverty in order to qualify for Medicaid and thereby avoid out-of-pocket health care costs.
Equal access to the full range of necessary health care for everyone will result in improved worker and population health.
We will greatly decrease administrative costs and improve business efficiency, allowing everyone to be covered while lowering health care spending overall.
What is good for people with disabilities, in terms of employment and access to health care, is good for our entire communities.
ISPC Position Statement on Fair Taxation and Just Fiscal Policy
October 17, 2016
Funding for a single-payer health care system under both the national bill, HR 676, the Expanded and Improved Medicare for All Act, and the state bill, HB 108, the Illinois Universal Health Care Act, includes progressive taxes.
ISPC supports progressive taxes in principle, as an efficient means of decreasing wealth inequality, which is harmful to public health and to social solidarity, and as the fairest way of funding necessary human services, including health care.
ISPC supports public financing of services through the simplest possible administrative structure, as in our proposal for national health insurance (improved and expanded Medicare for all), so that tax revenues are used for their intended purpose, not for wasteful bureaucracy, and not for enriching corporations. (Thus, under a single-payer system, most people would pay less for health care than they pay now.)
We note that universalizing services, wherever that is possible, decreases bureaucracy and total cost, and increases efficiency, quality, equity, and social solidarity. The single-payer movement has documented why this is so for health care. We believe that the same principles apply to other services such as child care, education, and transportation.
ISPC opposes privatization of public services, including Medicare, Medicaid, and the Veterans Health Administration. Privatization results in inefficient and unjust use of tax money, with higher costs for poorer quality, inequitable access to services, and transfer of wealth from those who have less to those who have more.
The ultimate goal of the single-payer movement is a national health program, with federal funding. While the federal government is not required to tie spending to revenue, the single-payer movement has generally favored funding health care through specific taxes that are transparent, easy to collect, difficult to avoid, and progressive.
Local and state governments are required to balance their budgets. We support taxing those best able to pay in order to generate sufficient revenue for health care and all human services to the extent that they are funded at the state and local level.
Based on these principals, the tax policies we support include a financial transaction tax, a graduated income tax, and closing corporate tax loopholes.
We urge that organizations and people working in all areas of social justice, including the single-payer movement, collaborate in developing policies that allocate tax money equitably and effectively, and that the social and technical infrastructure required for such policy development be a high priority.
We believe that the single-payer health care system (expanded and improved Medicare for all) that we work for is a necessary but not sufficient condition for social justice; and that it provides a useful model for pursuing social justice in other aspects of society.
Statement from ISPC Chicago to Chicago Public Schools, RE: Special Education Budget Cuts
August 11, 2016
The Illinois Singer-Payer Coalition Chicago supports full funding for the special education program for CPS students with disabilities.
We work for universal access to all necessary health care, including mental health care, as a necessary but not sufficient condition for social justice. We work for a health care system that transfers wealth from those who have the most to those who have the least.
We acknowledge that a well-designed health care system, while necessary, is not the most important factor in people's health. We believe that providing for social determinants of health, including education and living wage jobs, is an essential foundation for a just health care system.
With years of inadequate special education funding from state and federal sources, students with disabilities suffer from lack of qualified teachers and quality education. CPS has failed many special education students, leaving them unprepared for college and life. According to the Bureau of Labor Statistics, only 17.5% of people with a disability were employed in 2015, compared to 65% of people without a disability (1). Without a good education students with disabilities will not have tools to get good paying jobs.
If you make budget cuts in special education, and deprive students of qualified teachers and teachers' aides, they will fall through the cracks in the school system. Without a quality education students will not have the credentials for jobs. Because education is related to good health, their health will suffer as well.
We urge you to fund special education fully, and to do so by taxing those who can most afford to pay.
(1) http://www.bls.gov/news.release/disabl.nr0.htm; accessed 8/9/16.
Position Statement: Single Payer Health Care and Public Health Care Delivery
June 21, 2014
The Illinois Single-Payer Coalition (ISPC) supports the preservation and expansion of public health care delivery systems at every level of government – city, county, state, and federal. This includes public health and mental health clinics, public hospitals, hospitals and clinics run by state-supported universities, and the VA system.
ISPC will join in grassroots movements to support these public assets as our resources allow. We also urge all activists working on issues involving public health care delivery, including community groups and workers, to join the movement for a single-payer system. Together, we can work to create a more equitable health care system.
Our position in a nutshell:
Public health care delivery systems are essential to local access to health care.
These systems – many of which are currently being privatized, cut back, or eliminated – are unlikely to survive without a single-payer health care system.
In its values and its arguments, the single-payer movement parallels the fight to preserve and extend public health care delivery. Activists in these struggles are natural allies.
A single-payer system supports public health care delivery in three critical ways:
In a single-payer system, access to health care is a right, not a commodity available to those who can pay.
A single-payer system relies on health system planning, not market forces, to locate care where it is needed rather than where it can generate profits.
A single-payer system makes public health systems financially viable by:
Reimbursing them for patient care on the same basis as private providers (no charity care, since everyone is covered)
Controlling total health care costs, in part by eliminating the wasteful, profit-driven insurance industry.
Public health care delivery improves access to care.
Existing public health care systems serve populations that are under-served by private systems. The loss of such systems is a step backwards from universal access. Therefore, they must be preserved wherever they exist.
Under the single-payer health care system we fight for, most health care delivery will be private. However, replacing our dysfunctional system with a single-payer system doesn’t itself assure that care is accessible to everyone in the short term.
Both before and after implementation of a single-payer system, expansion of public health care facilities and providers may be the most rapid and efficient way to increase access to comprehensive, integrated care for people who don’t have it.
Supporters of public health care delivery and supporters of single-payer health care face the same opposition.
Attacks on public health care delivery and opposition to single-payer health care are intimately related.
Both are based on claims, contradicted by evidence, that market forces can provide for the common good better than the public sector can.
Both undermine the role of government in protecting and promoting the health and well-being of the people.
Both undermine organized labor.
Both undermine social solidarity.
Both promote the primacy of corporate profits over the needs of people.
Both transfer wealth from the bottom up.
Only by working together can we overcome this powerful and well-financed opposition.
Local activists and public health care workers will be key players in a single-payer system.
Under a single-payer health care system, a public or quasi-public board will be responsible for system planning. This board will be accountable to the public, and will require the active and organized participation of local communities. Existing activists’ groups and organized workers fighting to preserve public health care can contribute essential expertise to such boards.
In summary, the fight for single-payer health care is logically closely related to the fight to preserve and expand public health care delivery. Singe-payer activists, organized clients of public health care delivery systems and their communities, and organized public sector health care workers are natural allies in the struggle for health care justice.
ISPC Position Statement on the Trans Pacific Partnership
February 7, 2014
The Illinois Single-Payer Coalition opposes the Trans Pacific Partnership (TPP), and opposes granting fast track authority for its approval. The details of this free trade agreement is being negotiated in secret; we work for public process for creating policy, and for public accountability on the part of the healthcare system. The TPP has the potential, because of its extreme pro-corporate provisions (for instance, limits on governments' powers to regulate public services, requirements that provision of public services be open to private corporations), to damage public health and public health care systems; we fight to protect and improve public health. The TPP has the potential to advance the privatization of all public services; we fight for public financing of health care. The TPP would allow corporations to sue governments over loss of expected profits; we fight to subordinate profits from health care related industries to human needs.
In summary, the TPP would enhance the power of the financial interests that are responsible for the crisis in the US healthcare system, and for immeasurable suffering on the part of our people. We oppose it out of our commitment to a health care system that will promote the health and well-being of all our people.
Petition: Governor Pat Quinn: Don’t Cut Illinois’ Medicaid Budget
May 2012
Governor Pat Quinn: Don't cut Illinois' Medicaid budget. Support Medicare for All (single-payer) instead!
Illinois governor Pat Quinn proposes to cut $2.7 billion (19%) from the state's $14 billion Medicaid budget. Three million Illinois residents (almost 1 in 4) depend on Medicaid for access to health care.
By making these steep cuts, the Governor is essentially cutting off access to health care, hospice care, and prescription drugs to hundreds of thousands of Illinois residents who have no other options. He is also cutting home care for the disabled. In addition he proposes to cut Medicaid’s already low provider reimbursements by another 8%, making it more difficult for all Medicaid patients to find doctors who can afford to treat them.
Like the government in Greece, Quinn is forcing those who depend on Medicaid to suffer the results of the financial crisis caused by Wall Street's casino operators.
Instead of cutting off health care to state residents, Governor Quinn should support Illinois' Medicare for All (single-payer) bill, HB 311.It would be more efficient, provide universal coverage and cost the state far less than the current system. Punishing the poor is cruel and unnecessary. Medicare for All (single-payer) is the right thing to do.
Text of petition published on change.org:
Illinois governor Pat Quinn proposes to cut $2.7 billion (19%) from the state's $14 billion Medicaid budget. Three million Illinois residents (almost 1 in 4) depend on Medicaid for access to health care.
By making these steep cuts, the Governor is essentially cutting off access to health care, hospice care, and prescription drugs to hundreds of thousands of Illinois residents who have no other options. He is also cutting home care for the disabled. In addition he proposes to cut Medicaid’s already low provider reimbursements by another 8%, making it more difficult for all Medicaid patients to find doctors who can afford to treat them.
Like the government in Greece, Quinn is forcing those who depend on Medicaid to suffer the results of the financial crisis caused by Wall Street's casino operators.
Instead of cutting off health care to state residents, Governor Quinn should support Illinois' Medicare for All (single-payer) bill, HB 311. It would be more efficient, provide universal coverage and cost the state far less than the current system. Punishing the poor is cruel and unnecessary. Medicare for All (single-payer) is the right thing to do.
Text of suggested letter:
Dear Governor Quinn, I just signed the following petition addressed to: Governor of Illinois, Pat Quinn.
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Don't cut Illinois' Medicaid budget. Support Illinois' Medicare for All (single-payer) bill, HB 311 instead!
I am deeply dismayed at your proposed cuts to the state’s Medicaid program. Nearly 1 in 4 Illinois residents depend on Medicaid for access to health care. Your cuts would reduce or eliminate healthcare access for hundreds of thousands.
Medicaid already offers the lowest reimbursement rates of any health care funding source public or private, and now you threaten to lower them further. That’s unacceptable.
As you know the financial crisis that Illinois faces has much to do with the corruption and greed of the financial industry and nothing to do with the people whose health care access you are prepared to cut. How can you compare the value of budget balancing with the human cost of seniors, children and the disabled not getting the services they need to maintain their quality of life? Just like the political leaders in Greece, you propose to punish the people for the crimes of the rich and powerful.
Before becoming governor, you presented yourself as an ethical and progressive reformer. While I am concerned about the state’s financial distress, the ethical progressive solution is not reducing health care access for millions of Illinois residents while government officials receive full health care coverage.
The ethical progressive solution is to go outside the box and support Medicare for All (single-payer) in Illinois.
Countries that use single-payer enjoy universal coverage at a cost approximately half of what Illinois spends per capita. Medicare for All is the right thing to do.
Thank you. We look forward to your response.
Joint Statement Supporting Home and Community Based Services
On February 24, 2012, ISPC Chicago endorsed the following statement, and requested that our name be added to the signers:
JOINT STATEMENT SUPPORTING ILLINOIS HOME AND COMMUNITY BASED SERVICES
We, the undersigned, call on the Illinois Administration and the General Assembly to defend Illinois home and community based services by taking the following actions in the FY 2013 budget:
PROTECT: People with disabilities, seniors and workers have fought for decades to build programs that serve people with disabilities and seniors in the community, and have fought to raise standards for the workers who are employed by those programs. Limiting eligibility, reducing and/ or cutting services and lowering standards for workers will only damage these vital programs.
INVEST: Serve more people by spending smarter. Home and community based services are the most cost effective way to support people with disabilities and seniors in our own communities. Illinois must ensure that it spends its budget wisely by investing in Medicaid home and community based services. Illinois also needs to invest in creating affordable, accessible, integrated housing for very low-income people with disabilities and seniors.
ENFORCE: Our state must meet the requirements set forward in the three major Illinois Olmstead class action cases: Ligas, Williams, and Colbert. These cases are based on Title II of the Americans with Disabilities Act and the idea that federal dollars (i.e., Medicaid) should support people with disabilities in the least restrictive environment.
STRENGTHEN: State-funded programs such as the Home Services Program, the Community Care Program, Centers for Independent Living, the Community Reintegration Program and many others ensure that people with disabilities and seniors can live in the community, and provide jobs for thousands of workers. These programs need adequate funding and up-to-date provider payments.
We, the undersigned organizations, support the fight to protect, invest, enforce and strengthen Illinois home and community based services:
Access Living of Metropolitan Chicago
Chicago ADAPT
Illinois Network of Centers for Independent Living
SEIU Healthcare Illinois and Indiana
The SILC of Illinois
Letter from ISPC Chicago in Support of Unite Here
September 2011
Attention Dr. Robert Wah, Chairman of the Board
American Medical Association
515 N. State Street # 9
Chicago IL 60654
Dear Dr. Wah:
It has come to our attention that the American Medical Association is scheduled to hold its House of Delegates meetings at the Hyatt Regency Hotel in Chicago in June of 2012 through 2014. Based on our direct conversations with Hyatt housekeepers, and actions taken by Hyatt workers, we have made the decision to honor the Hyatt boycotts. I am writing on behalf of the Illinois Single-Payer Coalition Chicago Group, one of hundreds of boycott endorsers, to urge you and all people of conscience to do the same.
We in the single-payer movement, and in particular as members of the Illinois Single-Payer Coalition Chicago Group, will continue to struggle against the United States for-profit health insurance industry that every year causes thousands of deaths by denying health care for profit. We hope to see the American Medical Association join us in this struggle and in all struggles to put the dignity, health, and lives of people ahead of corporate profit.
As members of a wider community fighting for health care justice, and for all forms of social justice, we are deeply concerned about the plight of workers at Hyatt hotels. Hyatt housekeepers suffer physical and psychological abuse. In a recent study of fifty hotel chains, Hyatt housekeepers had the highest rate of injury, and Hispanic housekeepers had an injury rate almost twice that of white housekeepers.
Housekeepers in Chicago’s Hyatt Regency Hotel report being required to clean 16 rooms in a day, lifting one or two large and heavy mattresses per room, changing five pillowcases per bed, and vacuuming thick carpets that require a lot of time. In recently remodeled rooms, the mattresses are heavier, and furthermore the beds are larger so that attendants have inadequate space to move about. Attendants stand on tubs to change shower curtains, and slip on wet bathroom floors. Injuries to shoulders, wrists, hands, legs, and backs are common. At one point in September of 2011, twenty women at this one hotel were on light duty due to injuries.
Furthermore, workers with less seniority are periodically subject to temporary lay-offs during which they lose their health insurance. At the same time, other workers may be required to work up to four hours overtime in a day, and up to six days per week. Some housekeepers are thus denied work and benefits, including health insurance, while other housekeepers suffer from even more overwork and fatigue.
The Hyatt Corporation exemplifies the worst behavior of the major corporations of our day. Its profits are rising and its CEO received over $6 million in compensation in 2011. Meanwhile, its business strategy is to treat housekeepers—the backbone of the hotel industry—as disposable commodities. By creating jobs without adequate wages, safety, benefits, or security, Hyatt contributes to the systemic poverty of our working class communities—at the same time that the rich get richer.
In response to Hyatt’s abuse, workers are taking action. Hyatt hotels have been subject to regular picket lines, leafleting, bullhorns, and other demonstrations throughout this labor dispute. Some of our members have been on those picket lines.
We strongly urge you to move all of your business out of Hyatt.
In calling for a boycott, workers are making significant and uncomfortable sacrifices. They will lose wages and tips when businesses leave their hotels. They do this willingly in order to ensure their livelihoods in the long term. We at the Illinois Single-Payer Coalition urge you to follow their bold example by taking all steps necessary to move your business out of the Hyatt Regency Hotel in Chicago and all Hyatt hotels.
We will be sharing this letter with our network of individuals and organizations.
Sincerely,
Sonja Rotenberg, Chair
Illinois Single-Payer Coalition Chicago Group
Position Statement by ISPC Chicago on South Side Trauma Center
August 2011
On August 15, 2010, a fifteen-year-old South Side Chicago boy named Damian Turner was shot in the back, then driven ten miles by ambulance to the nearest trauma center, at Northwestern Memorial Hospital, where he was pronounced dead.
Before the closing of the University of Chicago’s trauma center in 1988, he would have been only one-half mile from care.
The not-for-profit University of Chicago Hospital gave as its reason for closing the trauma center large financial losses due to uncompensated care.
It is impossible to know whether Damian Turner would have died had the travel distance to definitive care been less by a factor of twenty. But which of us would not want that chance for one of our own children? Which of us does not want that chance for any person of any age who is injured in our city—because each person who lives among us is a part of us?
The Illinois Single-Payer Coalition works for a single-payer system of financing health care, with coverage that is universal, equitably financed, not for profit, and publicly accountable, and with comprehensive benefits and free choice of providers.
A single-payer health care system that we the people struggle for, win, and continue to support and defend will be accountable to us. This means that health care facilities will be built and maintained where they are needed, not where they can generate profits for investors, or prestige for their boards of directors and chief executives. Health care institutions will be required to serve their communities, not allowed to abandon them.
Every person will be covered under the national health plan, for all care including hospital care. Every person will be treated by the health care system as having equal value. Every institution will be equally entitled to reimbursement for care provided. There will be no such thing as uncompensated care.
The Illinois Single-Payer Coalition Chicago condemns our health care system’s abandonment of the poor, Blacks and other minorities, the disabled, the sick, the uninsured, and the underinsured. The Illinois Single-Payer Coalition Chicago condemns our health care system’s failure to take as its reason for existence the needs of the people.
We invite you to join us in working for a single-payer health care system for the state of Illinois and ultimately for our country. Go to our web site to receive periodic Action Alerts regarding access to health care on Chicago’s South Side and other issues that are part of the struggle for comprehensive universal health care:
Testimony to Illinois House Special Committee on Medicaid Reform
January 13, 2011
Written testimony presented by Anne Scheetz, MD, FACP on behalf of Physicians for a National Health Program Illinois and the Illinois Single-Payer Coalition
As I have listened to the proceedings of the University of Illinois Institute of Government and Public Affairs State Summit 2010, “Reforming Medicaid in Illinois: Managing Service Delivery and Controlling Costs,” and to those House and Senate special committee hearings that I have been able to attend, I have heard several recurring themes, among them, restoring public trust in government by eliminating fraud and abuse in the Medicaid system; controlling costs; and obtaining good value for taxpayer money.
Committee members have been assured that by privatizing Medicaid, that is, by turning over taxpayer money to private insurance companies, and forcing Medicaid recipients into HMOs, they can control Medicaid costs while improving recipients’ quality of care.
The Illinois Chapter of Physicians for a National Health Program and the Illinois Single-Payer Coalition oppose forcing patients into HMOs. We work for a health care system in which every person has access to all necessary care without financial barriers and with complete choice of hospitals, physicians, and other providers. We note that the only health care system capable of controlling costs is, paradoxically, one in which everyone has access to care, because only a universal system is able to reduce the bureaucracy that consumes at least 30% of our health care dollars.
In regard to proposals for forcing people into Medicaid HMOs, we note that evidence from the Medicare program contradicts the assurances about cost and value that the committees have received.
Medicare was enacted in 1965 as a public program under which nearly all persons in the US over age 65 are entitled to receive certain health care services on a fee for service basis. Beginning in 1972 there have been multiple forays into partial privatization. Currently, Medicare recipients are allowed to choose between the public program and private HMOs called Medicare Advantage Plans (MAPs). Insurance companies offering qualified MAPs receive capitated payments and assume full risk for covered services for their enrollees.
I will review briefly the results of partial privatization in terms of value, cost control, fraud and abuse, and public trust.
A report released by the US House of Representatives Committee on Energy and Commerce on December 9, 2009, found the following: Traditional Medicare spends 1.5% of revenues on administration and over 98% on health care. By contrast, the average MAP insurer spent 15% of premium revenue on profits, marketing, and other corporate expenses, and some insurers spent less than 75% on medical care in at least some years. MAPs spent nearly ten times as much as traditional Medicare on administrative expenses per beneficiary. MAPs that spent less than 85% of revenues on medical care paid their executives over $1.2 billion, and one company that spent 83% of revenues on medical care spent $3.1 million for two executive retreats in Hawaii. In summary, the House report found that MAPs shift taxpayer money away from medical care into administrative overhead and wasteful executive benefits.
Dr. John Geyman in his 2006 book Shredding the Social Contract: The Privatization of Medicare provides further analysis of the effects of MAPs on beneficiaries’ health and on Medicare spending (pages 103 to 106). MAPs received on average 13% more than the cost of traditional Medicare per patient. Medicare beneficiaries enrolled in MAPs were hospitalized almost 40% less than traditional Medicare patients, saving the insurance companies the cost of those hospitalizations. However, during the first year after disenrollment, those patients were hospitalized at 180% of the rate of patients who had not been enrolled in MAPs, meaning that they emerged from the MAPs in worse health and needing more costly care. The cost of necessary hospitalizations was thus shifted from the insurance companies to the Medicare program. Additionally, 54% of chronically ill Medicare patients in HMOs had declines in physical health during a four-year period compared to 28% in traditional fee for service Medicare. These are only some of the damning pieces of evidence listed in Dr. Geyman’s book; all were derived from articles published in Health Affairs and in top peer-reviewed medical journals. Furthermore, Medicare private plans engaged in both legal and illegal practices in order to enroll healthier beneficiaries and avoid sicker ones, despite their receiving excessive payments (pages 69-70). Finally, between 1999 and 2002, about one-third of MAP enrollees lost their plans when insurance companies pulled out of certain markets due to what they considered low profitability, and/or inability to enroll sufficient providers in their networks (page 76).
A 2010 study by The Medicare Rights Center (www.medicarerights.org) provides a beneficiary perspective on disenrollment from MAPs. Voluntary disenrollment occurred because of provider access problems for such services as cancer specialists, home health, and rehabilitation; misinformation and marketing abuse, including enrolling customers without their consent; coverage problems; cost sharing that was higher than expected; and data systems problems. Although the practice is illegal, some patients were disenrolled involuntarily when they received a diagnosis of cancer, through plans claiming that premiums had not been paid and refusing to rescind disenrollment even when proof of payment was presented.
To summarize, partial privatization of Medicare has resulted in the opposite of cost control, increased value, and elimination of fraud and abuse. Instead, privatized Medicare as compared with traditional public Medicare has resulted in the following: increased per beneficiary cost to Medicare; increased beneficiary out of pocket costs; higher overhead; disruption of continuity of care; decreased choice of providers; denial of services; and poorer health outcomes. Furthermore, insurance companies break the law and waste taxpayer money.
Privatized Medicaid, as I have heard it presented during these hearings, will be different in some respects from privatized Medicare. For instance, recipients who cannot access providers and other services they need, such as cancer care and rehabilitation, will not be able to switch to a public program. We do not know what will happen to these patients, but we can anticipate that their needs will not be met. On the other hand, we can anticipate that insurance companies will demand that the state pay them enough to ensure their profitability, regardless of the loss to patients and to taxpayers; if they do not get the profits they want they will withdraw, in itself an expensive process for the Medicaid program and for patients and providers. We can expect multiple disruptions of continuity of care. We can expect the insurance companies to engage in illegal practices. We can expect poorer health outcomes among Medicaid recipients.
At the same time that Physicians for a National Health Program and the Illinois Single-Payer Coalition foresee these problems for Medicaid recipients, we acknowledge that every person in the contemporary US health care system faces the risk of denial of services, disruptions of care, and financial devastation in the event of serious illness. Thus, we work for true reform of the entire US health care system in the form of Expanded and Improved Medicare for All. We urge all of you to support the Illinois single-payer bill, House Bill 311, when it is reintroduced during the next legislative session.
Thank you.
Reference: John Geyman, M.D. Shredding the Social Contract: The Privatization of Medicare. Monroe, ME: Common Courage Press, 2006.
Financial Disclosures: None. I receive no reimbursement, including expenses, for my work for PNHP and ISPC.
ISPC Position Statement on The Affordable Care Act of 2010
October 2010
ISPC Position Statement on the Affordable Care Act of 2010
Many of our allies in the single-payer movement believe that the ACA, while “not perfect” is “not bad;” and is, anyway, the best we can do right now. Some believe that “something is better than nothing,” or than “anything is better than what we have now.” Some see the chance to acquire health insurance, and the financial security they believe insurance represents, for the first time.
Why does ISPC decline to support a law that many people see as offering a lifeline to themselves, members of their families who have been unable to get insurance, and the businesses or not-for-profits that they work for?
Cost control: The law increases health care costs, and the US already has by far the most expensive health care system in the world. Health care costs ultimately come out of our pockets, whether in the form of premiums, out of pocket costs for services, or taxes. The increasing costs inevitably mean that health care becomes more and more unaffordable--that is, people cannot afford the premiums, or, after having paid the premiums they cannot afford to access care. Subsidies will inevitably not keep up with escalating costs. People will continue to go bankrupt and lose their homes because of medical expenses.
Bureaucracy: The law increases bureaucracy. This has two adverse consequences: increasing amounts of money diverted from health care to administration; and bureaucratic barriers to accessing insurance and/or care that are especially intractable for the sick, the poor, and those with limited literacy or mobility. Already, people who are eligible for Medicaid, SCHIP, and other special programs are not receiving services because they cannot navigate the systems required to sign up, or because their eligibility changes frequently. In any complex system, the most vulnerable will fall through the cracks.
Universality: The law does not and does not intend to make health insurance coverage available to everyone.
Effect on employer sponsored coverage: Although people were promised that they could keep what they have if they like it, many people will be forced to keep what they have even if they don't like it. Many others will suffer loss of employer sponsored coverage; or be subjected to increased cost sharing, and have further restrictions on physicians, hospitals, and other providers. Under this law, employers are rewarded financially for dropping coverage because the penalties for doing so are less than the cost of insurance. The percentage of people in the country who have employer sponsored coverage is declining every year, and will continue to decline under this law.
Health insurance: Some policies offered on the exchanges will have an actuarial value of only 60%. This means that the policy pays only 60% of health care costs, leaving 40% to the patient in the form of deductibles, co-insurance, co-pays, and exclusions. People will be discouraged from getting care, or will be unable to get it, because of the out of pocket costs. (It is to the benefit of insurance companies to issue insurance that people can’t afford to use, because if the insurance is not used, they don’t have to pay anything.)
Medicare: Medicare is an excellent program that has lifted many elderly people and their families out of poverty, and that provides access to care for millions of elderly people, people with disabilities, and people on dialysis. However, it is inadequate, as is inevitable for any program that a) is partially privatized, and b) segregates the sickest and most expensive patients in a risk pool separate from the healthy. Although Medicare Advantage Plans (MAP’s) will be paid less, there is nothing in the law to effectively prevent them from continuing the illegal practice of cherry-picking the healthiest seniors. (Seniors in MAP’s have lower hospital costs while they are in the plans but higher hospital costs during the year after they disenroll and return to regular Medicare--thus increasing Medicare’s costs.) Medicare pays only 80% of the cost of most services that it covers (it does not cover dental care or most long-term care, for example, and pays less for psychiatric care than for other medical care), after an annual deductible, requiring seniors to absorb these high costs out of pocket, or to buy supplemental policies that may cost more than $11,000 per year and have medical loss ratios as low as 72% compared to Medicare’s 97%. (The medical loss ratio, a term invented by the health insurance industry, is the percentage of the premium that goes to medical care as opposed to administration.) One in four seniors spent 30% of household income on medical expenses in 2003. The law does nothing to correct these problems. Furthermore, the law takes money from hospitals that care for a disproportionate share of uninsured and poor people and gives that money to insurance companies in the form of premium subsidies.
Medicaid: Medicaid could have been expanded without creating the other provisions of the law. Medicaid remains, under this law, what it has always been, a program without adequate public support that segregates the poor and the disabled and underfunds their care. People on Medicaid will continue to be forced into managed care programs that do not give them access to the care they need.
Community health centers: CHC's could have been expanded without creating the other provisions of this law. CHC's will be expanded, but will continue to suffer from the inability to provide access to many needed services, especially sub-specialty care. Some areas may not be able to acquire CHC's at all because of the lack of sub-specialty support.
Women’s reproductive health: Many women will not be able to obtain insurance coverage for abortion. This includes women in the high risk pools, who are especially vulnerable to serious complications of pregnancy.
Health insurance companies: They are the cause of our health system's failures, yet through this law they are given huge amounts of public and private money. They will spend this money on denial-management bureaucracy, lobbying of national and state legislators and regulatory bodies in order to make the law work to their advantage, shareholder profits, and inflated executive compensation.
Pharmaceutical industry: Drug prices will continue to escalate, wiping out any savings from new regulations, and subsides will be increasingly unaffordable. Patients will remain subject to formularies that may deny them access to expensive necessary drugs.
Overall effect of the bill: The law is an insurance company bail-out. Health insurance companies add zero value to the health care system, and their products are more and more unaffordable. They need subsidies in order to continue to make a profit. This bill provides the subsidies, both by handing over taxpayers' money and by forcing people to buy a product that is worth less than its cost.
Fairness: The law discriminates against the sick, who will not be able to afford the out of pocket costs associated with expensive health care. It discriminates against providers who care for the poor and the sick, who will continue to be unable to absorb the unreimbursed costs. It discriminates against women, who earn less than men and yet have higher health care costs and therefore higher out of pocket costs (equalizing premiums for women and men does not address this discrepancy). It does not even attempt to assure the full range of necessary health care services will be available in every part of the country. The poor and disabled, and undocumented residents, remain especially vulnerable to being denied care.
What does ISPC support instead of the (misnamed) Affordable Care Act?
Single-payer national health insurance, also called Improved and Expanded Medicare for All
Full public financing of health care through a progressive tax, with the healthy and the wealthy subsidizing the poor and the sick; pay according to ability and receive according to need.
Care free at the point of service.
Health insurance companies are not permitted to sell coverage duplicating that of the public plan.
Effective cost controls, including much simplified administration, negotiation of fair prices for all goods and services including drugs, rational health system planning with capital investment according to need, and global budgets for hospitals.
Increased investment in public health infrastructure.
Increased investment in primary care but with access for everyone to all necessary services from prevention to specialty and long-term care to hospice care.
National health plan card for every person, from birth to death, with no bureaucratic obstacles to access to care.
Complete choice of physicians, nurse practitioners, hospitals, pharmacies, sand other providers.
Everybody in, nobody out. One nation, one health plan.
ISPC Position Statement on Medicaid Managed Care and Racial Disparities in Muscular Dystrophy Survival
September 2010
A study, summarized below, recently published in the medical journal Neurology, finds that black people with muscular dystrophy die 10 to 12 years earlier than their white counterparts; and this discrepancy is increasing. Black people are less likely to have health insurance, and more likely to be on Medicaid.
The results of this study are of particular urgency in Illinois, where a pilot program will force disabled people with Medicaid into managed care programs. The deficiencies inherent in Medicaid, a program that segregates the poor and vulnerable, are intensified when, in addition, insurance companies are handed an incentive to deny care in order to increase their profits.
Under single-payer Improved and Expanded Medicare for All, no person of any income level would experience financial barriers to receiving all necessary medical care from providers of their choice. (Having removed financial barriers, we will have an obligation to work to dismantle all other barriers as well.)
While continuing to work for a single-payer national health program, the Illinois Single-Payer Coalition also renews our condemnation of the state of Illinois pilot program that will sacrifice our most vulnerable people to the greed of insurance companies.
PNHP
September 13, 2010
Blacks with muscular dystrophy die 10-12 years younger than whites: new study
African Americans with muscular dystrophy die 10 to 12 years younger than their white counterparts, according to research published in today’s (Tuesday, Sept. 14) issue of Neurology, the medical journal of the American Academy of Neurology.
The black-white mortality gap, which was calculated on the basis of 20 years of data, is among the largest ever observed in the annals of research into racial disparities in health care, says Dr. Nicte Mejia and Dr. Rachel Nardin, co-authors of the editorial. “Furthermore,” they write, “white patients with MD [muscular dystrophy] enjoy increasing survival, while survival of black patients with MD barely budges,” leading to an ongoing widening of that gap.
“Inequities in the health delivery system – and the multiple ways in which race constraints access to care – seem the most likely explanation for the observed MD black-white mortality gap,” Mejia and Nardin write in their editorial. But they add that inadequate access to care due to lack of good quality health insurance may also be part of the picture.
“Nonelderly African Americans are 1.5 times more likely than whites to lack any type of insurance and about twice as likely to rely on Medicaid,” they write, noting that lack of health insurance is linked to lack of access to care.
And while Medicaid, the public health program for the poor, compares favorably with private insurance in providing access to primary care, it falls short when it comes to providing access to the standard-of-care treatments needed to manage conditions like muscular dystrophy, they say.
These shortcomings of Medicaid coverage are “particularly worrisome because more than half of the new health coverage under the 2010 National Health Reform will be Medicaid.”
In a separate comment made today, Nardin said, “Replacing the current U.S. health care financing system with a single-payer system that would ensure comprehensive insurance coverage for every American, regardless of race, would go a long way toward reducing this type of disparity.”
http://www.pnhp.org/news/2010/september/blacks-with-muscular-dystrophy-d...
Neurology: Widening gap in age at muscular dystrophy–associated death between blacks and whites, 1986–2005
http://www.neurology.org/cgi/content/abstract/75/11/982
Comment: It is shameful that we have tolerated for so long a health care system that has failed to address the inequities and injustices exemplified by a widening black-white mortality gap in patients with muscular dystrophy - an inherited disorder inflicted on blameless victims.
Opponents of true reform (based on principles of health care justice) often blame the victim, implying that it is not the deficiencies in our healthcare system that are to blame, but it is the patients' own personal failures that result in their predicament, and we have no responsibility to intervene.
Even the most callous opponents of reform may acknowledge that there are exceptions in which the victims cannot be blamed, but even in those instances, the unfavorable outcome is often attributed to other socioeconomic factors over which we have no control. The "leave me out of this" mentality certainly contributes to our national inertia.
Maybe we can't fix everything that's wrong with our healthcare system and with society in general, but what we can do is reject the message of the passive obstructionists who contend that we're each on our own, and join together in solidarity to address our societal deficiencies that have permitted terrible injustices such as sentencing muscular dystrophy patients to die a decade early merely because of their personal circumstances associated with being black.
The Patient Protection and Affordable Care Act will provide many of these unfortunate individuals with access to an insurance program, Medicaid, but as a chronically underfunded welfare program, that in no way ensures access to the actual medical care that they need. Many of them are already on this program, yet it doesn't prevent them from dying a decade earlier than they might otherwise.
Although we have much to repair in this nation, a very good place to start would be to enact a health care financing system that would ensure that all of us receive the health care that we need - an improved Medicare for all. Furthermore, since collectively we are multi-tasked, we can revitalize and expand simultaneously our work on all of the other social justice issues as well.
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Action Alert: Support Illinois HB 5113
March 2010
The Illinois Single-Payer Coalition (ISPC) strongly opposes a proposal by the State of Illinois to enroll Medicaid recipients in managed care programs.
On February 8, 2009, the IL Department of Healthcare and Family Services issued a Request for Proposals seeking managed care organizations to deliver services to elderly and disabled people on Medicaid in a six-county area.
ISPC urges that this proposal be withdrawn. ISPC endorses HB 5113, which would stop this proposal.
ISPC works for single-payer Expanded and Improved Medicare for All at the state (and ultimately the national) level; that is, for a health care system that is universal, not-for-profit, publicly accountable, and equitably financed; that offers comprehensive benefits, high quality, and free choice of doctors, hospitals, and other providers; and that controls costs (in part through greatly diminished bureaucracy) so that it is sustainable. ISPC works for one nation, one health plan; for everybody in, nobody out.
ISPC opposes attempts to balance the state budget on the backs of the most vulnerable among us; and notes that in fact for-profit health care organizations have been shown to increase rather than decrease costs and yet to deliver care of lower quality.
ISPC opposes using public money that is designated for the provision of services to the vulnerable to instead enrich the for-profit health insurance industry.
ISPC opposes increasing rather than decreasing health care bureaucracy.
ISPC opposes allowing managed care companies to place restrictions on patients' access to providers of their choice.
ISPC opposes allowing companies whose fiduciary duty is to their
shareholders to be placed in the position of approving or disapproving expenditures for expensive durable medical equipment that allows people with physical disabilities to live in the community; as well as expenditures for sub-specialty care and other necessary services.
We urge single-payer activists and supporters to contact your state representative and urge her or him to work for passage of HB 5113. We urge you to contact your state senator and Governor Quinn to express your support of HB 5113.
Find out who your state representatives are here. Additional contact information for Illinois General Assembly members here, Illinois Senate here.
We urge you to discuss this legislation with your friends, neighbors, and colleagues and urge them to take action as well.
Illinois Single-Payer Coalition