Previously: Ask Nixon about Medicare for All (June 27, 2012)

Governor Jay Nixon spoke at Missouri Boys State on the campus of the University of Central Missouri in Warrensburg on Sunday, June 17, 2012. We were there. We heard his speech and the question and answer session that followed. We recorded it.

In today’s St. Louis Post-Dispatch:

Nixon: Health care stance explained at Boys State

JEFFERSON CITY • Gov. Jay Nixon has responded to Republican criticism that his position on the federal health care law has been murky, at best.

But his response still leaves some unanswered questions….

….Nixon’s office followed up by distributing audio of Nixon’s question-and-answer session with youths attending Boys State in Warrensburg — an event that took place earlier this month….

Governor Jay Nixon (D) at Missouri Boys State on the campus of the University of Central Missouri in Warrensburg on June 17, 2012.

And yes, we caught the exchange. We didn’t transcribe it at the time. So, late, here it is:

….Question: […] In your support of Obamacare what outlook do you have for health care professionals [crosstalk]…

Governor Jay Nixon: My support of what?

Question: Obamacare.

Governor Nixon: Where’d you, what, what, what, what kind of fact based? [voices: “Woo.”] I mean, where’d you get that, I, that I support that?

Question: I just assumed you were a Democrat, so. [voices: “Whoa.”]

Governor Nixon: You know, I, it, uh, I lost to a guy in the, in, in tennis from Chillicothe so I’ll assume you’re a good tennis player, too, you know. [laughter]

Um, the, uh, I don’t think that, I don’t think you should have, uh, uh, a, uh, I don’t think you should have the federal law that orders people that they have to buy insurance. I never have supported that. Uh, you know [applause], I, I, [cheers]. So, I’ll give you a second shot. Go ahead, fire away. [laughter]

Question: Okay, so what is your opinion of Obamacare and what do you think the outlook of it will have for health care officials? [crosstalk][inaudible]

Governor Nixon:  Yeah, I do think it’s, I think it comp, I think there’s a couple things. The short run it’s had some, some, some, some, some challenging effects. I mean, I think people’ve kind of frozen up, they’re not sure what’s gonna happen. And when you get, you know, o, a quarter of your economy waiting, you know, to, to, what to do next, what are the rules gonna be, I think, I think it slugs things, that slows things down. I think that’s, I think once the Supreme Court rules that, that, I think then some decisions can begin to be made.

Um, uh, clearly I think that, that some of the insurance reforms are important and needed. I think that ya, parents should have the option to con, to, to have kids on their policies much older. I don’t think you should be able to, just because you get sick an insurance company should say, [unintelligible] now it cost a hundred thousand or two or three hundred thousand we’re cutting off your insurance. I don’t think you should be able to say, uh, that, that you’re just gonna say, if you get cancer that you’re poor the rest of your life, there’s no, even if you pay for insurance for ten or fifteen or twenty years. I think there’s some really solid insurance reforms in there that are important. But I just think the states are much better positioned, because we’re much more, um, close, uh, in as far as what health care needs to be expanded. I think every kid needs to be covered. I mean, I, I, I think that, that, that, that, that while I’m interested in, kids, to say, ’cause this year I had a big fight with the legislature as they tried to cut blind health care. I mean, my golly. Um, you know, it, it’s, so, I think that kids and, and disabled folks, uh, ex, the expansions that, that’ll help them, uh, are important. Uh, I think some of the stuff that, that, that messes with the market, uh, and, and drives too much on the government side is problematic. I wish they had go, had, had gotten rid of a, a prohibition that we currently have as states that makes it impossible for us to bid, for example, for drugs, uh, you know the quantities of drugs. So, I think that, that, uh, uh, I’m not sure what the Supreme Court will do, uh, but it’ll good to get that done and us then get back to what we’re doing before, which is running these programs from the state level, uh, with, with some federal dollars coming in. But I think this, this, uh, uh. I, I think that that level of sweeping reform and, and the, and the, the constitutional principle of saying that the federal government can pass a law saying you have to buy something, I just, maybe it’s just because I’m from Missouri, but I, I don’t, I don’t like that, they, they haven’t done that before. I, I, you know, I, I think we live in a, in a, uh, in a society that should be much more, much more free. And I understand economically why, if you’re gonna sit there theoretically and say you ought to do it that, that, that folks would, would do it. But I just have never supported that. [inaudible][applause]…

“…But I just think the states are much better positioned, because we’re much more, um, close, uh, in as far as what health care needs to be expanded…”

“…this year I had a big fight with the legislature as they tried to cut blind health care. I mean, my golly…”

Game, set, match. If you don’t see the incompatibility of those two statements I’ll spell it out for you. If we have federal health care reform the Missouri General Assembly won’t be able to cut health insurance for blind people. Instead they’ll be better able to use their time erecting bronze busts of right wingnut radio jocks.

As we hear in some Democratic Party circles: “Jay Nixon is the best republican governor we’ve ever had.”

Also previously:

Missouri Boys State 2012 (June 16, 2012)

Attorney General Chris Koster at Missouri Boys State 2012 – Q and A (June 17, 2012)

Governor Jay Nixon (D) and Kansas City Mayor Sly James at Missouri Boys State 2012 (June 18, 2012)

Kansas City Mayor Sly James at Missouri Boys State 2012 (June 18, 2012)

James Carville at Missouri Boys State 2012 – photos (June 19, 2012)

James Carville at Missouri Boys State 2012 (June 19, 2012)

Organized labor has a thing or to to say to Governor Jay Nixon in support of a veto of HB 749:

The Greater Kansas City AFL-CIO is urging Governor Nixon to veto Senate Bill 749,

an attack on the rights of American workers.

Organized labor has struggled to extend and maintain workers’ rights, by fighting against many intrusive forms of legislation. One such piece of legislation, S.B. 749 is a violation of every American’s right to decide their health care. It gives employers the unchecked ability to force their own religious beliefs upon their employees. America was built on the idea that people can go to different places on Sunday, but come together on Monday. This principle has given us the freest and most productive economy in the world. Under S.B. 749, employees must check their religious freedom at the workplace door, and take their bosses’ religious beliefs home at the end of the day.

Passing this piece of legislation has seriously negative implications, which will lower the quality of life for Missouri. An employer who manages thousands of workers may refuse to cover the basic, sensible procedures, even when most or all of the employees’ religious views permit these procedures. An employer can impose one religion on all employees. This logic taken to extreme would allow employers to restrict any medical procedure. For instance, it is against the beliefs of Jehovah’s Witnesses to accept blood transfusions, and it is against the beliefs of the Church of Christ, Scientists to seek out any medical professional, using prayer as their only medicine. How would you like to have your boss tell you that they only provide prayers for your child in that case of serious illness or injury?

S.B. 749 also poses an internal conflict with other dumb legislation. For instance, House Bill 708 (anti-Sharia law) proposed this past session, would ban the application of any foreign law that does not provide identical protections to domestic law. S.B. 749 now provides governmental protection to foreign religious law in Missouri workplaces. This is not the direction we should be headed, and vetoing S.B. 749 is the only feasible solution. After all, neither the Catholic catechism nor Muslim sharia was created on American soil.

Using an employer’s religious convictions as a lens to establish health care coverage for employees is unquestionably dangerous, and illegal.  Once started on this path to restrict reproductive coverage, we will see an upsurge of employers using this law against medical coverage of any kind for their employees. Regardless of your personal beliefs about the issue of contraception and abortion, it comes down to protecting workers’ rights in our workplaces. What is done with the coverage thereafter is to each their own personal decision, but to be able to make that decision is strictly an American right. This bill is a wolf in sheep’s clothing. It threatens the religious freedoms of every Missouri employee. We urge the Governor to veto S.B. 749.

Sincerely,

Patrick A. Dujakovich

President, Greater Kansas City AFL-CIO

Yes, there’s a certain lack of ironic awareness when the republican majority in the General Assembly uses government to impose one individual’s religious belief system on others. Nah, with them it’s a feature, not a bug.

In 2010 about 20% of eligible Missouri voters went to the polls. Not surprisingly, a majority of that 20% were the foaming at the mouth Tea Partiers and other like-minded souls who were all riled up by anti-Obamacare agit-prop of organizations like Freedom Works and Americans for Prosperity (not to mention the simple fact of the first black president). One of the results of that election was that a crop of impenetrably hard-right pols were introduced into the Missouri legislature.

As a result, the real work of government has been left to patronage groups like the American Legislative Exchange Council (ALEC), which supply anti-union, anti-education, anti-environmental “model” legislation that best serves their anti-worker, anti-tax, corporate purposes. Since such corporate groups are so willing to do the hard work for them, the junior Representatives have been free to ride their favorite hobby horses into the legislative arena. Most recently we’ve seen bills to combat the non-existent threat of Sharia law and bills that the promote hard-currency schemes of paranoid gold-bugs – oh, and don’t forget the bill that would allow bullies to torment gay classmates with impunity.  

Now State Rep. Kurt Bahr (R-19) has married the desire to carry water for the corporatocracy with the 10th amendment fetishism of many of those on the right-wing fringe. Well in advance of the Supreme Court’s decision about the constitutionality of Obamacare, this former intern of U.S. Rep. Todd Akin (R-2) (says it all, doesn’t it?) has introduced HB1534 which asserts that if anybody in Missouri tries to implement the Affordable Care Act (ACA, or Obamacare), they will be subject to criminal charges. Bob Priddy at the MissouriNet Blog sums up Bahr’s position:

So let’s see if we understand Rep. Bahr. He has sworn to uphold the Constitution of the United States. The Constitution of the United States says there are three separate and co-equal branches of government, legislative, executive, and judicial. Rep. Bahr argues that a legislature in one of the 50 states can make a judicial ruling as it affects only the people of that state. (The PP&ACA is so unconstitutional that anyone implementing any part of it is a criminal.) It appears he should start getting ready to issue warrants because some parts of the Affordable Healthcare Act already are being implemented in Missouri.

Wouldn’t you know that, first-time around, the rampaging GOP nullifiers in the House passed this piece of idiocy 109-41. Details of the debate, including some very amusing audio, can be heard here. It’s worth reading (and listening to); Rep. Chris Kelly aptly sums up the Democrats’ frustration with Bahr’s thick-headed embrace of nullification, declaring that “this is breathtaking in its contempt for the Constitution of the United States.”

Bahr’s last (first? middling?) stand also works well with the goals of the mostly anonymous corporate types who finance organizations like ALEC. Ed Quillen of the Denver Post has argued that the rabid anti-Obamacare frothing of politicians like Bahr is just another facet of the attack on workers that the corporate elite is waging through their GOP proxies. Writing about why the GOP is doing little to actually promote job creation, but lots to benefit “job-creators,” he states that Republicans aren’t just stepping on the brakes because they want our Democratic president to fail:

When it comes to jobs, there’s more to the story than the normal political desire to defeat someone of the other party. Republicans like employers, those noble “job-creators” vexed by bureaucracy and regulation. They don’t like workers.

If jobs are hard to come by, then employers have more power, just as it’s a lot easier to say “take this job and shove it” if you know they’re hiring down the street. That’s another reason Republicans want to keep unemployment high.

This also helps explain the Republican resistance to universal health care. If you must rely on your employer for health insurance, that helps keep you in your place, and your employer literally has power of life and death over you.

Bahr’s spite-fueled legislative tantrum directed at the ACA may be feel-good medicine for those who are inclined to constitutional posturing, but it is also intended to insure that it is the unfettered market – that is to say, employers, and ultimately, the corporatocracy – that will have the ultimate power over our lives. Quillen correctly observes that the model that the right embraces is that of the Deep South where the Republican “oligarchs”:

… want “a compliant, poorly educated, low-wage workforce with as few labor, workplace safety, health care, and environmental regulations as possible.

Dare I mention that, when it comes to the legislative crop of 2010 we get a do-over this November?

FuseWashington.org notes that many states – at least 38 states, in fact – permit insurance companies to discriminate in pricing health care based on gender. The site offers (h/t DailyKos) a nifty little chart that shows how much more than men women in each of the 50 states pay now pay. Here in Missouri the figure is 25-50% more.

The chart also shows that after Obamacare is fully phased in in 2014, women will pay no more or no less than men – because such discrimination will be prohibited by the law of the land.

Of course that depends on whether or not the Bush appointees (both Bushes – remember who nominated Thomas) on the Supreme Court decide to go on a repeal-the-new-deal bender.  

So Rush Limbaugh thinks our Missouri Senator Claire McCaskill is a “commie babe liberal“? Lordy! Sure fooled me. I can’t speak to the “babe” epithet, but nobody’s really a “commie” nowadays. It’s passé. McCaskill might be mildly liberal, although I think that she’s been pretty careful to try to hew to the right-of-center line with only tiny detours leftwards now and then. If labels were strictly a function of policy positions, I suppose I’d be inclined to describe her as similar to that old standby, the “Rockefeller Republican” with a little feminist leavening. But these days, of course, we Democrats make do with what we can get.

To make that point even clearer, McCaskill proved that it takes a centrist to know a centrist policy when she pointed out that Obamacare is a mild-mannered and moderate plan that lines up with many GOP preferences. In McCaskill’s words it is Ryancare for the non-elderly:

“The irony of this situation is that these are private insurance companies people will shop to buy their insurance. It’s not the government,” she told KMOX of St. Louis on Wednesday. “It’s exactly what Paul Ryan wants to do for Medicare.”

TPM explains the seeming GOP cognitive dissonance about Obamacare in terms of the underlying agendas of progressives and conservatives:

McCaskill’s point is an important one that exposes the real nature of the underlying fight over how to fix health care. The progressive ideal is a single payer system, a la Medicare, but for everyone. The conservative ideal is a deregulated market-based system with a diminished federal role. The Affordable Care Act, despite the right’s protestations of socialism, is a middle ground between the two. And the insurance exchanges mirror what the Ryan plan does to Medicare – as Speaker John Boehner (R-OH) and Sen. John Cornyn (R-TX) have conceded.

These awkward admissions reveal that the broader fight is really about which direction to move vis-a-vis national health policy. Conservatives hate Obamacare because, by setting up regulated, subsidized exchanges for the public at large, it moves the existing system away from their goal of rolling back federal health care programs. Liberals hate Ryancare because, by replacing Medicare with a subsidized private insurance market, it constitutes a leap backwards from the current state of affairs.

As TPM’s Sahil Kapur implies above, no matter how big a backwards step Ryancare might represent, Obamacare still constitutes a mighty step forward for American health care overall given the nature of the previous status quo. It represents a necessary compromise in light of the rightward drift of American politics over the past couple of decades, which has created an environment in which a middle-aged, middling moderate pol can be described by a nasty-mouthed shock-jock as a “commie liberal babe.”

 

Today, at the Missouri Ethics Commission:

C000953 02/20/2012 MO REPUBLICAN PARTY RightChoice Managed Care, Inc. PO Box 68086 Cincinnati OH 45206 2/20/2012 $25,000.00

[emphasis added]

From 2011 (contributions over $5,000.00):

C000653 02/23/2011 MO INSURANCE COALITION PAC RightCHOICE Managed Care, Inc. PO Box 68086 Cincinnati OH 45206 2/23/2011 $10,000.00

C061138 04/26/2011 LEWIS & CLARK REGIONAL LEADERSHIP FUND RightCHOICE Managed Care, Inc. P.O. BOX 68086 Cincinnati OH 45206 4/26/2011 $12,000.00

C031160 06/23/2011 FRIENDS OF TILLEY RIGHTCHOICE MANAGED CARE INC PO BOX 68086 CINCINNATI OH 45206 6/22/2011 $12,500.00

C091248 06/28/2011 FRIENDS OF CALEB JONES RightCHOICE Managed Care, Inc. PO Box 68086 Cincinnati OH 45206 6/28/2011 $10,000.00

C051087 06/30/2011 CITIZENS FOR TIMOTHY W JONES RightCHOICE Managed Care Inc. Post Office Box 68086 Cinncinatti OH 45206 6/30/2011 $11,500.00

C061726 07/09/2011 DEMPSEY FOR SENATE RightChoice Managed Care Inc PO Box 68086 Cincinnati OH 45206 7/8/2011 $10,000.00

C071116 07/20/2011 FRIENDS OF CHRIS MOLENDORP RightCHOICE Managed Care, Inc. PO Box 68086 Cincinnati OH 45206 7/18/2011 $10,000.00

C031160 07/21/2011 FRIENDS OF TILLEY RightChoice Managed Care, Inc. PO Box 68086 Cincinnati OH 45206 7/21/2011 $12,500.00

C091068 07/28/2011 HOUSE REPUBLICAN CAMPAIGN COMMITTEE INC RightChoice Managed Care Inc PO Box 68086 Cinncinnati OH 45206 7/28/2011 $12,500.00

C071320 08/04/2011 SCHMITT FOR SENATE RightChoice Managed Care Inc PO Box 68086 Cincinnati OH 45206 8/4/2011 $10,000.00

[emphasis added]

Let’s look at that list:

C091248: Friends Of Caleb Jones

Po Box 5 Committee Type: Candidate

California Mo 65018 Party Affiliation: Republican

(573) 424-7452 Established Date: 10/09/2009

[emphasis added]

C051087: Citizens For Timothy W Jones

Po Box 434 Committee Type: Candidate

Eureka Mo 63025 Party Affiliation: Republican

(314) 229-0338 Established Date: 04/01/2005

[emphasis added]

C031160: Friends Of Tilley

718 Big Spring Blvd Committee Type: Candidate

Perryville Mo 63775 Party Affiliation: Republican

(573) 768-1530 Established Date: 08/19/2003

[emphasis added]

C061726: Dempsey For Senate

Two Westbury Drive Committee Type: Candidate

St Charles Mo 63301 Party Affiliation: Republican

(636) 946-2800 Established Date: 12/29/2006

[emphasis added]

C071116: Friends Of Chris Molendorp

Po Box 722 Committee Type: Candidate

Belton Mo 64012 Party Affiliation: Republican

(816) 331-9335 Established Date: 05/25/2007

[emphasis added]

C071320: Schmitt For Senate

Po Box 220722 Committee Type: Candidate

Kirkwood Mo 63122-0022 Party Affiliation: Republican

(314) 822-3808 Established Date: 10/12/2007

[emphasis added]

Why would that be?

Those who have been paying attention to facts rather than GOP rhetoric know that the Affordable Care Act (ACA), a.k.a. Obamacare, has already had a positive impact in a number of areas such as permitting parents to keep their young adult children on their existing insurance policies until they are 26, providing  affordable coverage for those with pre-existing conditions, and strengthening existing and creating new community health centers (which also, incidentally, adds jobs). The primary goal of Obamacare, however, is to  extend insurance to uninsured Americans. As the Kaiser Foundation notes, starting in 2014, it will do so in two ways:

The Affordable Care Act (ACA) includes two primary mechanisms for helping people afford health coverage. Starting in 2014, people with family incomes up to 138% of the poverty level ($31,809 for a family of four and $15,415 for a single person in 2012) will generally be eligible for the Medicaid program. And, people buying coverage on their own in new state-based health insurance exchanges will be eligible for federal tax credits to subsidize the cost of insurance. Tax credits will be calculated on a sliding scale basis for people with family income up to four times the poverty level ($92,200 for a family of four and $44,680 for a single person in 2012). …

The map below, from a new Kaiser Foundation report, shows the geographic distribution of the nonelderly Americans who stand to benefit from these twin programs:

Using the accompanying zip code based calculator provided by the Kaiser Foundation, one finds that in Poplar Bluff, Missouri 26% of the nonelderly population could benefit from these ACA programs; 20% are eligible for these programs in the Central Missouri area around Columbia. In my own relatively prosperous West St. Louis County zip code, 63011, from 8%-10% of the nonelderly population will benefit from either the Medicaid expansion or subsidized coverage available through the health care exchanges in 2014. Looks like the ACA stands to meet some serious need in much of Missouri, especially, as the map suggests, in extreme Southeastern, Northeastern and pockets in Southwestern Missouri.

Meanwhile, in the state Senate, a few die-hard anti-Obamacare zealots, like, for example, my own Senator Jane Cunningham (R-7), are standing in the way of the work that is needed to establish the insurance exchanges that the ACA mandates as the mechanism to provide low-cost, federally-regulated insurance to those who need it. They’ve stormed, raged and lied themselves blue in the face about what the ACA will do, and now they’re stalling, hoping against hope that the Supreme Court will uphold their extremist reading of the Constitution.

Bear in mind that if our intransigent lawmakers continue to stall and their trust in conservative judicial activism is not fulfilled, Missouri will not be prepared to submit a plan for an exchange by Jan. 1, 2013 – which means that the federal government will step in do the work that the state refuses to do. Given the general level of functioning that I see in Missouri governmental circles, that doesn’t seem like too much of a problem to me, but I do seem to remember that these folks are the very ones who constantly whine that the federal government can’t deal effectively with local needs.  As the News-Leader points out:

We already have a $20.8 million federal grant for the exchange. It’s not a question of money. It’s a question of political will. The Missouri House passed legislation moving the state-based exchange forward. The Missouri Senate should do the same. And Gov. Jay Nixon should be stepping out front to lead on this important issue.

Hear! Hear!

Via a pastoral letter, Archbishop Robert Carlson has formally added his name to the roster of American Catholic heavyweights who oppose the Obama administration’s new rule that would widen access to contraception. He claims he is doing so in the name of “rights of conscience.” The Missouri legislature is also jumping into the fray because “religious groups should not have to pay for birth control or abortions for their employees if that would violate their beliefs.” Specifically, GOP Senator Scott Rupp “introduced a measure Tuesday to amend the state’s constitution and forbid state laws or rules that force an individual, employer or health care provider to cover the costs of birth control or abortions.”

All this gum-flapping on the topic of “conscience” and “religious freedom” leaves me with few questions and observations:

— Does this rule force anyone to buy or use contraception?  

— Does this rule force any specifically religious organization staffed by members of the church in question to field health care plans that cover contraception?

— Does anything in the new rule, Senator Rupp, mention abortion or even drugs such as the morning after pill (RU486)?

— Are any insurance providers required to provide coverage for contraception?

The answer in all cases is emphatically no.

The new rule does, though, require that contraceptives be included in insurance plans offered by religiously-affiliated organizations with a non-religious mission that employ individuals who are not necessarily members of the affiliated churches. If such organizations do not comply, they stand to forfeit federal funds or tax credits. The argument offered by the Archbishop and by Senator Rupp is that, by offering such a health care plan, the church in question is being forced to indirectly subsidize (horror of horrors) contraception. That this reasoning is, at the very least, questionable is obvious when one considers a number of questions that it gives rise to:

— Don’t many of these religiously affiliated organizations derive income from public payments for services they render, or from the federal government? So why are the churches carrying on like they bear the brunt of paying for the health care these institutions provide their employees and, in the case of colleges and universities, students.

— The whole issue of indirect culpability is problematic. For instance, if a religiously affiliated hospital were to have saved the life of Hitler – knowing that he was was in the process of instituting the final solution – is the affiliated church indirectly responsible for Hitler’s crimes? If so, should the doctors have let Hitler die? Or, perhaps, even hasten his death? You can, doubtless come up with numerous parallel if less extreme examples. (I only mention Hitler because already some right-wing fools have predictably started comparing the new rule to the rise of the German Nazis. We can all play at rhetorical overkill.)

— How expansive should arguments about rights of conscience be? What about a religious businessman who thinks contraception is the devil’s tool and  wants his business to be granted the same religious exemption the churches are demanding in order to curtail his female employees’ access to birth control?

— To narrow the frame of reference of the question above, why are some religions and religious issues privileged over others? As Katha Politt puts it in regard to Catholic opposition:

Are Quakers, Jehovah’s Witnesses and other pacifists exempt from taxes that pay for war and weapons? Can Scientologists, who abhor psychiatry, deduct the costs of the National Institute of Mental Health?

— Should conscience rights take precedence over public welfare? Certainly, the courts don’t always think so. Consider, for instance, the Supreme Court decision that found polygamy illegal because it was successfully argued not to be in society’s interests.  

— What about the right of non-believing employees to be free from religiously motivated interference in their personal lives, “freedom from religion” if you will, which is arguably implicit in the construct “freedom of religion”?  Senator Rupp and the Archbishop would, presumably, answer that such individuals are free not to seek employment at religiously affiliated institutions. In a time of massive unemployment, most of us can readily see that this response is both callous and unrealistic, and, even from the point of view of the institutions in question, would lead to undesirable consequences.

Actually, to get an idea about why this argument fails, just turn the tables. If the issue is really one of conscience, aren’t religiously affiliated organizations free to give up the federal funds that are tied to their compliance with the rule? No fuss, no bother. One could even argue that it hardly behooves tax-exempt organizations like churches to take taxpayer dollars in the first place. Conscience does not operate in a vacuum.

— To take the question of rights one step further yet, what about the conscience rights of women to plan their families for the benefit of their children? Why should Archbishop Carlson’s Catholic conscience rights have more standing than that of an agnostic nurse in a Catholic hospital?

— If the issue is so pressing that the august leaders of the Catholic Church and GOP lawmakers have to leap in wearing their heavy stomping boots, why have religiously affiliated organizations, such as, for instance, Depaul University, Boston College and Caritas Christi Catholic hospitals in Massachusetts, been willing to offer their employees, without handwringing and undue melodrama, insurance plans that cover contraception? Several states, in fact, have enacted similar mandates:

Over half of Americans already live in the 28 states that require insurance companies cover contraception: Several of these states like North Carolina, New York, and California have identical religious employer exemptions. Some states like Colorado, Georgia and Wisconsin have no exemption at all.

— Finally, could there be hidden agendas on the part of folks like the Archbishop and Senator Rupp?

In the context of the Archbishop’s righteouos indignation, I’ll point out that according to a recent poll, conducted by the Public Religion Research Institute, 58% of Catholics support requirements that Catholic affiliated colleges, hospitals and charities offer access to birth control in their insurance plans. It is well-known that many, if not most, Catholics use birth control – 98% according to the Guttmacher Institute. If Church leaders like Archbishop Carlson cannot control their wayward flocks, why should the U.S. government be subborned into doing so via state edict?

As for Senator Rupp, maybe he smells an opportunity to make trouble for the opposition while reaping some pander points. He can ga
rner credit with sex-obsessed zealots by opposing contraception, and he can do it by making ostensibly high-minded claims about “freedom of conscience.” He has to know that the claims are weak; why else would he evoke abortion – a non-issue in the new rules, but a guaranteed alarm bell to the aforesaid zealots?

No matter how you slice it, the  self-congratulatory, high-minded dudgeon of the anti-birth control crowd ignores the welfare of real people while limiting the right of all women, all individuals actually, to make their own health choices in private.  I wouldn’t want to ask my boss if I could use birth control and I don’t think you should have to do so either.  

From MoveOn:

Wolf Blitzer: But congressman, are you saying that society should just let him die?

[voice: “Yeah”]

Congressman Ron Paul (r): No…

[voice: “Yeah”]

Susan Grigsby: What really horrified me about that debate wasn’t the, the poorly phrased question. It wasn’t Dr. Paul’s answer. And it wasn’t even the scream after Wolf Blitzer asked would you let him die and somebody in the audience yelled, yeah. That wasn’t as horrifying as was the silence from the stage from these men and women who are running for office. Not a word. Nothing. I was horrified.

That’s when I started thinking about Steve. As an adult he worked full time all the time. And when he was fifty-five he was replaced by a young man and he had to start looking for a job. At fifty-five years old, you know, you can kiss that good bye. He looked for a job, he looked for a job.

My brother Steve at sixty-three, and unemployed and uninsured was too young for Medicare and he was too male for Medicaid.

The spot was found on Steve’s lung on December third of twenty-ten. Within five months he had gone through radiation, he’d gone through some therapy, he had been warehoused, he slowly, painfully, he couldn’t stand up, the cancer went into his nerves and his spine. Five months later he died. That’s what it means to let someone die.

[What would you ask the GOP nominees if you could?]        

Do you, as a candidate for president, really believe that if an American cannot get or does not get insurance that they should be treated the way Steve was? Do you really believe that?  

[Dear GOP candidates: Answer the question.]

That was my brother’s death you were cheering, you a$$holes (September 13, 2011)

Crossposted from Antemedius

While the silence from most of US mainstream media remains deafening, the print and online news publication for physicians published by the American Medical Association – American Medical News – reported yesterday May 16 that Vermont Governor Peter Shumlin has scheduled a bill-signing ceremony for May 26 during which he will sign a bill approved by the Vermont Democratic-controlled legislature, with the state Senate voting 21-9 to pass it on May 3, and the House adopting it on May 5 with a 94-49 vote “that paves the way for the state to launch a health system approaching a single-payer model later in the decade and to create a state health insurance exchange”.

The measure creates a powerful five-member Green Mountain Care Board, members of which will determine the benefits and craft a funding plan for Green Mountain Care, a state universal health plan. The board would have wide authority over state health spending and health system reform. The bill requires the governor to nominate Green Mountain board members by Oct. 1 and the Vermont Senate to confirm them.

All Vermonters would be eligible for the plan, which would cover hospital services and prescription drugs.

Shumlin had pledged to enact a single-payer health system during his January 6 inaugural address, saying “Let Vermont be the first state in the nation to treat health care as a right and not a privilege.”

The rising cost of healthcare for Vermont’s middle class and small businesses provides an equally daunting threat to economic prosperity. Just ten years ago our little state was spending $2.5 billion a year to stay healthy. Today we spend over $5 billion. That increase represents an enormous hidden tax on families and small businesses across our state. If left untethered, the rising cost of health insurance will cripple us.

That’s why we must create a single-payer healthcare system that provides universal, affordable health insurance for all Vermonters that brings these skyrocketing costs under control. Let Vermont be the first state in the nation to treat healthcare as a right and not a privilege; removing the burden of coverage from our business community and using technology and outcomes-based medicine to contain costs. By doing so, we will save money and improve the quality of our care.

Some will say it can’t be done. The special interests; insurance companies, pharmaceutical industry, medical equipment makers; the same lobbyists that spent hundreds of millions of dollars to make sure that real reform withered in Washington can be expected to exercise their will to protect their enormous profits.

Shumlin went on in his inaugural address to make clear that the current system of private health insurance is a job killer:

Others will say reform will destroy our existing healthcare system. But logic suggests – and our experience shows – that our current system is unsustainable; that underfunded reimbursements starve our doctors and hospitals; that duplication, waste, inefficiencies and rising costs will drive more rural providers into bankruptcy and destroy our quality of care, which is the very best in the land. I ask the defenders of the current system to explain how small businesses, municipalities and taxpayers can sustain double digit premium increases year after year.

The AMN article notes that:

The measure approved by the Legislature has three major parts:

• The Green Mountain Care Board, a five-member panel appointed by the governor with Senate confirmation. The board would design the state’s universal coverage plan, develop state health care budgets, and carry out health cost containment and payment reform.
• The Vermont Health Benefit Exchange, a state marketplace for health insurance as called for under the national health system reform law. The exchange would start operating by 2014 and could become the main source of health coverage in Vermont by 2017.
• Green Mountain Care, the state’s universal coverage plan, which could launch by 2017. The state would need federal approval to use federal health funds to help finance the plan. The state is expected to adopt payroll or income taxes to help pay for the plan.

…and goes on to note that:

the bill does not meet the strict definition of a single-payer plan, in which the government is the sole third-party payer for health care. “But it is as close as we can get at the state level,” said bill sponsor [Vermont Rep. Mark] Larson.

The measure would allow private health plans to continue in the state indefinitely. “You give up a significant part of the administrative savings by doing that,” said David Himmelstein, MD, founder of Physicians for a National Health Program. The organization, based in Chicago, advocates for a single-payer health system.

A true single-payer plan should have separate operating and capital budgets, Dr. Himmelstein said. It should require a single insurance fund to pay all claims, he said.

Green Mountain Care – greenmountaincare.org – is the official State of Vermont website for health insurance. It includes plans such as Catamount Health, Vermont Health Access Plan (VHAP), Dr. Dynasaur, Medicaid, and a number of pharmacy assistance and premium assistance programs.

Plan eligibility and cost is based on household size and income. There may be a program for you, no matter how much you earn. Call 1-800-250-8427 or complete the Green Mountain Care Screening Tool to find out which plan is right for you!

Each program has different eligibility requirements. Eligibility for these programs is based on your application. You do not need to apply for a specific program. We will screen you for the health care program for which you are eligible.

Click here to learn more about eligibility, covered services, and the cost of each Green Mountain Care plan.

Vermonters who need long-term care services may qualify for financial assistance through Choices for Care – Vermont’s Long-Term Care Medicaid Program.  Click here to go to the Department for Children and Families’ website for details about the program and how to apply.

Hopefully the new Vermont plan will begin the same kind of momentum for the U.S. that led to the  development of true national single payer health care in Canada, and go a long way towards redressing the inequities Holly Dressel illuminated forcefully in a 2006 Yes Magazine article…

  Publicly funded health care has its problems, as any Canadian or Briton knows. But like democracy, it’s the best answer we’ve come up with so far.

   Should the United States implement a more inclusive, publicly funded health care system? That’s a big debate throughout the country. But even as it rages, most Americans are unaware that the United States is the only country in the developed world that doesn’t already have a fundamentally public–that is, tax-supported–health care system.

   That means that the United States has been the unwitting control subject in a 30-year, worldwide experiment comparing the merits of private versus public health care funding. For the people living in the United States, the results of this experiment with privately funded health care have been grim. The United States now has the most expensive health care system on earth and, despite remarkable technology, the general health of the U.S. population is lower than in most industrialized countries. Worse, Americans’ mortality rates–both general and infant–are shockingly high.

   …

  The United States spends far more per capita on health care than any comparable country. In fact, the gap is so enormous that a recent University of California, San Francisco, study estimates that the United States would save over $161 billion every year in paperwork alone if it switched to a singlepayer system like Canada’s. These billions of dollars are not abstract amounts deducted from government budgets; they come directly out of the pockets of people who are sick.

British Columbia is one of three of the ten Canadian Provinces that charges a monthly premium for health insurance. In the other 7 provinces there is no monthly premium – the entire program is covered from general tax revenues.

Also, in British Columbia,

there are two premium assistance programs that offer subsidies to those in financial need: regular premium assistance and temporary premium assistance.

Regular Premium Assistance

Effective  January 1, 2010, the regular premium assistance program was enhanced to  allow more British Columbians to qualify and to allow persons already receiving  a partial subsidy to qualify for a higher level of assistance.

Regular  premium assistance offers subsidies ranging from 20 to 100 per cent, based on  an individual’s net income (or a couple’s combined net income) for the  preceding tax year, less deductions for age, family size and disability. The  resulting amount is referred to as “adjusted net income”. See the Monthly Premium Rates chart below for details of premium assistance rates.

In 2004 Morton Mintz writing for The Nation put together a very long and exhaustive analysis of the economic impacts of single payer health care, stating among other things that:

Publicly financed but privately run healthcare for all–including free choice of physicians–would cost employers far less in taxes than their costs for insurance. Universal coverage could also work magic in less obvious ways. For example, employers would no longer have to pay for medical care under workers’ compensation, which in 2002 cost them more than $38 billion. Auto-insurance rates would fall for them–and everyone–if the carriers were no longer liable for medical and hospital bills. You’d think that in its own selfish interest, Corporate America would be fighting to replace the existing system with universal health coverage. Yet it doesn’t lift a finger.

[snip]

“Double-digit increases in healthcare costs are a drag on economic growth,” says Henry Simmons, president of the National Coalition on Health Care, an alliance of groups working for healthcare reform. They “slow the rate of job growth,” “suppress wage increases for current workers,” “undercut the viability of pension funds,” “put American firms at a steep disadvantage in world markets” and produce “severe long-term budgetary problems” for the federal and state governments.

Two unrelated but mutually reinforcing reports coming out on a single day, August 19, validate the economic-drag theory. First was a study that found a “relationship between job growth and health-care costs” in eighteen industries between 2000 and 2003. It was done for the Kerry campaign by Sarah Reber, assistant professor of policy studies at the University of California, Los Angeles, and Laura Tyson, dean of the London Business School and former head of President Clinton’s Council of E
conomic Advisers and National Economic Council. The evidence, the authors write, “suggests that employers have reduced hiring in response to rising health insurance premiums,” and that rising premiums have led to a deterioration in the quality of jobs. In industries where health-insurance benefits accounted for a comparatively large share of total employee compensation, job growth was slower than in industries where they accounted for a smaller one. Thus, in the accommodation and food services industry, “benefits constituted about 12 percent of total compensation for workers…and jobs grew…by about 2.5 percent. In manufacturing…the benefits share was 18.5 percent and job losses topped 18 percent.” [Emphasis in original.]

This picture was reinforced by a New York Times article based on “government data, industry surveys and interviews with employers big and small.” It said:

employers big and small…remain reluctant to hire full-time employees because health insurance, which now costs the nation’s employers an average of about $3,000 a year for each worker, has become one of the fastest-growing costs…. Health premiums are sapping corporate balance sheets even more than the rising cost of energy.

[snip]

Canada has had a single-payer system for more than thirty years. (Australia, Denmark, Finland, Iceland, Sweden and Taiwan also have one.) American executives who have run Canadian subsidiaries see it as a business boon. Take General Motors. In 2003 its costs of building a midsize car in Canada were $1,400 less than building the identical car in the United States (the comparable figures for DaimlerChrysler and Ford were $1,300 and $1,200). Such savings are no mystery. Canadian companies pay far less in taxes for health coverage for everyone than the premiums they would pay under the US system to provide their employees with comparable benefits.

Highly placed Canadian business executives affirm that single-payer nurtures free enterprise. A. Charles Baillie, while chairman and CEO of Toronto Dominion Bank, one of Canada’s six largest, hailed it in 1999 as “an economic asset, not a burden.” He told the Vancouver Board of Trade, “In an era of globalization, we need every competitive and comparative advantage we have. And the fundamentals of our health care system are one of those advantages.” He added: “The fact is, the free market…cannot work in the context of universal health care. While health care could be purchased like any other form of insurance…the risk and resource equation will always be such that, in some cases, demand will not be matched by supply. In other words, some people will always be left out.” (A recent report by the World Bank ranked welfare states like Denmark, Finland and Sweden high in international competitiveness. An author of the study said, “Social protection is good for business, it takes the burden off of businesses for health care costs.”)

In 2002, top executives of the Big Three automakers’ Canadian units joined Basil (Buzz) Hargrove, president of the Canadian Auto Workers (CAW) union, in signing a “Joint Letter on Publicly Funded Health Care.” At a press conference with Hargrove, Michael Grimaldi, president and general manager of GM Canada and a GM vice president, called single-payer “a strategic advantage for Canada.” The joint letter, also signed by Ford’s and DaimlerChrysler’s presidents and CEOs, Alain Batty and Ed Brust, said that while providing “essential and affordable healthcare services for all,” single-payer “significantly reduces total labour costs… compared to the cost of equivalent private insurance services purchased by US-based automakers” and “has been an important ingredient” in the success of Canada’s “most important export industry.”

[snip]

Corporate America is blowing a supreme opportunity to do well by doing good. Enlightened self-interest this is not.

……….

Read it all here…

Single-Payer: Good for Business

Morton Mintz, The Nation, October 28, 2004