Monday, May 21, 2007

Health Policy; Phil E. Benjamin, Health Editor

Broaden our Movement


Dare to Struggle;  Dare to Win




We don't have to repeat the myriads of personal disasters;  medical outrages [100,000 dead each year due to mistakes];  and economic reality that has the US spending more on per capita health than other nations:   $6,102 vs $2,571 for median of OECD countries [ A significant amount of this money is workers' tax dollars];  and just 43 cents per capita as compared to $192 per capita in the UK on health information technology.   The US remains ranked 37th in the world in health care based on the World Health Organization.   France, a system which is fully government regulated, universal and comprehensive, remains number one. 


We all agree that we need a left-center and center-left unity strategy to successfully gain Congressional support and passage of a national health care bill that truly is universal in every aspect;  and, then to enforce and protect the legislation.


The issue is how to get there.


I use the left/center and center/left options since they will differ depending on where and when the struggle is taking place.


Also, and most importantly:


Will that left/center and center/left unity struggle be to:


A.      A struggle for a mass movement for health with HR 676 as a significant, but not the only option;


or, will that   


B.      Struggle be around HR 676 as the only option.


Most leaders of the HR 676 movement see the latter strategy, but that strategy, while gaining significant labor support, support that has influenced the AFL-CIO,  has not gained Congressional support from House [75] or Senate [0] member support.    That one dimensional approach is not working and needs to be adjusted.   This important grass roots, labor effort has the grim future of becoming another isolated, well meaning effort.


This one dimension strategy also keep activists away from other major health struggles that will be needed to bring us a national health care program. 


There are risks associated with opening up the campaign.  To open up the struggle for more than just the most advanced option, including Congresswoman Barbara Lee's National Health Service proposal, does put a more advanced position at some risk. 


But, that risk must be taken.  Dare to struggle; Dare to win.


Key Elements


While struggling for greater labor and related support for HR 676,  many other proposals are and will be put forward by members of Congress and candidates for the 2008 elections.    Here are a few of the elements that will make this process more effective.


A.               Elected Union Local and International Union Leaders


We all agree that a progressive national health legislative proposal must have labor's full support.  A divided labor movement in the post WWII period [Wagner Murray Dingle Bill];  the 1970s Kennedy/Griffiths National Health Insurance effort; and in the early 1990's, in part, killed those opportunities.


Protecting labor and workers gains of the past and into the future is crucial in gaining full labor support for the future.  


For example, while there is much bemoaning of the employment-based system, most of it very legitimate forecasts that the employment-based health insurance system is dead, is not just wrong, it is anti-labor in its essence.   It can translate into telling elected union leaders and members that their struggle at the bargaining table is useless; and, even politically backward. 


There are examples of Congressional action which has retarded union-based health programs.   The Health Insurance Portability and Accountability Act  [HIPAA] is a good example.    What started as a good idea has grown into a financial albatross on union health funds. 


The Bush Medicare Modernization Legislation, providing a deficient drug benefit, is another backward example of what Congress is capable of.   This has made elected labor leaders more wary of Congressional action on health benefits.  True, that Congress was Republican, but when push comes to shove, Democrats will not always act in the most progressive manner in regard to workers' rights. 


A step toward gaining greater labor leaders support, leaders who negotiate for health benefits and then must stand for election,  would be to start with the promise that any proposal being considered in Congress must permit labor leaders and their unions to maintain their current negotiated health plans.   


That act of faith can begin to bridge the gap between well meaning health professionals, labor activists, and others with these wary union leaders.


The beauty of Jacob Hacker's paper ["Health Care for America:  A proposalfor guaranteed health care for all Americans building on Medicare and employment-based insurance"  www.EPI.Org], done for the Economic Policy Institute, labor's economic think tank arm, discusses this element.





B.      Medicare for All


Concomitantly, to the fight for a national health care system, is the fight to radically change the Bush Drug Plan; and, a general reform of Medicare, ridding it of its 40 years of privatization schemes,  to what its framers wanted forty years ago.


There is a continuing and growing outcry against the drug monopolies, in general, and the Bush drug program in particular.  While the drug monopolies are all powerful, the power of people is even greater. 


Rekindling Reform, a center/left group in New York, with a strong left, developed an excellent position on this reform effort ["Reclaim and Strengthen Medicare:  Undo the Damage to Health Care for All"]


Engaging in these struggles  will bring millions of Medicare recipients into the struggle.


C.       Peace and Veterans


Returning veterans deserve the best health care.    The system of Veterans Hospitals and health care, labeled by many as our example of socialized medicine [Krugman, NY Times], are an example of a successful government program.   Note:  The disastrous care at Walter Reed hospital came from that hospital being a Military Hospital, not a veterans hospital. 


This will bring millions of veterans and their families into the struggle.




D.      Save Our Hospitals and Community Health Facilities:                        Stop Privatization


Across the country, state and local governments are considering drastic reductions on these health facilities.   Part of the reason is to save money; the other is to further limit the access to hospital beds, monopolizing them into closely held groups, and driving up the price of a hospital bed, the "profits" in a non-profit system.   That is taking place in the so-called voluntary, non-profit hospitals sector.   


These hospitals do need an injection of federal financial support, with strong strings attached, to make hospitals less cash cows for the private, for profit health industry.    In the late 1940s, the Hill-Burton federal financing program did just that.  


Many of these private, non-profit hospitals spending is out of control.  Multi-million dollar salaries for these hospitals CEOs and other administration have got to end.


These structural changes in our health system, at this moment, are driven by neo-liberal privatization goals of corporate think tanks and not to improve health care. 


Of course, the struggle to maintain and expand public hospitals is crucial.   Privatization of these public hospitals must stop.    Any federal finance program must place them first.  That is the lesson of the Katrina hurricane and flood disaster.   


Conducting these struggles will bring millions into the fight for national health care.


E.       End Racism and Discrimination in Health


The continuing expose' of gross disparities of health services to racially and nationally oppressed patients and people must be part of the struggle.   The Civil Rights Movements must become part of the struggle.   The current systems are not sufficiently serving everyone in a fair and indiscriminate manner.    The mere fact that life expectancy for Black males is still at 60 years old;  Black women at about 67, the same as white men; and white women is about 75 says it all.


By truly engaging on these issues will bring millions of people into the struggle. 


F.        Native American Indian Health Services


The federal health program intended to serve the Native Americans is still has wide variations on its quality and quantity.  But, in some instances, such as in Alaska, the Native American community has fought long and hard for its programs; which, it heartily supports and wants to keep.   These kinds of programs must be maintained in any national health care program.


Carefully working with the Native American communities would bring tens of thousands of people into the fight for a national health care program. 


By linking all of these struggles with a national health care program, tens of millions will join the struggle. 




It would be nice to say we are on the brink of Congressional action for a national health care program.  But, we aren't; and, that is probably a good thing.  


Congressional action, now, would yield a deficient health insurance program similar to the Massachusetts and California plans.  That is where the Wyden program stems from.


Let's broaden our struggle.


Drop the tone of:  "My Way or the Highway."


Engage with all struggles for health care, on every level.


Take our set of principles for a national health care program to the broadest number of people and let them decide.    These were described in the CPUSA's Health Commission.   


Build health coalitions based on a broader perspective as outlined above.


Then, in the not too distant future, our massive health care movement will be a position to tell Congress what want and have the strength of numbers to win.


Dare to Struggle

Date to Win




PS   As was pointed out to me, a real health program for our people would include occupational health, housing, massive public health education, environmental issues, in short, a public health program.    That is more to the Congresswoman Lee's proposal. 






Key Elements

National Health Service System

Include,  But Not Limited T:o




the elimination of profit from all aspects of health care and public health measures;


payment for all health care including true public health measures from steeply progressive taxes;


the delivery of all health care and public health services from publicly owned hospitals and community health facilities federally financed via global budgeting;


the delivery of all health care and public health services by salaried public health care providers and workers, who earn a living wage, have job security and full benefits and who have the right to organize;


the elimination of all financial barriers to access to health care;


a tiered and publicly system of governance relying on local, regional, and national elected boards;


a national system of quality assurance and guaranteed services;


a regionally based system of publicly owned health care worker education and research facilities which have no financial barriers to access and no ties to corporations.



Phil E. Benjamin, Health Editor

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