Health Care, Essential to Democracy
by Katie Robbins and Andy Coates

Two weekends ago, after the bait and switch of a vote on single-payer for a vote on an anti-abortion amendment, we felt wizened to the possibility of unknown threats in the legislative churn on health reform. As insurance and pharmaceutical companies, Catholic bishops, and the right wing throw in dollars, lobbyists, and pressure for no votes on the final bill, it is clear we who are in the business of protecting and improving our rights to access to health care, including abortion, must remain vigilant and ready to challenge these threats.

First, a little history is in order. In mid-July Rep. Kucinich passed in the Education and Labor Committee an amendment to the House bill for health insurance reform that would make single-payer easier to enact at the state level. On July 31st Rep. Weiner and 6 other members of Energy and Commerce Committee brought to committee an amendment to that would substitute the text of HR 676, the national single-payer bill, for the House bill. Speaker Nancy Pelosi offered a floor vote on single payer — if Rep. Weiner would withdraw the amendment from committee.

Single-payer advocates embraced these efforts wholeheartedly. And we counted upon our champions in the House of Representatives to stand with us.

Vigorous activity ensued, a fourteen week campaign involving millions of people in phone calls, petitions, forums, local protests and vigils, emails and faxes, op-eds and letters-to-the-editor and personal visits. There were conscientious objectors. 158 single-payer supporters were arrested performing acts of civil disobedience, peaceful sit-ins to register their outrage in the offices of health insurance companies and Congress across the nation.

As the grassroots clamor rose, Reps. Weiner and Kucinich sought to surf the wave. The crescendo grew and grew, until one day before the House vote on health insurance reform.

And then — poof! — single payer was back off the table.

Rep. Kucinich’s state-based amendment was out of the bill, “dead as a doornail.” And Speaker Pelosi explained that the substitute amendment couldn’t possibly have a debate and vote, for if it did, amendments to restrict health care for women and undocumented immigrant workers would also get to the floor. Congressional leaders suddenly opined that a losing vote for a single-payer amendment would be “tantamount to driving the movement off a cliff.” Even the President weighed in to discourage a vote on single payer. Rep. Weiner withdrew the amendment.

Yet the next day the Speaker allowed the anti-abortion amendment to the floor, where it passed and was added to the bill. In the end, the only progressive Democrats to vote against the House bill, abortion ban and all, were Reps. Kucinich and Massa, both single-payer supporters.

The people expected universal health care, and the House of Representatives delivered an anti-abortion bill.

Worse, the Democratic Party traded away fundamental women’s rights for a Massachusetts-style mandate, a law to criminalize the uninsured and subsidize unaffordable private insurance premiums with tax money, something we know already will not reduce costs and will not cover everyone, will not lessen disparities and will not improve the health of the nation.

It is astounding to think the Democratic Party has made a bid for the United States to join a few shameful nations that severely restrict women’s access to abortion. Earlier this year we watched, with great dismay, when Mr. Obama chose not to strike the Hyde Amendment from his federal budget proposal. The President has now gone farther, re-affirming the prohibition of federal funding for abortion as a “principle.”

Reproductive rights cannot be bargained away for any reason. Autonomy over our bodies is essential to health care and to democracy.

No nation on earth can call itself a democracy without equal and full access to health care. No nation on earth can call itself a democracy without allowing full personal autonomy over all health decisions, including abortion. These values are severely threatened under the proposed legislation. It is time for protest.

As single payer advocates, we firmly believe that health care decisions must be made between the provider and the patient, with full protection of privacy. Women must be able to access abortion if determined necessary — by either the patient or the doctor.

We call upon the President and the Congress to start from scratch and ask you to join us. Senator Bernie Sanders will introduce a single payer bill in the United States Senate in the coming weeks. Demand that your Senator vote for this bill. In addition, join the National Organization for Women, strong single-payer advocates, in organizing days of action in DC and Pennsylvania to protest the Stupak-Pitts amendment.

The solution to the health care crisis must provide personal freedom from a dysfunctional and unsustainable system that ties health care to the employer and to the spouse. When Medicare was enacted, it reduced poverty in those over 65 by 60%. By this measure, a universal, single-payer system would also provide economic freedom, by raising over 22 million people out of poverty, while providing each of us with full and necessary access to health care. Nothing less will do.

Katie Robbins is National Organizer of Healthcare-NOW! Andy Coates, MD, is a member of Physicians for a National Health Program.

For more information on joining the fight to demand reproductive freedom and single-payer health care, visit:
now.org
pnhp.org
healthcare-now.org

“From the beginning of my management of Starbucks, I wanted it to be the employer of choice, the company everybody wanted to work for.  By paying more than the going wage in restaurants and retail stores, and by offering benefits that weren’t available elsewhere, I hoped that Starbucks would attract people who were well educated and eager to communicate our passion for coffee.  To my thinking, a generous benefits package was a key competitive advantage.”

The Starbucks story has been phenomenal.  The company went public in 1992 with a market capitalization of $200 million. By 2004 it was worth almost $19 billion.  Its worldwide work force grew to about 172,000 by 2007, and all of its employees in the U. S., even part-time, are offered health insurance with generous coverage.  From the beginning, the company’s consistent policy has been to offer health insurance to all employees working 20 or more hours a week (240 hours per quarter). As a result, Starbucks has had one of the most loyal work forces in American retail business, with a very low rate of attrition.

But the writing was on the wall.  In 2004, Schultz acknowledged in an interview with Business Week that the company’s biggest challenge to future growth was its health care costs, which by then were costing about $200 million a year for its 80,000 U. S. employees—more than the total it was spending on green coffee from Africa, Indonesia, and other countries. As Schultz said at the time “This is completely non-sustainable”, further noting that companies trying to do the right thing for their employees are paying for the many companies not doing so.

Today, Starbucks is hurting.  Caught in this economic downturn, it has been forced to cut thousands of jobs.  About 600 Starbucks stores in this country will be closed over the coming year, as well as most of those in Australia. This week, the company reported its first-ever quarterly loss, a net loss of $6.7 million. The company attributes its problems to the economy, increasing competition from fast-food companies such as McDonalds (not known for its health care coverage), and perhaps to its rapid expansion.

All of this is predictable. U. S. employers need a healthy work force, but can no longer afford to provide comprehensive employer-sponsored coverage (ESI). The average cost of ESI is now over $15,000 a year for a family of four, with the employer paying for about 60 percent of that and the employee picking up the rest. All of these numbers keep going up each year by three or four times the cost of living and median wages. As a result, more employers are cutting back on coverage (if provided at all), passing along more costs to their employees, and eliminating retiree coverage altogether (eg., General Motors). It is an open question how much longer employers with a social conscience, such as Starbucks and Costco, can continue to offer coverage.

Fortunately, there is a fix for this problem— single-payer national health insurance (NHI) along the lines of the Conyers bill (HR 676) in Congress with 93 co-sponsors.  Both employers and employees would pay less than they do now for better coverage.  By eliminating the waste and inefficiencies of 1,300 private insurers, NHI will save more than $300 billion a year and still guarantee coverage of all Americans. The differences in overhead between private and public financing are striking—Medicare operates as a single-payer system with an overhead of about 3 percent, compared to an average of 18 percent for commercial carriers and 26.5 percent for investor-owned Blue Cross plans.  Under HR 676 employers will pay a payroll tax of about 7.7 percent (less than their average of 8.5 percent now) while individuals will pay an income tax averaging about 2 percent for most taxpayers.

NHI will not solve all of the problems now being confronted by Starbucks and other U. S. employers, but will go a long way to level the playing field in a global economy. We can no longer afford the skyrocketing costs of private health insurance for less reliable and more skimpy coverage each year. Employers and employees alike, as well as our country, will win with NHI.

Howard Schultz has built a legendary company with a social conscience.  But the landscape and business environment is changing fast. He can add to his legacy by taking a leadership role in helping other employers to see NHI as an advantage to their future.

John Geyman is the Author of Shredding the Social Contract: The Privatization of Medicare, Common Courage Press, 2006, and Do Not Resuscitate: Why the Health Insurance Is Dying, and How We Must Replace It, Common Courage Press, 2008, Use only with permission of the Author.

Buy These Books: http://www.commoncouragepress.com/index.cfm?action=book&bookid=376