PNHP

Senate GOP health care bill estimated to kill 28,600 more in U.S. each year & drop 22M from insurance

Senate GOP health care bill estimated to kill 28,600 more in U.S. each year & drop 22M from insurance

Interview With Dr. Steffie Woolhandler

By Amy Goodman
Democracy Now!, June 27, 2017

PNHP Note: To view video of this interview, click here.

Twenty-two million Americans would lose their health insurance under the Senate Republicans’ healthcare bill over the next decade. That’s according to the Congressional Budget Office, which released its assessment on Monday. Following the report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Republican leaders had been pushing for a vote as early as today, ahead of the July 4 recess. On Monday, the American Medical Association came out against the Senate bill, writing in a letter to Senate leaders, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.” For more, we speak with Dr. Steffie Woolhandler, a professor at CUNY-Hunter College and a primary care physician. She is a lecturer at Harvard Medical School and the co-founder of Physicians for a National Health Program.

TRANSCRIPT
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Twenty-two million Americans would lose their insurance under the Senate Republicans’ healthcare bill just over the next decade. In addition, Medicaid would see a $772 billion cut over the next decade, while wealthy Americans would receive $541 billion in tax cuts. This is according to the Congressional Budget Office, which released its assessment of the Republican healthcare bill in the Senate Monday.

Following the release of the CBO report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Senator Ron Johnson of Wisconsin has suggested he, too, would oppose voting on the bill. Republican leaders had been pushing for a vote this week, ahead of the July 4th recess.

The Republican bill also faces major opposition from all Senate Democrats, a slew of governors from both parties, the majority of the healthcare industry, hospitals, doctors, nurses, patient advocacy groups, the U.S. Conference of Catholic Bishops, and even members of the far-right Koch brothers’ political network, who claim the legislation is not sufficiently conservative.

This is Vermont Senator Bernie Sanders speaking Monday on the Senate floor.

SEN. BERNIE SANDERS: Mr. President, today’s Congressional Budget Office analysis of the Trump-McConnell healthcare bill gives us 22 million reasons why this legislation should not see the light of day. What CBO tells us, in truth, is that this bill really has nothing to do with healthcare. Rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled and the poor into the pockets of the wealthiest people in this country. Mr. President, according to CBO—and that report just came out a few hours ago—this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood and substantially increase premiums for older Americans. … Mr. President, this, in fact, is a barbaric and immoral piece of legislation.

AMY GOODMAN: On Monday, the American Medical Association came out against the Senate bill. In a letter to Senate leaders, the AMA wrote, quote, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels,” unquote.

Meanwhile, a stunning new study in the Annals of Internal Medicine is estimating some 28,600 people could die early deaths if they lose health insurance.

We’re joined now by the author of the study, Dr. Steffie Woolhandler, professor at CUNY-Hunter College, primary care physician, lecturer at Harvard Medical School and co-founder of Physicians for a National Health Program.

Welcome to Democracy Now!

DR. STEFFIE WOOLHANDLER: My pleasure.

AMY GOODMAN: Tell us what you found.

DR. STEFFIE WOOLHANDLER: We reviewed the world’s scientific literature on the relationship between health insurance and mortality. And there is really now a scientific consensus that being uninsured raises the death rates. It raises your death rates by between 3 and 29 percent. And the math on that is that if you take health insurance away from 22 million people, about 29,000 of them will die every year, annually, as a result. That’s what we found by reviewing the literature. There was a similar review in New England Journal of Medicine. We punished our own study in the Annals of Internal Medicine, which is the official organ of the American College of Physicians, the nation’s largest medical specialty society. So, being uninsured raises your death rate. That is established scientific consensus. And many of the Republicans have been trying to say, “Oh, you can take away health insurance from 22 million people, and nothing will happen.” That’s simply contradicted by the scientific consensus.

AMY GOODMAN: And explain how people die as a result.

DR. STEFFIE WOOLHANDLER: Well, people might have an acute illness, like major trauma. You get hit by a car, and you have to go to the hospital. If you’re uninsured and you have major trauma, your death rates are higher. You might have an illness like breast cancer. If you’re uninsured and you have breast cancer, your death rates are higher. But mostly this has to do with that routine medical care to treat high blood pressure, to treat diabetes, before they cause complications, and to prevent those serious complications and deaths. Seems like hypertension, high blood pressure, is probably the largest single contributor to deaths among uninsured people. You need to be taking medicines to control high blood pressure to prevent strokes and heart attacks and death.

AMY GOODMAN: So this number, 22 million people will lose their health insurance over the next 10 years, and then it only goes up from there.

DR. STEFFIE WOOLHANDLER: Well, according to the Congressional Budget Office, yes, it goes up from there, because the Medicaid cuts in the Senate bill are delayed, but then they’re very, very deep. They’re even deeper over the long run than what was in the House bill. So, Medicaid is going to be cut not just for poor people, but for people in nursing homes. You know, most people in a nursing home eventually have to rely on Medicaid to pay the bill, because nursing home care takes all your money, and you have to rely on Medicaid. If you have a disabled child, you have to rely on Medicaid. If you have a relative who has serious mental illness or substance abuse, they’re going to be relying on Medicaid. So it takes money from all of these people, not just the folks who are poor now, to give this giant tax cut to the top 1 percent of taxpayers.

AMY GOODMAN: I wanted to turn to a comment made by the Idaho Republican Congressman Raúl Labrador during a town hall meeting last month. He came under fire for his answer to this question from an audience member.

AUDIENCE MEMBER: You are mandating people on Medicaid accept dying. You are making a mandate that will kill people.

REP. RAÚL LABRADOR: No, no one wants anybody to die. You know, that line is so indefensible. Nobody dies because they don’t have access to healthcare.

AMY GOODMAN: “Nobody dies because they don’t have access to healthcare.” Dr. Steffie Woolhandler?

DR. STEFFIE WOOLHANDLER: Well, Raúl Labrador said it. Senator Ted Cruz has said that. Marco Rubio has said that. Secretary Tom Price, the secretary of health and human services, has implied that, that you can be uninsured and nothing happens. That’s simply not true. The science is showing us that if you lack health insurance, you don’t get the care you need to stay healthy, and that people die earlier as a result. And I think it’s a—the Republicans recognize this is a very dangerous idea for them, that people are going to die because of their behavior. But that’s what the scientific consensus is saying.

AMY GOODMAN: So, what has to happen now?

DR. STEFFIE WOOLHANDLER: Well, right now, the betting markets are saying it’s 50/50 that this Senate bill will pass. So when something’s 50/50, that means now is the time to mobilize. You know, you can call your senator. You can call your congressman. You can demonstrate. There’s demonstrations all over the country about this bill. You can tweet about it. You can tell your friends about it. But now is the time to really get active on this issue.

We also need to be saying, “Let’s move forward to single payer, that covers everyone, not backward through this repeal.” You know, even under the Affordable Care Act, 28 million Americans have no health insurance. Many Americans are underinsured. They have insurance they can’t afford to use because of gaps in their coverage, like copayments, deductibles and uncovered services. So we need to be fighting this Republican step backward, but also saying to our Democratic legislators, “We need to be moving forward to single payer,” that will actually improve care for all Americans.

AMY GOODMAN: You were never an advocate of Obamacare. And now, what will happen? I mean, even if they don’t vote on it, the gutting of the health insurance—of health insurance today is, you know, moving full speed ahead. So what does it look like even if this bill doesn’t move forward?

DR. STEFFIE WOOLHANDLER: Well, there’s more support for the Medicare-for-all, single-payer idea than ever in history. Polls are showing 56 percent of the American people support the idea. The majority of House Democrats have endorsed the Conyers bill, HR 676, a Medicare-for-all bill. More than half of House Democrats have endorsed that bill, about 112. Senator Sanders is putting a bill into the Senate in July. So this is a great time for people to be saying, “We need to move forward from the ACA to single payer.”

AMY GOODMAN: And what would Medicare for all look like?

DR. STEFFIE WOOLHANDLER: OK.

AMY GOODMAN: How would that happen?

DR. STEFFIE WOOLHANDLER: OK, well, it would be expanded and improved Medicare for all. You would get a Medicare card the day you were born, and have it your entire life. All medically necessary care would be covered by a tax-funded Medicare-for-all program, that’s—it would be a lot cheaper over the long run, because you save so much money on administrative costs. All that billing and insurance enrollment is extremely expensive in the United States, consuming 31 percent of total U.S. health spending, according to our research that’s appeared in New England Journal of Medicine. By going to a simple single-payer system, you could save about half of it, about $500 billion a year, which you could use to get to universal healthcare and to remove copayments and deductibles from people who now have them.

So, a single—that’s what’s happened in other countries. Canada has a single-payer system—doesn’t work perfectly, but it does cover everyone. Scotland has a single-payer system. Much of Western Europe has single-payer systems. They cover everyone. They live two years longer. They pay less for healthcare than we do.

AMY GOODMAN: Well, now, this is important, because you talked about mortality, if this bill were to pass and become law, that close to 29,000 people a year could die, more Americans could die. What is our mortality rate with our insurance system compared to others?

DR. STEFFIE WOOLHANDLER: Well, Americans live two to three years shorter than people in Canada, just across the border, with very similar culture, very similar lifestyle, yet we live two years shorter. Similarly, we live about two years shorter than people in many Western European countries. And some of the studies we reviewed in our article actually look at the international evidence, which, again, is totally consistent with the idea that being uninsured is bad for your health, it can cause deaths, and that being fully covered for all medically necessary care, as would happen under Medicare for all, makes people healthier, and it prolongs their life.

AMY GOODMAN: I wanted to turn to President Trump being interviewed recently by Peter Hegseth of Fox & Friends.

PRESIDENT DONALD TRUMP: Because I want to see—I want to see—and I speak from the heart—that’s what I want to see. I want to see a bill with heart.

AMY GOODMAN: Your response?

DR. STEFFIE WOOLHANDLER: Well, Trumpcare has no heart whatsoever. The House bill was going to throw 23 million people off insurance. The Senate bill is going to throw 22 million off in 10 years but then keep throwing more off. You know, they’re going to make health insurance worse for people with private coverage by getting rid of the rules about what has to be covered, so your private insurance will no longer have to cover maternity care. They’re actually robbing money from the Medicare trust fund. They’re taking $117 billion out of the Medicare trust fund, which pays for the health insurance when people turn 65. $117 billion is taken out of that trust fund to give tax cuts to the top 1 percent of taxpayers. That is not heart. That’s the opposite of heart.

AMY GOODMAN: Well, I thank you very much for being with us, Dr. Steffie Woolhandler, professor at CUNY-Hunter College here in New York, primary care physician, lecturer at Harvard Medical School, co-founder of Physicians for a National Health Program. And we’ll link to her report on the mortality that would be related to the Republican healthcare bill becoming law. Roughly 28,600 more Americans could die per year.

https://www.democracynow.org…

Dr. Steffie Woolhandler on ‘Democracy Now!’

PNHP co-founder Dr. Steffie Woolhandler appeared on “Democracy Now!” on June 27, 2017, to discuss the deadly impact of being uninsured. She pointed to a review of studies, published in the Annals of Internal Medicine, that confirmed thousands of Americans die each year because they lack health insurance.

Insurance rescinded: People will die

H.R. 1628, Better Care Reconciliation Act of 2017

Congressional Budget Office, June 26, 2017

CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law.

Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law.

https://www.cbo.gov…

***

The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?

By Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.
Annals of Internal Medicine, June 27, 2017

Abstract

About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.

From the Discussion

The evidence accumulated since the publication of the IOM’s report in 2002 supports and strengthens its conclusion that health insurance reduces mortality. Several newer observational and quasi-experimental studies have found that uninsurance shortens survival, and a few with null results used confounded or questionable adjustments for baseline health. The results of the only recent RCT, although far from definitive, are consistent with the positive findings from cohort and quasi-experimental analyses.

Several factors complicate efforts to determine whether uninsurance increases mortality. Randomly assigning people to uninsurance is usually unethical, and quasi-experimental analyses rest on unverifiable assumptions. Deaths are rare and mortality effects may be delayed, mandating large studies with long follow-up. Many people cycle into and out of coverage, diluting the effects of insurance. And statistical adjustments for baseline health usually rely on participants’ self-reports, which may be influenced by coverage. Hence, such adjustments may under- or overadjust for differences between insured and uninsured persons.

Our focus on mortality should not obscure other well-established benefits of health insurance: improved self-rated health, financial protection, and reduced likelihood of depression. Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.

Overall, the case for coverage is strong. Even skeptics who suggest that insurance doesn’t improve outcomes seem to vote differently with their feet. As one prominent economist (Paul Krugman) recently asked, “How many of the people who write such things… choose to just not bother getting their healthcare?”

http://annals.org…

***

Comment:

By Don McCanne, M.D.

Although the precise numbers are somewhat elusive, this comprehensive review of existing studies confirms that health insurance reduces mortality. The Congressional Budget Office concludes that another 22 million people will be uninsured compared to current law if the Better Care Reconciliation Act were enacted and implemented. If this Republican repeal and replace bill becomes law, more people will die as a result.

Obviously the reduction in mortality is not the sole function of insurance. As the authors of this Annals of Internal Medicine article state, “Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.” Importantly, it also provides financial protection, which otherwise would deteriorate under the Republican proposal. (The full landmark article by Steffie Woolhandler and David Himmelstein is available for free at the link above.)

If there ever was a time to intensify the policy debate, this is it. The repeal and replace movement became popular because of the acknowledged deficiencies of the Affordable Care Act – leaving millions uninsured, millions more with inadequate financial protection, perpetuation of a dysfunctional insurance market that takes away choices, while failing to remedy the profound administrative waste that uniquely characterizes the U.S. health care financing system.

The Republicans have done us a favor by showing us that replacement policies that assume perpetuation of our fragmented infrastructure of private plans and public programs cannot remedy the profound deficiencies in our system. With six years of debate, the policies proposed do not correct the fundamental flaws in the financing infrastructure and actually would only compound the problems, including increasing mortality caused by being uninsured.

It is not as if we do not understand optimal health policy. We do. A well designed single payer national health program – an improved Medicare for all – would ensure that all of us would have the essential health care services that we need in a system that would be affordable for each of us. And, oh yes, nobody would die simply because they were uninsured.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

Insurance rescinded: People will die

H.R. 1628, Better Care Reconciliation Act of 2017

Congressional Budget Office, June 26, 2017

CBO and JCT estimate that enacting the Better Care Reconciliation Act of 2017 would reduce federal deficits by $321 billion over the coming decade and increase the number of people who are uninsured by 22 million in 2026 relative to current law.

Because nongroup insurance would pay for a smaller average share of benefits under this legislation, most people purchasing it would have higher out-of-pocket spending on health care than under current law.

https://www.cbo.gov…

***

The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?

By Steffie Woolhandler, M.D., M.P.H.; David U. Himmelstein, M.D.
Annals of Internal Medicine, June 27, 2017

Abstract

About 28 million Americans are currently uninsured, and millions more could lose coverage under policy reforms proposed in Congress. At the same time, a growing number of policy leaders have called for going beyond the Affordable Care Act to a single-payer national health insurance system that would cover every American. These policy debates lend particular salience to studies evaluating the health effects of insurance coverage. In 2002, an Institute of Medicine review concluded that lack of insurance increases mortality, but several relevant studies have appeared since that time. This article summarizes current evidence concerning the relationship of insurance and mortality. The evidence strengthens confidence in the Institute of Medicine’s conclusion that health insurance saves lives: The odds of dying among the insured relative to the uninsured is 0.71 to 0.97.

From the Discussion

The evidence accumulated since the publication of the IOM’s report in 2002 supports and strengthens its conclusion that health insurance reduces mortality. Several newer observational and quasi-experimental studies have found that uninsurance shortens survival, and a few with null results used confounded or questionable adjustments for baseline health. The results of the only recent RCT, although far from definitive, are consistent with the positive findings from cohort and quasi-experimental analyses.

Several factors complicate efforts to determine whether uninsurance increases mortality. Randomly assigning people to uninsurance is usually unethical, and quasi-experimental analyses rest on unverifiable assumptions. Deaths are rare and mortality effects may be delayed, mandating large studies with long follow-up. Many people cycle into and out of coverage, diluting the effects of insurance. And statistical adjustments for baseline health usually rely on participants’ self-reports, which may be influenced by coverage. Hence, such adjustments may under- or overadjust for differences between insured and uninsured persons.

Our focus on mortality should not obscure other well-established benefits of health insurance: improved self-rated health, financial protection, and reduced likelihood of depression. Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.

Overall, the case for coverage is strong. Even skeptics who suggest that insurance doesn’t improve outcomes seem to vote differently with their feet. As one prominent economist (Paul Krugman) recently asked, “How many of the people who write such things… choose to just not bother getting their healthcare?”

http://annals.org…

***

Comment:

By Don McCanne, M.D.

Although the precise numbers are somewhat elusive, this comprehensive review of existing studies confirms that health insurance reduces mortality. The Congressional Budget Office concludes that another 22 million people will be uninsured compared to current law if the Better Care Reconciliation Act were enacted and implemented. If this Republican repeal and replace bill becomes law, more people will die as a result.

Obviously the reduction in mortality is not the sole function of insurance. As the authors of this Annals of Internal Medicine article state, “Insurance is the gateway to medical care, whose aim is not just saving lives but also relieving human suffering.” Importantly, it also provides financial protection, which otherwise would deteriorate under the Republican proposal. (The full landmark article by Steffie Woolhandler and David Himmelstein is available for free at the link above.)

If there ever was a time to intensify the policy debate, this is it. The repeal and replace movement became popular because of the acknowledged deficiencies of the Affordable Care Act – leaving millions uninsured, millions more with inadequate financial protection, perpetuation of a dysfunctional insurance market that takes away choices, while failing to remedy the profound administrative waste that uniquely characterizes the U.S. health care financing system.

The Republicans have done us a favor by showing us that replacement policies that assume perpetuation of our fragmented infrastructure of private plans and public programs cannot remedy the profound deficiencies in our system. With six years of debate, the policies proposed do not correct the fundamental flaws in the financing infrastructure and actually would only compound the problems, including increasing mortality caused by being uninsured.

It is not as if we do not understand optimal health policy. We do. A well designed single payer national health program – an improved Medicare for all – would ensure that all of us would have the essential health care services that we need in a system that would be affordable for each of us. And, oh yes, nobody would die simply because they were uninsured.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

Senate GOP health care bill estimated to kill 28,600 more in U.S. each year & drop 22M from insurance

Interview With Dr. Steffie Woolhandler

By Amy Goodman
Democracy Now!, June 27, 2017

PNHP Note: To view video of this interview, click here.

Twenty-two million Americans would lose their health insurance under the Senate Republicans’ healthcare bill over the next decade. That’s according to the Congressional Budget Office, which released its assessment on Monday. Following the report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Republican leaders had been pushing for a vote as early as today, ahead of the July 4 recess. On Monday, the American Medical Association came out against the Senate bill, writing in a letter to Senate leaders, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels.” For more, we speak with Dr. Steffie Woolhandler, a professor at CUNY-Hunter College and a primary care physician. She is a lecturer at Harvard Medical School and the co-founder of Physicians for a National Health Program.

TRANSCRIPT
This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Twenty-two million Americans would lose their insurance under the Senate Republicans’ healthcare bill just over the next decade. In addition, Medicaid would see a $772 billion cut over the next decade, while wealthy Americans would receive $541 billion in tax cuts. This is according to the Congressional Budget Office, which released its assessment of the Republican healthcare bill in the Senate Monday.

Following the release of the CBO report, Republican Senators Susan Collins of Maine and Rand Paul of Kentucky joined Senator Dean Heller of Nevada in pledging to vote against even debating their party’s healthcare bill this week. Senator Ron Johnson of Wisconsin has suggested he, too, would oppose voting on the bill. Republican leaders had been pushing for a vote this week, ahead of the July 4th recess.

The Republican bill also faces major opposition from all Senate Democrats, a slew of governors from both parties, the majority of the healthcare industry, hospitals, doctors, nurses, patient advocacy groups, the U.S. Conference of Catholic Bishops, and even members of the far-right Koch brothers’ political network, who claim the legislation is not sufficiently conservative.

This is Vermont Senator Bernie Sanders speaking Monday on the Senate floor.

SEN. BERNIE SANDERS: Mr. President, today’s Congressional Budget Office analysis of the Trump-McConnell healthcare bill gives us 22 million reasons why this legislation should not see the light of day. What CBO tells us, in truth, is that this bill really has nothing to do with healthcare. Rather, it is an enormous transfer of wealth from the sick, the elderly, the children, the disabled and the poor into the pockets of the wealthiest people in this country. Mr. President, according to CBO—and that report just came out a few hours ago—this bill would throw 22 million Americans off of health insurance, cut Medicaid by over $770 billion, defund Planned Parenthood and substantially increase premiums for older Americans. … Mr. President, this, in fact, is a barbaric and immoral piece of legislation.

AMY GOODMAN: On Monday, the American Medical Association came out against the Senate bill. In a letter to Senate leaders, the AMA wrote, quote, “Medicine has long operated under the precept of Primum non nocere, or ‘first, do no harm.’ The draft legislation violates that standard on many levels,” unquote.

Meanwhile, a stunning new study in the Annals of Internal Medicine is estimating some 28,600 people could die early deaths if they lose health insurance.

We’re joined now by the author of the study, Dr. Steffie Woolhandler, professor at CUNY-Hunter College, primary care physician, lecturer at Harvard Medical School and co-founder of Physicians for a National Health Program.

Welcome to Democracy Now!

DR. STEFFIE WOOLHANDLER: My pleasure.

AMY GOODMAN: Tell us what you found.

DR. STEFFIE WOOLHANDLER: We reviewed the world’s scientific literature on the relationship between health insurance and mortality. And there is really now a scientific consensus that being uninsured raises the death rates. It raises your death rates by between 3 and 29 percent. And the math on that is that if you take health insurance away from 22 million people, about 29,000 of them will die every year, annually, as a result. That’s what we found by reviewing the literature. There was a similar review in New England Journal of Medicine. We punished our own study in the Annals of Internal Medicine, which is the official organ of the American College of Physicians, the nation’s largest medical specialty society. So, being uninsured raises your death rate. That is established scientific consensus. And many of the Republicans have been trying to say, “Oh, you can take away health insurance from 22 million people, and nothing will happen.” That’s simply contradicted by the scientific consensus.

AMY GOODMAN: And explain how people die as a result.

DR. STEFFIE WOOLHANDLER: Well, people might have an acute illness, like major trauma. You get hit by a car, and you have to go to the hospital. If you’re uninsured and you have major trauma, your death rates are higher. You might have an illness like breast cancer. If you’re uninsured and you have breast cancer, your death rates are higher. But mostly this has to do with that routine medical care to treat high blood pressure, to treat diabetes, before they cause complications, and to prevent those serious complications and deaths. Seems like hypertension, high blood pressure, is probably the largest single contributor to deaths among uninsured people. You need to be taking medicines to control high blood pressure to prevent strokes and heart attacks and death.

AMY GOODMAN: So this number, 22 million people will lose their health insurance over the next 10 years, and then it only goes up from there.

DR. STEFFIE WOOLHANDLER: Well, according to the Congressional Budget Office, yes, it goes up from there, because the Medicaid cuts in the Senate bill are delayed, but then they’re very, very deep. They’re even deeper over the long run than what was in the House bill. So, Medicaid is going to be cut not just for poor people, but for people in nursing homes. You know, most people in a nursing home eventually have to rely on Medicaid to pay the bill, because nursing home care takes all your money, and you have to rely on Medicaid. If you have a disabled child, you have to rely on Medicaid. If you have a relative who has serious mental illness or substance abuse, they’re going to be relying on Medicaid. So it takes money from all of these people, not just the folks who are poor now, to give this giant tax cut to the top 1 percent of taxpayers.

AMY GOODMAN: I wanted to turn to a comment made by the Idaho Republican Congressman Raúl Labrador during a town hall meeting last month. He came under fire for his answer to this question from an audience member.

AUDIENCE MEMBER: You are mandating people on Medicaid accept dying. You are making a mandate that will kill people.

REP. RAÚL LABRADOR: No, no one wants anybody to die. You know, that line is so indefensible. Nobody dies because they don’t have access to healthcare.

AMY GOODMAN: “Nobody dies because they don’t have access to healthcare.” Dr. Steffie Woolhandler?

DR. STEFFIE WOOLHANDLER: Well, Raúl Labrador said it. Senator Ted Cruz has said that. Marco Rubio has said that. Secretary Tom Price, the secretary of health and human services, has implied that, that you can be uninsured and nothing happens. That’s simply not true. The science is showing us that if you lack health insurance, you don’t get the care you need to stay healthy, and that people die earlier as a result. And I think it’s a—the Republicans recognize this is a very dangerous idea for them, that people are going to die because of their behavior. But that’s what the scientific consensus is saying.

AMY GOODMAN: So, what has to happen now?

DR. STEFFIE WOOLHANDLER: Well, right now, the betting markets are saying it’s 50/50 that this Senate bill will pass. So when something’s 50/50, that means now is the time to mobilize. You know, you can call your senator. You can call your congressman. You can demonstrate. There’s demonstrations all over the country about this bill. You can tweet about it. You can tell your friends about it. But now is the time to really get active on this issue.

We also need to be saying, “Let’s move forward to single payer, that covers everyone, not backward through this repeal.” You know, even under the Affordable Care Act, 28 million Americans have no health insurance. Many Americans are underinsured. They have insurance they can’t afford to use because of gaps in their coverage, like copayments, deductibles and uncovered services. So we need to be fighting this Republican step backward, but also saying to our Democratic legislators, “We need to be moving forward to single payer,” that will actually improve care for all Americans.

AMY GOODMAN: You were never an advocate of Obamacare. And now, what will happen? I mean, even if they don’t vote on it, the gutting of the health insurance—of health insurance today is, you know, moving full speed ahead. So what does it look like even if this bill doesn’t move forward?

DR. STEFFIE WOOLHANDLER: Well, there’s more support for the Medicare-for-all, single-payer idea than ever in history. Polls are showing 56 percent of the American people support the idea. The majority of House Democrats have endorsed the Conyers bill, HR 676, a Medicare-for-all bill. More than half of House Democrats have endorsed that bill, about 112. Senator Sanders is putting a bill into the Senate in July. So this is a great time for people to be saying, “We need to move forward from the ACA to single payer.”

AMY GOODMAN: And what would Medicare for all look like?

DR. STEFFIE WOOLHANDLER: OK.

AMY GOODMAN: How would that happen?

DR. STEFFIE WOOLHANDLER: OK, well, it would be expanded and improved Medicare for all. You would get a Medicare card the day you were born, and have it your entire life. All medically necessary care would be covered by a tax-funded Medicare-for-all program, that’s—it would be a lot cheaper over the long run, because you save so much money on administrative costs. All that billing and insurance enrollment is extremely expensive in the United States, consuming 31 percent of total U.S. health spending, according to our research that’s appeared in New England Journal of Medicine. By going to a simple single-payer system, you could save about half of it, about $500 billion a year, which you could use to get to universal healthcare and to remove copayments and deductibles from people who now have them.

So, a single—that’s what’s happened in other countries. Canada has a single-payer system—doesn’t work perfectly, but it does cover everyone. Scotland has a single-payer system. Much of Western Europe has single-payer systems. They cover everyone. They live two years longer. They pay less for healthcare than we do.

AMY GOODMAN: Well, now, this is important, because you talked about mortality, if this bill were to pass and become law, that close to 29,000 people a year could die, more Americans could die. What is our mortality rate with our insurance system compared to others?

DR. STEFFIE WOOLHANDLER: Well, Americans live two to three years shorter than people in Canada, just across the border, with very similar culture, very similar lifestyle, yet we live two years shorter. Similarly, we live about two years shorter than people in many Western European countries. And some of the studies we reviewed in our article actually look at the international evidence, which, again, is totally consistent with the idea that being uninsured is bad for your health, it can cause deaths, and that being fully covered for all medically necessary care, as would happen under Medicare for all, makes people healthier, and it prolongs their life.

AMY GOODMAN: I wanted to turn to President Trump being interviewed recently by Peter Hegseth of Fox & Friends.

PRESIDENT DONALD TRUMP: Because I want to see—I want to see—and I speak from the heart—that’s what I want to see. I want to see a bill with heart.

AMY GOODMAN: Your response?

DR. STEFFIE WOOLHANDLER: Well, Trumpcare has no heart whatsoever. The House bill was going to throw 23 million people off insurance. The Senate bill is going to throw 22 million off in 10 years but then keep throwing more off. You know, they’re going to make health insurance worse for people with private coverage by getting rid of the rules about what has to be covered, so your private insurance will no longer have to cover maternity care. They’re actually robbing money from the Medicare trust fund. They’re taking $117 billion out of the Medicare trust fund, which pays for the health insurance when people turn 65. $117 billion is taken out of that trust fund to give tax cuts to the top 1 percent of taxpayers. That is not heart. That’s the opposite of heart.

AMY GOODMAN: Well, I thank you very much for being with us, Dr. Steffie Woolhandler, professor at CUNY-Hunter College here in New York, primary care physician, lecturer at Harvard Medical School, co-founder of Physicians for a National Health Program. And we’ll link to her report on the mortality that would be related to the Republican healthcare bill becoming law. Roughly 28,600 more Americans could die per year.

https://www.democracynow.org…

Priceless benefits would come from single-payer health care system

It’s part of the same moral responsibility that Americans share for public safety and education.

By Joshua Gear, M.D.
Portland (Maine) Press Herald, June 26, 2017

As a piece of legislation intended to provide affordable, quality health care to the greatest number of Americans, the Affordable Care Act has failed miserably. Twenty million Americans remain uninsured and tens of millions more with insurance have trouble affording their co-pays or deductibles. Half a million Americans with health insurance coverage declare bankruptcy every year as a result of medical expenses.

The ACA has been a disaster for providing affordable coverage, but soon our health care system will be in worse shape. Far worse. The “death spiral” of health care coverage, stimulated by a Republican Party hell-bent on undermining any legislation promoted by Barack Obama, has accelerated.

Both the House and Senate versions of the American Health Care Act attempt to stall that death spiral, but the trade-off they offer is less coverage and a certain increase in pain, suffering and premature death to older Americans as well as those who struggle the most to pay their bills. The beneficiaries of the AHCA through tax cuts and subsidies are the super wealthy, the health insurance industry and Big Pharma.

Only weeks after championing the House version and then celebrating its passage in the Rose Garden, President Trump recognized that what House Speaker Paul Ryan, et al., had crafted was “mean” – a remarkable admission for a man who has a profound aversion for the truth.

The Senate version, crafted in secret by 13 hand-picked older white men, was finally offered up four days ago, giving the other 87 members less than a week to critique, discuss and amend before being asked to pass it. Any reasonable person would agree that this is not only unprecedented but also a dangerous way to legislate.

Though their version in many ways is even more “mean” than the House version, those 13 senators may have managed to make it more palatable by extending time lines and shuffling numbers. So it may well pass.

Regardless of how this plays out, whether we continue with the ACA or get some version of the AHCA, America in general and the poor, the elderly and the middle class in particular, will not do well in regard to having their health care needs met over the next several years.

It’s important to recognize that the United States pays nearly two times more in health care costs than any other industrialized country while having far worse outcomes on most measures of care, and still we leave over 10 percent of our citizens without access to care because of lack of insurance.

Being uninsured means being unable to treat chronic conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, schizophrenia, addictions, Crohn’s disease – and the list goes on and on. Failure to treat these chronic conditions results in pain, suffering, expensive trips to the emergency room and premature death. The financial costs are huge to the taxpayers, but they pale in comparison to the emotional costs paid by individuals and families of those with pre-existing conditions.

Call it what you will, but “single-payer” or “Medicare for all” or “socialized medicine” would guarantee quality health care for every American, and it would provide it for a fraction of the cost we pay for health care today. Why? Because a single-payer system would not be burdened by financially supporting insurance or pharmaceutical industries that take advantage of our campaign finance and lobbying laws and in doing so manage to generate enormous profits through limiting patients’ access to care or life-saving treatment.

Our elected officials, on both sides of the aisle, have become intoxicated by the money poured into their campaigns and have become dependent on that money to get re-elected. Their primary focus is to stay employed, i.e., to get re-elected, and access to quality health care by their constituents can be damned.

We guarantee our children access to a quality education through high school for good reason: It makes for a better society and a more robust economy.

And you would not deprive your neighbors a quick response from the local fire department if their house were on fire. If you did, lives could be destroyed or lost and businesses and communities decimated.

Is it any less cruel or ill-advised to deprive those same neighbors access to health care?

Our country needs an affordable, effective health care system. Plans that are not single-payer, quite simply, are motivated by greed and fueled by ignorance. And they are cruel.

There is no question that the ACA needs to be repealed and replaced. It needs to be replaced with comprehensive, universal coverage that is affordable and compassionate. Single-payer.

http://www.pressherald.com…

Dr. David Himmelstein on ‘CBS Evening News’

PNHP co-founder Dr. David Himmelstein appeared on the “CBS Evening News” on June 26, 2017, to discuss the broad scientific consensus that there is a link between a lack of health insurance and mortality. He noted, as part of a larger segment, that the uninsured tend to forego care for even the most serious medical conditions.

Dr. David Himmelstein on ‘CBS Evening News’

PNHP co-founder Dr. David Himmelstein appeared on the “CBS Evening News” on June 26, 2017, to discuss the broad scientific consensus that there is a link between a lack of health insurance and mortality. He noted, as part of a larger segment, that the uninsured tend to forego care for even the most serious medical conditions.

New Gallup and Pew surveys show concern and hope for health care

Cost of Healthcare Is Americans’ Top Financial Concern

By Andrew Dugan
Gallup, June 23, 2017

The cost of healthcare is now the top financial problem facing U.S. families. Concern about healthcare costs is at nearly the same level now as it was in 2007, a time before the recession and the passage of the ACA.

What is the most important financial problem facing your family today (open ended)?

17% – Healthcare costs
11% – Too much debt/Not enough money to pay debts
10% – Lack of money/Low wages
10% – College expenses
9% – Cost of owning/renting a home
8% – High cost of living/Inflation
Other choices 6% or less (see table at link)

http://www.gallup.com…

***

Public support for ‘single payer’ health coverage grows, driven by Democrats

By Jocelyn Kiley
Pew Research Center, June 23, 2017

A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.

Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.

Among Democrats, 52% now say health insurance should be provided through a single national insurance system run by the government, while fewer (31%) say it should be provided through a mix of private companies and government programs. The share of Democrats supporting a single national program to provide health insurance has increased 9 percentage points since January and 19 points since 2014.

Nearly two-thirds of liberal Democrats (64%) now support a single-payer health insurance system, up 13 percentage points since January.

Two-thirds of adults younger than 30 (67%) say the government has a responsibility to provide health coverage for all, with 45% saying coverage should be provided through a single national program.

Among Republicans, a greater share of those younger than 30 (39%) than those 30 and older (28%) say the government is responsible for providing health coverage for all; more young Republicans than older Republicans favor single payer (22% vs. 10%).

The share viewing this as a government responsibility has increased 9 percentage points since 2016, from 51% to 60%.

http://www.pewresearch.org…

***

Comment:

By Don McCanne, M.D.

Cost of health care is the top financial concern of Americans, and that has been increasing, now as high as it was before the Affordable Care Act was enacted. The more reassuring news is that support for a government responsibility to provide health coverage for all remains high, and preference for a single payer approach is increasing.

That increase in single payer support is greater amongst Democrats, especially liberals, and amongst adults under 30. Although the concept of single payer is less popular amongst Republicans, some do favor it.

We should take advantage of being sure that those not yet sold on single payer understand two things; 1) They are correct that the Affordable Care Act is not satisfactory because it falls far short of universality and it fails to prevent financial hardship, and thus it needs to be replaced, and 2) The six years of vacuous proposals of the Republican legislators have obliterated any hope that a solution lies within the fantasies of a free market health care nirvana. The Republican proposals acknowledge that government involvement is essential, but they propose an emasculated role – the worst kind of government, heavy with bureaucracy but placing our tax funds into the hands of entrepreneurial rent seekers.

More people are realizing that the circuitous route taken by our health care dollars wastes tremendous resources while depriving too many individuals of the health care access and financial protection that they need. Conservatives and the business community are beginning to understand this. We have to make sure that we provide the information to them that they need to have a clearer understanding of optimal health care financing policy. Not only is $3.2 trillion at stake, our health is as well.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

New Gallup and Pew surveys show concern and hope for health care

Cost of Healthcare Is Americans’ Top Financial Concern

By Andrew Dugan
Gallup, June 23, 2017

The cost of healthcare is now the top financial problem facing U.S. families. Concern about healthcare costs is at nearly the same level now as it was in 2007, a time before the recession and the passage of the ACA.

What is the most important financial problem facing your family today (open ended)?

17% – Healthcare costs
11% – Too much debt/Not enough money to pay debts
10% – Lack of money/Low wages
10% – College expenses
9% – Cost of owning/renting a home
8% – High cost of living/Inflation
Other choices 6% or less (see table at link)

http://www.gallup.com…

***

Public support for ‘single payer’ health coverage grows, driven by Democrats

By Jocelyn Kiley
Pew Research Center, June 23, 2017

A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.

Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.

Among Democrats, 52% now say health insurance should be provided through a single national insurance system run by the government, while fewer (31%) say it should be provided through a mix of private companies and government programs. The share of Democrats supporting a single national program to provide health insurance has increased 9 percentage points since January and 19 points since 2014.

Nearly two-thirds of liberal Democrats (64%) now support a single-payer health insurance system, up 13 percentage points since January.

Two-thirds of adults younger than 30 (67%) say the government has a responsibility to provide health coverage for all, with 45% saying coverage should be provided through a single national program.

Among Republicans, a greater share of those younger than 30 (39%) than those 30 and older (28%) say the government is responsible for providing health coverage for all; more young Republicans than older Republicans favor single payer (22% vs. 10%).

The share viewing this as a government responsibility has increased 9 percentage points since 2016, from 51% to 60%.

http://www.pewresearch.org…

***

Comment:

By Don McCanne, M.D.

Cost of health care is the top financial concern of Americans, and that has been increasing, now as high as it was before the Affordable Care Act was enacted. The more reassuring news is that support for a government responsibility to provide health coverage for all remains high, and preference for a single payer approach is increasing.

That increase in single payer support is greater amongst Democrats, especially liberals, and amongst adults under 30. Although the concept of single payer is less popular amongst Republicans, some do favor it.

We should take advantage of being sure that those not yet sold on single payer understand two things; 1) They are correct that the Affordable Care Act is not satisfactory because it falls far short of universality and it fails to prevent financial hardship, and thus it needs to be replaced, and 2) The six years of vacuous proposals of the Republican legislators have obliterated any hope that a solution lies within the fantasies of a free market health care nirvana. The Republican proposals acknowledge that government involvement is essential, but they propose an emasculated role – the worst kind of government, heavy with bureaucracy but placing our tax funds into the hands of entrepreneurial rent seekers.

More people are realizing that the circuitous route taken by our health care dollars wastes tremendous resources while depriving too many individuals of the health care access and financial protection that they need. Conservatives and the business community are beginning to understand this. We have to make sure that we provide the information to them that they need to have a clearer understanding of optimal health care financing policy. Not only is $3.2 trillion at stake, our health is as well.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.

Priceless benefits would come from single-payer health care system

It's part of the same moral responsibility that Americans share for public safety and education.

By Joshua Gear, M.D.
Portland (Maine) Press Herald, June 26, 2017

As a piece of legislation intended to provide affordable, quality health care to the greatest number of Americans, the Affordable Care Act has failed miserably. Twenty million Americans remain uninsured and tens of millions more with insurance have trouble affording their co-pays or deductibles. Half a million Americans with health insurance coverage declare bankruptcy every year as a result of medical expenses.

The ACA has been a disaster for providing affordable coverage, but soon our health care system will be in worse shape. Far worse. The “death spiral” of health care coverage, stimulated by a Republican Party hell-bent on undermining any legislation promoted by Barack Obama, has accelerated.

Both the House and Senate versions of the American Health Care Act attempt to stall that death spiral, but the trade-off they offer is less coverage and a certain increase in pain, suffering and premature death to older Americans as well as those who struggle the most to pay their bills. The beneficiaries of the AHCA through tax cuts and subsidies are the super wealthy, the health insurance industry and Big Pharma.

Only weeks after championing the House version and then celebrating its passage in the Rose Garden, President Trump recognized that what House Speaker Paul Ryan, et al., had crafted was “mean” – a remarkable admission for a man who has a profound aversion for the truth.

The Senate version, crafted in secret by 13 hand-picked older white men, was finally offered up four days ago, giving the other 87 members less than a week to critique, discuss and amend before being asked to pass it. Any reasonable person would agree that this is not only unprecedented but also a dangerous way to legislate.

Though their version in many ways is even more “mean” than the House version, those 13 senators may have managed to make it more palatable by extending time lines and shuffling numbers. So it may well pass.

Regardless of how this plays out, whether we continue with the ACA or get some version of the AHCA, America in general and the poor, the elderly and the middle class in particular, will not do well in regard to having their health care needs met over the next several years.

It’s important to recognize that the United States pays nearly two times more in health care costs than any other industrialized country while having far worse outcomes on most measures of care, and still we leave over 10 percent of our citizens without access to care because of lack of insurance.

Being uninsured means being unable to treat chronic conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, schizophrenia, addictions, Crohn’s disease – and the list goes on and on. Failure to treat these chronic conditions results in pain, suffering, expensive trips to the emergency room and premature death. The financial costs are huge to the taxpayers, but they pale in comparison to the emotional costs paid by individuals and families of those with pre-existing conditions.

Call it what you will, but “single-payer” or “Medicare for all” or “socialized medicine” would guarantee quality health care for every American, and it would provide it for a fraction of the cost we pay for health care today. Why? Because a single-payer system would not be burdened by financially supporting insurance or pharmaceutical industries that take advantage of our campaign finance and lobbying laws and in doing so manage to generate enormous profits through limiting patients’ access to care or life-saving treatment.

Our elected officials, on both sides of the aisle, have become intoxicated by the money poured into their campaigns and have become dependent on that money to get re-elected. Their primary focus is to stay employed, i.e., to get re-elected, and access to quality health care by their constituents can be damned.

We guarantee our children access to a quality education through high school for good reason: It makes for a better society and a more robust economy.

And you would not deprive your neighbors a quick response from the local fire department if their house were on fire. If you did, lives could be destroyed or lost and businesses and communities decimated.

Is it any less cruel or ill-advised to deprive those same neighbors access to health care?

Our country needs an affordable, effective health care system. Plans that are not single-payer, quite simply, are motivated by greed and fueled by ignorance. And they are cruel.

There is no question that the ACA needs to be repealed and replaced. It needs to be replaced with comprehensive, universal coverage that is affordable and compassionate. Single-payer.

http://www.pressherald.com…

URGENT: Steffie Woolhandler’s message on California

Speaker Anthony Rendon Statement on Health Care

California State Assembly, June 23, 2017

Yesterday, Republicans in the U.S. Senate released a cynical plan to repeal the Affordable Care Act, posing a real and immediate threat to millions of Californians who only have health coverage because of the ACA.

Preparing California to meet this threat must be the top health care priority for the Legislature, Governor Brown, and organizations that advocate for increasing access to health care.

As someone who has long been a supporter of single payer, I am encouraged by the conversation begun by Senate Bill 562.

However, SB 562 was sent to the Assembly woefully incomplete. Even senators who voted for SB 562 noted there are potentially fatal flaws in the bill, including the fact it does not address many serious issues, such as financing, delivery of care, cost controls, or the realities of needed action by the Trump Administration and voters to make SB 562 a genuine piece of legislation.

In light of this, I have decided SB 562 will remain in the Assembly Rules Committee until further notice.

The fight for single payer also is moving forward on other fronts. The head of the Campaign for a Healthy California, an organization created to pass SB 562, has acknowledged their ultimate goal is to get a single payer initiative on the ballot, and there remains ample time for them to pursue that before November 2018.

https://speaker.asmdc.org…

***

Support Grows for Single-Payer Medicare-for-All Plan Instead of Massive Cuts to Healthcare

Democracy Now!, June 23, 2017

Dr. Steffie Woolhandler: We’re seeing a lot of public support for the idea of single payer. We’re seeing a big movement for single payer at the state level in California. Obviously we’re getting a whole lot more discussion of single payer now than we’ve ever had before.

Amy Goodman: In California, it’s passed the state Senate. It’s got to go through the Assembly, and then it has to go to Governor Brown. Do you think that he will sign off on it?

Dr. Steffie Woolhandler: OK, well, we’re only going to get single payer if the populace keeps the pressure on the politicians. It’s not going to happen automatically. It’s not going to happen because Governor Brown has occasionally in the past said he likes single payer. It’s going to happen because we have a movement that’s strong enough to counter the political power of these rich people, who are getting these huge tax cuts; of the insurance industry, who would have no place in an efficiently run single-payer system; of Pharma, who thinks that they’re going to have to accept lower prices under single payer. In fact, they’re right. So that’s a lot of political power. And the only way to push through that is to really build a movement. But, you know, that really seems possible right now, with polls showing that two out of every three Americans who have an opinion on health care think we need some sort of Medicare-for-all program. So, now is really the time to be pushing this—in fact, the only way to really counter the Republican momentum at this point.

https://www.democracynow.org…

***

Comment:

By Don McCanne, M.D.

Holding SB 562, California’s single payer bill, in the Assembly Rules Committee would mean that no further action would take place on it this year. The Republican ACA repeal bill before Congress is no excuse to block California’s progress on single payer, especially since the repeal bill likely will be defeated within a week or so. The fact that SB 562 needs more work is an even greater reason to move forward with it, not to abandon the effort.

Steffie Woolhandler was interviewed on Democracy Now! yesterday just before California Assembly Speaker Anthony Rendon released his statement announcing that he was putting a hold on the single payer bill. Although she was not aware of his decision, her words seem prescient.

Her pronouncement applies not just to California but to the entire nation. We must make every effort, not simply to keep the single payer momentum going, but to escalate it into a movement that would be impossible to repel.

The immediate task for Californians is to demand that Speaker Rendon move the bill out of the Rules Committee and advance it to other committees so that the essential markups that need to be done can be accomplished. Contact him at: 916-319-2063, @Rendon63rd, or assemblymember.rendon@assembly.ca.gov.

And for the rest of the nation? It won’t come from the politicians. It won’t come from the powerful and rich. It won’t come from the medical-industrial complex. As Steffie says, “we’re only going to get single payer if the populace keeps the pressure on the politicians.” We – all of us – have to do it.

Stay informed! Visit www.pnhp.org/qotd to sign up for daily email updates.