PNHP

Single-payer health care – its time has come

Single-payer health care – its time has come

By Mark Dimondstein
The Plain Dealer (Cleveland.com), September 20, 2017

WASHINGTON, D.C. – Congress is back from its summer recess and the problems with our nation’s health care system haven’t gone away. How to fix health care is once again being hotly debated. Recently, President Donald Trump warned Republican senators that they must do something or be confronted with the dangers of “single-payer” health care. But, single-payer shouldn’t be the boogeyman – its time has come.

As a postal worker and now president of the American Postal Workers Union, I’ve had many occasions to meet with Canadian postal workers. The lives and dreams of postal workers just across Lake Erie are similar to workers in Northeast Ohio and other parts of the United States. One huge difference stands out – Canadian health care. Canadians never worry about being denied access to medical care. Unlike in the United States, no one is forced to choose between food and medicine. A major illness won’t drive them to bankruptcy or out of their homes.

Canada’s single-payer health care system is similar to Medicare but in Canada every man, woman and child has cradle-to-grave coverage for their doctor, hospital and nursing care – with full choice of physicians. The government also negotiates affordable drug costs with pharmaceutical companies.

Imagine how much less stressful our lives would be without co-pays, deductibles, billing for services, lifetime limits or huge insurance premiums. According to University of Massachusetts Economics Professor Gerald Friedman, 95 percent of U.S. households would save money under a single-payer plan.

It is striking that the Canadian success is rarely discussed in the current health care debate. The leadership of both major political parties treat health care as a privilege rather than a human right. The profits of the medical industrial complex sadly take center stage over the people’s interests.

Most of the Democratic Party leadership is wedded to the Affordable Care Act (ACA). While some measures of the ACA should be preserved, such as coverage for the 153 million Americans with pre-existing conditions, the law has failed. It is not affordable. It contains no public option, does nothing to lower pharmaceutical prices, is a boon to the insurance companies and still leaves tens of millions uninsured and millions more with inferior insurance plans.

The failed legislation promoted by the Republican leadership is far worse. The GOP plans would gut Medicaid (used by one in five Americans and two-thirds of nursing home patients). Their plans would drive 22 million people from health insurance rolls, according to the Congressional Budget Office; incentivize employers to eliminate health coverage; limit coverage for pre-existing conditions; and drastically raise medical costs for seniors – all while giving billions in tax breaks to the wealthiest.

Most workers our union represents have employer-based health insurance. Every year we are paying more and receiving fewer benefits. A postal employee typically pays $6,000 a year for their share of family plan premiums – plus co-pays, deductibles and co-insurance. A “Canadian style” system would offer financial relief, even to those currently insured.

Donald Trump was right back in 2000 when he said: “We must have universal health care. Just imagine the improved quality of life for our society as a whole…The Canadian-style, single-payer system…helps Canadians live longer and healthier than Americans…There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees.”

According to the most recent figures, the United States spends 17.8 percent of GDP on health care – more per capita than any other country. More than 25 percent of health care expenses are administrative – money diverted to needless insurance industry overhead and profits. (Twice that of Canada.) U.S. citizens average $9,000 a year in health-related costs.

Yet, health outcomes are dismal. The United States ranks 34th in life expectancy. (Canada ranks 13.) A 2017 study by the Commonwealth Fund, found that the United States ranks last of the 11 most “developed” countries in health care quality, access, results and efficiency.

The ACA should be replaced with a better system. The recent debate between bad (“Obamacare”) and worse (“Trumpcare”) fails to meet the health care needs of the 99 percent. Let’s learn from our neighbor and demand single-payer universal health coverage – “Medicare for All!”

It is a proven, simple, cost-effective, and just way to heal what ails us.

Mark Dimondstein is president of the 200,000-member American Postal Workers Union and a vice president of the AFL-CIO.

http://www.cleveland.com…

E.J. Dionne’s inadvertent lesson for us

The priority is still to save Obamacare

By E.J. Dionne, Jr.
SouthCoastToday, September 16, 2017

Before supporters of universal health coverage get all wrapped up debating a single-payer system, they need to focus on a dire threat to the Affordable Care Act likely to come up for a vote in the Senate before the end of the month.

The latest repeal bill is an offering from Sens. Lindsey Graham, R-S.C., and Bill Cassidy, R-La., that would tear apart the existing system and replace it with a block grant to the states. Block grants — flows of money for broad purposes with few strings attached — are a patented way to evade hard policy choices. All the tough decisions are kicked down to state capitals, usually with too little money to achieve the ends the block grant is supposed to realize.

This is a matter of urgency because the authority the Senate has to pass Obamacare repeal with just 51 votes expires on Sept. 30. So if the bill comes up, it would likely hit the floor in the last week of this month. All who care about the expansion of health care coverage need to focus their energies on defeating this latest attack on Obamacare. However we eventually arrive at universal coverage, which we must, it will be far easier to get there by building on the ACA.

And assuming the latest repeal effort fails, last week’s push for a single-payer system could come to be seen as a useful initiative provided that “Medicare for All,” as its supporters like to call it, is treated as a goal, not a litmus test. Defining the left pole of the health care debate is helpful, in part because it shows how fundamentally moderate Obamacare is. It is not, as many conservatives have claimed, anything close to a socialist scheme.

And for those whose objective is single-payer, there are many options available that could gradually open the way for it. As Medicare for All’s leading advocate, Sen. Bernie Sanders, I-Vt., noted in an underappreciated tweet in July: “In the short-term, to improve the Affordable Care Act, we should have a public option in 50 states and lower the Medicare age to 55.” Many progressives and moderates who favor universal coverage but are not yet sold on single-payer would embrace options of this sort. Such measures would help a lot of people immediately and make any move to single-payer less disruptive.

http://www.southcoasttoday.com…

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Comment:

By Don McCanne, M.D.

This column by E.J. Dionne is important because it represents the current most prevalent view on health care reform, written by an intelligent, highly respected journalist with great credibility and uncompromising ethics. We need to listen to him.

The more immediate issue that Dionne discusses is the cruel Graham/Cassidy proposal that would take health care away from millions of people. Since action on this bill is imminent, he calls for focusing our energies on defeating it. He is right. The bill needs to be defeated.

The larger issue here is that he demonstrates where the progressive/liberal camp is headed on long term reform. He describes single payer Medicare for all as the left pole of the health care debate, showing “how fundamentally moderate Obamacare is” in comparison. He then mentions what we are hearing from a multitude of reform advocates – that “there are many options available.” He then dials in on the dual option that has now become so prevalent in the national reform dialogue: “we should have a public option in 50 states and lower the Medicare age to 55,” even quoting Bernie Sanders as the authoritative source for this concept.

It has been repeated so many times that a Medicare buy-in and a public option will lead to single payer that it has become a meme. Everyone knows it’s true, well… just because it is.

A Medicare buy-in would have almost no resemblance to the existing traditional Medicare program. It is much more likely that private plans similar to Medicare Advantage plans would be modified to fit a new market, though difficulties would remain in risk pool management, reinsurance, benefit design, and other features that would require the support of Congress, much as they are now supporting the Medicare Advantage plans to give them an advantage over the traditional Medicare program.

A public option would have basically the same problems – creating a plan which will be public in name only but structured like private plans, except that it would be stripped of essential features to avoid giving it an “unfair” advantage over competing private plans. In fact, this is what Congress did with the public option that was part of the Affordable Care Act before it was pulled from the legislation because of Joe Lieberman’s tantrum.

If we follow either or both of these routes we will end up not only with inferior plans but also with none of the efficiencies or benefits of a single payer system. That will then be used as “proof” that single payer cannot work in the United States. Any further transition to single payer would be aborted.

But then there will be other ways we can do it. We’ll just have to turn everything over to the private insurers, except for high risk patients whose care we taxpayers will have to fund. Then we will have the hybrid system which our progressive friends are clamoring for.

It doesn’t have to be this way, but it could happen unless we mobilize the masses.

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Dr. Carol Paris on ‘Rising Up With Sonali’

PNHP president Dr. Carol Paris appeared on “Rising Up With Sonali” on Free Speech TV and Pacifica radio stations on September 19, 2017. She discussed the GOP’s latest attempt to repeal the Affordable Care Act (aka Graham-Cassidy) and contrasted this effort with Sen. Bernie Sanders’ recently introduced Medicare For All Act.

Carroll, Frakt, Garthwaite, Reinhardt, and Jha help us choose the best health care system

The Best Health Care System in the World: Which One Would You Pick?

By Aaron E. Carroll and Austin Frakt
The New York Times, September 18, 2017

To better understand one of the most heated U.S. policy debates, we created a tournament to judge which of these nations has the best health system: Canada, Britain, Singapore, Germany, Switzerland, France, Australia and the U.S.

“Medicare for all,” or “single-payer,” is becoming a rallying cry for Democrats.

This is often accompanied by calls to match the health care coverage of “the rest of the world.” But this overlooks a crucial fact: The “rest of the world” is not all alike.

The commonality is universal coverage, but wealthy nations have taken varying approaches to it, some relying heavily on the government (as with single-payer); some relying more on private insurers; others in between.

Experts don’t agree on which is best; a lot depends on perspective. But we thought it would be fun to stage a small tournament.

We selected eight countries, representing a range of health care systems, and established a bracket by randomly assigning seeds.

To select the winner of each matchup, we gathered a small judging panel, which includes us:

* Aaron Carroll, a health services researcher and professor of pediatrics at Indiana University School of Medicine

* Austin Frakt, director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and adjunct associate professor with the Harvard T.H. Chan School of Public Health

and three economists and physician experts in health care systems:

* Craig Garthwaite, a health economist with Northwestern University’s Kellogg School of Management

* Uwe Reinhardt, a health economist with Princeton University’s Woodrow Wilson School of Public and International Affairs

* Ashish Jha, a physician with the Harvard T.H. Chan School of Public Health and the director of the Harvard Global Health Institute

So that you can play along at home and make your own picks, we’ll describe each system along with our choices (the experts’ selections will decide who advances).

(Interactive comparisons follow.)

Conclusion

(The conclusion is available at the link but is omitted here for those who wish to make their own choices in the matchups before knowing the final conclusion.)

https://www.nytimes.com…

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NYT Reader Comment:

By Don McCanne, M.D.

Although this is an interesting exercise, it might be more productive to look at these systems from the perspective of the major problems that we have and what features of other systems might ameliorate them.

The uninsured: Make enrollment automatic. A mandate falls short because of compliance problems.

The underinsured: Reduce cost sharing to levels that will not create financial barriers to care.

High costs: Publicly-administered pricing comes closest to getting it right – legitimate costs plus fair margins.

Lack of choice of physicians and hospitals: Do not create artificial panels that serve third party payers at the cost of patient choice.

Impaired access to specialized services: Do not segregate low-income individuals into chronically underfunded welfare programs.

Profound administrative waste: Hundreds of billions of dollars could be recovered with a much more efficient financing system.

Now look again at how the various systems address these issues. Oops. There is not enough information here since the field of health policy is so much more complex than can be boiled down to simple comparisons. But when you add the other features that cannot be included here, you would end up with a single, equitably-financed, publicly-administered program – not an exact duplicate of any of the nations listed. That could be accomplished by improving our Medicare program and expanding it to include everyone.

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Should the United States go for single-payer?

By Jay Brock, M.D.
The Washington Post, Letters, September 18, 2017

Eugene Robinson was correct that Sen. Bernie Sanders’s (I-Vt.) proposal for a “Medicare for All” health insurance system is the “right thing to do” [“An idea no longer on the fringe,” op-ed, Sept. 15]. It would cover everyone with first-dollar coverage for all medically necessary care.

But “Medicare for All” is not socialized medicine, in which the government would own medical facilities and health-care providers would be government employees. Rather, this is socialized insurance, and it is enormously popular among conservatives and liberals already covered by Medicare. The excellent medical system we have now wouldn’t change; how we pay for it would.

Also, regarding those projected 10-year costs: We already spend a “staggering” $3.4 trillion each year on health care and still manage to leave 28 million people without any health insurance and tens of millions more greatly underinsured. An improved “Medicare for All” single-payer system would fix that, with a cost-effective system based on competition among providers that would be the continuing envy of the world. (That $3.4 trillion is enough to cover everyone. We just don’t spend it wisely because we waste as much as $500 billion on administrative costs to accommodate our multiple-payer system.)

It’s only a matter of time before the politicians catch up with the majority of Americans who already want a single-payer system.

https://www.washingtonpost.com…

Dr. Ed Weisbart on ‘The Real News’

PNHP-MO chair Dr. Ed Weisbart appeared on “The Real News” on September 18, 2017 to discuss the GOP’s latest push to repeal the Affordable Care Act. He discussed the disastrous effect Graham-Cassidy would have on American health care and urged Congress to reverse course and embrace a proven solution: improved Medicare for all.

Primary care EHR overload worse than many realize

Tethered to the EHR: Primary Care Physician Workload Assessment Using EHR Event Log Data and Time-Motion Observations

By Brian G. Arndt, M.D., John W. Beasley, M.D., Michelle D. Watkinson, M.P.H., Jonathan L. Temte, M.D., Ph.D., Wen-Jan Tuan, M.S., M.P.H., Christine A. Sinsky, M.D. and Valerie J. Gilchrist, M.D.
Annals of Family Medicine, September/October 2017

Primary care physicians spend nearly 2 hours on electronic health record (EHR) tasks per hour of direct patient care. Demand for non–face-to-face care, such as communication through a patient portal and administrative tasks, is increasing and contributing to burnout. The goal of this study was to assess time allocated by primary care physicians within the EHR as indicated by EHR user-event log data, both during clinic hours (defined as 8:00 AM to 6:00 PM Monday through Friday) and outside clinic hours.

From the Discussion

This study provides a validated mechanism for EHR task analysis using EHR system event logs to evaluate primary care physician workload. Our event logs indicate that family medicine physicians spend approximately 45% of their workday (4.5 hours) on the EHR. Direct observation data were consistent with this finding. The remaining 55% of the workday (5.5 hours) was spent on non-EHR activities such as direct patient care, team interactions and meetings, paperwork, e-mail, and other work. An additional 1.4 hours per day of EHR time was spent outside of clinic hours (before 8:00 AM or after 6:00 PM), including 51 minutes per weekend. This extra time equates to an average workday (excluding time providing care to patients in the hospital) of 11.4 hours, representing a considerable encroachment on physicians’ personal and family lives.

http://www.annfammed.org…

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Comment:

By Don McCanne, M.D.

This is serious. In this study, not only did primary care primary care physicians spend almost half of their clinic hours on electronic health records (EHRs), outside of clinic hours they spent an average of an additional 7 hours and 51 minutes – the equivalent of an extra workday per week. Does this investment in time provide enough direct patient benefit to warrant it? Of course not.

We would hope that a single payer system would address this problem, but there is risk that the public stewards would rely heavily on EHRs for administrative purposes and for current data-intensive information technology trends.

Hopefully shifting the culture from the business-oriented medical/industrial complex to a patient-service environment, as should occur with implementation of a well-designed single payer system, would cause the stewards to wake up and take a serious look at such wasteful services that induce physician/nurse burnout and patient malcontentment.

Clearly, we cannot allow this to continue.

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Universal healthcare in the U.S. is possible. We already have proof.

Bernie Sanders and Kamala Harris’s universal healthcare bill is a step towards a humane and cost-effective system. Naysayers are denying reality.

By Farzon A. Nahvi, M.D.
The Guardian, September 15, 2017

Speaking to opponents of universal healthcare in the U.S. today is much like speaking to a moon-landing denier or any other conspiracy theorist – they insist on arguing impossibility in the face of proven reality.

As Bernie Sanders, Kamala Harris and 15 other senators release details of their universal healthcare bill – one that guarantees access to healthcare for all Americans while simultaneously creating cost savings – there will be many healthcare conspiracists claiming that such a plan is infeasible. So as we consider these arguments in the coming weeks, we must always be prepared to make sure they pass the “look!” test.

That is, when someone argues that something cannot be done, we needn’t argue. Rather, we simply need to point and say: “Look!”

Someone doesn’t believe we landed on the moon? “But look! There’s an American flag up there!” Someone doesn’t believe we can insure every single American while simultaneously reining in the exorbitant costs of our healthcare system? “But look! Every other developed country in the world is already doing it!”

These medical conspiracists claim that such a system would be impractical, overly expensive, or provide inferior care. But to make these claims in the face of obvious proof is laughable.

If Canada is able to provide coverage for each of its citizens from birth to death, with no out-of-pocket-costs to any of them, all the while providing high-quality care with excellent patient outcomes at half the cost of our system, it is unacceptable to say that we somehow cannot.

Real people living in other countries are currently enjoying these systems. They can change jobs without fear of losing access to their diabetes medications. They can go jogging without worry that one slip and broken bone would send their families into bankruptcy. They can go to their doctor never questioning that, at the end of the day, she has any incentive to do anything but make them better.

So how could one be so bold as to deny this reality?

The truth is that nobody is content with our current healthcare system. We do poorly when it comes to access to care and equity, administrative efficiency and cost containment, as well as basic health outcomes.

We pay more than double what other countries do, and get worse results. Our life expectancies are shorter than any other developed nation. Children die in the US unlike in any other modern society. Medical bills are the leading cause of bankruptcy in the US. Our overspending in healthcare directly limits what we can do with defence, education and infrastructure.

Yet when it comes to talk of change, people become skittish. Doctors become scared that change would mean lower incomes. Patients fear longer wait times and loss of access to services.

The fear of losing the small benefits we currently enjoy is prohibiting us from enjoying far greater ones at half the cost. It’s as if we’re so scared of losing our crumbs that we are ignoring the entire loaf sitting within reach.

We need to learn to trust our eyes and ears and be suspicious of the naysayers fearmongering us away from something better. We can, and should, argue about the precise form our system will take – the US’s universal healthcare system will almost certainly have a different flavour than, say, France’s – but we can no longer accept that such a system is impossible.

Importantly, we should never forget the stakes. Real Americans are going through real pain every day. I have seen a patient come to my emergency room stating: “They diagnosed me with cancer but said they couldn’t see me because I have no insurance. I have nowhere to go.”

I have seen a patient having a florid heart attack walk out against medical advice stating, “Thanks doc, but my brother went through this and lost his house. I’m gonna go.” And I have heard many well-insured patients say “I hear you and you seem nice, but all you doctors want to do is make money off me, so I don’t know who to trust.”

To experience all this while knowing that something better is already out there is simply unacceptable.

Those who deny the plausibility of a universal healthcare system are inevitably the same people who stand to benefit most from our current system. They can argue up, down, left and right, but ultimately they can never pass the “look!” test. The next time they try to claim that universal health care would be impossible in the US, point them to footage of Neil Armstrong bouncing on the moon and dare them to deny reality. A universal healthcare system is not only possible here, but long overdue.

Dr. Farzon A. Nahvi is an emergency medicine physician and an instructor of emergency medicine in New York City.

https://www.theguardian.com…

Dr. Diljeet Singh on ‘The Big Picture’

PNHP board adviser Dr. Diljeet Singh appeared on “The Big Picture” on RT America on September 14, 2017. She spoke with guest host Sam Sacks about Sen. Bernie Sanders’ Medicare For All Act, how universal coverage has become a mainstream expectation, and how single payer would affect the medical community.

Canada’s Danielle Martin explains in a few words the rationale of single payer

Senator Sanders News Conference on Medicare for All

C-SPAN, September 13, 2017

(Following is a transcript of Dr. Danielle Martin’s comments, but I would highly recommend viewing the C-SPAN video instead – four minutes beginning at 21:00 – link below.)

Sen. Bernie Sanders: Last, but very much not least, is Dr. Danielle Martin. You know, I think that it is high time that we started taking a look at what countries around the world were doing in providing quality care all of their people in a far more cost effective way than we do, and one of examples of a single payer system that is working well, that is popular, is the Canadian system. Dr. Martin is a Canadian physician, health care administrator, and an associate professor at the University of Toronto. She is the author of a Canadian best selling book, “Better Now: Six Big Ideas To Improve Health Care for All Canadians.” Dr. Martin.

Dr. Danielle Martin: Thank you Senator.

I must say that I am very grateful that so many Americans are interested in learning about the experience of your Canadian neighbors under our single payer health care system, which we also call Medicare.

As a practicing doctor, a hospital administrator, and a citizen, I am so proud to be part if a system where access to doctor and hospital services is truly based on need, not ability to pay. And I’m not the only one. In public polls, 94 percent of Canadians say that our health care system is a source of personal and collective pride, even more than ice hockey! Single payer health care is a symbol to us of what it truly means to be Canadian, that we take care of each other.

My grandparents immigrated to Canada in the early 1950s like so many people who come to this country, hoping to build a better life for their kids. And at that time, there was no universal health coverage in Canada. So when my grandfather had his first heart attack in his early 40s, his world was shaken, and by the time he died nearly a decade later, the family was essentially bankrupted by medical bills. I know that this remains a reality for many in the United States today, but you should know that just north of your border, that kind of a situation is essentially unimaginable.

My generation of Canadians does not remember what it was like to worry about paying a doctor or hospital bill. And despite our challenges, which of course every country experiences, Canadians have a longer life expectancy, lower infant mortality rates, and fewer preventable deaths than in the United States.

Single payer health care is also, as you know, less expensive. In Canada, our administrative overhead is less than 2 percent in our public plan as compared to 18 percent in the private plans here in the U.S. We spend just under $5000 per capita in Canada to cover everyone. You spend nearly $10000 per capita and yet tens of millions of people are uninsured. But most importantly, when my patients are sick I do not need to ask if they have insurance or if they can afford to pay for my services. And throughout my pregnancy, and for the birth of my daughter in a world-class hospital, I was never asked for money, and I never received a bill. I just handed over this card – my Canadian health care card – to my doctor, and that was it.

I wish that all of my American neighbors could experience the same simplicity in their moments of need. And I hope that the American people will seize this opportunity to declare to each other and to the rest of the world that you do believe access to health care is a human right.

Thank you.

https://www.c-span.org…

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Comment:

By Don McCanne, M.D.

Everyone included. Care based on need. Lower costs. No financial barriers to care. Better outcomes. Less administrative hassle. And greater pride than even for their ice hockey teams!

Are Americans all bonkers, that we continue to reject this?

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PNHP welcomes Sen. Sanders’ Medicare-for-all bill

Single-payer legislation a major step forward to solving national health crisis

Physicians for a National Health Program, September 13, 2017

Physicians for a National Health Program (PNHP), a nonprofit research and education organization of 21,000 physicians, medical students and health professionals, welcomes Sen. Bernie Sanders’ single-payer bill, The Medicare for All Act of 2017. Replacing America’s fractured, for-profit health system with improved Medicare for all would provide comprehensive care for everyone, help rein in skyrocketing health costs, and deliver better medical outcomes. 

“Congressional leaders can no longer sit on the sidelines watching our broken health system cripple the economy,” said Carol Paris, M.D., president of PNHP. “Every year that we do nothing, health care costs swell by another 5.6%. The only way to both control costs and guarantee access to care is to eliminate the administrative waste and profiteering of the insurance industry.”

At $3.2 trillion per year, the U.S. spends nearly twice as much per capita as any other high-income country on health care, but scores poorly on life expectancy, infant and maternal mortality, and access to health services. Despite the improvements of the Affordable Care Act,  28 million Americans remain uninsured, according to the Census Bureau’s estimate released on Tuesday. Researchers estimate that 36,000 Americans die prematurely each year because they lack insurance. Sen. Sanders’ bill would reduce the number of uninsured to zero, allowing everyone to visit the doctor or hospital of their choice for medically-necessary care, including dental, vision and mental health services.

By eliminating the wasteful, profit-driven private insurance industry, a single-payer program would save the nation hundreds of billions annually on paperwork and profits. Physicians, who now spend an average of nine hours each week on administrative tasks like billing, could focus more time on patient care. Not surprisingly, a majority of American doctors now support Medicare for all.

Under Medicare for all, medical bankruptcy would be a thing of the past. Today, the crushing cost of health care is the top financial problem facing U.S. families. Even many of the insured face obstacles to care: More than half of all workers with employer plans face deductibles of $1,000 or more, and more than one-third of U.S. adults report difficulty paying premiums and deductibles. By untangling health care from employment, workers would be free to switch jobs or launch a new business without losing coverage.

Dr. Paris notes that incremental tweaks like subsidizing ACA premiums, or offering Medicare or Medicaid buy-ins, will do little to change long-term health or financial outcomes. “We’ve tried everything else,” said Dr. Paris. “Medicare for all is the only plan that will solve our nation’s growing health care crisis.”

In 2016, PNHP released its Physicians’ Proposal for Single-Payer Health Care Reform, a proposal based on decades of careful analysis and research. PNHP recommends several improvements to the Medicare for All Act that would save money and improve patient care, including global budgeting of hospitals and other health care institutions; the separation of capital and operating payments to hospitals and other health care institutions; full coverage of all medications, without copayment; the exclusion of investor-owned, for-profit health care providers; and the establishment of a national long-term care program.

“PNHP applauds Sen. Sanders and the thousands of grassroots advocates whose tireless advocacy has pushed single payer to the forefront of the national debate on health care,” said Claudia Fegan, M.D., PNHP’s national coordinator. “We look forward to working with Sen. Sanders to strengthen and advocate for this bill.”

https://pnhp.org…

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