A government health system. Fine. California's SB 810.

It may be Congress will pass healthcare reform legislation sooner rather than not at all. I remain sceptical that it will happen, or that the resulting legislation will actually make meaningful health care, including preventive care, available to the increasing millions who currently do without.

One can be more confident about supporting a California opt-out from any federal program, bringing a single-payer system to the State as an alternative. The Physicians for a National Health Plan (PNHP) a pretty tweedy bunch by the look of them, advocates for the single-payer approach. PNHP, with California chapters, is another source of information regarding the single-payer approach, if the New York Times reporting is feeling old (it remains one of the most fact-based sources of information on the legislation pending in Congress and the human and economic benefits of universal health care).

California's pending legislation, SB 810, would deliver universal health care via a single-payer system. Check out the fact sheet here. We can see what SB 810 would provide. The State legislation isn't padded by nearly a thousand pages including limiting qualifiers and special giveaways to private interests. SB 810 has been vetted for some time now. Implementing the State system would be more manageable - and faster - than implementing whatever the federal program will be.

SB 810 is one government program we can get behind. We the people can see from the terribly disappointing past twelve months that those people in Congress aren't thinking about us. This may be one more case where buying local is the right choice. LLII.

California death spiral (Healthcare reform needed more than ever)

One of the saddest news pieces I have read in a very long time was about 911 emergency services in Tracy (a commuter's distance from San Francisco). The citizens of Tracy must pay a fee for 911 service. Their choice: $48/year or $300/call. Right. $300/call. And, honestly, not every household can afford $48/year. This system means people will be forced to think about whether to call 911. Someone having a stroke or a heart attack? Can you afford the call or should you try to get the suffering person to the hospital yourself? Do you hear your neighbor being physically abused? Will you call 911 if the response will be charged to you? Carry on with the possibilities. Nothing good comes from the fee structure, except that Tracy will be able to afford to provide the services (which, we acknowledge without hesitation, is not only good but essential for public safety and welfare). This is truly an indicator of California in a death spiral.

But I digress slightly. Paul Krugman had California on his mind last week in the wake of all the hubbub about the health insurance premium increases for privately purchased insurance coverage. Mr. Krugman devoted his February 16 column to what he termed the California Death Spiral. Privately purchased health insurance is a complete, predictable disaster: Premiums get higher so healthy people decide to chance going without coverage which makes the "pool" of insured persons more highly populated with the people who really need and use insurance coverage, which causes premiums to increase which forces more of the less terribly ill people out of that "pool." Etc. We know this spiral. And we are living it.

Who knows if Washington will manage healthcare reform that does anything meaningful. Every good wish to them. In the interim, in California, the legislature may do something. Believe it or not, the California Universal Healthcare Act, SB810, is showing signs of life! Let's remind ourselves of what a good idea this is, and start talking local progress that benefits California. Let's do our part to arrest the death spiral. LLII.

Quite a change from 1993

As almost everyone in the U.S. knows, today the House of Representatives is holding a debate on the healthcare bill. A vote will be held this evening--or tonight--or early tomorrow morning on passage of the bill. Newspapers are covering the debate, of course, but most people interested in following the debate wouldn't dream of waiting for a newspaper report. Was it only fifteen years ago that we were content to wait for the network TV news to tell us what was happening in Congress? This morning the cable channels are giving us fulltime video about the debate, newspapers such as the N.Y. Times are linking to cable to give live action coverage, and twitter is ablaze with tweets giving a minute-by-minute account of what's going on in Congress. There is no excuse for anyone who wants to participate in the debate not to be aware of what individual members of Congress are thinking and saying on the topic. It's a perfect climate for citizen action, which is something the League has always encouraged. This debate covers two areas of League concern--healthcare reform, which the League supports, and a woman's right to choose, also supported by the League, which has become a contentious item in the bill. With all the technological support now given us, it's time for citizens to let their representatives know how they stand--call, write, or tweet right now.

This in the other day from our Governor:

"As governor, I have made significant efforts to advance health reform in California. As the Obama administration was launching the current debate on health care reform, I hosted a bipartisan forum in our state because I believe in the vital importance of this issue, and that it should be addressed through bipartisan cooperation.

Our principal goals, slowing the growth in costs, enhancing the quality of care delivered, improving the lives of individuals, and helping to ensure a strong economic recovery, are the same goals that the president is trying to achieve. I appreciate his partnership with the states and encourage our colleagues on both sides of the political aisle at the national level to move forward and accomplish these vital goals for the American people. "

Would it be churlish to note that this very same Governor closed enrollment to the State's children's healthcare program...and restored it after the waiting list grew to more than 100,000 with alarming speed? Yes. Instead, let's be optimistic that more and more Congresspeople will come around to speak up for universal healthcare as a fundamental right. At the very least, if Congress fails us, perhaps California will craft and launch its own plan providing affordable, universal coverage. We will remember our Governor's words from this week, and look to him for leadership. It would be quite the legacy. LLII.

Is healthcare a right of the states?

One of the strangest movements in the healthcare debate is coming from some state capitols where legislators are trying to ban a mandate for everyone to have health insurance. Although health economists agree that universal coverage would not be possible without requiring everyone to share the costs of insurance, these legislators, according to a report in the N.Y. Times, are trying to enact amendments to the state constitutions forbidding the mandate to buy or otherwise acquire health insurance in their state. Arizona's plan is slated to come before the voters in 2010. What exactly are these people trying to do? It seems clear that their goal is to preserve the current haphazard system of health insurance in America and leave the uninsured to suffer. Fortunately it seems likely their efforts will be deemed unconstitutional, but perhaps they just want to delay the process of reform.

Woman to woman

Michelle Obama has joined her husband in talking about the importance of healthcare reform. Her speech, as reported in the Boston Globe, pointed out that women across the country are often in charge of healthcare for family and relatives. Most caregivers for the sick and elderly are women and most children are cared for by women, yet policy decisions are often made by men, many of whom have little experience with the issue. This is the kind of situation the League of Women Voters was formed to change. When women got the vote, almost a century ago now, many people expected the country would become a more caring society. That didn't happen. Women tend to vote pretty much the same way men do, but when we deal with an issue that particularly affects women and children, it's time to call for a louder voice for women. It's time for all those hardworking caregivers to stand up and insist that medical services be given to every American. It is a basic right and women all over the country can join Michelle Obama to call on our nation to give effective healthcare to all.

Looking North

Almost everyone is getting tired of the healthcare debate as it goes on and on--a fire that keeps burning without much new fuel to feed it. One of the striking, and disturbing, aspects of the debate is the lack of facts to back up the wild speculation of many participants. The S.F. Chronicle this morning had an article that clarifies some of the misconceptions about the Canadian healthcare system that are beging spread in the U.S. Many Canadians are watching in horror as Americans spread wild rumors about what goes on just north of our border. For starters, it's not true that Canadians can't choose their own doctor. They can, and most have a wider choice than Americans who are tied into the network authorized by their insurance company. The length of time to wait for treatment has also been wildly exaggerated. Emergency treatment is provided as quickly as it is in the U.S., as are treatments for acute illnesses and lifesaving surgical procedures. Elective surgery may have to be postponed, especially in rural areas, but that is true for many Americans too. It is important to look at our neighbors as well as ourselves when we make sweeping generalizations about health services. This article is a good primer to start with.

Healthcare reform - Still a matter of life or death.

This week we were debating what message to put front and center on the SFVotes.org site for September. Healthcare reform was the natural choice, since the legislation is likely to be decided this month. After a disastrous August, with "discussions" characterized by misinformation and misunderstanding, the President and Congress are primed for what passes for compromise within the Beltway, and what is more accurately described as a race to the bottom anywhere else. This is the moment for fervent defense of everyone's right to healthcare.

The reality is people are weary of the subject, so we turned to another pressing issue (water).

Nonetheless, if you can manage it, please hold on and act again and again to insist on your rights. Even if you have great insurance coverage, it's highly probable your coverage will be eroded either through restricted benefits or higher costs. And, if you are reading this, you are the type of person who looks beyond yourself. A healthy populace is the greater good. Act again now. Please.

The League of Women Voters offers action opportunities.


Read the balanced, fact-based coverage of reform options on the New York Times. Talk to your neighbors, and encourage them to act.

And, as a backup, support the Kucinich amendment (right click to access the pdf), permitting states to waive out of the federal initiative if a state plan is better. LLII.

Healthcare - At least one national entity continues to represent all Americans

And it may not be the Office of the President.

See today's NYT's lead editorial, presenting more facts about the (enormous) numbers of uninsured and underinsured. It's more objective reporting than editorial, peppered with a few measured comments. The need for affordable and accessible healthcare is (still) clear.

In other news, see who has been advising President Obama, as recently as last Friday before the president flew off for a much needed vacation. Tom Daschle, who you may recall fell to the wayside as possible HHS Secretary because he couldn't manage to correctly report income and pay taxes. Mr. Daschle now works for a law and lobbying firm, Alston & Bird, which represents hospital, drug, pharmaceutical, and other health care industry clients. For example, United Health and the Tennessee Hospital Association.

Mr. Daschle, not registered as a lobbyist, reportedly believes there is no conflict in his advising the president and advising the Alston & Bird clients because he tells them both the same thing. True enough. Plus, it's not as though Mr. Daschle is a public servant any longer (if he every was, really). The pertinent question is what the president is doing having cosy chats about healthcare reform with the compromised Mr. Daschle.

So, let's be grateful for the Times. The paper seems to have the public's interests more in mind than our president. Subscribe if you don't. We need a national conscience more than ever. LLII.

Do you know what's in those health bills?

The healthcare issue is absorbing more and more attention from the media and the public. We hear about surprising anger from retirees at town halls and even at family dinner tables and local coffee shops. Perhaps it's time for all of us to learn a little more about what is actually in the healthcare bills now being considered in Congress. In the nick of time the N.Y. Times has come through with a brief primer on the proposed legislation. While this article doesn't answer all the questions, at least it is a start toward a responsible discussion and may help both advocates and opponents of reform agree on what is actually on the table. No one can predict what may follow from the adoption of any particular bill, but we can at least get over groundless worries like euthanasia and "killing granny". Americans have usually been able to face up to the facts when the time comes for action, perhaps that time is now.

Healthcare reform legislation in ~ five minutes (and compared to war funding).

Today's Times editorial page summarizes the healthcare legislation in its present form, including its impact on virtually everyone (even people who have coverage they don't want to give up). Reading the editorial takes about five minutes.

Putting things in perspective, approximately $668 billion has been allocated in the federal budget for the war in Iraq; $222 billion has been allocated for the war in Afghanistan. Disclosure about the numbers shown here. To state the obvious, our war costs expended in fewer than seven years nearly cover the worst case financial scenario for healthcare reform over ten years. One dares say the healthcare returns will be greater. LLII.

Keep going!

I know this healthcare legislation was supposed to be written and voted on by now. Of course that schedule was entirely too aggressive. Nonetheless, reform appears to have momentum, which is important. Plus meaningful reform truly seems to have the hearty support of the president, based on tonight's speech. The opposing sides' fever pitch may mean we are closer than it seems. But it also means we citizens - the beneficiaries of universal healthcare - can't flag. Here's a click and send. Caution! This particular effort will publish names in newspaper ads. Names only, it says.

Now, as we enter the tense, emotional days leading up to a final healthcare bill and the Congressional votes, let's remind ourselves that the media reporting and advertising may not be the truth, the whole truth, and much entirely close to the truth (whatever that is). As an example, the good people at MediaMatters, who are more statisticians than commentators, are noticing some media slant toward fear-mongering about the progress of the reform debate. We'll need to keep an eyebrow arched as we read and listen. Good practice for the November election promotional blitz. (Yes! there will be a November election, involving San Francisco races and ballot measures. Stay tuned to the League space for more information.)

Speaking of local issues, when you ride muni, hold on!?! LLII

San Francisco's public access cable television (and startling healthcare update)

AccessSF lived up to its name for years - providing ready access to the local cable audience to the warp and woof of San Francisco. Among those benefiting from AccessSF's spirited production capabilities, studios, and airwaves was the League of Women Voters of San Francisco. The League regularly taped and aired pro's and con's of ballot measures. Viewers have long told us this programming is important to them when deciding how to vote.

AccessSF's work with the League and others was funded in large part by the City, as part of the station's mandate to serve the public. This funding was cut. The City requested proposals to act as a public access channel. Only those who would not be so dependent upon public money need apply. Bay Area Video Coalition seems to have succeeded in earning the opportunity to contract with the City to serve as its public access television outlet.

Check out BAVC's winning proposal. It goes into some depth, so have a sandwich and milk handy for the read. My take is that BAVC is a media engine with a commitment to the new programming. It seems particularly strong in leveraging all forms of new technology and internet-based media. BAVC offers training programs and involves masses of kids. All good now and going forward, in the way of increased skills and outlets for imagination. BAVC also makes a point of being financially sustainable. That's good, too, of course.

What isn't at all clear is what kind of access non-profits such as the League will have via BAVC. We'll be inquiring in advance of the November elections. More in this blogspot as we learn. In the interim, congratulations to BAVC, and we hope to be able to work with you!

More on healthcare:

Tucked into the article, "Pay or Play," on page 32 of this week's Economist is this sentence: "Rahm Emanuel, Mr. Obana's chief of staff, softened the president's previous insistence [on a public insurance plan to compete against private insurers]. He suggested that a public plan should come into force only if an initial attempt to reform private insurance market fails." What!!??!! And in whose lifetime??!!?? Of course Mr. Emanuel speaks for President Obama. We must speak to the President. Click here to jot a few convincing words, then send. Thanks. LLII




(BAVC calls them 'youth'), which is fabulous for the kids and San Francisco's future.

Healthcare Reform - No letting up.

Did you hear NPR this morning? Senator Chris Dodd and another Congressional rep assured us that mixing fundraising from healthcare special interests while drafting healthcare legislation doesn't affect their decision-making, or distract them from keen advocacy for their constituents. All together now: eye-roll. Seriously: it's to be expected that all of Congress are booked for events with healthcare special interests (some may even have views we support), now through the date of the August vote on the legislation.

We know we need healthcare reform that gives us affordable care designed to both keep us healthy or restore us to good health. I for one am weary of the emails asking me to tell my representatives I still care about the subject. But last night at a LWVSF advocacy meeting, I heard an impassioned recitation of the systemic miseries defective healthcare creates. I was reminded that lobbying only gets more intense as a vote looms; the promises more lucrative and irresistible.

We voters, one voice becoming many, must provide balance. Most of us may not be able to substantially add to a campaign coffers but we can, one voice becoming many, firmly promise that disappointment will result in turning people out of office. Opening those emails, then clicking to send the messages to your reps actually works.

Over these next critical weeks, let's try to click and send in support of healthcare reform - whatever reform you believe to be best for your family and friends - at every opportunity. I will. If the money people can stay motivated, so must we. After all, we have more to lose, and to gain! LLII.