Medicare for All takes show on the road in Calif.

By Mari Edlin
California Healthline, June 26, 2012

Neither the Affordable Care Act nor the challenges it faces in the Supreme Court has stopped the wheels from turning for the California Nurses Association, Physicians for a National Health Program and Campaign for a Healthy California.

The three organizations took to the road last week on a three-week, statewide bus tour to rally for single-payer, national health system -- "Medicare for All."

Akin to the Canadian system, which sprouted in Saskatchewan in the 1940s and quickly spread to other provinces, Medicare for All would replace private insurance with a single public agency paying medical claims – not much different than how Medicare operates today for senior adults.

Short of being a federal initiative, Medicare for All is holding out for buy-in from individual states.

Each stop along the route of the California tour will provide basic medical screenings followed by a public town hall meeting, raising awareness for Medicare and a single-payer system and enabling Californians to express their opinions.

"Our tour will showcase the fact that there is a single payer solution to the health care crisis, while also getting word out to districts to urge legislators to vote," said Bill Skeen, executive director of the California Chapter of Physicians for a National Health Program in Oakland.

"Right now, we look at Medicare as a program for when we turn 65, but it has proven to work for the Veterans' Administration, the chronically disabled and for legislators, who get lifetime health insurance despite how long they serve in office," said Deborah Burger, president of the California Nurses Association.

The campaign is heartened by the California State Legislature's passage of a statewide, single-payer bill in 2006 and 2008; both were vetoed by Republican Gov. Arnold Schwarzenegger.  SB 810, The California Universal Healthcare Act resurrected in 2010, failed to pass the Senate floor by two votes earlier this year.

The California Nurses Association and the Physicians for a National Health Program agree the Supreme Court ACA rulings will not affect their initiative no matter what direction it takes. But that's not to say they don't support some of the law's provisions, such as guarantee issue and health care coverage of young adults – 26 or younger -- under their parents' plans, Burger said.

"If the law is overthrown, we plan to move forward anyway," she said. "As a nurse, I see the devastating effect of self-rationed health care, where patients either end up in the emergency room, hospital or in the morgue. Medicare for All will help cut costs and ensure affordability and accessibility."

Skeen said the Affordable Care Act is built on a shaky foundation and will not change the current underlying private insurance model. "To get health care for all, you have to eliminate private insurance and expand public insurance to everyone," he said. "If the law is struck down, we'll just be back to status quo."

 Another concern, expressed by Don McCanne, senior health policy fellow for Physicians for a National Health Program, is failure of the state's health insurance exchange to fully cover the uninsured.

Despite the upward pressure on Medicare spending, per capita expenditures for Medicare beneficiaries are expected to increase more slowly than in the private sector, according to the Kaiser Family Foundation. Burger is confident that Medicare for All would provide more savings than accrued through private insurance. Among private insurers, about 30 cents of every dollar goes to administration, lobbying and profit, while the overhead for Medicare is just 3%, Medicare for All proponents point out.

"The industry has a vested interest in the individual mandate, which will require people to buy insurance coverage," Burger said. "But that's not the same as Medicare's goal of getting more people treated and providing better health care."

Most Medicare for All proponents believe there's enough money being spent now to provide coverage for everybody -- a combination of contributions to Medicare through taxes and redirecting current premiums to Medicare.

We don't need to spend more money; we just have to spend it differently by eliminating overhead and spending more on patient care, Skeen said.

Skeen, who estimates single payer could save $8 billion, is in favor of making health care into a social service. "Health care should be a given right and not cause people to go bankrupt in order to pay for it," he said.

He hopes California will follow in the footsteps of Vermont, which last year  passed a single payer health care law.