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What do you think is the most effective way to turn this idea into real policy? Add your suggestions here for how you think we should run an advocacy campaign to advance the idea – including the overall strategy, messaging, targets, and tactics.

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  1. Gerard Lefevre

    My suggestion is this is how Jared's idea should read:

    Single Payer Health Care

    Health Care is a fundamental human right.  No one should have to sell their house to pay for their mother's cancer.  No one should have to choose between food and medicine.

    Comprehensive health care for all! No deductibles, no co-pays, no pre-existing conditions, no denial of health care, no more  bankruptcies from medical bills. Just health care for everyone from womb to tomb.

    Why?
    1) Its the most efficient approach
    2) It works.  Why do places such as Cuba and Costa Rica have such good healthcare systems when they spend so little on healthcare?
    3) It will solve insurance problems and people being left without insurance (obama's approach won't get everyone covered).
    4) For our children

    HR 676 Bill is THE way of achieving this.

    (NOTE: Medicare tax on most individuals will increase from 1.45% to 4.75%.  A significant saving compared to the health insurance premiums, deductibles, co-pays and prescription costs most are currently paying.)

    Suggested by Gerard Lefevre on 01/17/2009 @ 12:04PM PT

  2. Anonyms Wasawoman

    Another idea re passage of a single payer PUBLICLY funded system (keep in mind, everybody here, that "single payer" means ONE FUND and that fund can be construed to be one single private company... so... it's really really REALLY important that proposals for this idea be real CLEAR as to WHO/WHAT the funding source is - per the "Medicare for ALL" idea):
    1. If HR676 fails to get enough votes by the senate and/or house, GIVE STATES FINANCIAL INCENTIVES to enact single payer bills (like SB840 in California) and single payer programs where funding is from a PUBLIC funding source vs. subsidizing private insurers to insure people (which was what Arnold Shwartzenegger proposed... and was roundly rejected by the California legislature).
    2. Pass HR676 on a TRIAL basis giving the trial say, 5 years (like Bush's tax cut to the wealthy which had an expiration date) and let's SEE if indeed it does what we all want a singls payer system to do. What we're doing now is NOT working; at LEAST let's give this a TRY!
    3. Suggest we NOT spend money spinning our wheels and re-inventing those wheels by setting aside HR676 and coming up with something else. WE DON'T HAVE TIME TO DO THAT. The economy and the recession being what it is right now, we have NO TIME to f*k around any more re this. LET'S TRY IT.
    4. Levy a STEEP SURTAX on any COSMETIC procedures that are not directly linked to accidents or birth defects. I.e., stars and wanna-be's who go in for face lifts, botox'ing, foot surgery in order to wear high heels, etc. etc. etc. - ALL of these procedures should be WAY taxed and those funds go directly into the single payer fund.
    5. NON-ESSENTIAL FOOD SURTAX - and make it as steep as the cigarette tax (at LEAST as steep as that tax). Include in this category: ANYthing grain/flour based that is NOT made with WHOLE grains, red meats that are ABOVE the metric used as defining "lean", etc.
    6. "INCENTIVIZE" CHANGE re HEALTH - REWARD "change" on a personal basis - People with over 10 lbs to lose (i.e., such as the huge number of obese people in the US now) should receive a TAX CREDIT for every 10 lbs lost. 
    7. TAX CREDIT on purchases of bicycles used for transportation, treadmills, ellipticals, etc. I.e., if your MD tells you you are over 10 lbs overweight, etc. and you buy a treadmill and then go to your MD and weigh in at the end of 3 months as 10 lbs lighter, YOU SHOULD GET A TAX CREDIT. 

    Suggested by Anonyms Wasawoman on 01/17/2009 @ 11:21AM PT

  3. Gerard Lefevre

    Excellent suggestions Patty! PLEASE correct the spelling and grammar errors and PLEASE REMOVE "preferably on the wealthy" from Jared's idea to help curb the opposition from wealthy individuals who are going to think they are ones who are going to pay for everyone else's health care.  We are ALL going to pay a little more tax for HR 676-Medicare for ALL.  Medicare tax on the majority of us will increase from 1.45% to 4.75%.  This will still be significant savings for 99% of us compared to the current "for-profit" health insurance we now have. And the 45 million uninsured will now be contributing 4.75% into the "pool" for their health care and fellow citizens.  Businesses that do not offer a health insurance plan, you will be required to contribute 4.75% for each employee, thank you.  Therefore, it would also make sense to remove the words FREE and BASIC from Jared's idea also.  The idea "Single Payer Health Care" and "HR 676" is the emphasis of this idea.

    Suggested by Gerard Lefevre on 01/17/2009 @ 11:04AM PT

  4. Julia Grace

    The first line for funding single-payer is ending the cap on income subject to FICA (social security tax).  The highly-paid have a hard time selling "no raising taxes"  when it's pointed out that ending the cap only extends the flat tax that is FICA to every earned dollar rather than exempting the higher incomes above $100,000 as the present cap does.           Extending FICA to every earned dollar (and including hedge fund managers' income in the meaning of "income" not capital gains) could permit lowering the FICA rate for all income earners.  That would give a tax reduction that extends to the lowest paid income earners.  Whoopee!!        Julia KGrace

    Suggested by Julia Grace on 01/17/2009 @ 11:00AM PT

  5. serena castaldi

    Biggest problem is the enormous disconnect between the astronomical costs of medical care and medical insurance and poor results of health care --an inefficient and wasteful system.  For example, in comparison to other developed countries, we have high rates infant mortality, cancer deaths and many chronic diseases.
     Any policy to address these problems should embrace:  a)strict accountability for all expenditures b)no lobbying in health care --go for the scientific facts         c)combine funds from all sources--federal, state, county,      employer, private, grants and foundations, etc. to fund      care as and where needed Public policy should promote quality health care providers by rewarding Doctors, nurses and employees who give the best service to people and by encouraging good coverage making sure people's needs are met.
    Health care should not be for profit.  give everyone universal medical coverage - tax-funded and other sources of revenue  Public policy for prevention should include :    a) allocating more funding for screening;    b) providing easy access to preventive programs in the community;      c) paid wellness coaches and programs with personal contact to targeted populations.    d) promoting education from birth;  e)health education in schools;    F)expanded education of health professionals in preserving health not just treatment of diseases.    G) Preventive services by providers should be reimbursed,  now, for the most part, it is not.   7)Public policy can promote healthier lifestyles by: A)providing or promoting healthy lunches in schools, prisons       and workplaces, B) organic gardens in schools ,prisons , communities (and the White House); C)through physical education in schools; fitness programs in the community and when possible in workplaces; D)creating adult playgrounds; E)teaching anti-stress practices; F) Encouraging media to have positive upbeat spins.; programming and news content with e much less violence. Negativity and violence in all forms of the "media", including entertainment, is a major source of stress which leads to violence and disease.   G)mandating periods of paid vacations for workers; H)teaching sex education covering SDT prevention and birth control; I)teaching conflict prevention and resolution (see: Non Violent Communication); J) promoting community based self-help(self-"health") and support groups (neighborhood Peace corps). K)Also it could greatly improve the health of our nation, along with that of others, and save much needed resources by seeking diplomatic solution to international conflicts and not waging wars.so called 'alternative care" and integrated care methods should also be included in coverage.Serena Castaldi





    astaldi
       

    Suggested by serena castaldi on 01/17/2009 @ 10:54AM PT

  6. Patty McCredie


    Couldn't you have corrected the gross spelling errors that make this writer seem less intelligent?
    Don't emphasize the "rich" paying for this. We will all pay for single payer and it will be amply worth it. After losing my job, I guess I'm among the lower middle class. I'M willing to scrape up some money to pay. If you talk about the rich paying, it will evoke automatic reactions and tarnish the value of this idea that we need so much. An avalanche (led by the "rich," that is, very well funded) of opposition propaganda could block our way. Maybe forever...

    Suggested by Patty McCredie on 01/17/2009 @ 10:12AM PT

  7. Kathy Early

    Several ideas will help this become reality:

    Increase the number of slots in medical schools, residencies, and nursing programs.  Part of our problem is a lack of health care providers.

    Offer more incentives to physicians and nurses to practice in underserved areas of our country, especially rural areas where there is typically the biggest need.

    Place a bigger emphasis on preventative health care.  Cover services offered by registered dietitians and exercise physiologists.  Most cases of type 2 diabetes could be prevented through lifestyle changes, but most insurance/Medicare won't currently pay for nutrition/exercise education until the diagnosis of type 2 diabetes (or you have had an MI, etc) has been made.  Anyone who is overweight (based on some criteria such as BMI) should be funneled into an intensive lifestyle change program to achieve a healthy weight and healthier habits.  This would save millions of dollars because the alternative is what we do now -- we pay for decades of chronic medications for type 2 diabetes, open-heart surgery, dialysis, and other chronic problems related to a life of obesity, poor eating habits, and inactivity.

    Encourage healthy lifestyles through lower costs to those who are taking care of themselves (maintaining a healthy weight, not smoking, etc).

    Encourage/teach healthy lifestyles early on through our public schools.  Some schools are already implementing these plans.  They don't allow certain foods like regular soda pop or candy in the schools (even in kids' lunches brought from home).  REQUIRE physical education, at least 50 minutes every day, unless medically excused.

    Implement a junk food tax.  I know this is controversial, and I am not a fan of it, but I think this is the only way to make unhealthy, highly processed and low-nutrition foods less appealing to the masses (especially to those low income individuals).  I have heard some smokers say they had to quit because they couldn't afford it, so perhaps if we make unhealthy foods more expensive, they will be less-frequently purchased.  The tax could be based on nutrient analysis data, the food label, etc, with recommendations from groups such as The American Dietetic Association, or independent nutrition researchers at the USDA, etc.

    Remove the agribusiness dollars from our school food program and other food subsidy programs.  The poor who rely on these programs do not need high-fat cheese and beef products.  Just the fact that they live in poverty places them at much greater likelihood of being overweight and unhealthy.  We need to offer them subsidized HEALTHY food choices.  Coupons for Farmer's Markets and/or grocery store fruits/vegetables, lean meats/poultry/fish, beans/legumes, whole grains, etc. 

    I know many of these ideas require radical societal changes that will likely take decades to become reality, but we are in a time of significant change (hopefully for the better), and this is an excellent opportunity to begin making these changes.

    Suggested by Kathy Early on 01/17/2009 @ 08:37AM PT

  8. Nancy Martin

    Partner with Physicians for a National Health Program (professionals) and with Healthcare-NOW (grassroots activists) to pass HR 676 -- the Medicare for All bill introduced by John Conyers.  We already have a blueprint for how to achieve universal health care (HR 676), and a system to tap in to (Medicare).   

    The insurance companies and pharmaceuticals that profit so well from our current system have been spreading fear and ignorance about the single-payer option.  The public and our elected officials need to know the truth.  If single-payer were actually compared side by side with the other options on the table, it would be obvious that single-payer is the best option -- both morally and financially. 

    Suggested by Nancy Martin on 01/17/2009 @ 08:19AM PT

  9. Eric Brooks

    Providing health care is more expensive in the United States than anywhere else in the world. The reason is not patient abuse of services. The reason is the huge amount of waste built in to the system but the overhead of the insurance companies. They provide no health related value, they do not bring down the cost of providing health care, and they pursue policies that are antagonist to meeting the health care needs of working families in this country. No matter what savings can be achieved through technological restructuring or new technological tools, replacing the insurance industry with a single payer solution as described in HR676 is the most effective, and in the end the only realistic, way to meet the needs of all the people of the United States for fundamental health care that is affordable and of good quality.

    Suggested by Eric Brooks on 01/17/2009 @ 08:09AM PT

  10. Linda Coleman

    Here's another video--very short--put together by a medical student to explain single payer by comparing it to an all-inclusive prom ticket.
    http://www.grahamazon.com/sp/whatissinglepayer.php

    Suggested by Linda Coleman on 01/17/2009 @ 08:05AM PT

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