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Turn, Turn, Turn – A Season for Healthcare Policy
Today, I heard the news. President Obama supports the Wyden-Brown amendment allowing states to innovate on healthcare reform. You’ll have to pardon some of us while we readjust the mirrors.
Just 20 brief months ago, I recall the trepidation and trauma that surrounded allowing the U.S. House of Representatives Education and Labor committee to even take a vote on what was then known as the “Kucinich amendment.” The amendment would have provided a path to waivers of some of the federal restrictions and requirements that keep states from implementing state-based single-payer healthcare plans or other kinds of health reform under the new law. At the time, text messages were flying back and forth from all the President’s men to all of the members of Congressman Miller’s committee to keep the flock in line – no one was supposed to vote for the Kucinich amendment.
It passed anyway. It was the only piece of health reform legislation of any kind that passed with bi-partisan support during the rough and tumble debate of 2009-2010. Republicans hated single-payer possibilities but voted for the Kucinich amendment as a states’ rights issue; Democrats voted for it if they thought their state might pass something better that the current federal bill, maybe even single-payer legislation. Some Democrats fought against it because they thought it was an affront to the President’s bill. But in a remarkable moment of sensibility, the amendment passed only to be stripped from the final bill to keep the President happy and more secure in his path to passage of his larger bill.
The Obama administration eventually succeeded in having it stripped from the final healthcare reform legislation lest anyone think even for an instant that the President would consider allowing any state to innovate and God forbid innovate toward a state single-payer plan. No one wanted less association with single-payer supporters or legislators than the President, though in a previous political cycle, he had supported an everybody in, nobody out approach to healthcare policy.
Not-so-fast-forward to 2011 when the President wants to show he’s listening to all the states screaming and filing court actions to avoid implementing the Patient Protection and Affordable Care Act of 2010, and now we come to learn he wants to support the Wyden- Brown amendment which allows for some of the same results as the old Kucinich amendment of 2009. The Wyden-Brown amendment the President now supports in 2011 would allow states to innovate well before the 2017 date outlined in PPACA – and those states like Vermont and soon California where single-payer effort is moving forward might be forgiven for being a bit taken-aback by the reversal of fortunes apparently embodied in this political turn of events.
Some states will seize the opportunity to innovate away from any federal involvement in their healthcare policy even if it means their own citizens will die. Take Arizona, for example, where Governor Jan Brewer would rather see hundreds of thousands of people suffer without access to state funded healthcare programs than show any reliance on federal aid. Arizonians will die. Arizonians have died waiting for care and being cut off from care. It’s a violence of policy that dwarfs many of the most grueling criminally violent acts. Human life has a value in Arizona. It is zero. Human suffering is merely a manifestation of weakness and there will be no provision for the weak and suffering masses. It’s a sad reality. Arizonians will suffer and will die. The new amendment for state innovation may potentially be used to make Gov. Brewer’s gruesome vision even more possible and likely.
In Vermont, in shining contrast, waivers from federal programs will be necessary for the state to approve and engage in a state-based single-payer plan like that proposed in their state bill offered by Gov. Peter Shumlin – everybody in, nobody out healthcare. Shumlin faced a different set of problems with healthcare delivery – though his outcomes were no better if states were restricted from acting outside of PPACA. At least in Vermont, rather than cutting residents off from healthcare access, Shumlin and his legislators want to find out how to make sure people do get the care needed.
In addition to this Vermont debate and state legislative work, California joins the debate as a state working to solve its budget woes not by harming people but by finding ways to progressively fund healthcare for all – the legislature there has passed single-payer reform repeatedly only to have former Governor Schwarzenegger veto the bill(s). Californians will not give up until they pass their bill and have their Governor poised to sign it. It will be a monumental effort, but Californians are up to the task.
And from one end of the country to the other and many points in-between, states are considering what to do about exploding budget problems combined with growing human need. Utahans are struggling; Vermonters are dying; Marylanders are going broke, Coloradans are looking for relief, Oregonians need healthcare, and even Texans are struggling. Budgets are at the breaking point or beyond and scapegoats are being found and blamed – even when some have done little wrong.
Some states are chomping at the bit to get out from under PPACA all together. The courts are involved and some think some provisions are unconstitutional – especially the insurance purchase mandates. It’s hard for me to argue that making people purchase a defective product sold to protect health and wealth which may do neither is a good and decent provision of any legislation. It didn’t work to control costs with Romney-care in Massachusetts and it won’t work to control costs nationally.
So, now the President wants states to innovate. It is preferable in the current political environment to support states’ rights. It is preferable in the current environment to allow states to wrestle with their problems without joining other states in lawsuits against the federal government. It is preferable to support this piece of legislation allowing states to innovate than to deal with other 2012 election cycle fall-out from PPACA.
So, go Vermont, onward California, go forward Pennsylvania, Colorado, Ohio, New York, Oregon, Hawaii, Illinois, New Mexico, and many more. As charged and challenging as the political climate may be right now, if the President is weighing in support of your state’s right to declare its healthcare policy destiny, make haste. You can fight for healthcare as a human right and fix your healthcare-related budget woes through sound, humane healthcare for all policies. People are hurting and dying and political minds change faster than a cup of Ben and Jerry’s melts in the summer sun.