Universal Healthcare

May 23, 2023

Happy Tuesday Healthcare Advocates

 Please enter requests for research using the comment button at the bottom of this newsletter. Remember our advocacy educates our representatives and lets them know what we want them to do for us.  

Items in work are prison healthcare (a hot mess) and rural healthcare (another hot mess).

Universal Healthcare

Last week Rep. Jayapal (WA) and Sen. Sanders submitted their Improved Medicare For All bills to Congress. They are respectively H.R. 3421 and S. 1655. These are links to Congress’ website. The official texts of the bills are not yet available at the congressional website. However, I received two notes last night from Lori B. who shared with me versions of the bills. Here is H.R. 3421 from Representative Jayapal’s website and Physicians for a National Health Plan (PNHP) had a version of Senator Sanders’ bill. Thank you, Lori!!!!

H. R. 3421

I have spent the morning reading H.R. 3421 and am pretty pleased. Here are some of the highlights.

You may recall that the Rand Corporation did an experiment in the 1990s to assess the effect of copays and deductibles on healthcare utilization and found that even small payments by patients severely cut back doctor visits. This bill has no copays/deductibles and no balance billing (billing the patient for amounts over reimbursement level) and no preauthorizations.

It will cover vision and dental, and hearing as well as long term care and transportation to medical facilities as needed. It covers reproductive health, gender affirming care, mental health and addition recovery, prenatal and postnatal care, contraception, reproductive technology assistance and a host of other things.

Note that it does not override state prohibitions on certain healthcare issues, like abortion or gender affirming care but it does send the Hyde amendment straight to Hell where it belongs (it precludes federal funds to be used for abortion).

It includes requirements to cover those within our borders and precludes medical tourism to the US to take advantage of the plan by foreigners.

The bill has a two year rollout period to full implementation. In the first year after enactment people under 19 and 55 and over are eligible to join. Everyone else is eligible two years after enactment. Until you are eligible you may keep your existing policy.

The bill establishes a trust fund from which to pay claims. The program will be funded by premiums paid to the trust, these are a tax. The program will absorb other federal programs such as Medicare, Medicaid, CHIP, Tricare, Tribal healthcare, and state marketplace programs (ACA). It identifies waivers for the poor and minimal payments for those at or near the poverty level and covers those who would have had Medicaid in states that did not expand Medicaid.

It allows for insurance companies to sell optional non-duplicative policies, similar to what other countries do when there is universal healthcare.

There are a number of other features I found well thought out. Of course, there will be prescription drug negotiations, but there is a feature that allows for R&D payments to pharmaceutical companies as well.

The budgeting includes specific funding for education to ensure a sufficient workforce of healthcare professionals by region. This was identified to bolster and improve healthcare in rural and medical deserts as well as to assist with the tremendous tuition debt that providers often have. Capital improvement projects are also called out to build and reinforce facilities. This applies to rural and underserved communities in particular as well as to other areas. Public health is also called out as a separate budget item. This will be important to have in place before the next pandemic hits.

Remember that this legislation will also drop malpractice premiums dramatically since most of those claims are for future medical payments.

Doctors and facilities will sign up with HHS to participate, but participation is not mandatory. Arrangements are made for both bulk infrastructure payments to networks and facilities that cover buildings, employees, devices etc. as well as support for fee for service for doctor offices as needed.

There will be significant quality monitoring of the system. That’s good and it will include collection of data that measures outcomes for a wide variety of communities. This is really important because there will be targets set for things like infant mortality. We do poorly on that and other metrics as a population and worse if you’re not white.

Healthcare can exist outside the national system for those doctors who choose not to participate and patients who choose not to use the system.

All in all it is a well thought out plan and I’m impressed. Tomorrow I will review S. 1655, Sen. Sanders bill.

ACTION

Call or email your Congressperson and Senators about this.  There is a sample text below or use RESISTBOT on your phone by texting SIGN PVUKKO to 50409 to tell them:

“I am your constituent in [zipcode] and I am fed up with a healthcare system that leaves 80 million people uninsured and underinsured. We have 65,000 unnecessary medical bankruptcies yearly. We have people begging for money on GoFundMe to cover medical bills. Insurance companies offer widespread denials of claims and demand pre-approval (based on their own alleged expertise) for medications and procedures that can delay life saving treatment. The system we have is over burdened with $400 billion of unneeded overhead. The list goes on and on.

Representative Jayapal has released H.R. 3421, Improved Medicare for All. This is a critical piece of legislation that establishes a universal healthcare system for the US. It is time we had it in place and I want you to co sponsor it and be a vocal supporter of it for the constituents in our district. You don’t work for an insurance company, you work for us and you owe this to us.”

References

Find My Elected Officials

Contact the White House  https://www.whitehouse.gov/contact/

Contact State and Federal Representatives

https://www.commoncause.org/find-your-representative/addr/

Important Healthcare Resources

League of Women Voters Healthcare Reform Toolkit

Our Newsletter resources including reproductive healthcare

Healthcare Advocacy Reading List

Organizations to Contact

NARAL - Pro Choice America

Planned Parenthood

Physicians for a National Health Plan

Claims Denials and Appeals & What to Do

Appeal a Healthcare Decision

Appeal/Negotiate a Hospital Bill

Save Democracy

Chop Wood, Carry Water by Jessica Cravens

RESISTBOT

Link to the RESISTBOT site to learn more

Link to Chop Wood, Carry Water Resistbot write up