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Hearing Follow Up:
Observations
of Dr. Walter Tsou, former Philadelphia Health Commissioner, and Chuck
Pennacchio, Executive Director of Healthcare for All Pennsylvania, on
yesterday's (12.16.09) Pennsylvania Senate Banking and Insurance
Committee hearing on SB 400.
Chuck Pennacchio:
In
addition to Walter's more detailed observations and insights below, I'd
like to make a few key points intended to translate events and chart a
path forward for passage of SB 400/HB 1660 at the earliest possible
moment.
First,
it was obvious that our SB 400 testifiers -- including Senator Jim
Ferlo's tone-setting statement at the top -- were far better prepared,
passionate, and on-point than our opponents. But no need to take our
word for it. The glowing wrap-up comments of Chairman White, his
decision to extend the hearing time an additional 50 minutes, his
desire to continue the hearings and research and bill-writing process,
as well as his personal congratulatory handshake while saying, "your
panel did a terrific job," give us real hope that we are within
shouting distance of accomplishing what all of us need -- a healthcare
system that, in moral and economic terms, puts patient care and dignity
first and foremost.
I
was also pleased with the preparedness, comments, and questions of
Senator Jake Corman, part of the GOP leadership team, Chair of Senate
Appropriations, and member of Banking and Insurance. His grasp of
issues, embrace of our "new ideas," openness to our fair-share health
and wellness tax, and query of SB 400 opponents (exposing their
ignorance of Single Payer) are all good signs.
This leads me to a broader discussion of the significance of what happened yesterday...
I
know, I know, you say, we've been here before. Right? Politicians
raising our hopes and then letting us down. Actually, based upon past and present experiences, I perceive elements remarkably different and, I believe, promising.
For
starters, it's time to imagine what is unimaginable to many (or most?)
citizen activists. And yet, the "unimaginable" is a course Healthcare
for All Pennsylvania has been on since 2006 -- a course that subsequent
events have borne out.
Based
on a repeatedly validated assumption that, because of the destructive
effects of campaign contributions from health insurance,
pharmaceutical, and allied interests to politicians in both major
parties, as well as a political culture of "incrementalism," we must be
fiercely non-partisan, evidence-based, organizationally sound,
forthright and flexible, and mindful of our federalist constitution and
political history.
In
other words, we have long held that the winning coalition around the
proven Single Payer Solution will be comprised of "conscience
Republicans" and "conscience Democrats," beginning with one of our
"modeling" fifty states. And, in the case of Pennsylvania, not only do
we have political advantages that others do not, but we have what
appears to be a thoughtful and courageous GOP leadership on the joined
issues of healthcare delivery, healthcare economics, and healthcare
financing. Put another way, we have legislative leadership in the
State Senate that "gets it" -- analysis of problems, openness to policy
prescriptions, and a feel for the political choreography needed to
bridge policy pieces, key players, and central institutions.
Finally,
and by way of consensus emerging from yesterday's historic Banking and
Insurance Committee hearing, our next critical step is to raise the
funding to complete our ECONOMIC IMPACT STUDY. Two months ago, you and
other HC4APA supporters provided the $5,000 in seed money to get us to
the point where we are today. Now, with the study prospectus in hand
and bidding negotiations finalized, it is on all of us to raise an
additional $49,000 to complete our EIS and, provided the learning
experiences of other states, "grease the legislative skids." We truly
are that close. So, obviously, if you can give, do so to the best of
your ability. If you know others who can contribute, please ask them
to help as well. And if you know folks who are serious enough about
considering a donation, but need a briefing on SB 400/HB 1660, let us
know that as well.
Dr. Walter Tsou:
"My
overall impression was this was an enormously successful and impressive
showing for Pennsylvania state single payer. Yes, I may be biased, but
our four panelists did a superb job in explaining the Family and
Business Health Security Act. To explain why I say this, consider the
concluding remarks of Senator Don White, Republican Chair of the Senate
Banking and Insurance Committee. First, Senator White offered that
"there were those who said I should not have this hearing" -- a clear
rebuke of the fearful during this time of healthcare and economic
crisis. Second, whereas in his opening comments he downplayed
expectations for the hearing as a "fact-finding session only," by the
end, his praise of the Single Payer presenters was so "positive," he
declared that this opening act was just the beginning of a series of
hearings on this most important topic.
The
hearing began with Senator White, a former insurance broker, welcoming
everyone and inviting Senator Jim Ferlo, the lead sponsor of SB 400, to
present some opening thoughts. Ferlo explained the need to look at
different approaches rather than be tied to the usual failed insurance
model. Among other attributes, he said that the state Single Payer
plan would free employers from the onerous burden of skyrocketing
health insurance costs by, instead, providing healthcare for everyone
at far less cost.
Chuck Pennacchio, Executive Director of Healthcare for all PA spoke
next and further explained the particulars of the state-level, Single
Payer approach, and how it represents values we can all embrace:
freedom, choice, fiscal conservatism, personal responsibility, modeling
solutions, constitutional federalism, fair-share taxation, efficiency,
transparency, accountability, jobs creation, bureaucratic streamlining,
investment and reinvestment, coordinated and comprehensive care,
reduced rationing, restored patient-provider relationship, healthy
outcomes, tort remedy, end bankruptcy fears, healthcare education,
"medical home" data base, and more.
Patricia
Eakin, RN from Philadelphia explained that she was a nurse in one of
the busiest ERs in Pennsylvania at Temple and that she sees the
problems of the lack of insurance on a daily basis. She gave some
examples of the problems faced by people who have lack insurance. She
noted how her hospital was losing money because they had to spend
limited resources on billing personnel, and had to absorb, and/or pass
along, financial losses on people without insurance or on Medicaid.
Dwight
Michaels, MD, a Republican, and family practice doctor from Gettysburg,
spoke about how his experience with private insurance bureaucrats had
driven him to support the Single Payer Solution. He said it is
increasingly difficult to practice medicine because his five-person
practice struggles daily with 20 different insurance plans, all with
different rules. This bureaucratic nightmare makes it impossible to
spend quality time with his patients because he is forced to justify
more and more of his procedures with the insurance carriers. Dr.
Michaels' testimony was a vivid description of the life of a family
doctor in a dysfunctional system.
David
Steil, a former Republican state legislator and head of a small
manufacturing business was another inspired choice. Not only did he
know all of the Senators but, as a creative-thinking lawmaker, he broke
the stereotype that all Single Payer supporters are lefties. Mr. Steil
spoke about how he tries to run a business, but the cost and hassle of
health insurance has made his company more vulnerable in an
international market where his non-American competitors have far
cheaper health costs.
I
think this panel worked extremely well. Not only were they excellent
speakers, but they spoke from real world experiences, not as paid
lobbyists. And two were Republicans which was an added bonus. The
committee had many questions, but none were nasty and all seemed
genuinely interested in the real world experiences of the panelists.
And the room was packed with 90% supporters of SB 400. I don't think
this was lost on the committee.
The
opposing panel were all known lobbyists for their respective interest
groups. They gave the usual refrain of condemning single payer.
NFIB
speaker - he simply declared that small businesses don't want Single
Payer, but admitted that healthcare costs are the number one concern of
businesses. They want the same outcomes that only Single Payer
provides. But since that involves "government bureaucracy," it cannot
possibly work.
PA
Medical Society - wants tort reform but not Single Payer because it
would be too powerful in controlling reimbursements (and costs).
Capitol
Blue Cross - gave a confusing talk about the problems with the
Washington federal bill and then simply concluded that SB 400 is just
like the Washington bill and should be rejected. Of course, nothing in
the federal bill even resembles Single Payer, which is why it is so
unpopular.
Hospital Association of PA - opposes any government controls generically. Gave a knee-jerk opposition to Single Payer.
Insurance
Federation of PA - same as the hospitals. They oppose Single Payer as
"monopolistic" -- working from the assumption that the
35-cents-on-the-healthcare-dollar insurance "middle man" is
indispensable, and that a little more regulation and industry
"innovation" will solve cost issues.
There
was not much time for questions but, frankly, they were special
interest lobbyists and not a very interesting opposing panel. If this
was a debate, the clear winners were the Single Payer SB 400 panel who
did a great service in advancing state-level Single Payer today.
Happy Holidays to everyone. And thanks for all you do.
Chuck and Walter
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