Senator Barbara Boxer emailed our 700,000+ members today asking them to stand with us to fight for women's health and stop the Stupak Amendment. Sen. Boxer has become a very strong, compelling voice against this odious amendment, which would make it very difficult for women to access their right to reproductive choice. It's going to take a strong show of force by the California progressive community to ensure that this is taken out of the final bill. Please join us by signing the petition.

Below is the email Senator Boxer sent to our members.   Read More »

Last Thursday the San Francisco Chronicle reported that under the current bills being considered in the House and Senate, 90% of Americans would not be able to pick a public health insurance option. The proposed rules would limit access to the Exchange, where the public option would be offered, to "individuals who cannot get insurance, or whose health care costs exceed 12.5 percent of their income."

Not only would that mean most Americans wouldn't have access to the public option - it also means that public option would be weaker. For the public option to bring down costs and provide quality care, it needs to have a large base of paying customers to be able to negotiate good rates. Further, it needs to be able to attract healthy young people. If it can't, then the public option may suffer what is known as "adverse selection" where only the sickest people get the public option. That would drive up the costs of the public option, and make it less effective.

In order to make the public option provide the most benefits for the most people, we need to open it up so that anyone who wants to buy into it may do so. Oregon Senator Ron Wyden is offering an amendment to allow anyone to access the Exchange, where the public option will be offered. Senator Barbara Boxer has already indicated her support for the Wyden Amendment. It's now up to Senator Dianne Feinstein to join Boxer, Wyden, and the American people in demanding everyone be allowed to choose the public option.

That's why we sent the following email to our members today, asking them to sign the letter to Senator Feinstein asking her to open the public option to everyone:   Read More »

Arnold Schwarzenegger wrote a letter to California's Congressional leaders today about health care reform. Most of it is a long extended whine about the feds not offering enough money to states to provide for health care, since Arnold believes California should not be spending much money to help people get health care.

But there's also an interesting proposal from our governor about the public option. Basically, he wants to use the "opt-out" as an opportunity for California to design its own public option, one that would benefit fewer people than the federal option:

In terms of state coverage options, I support the inclusion of language that will provide states the option of developing state-based insurance options for people with incomes above 133 percent of the federal poverty level but below 200 percent. I believe this provision can be strengthened and made more effective by allowing states, especially those with higher costs of living, to serve populations up to 300 percent FPL, providing states access to at least 95 percent of the tax credits and cost-sharing subsidies available for eligible individuals in the state and ensuring sufficient state flexibility to enable continuity of care between Medicaid and the state-based option. Providing states with the flexibility to set eligibility to 300 percent of the federal poverty level recognizes different cost structures across states and is more consistent with existing income eligibility thresholds allowed under the federal children’s health insurance program, which will help support the policy goal of keeping families together for health insurance purposes.

Finally, creating transparent and user-friendly health insurance exchanges at the state level can help facilitate the enrollment process. At the same time, I believe these state-based exchanges must be more than simple clearinghouses of information, but instead allow states to certify plans and negotiate within broadly established federal parameters to help promote competition among health plans. I also continue to believe that states must remain the primary regulator of health insurance in order to maintain the strongest consumer protections possible.

What this means is that Arnold Schwarzenegger would have California exercise the opt-out in order to design a "public option" much more restrictive in who it is available to, provided in state-based exchanges instead of through a national system. Alongside protecting the customer base of his insurance industry allies, this would also enable California to force the people who would want a public option to jump through a number of hoops designed to discourage them from actually getting the benefit, as California now does with things like IHSS, food stamps, and such.

Some may argue that California would never go for this kind of "Arnold option," but let's consider some things here. First, the Senate language regarding the opt-out has yet to materialize. Arnold may well be mainstreaming right-wing and corporate talking points that could be used by conservadems in the Senate to shape the opt-out in a way that would have the program more closely resemble the Nixonian "block grants" that have given states too much power to restrict federally-mandated benefits. In short, Arnold might be saying "hey, here's how the opt-out should look!"

Arnold may also be setting up the language and framing that could be used by Republican gubernatorial candidates to deal with federal health care reform. In a state where the public option concept is popular, Arnold could be showing how the public option could be neutered in practice while preserved in name.

In a state that has gutted much of its public sector over the last two years, with bipartisan support the entire time, it's a strategy worth watching closely. Especially since the outcome of the federal health care reform project now appears to be a shifting of the battleground to the states.

UPDATE by Robert: John Myers reports via Twitter that "Guv's ofc says his health care letter should not be interpreted as support for opt-in/opt-out public option" and that, quoting a governor's office spokesperson, Arnold "is calling for state-based insurance options to offer coverage for lower income populations not eligible for Medicaid."

The "insurance" business model does not deliver health care well.

It delivers reimbursement well for anomaly events, like random house fires for a large pool of people who have statistically only a few claims amongst them over a long period of time. "Insurance" is the appropriate choice to spread risk of an unlikely loss, and prevent a potential bankruptcy.

However, delivering health care requires a business model that is publicly funded, flexible, provides consistent, paperless, and dependable customer health care services seamlessly, and effortlessly with health care facilities. Health care needs increase and decrease throughout a humans life, irrespective of their finances.

Health care provided well must be delivered with a business model that matches humans health care needs. There are many business models to study from all over the world that provide health care well.

First, the USA needs to figure out a new business model, one that matches the customer service it is trying to deliver, health care.

Second, within the new "Health Care" business model framework, decide what entities, be it public or private combinations, meet consumers health care needs best.

The "insurance" business model was not meant to deliver health care services well, and it hasn't!

It's time to move forward...toward "health care" and away from insurance!

There's an interesting generational phenomenon at work here. The age group that currently enjoys the benefits of a single-payer system, those over 65, are among the least likely to support health care reform. The age group most likely to support reform is the other end of the spectrum - people age 18-29, as the LA Times reported yesterday:

Adults 18 to 29 are the group most supportive of President Obama's plan to overhaul healthcare, according to a recent poll by SurveyUSA. They are also the age group that most supports creating a government-run health insurance option.

Young people account for 30% of the uninsured population, according to a report by the Commonwealth Fund, a health policy research foundation. They are least likely to be offered health insurance through employment benefits -- just 53% of working young adults are eligible for employer-based coverage. And since their incomes tend to be low, buying coverage on their own is usually too expensive.

As the article explains, much of the support for health care reform among younger people is as function of our drearier economic prospects. We tend to have high debt loads or low wages - or both. We don't have assets to fall back on, we couldn't buy a house during the affordable years and have that asset be subsidized by Prop 13.

And yet there are deeper factors at work here. The health care crisis affects every generation, especially those who thought they were living a comfortable middle-class lifestyle until medical debt their insurance didn't cover wiped them out. Many of those older homeowners are barely surviving the recession with their finances intact. We younger folks may be feeling the recession's bite harder than most others, but there is plenty of misery to go around.

So why is it that younger people are more supportive of reform? Part of it is that we are more progressive than virtually every other age group, by virtually every measure out there. Because we weren't raised in an era of McCarthyism, because those of us under 30 have only vague memories of Reagan, and because we have recoiled so strongly from the Republican who has dominated our conscious lives the most - George W. Bush - we are not trained to see government as the enemy. We are more willing to see government as the solution because we aren't carrying around the burdens of the 1950s or the 1980s, because we do not take the New Deal state for granted.

But there's another factor at work here as well. We can call it the *boiling frog effect*. Older generations of Americans were socialized into a society where the economy generally worked, at least for most people middle-class and above. If you had a job, you could expect to have health care. You could expect to own a home, and enjoy a basic level of economic security.

That is not true today, not for any American outside the wealthiest percentiles, no matter what your age. But for folks who were socialized to think of America as the awesomest economy in the world, where you could expect to have security and health care if you held down a job, the present crisis snuck up on people the way heat snuck up on the frog in what had been a cold pot of water. They didn't expect it, and they still haven't adjusted their expectations to the new reality. They still see the present crisis as a temporary but difficult spot.

Us younger folks, though, have been thrown right into the boiling pot. We're entering an economy that doesn't offer anything of use to anyone who isn't rich, and we can see that right off the bat. Unlike older generations who may have seen the system as offering realistic opportunities for security and advancement when they first entered, we are under no such illusions. We know things are fucked and that we are not likely to see any meaningful improvement in our fortunes anytime soon.

Moreover, we're thrown into this crisis at a crucial moment in our lives - when we want to build lives, families, communities. The number of people I know who have delayed having children because of dire economic straits is staggering. And when you take away someone's future like that, you create a cohort of people who quite clearly and instinctively understand the need for fundamental, root and branch reform.

We're the natural foot soldiers of reform. But we're not being spoken to by the reformers.

The LA Times article also examined how the current reform proposal might affect the young:

Michael Tanner, a senior fellow at the Cato Institute, a libertarian think tank, says a requirement to buy insurance would hurt young people most, forcing them to subsidize the healthcare needs of older people without making health insurance more affordable for them.

"Young people are probably one of the groups that's going to come out the worst on this," Tanner said. "They're going to pay more in the short term because they're going to have to go out and buy health insurance. And they're going to pay more in the long term."

Genevieve Kenney, a health economist at the Urban Institute, a nonpartisan Washington think tank, disagrees.

"I think many more uninsured young adults stand to gain from healthcare reform than stand to lose," Kenney said, citing plans in Congress to provide insurance subsidies for low-income people, many of whom are young.

As much as it pains me to say this, the guy from Cato is right. Mandated insurance without a public option offers nothing of value whatsoever to younger people. That's because it's not designed to help us. It's designed to extract even more money from our already meager bank accounts and deliver us virtually nothing in return. It is a classic case of screwing over the young in order to preserve a zombie economy that is dead, but is still being clung to by those who refuse to admit it, who cannot envision a new economic policy, and who are deathly afraid of change.

Because the Obama Administration seems to have repeated the flaw of most Democratic political leaders that preceded it and chosen to ignore younger voters, even though we were *by far* the group of voters that backed him the most strongly in 2008, we are feeling left out of a debate that is primarily focused on appeasing seniors and right-leaning boomers. The more transformative approach, to build a coalition of change that unites seniors, the young, and those in the middle under stress in support of an expanded Medicare for all, has been ignored.

Obama will suffer the consequences for that. Us younger folks will stagger on, even more determined to build political movements and to assert political power. Eventually we will be the ones to lead the implementation of a universal single-payer system in America.

I only hope it comes sooner and rather than later. I don't intend to become a part of a new Lost Generation.

That's what the Courage Campaign, Credo Mobile and Democracy for America are asking today. We are teaming up to urge Senator Feinstein to come out with a definitive statement in support of the public option.

The response you get on Senator Feinstein's position on the public option varies, depending on what staffer you get on the phone. Not true of Senator Boxer (from her campaign's blog) who isn't afraid to be clear about her support for the public option:

She laid out where she thinks these complex negotiations will lead and why it’s so important: “I do think we’ll have a public interest option at the end of the day because we have to contain the costs.” And “what is the best way to keep down the cost? I think it’s competition and I think a public interest plan will do just that.” Which is exactly why Boxer has long been a cosponsor of Sherrod Brown’s Senate resolution declaring that “any efforts to reform our Nation’s health care system should include as an option the establishment of a federally-backed insurance pool to create options for American consumers.”

With the Senate about to return from the August recess, it is crucial that Senator Feinstein take a firm stance on the public option and work to get it passed.

There are some rumors that she will be issuing a statement about the public option tomorrow. The best way to ensure that it happens is to keep the pressure up on Senator Feinstein. So sign the letter. Check the flip for the full email we sent out to our members today.   Read More »

Over the last few days it has become quite clear that the initiative in health care reform is passing to us. Progressive activists have become organized and energized to ensure that the public option, itself the minimally acceptable compromise, remains a part of the health care bill. Thanks to the work of Caliticians like David and Dante Atkins, Bob Brigham, and the rest of the progressive netroots, we are now having a great deal of success at drawing a firm and hard line.

Of course, we also must remember the reasons why a public option matters. A strong public health insurance option that any American can choose to join is one of the only ways to ensure that the private insurance companies remain honest.

Particularly because the private insurers have been operating their own "death panels" for some time now. As we saw in the high-profile cases of Nataline Sarkisyan and Nick Colombo health insurance companies routinely deny coverage and care to insured patients once they get a terminal illness.

One such patient was Patsy Bates. The Courage Campaign decided to dramatize her story last year in an ad we call Insurance Jive - the impenetrable language of insurance companies that obscures their deadly effect.

Today the Courage Campaign relaunched that video in order to provide a strong visual message about the need to act for the public option. Wendell Potter, a former Cigna executive who has been making the rounds explaining his insiders' view about why we need major health care reform in America, wrote an email to our members calling on them to watch the video and to call their members of Congress to shore up support for the public option.

The video and click-to-call action is Courage Campaign's contribution to the broad progressive netroots mobilization on behalf of real health care reform. Make no mistake, the public option is at best a compromise position, and only a halfway step toward full single-payer care. But it is important that we win this fight and show the insurance companies for what they really are - a danger to our very survival.

Below the flip is the email Wendell Potter sent to our members today.   Read More »

I don't know about you, but I can't find anything in the outcome of the May 19 election that justifies, say, ending welfare entirely, or denying AIDS patients life-saving medicines, or throwing a million kids off of health care, or closing the state park system, or eliminating affordable access to higher education. Can you?

In fact, even though polls show voters emphatically *reject* that kind of budgeting Arnold Schwarzenegger has gone ahead and proposed it anyway. In his best effort to play the role of a modern-day Herbert Hoover he has decided to interpret the election as a mandate to push through the radical attack on government he has always wanted to lead.

In recent hearings in the Legislature - which in themselves prove the value of an open budget process - the scope of the cuts has become clear, and even legislators who were just last week speaking of the need for cuts are starting to have second thoughts, as Anthony Wright reported:

Some members, like Senator Denise Ducheny, asked whether some of these cuts would not create more costs, as people end up in emergency rooms or elsewhere, even within the budget year. "What makes you think this doesn't create a cost shift?... Will people just die and we won't have to take care of them?" she asked.

Senator Mark Leno talked about how the AIDS Drug Assistance Program "literally keeps people alive," and asked for information about the increased cost of ermegency room visits as a result of the cut. Senator Alan Lowenthal asked if there was a "longitudinal" analysis, and asked for the "long-range implications" of these cuts.

Assemblywoman Noreen Evans was alarmed when she noted that dialysis would be cut for some patients, exclaiming that her father was going through such treatment, and was not optional. She also noted that some cuts, like the elimination of HIV Testing, would have public health impacts. Assemblyman Kevin DeLeon pointed out the cuts to community clinics, arguing that for many Californians, "this is the only safety-net they have."

As the Sac Bee reports, even some Republicans acknowledge that there is such a thing as a successful government program:

Assemblyman Danny Gilmore, R-Hanford, wrote an opinion piece this month for the Bakersfield Californian telling constituents how to apply to Healthy Families and touting it as a program that works "especially well."

Of course, the Zombie Death Cult still has its adherents, like Chuck DeVore:

But Assemblyman Chuck DeVore, R-Irvine, said the state must scale back because it cannot afford the benefits it provides. DeVore asserted that overregulation and high taxes have stifled businesses and led to layoffs, while California has compounded the problem with too much public aid.

"When you have an unemployment rate as high as it is in this state, it should be a signal to people to look for jobs in other states with more jobs and a lower cost of living," DeVore said. "We have had policies subsidizing poverty in this state for years, and we can't keep doing that."

And this guy wants to be in the US Senate! The irony is that even his own constituents disagree with him. Orange County residents don't want their parents to lose dialysis treatment. They don't want their kids to lose Cal Grants. They don't want to be barred from going to the nearby beach.

As we have been explaining for months now, these kinds of cuts are suicidal. They will make the budget picture worse by costing more money than the cuts would save. They will certainly make the economic crisis FAR worse by forcing consumers to pull back even further on spending in order to replace the lost state aid. Arnold Schwarzenegger is demanding a Depression.

Unfortunately the legislative leadership has woefully unprepared themselves to respond. Instead of spending the months leading up to the May 19 election talking about protecting Californians against horrific cuts, the Democratic leadership instead went along with Arnold's scare tactics and made a cuts-only budget sound inevitable - and then doubled down the day after the election.

It's time for legislators to "just say no" to these cuts. And not say it in order to accept lesser but similarly damaging cuts, but say "no" in order to walk through the wide open door that leads out of the Jarvis nightmare scenario. We have a golden opportunity to bury 30 years of anti-tax nonsense - Californians understand that taxes are necessary to prevent people from dying and to provide economic recovery. There is widespread support for raising taxes on the wealthy, closing the loopholes, and ending a failed prisons policy that costs us billions.

It's time for legislators to move beyond outrage and to start showing real leadership against this madness. If they want to restore their reputations with voters, the best way to do so is to show that the Legislature still understands common sense and can give the people what they want - a fair tax system that will stop these cuts in their entirety.

The Courage Campaign has long championed the battle for affordable and accessible health care. It's why we asked you to join us in asking Terry McAuliffe to please don't do it as we approach his high-priced speaking engagement in San Francisco for insurance executives. And it's why we partnered with the California Nurses Association and Senator Sheila Kuehl today to introduce our new "Insurance Jive" ad.

Rick Jacobs emailed Courage subscribers earlier today explaining just how much is at stake and and how much a small contribution to air this ad can accomplish:   Read More »

This is a year unlike any in recent memory for the prospects of progressive progress and reform. There's an opportunity to take huge steps towards fixing the damage done by the Bush Administration and make positive change towards a country that simply takes better care of its citizens.

But as Democrats, we're going to have a much tougher time getting there if we don't all travel together. Which is why, with millions of Americans unable to get basic health care, it's so distressing that former DNC Chair Terry McAuliffe is cashing a big check from the insurance companies in San Francisco June 19.

We know all too well that insurance companies don't spend a dime on actually providing health care to the sick and injured if they can help it, which is why it's such a concern that McAuliffe is willing to accept this money that should be spent on medical treatment.

But, not surprisingly, Rick Jacobs said it much better than I ever could earlier today:   Read More »

During the morning drive today, NPR ran through John McCain's healthcare plan, which isn't really a plan so much as a plot to throw sick people to the wolves. But what struck me most wasn't how ineffectual McCain's plan would be (make private insurance cheaper...somehow), but how dramatically he apparently misunderstands the fundamental nature of the health care crisis in this country. Senator McCain believes:

The problem is not that most Americans lack adequate health insurance...The biggest problem with the American health care system is that it costs too much.

Which of course ignores the millions of people who have health insurance but still can't get adequate health care. And the millions of people who have become uninsurable because of prexisting conditions. Those people aren't John McCain's concern apparently, and why would it be since his goal is protecting insurance companies? What's even more shockingly ignorant though is the parallels he tries to draw with other national programs. McCain flatly rejects the notion of mandated health insurance (a debatable issue, granted) with the argument that he wants everyone to have a college education too, but he's not going to force it on them. Unfortunately for McCain, this country mandates over a decade of education already. You know- the basic level necessary to reasonably function in modern society? Yeah, that one. Which is exactly what a health insurance mandate would be doing. So either McCain doesn't realize that kids are required to go to school in this country (rather unlikely), he doesn't understand what a health insurance mandate is (also unlikely, but less so), or he's just being willfully deceptive and dishonest with the country (I think we have a winner). It's amazing not only that he thinks he can get away with this, but that the people in this country deserve to be treated with this sort of intellectual contempt. I can't wait to beat this guy.

"It was here, four years ago where presidential candidate John Edwards was first inspired by the labor movement, says Sal Rosselli," president of California's largest labor union, United Healthcare Workers West. This weekend, Elizabeth Edwards will keynote their 2007 Leadership Conference.   Read More »

Health Reform and the Year of Magical Thinking

The Year of Magical Thinking is the title of a memoir by Joan Didion detailing her state of denial, inexplicable behaviors and, finally, coming to grips with, the death of her husband. It's also an apt description of the Governor's 2007 approach to reforming our broken healthcare system, with the glaring difference that he still hasn't come to grips with the truth. (After all, if a complicated movie plot could be resolved in less than two hours, who not fix healthcare in California in nine months?)

Beginning in January, the Governor ordered his health advisors to sketch the outlines of a plan that would magically "cover" all Californians by simply requiring them to buy health insurance. To this moment, he has refused to negotiate any of his major points with the Legislature. The language for his plan was finally drafted five months later, and shown, under wraps, to a few, select people. Not one legislator agreed with it, and no one would carry the bill as legislation.

To fill the void raised by the Governor's magical "we must do something this year" drumbeat, the Democratic leaders began crafting their own reform plan. To date, however, the Governor and the Legislative leadership have remained oceans apart on the broad policy strokes of health care while public support for the current insurance-company controlled system has plummeted and support for the reforms contained in SB 840, the Medicare-like fix for California, has grown.

Now, with less than two weeks remaining in the first half of the two-year legislative session, there is still no "something" on the table and the Governor, like a Barnum and Bailey's ring leader, continues to announce that he will, assuredly, pull a rabbit out of a black hat. Actually, there is no way of knowing if the result would really be a rabbit; it could just as easily be an albatross.

The Governor has further limited discussion by announcing that he would veto both of the legislative proposals that have actually been introduced as real bills. SB 840, by far the most carefully crafted, transparent and fully vetted bill, will remain in the Legislature until next year, since sending it down to him for a veto would end any consideration of single payer until 2009. The individual mandate provisions in the Governor's pronouncement are being emphatically rejected by virtually all stakeholders representing the people who would be forced to pay uncapped premiums. The percentages to be paid by employers and individuals, hospitals and doctors, people in a "pool" and those outside, those above differing percentages of the poverty scale and those below, are so far apart in the Governor's pronouncements and the Speaker's bill, you could drive trucks through the gaps. The Governor's lynchpin financial mechanism of a provider tax remains submerged under the very murky water of a 2/3 vote. What convoluted compromise might be devised in a last-minute attempt is anyone's guess.

Nonetheless, we are told that, unless we agree to pass a yet-to-be hastily drafted bill that incidentally may be the biggest reform proposal ever attempted in health care, and pass it in two weeks, thus completely bypassing the entire political process and any semblance of open public input, we've completely failed and health reform is doomed forever. Please.

The prospect of legislative staff, sitting behind closed doors, hastily crafting a 100-page health reform "compromise", to be pushed through the legislature with little or no public input over the course of the next 14 days, is deeply irresponsible. Frankly, given the example of the energy deregulation bill, we ought to know better.

Moreover, we lose nothing by taking advantage of the fact that the sessions of the California legislature are two year sessions. Many of our major accomplishments, most recently, AB 32, the bill related to greenhouse gas, took more than one year to achieve. Next year's Presidential campaigns will ensure that health reform stays as the top of the agenda. More importantly, the issue of health reform will continue to dominate because the people need it and want it. What they want, and deserve, however, is responsible health reform, not a new debacle that benefits the health insurance companies the way the electricity bill benefited Enron.

Finally, we must not forget the reason that we are in this crisis to begin with. Health care premiums changed by insurance companies continue to grow 3-4 times faster than wages. A solution is needed that pays attention to adequate funding, affordability, cost controls and quality.

Even if the Legislature should pass a last minute convoluted experiment in health reform, there will still be a need to continue the work to enact a fully vetted, Medicare-like single payer system that replaces the insurance companies with a plan for all Californians, allows each person to choose their own providers, and protects affordability, comprehensive coverage and quality. Such a solution is the only sensible and tested way to achieve universal health care responsibly. Whatever happens in the next two weeks, the movement for single payer universal health care is continuing to grow, and SB 840 will continue as its focal point, the only legislation that establishes the kind of truly universal, modern and affordable health care system the people of California need and deserve.

California Speaks: We Want Single Payer
by Senator Sheila Kuehl

On August 11th, 2007, at the culminating and boisterous OneCareNow rally in Los Angeles, as well as eight coordinated "listening" events around the state, sponsored by Blue Shield and the California Endowment, among others, a random selection of thousands of Californians spoke out overwhelmingly in favor of major health care reform.

At the largest rally of the year, more than two thousand advocates, patients, nurses, doctors and universal health care fans gathered on the steps and lawns of the Los Angeles City Hall to excoriate a health care system that does nothing but devastate working families with systematic cancellations, denials and delays in care. This doesn't promote health, it isn't care, and it certainly isn't a "system"-- it's traumatizing and often deadly for people who thought they would be given care, but, instead, got nothing but a tangle of insurance red tape.

Convinced that single-payer universal health care is the only hope for fixing our broken health care system, they gathered to support SB 840 (Kuehl), the only truly universal health care plan proposed in legislation that is shown to contain costs, improve health care quality and allow Californians total choice of their doctors and hospitals.

Perhaps by design, on that same Saturday, health care foundations (including Blue Shield Foundation, Kaiser Family Foundation and the California Endowment) spent over $4 million on an event originally spun as an exercise in "deliberative democracy", but in reality was carefully structured to control discussion, in order to ask randomly selected participants to discuss and "vote" on their preferences for healthcare reform.

Naming the event CaliforniaSpeaks, organizers claimed the event would bring together thousands of Californians to discuss their perspectives on the current health reform proposals still under debate in Sacramento, yet the agenda was careful to exclude single payer from the discussion. Organizers of the event told us the reason that they didn't include single payer was because the governor said he wouldn't sign it.

Apparently when they said the event was designed to give Californians the chance to set the health care agenda, what they actually meant was that the event would be an opportunity for the people to jump in line with the Governor's healthcare agenda. As is often the case, the people had a different idea--they did, in fact, jump; they jumped out of their seats demanding that single payer and SB 840 be included in the discussion, forcing the organizers to tack the issue on at the last minute at the end of the day.

The fact that participants were forced, on their own accord, to demand the inclusion of single payer at the CaliforniaSpeaks events clearly indicates that the conventional political message, mostly propagated by the health insurance companies, has yet to understand that two decades worth of traumatized patients and families, along with an even higher consciousness of our failings set out in Michael Moore's new film, "SiCKO", has changed health reform politics forever. Consider the overwhelming standing ovation that Steve Skvara received (http://www.youtube.com/watch?v=C5SSyS5n6U4) at last Tuesday's Democratic Presidential Debate when he asked, chocking back tears, "What's wrong with America?", describing how his family lost their guaranteed retiree health coverage when the company who owed it to him filed for bankruptcy. Skvara's story immediately resonated with millions of Americans across the nation, and he became an instant online celebrity. Why? Because he clearly illustrated our broken health care system and the abuses of corporate greed. Skavara's story is one of thousands that are positioned to spark the simmering anger that a broad spectrum of Americans feel toward our insurance based non-system.

California families are becoming so hurt and so incensed at insurance company greed and abuse that they are increasingly willing, like nurse Cynthia Campbell's husband, to pick up a megaphone and plead "Don't Kill My Wife" in front of Blue Shield's headquarters. And the transformation crosses the political spectrum. Art DeWerk, the Police Chief for the central valley town of Ceres, spoke out recently in favor of single payer as he described the helplessness he felt after his wife was unable to get timely access to routine medical care as she battled cancer.

These and other stories are found all too often in a health care system where the only competition is between insurance companies focused only on how much risk they can avoid, instead of the more appropriate competition between direct health care providers for quality service, driven by a single payer system that allows total patient choice of doctors and hospitals. And stories like those set out above, as well as others, even worse, will continue until we ditch the "system" that spends 30% of every health care dollar simply to weed out those of us who are sick enough to need our coverage and move to a real universal healthcare system that eliminates the middleman and returns decision making in healthcare to doctors and patients.

By the end of Saturday's "listening" event, after everyone had discussed the intricacies of the incremental plans, single payer surprised the organizers by polling better than the others, with significantly more people saying they would support it under any condition. For those who supported a generic single payer system, but with conditions, SB 840 was, in fact, the only plan that actually met all the conditions set out by the discussants. For example, 53% of the participants statewide said they would support single payer if they could choose their own doctors and hospitals. SB 840 guarantees this. In contrast, both mandates which define the Governor's policy paper and the Speaker of the Assembly's bill, AB 8, received support by the discussants only if there were caps on costs and premiums. In fact, neither proposal currently includes this provision.

Both the rally in Los Angeles and CaliforniaSpeaks showed us that the people of California are way ahead of the Governor, as well as the Speaker, with regard to healthcare. At the end of the day, more participants felt that quality of care shouldn't depend on how much money you have, that everyone should have access, and that greed should be kept out of the health care system.

Interestingly, and perhaps tellingly, later that same day, the Governor was quoted on a Fresno news station as saying he would sign SB 840 "as soon as we have the money for it". Of course, the Lewin Report, studying the factors set out in the bill, has already shown how the plan will be funded. But, whether the Governor's pronouncement signals a serious shift in his thinking, it certainly acknowledges the political momentum that SB 840 has garnered. I welcome the conversation on funding, because we've got the money. SB 840 can easily be achieved with our current health care spending, personal, employer and state and federal. It would use the money wasted by the insurance companies on denying care to provide it, to all Californians, without co-pays or deductibles, for one affordable premium each year. What we need is the political will to catch up with the will of the people of California.