Integrated Single-Payer Health Care System is best approach to dealing with Ebola and future Pandemics

California Nurses Association Testifies at State Capitol on need for Single Payer

This is a proud moment for California Nurses Association/National Nurses United, whose members have taken the lead in blowing the whistle for Ebola preparedness. From a die-in on the Las Vegas Strip in September to the 50,000 strong national day of action on November 12th, the nurses of CNA/NNU have made history.
Contrary to what their hospital administrators have said about their adherence to the CDC guidelines—nurses reported quite the opposite in a survey of over 3500 nurses from every state in the US. So this new guidance in California creates a real level of security for nurses, and we thank Governor Brown and Director Baker, and the staff who worked so diligently to set this new national standard.
But what about the patients in a fragmented, under resourced “non-system” who are at the mercy of their insurance company’s high-deductible, minimal benefit, narrow network, sparse drug formulary health plan? And those on Medi-Cal who can’t find a doctor to accept them, or those undocumented workers and others who must rely solely on ER visits and a decimated public health system.

- Funding for public health preparedness and response activities in the US was $1billion less in 2013, than in 2002, according to a CDC report from earlier this year.

According to CMS data collected in 2013, patients in California Emergency Departments faced waits that are 23 minutes longer than the national average. Specifically, California patients waited on average more than two-and-a-half hours in the ED.
Further, if a patient is admitted to the hospital, the average wait increased to:

  • About five hours and 18 minutes from arrival to the time a patient is admitted; and
  • Nearly an additional two hours before a patient is moved to a bed.

At least 5% of patients at 20 of the state’s EDs left before being treated because of the long waits, according to Center for Health Reporting/Daily News.

Let’s make a distinction between an integrated, well-resourced system that guarantees a single standard of care for all with a dedicated funding source and real public accountability – known as single-payer – verses the existing fragmented approach that seeks to regulate behavior sometimes with the force of law as in the case of this new guidance, and mostly as monetary incentives and voluntary guidance. Now, the treatment response to Ebola, for example, as other in other pandemics is largely governed by private healthcare corporations who are only accountable to their shareholders or board of directors, not the public.

Understaffing, access to treatment based on ability to pay, technology replacing hands-on care, difficulty gaining admission: it could and does happen everyday in our fragmented corporate health care system. All this happened to Ebola patient Thomas Eric Duncan in a Dallas hospital, and in his case, it was fatal and two nurses infected.
We know what works, Canada has done it: A province-based single-payer system and federal agency that has the responsibility and authority to ensure local, state and national coordination to detect, respond and treat outbreaks.
The Ebola epidemic reveals the fissures and fatal inadequacies of our healthcare “non-system.” Only greater integration, planned and directed resources, and authority to a public health system can protect people in California from the dangers of pandemics like Ebola.
This new guidance issued by Cal/OSHA stands out as a clear mandate for precaution and protection establishing a national standard. Let us a create system where that is the rule, rather than the exception.

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Huge victory for California RNs, Caregivers, and Patients!

Follows Global Day of Action With 100,000 RNs Demanding Highest Safeguards, Contrast to Hospital Industry’s Failure to Act

Following a worldwide day of actions of 100,000 registered nurses and health workers demanding substantial improvements in safeguards for the deadly Ebola virus, California officials have announced landmark mandatory Ebola guidelines that should be a model for federal and state action for all U.S. hospitals, National Nurses United said today.

NNU, which has sponsored two months of actions to upgrade Ebola protections, and its California affiliate, California Nurses Association, praised the new standards released today by the California Occupational Safety and Health Administration (Cal-OSHA) under the leadership of Gov. Jerry Brown.

“These rules are a testament to the outspoken efforts of nurses who have repeatedly pressed for the highest level of mandatory safety precautions to protect nurses, patients, and the public. Nurses have raised their voices, and California has now listened, acted, and once again set a benchmark for the nation,” said NNU and CNA Executive Director RoseAnn DeMoro.

The new California standards, an elaboration of existing Cal OSHA regulations on Aerosol Transmissible Disease and other existing regulations, go well beyond the faulty procedures and protective gear employed by hospitals across the U.S., and the current, unenforceable recommendations of the federal Centers for Disease Control and Prevention.

By contrast, California regulations are mandatory. The guidance under existing standards, which are effective immediately, stipulate the optimal level of personal protective equipment, rigorous training and drills, and break additional ground in identifying modes of possible transmission of the virus and when safety precautions must be engaged for nurses and other front line health workers who encounter patients with the deadly Ebola virus.

“With the hospital industry dismissing the concerns of the nurses, and the federal government failing to order the hospitals to implement the optimal level of Ebola protection, California, under the stewardship of Gov. Brown, has heard the voices of nurses, and established a model that all should follow,” said CNA Co-President Zenei Cortez, RN.

Not only are the new guidelines a substantial step beyond existing federal standards, the California rules are mandatory, with civil penalties for hospitals that fail to comply.

“The nurses are fighting for the public. They went to the governor demanding action.  He departed from the paralysis of government and corporate inaction. He listened intently and heard the nurses reports of how deeply unprepared and resistant hospitals were and he moved to protect the public, the nurses, and other health care workers,” DeMoro said, adding, “That’s how government should work, Gov. Brown has delivered an example for the nation.”

In addition to Gov. Brown’s leadership, the nurses also praised the diligent work of Cal OSHA in developing guidance on the standards.

The California regulations embody the precautionary principle NNU has advocated in response to Ebola, that absent scientific consensus that a particular risk is not harmful, especially one that can have catastrophic consequences, the highest level of safeguards must be adopted, and a sharp contrast to the profit principle that has guided the response of most hospitals, DeMoro noted.

Further, the Ebola standards set a new benchmark for strong infection control protections for other epidemics which are expected to accelerate in the coming years.

NNU will press for legislation and regulation in other states, and continue to demand the federal government enact mandatory guidelines all hospitals must follow for Ebola and other epidemics modeled on the California standards.

In California, CNA will closely monitor hospital compliance with the guidelines, and work closely with Cal-OSHA on enforcement.

The California regulations, says NNU, exceed existing federal guidelines, close the biggest loopholes in CDC regulations, and replicate the demands NNU has made across the nation for two months.

Among highlights, under the new standards:

  • California hospitals are now required to have full-body protective suits, that meet the American Society for Testing and Materials F1670 standard for blood penetration, F1671 standard for viral penetration, that leave no skin exposed or unprotected, and that are available for all hospital staff providing care for a suspected or confirmed Ebola patient, employees cleaning contaminated areas, and staff assisting other employees with the removal of contaminated protective gear.
  • Hospitals must provide air-purifying respirators (PAPRs) with a full cowl or hood for optimal protection for the head, face and neck of any RN or other staff who provide care for a suspected or confirmed Ebola patient. Like the suits, this requirement extends to cleaning contaminated areas or assisting staff in removal of protective gear. Both these respirators and the suits have been a key NNU demand.
  • Infection by the Ebola virus can occur not just through direct contact with droplets of bodily fluids, but even through aerosol transmission of fluids from coughing or other aerosol exposure with a symptomatic Ebola patient.
  • Regular training is required for any staff who are at risk of exposure, including hands on practice in teams with the ability to interact and ask questions. Computer based training does not meet the requirement.
  • Employees who report hospitals that violate the regulations are protected from retaliation by their employers with whistleblower protection.
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Ah, Mitch McConnell and the Great Myth of Healthcare Freedom

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The election Tuesday evening represents a magnificent opportunity for us all to observe the full spectrum of political dysfunction as it applies to health care reform.  Those who support single-payer, Medicare for all for life reform would do well to focus on some of the issues the Republicans and many Americans claim bother them most about the Affordable Care Act/Obamacare.

The simplest problem solved completely by an improved and expanded Medicare for all for life system is the issue of cancellation of policies that do not meet the minimum standards of the ACA or that were cancelled when insurance companies chose not to issue plans for any number of other profit-related issues.  No one gets cancelled under a Medicare for all for life plan.  That’s the end of that problem.

Then there is the issue of being able to keep your doctor or provider.  Single-payer solves that too. You could choose to see any provider who accepted the Medicare for all for life plan.  And if we were all covered under that plan, I expect nearly every doctor would accept you as a patient rather than forego that revenue.  Well, it surely isn’t the government telling my husband’s doctors who to accept and who not to accept as patients under his current Medicare and supplemental plans.  And if Mitch McConnell has his way, the private insurance industry will have even more control over our current Medicare system.

110614 Larry's doc letterOver the past two weeks, we have gotten two separate letters explaining that only those Medicare Advantage plans offered by Humana will be accepted.  Clearly this physician group has negotiated a contract with Humana — the private, for-profit health insurance company — to exclude anyone who is enrolled in a non-Humana Medicare Advantage plan. Further, Humana wants to make sure this physician group pushes its patients during the Medicare plan open enrollment period to make sure that those who do want to keep their doctors and who favor Medicare Advantage only sign up for Humana’s plans.  Sweet deal for Humana — and none of this is orchestrated by the government in any way.  This is private, free-choice health care system flow that Mitch McConnell supports.

My husband must now change doctors.  As a person with a difficult health history, being forced by Humana or any other corporation to change doctors is problematic.  Under an improved and expanded Medicare for all for life system, none of this would happen.  There would be no need for the Medicare Advantage plans as the benefits for us all would be comprehensive and universal.  So long, Humana and your control over my husband’s medical care — and yours.

Others will unbundle for us the political implication of the Republican sweep, and I have made my share of comments about the ridiculousness of so many Americans either not voting or voting against their own self-interests as they buy into the propaganda from one side or the other.

I cannot resist responding to Mitch McConnell’s deep concern about repealing the tax medical device corporations pay under the ACA/Obamacare.  can you guess who gets the most in campaign contribution from the medical device and medical supplies industry?  Come on, I know you are quick on the uptake — oh, surprise, surprise, surprise — it’s none other than Mitch McConnell.  Number one on the list – more than $72,000 bought his loyalty to the medical device industry.  Don’t worry, Senator Ed Markey, the Democrat from the Romney-care state of Massachusetts, is right behind McConnell on those mega-bucks from the medical device folks.  And that’s that.

November 6, 2014 —  Today’s count of the health care dead and broke for profit in the U.S.:
The 2014, to date, U.S. medical-financial-industrial -complex system dead: 37,761
The 2014, to date, U.S. health care system bankrupt: 607,246

** These figures are calculated based on the Harvard University studies on excess deaths in the U.S. due to lack of insurance coverage or the ability to pay for needed health care, and the Harvard University study that calculated the high percentage of personal bankruptcies attributable to medical crisis and debt in the U.S. 123 people die daily due to lack of coverage or cash to pay for care; 1,978 go bankrupt every day due to medical crisis and debt though the majority had insurance at the time their illness or injury occurred. This statistic is also based on the 1.2 million bankruptcies in the U.S. in 2012, according to the U.S. Bankruptcy Court, and calculating those medically-related bankruptcies from that number.http://www.healthcareforallcolorado.org/endorse_right_to_health_care

 

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Thanks to CHC and our Allies, Covered California Board Takes a Neutral Position on Prop 45

chc-prop45Campaign for a Healthy California (CHC) scored a victory at the most recent Covered California Board Meeting when the Board decided to take a neutral position on Proposition 45. It had been rumored that the Covered California Board would come out in opposition to Proposition 45.

CHC affiliates and allies spoke up on the days leading up to–and during the public comment period of the Board Meeting, calling for Covered California, a public entity, to take a neutral position on Proposition 45. Those efforts proved successful. CHC affiliates who spoke to the benefits of Prop 45 at the Covered California Board Meeting included: the California Nurses Association, the California Alliance of Retired Americans, and the California Federation of Teachers.

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Last day to Register! Single Payer Healthcare National Conference – Oakland – August 22-24

medicare for allThe Campaign for a Healthy California is hosting a conference with three national single payer organizations: Labor Campaign for Single Payer, Healthcare-Now!, and One Payer States. Our conference agenda is chock full of substantive and interactive workshops we know you will enjoy.

Today is the last day to register online now for the August 22-24 super-conference that will bring together One Payer States, Healthcare-NOW! and the Labor Campaign for Single-Payer Health Care, in Oakland, CA!

This conference will give attendees a chance to learn from the best organizing going on around the country, build bridges between labor and community groups, and energize the movements for both state and national single-payer reform.

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Campaign for Healthy California Legislative Alert: Please Call Today!

Your calls needed today on Campaign for Healthy California-endorsed bills to protect patients and our communities! Let’s hold big insurance companies and the wealthy healthcare industry accountable. 

Critical CHC-sponsored legislation is up for critical votes this week in the Appropriations Committees in the California Senate and Assembly.

Your voice – and your calls – can make the difference in whether we can advance these bills.

Call Senate Appropriations Committee Chair Kevin DeLeon: 916-651-4022

Tell him your name and that you’re calling from the Campaign for Healthy California AND:

“I urge you to pass AB 2533 so that patients can go to the doctor or hospital for the medical care they need without facing financial ruin if they go outside their restrictive insurance network

I am also asking you to pass AB 503, to ensure that California non-profit hospitals are properly providing and reporting, with uniform standards, how much charity care and community benefit services they give patients and communities in exchange for their taxpayer funded non-profit status.”

Call Assembly Appropriations Committee Chair Mike Gatto: 916-319-2043

Tell him your name and that you’re calling from the Campaign for Healthy California AND:

“I urge you to pass SB 1182 to make health insurance companies justify their rate increases through full public disclosure. SB 1182 will put a stop to unnecessary and costly health care premium rate hikes, saving Californians millions of dollars.

I am also asking you to pass SB 1299, the Healthcare Workplace Violence Prevention Act to ensure that all California hospitals have an effective plan to prevent and reduce hospital workplace violence to protect patients, their families, hospital visitors, and everyone who works in a hospital.”

See our legislative page for additional info on the bills.

 

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On Medicare’s 49th Birthday Statewide Actions Call to: Protect, Improve, and Expand Medicare to All

Let's Have Medicare for All bannerOn Medicare’s 49th birthday, Wednesday, July 30, the Campaign for a Healthy California plans actions in 15 cities throughout California to celebrate Medicare’s successful provision of guaranteed health care to millions of elderly senior and disabled Americans for nearly half a century.

These actions will underscore the need to protect, improve and expand Medicare at a time when it is under attack, with efforts in Congress and the White House to reduce coverage, raise the eligibility age, eliminate providers and turn Medicare into a voucher program.

“It’s very important for people to remember that the Medicare program has been in existence for 49 years and that’s long enough to see that it works.  We don’t want it privatized because we know that the proposed schemes, such as vouchers, will hurt many people,” said Myrtle Braxton, Vice President of California Alliance for Retired Americans (CARA).

“Medicare’s birthday is a time to reflect on what works and what doesn’t. While the ACA extended health coverage to a number of low and moderate -income individuals and families, there are still far too many people who remain uninsured or inadequately covered,” said Martha Kuhl, RN, CNA treasurer and a Children’s Hospital RN in Oakland, who represents CNA in the coalition. “We need guaranteed universal coverage with a single standard of high quality care that is not based on ability to pay. Medicare’s terrific track record indicates that is best achieved through single payer reform, and expanding and updating Medicare to cover all Americans,” said Kuhl.

This week’s anniversary events coincide with the release of a new report Monday by trustees for Medicare and Social Security showing the trust fund that pays for Medicare is in much better shape than the doom and gloom predictions of the budget cutters and legislators who favor cutting benefits, raising the eligibility age or privatization. Now the trustees say that Medicare is on solid financial footing through 2030. The best way to further improve the funding, says CNA, is to expand the risk pool by adding more healthy people, as in extending the eligibility age to cover everyone.

“We are also trying to draw attention to how the 10% cuts, made in March 2013, are currently hurting people who are trying to access their Medicare benefits,” said Myrtle Braxton. “For example, where I live in Richmond, the cuts have further reduced access to the Social Security office, which administers Medicare benefits in addition to Social Security benefits. The office was already inaccessible to people who don’t have cars and now, with cuts in staff and hours, it’s impossible to reach people on the phone and many poor people, disabled and seniors don’t have computer access so that’s not an option for them,” said Braxton, who is also Chairperson of the Health Ministry at Easter Hill United Methodist Church in Richmond, CA.

July 30th actions will be taking place in: Berkeley, Modesto, Fresno, Oakland, Los Angeles, Anaheim, San Diego, Richmond, Sacramento, San Francisco, San Jose, San Bernardino, Bakersfield, Stockton, and Walnut Creek. For more information on attending an event near you, view the list of event details or call 213-359-3997.

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