The PEOPLE’S SUMMIT 2017

https://www.thepeoplessummit.org/

The People’s Summit
June 9 – 11, 2017
McCormick Place • Chicago, IL

The People’s Summit is an annual conference in Chicago held by a group of progressive political organizations in the United States, led by National Nurses United and The People for Bernie Sanders. Other groups involved in organizing this conference include Democratic Socialists of America, Food & Water Watch, Our Revolution, People Demanding Action, People’s Action, Progressive Democrats of America. https://en.wikipedia.org/wiki/People%27s_Summit

Indiana Becomes Fourth State To Ban Great Sex (theonion.com)

INDIANAPOLIS—Following the lead of Missouri, Oklahoma, and Georgia, the Indiana legislature Tuesday passed “HB 1679: Prohibiting Sexual Intercourse Of An Excessively Pleasurable Nature,” officially becoming the fourth state in the country to outlaw great sex. “Here in Indiana, we have long believed that sexual activity should be brief, unexceptional, and performed in the most perfunctory of ways, and the landmark legislation we sent to the governor today embodies the traditional values that are so deeply ingrained in this state,” said State Senator Mark Messmer in a morning news conference, explaining that any sexual relations in which the participants are mutually satisfied emotionally or physically would result in fines of up to $1,000, depending on how incredible the sex was. “By restricting sexual activity to seven minutes or less and banning all sexual positions within the state aside from the missionary position, this bold new law stands up for the passable, fairly mechanical sex that my fellow Hoosiers and I have long disinterestedly engaged in—and that we will continue to disinterestedly engage in, provided we do so no more than twice per calendar month, as per the legally mandated limit.” Messmer went on to say that he didn’t anticipate any negative effects from the ban as nearly every Indiana resident was already in compliance with the new law.

“A FAQ About California’s Single Payer Health Care Legislation, SB 562” by JP Massar

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Enthusiastic California nurses leading a rally at the State Capitol for SB 562

June 7, 2017 (dailykos.com)

I’ve gathered together many of the questions people ask, and objections they raise, when single payer health care is discussed. Accompanying the questions are my answers: some definitive, some an admission of doubt and uncertainty.  With a few jabs and a bit of snark thrown in.

So enjoy! And point your dubious friends here when they ask you any of these 50+ questions…

THE BASICS

Q. What is SB 562?
A. It’s legislation introduced by Senator Richard Lara into the California legislature in 2017, designed to create a single-payer, universal health care system in the state. It would set up an organization called Healthy California to administer the program.

Q. Who would it cover?
A. Everyone who is a resident of California, using a residency requirement very similar to that of California’s current Medicaid program (MediCal).

Q. Including undocumented individuals?
A. Yes. Everyone.

Q. Homeless people?
A. Yes. Everyone.

Q. Health insurance company CEO’s?
A. Hmmm. Maybe there’ll be an exception…

Q. What would it cover?
A. Pretty much everything. Anything you’d normally think of as associated with doctors and hospitals as well as mental health services, dental services, vision, medical equipment purchases, nursing home and long-term care, and on. You can find a non-limiting list in the legislation (Chapter 4, 100630).

Q. What would people have to pay to get services?
A. Zero. Zip. Nada. $0.00.  No copays, no fees, no deductibles, no premiums.

Q. How would it work from an individual’s perspective? 
A. You’d get a Healthy California membership card. You make an appointment. You present your card. You get treated. You go to a pharmacy. You get your medicine. You never pay anything.

Q. How would it work from a company’s perspective?
A. Companies would no longer have to deal in any way with health insurance, health insurance companies, self-insurance, or health benefits. It would all just go away.

Q. How would it work from a medical services provider’s perspective?
A. Logically, a service would scan your card, provide services to you, and then bill the Healthy California Trust Fund, which would process the request and send the service provider a check.  Of course the details may be different (e.g., reimbursements may be aggregated and sent in one weekly check, covering everyone treated, or sent via an electronic transfer). Most importantly health service providers would not be dealing with twenty different insurance companies’ rules and regulations, questions of coverage or denial of claims issues.

There’s another way – the Kaiser way (integrated care). The legislation allows Healthy California to pay an organization like Kaiser a fixed fee per person per year (perhaps adjusted by age). It would be Kaiser’s responsibility to make ends meet from that revenue stream. In such a case there wouldn’t even be a need for billing or reimbursement.

COSTS

Q. What will it cost?
A. A guesstimate by the staff of the California Senate Appropriations Committee put the cost at $400 billion annually. A detailed analysis by economists using hard data and modelling arrived at a figure of $330 billion annually.

Q. That’s a lot of money, even by Carl Sagan standards. How could we possibly come up with a sum like that?
A. In order for these numbers to have any meaning, they must be compared to what California spends now on health care per year. That’s close to $370 billion!  So the money already exists and is being used for the same purposes. No one has to “come up with it.”

That $370B figure includes all money spend by the federal government in California (e.g., Medicare, Medicaid, CHIP, ACA subsidies, emergency room subsidies, etc), all money spent by the state and local governments (insurance premiums for employees, costs to keep County hospitals open, mental health services spending, etc), all money spent by employers on health insurance premiums and other health benefits, and all money spent by individuals on premiums, co-pays, deductibles, fees, medical equipment, etc.

For more perspective, the GDP of California is $2.6 Trillion.

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Robert Pollin, study author, presenting its findings at a May 31st press conference in Sacramento with California Nurses looking on.

Q. So depending on who you believe, it will either cost California $30B more per year or $40B less per year?
A. Yes. Keep in mind the smaller figure is based on a rigorous analysis by a team of academics — led by Robert Pollin. Governor Brown’s former economic advisor – with extensive experience in these matters. The larger figure was a fairly quick guesstimate by competent legislative staff but was by no means a rigorous analysis.

Q. Why might it cost less?
A. Insurance companies would go away. So no more insurance company profits and far less paperwork and red tape. Fewer emergency room visits. Healthier individuals overall whose conditions are treated before they become million-dollar problems. The ability (and mandate) to negotiate drug prices with pharmaceutical companies. The mandate to negotiate fair and reasonable prices for medical services based on Medicare reimbursement rates, which are less than current private-market prices. Along with other efficiencies that can be realized once you have a non-profit, single-payer entity managing the system.

Q. Why might it cost more?
A. Higher utilization and frivolous use.  More people (everyone) covered. Possible increased fraud.

Q. Is there any evidence one way or another?
A. We know that other countries, most notably Canada and Taiwan, have single-payer systems and costs a) are much less than they are in the United States per capita, and b) they don’t have unacceptable problems with too much utilization, frivolous use or fraud.

We know that Canada negotiates drug prices and gets around a 30% reduction vis a vis the prices we pay in America.

We know that our existing single-payer system in the United States – Medicare – has far lower administrative overhead than private insurance companies.

We know, from our own personal experience and studies, that insurance companies impose huge bureaucratic burdens both on doctors and patients.

Of course we don’t know for sure what will happen until we try.

Q. What if the analysis is wrong and it does cost more?
A. We still get universal coverage, dental and vision for everyone, the elimination of medical debt, peace of mind, no more bake sales and GOFUNDme’s when someone gets sick, and more. We retain the ability to look at what’s going wrong and make the appropriate corrections, unlike the situation now, where the ACA, even if it survives, can’t be tweeked or repaired because of Republican intransigence.

FINANCING

Q. Where will the money to pay service providers come from? How does it get into the Healthy California Trust Fund?
A. California would take all the money it’s getting now from the Federal government, and all other state and local allocations for health care, and direct it into the Trust Fund. New sources of revenue (aka new taxes) will be created to fund the difference, which is approximately $100B using the study’s numbers.

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Q. Did you say ‘new taxes’ ?
A. Yes. Taxes. The same sort of mechanism that now pays for schools and roads would also be used henceforth to pay for health care. It’s radical, but the alternative is continuing to pay health insurance company CEO’s millions to pay people low wages to stamp DENIED on claims.

Q. What taxes?
A. There is no specific additional tax written into the legislation at the moment. However, the financial analysis study proposed two revenue sources:

  •  A gross receipts tax for businesses of 2.3% in lieu of all the health insurance costs they now incur, imposed only on receipts over $2,000,0000. (Therefore, the smallest businesses would pay nothing, and a small business with, say, $2,500,000 in gross receipts, would pay only on $500,000, not $2,500,000, for a total annual bill of $11,500). The bigger the business, the higher the effective rate.
  •  An increase in the sales tax of 2.3%, with a rebate to low-income households to insure that the net effect on those with low income is minimal, or even net beneficial.

Q. Why aren’t these funding sources written into the legislation?
A. Because the financing proposal came out too late to be inserted into the legislation before it was voted on by the California Senate (the legislature now has a 72-hour posting rule, which, while it may or may not have actually applied here, was honored by the Senate).

Also, because there are other financing mechanisms possible (e.g. a progressive payroll tax, progressive capital gains and interest income taxes, or a carbon tax), and the authors want an open debate and flexibility.

[Nerdlyness warning — The next four questions are a bit on the policy wonk side. You can scroll down to “Prospects for Passage” if that’s not your thing.]

Q. What happens if the Federal government refuses to give California the money it’s currently spending in California on medical services if California sets up a single-payer system? Doesn’t the Trump administration already hate us?
A. Yes, they already hate us. No, they can’t just say “Screw you.” And if they try to, there is sound legal basis for suing to compel them to provide the money. The Feds can’t let Indiana get special waivers to do what they want with Medicaid money while not letting California have the same rights.

Existing Medicare law already allows California to take over the administration of Medicare. Medicare and Medicaid are the two biggest chunks of money coming from the Feds.

Could it get messy? Indeed. Could Trump figure out a legal way to screw California over? It’s certainly possible. But since there is no possibility of a better health care system any time soon at the Federal level, and a significant possibility of a worse one – that California will suffer immensely from – we need to push forward.

Q. What happens to this plan if Congress repeals the ACA?
A. Congress isn’t considering repealing the ACA. At least not currently. They want to change the way the ACA exchange subsidies are doled out, and change Medicaid reimbursement, cutting the amount of each (and they want to give states greater authority to screw people). So the amount of money that California (and every other state) would receive from the Feds would be reduced, but it would not be eliminated.

If states gets less money from the Feds for healthcare, either that money has to be made up somehow by the state and/or its people or everyone gets less healthcare, takes on more medical debt, and starts dying. The latter may be acceptable in Alabama but is probably not going to play well in the Golden State.

So either our state taxes go up to cover the shortfall, or companies and people with enough money start paying out-of-pocket for more of their health care. The former seems like a fairer thing to do. And given that the Republican plan, the ACHCA, is basically a tax cut for the rich, it seems fairest of all for the state to then tax California’s rich to claw back some or all of that bonanza and use it for health care.

Q. What about ERISA (Employee Retirement Income Security Act), Federal legislation which reserves for the Federal government the right to regulate self-funded employer health plans such as those offered by large corporate employers?
A. That could be a problem.  Changing ERISA would require an Act of Congress. California seemingly cannot otherwise force self-funding companies operating in California to become part of its single-payer plan.

However, there is nothing that prevents California from taxing businesses using the gross receipts tax regardless of whether they self-insure their employees or not. What company in its right mind would continue to choose to self-insure its California employees, effectively paying for their health care, AND pay the gross receipts tax? Why not voluntarily drop the self-insurance plan and save a lot of money?

Q. So if you institute these new taxes and now the state is going to spend some $330B on health care, that will more than double the state budget. What about that?
A. Yes, the state budget would increase by a large factor, in a technical sense.

The money will come into the state in various forms, and immediately go out again directly to the Healthy California Trust fund, where it will then be disbursed to health care providers.
Remember, California’s (as in everyone in California’s) budget for health care is already $370B. Whether electronic money flows through a state owned computer and therefore technically increases the state “budget,” or the Feds, insurance companies and people send the money to health care providers is a technical detail that the press and opponents have blown up into a scare headline: “State budget would more than double!”

Ultimately, the money still goes to the health care providers. The path it takes is of pretty much no concern to those receiving health care, taxpayers or anyone else except the insurance companies who will no longer be able to extract their pound of flesh.

In meaningful terms the State budget will increase by the costs to administer the Healthy California program – a bunch of people will have to be hired by the state, and paid like other State employees.  Administration is estimated to be about five percent of total spending, so we’re talking about a some $17 billion “non-vacuous” increase in spending for the State of California.

PROSPECTS FOR PASSAGE

Q. Won’t any financing require a 2/3rd majority in both houses of the legislature?
A. Yes. Any increase in taxes requires a supermajority, per the California Constitution. Democrats currently have 2/3rds majorities in both houses but were only able to obtain 23 votes out of the 27 Democrats in the Senate (with no Republican ayes) for SB 562. Since the financing mechanism was not yet in the bill, it only required a majority, 21, and it passed. The Assembly is considered more conservative than the Senate.

Q. So the legislation is doomed?
A. Who can say? Even if it were miraculously to pass both houses with a supermajority it might still face a veto from Governor Brown.

HOWEVER various analyses have concluded that some provisions of the legislation would require a constitutional amendment to overcome certain constitutional restrictions. In California a constitutional amendment can only be passed by the voters, but needs a simple majority. So if parts of the legislation require a vote on a supporting constitutional amendment anyway, the  bill itself could be turned into a ballot initiative and voted on by the people at the same time – again, with only a majority vote to become law. That could happen in June of 2018 but more likely in November, 2018.

Therefore the legislation could theoretically be enacted without the legislature’s or the Governor’s support.

Another path would be fort enough signatures to be gathered to put it on the ballot — then go to the negotiating table with the Legislature and the Governor to have them pass and sign some form of the bill, avoiding the enormous effort a ballot initiative would entail. This was how California’s eventual $15 statewide minimum wage came to be, and the recently renewed millionaire’s tax.

Yet another more distant possibility is that after 2018 there will be a different Governor and possibly an even more progressive legislature. Lt. Governor Newsom has endorsed the idea of single payer for California, and he is probably the front-runner at the moment of those who have announced a run for Governor.

OBJECTIONS.

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Q. Isn’t this a government takeover of the health care system?
A. No. It’s the replacement of the health care REIMBURSEMENT SYSTEM as it exists now (a bizarre combination of for-profit insurance companies, cash payments by individuals and government payments) with a single, government administered, reimbursement system.

The health care system itself is not changed by this legislation, nor is it “taken over.” True, the legislation allows Healthy California to regulate health care in various ways – but there is already regulation under the ACA and before the ACA there was a patchwork of Federal and State regulation of the industry.

In fact, the legislation provides for the reverse of a takeover. It specifically calls for medical decisions to be made by medical experts – your doctors – rather than by either health insurance company death panels or by government bureaucrats.

Q. Won’t people come from other states and get free health care?
A. They can’t just drive or fly in, get free health care and leave. They would have to become residents.

Q. Won’t people move here from states where they would otherwise have to pay for expensive treatments or die?
A. It’s possible. Neither the Sierras nor the Mojave Desert proved enough of a barrier to keep people out hundreds of years ago; the fruit inspection stations along I80, I15 and I10 probably won’t be able to either (snark).

Again, you would have to become a resident, which takes time. And money. People who can afford it might choose instead to do “medical tourism” to another country for a month or two instead of picking up stakes and literally moving.

It is interesting to note that a similar situation existed vis a vis Massachusetts, with Romneycare, before the ACA was passed. All the sick people and people with pre-existing conditions in the country could have decided to move to Massachusetts, get residency, and be covered via Medicaid or subsided insurance on their exchange.  But that didn’t happen.

The passage and implementation of single payer in California may prompt other states to do so as well, which would limit the problem.

In truth, we simply don’t know for sure what will happen.

Q. Won’t people go to the doctor for every little ache and pain? 
A. There may be a few people who do this. If so, it seems like it is a reasonable tradeoff to have a few people get more care than they need than to have a bunch of people not get enough care. I don’t know about you, but the last thing I want to do is go to a doctor or a dentist if I don’t have to, have my blood drawn and/or have to pee in a cup. This simply does not appear to be a serious problem in any of the countries that have universal health care.

Q. Won’t doctors order unnecessary tests, have people come in ‘for yuks’ so they can bill for appointments, and prescribe unnecessary drugs? 
A. That could happen. Remember, we do have proof of concept in Canada and Taiwan, and it doesn’t seem to be a budget-killing problem in those countries. And as it stands right now doctors could (and some of them probably do!) order unnecessary tests, create unnecessary appointments and prescribe unnecessary drugs.

Q. Won’t costs explode?
A. We’ll never know for sure until we try. They haven’t in other countries. The legislation provides the Healthy California Board with sufficient oversight and regulatory authority to insure that this doesn’t happen. Whether they will use that mandate appropriately only time can tell.

The flip side of this question is that costs have already exploded. We pay far more per capita for health care than any other advanced country and it keeps going higher faster than the inflation rate. Are we going to keep doing the same thing over and over and expecting anything to change?

Q. Won’t businesses object?
A. Maybe, but they shouldn’t. The study shows that all businesses will save money – especially small businesses which now pick up part or all of their employees health costs.

Q. Won’t the Chamber of Commerce object?
A. Yes, they will (and already have). Fuck them.

Q. Won’t the insurance companies object?
A. Yes, they certainly will (and already have). Fuck them and the horses they ride in on (keeping in mind we are against cruelty to animals, just in favor of rhetorical devices). Health insurance companies are by definition unethical and immoral – once you get sick, the best outcome for them is that you die, quickly. It’s better for all of us if they, instead, die quickly.

Q. Won’t the drug companies object?
A. Yes, they certainly will. Fuck them and their $1000 a dose pills.

Q. What if drug companies refuse to sell to California?
A. They don’t refuse to sell to Canada. They don’t refuse to sell to Taiwan. They don’t refuse to sell to the Veteran’s Administration, which pays significantly reduced prices. they don’t refuse to sell to other countries that regulate drug prices. Why would they refuse to sell to the world’s 6th largest economy? And if they do, we can tell Google, Apple, Twitter and Facebook to cut off their access to Internet search and social media (snark).

Q. Won’t people freak out when they hear you’ll be raising the sales tax?
A. Assuming that a sales tax hike is written into the legislation, yes, yes they will. (This freaking out concept would apply to just about any proposed tax). It remains to be seen whether facts and math can convince people that a sales tax hike of 2.3% is a sensible way to pay for health care instead of what people are paying now.

All we can do is try:

Let’s say a household buys $20,000 in taxable goods a year (remember, rent or mortgage, which consumes a large part of post-tax income, groceries, movies, live entertainment and certain other things are not sales-taxable in California, so $20K is A LOT of taxable goods for the average family).  That household would pay $460 in increased sales tax. For that they get completely free health care for the entire household. What an incredible deal.

Do the math. Only those with enormous incomes who also spend a lot on material goods are going to come out behind.  Even if your household spends $200,000 on taxable goods in a year you still only pay $4600 for everyone’s healthcare!

The proposal also sees to it that poor households will basically get back all that they have spent in sales tax, possibly even more, through a tax rebate.

Will people have enough common sense to see this and reject the hysterical anti-tax rhetoric we know will be thrown at the proposal?

ALTERNATIVE APPROACHES

Q. Why don’t we just tax the rich to pay for the single-payer plan? 
A. Revenue sources such as capital gains taxes are notoriously variable, so one reason not to rely solely on taxing the rich is to have a steadier funding stream.

Also, California recieved about $12B in capital gains tax revenue in 2016. Even doubling the capital gains tax rate would therefore bring in at most another $12B.

Using a gross receipts tax that is paid mostly by big businesses does seem to be a pretty reasonable way to  “tax the rich,” albeit indirectly.

This all said, there is no obvious reason why the financing plan could not also contain various direct “tax the rich” methods such as progressive increases in taxes on capital gains, interest and income.

Q. Why don’t we tax X more? Why don’t we implement a new Y tax? (For all conceivable values of X and Y).
A. You have to do something, it can’t be too complicated, and you don’t want to do everything. Everyone has their favorite tax scheme. Mine is a carbon tax with rebates. Yours may be an increase in the millionaire’s tax. Ultimately, someone has to pick some subset of possible taxes that will bring in enough revenue and run with it. It is unlikely that any particular scheme will be able to please even most of the people most of the time.  The goal is not to argue for years over the “perfect” revenue producing scheme, it’s to make sure that everyone gets the healthcare they need.

Q. Why aren’t there any co-pays? Wouldn’t that put a stop to the most frivolous abuses? Wouldn’t it make the system cost less?
A. Co-pays are a severely regressive tax, especially on poor families with kids. And if you start exempting people, co-pays become an even larger administrative burden than they would be otherwise.

Again, better to put up with a bit of frivolous usage than have people unable to go to the doctor when they or their kids need to.

Copays would only gross the health care system a few billion dollars, not a significant percentage of what health care costs.

It’s just not worth it, and they violate the principle that health care is a right.

Q. Why don’t we just do a ‘Medicare for All’ model?
A. At some level it is already a lot like Medicare for All. Everyone is covered, and the government pays the bills. At another level, this is a lot better. No monthly payments, no confusion about Parts A, B C and/or D. No having to have supplementary coverage for the 20% Medicare doesn’t pay for. No confusion about which drug plan to choose…

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Q. Why don’t we go with the Swiss [ German, Japanese, French, UK … ] model?
A. If people proposed going with the Swiss model (private, highly regulated companies with everyone required by law to obtain policies for basic health insurance, no profits allowed on this basic insurance, low limits on deductibles and cost sharing, limits on premiums as a percent of income, and subsidies for the poor), or the Japanese model (similar to the Swiss, but with additional strict controls on medical fees), or the French model (single-payer-ish, with a single insuring entity covering 84% of the population, along with co-pays and complicated reimbursement rules) other people would ask why we weren’t going with the Canadian model.

Every other advanced country has some sort of universal health care system that doesn’t let private, for-profit health insurance and pharmacutical companies run amok. These systems run the gamut from an actual takeover of the health industry (the NHS, in the UK) to the Swiss and German models, which still allow insurance companies to exist but keep them under control.

No one is saying that the proposed SB 562 single-payer system is a perfect system. But it’s pretty clear that a) no one knows what THE perfect system is, and b) our current system seems to be worse than any we could choose from.

Again, you have to pick some way. At some point the parameters have to be chosen. We know single-payer works (as do other mechanisms for universal care), and there’s no point spending decades debating the perfect system and parameters while people continue to get screwed and the country reverts to a system with even less care.

LOGISTICAL ISSUES

Q. Won’t it take a long time to see a doctor?
A. This has not been the experience in other countries; in fact it is just the opposite in serious and emergency situations. For certain things, like elective surgery, it may indeed take longer as has been reported in other countries.  But that’s a small price to pay to have your cancer treatment start the day after you are diagnosed instead of waiting two months to have the treatment approved by an insurance company.

The time it takes to see a doctor depends on how many doctors there are, as well as how many people want to see one. The supply of doctors is not easily changed in this country, and the legislation does not address this issue except in a very general way. It’s certainly something that should be addressed, and should be addressed on a national level.

Q. What about all the people employed by insurance companies?
A. Some of them will quickly find work in similar jobs elsewhere, or with the Healthy California administration. The legislation provides for job training benefits and assurances that people will be given assistance over the years of transition. (A comforting twist is that we know they won’t have a financial problem just because they get sick if they are still unemployed!)

Q. What about extending the single payer system in California to other likeminded states like Oregon?
A. In principle it makes perfect sense. In practice, the logistics of getting it to work in just one state will be challenging enough – trying to negotiate an interstate compact before getting it up and running first in California is probably unrealistic.

Also, my understanding is that any such interstate pact would have to be approved by Congress. This could be a stumbling block.

Q. What if you, as a Californian, travel to another state?
A. The legislation provides for the Healthy California administration to work the details out in those cases. But since health facilities in other jurisdictions will know that you have insurance and know they will get paid you should be treated almost like royalty…

Q. If I’m already on Medicare, what happens to me?
A. You’ll get a Healthy California card and you’ll continue to get health care as you do now. You’ll just stop paying monthly Medicare premiums, co-insurance, and any other fees.

Q. If I’m not a Californian but am visiting and need medical care, how will that work?
A. The legislation does not specify that. The Healthy California Board will have the authority to create regulations and procedures to deal with these matters.

Q. What about workman’s compensation?
A. The legislation gives the newly established Healthy California Board two years to come out with a plan to incorporate WC into single payer. For the nonce, it will apparently continue as is.  The simple solution would be “do it like they do it in Canada” which still operates a Workman’s Compensation system but where

…medical benefits are not the primary driver of workers’ compensation costs. Canada’s loss of earnings benefits/wage loss benefits are the primary driver of costs due to the publically funded nature of the healthcare system.

so it looks like they’ve make Workman’s Compensation work alongside and with their single-payer system while still continuing to exist as a separate entity.

Q. Kaiser says they would be destroyed if SB 562 were to become law. Is that true?
A. Kaiser is an “integrated health care delivery system” as well as being an insurance entity. The legislation provides for integrated health care systems such as Kaiser. Kaiser would have to stop being an insurance company, of course, but all their doctors, hospitals and impressive, computerized, integrated health systems would remain.

It’s not clear why they think they could not operate in the new environment. One reason might be that they would lose customers because people would prefer the freedom to choose any provider instead of just Kaiser employees. A counterargument is that patients which Kaiser does not currently accept, such as some people who qualify for MediCal in some counties such as Alameda, could enroll in Kaiser.

If Kaiser can actually provide good healthcare cheaper than average, and they are being paid the average by Healthy California, then maybe Kaiser should give people a “signup bonus” to become or stay on as a member.

Since Kaiser serves a large portion of California’s population, it’s clear that whatever happens, Kaiser will not be allowed to just vanish.

MISCELLANEOUS

Q. They say single payer has already failed in Vermont and Colorado, so it makes no sense to try it in California. Is this true?
A. It’s false. Single-payer has never actually been implemented in any state. Vermont passed legislation that would have implemented it, but then they got cold feet. Colorado had a ballot initiative which, if it had passed, would have implemented a rather odd variant of single-payer, quite different from this proposal.  But it did not pass.

Vermont’s size, economic situation and demographics are radically different than California. The funding proposal to pay for the Vermont legislation, a payroll tax, was very different than the proposed funding mechanism for California. Claiming a system that was never implemented and had a much less sensible funding mechanism as proof that a similar system won’t work in California is a bogus argument.

Q. Some say price controls are the only way to save money and stop the rise in costs. Why doesn’t SB 562 insist on price controls?
A. Some other countries have price controls; some don’t. SB 562 provides for mandated negotiations that result in “fair and reasonable” prices for medical services and for drug supplies.

Q. If people no longer went bankrupt as a result of medical problems wouldn’t that be a boon for California’s economy? Has that been factored in to the calculations?
A. It would be a boon. To the best of my knowledge, it hasn’t been factored in.

Q. If Californians saved $40B a year in health care costs, who’s going to make out?
A. Mainly people who are now paying their own premiums – self-employed middle class types, for example, and small businesses who are now paying premiums for their employees.

Q. Seems like that would be also boost California’s economy, encouraging people to start their own businesses and allow small companies to hire new employees?
A. Seems that way. I’m not aware of any analysis along those lines.

Q. How will California’s homeless become eligible if they don’t have any residence?
A. California’s homeless population is generally eligible for MediCal, the state’s Medicaid program, and Healthy California will use similar means of determining residency. California also makes it easy for homeless people to register to vote, another way of establishing residency.

Q. Won’t this make California a Socialist paradise? And isn’t that bad?
A. Hmmm.

Q. What about medical marijuana?
A. The legislation doesn’t address that. Even if medical marijuana were found to be appropriate to be prescribed by doctors in California under the Healthy California system there would still be the issue of federal funds being used to pay for it.

That’s all folks!  That covers a whole lot of the questions people have asked about SB 562 in diaries I’ve published previously, such as the ones below.

Background and More Information:

SB 562 text and legislative record.

Why do we need a California Public Bank?


Published on May 17, 2014

California has the financial ability … right now … to fully fund education, support small business, rebuild our infrastructure, protect homeowners from Wall Street predatory lending, become a leader in protecting our environment while saving money on energy, and significantly expand low-cost public transportation. With a state-owned, public bank we can make all these changes and more.

Thanks to Rudy Avizius for sharing his text and graphics!

OPEN LETTER TO THE 47th GENERAL ASSEMBLY OF THE ORGANIZATION OF AMERICAN STATES (OAS)

Dear Occupy San Francisco:

From the human rights organizations working here in Ecuador, we are concerned about the possibility of Douglas Cassel being elected member of the Inter-American Commission on Human Rights.  Cassel has been nominated by the United States Government and would be elected during the upcoming General Assembly of the Organization of American States, June 19th-21st.

Cassel has worked for Chevron, as consultant and lawyer, defending the transnational corporation against the lawsuit by indigenous and rural Ecuadorians of the Ecuadorian Amazon whose rights were violated by Chevron/Texaco.  We do not believe the prominent human rights institution of the Americas should include a member who has chosen to support a powerful corporation guilty of human and environmental rights violations instead of the Ecuadorian communities fighting for justice.

Attached is our open letter to the General Assembly of the Organization of American States, in English and Spanish.  We ask for the signature and support of OccupySF.

We would be grateful for your confirmation that we may include the endorsement of OccupySF on our letter at your earliest convenience.

Many Thanks,

Emily Parker
Intern
UDAPT (Union of People Affected by Chevron/Texaco)

OPEN LETTER
TO THE XLVII GENERAL ASSEMBLY OF THE ORGANIZATION OF AMERICAN STATES
(OAS): “STRENGTHENING DIALOGUE AND CONCERTATION FOR PROSPERITY”
Cancun, Mexico, June 19 to 21, 2017

As organizations of civil society who work on the frontlines for the defense and promotion of human rights on the continent, we are concerned about a the nomination of Douglass Cassel as a member of the Inter-American Commission on Human Rights (from here on, the IACHR). While we recognize Dr. Cassel’s long academic trajectory, we do not consider him to have the “high moral character” established in the Regulations of the IACHR, which should be required of any person who wishes to be part of the main human rights institution of the continent.

In many of our battles for the defense of human rights, the IACHR is the ultimate and only institution to which we can turn. We are alarmed that our last hope for obtaining justice falls in the hands of a person who, in one of the most emblematic cases in the world concerning the defense of human rights violated by corporations, has not had the integrity to stand with justice and the victims. In the trial pursued by Ecuadorian Amazonian communities against Chevron Corporation, Douglass Cassel accepted the position of defense lawyer for the company in exchange for a sum of money that has never been disclosed, despite various petitions.

For 24 years the indigenous and rural communities of the Ecuadorian Amazon have fought in court for the reparation and restoration of their human, collective and environmental rights, as well as the rights of nature, violated by the petroleum operations of Texaco (now Chevron). To obtain the first sentence regarding the environmental, social and cultural crime committed by Chevron in the Northern Ecuadorian Amazon, the indigenous and non-indigenous Ecuadorians had to wait 17 years. To achieve that Chevron complies with the legitimate legal sentence, issued five years ago in the judicial system selected by Chevron, the plaintiffs continue to fight, taking their case to various foreign courts to enforce the judgement. Chevron, far from complying with the legitimate court order, has opted to not recognize the court ruling and to perpetuate the environmental, social and cultural crime it generated over 50 years ago. It is this oil company that Dr. Cassel defends—Dr. Cassel who now wants to be a member of the Inter-American Commission on Human Rights.

Chevron, on the other hand, Cassel has defended in the most aggressive manner possible, pledging to the plaintiffs, “We’re going to fight this until hell freezes over. And then we’ll fight it out on the ice.” [1] The oil company has utilized its enormous economic power and political lobbying to ensure the crime committed in the Amazon remains unpunished. The transnational corporation has pressured governments for favor in the judicial process and has spent near one billion dollars on the defense of the case. Chevron has contracted a military of two thousand defense lawyers for the trial. This case exemplifies the inability of the law to access justice for communities in developing countries who confront large transnational corporations.

In this context of inequality, in which marginalized communities whose rights have been violated fight to obtain justice before one of the largest companies in the world, Douglas Cassel has accepted the position of lawyer and advisor for Chevron. Dr. Cassel would work, as a representative of the company, with all international human rights organizations to which plaintiff communities turn. These acts conflict with an academic position, which demands objectivity.

The previously stated is corroborated when Dr. Cassel, as a “human rights” lawyer, repeats, supports and defends the arguments used by the oil company without raising any questioning. Employing arguments that were used by the tobacco industry for its defense, such as the argument that cigarettes do not damage health, Cassel questions the lawsuit of the Ecuadorians affected by Chevron, claiming there is no evidence that the toxins dumped by the oil industry cause illness. In fact, in one document produced by him he states: “the legal team of the plaintiffs has not presented credible scientific evidence, not even of particular cases of cancer caused by oil pollution, much less of a public health catastrophe.” [2] Cassel dismisses all available information that demonstrates the existence of grave health problems in populations of the zones operated by Chevron and that demonstrates that the health problems are the result of the environmental contamination caused by poor practices by the oil company.

This position is contrary to the IACHR, to which Cassel claims to be a member. Members of this international organization, after a visit realized in 1994 (just one year after Texaco left Ecuador), confirmed in their report that:

“It has been amply documented that exposure to petroleum and the chemical compounds linked to petroleum via the skin, via ingestion by food or water, or via the emanations absorbed by the respiratory system cause adverse effects for human health and life. In the case before us, the data collected attests to the considerable risk to human life and health represented by oil exploitation activities in the Ecuadorian Amazon.” [3]

It is noteworthy that Cassel, a lawyer who supposedly defends human rights, turns to arguments from corporate law and supports Chevron’s approach of evading its responsibility for damages in the Ecuadorian Amazon [4] and hiding in a complex corporate structure to defend its capital. In asserting that Chevron never operated in Ecuador and that the tried is Texaco, he assumes that the merger between the two companies in 2001 left out of the agreement the responsibility for the pollution and its subsequent impacts. To block justice and the recognition, exercise and reestablishment of human rights, under the argument that Chevron and Texaco are two legal entities, although in practice the company stock package is one, could be expected from a lawyer of a private investment protection court but not from someone who professes to be a member of the principal inter-American human rights defense court. It is a fact that Cassel not only approves but also defends the legitimacy of a private international arbitration process that undermines fundamental human rights, contrary to our experience and the growing academic literature on this subject.

The position of Cassel, in favor of the company and not the people whose fundamental rights have been harmed, puts in doubt his suitability for the most important human rights organization of the region. In a continent where the violations of fundamental rights committed by companies continue to increase, it is necessary to count on an IACHR whose members apply the pro homine principle and who do not represent the interests of large corporations.

Someone who lacks sufficient sensitivity to commiserate with the difficult situation lived by thousands of victims of human rights violations in the Ecuadorian Amazon and who fails to understand how complicated it is for small communities to launch judicial battles against large corporations does not deserve to be part of an organization whose principal function is “to promote the observance and protection of human rights” of the continent.

Quito, May 3, 2017

Notes:

[1] John Otis, Chevron vs. Ecuadorean Activists, The Global Post, May 3, 2009, disponible en: http://www.globalpost.com/dispatch/the-americas/090429/chevron-ecuador?page=0,2#.
[2] Translated from Spanish June 2, 2017. Original quote: “el equipo legal de los demandantes no ha presentado evidencia científica creíble, ni siquiera de casos particulares de cáncer causados por contaminación por petróleo, menos aún de una catástrofe de salud pública.”
[3] Translated from Spanish June 2, 2017. Original quote: “Se ha documentado ampliamente que la exposición al petróleo y a los compuestos químicos vinculados al mismo petróleo a través de la piel, por ingestión en los alimentos o el agua, o bien en las emanaciones absorbidas por el aparato respiratorio, provoca efectos nocivos para la salud y la vida del ser humano. En el caso que nos ocupa, los datos recogidos dan fe del riesgo considerable para la vida y la salud humana que representan las actividades de explotación petrolera en el Oriente.”
[4] In one of his documents Cassel, with the end of minimizing the responsibility of Chevron, stated that the company “never had worked in oil drilling or extraction activities in Ecuador. In 2001 a Chevron subsidiary merged with Texaco and acquired its subsidiary, Texaco Petroleum Company (“TexPet”), which until 1990 had been the operator and minority shareholder in a consortium with the Ecuadorian state oil company in the Amazon basin.”
[5] For us it is unprecedented that only one company be held liable for the violations of fundamental rights, arguing that the companies are different legal entities, when in practice the stockholding of the companies is one entity.  Translated from Spanish June 2, 2017. Original quote: “nunca ha trabajado en actividades de perforación o extracción petrolera en el Ecuador. En el 2001 una subsidiaria de Chevron se fusionó con Texaco y adquirió su subsidiaria, Texaco Petroleum Company (“TexPet”), la misma que hasta 1990 había sido la operadora y accionista minoritaria en un consorcio con la compañía estatal petrolera ecuatoriana en la cuenca amazónica.”

Animals Against Extinction Appear on I-80 Overpass in Berkeley to Rally Support as Trump Ditches Paris Climate Agreement

June 3, 3017

Bannering on Berkeley I-80 Overpass: “WTF? There IS no Planet B!!!” RESIST!!!

The Movement will not sit still for Climate deniers like trump. City and State Governments Unite with the rest of the World!!!From the overpass:  Hundreds of cars (44,000 in 2 hours!) and hundreds of honks, waves, power salutes as cars pass under us!

–from Kathy, Katy, Jan, Ruthie, Eric

“First they came for the homeless” by Sandy Perry (peoplestribune.org)

June 2017

(From Left) Los Angeles’s People’s Tribune correspondent, Chris Venn, Stephanie Williams, organizer in her L.A. Skid Row community (humorously in a police hat), and Robert Aguirre of San Jose, organizer with H.O.M.E.L.E.S.S., visit Skid Row during the Los Angeles leg of the recent “First they came for the homeless” three-city California tour.
PHOTO/GENA MERCER

 

The “First They Came for the Homeless” California speaking tour brought together some key leaders of the movement against homelessness from April 22 to 24. The tour was named after a grouping of houseless people that emerged from Occupy San Francisco and then organized a series of dramatic encampments confronting political officials in Berkeley, California. The name is in fact an accurate warning to all of us: the fascist daily persecution of the homeless today is the likely future fate of all American workers if we fail to defend and unite with them now.

The tour featured leaders from Berkeley, San Francisco, San Jose, Merced, and Los Angeles, each sharing the aspirations and lessons of their respective battles with the system. In addition to uniting these leaders, the purpose of the tour was to raise funds to finance broader circulation of the Peoples Tribune and amplify the voices of the homeless leaders whose articles appear in it.

The message of the tour was unique, because like the Peoples Tribune, it was political and strategic. It was different from typical speaking engagements by homeless individuals that attempt to create an “immersion experience” or “reality tour” to expose people to the realities of homelessness, or make people feel sorry for them. Speakers on this tour had a clear-eyed assessment that the system necessarily creates homelessness in order to make money for profiteers. The question is not to make a pitch for sympathy, but to sound the alarm about a system that has no respect for human life, and begin to organize the resistance.

These Tour speakers remarked about their experiences with the Tour and about the situation in the homeless movement:

“Money is the enemy, not the solution. Profit before people put us here. People before profit will fix it.” — Mike Zint, San Francisco/Berkeley, ‘First they came for the homeless’ and the Poor Tour.

“I am someone and I matter.  Next is that we all need to believe it.” — Gena Mercer, Merced, California Central Valley Journey for Justice.

“San Jose destroyed the ‘Jungle’ camp in 2014, but it has not made any progress since then. They say they have housed 1000 homeless people, but that doesn’t count the new people who become homeless all the time. Thousands are still forced to live outside every night. The City sweeps their camps and illegally takes their possessions, but they always come back because there’s no place for them to go.” — Robert Aguirre, H.O.M.E.L.E.S.S, San Jose

“It was a great privilege to attend and speak at the event and hear from those on the front lines experiencing homelessness and their grassroots efforts in the struggle to end homelessness.” —Bilal Mafundi Ali,  San Francisco, Coalition on Homelessness and People’s Commission for Justice.

The tour visited San Francisco, the California Central Valley, and the heart of Skid Row in Los Angeles. The message from the L.A. leaders was especially clear: the time has come to formulate a new paradigm. Merely reacting to the endless attacks is not effective.

What needs to be done, several speakers concluded, is to first build a community in and around a section of the homeless to assemble at least the nucleus of a fighting force. Then we have to enter the political battle to hold the government accountable for ending homelessness. In L.A. they are calling on people to “disrupt the Mayor” until he answers their demands. Political battle may start with confronting the government, but it also means organizing our troops, distinguishing who are our enemies and who are our friends, and uniting all who can be united in our campaigns for housing, basic human needs, and basic human dignity. As one leader said at the end of the tour, “There are more of us than there are of them. The question is, how do we get ourselves united?”

We encourage reproduction of this article so long as you credit the source.
Copyright © 2017 People’s Tribune. Visit us at http://peoplestribune.org

(Courtesy of Mike Zint.)

HUMAN EXTENDED VERSION VOL. 1 OF 2 (from Bob of Occupy)


Turn on the Closed Captions (CC) to know the countries where the images were filmed and the first name of the interviewees.

What is it that makes us human? Is it that we love, that we fight ? That we laugh ? Cry ? Our curiosity ? The quest for discovery ?
Driven by these questions, filmmaker and artist Yann Arthus-Bertrand spent three years collecting real-life stories from 2,000 women and men in 60 countries. Working with a dedicated team of translators, journalists and cameramen, Yann captures deeply personal and emotional accounts of topics that unite us all; struggles with poverty, war, homophobia, and the future of our planet mixed with moments of love and happiness.

The VOL.1 deals with the themes of love, women, work and poverty.
In order to share this unique image bank everywhere and for everyone,
HUMAN exist in several versions :
A theatre version (3h11) , a tv version (2h11) and a 3 volumes version for the web

CONTACTS
Office Yann Arthus-Bertrand : Yann2@yab.fr
Project manager: jessica@human-themovie.org
French events and non-commercial distribution : event@human-themovie.org

Official website HUMAN : http://www.human-themovie.org
For further contents, visit http://g.co/humanthemovie
Enjoy and share #WhatMakesUsHUMAN
Watch the full film from September 12 at https://www.youtube.com/channel/UCJy4…

All these shoots were carbon-offset through the GoodPlanet Foundation’s United Carbone Action program: http://www.goodplanet.org/en/united-c…