Harriette Seiler, at right, with Nan Goheen at the 2009 sit in at Humana as part of nationwide actions seeking to place single payer into the health care debate. Harriette’s current letter printed in the Courier-Journal is below.

Nov. 20, 2014, Courier-Journal

Most Kentuckians are pleased that health care coverage has been expanded in our state, but there are questions to be considered.

Are the managed care organizations (MCOs) that oversee Medicaid providing quality treatment and follow-up — including prescribed medications for the mentally ill? MCOs profit by reducing costs and, bluntly stated, cost-cutting strategies often involve cutting care.

Persons who bought private plans (gold, silver, etc.) on the Kynect exchange last year must now re-enroll for 2015. Before buying, enrollees should read the policy carefully: Can you see your preferred doctor? How narrow is the hospital network? How high is the deductible? If you had to pay out of your own pocket for treatment, would that keep you from going for help when you have worrisome symptoms? If you have a chronic disease, check the drug formularies: Is your medication listed? Has the co-pay gone up?

As we ponder all these critical issues, the people in other advanced nations are happily going about their day because their leaders had sense enough to implement a single-payer system —saving money for their country and for each individual. Instead of all the political and judicial machinations now going on across the U.S., let’s just tell Congress to pass HR 676. Simply improve traditional Medicare and give it to everybody!

HARRIETTE NYE SEILER

Vicco, KY endorses single payer.

The Vicco City Commissioners are Lula Gibson, Jimmy Slone, and Claude Branson. (photo by Lane Adams)

KSPH Chair Kay Tillow and Vicco Mayor Johnny Cummings.

I’ve just been part of a Twitter exchange as to whether or not the ACA is a pathway to a single payer plan? Many single-payer supporters hope that the good things in the ACA (no exclusion for pre-existing conditions, for example) will bring us closer to truly universal coverage. There are Twitter folk who think Obamacare could just be tweaked to offer plans that would bypass the private insurers–plans such as a Medicare buy-in or a public option. The physicians at PNHP.org point out the flaws in such proposals. See the 06/15/2010 article by Margaret Flowers, M.D.. During the debate on health care reform, Dr. Flowers was one of the “Baucus 8,” a respected physician removed from the Senate chamber when she and seven others asked to be allowed to testify on the merits of a single payer system. She explains why a publicly funded, nonprofit single payer cannot co-exist within a national system that includes the private insurers. Here’s the link to the article.

Members of the Steering Committee of KSPH are often asked to give a talk about single payer. Ideally, we like to have about 40 minutes for a PowerPoint presentation, followed by 15 minutes for Q&A. But quite often the hosting group asks for a shorter talk, so we have prepared this “nutshell” version of our message. It takes less than 5 minutes to deliver–and can be adapted by the speaker.

1. We are members of Kentuckians for Single Payer Healthcare, volunteer advocates for a health care program that would go beyond the Affordable Care Act(ACA) to cover absolutely everyone in our country. We acknowledge that the ACA will benefit certain people, but over 30 million will be left uninsured.

2. We are nonpartisan, but we do support a bill in Congress, HR 676, that would expand and improve Medicare–and give it to everyone. You have our brochure which will give you details about the legislation. You may also read a summary, or the full text, online.

3. HR 676 would provide coverage for all necessary medical care–dental, vision, and long-term care–and we could choose our own doctor.

4. Passage of HR 676 would save billions of dollars per year by cutting the administrative waste caused by our current dependence on private insurers. The plan would be nonprofit, and publicly funded. The ‘”single payer” would be “we the people” using our taxes to provide coverage and care for each other. Ninety-five percent of Americans would pay less than they do now–considering what we currently pay if you add up premiums, out-of-pocket expenses, and taxes. The health of our people and our economy would benefit. Business would be relieved of the burden of providing and managing health insurance.

5. Our companies would be more competitive in the global marketplace. The governments of other advanced industrial democracies–countries where capitalism is thriving–have set up some version of single payer to provide universal care to their people. Moreover, their health outcomes are better than ours–outcomes such as infant mortality, life expectancy, etc.

6. You may ask about the impact on jobs. HR 676 has built-in funding for transitioning employees from a for-profit system to a system focused on providing care. As everyone gets access to care, thousands of health care jobs will be created.

7. We think you will agree that this also is a moral issue, a human rights issue. No one who is ill should be denied treatment. No one who has been hospitalized should face bankruptcy due to medical bills. No one should have to go through Medicaid’s humiliating process to prove they are “poor enough” to get coverage for themselves and their children. “Ability to pay,” or a high deductible, should not be a barrier to care.

We are a grassroots movement. We believe we can make this happen. We invite you to join us. We meet on the 1st and 3rd Thursday each month in the downtown Louisville Library. You may find us on Facebook. If you would like more information, the brochure lists several websites. For those who want to view data and the results of research, go to pnhp.org the web site of Physicians for a National Health Program.
(Louisville, KY, January 14, 2014)

I am a member of the League of Women Voters–Kentucky. I was asked recently to write an article about kynect, our state’s ACA exchange, for the organization’s newsletter, The Voter. It seems worth sharing:

September 8, 2013
Across our state, public officials, health and wellness advocates, and caregivers in community clinics are working to educate the public about the benefits of the 2010 Affordable Care Act (ACA), and to publicize news of the recent expansion of Medicaid. In Frankfort, the Cabinet for Health and Family Services (CHFS) is preparing for the October 1 launch of kynect, the Kentucky Healthcare Connection, an “exchange” or marketplace where individuals who are not covered by an employer may go to purchase an insurance plan from an approved list of private vendors. The open enrollment period runs from Oct. 1, 2013 to March 31, 2014, with policies going into effect in 2014. Plans (platinum, gold, silver, bronze) will vary as to premium cost, level of deductible, and co-pay, but all plans must, by law, provide a set of essential benefits. To see a list of ACA reforms having an impact in Kentucky, go to federal government sites such as http://www.hhs.gov/healthcare/facts/bystate/ky.html
The Kaiser Foundation also has up-to-date information: http://kff.org/health-reform/

Medicaid applications will also be processed by kynect. The Medicaid program, operated in Kentucky by five private managed care companies, serves a lower-income population, children, pregnant women, and the disabled. Eligibility for Medicaid coverage will depend on family size and income level. Certain applicants will pay no premium; others will be eligible for tax credits, payment assistance or special discounts. A CHFS white paper gives a detailed rationale for the expansion of Medicare:
http://governor.ky.gov/healthierky/Documents/MedicaidExpansionWhitePaper.pdf
The report concludes: “Medicaid expansion, coupled with the Kentucky Health Benefit Exchange, means that every individual currently uninsured, an estimated 640,000 Kentuckians, will have the opportunity to gain health insurance.”

In 2014, the controversial individual mandate will come into effect: most Kentuckians, including refugees and lawfully present immigrants, will be required to have health insurance or pay a tax penalty. The start of a special program for businesses with 50 or fewer employees has been delayed until 2015.

At the State LWV Conference on April 13, 2013, delegates approved a recommendation of the Louisville League that state members monitor the implementation of the ACA in Kentucky, insisting on “transparency, oversight of contracts, and accountability in order to maintain the focus on equitable distribution of health services.” League members are encouraged to assess the quality and affordability of plans sold through the kynect exchange and to evaluate follow-through on the handling of claims.

Posted November 17, 2013

At a recent KSPH meeting, our public relations director, David Ross Stevens led a discussion of the TIME magazine article,”Bitter Pill.”

Note: this post is a response to this thread on DailyKos.

I doubt anyone will follow the chain of comments all the way to this post. The Baucus Plan, like the Massachusetts model, is just too darn complicated. And it will never be able to contain escalating costs going forward because the insurers will insist on their profits. Keep it simple, Max. Use the model of traditional Medicare (before the Republicans allowed the insurers into the game).

Let’s enact HR 676, the single payer legislation (already spelled out at thomas.loc.gov (Full Text) and co-sponsored by 94 representatives in the House. That proposal has been vetted. The Lewin Group has done the math–we would save billions and only the wealthiest would pay a little more in taxes. We would pay for health care the way we pay for fire and police protection. The Canadian plan is not perfect, but we can improve on that model, adding dental, vision and long term care, for example. As for John Goodman, of the McCain campaign and the National Center for Policy Analysis, he has a tendency to misspeak, citing outdated data or anecdotal research. Usually he is in synch with the Fraser Institute–former pro-market pals of the tobacco industry.