the lookout for ways to get involved! - Ben Day, Mass-Care This document summarizes the Fall 2011 issue of the Universal Health Care Education Fund newsletter. It discusses rallies held in Boston to advocate for single-payer healthcare. It also summarizes a survey finding that most Massachusetts physicians support a single-payer or public option approach. Additionally, it outlines Mass-Care's efforts to campaign against high deductibles for students and to organize for single-payer healthcare in major Massachusetts cities.

1. UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011
CommonHealth
Day of Action November 12th
We gathered at Occupy Boston a thousand nurses and their allies demanding a Main Street
in Dewey Square to hold a Contract for the American People, including strengthened
spirited rally for the real and improved Medicare for all, to be funded by a financial
healthcare reform which we transaction tax on Wall Street activity.
call single payer and against
every manner of disparity in Then on September 17th, hundreds of young people moved
our existing inadequate sys- into Zuccotti Park in Lower Manhattan, two blocks from
tem. Among our dynamic Wall Street and a stone’s throw from Ground Zero. Occupy
speakers was Katie Murphy, Wall Street was born, an in-your-face challenge to the 1%
RN, Mass-Care secretary (left). that lords it over the 99%. Within weeks, many hundreds of
Led by health professional such encampments blossomed across the country and
students, members of Mass-
Care, Physicians for a National
Health Program, allied clini-
cians and people from all
walks of life then marched
through the financial district
and up Beacon Hill for an
equally spirited rally in front of the State House, followed
by a parade down to Louisburg Square to remind Senator
John Kerry and the debt-deal Committee of Twelve that any
Congressional attack on Medicare, Medicaid or Social
Security would be met with righteous anger.
We’ve all come to understand that the country is awash in
money but that it is in the wrong hands and being used all
too often for nefarious purposes. Our march came toward
the end of a momentous year of mass education.
around the world, many near their city’s financial hub.
Occupy Boston is a prime example. It quickly became the
meeting ground for many labor, environmental, peace and
healthcare activists, the locus from which sorties moved
out to confront corporate exploiters and their political
enablers. So our choice to rally there was a natural.
(continued on page 2)
Mass-Care’s Bea Mikuleckyi & Pat Berger,
with Katie Murphy & Marvin Miller behind
We’ve learned from the Arab Spring that arrogance on high
must be confronted and that desperation is no longer
tolerable. The people found their power. Attacks on the
rights of public sector workers, especially in the Heartland,
provoked the most massive and prolonged battle seen here Universal Health Care Education Fund c/o Mass-Care
in decades. Organized nursing brought forward the 33 Harrison Avenue, Fifth Floor, Boston, MA 02111
demand: “No cutbacks, no concessions!” In June the US P: 617-723-7001, F: 617-723-7002
Chamber of Commerce headquarters in DC was picketed by info@masscare.org http://www.masscare.org

2. UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011
Massachusetts Medical Society Day of Action (Continued)
2011 Workforce Survey
On a personal note, on October 13th on my way home
For the past two years the Massachusetts Medical Society from the Greater Boston Labor Council rally at Occupy
has carried out a survey of its members’ attitudes Boston, I received the call that two Massachusetts nurses
regarding healthcare reform, as part of its annual were needed the next morning to help New York nurses
physicians workforce survey. The results of the 2011 erect a tent over the first aid station at Occupy Wall Street.
survey revealed that 41% of members felt that a single- So bright and early, Carlotta Starks and I from the Massa-
payer national healthcare system offering universal health chusetts Nurses Association hopped the Acela. A threat by
care to all US residents was their choice of an optimal NYC officials to sweep clean Liberty Plaza (aka Zuccotti
system. This represented a 7% increase since 2010. Park) earlier that morning had been thwarted by thou-
sands of trade unionists emerging from the subway at six
The other choices in this survey were as follows: o’clock to pack the area. NYC ordinances prohibit tents in
parks, so we nurses and medics successfully erected the
1. Both public and private plans with a public buy-in tent and reorganized the dispensary as an act of civil
option which would allow businesses and individuals to disobedience, despite surrounding police.
enroll in a public Medicare-like health-insurance plan that
would compete with private plans. 23% of physicians
chose this option.
2. The National Patient Protection and Affordable Care Act
(also known as Obama care). This plan does not have a
public option but maintains Medicare and Medicaid. 17%
of physicians chose this option.
3. Keep the existing mix of private insurance plans,
Medicare, Medicaid and the Veterans Administration
coverage. 15% of physicians chose this option.
4. Other plans were chosen by 4% of physicians.
These results show that a majority of Massachusetts
physicians support a government-sponsored Medicare-
like plan either as a public option (23%) or as a single
payer approach (41%). There are presently bills in the
Massachusetts legislature which address these two
options. It is time for Massachusetts physicians to make
their preferences known to move forward a vote which
would allow Massachusetts to join Vermont in eventually
establishing a Medicare for All type of healthcare reform.
- Leo Stolbach, MD Nurses & Medics Commit Civil Disobedience
Barbeque & Bake-Off for Health Care Justice! Among the youthful occupiers there, the hungry found
hot food, the homeless found shelter, the poor found the
On October 9th rudiments of health care and children found books to
Mass-Care hosted read. Wall Street financiers had no interest in nutrition,
a contest for decent housing, health care or education unless they
mouth-watering could turn a profit. The limits of allowable dissent had
b a r b e c u e d been reached, so without notice batons and tear gas were
appetizers and brought to bear in the wee hours of November 15th and
delectable baked Liberty Plaza was reduced to Zuccotti Park once again.
desserts as a The first aid station, tent and all, sleeping bags, food and
fundraiser at Larz five thousand books were tossed into garbage trucks and
Anderson Park in destroyed. A fascist book-burning couldn’t have been
Brookline. The more thorough. In an apparently coordinated effort,
Senator Jamie Eldridge & Ben Day grilling competi- similar violent assaults have occurred on occupation sites
tors included Ben Day, Executive Director of Mass-Care, across the country, with the wounding of two Iraq Marine
Rob Hall, waiter at Grille 23, Jennifer Doe, JwJ, and Mike Corps veterans in Oakland and the pepper-spraying of
Fiske, owner of Fiske & Co. seated students at the University of California in Davis the
most shocking.
The bakers were Olivia Alfond, former Mass-Care intern,
Judy Deutsch, Chair of Mass-Care’s Legislative And so on Capitol Hill, a partial victory was won on
Committee, Margaret Reeve Panahi, family nurse November 21st as the Committee of Twelve ack-
practitioner, and Denise Zwahlen, physician’s assistant. nowledged deadlock. Massive cuts are still slated to take
place, but now is the time to plan to turn the 2012
The esteemed judges were Jay Murray, Executive Chef at elections into a referendum on the austerity plans of the
Grille 23, State Senator Jamie Eldridge and Mohamed 1%. Now is the time to demand no cuts whatsoever to vital
Maenaoui, former Executive Chef at the Barking Crab. Dr. social programs. This is the time to insist on the
Arnold Relman roused the happy feasters with a lively talk strengthening of Medicare and Social Security. We shall
on why we need a single payer system! A great time was forge ahead in the fight to create a just healthcare system
had by all! - Pat Berger, MD for all! - Sandy Eaton, RN, Editor

3. UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011
Professor Hsiao Brings Vermont Single Payer The Massachusetts Model of Health Reform in
Plan to Massachusetts Legislature Practice & the Future of National Health Reform
Professor William Hsiao, If you have forty-five minutes, read the entire report that
PhD, currently the Li was released in November by Mass-Care and
Professor of Economics at Massachusetts Physicians for a National Health Program,
the Harvard School of Public available at:
Health, gave a thought-
http://www.masscare.org/massachusetts-health-reform-in-practice
provoking briefing to the
Massachusetts legislature You'll find some surprising and compelling information! If
November 14th. Dr. Hsiao you have five minutes, read the two-page executive
has been the architect of summary in the report. In you only have two minutes, read
single-payer systems in the following list of some of the findings:
eight countries and is now
working with the governor • The state has significantly decreased the percentage of
and the legislature of uninsured (from 10.4% in 2006 to 5.6% in 2010
Representative Jason Lewis Vermont to plan single payer according to Census Bureau's Current Population
Introduces Professor Hsiao reform for Vermont by 2017. Survey).
• In order to manage the state's portion of the healthcare
Dr. Hsiao’s strategy specifically addresses the political as costs, the state's Commonwealth Care program has cut
well as the economic issues in the campaign for single enrollment eligibility and reduced benefits (e.g. dental
payer reform. His team in Vermont had in-depth talks and eyeglass coverage).
with all the stakeholders including patients, doctors,
hospitals, lawyers, insurance companies, workers and • The changes in reimbursement rates for Medicaid have
had a negative effect on our safety net providers
employers to determine what they might all agree on and
(community health centers and hospitals serving large
how much they are willing to compromise to win an
numbers of the uninsured and publicly insured).
agreement. The final step in gaining support for single
payer is to create incentives built into the law to motivate • The increases in health care costs are negatively
stakeholders to support the change. affecting the insurance coverage of small business
employees. The percentage of total enrollees in small
Dr. Hsiao’s team collected data showing how single payer group plans that have high healthcare coverage
addresses the spiraling cost of healthcare, provides (covering more than 80% of medical costs covered by
universal access, and how it affects different stakeholders. insurance) has decreased dramatically from 78% to 23%.
Specific findings: • The increased costs have resulted in an unfair burden
with some lower income groups paying proportionally
• Vermont’s health expenditures as a share of Gross State more. Those with a family income of $20,000 - $41,000
Product (GSP) have risen from 12% in 2000 to 18.5% in (those in the second 20% income range), increased the
2009. percentage of their family income on health care
• Vermont’s single payer system projected savings of spending by 4.6%, compared with only a 0.4% increase
25.3% based on an integrated delivery system, reduction for those with family incomes of $111,000 and greater
in fraud and abuse, lowering the administrative costs (those in the top 20% income range).
generated by the health insurance industry, reduced • A significant portion of the increase (estimated as
cost of billing by doctors and hospitals and reform of $817,000,000 increase for the year 2009) in cost has
medical malpractice. been born by the federal government, which means that
• Single payer will increase the number of jobs in Vermont your Federal income tax dollars are paying that portion
by increasing the amount of money people will have to of the cost increase.
spend because of decreased medical costs. • Many of the figures quoted in the media for
• The Vermont GSP will increase because of the increase Massachusetts healthcare reform are misleading, if not
in jobs. inaccurate.
• Massachusetts health care reform is unsustainable from
Key to achieving a single payer system, Dr. Hsiao says we a cost perspective.
need support of physicians, strong grassroots support,
and buy-in from other stakeholders. While we in - Norman Daoust, Cambridge-Somerville for Change
Massachusetts are waiting to get the support we need, we
should push for a comprehensive all-payer claim data
base to reduce fraud and reduce total health care CommonHealth, Volume 5, Number 2
spending by 5%. We should also push uniform payment Director: Benjamin Day
Editor: Sandy Eaton
methods and claim adjudication rules, and develop an
Photography: Sandy Eaton, Katie Murphy, NNU
integrated health delivery system. With this kind of single Production: Erin Servaes
payer infrastructure we can win when there is an opening Printing compliments of the Massachusetts Nurses Association
in the political climate. - Pat Berger, MD

4. UNIVERSAL HEALTH CARE EDUCATION FUND ~ VOLUME 5, NUMBER 2 ~ FALL 2011
Mass-Care Helps Launch ‘Co-Insurance Mass-Care Starts Multi-Year Big
is NO Insurance’ Campaign City Campaign for Single Payer
Students must have insurance coverage to enroll in a Mass-Care has voted to expand its grassroots organizing
college or university program in Massachusetts. efforts into large urban areas of the state including Boston,
However, unlike other residents who are required to Worcester and Springfield. This is a multi-year campaign, the
purchase health insurance, they are banned from first year of which will reach out to organizations that are
receiving state subsidies no matter how low-income already fighting to preserve health care coverage or are
they are. While many students are enrolled in their struggling because of rising health care costs. Outreach to
family health plan, 27% are either too old or their these groups will highlight the need for systemic reform
parents are uninsured, and must enroll into their while building a more diverse leadership base for the single
college’s student health insurance plan (or SHIP). payer movement.
For the past few years, colleges and universities have
been reducing the actual coverage of SHIPs by
introducing an increasingly high-level of co-insurance.
Co-insurance means that students must pay 15%, 20%
and sometimes 35% of the total cost of care in addition
to the yearly insurance premium. For surgeries or
other expensive forms of care, students can end up
Massachusetts Senior Action Council Leads the Way
owing thousands of dollars. For low-income students
who can’t afford these cost barriers, co-insurance
effectively means no insurance, potential insolvency, Mass-Care has already begun working with student groups
more stress and a constant fear of getting sick. who are protesting the new co-insurance fees being added
to their out-of-pocket costs. Other struggling groups
include private sector attacks on benefits and bargaining
To stop co-insurance from creating a two-tiered
rights (GE, Verizon), attacks on public employees’ health care
insurance coverage system among students, Mass-
Care and a network of other organizations have taken (particularly municipal employees), immigrant groups’ access
to care, municipal governments that struggle with the rising
action to ban its practice in the state of Massachusetts.
cost of employee health care, minority groups that suffer
Some of the organizing that has taken place include a
from disparities and safety net institutions that are losing
‘sick-in’ at UMass, a complaint filed with the Division
funding.
of Health Care Finance and Policy to investigate the
legality of co-insurance, and a symbolic ‘fundraiser’ The goal is to build an active steering committee in each city,
held across the state to raise funds to help cover co- that is committed to supporting each group’s health care
insurance expenses for low-income students in need struggles through solidarity actions, but also committed to
of vital medical care. - Ibrahima Sankare, former addressing systemic reform of the health care system. Mass-
Massachusetts PNHP Intern Care will need volunteers to develop linguistically and
culturally appropriate educational materials, establish con-
nections with the targeted groups, and develop a “story-
based” speakers’ training program to empower new leaders
for single payer. This is an exciting new campaign, so be on
the lookout for opportunities to join in!! - Pat Berger, MD
You Can Help Mass-Care
Mass-Care is hoping to build a vibrant new coalition for
single payer in the urban centers of Massachusetts. We need
your help! We need funding for producing new educational
outreach materials, setting up leadership training con-
ferences, and running actions and forums to generate media
coverage. We also will need volunteers to help in the
organizing effort. To volunteer, please contact the Mass-
Care office at 617-723-7001. Please be as generous as you
Students & Workers Rally in August for Healthcare Justice can to keep Mass-Care growing!