VERMONT: Democrats Enact Single-Payer Health Care!

Peter Shumlin is the Democratic Governor of Vermont

Thanks to the Affordable Care Act, individual states have the opportunity to enact their own health care reform policies which suit each individual state. In Vermont, Democrats control the state legislature and the governorship for the first time in a long time. When Republicans gain legislative control they use their power for evil, in Minnesota (putting an anti-gay marriage constitutional amendment on the 2012 ballot), in Wisconsin and Michigan (to eviscerate unions and disempower working families), in Ohio and Florida (disenfranchise elderly and minority voters) and in South Carolina and Tennessee (legislatively bully LGBT citizens and deny them equal access to constitutional rights).

Democrats, however, use their power for good, like in Vermont where they are ensuring that all state citizens will have access to health care.

Amy Goodman of TruthDig reports:

Vermont hired Harvard economist William Hsiao to come up with three alternatives to the current system. The single-payer system, Hsiao wrote, “will produce savings of 24.3 percent of total health expenditure between 2015 and 2024.” An analysis by Don McCanne, M.D., of Physicians for a National Health Program pointed out that “these plans would cover everyone without any increase in spending since the single payer efficiencies would be enough to pay for those currently uninsured or underinsured. So this is the really good news—single payer works.”

Vermont Gov. Peter Shumlin explained to me his intention to sign the bill into law: “Here’s our challenge. Our premiums go up 10, 15, 20 percent a year. This is true in the rest of the country as well. They are killing small business. They’re killing middle class Americans, who have been kicked in the teeth over the last several years. What our plan will do is create a single pool, get the insurance company profits, the pharmaceutical company profits, the other folks that are mining the system to make a lot of money on the backs of our illnesses, and ensure that we’re using those dollars to make Vermonters healthy.”

Governor Peter Shumlin did indeed sign the bill into law. 1 state down, 49 to go. California also has a single-payer health care bill pending in the legislature. MadProfessah has endorsed this legislation.

HIV Treatment *IS* HIV Prevention

There's an interesting twist to the news that HIV+ people on anti-retroviral medication have surprisingly low chances of passing the virus on to their sexual partners in this weekend's New York Times column by Charles Blow.

Blow makes the point that the AIDS Drug Assistance Program (ADAP) has been a victim of both state and federal budget cutting and points out the long-term fiscal irresponsibility of such actions.

According to data from the ADAP Advocacy Association: as of last week, the number of people on ADAP waiting lists had risen to 7,873; between April 2009 and April 2011, 14 states reduced the number and types of drugs they would pay for. A number of states have stiffened financial eligibility requirements, capped enrollment or removed some people already enrolled. Other states are considering doing so.


This is particularly problematic since the National ADAP Monitoring Project’s annual report, released in March, showed that those most dependent on the program are some of society’s most vulnerable. About a third of all people diagnosed with AIDS are enrolled in ADAPs, three-quarters of them had incomes of less than 200 percent of the national poverty level, 61 percent were uninsured, and 55 percent were black or Hispanic.


But as the recession put more patients in need, federal and state aid didn’t keep track. From 2007 to 2010, the number of people using ADAPs jumped by a third, but federal and state funds specifically appropriated for it grew by just 3 percent and 18 percent, respectively.


Not only is it morally reprehensible to restrict or deny life-saving drugs to those who need them (talk about death panels), it is a colossal miscalculation of public health policy, not to mention fiscally irresponsible.


The new findings should help change a paradigm that’s badly in need of changing. Treatment benefits the healthy as well as the sick. It not only prolongs and improves the lives of those who are H.I.V.-positive, but also is a prophylactic for those who aren’t. Everyone wins.


It’s time to expand ADAPs, not diminish them.

It's just amazing how we spend health care dollars in this country. It simply is not rational to be cutting funds for  prevention of any disease, especially when prevention is always cheaper than treatment. In the case of HIV, treatment can also improve prevention of future infections so it should be a no-brainer to increase, not decrease such expenditures. Unless you live in Mississippi, of course.

Happy Birthday, Health Care Reform!

Hat/tip to Ezra Klein for this flow chart depicting how people will get coverage under the Affordable Care Act starting in 2014. Today is the first anniversary since President Obama signed the measure into law.

Federal Judge Strikes Down Entire Health Care Law

Gee,  I wonder if the Republicans will be complaining about this form of judicial activism?

From The New York Times:

A second federal judge ruled on Monday that it was unconstitutional for Congress to enact a health care law that requires Americans to obtain commercial insurance, evening the score at two-to-two in the lower courts as conflicting opinions begin their path to the Supreme Court.

Like a Virginia judge in December, Judge Roger Vinson of Federal District Court in Pensacola, Fla., said he would allow the law to remain in effect while the Obama administration appeals his ruling, a process that could take two years. But unlike his Virginia counterpart, Judge Vinson ruled that the entire health care act should fall if the appellate courts join him in invalidating the insurance requirement.

“The act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker,” Judge Vinson wrote.

In a 78-page opinion, Judge Vinson held that the insurance requirement exceeds the regulatory powers granted to Congress under the Commerce Clause of the Constitution. Judge Vinson wrote that the provision could not be rescued by an associated clause in Article I that gives Congress broad authority to make laws “necessary and proper” to carrying out its designated responsibilities.

“If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain,” Judge Vinson wrote.

Insanely, the entire law can be struck down because Democratic staffers forgot to include a severability clause in the legislation in the last minute scramble to pass the legislation in Spring 2010. Those staffers should be fired! Oh wait, the voters already did that in November 2010!

It is unlikely that Judge Vinson's law will survive appellate review. Even if the individual mandate is ruled unconstitutional, there are many other ways to fund the other changes that the health care law mandates.