This is the official Healthcare for All PA response from Executive Director Chuck Pennacchio to the Supreme Courts decision on Thursday.
Dear Friends of the Proven Single Payer
Solution:
The Supreme Court of the United States ruled
this morning, by a narrow 5-4 decision, that the Patient Protection and
Affordable Care Act (PPACA) is largely constitutional. Writing for the
majority, Chief Justice John Roberts found the insurance purchase mandate
permissible, but only if re-conceived of as a "tax" and, therefore,
consistent with Congress' regulatory powers under the Commerce Clause.
The remainder of the national health insurance bill was also found to be
constitutional, with the notable exception of the law's punishing effects of
withholding funds from states that refuse to accept PPACA's new Medicaid
eligibility standards.
Now that the Supreme Court is permitting the
implementation of PPACA, what does the ruling mean for potential recipients,
costs, access, quality, providers, jobs, economy, and sustainability? And
what will it mean for the proven Single Payer Solution that effectively
addresses and resolves the aforementioned issues and steers clear of any
current of future constitutional challenges?
Given the six-year implementation of the
Massachusetts Model, the PPACA-related answers to the above questions are mixed
- but, regrettably, mostly negative. Yes, perhaps 2% percent of Americans
- those aged 19 to 26 (2.6 M), those with pre-existing conditions (70 K), those
who are indigent and uninsured (3 to 4 M) - will appreciate increased access to
healthcare providers and services. That is PPACA's best news - and
one cannot understate or undervalue the importance of expanding healthcare to
Americans previously shut out of the system altogether. On the other
hand, a significant chunk of the 2% targeted beneficiaries intended for
inclusion in expanded healthcare will not get what they need because of the
shrinking pool of primary care physicians, community hospital closures,
unaffordable premiums/co-pays/deductibles, across-the-board cuts in healthcare
spending, and systemic "gaming" and "cherry-picking" by a
profit-centered health insurance industry.
Now for the predictable bad news - based on
PPACA's legislative forerunner, the Massachusetts Model.
Initial Massachusetts successes in increasing those with health insurance
paperwork and those with actual access to healthcare have given way, in the
last four years, to alarming rises in the uninsured, the under-insured, taxes,
premiums, co-pays, deductibles, hospital closures, physician flight, and
overall healthcare outcomes (http://tinyurl.com/723stts). The Massachusetts
legislature is now cutting, not increasing, services, as economic and budgetary
restraints bring political calls for austerity. Profit-first, health
insurance-centered healthcare is proving to be unsustainable in a state that is
disproportionately wealthier and more liberal than most. If PPACA
modeling can't work in Massachusetts, how can we expect it to work in the
partisan puzzle palace known as Washington, D.C.?
Now for the good news: advancing the Proven
Single Payer Solution. PPACA is simply unsustainable - financially,
economically, morally, politically, and logically. Simply put, PPACA
over-promises and under-delivers. It increases the power and profits of
the profit-first, healthcare denying health insurance industry, while leaving
patients, providers, taxpayers, municipal governments, businesses, labor
unions, and more, at the mercy of the predatory medical-industrial-complex.
Politicians enable, corporate insurance profits, citizens suffer.
Only the Proven Single Payer Solution solves
the system. And, irony of ironies, PPACA provides state-based waivers and
instruments to implement state-based single payer! As healthcare-related
costs continue to escalate out of control (to perhaps 25% of GDP in 2025),
healthcare access diminishes, medical bankruptcies and preventable medical
tragedies increase, and more, the system will collapse on itself. Who
knows where the tipping point is? But we all know that the evidence and
morality point to the American answer: Single Payer, aka, Expanded and Improved
Medicare for All. That is, publicly-funded, privately-delivered,
guaranteed, quality, comprehensive, doc-and-nurse-retaining, cost-cutting,
job-generating, healthcare for all. Single Payer. Centrist.
Sensible. Solution.
Today is a day to build on. Our struggle
continues. We will win. Healthcare for all!
Yours in solidarity,
Chuck Pennacchio
Executive Director
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