Saturday, June 30, 2012

Healthcare 4 All PA Response: Supreme Court Ruling on PPACA and Implications for the Single Payer Solution


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
Healthcare for All Pennsylvania 
cpennacchio@gmail.com

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