Medicare for All
It is time to work towards affordable healthcare for everyone, to guarantee the success of our nation and the vitality of our people. In Congress, I would be willing to work with my colleagues to come to a compromise in regards to healthcare that works for Oregon’s 2nd District.
Since I do not accept donations from corporations or special interests, I can fight for the affordable healthcare we need without corruption. The Willamette Week reported that Greg Walden’s district (our district!) came first in Medicaid enrollment expansion out of all districts held by Republicans. At the time of the report there had been 129,200 people taking advantage of the expansion in our district, with a total of 400,000 Oregonians enrolling throughout the state.
We need to build on the strength of the 50 years of success of the Medicare program creating a single payer health care system that:
- Ensures all people can get the care they need to maintain and improve their health when they need it regardless of income, pre-existing conditions, age, or socioeconomic concerns, to make a system that works not just for millionaires, billionaires, and members of Congress, but for everyone.
- Covers the entire continuum of health care: inpatient to outpatient care; preventive to emergency care; primary care to specialty care, including long-term and palliative care; vision, hearing and oral health care; mental health and substance abuse services; as well as prescription medications, medical equipment, supplies, diagnostics and treatments.
My plan would be Medicare for all. It would cover:
- Maternity and newborn care;
- Ambulatory patient services (outpatient services);
- Emergency services;
- Mental health and substance use disorder services, including behavioral health treatment;
- Prescription drugs;
- Rehabilitative and habilitative services (those that help patients acquire, maintain, or improve skills necessary for daily functioning) and devices;
- Laboratory services;
- Preventive and wellness services and chronic disease management;
- Pediatric services, including oral and vision care;
- Palliative care
- Dental; and
Medicare for all would:
- Significantly reduce overhead, administrative costs and complexity;
- Allow all people to get the care they need to maintain and improve their health, when they need it, regardless of income, age or socioeconomic status;
- Allow patients to choose a health care provider without worrying about whether that provider is in-network;
- Allow patients to get the care they need without having to read any fine print or trying to figure out how they can afford the out-of-pocket costs.
Before we can do this, we need to work on lowering costs so that healthcare is actually affordable and accessible. I know that this will not be a simple fix or a short process, but our people deserve better. We are all better off when our neighbors are healthier.
Although the Affordable Care Act (ACA) is not perfect, current attempts to dismantle the ACA would be an unfettered disaster for many Oregonians in the 2nd Congressional District. With the dismantling support of Walden and others, it has the potential to devastate Oregon communities.
Walden’s Wealth Care Plan, had it become law, would have:
- Taken health insurance away from over 64,000 who live in CD 2 (which would have both radically increased premiums for those who have insurance and cost all of us when uninsured people are forced to go the hospital);
- Been particularly painful to rural Oregonians who do not benefit from competitive marketplaces for doctors, hospitals or insurers.
- Increased the amount health insurers can increase premiums on people ages 55-64 by 5 times as much as younger people pay (versus 3Xs under the ACA).
- Over the next 10 years, cut $880 million in federal funding for Medicaid (a/k/a the Oregon Health Plan), the public health insurance program for the poor and disabled. Such a huge cut would have adversely affected a quarter of Oregonians in District 2 who cannot afford to get insurance.
- Given Oregon a fixed amount of money for each person on Medicaid, instead of a share of whatever Oregon needs to spend. Such a funding change would have caused Oregon to either have to pick up the difference with higher taxes or reduce the number of Oregonians with Oregon Health Plan coverage.
- Adversely affected rural hospitals where the patients tend to be older, poorer and sicker, and the hospital’s profit margins much narrower. If rural hospitals had to treat large numbers of uninsured the hospitals would be forced to:
- either cut back on services;
- pass along the uninsured treatment costs to other, insured patients; or go out of business.
- Limited the tax credits to be based on age rather than need, covering less than 20% of the cost for the average family. This would have especially adversely affect older Oregonians.
The Kaiser Family Foundation has provided an interactive map that will show you exactly how Walden’s attempt at repeal and replace, the American Health Care Act (AHCA), would have affected coverage by county, compared with the ACA. This plan:
- Increases the amount health insurers can increase premiums on older folks to up to 5 times as much as younger people pay.
- Cuts $880 million in federal funding for Medicaid (also known as the Oregon Health Plan), which will adversely affect a quarter of Oregonians in District 2 who cannot otherwise afford to get insurance.
- Changes the way Oregon will be given money for health care, meaning that Oregon will either have to raise taxes or reduce the number of Oregonians with Oregon Health Plan coverage, leaving many without health care.
- Does not in any way increase healthcare options and competition for rural Oregonians who do not benefit from marketplaces for doctors, hospitals and insurers.
- Limits the tax credits to be based on age rather than need, covering less than 20% of the cost for the average family.
- Decreases the number of people on health insurance, radically increasing premiums for those who have it and costing all of us when uninsured people are forced to go the hospital.
- Ends substantial assistance to rural hospitals where the patients tend to be older, poorer and sicker, and their profit margins much narrower, forcing them to cut back on services and pass along increased costs to insured patients. This would have an especially detrimental effect in many of Oregon’s rural communities already experiencing the brunt of the economic downturn.
The AHCA (and other GOP plans to repeal Obamacare) is good news only for the very rich. It provides:
- Large tax cuts for the wealthiest Americans, with 40% of the tax cuts going to the richest 1%. Those wealthy households would receive an average tax cut of $37,000.
- Billions of dollars’ worth of tax cuts to health insurers, pharmaceutical companies, Wall Street investors, and tanning salon operators.
- Health insurers with greater incentives to give their executives pay raises by eliminating the ACA’s cap on compensation deductions.
We need a healthcare system that is efficient, effective, and works for all Oregonians, not just the rich and powerful.
Medicare Part D Reform
Medicare Part D is the federal program to subsidize the costs of prescription drugs and prescription drug insurance premiums for Medicare beneficiaries.The pharmaceutical industry has used its lobbying heft to write a law banning the government from bargaining for drug prices in Medicare Part D. They are forced to pay whatever deal smaller insurance companies with less leverage have negotiated, meaning that we, the taxpayers, get the raw end of the deal. The Department of Veterans Affairs is allowed to negotiate drug prices, and has been estimated to pay up to 48% less for drugs than Medicare.
Former Congressman Billy Tauzin, R–LA, who steered the giveaway bill through the House, retired soon after and took a $2 million a year job as president of Pharmaceutical Research and Manufacturers of America (PhRMA), the main industry lobbying group (see Congressional Ethics). Greg Walden’s biggest contributors are those same pharmaceutical lobbies.
Another important step to reducing the cost of Medicare Part D is to end the practice of ‘evergreening,’ or one company preserving the patent to a drug beyond the twenty years they are allowed before generics become available. Access to generics saved Medicare saved 239 billion dollars in 2013 alone, and as drug prices soar, these savings will matter more and more.