Health Equity, the Underinsured, and Advantages of Single-Payer

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Takeaways from First Universal Health Care Work Group

What You Can Do: Watch the TVW recording of the first UHC Work Group meeting. Read the Budget Proviso that funded the Work Group, and posted meeting materials

Provide public comment by Friday, September 27 at 5 pm.

Next meeting: November 1, 2019 in Olympia.  More Meetings here.


We are excited to report that the first Universal Health Care Work Group met last Friday in Olympia. Health Care is a Human Right-WA has three Steering Committee members on the 33 member UHC Work Group: Sybill Hyppolite (SEIU 1199), Bevin McLeod (Alliance for a Healthy Washington) and Kelly Powers (Exchange Consumer). It was energizing to see so many medical, community and labor allies from around the state on the committee and in the audience.

Rep. Nicole Macri (LD-43) , Senators John Braun (LD-20) and Emily Randall (LD -26) attended the meeting. Rep. Schmick (LD-9) was not in attendance.

After discussing the Work Group’s directive from the legislature in the Budget Proviso, there were two presentations: Health Coverage in Washington State and the Washington State Institute of Public Policy (WSIPP) Studies, Single-Payer & Universal Health Care Systems.

Here are key takeaways from Kelly Powers, Washington Health Benefits Exchange Consumer (the ACA) serving on the Universal Health Care Work Group & representing Health Care for All – WA on the HCHR-WA Steering Committee:

1) Work Group members offered the following additional Single-Payer advantages that were not presented during the WSIPP presentation:

  • Controls costs by negotiating reimbursement rates and drug prices
  • Alleviates the high costs of delayed health care
  • Reduces the need for expensive legal action to recover medical costs
  • Ends medical debt
  • Ends job lock

2) Information about underinsured Washingtonians, and the impact of health care expenses on the family budget was lacking. We believe the Work Group members need this information to inform our work.

3) There are important things to learn from initiatives around the state, such as Accountable Communities of Health and tribal health systems.

4) Several Work Group members brought up health equity and affordability. Note: The Robert Wood Johnson Foundation says, “Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care.”

Members encouraged the Work Group to be culturally attuned.

5) Public testimony urged the Work Group to look at the Basic Health Plan work in the 1990s to see what could be learned and used.

An oncologist from Spokane also gave public testimony that patients and doctors agree our health care system is broken.

6) The Work Group needs to hear from you! We need more voices of people struggling with current health care system

All in all, it was a solid start at laying out the issues and coming together to work through the challenges.

updated Sept 27, 2019

Universal Health Care Work Group Roster & Meetings

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Work Group Members

Work Group Roster

Past UHC Work Group Meetings

1) Friday, September 20, 2019, Olympia
Watch the TVW recording of the first UHC Work Group meeting. Read the budget proviso and meeting materials.

For more details, see the Health Care Authority UHC Group website

Future Meetings

The Health Care Authority has revised the original schedule of meetings. There are now two fewer meetings scheduled.

* Changes are starred.

All meetings are from 1-5 pm.

2) Monday, December 9, 2019, Olympia, TBD*
3) February 2020, TBD
4) Wednesday, April 22, 2020, Seattle, TBD
5) Wednesday, June 24, 2020, Spokane, TBD
6) Tuesday, August 25, 2020, Olympia, TBD
7) September 2020, Olympia, TBD*
8) Thursday, October 15, 2020, Olympia, TBD

Updated October 9, 2019

The Universal Health Care Work Group Budget Proviso

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The budget proviso contains the directions for the formation of, and the work of, the Universal Health Care Work Group. The budget proviso, which is like a line item in a budget, was passed in the House Budget HB 1109, Section 211, on pages 135 & 136 at the end of the 2019 Legislative Session:

(57) The health care authority is directed to convene a work group on establishing a universal health care system in Washington. $500,000 of the general fund—state appropriation for fiscal year 2020 is provided solely for the health care authority to contract with one or more consultants to perform any actuarial and financial analyses necessary to develop options under (b)(vi) of this subsection.

(a) The work group must consist of a broad range of stakeholders with expertise in the health care financing and delivery system, including but not limited to:

(i) Consumers, patients, and the general public;
(ii) Patient advocates and community health advocates;
(iii) Large and small businesses with experience with large and small group insurance and self-insured models;
(iv) Labor, including experience with Taft-Hartley coverage;
(v) Health care providers that are self-employed and health care providers that are otherwise employed;
(vi) Health care facilities such as hospitals and clinics;
(vii) Health insurance carriers;
(viii) The Washington health benefit exchange and state agencies,including the office of financial management, the office of the insurance commissioner, the department of revenue, and the office of the state treasurer; and
(ix) Legislators from each caucus of the house of representatives and senate.

(b) The work group must study and make recommendations to the legislature on how to create, implement, maintain, and fund a universal health care system that may include publicly funded, publicly administered, and publicly and privately delivered health care that is sustainable and affordable to all Washington residents including, but not limited to:

(i) Options for increasing coverage and access for uninsured and underinsured populations;

(ii) Transparency measures across major health system actors, including carriers, hospitals, and other health care facilities, pharmaceutical companies, and provider groups that promote understanding and analyses to best manage and lower costs;

(iii) Innovations that will promote quality, evidence-based practices leading to sustainability, and affordability in a universal health care system. When studying innovations under this subsection, the work group must develop recommendations on issues related to covered benefits and quality assurance and consider expanding and supplementing the work of the Robert Bree collaborative and the health technology assessment program;

(iv) Options for ensuring a just transition to a universal healthcare system for all stakeholders including, but not limited to, consumers, businesses, health care providers and facilities, hospitals, health carriers, state agencies, and entities representing both management and labor for these stakeholders;

(v) Options to expand or establish health care purchasing in collaboration with neighboring states; and

(vi) Options for revenue and financing mechanisms to fund the universal health care system. The work group shall contract with one or more consultants to perform any actuarial and financial analyses necessary to develop options under this subsection.

(c) The work group must report its findings and recommendations to the appropriate committees of the legislature by November 15, 2020. Preliminary reports with findings and preliminary recommendations shall be made public and open for public comment by November 15, 2019, and May 15, 2020.

Action Alert: Reauthorize the Community Health Centers Fund Now!

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According to the Washington Association of Community Health, community & migrant health centers in Washington serve more than 1.1 million residents at over 300 clinic sites, offering primary, preventive & supportive health services.
Don’t Let Funding for CHCs Expire. We strongly urge our friends in Congress to support a long-term re-authorization of the Community Health Centers (CHCs) Fund before the funding authorization expires on September 30. We encourage you to share this Action Alert with your own organizations.

Washingtonians Count on CHCs. In Washington State, Community Health Centers serve over 1.1 million patients annually. CHCs are community-based, nonprofit health care providers that serve individuals and families in medically underserved areas or medically underserved populations. They welcome everyone who walks through the door, regardless of ability to pay, and are governed by patient-majority boards. Additionally, they provide a host of services beyond what you’d expect to find in a traditional doctor’s office, including language and transportation assistance, referrals to food and housing assistance programs, and family case management. See map of Washington CHCs below.

CHCs Rely on Federal Funding. For over 50 years, America has relied on CHCs to provide comprehensive primary care, dental, and behavioral health services to underserved communities. CHCs have relied on federal grants to do this critical work. Over 70 percent of the funding for these grants program comes from the $4 billion Community Health Center Fund, allowing CHCs to:

  • Provide care for the uninsured;
  • Establish new clinics in hard-to-reach communities;
  • Expand the scope of their services, including responding to national and regional health crises like the opioid use disorder epidemic or local measles outbreaks; and
  • Invest in services like transportation and care coordination to make a more meaningful impact in the lives of the individuals and families they serve.

Preserve this Vital Safety-Net. Long-term funding will allow CHCs to more thoroughly plan for the future, expand services for patients, and reduce the uncertainty caused by year-to-year funding renewals. Now is not the time to reduce the safety net for Americans who are struggling to survive our health care crisis.

CHCs Are Critical for Universal Health Care. The CHCs are the largest and most successful primary care system in the US. located in all 50 states and territories. They must be a key part of any universal health care system.

What You Can Do Now

Please take a few minutes to do any or all of the following quick actions today. We want to keep the pressure on your Members of Congress!

Thank them for their efforts to date. Ask them to take action as soon as possible to extend health center mandatory funding before the September 30th deadline — as much funding as possible (room for growth) for as long as possible (stability).

1. Email Your MOCs
2. Tweet Your Senator
3. Tweet Your Representative

Thanks to the National Association of Community Health Centers for this Action Alert.

Ferndale Murder-Suicide Exemplifies Why Americans Need Expanded and Improved Medicare for All

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The Seattle Times published David McLanahan’s Letter to the Editor (LTE) last weekend in response to the tragic news about the apparent murder-suicide of an elderly couple in Ferndale, WA who could no longer afford their medical expenses. David represents Physicians for a National Plan-WW (PNHP-WW) on the HCHR-WA Steering Committee.

Dashing off a letter to the editor in response to a news story is an effective way to highlight that single-payer is the cure to our health care crisis to a wider audience. New to writing LTEs? Check out this guide from the League of Women Voters.

A cure for our dysfunctional health-care system

By Letters editor
The Seattle Times

Re: “Murder-suicide is suspected in pair’s deaths” [Aug. 11, B7]:

The news of the elderly couple’s death is another in the litany of tragedies inflicted upon American families by our dysfunctional health-care system.

As the article points out, current Medicare and Medicaid cover only 65% of medical expenses. As well as bearing the discomfort of illness, elderly people face deductibles, co-pays, high-cost medications, other out-of-pocket expenses and oppressive insurance paperwork. They often face the prospect of going bankrupt, losing their life savings, if any, and the prospect of asking family members and friends to help out. We all can understand this couple’s resolution.

The tragic decision facing this family would likely have been averted if they were covered by Improved Medicare for All, such as embodied in Rep. Pramila Jayapal’s H.R. 1384. This legislation would enable all of us to receive the health care we need from birth without any financial worries.

It’s time for all of our representatives — national, state, and local — to follow the lead of their constituents to join us in supporting justice in health care.

David McLanahan, M.D., Seattle

Link to HR 1384 explainer added for your reference.

Rally for People Over Pharma Profits

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Join Us Aug 20th for the National Day of Action

Fight for Lower Drug Prices NOW!


Tuesday, August 20th at Noon
Seattle Press Conference and Rally
Jackson Federal Building, 2nd Ave Plaza
915 2nd Avenue, Seattle
Please spread the word!

Drug corporations and their powerful Pharma lobbyists continue to stand in the way of our health and economic security by dramatically jacking up prices to boost profits, forcing people to make stark choices between medicine and other basic necessities.

Every day we learn about people who are dying because they cannot afford life saving medicines and so they ration what they have, go into debt, forgo medication, or try to use alternatives that do not help or are even harmful. People are having to choose between basic necessities like housing and food, and the medicine they need to live. Many are helpless as they watch loved ones suffer without the medicine they need to get better.

President Trump promised to lower drug costs but, at the same time, he is pandering to Big Pharma with a trade deal that locks in high drug costs for the next decade in the NAFTA 2.0 (USMCA).

It’s time to fix this broken system. That’s why on August 20, Health Care is a Human Right – WA joins organizations, advocates, and patients coming together to demand that lawmakers take serious action to lower drug prices so that people everywhere can finally get the affordable medicines they need.

In Washington State, we’re fortunate to have Senators and Congressional representatives who want to see lower drug prices. Sens. Murray and Cantwell, and Reps. Jayapal, Smith, and Schrier have been invited to speak.

Co-sponsors include: 350 Seattle, Health Care for All – WA, Health Care is a Human Right, Occupy Bellingham, Physicians for a National Health Program – Western WA, Puget Sound Advocates for Retirement Action, Washington CAN!, Washington Fair Trade Coalition, Washington State Alliance for Retired Americans, Washington State Labor Council.

Action Alert: Your help needed to protect health civil rights, reproductive health care, and the ACA

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Our friends at the Northwest Health Law Advocates (NoHLA) have alerted us to an urgent action needed. The Trump administration intends to roll back anti-discrimination protections in the ACA. These rollbacks would cause harm to people who need access to language services, people who need abortion services or who have had an abortion in the past, and transgender, non-conforming, and LGBTQ+ people.


TAKE ACTION by Tuesday, Aug 13th: 

Submit your comment to the U.S. Department of Health & Human Services on the proposed civil rights rollback by August 13, 2019. 

Read NoHLA’s blog post to find out more about the proposed changes. The post also includes resources to help you write comments, which can be simple, focused on one issue, or comprehensive.