“Thanks to Obamacare, the ranks of the uninsured fell this year,” writes Kevin Drum for Mother Jones Magazine.

“Attention Obamacare haters: The law you despise appears to be working,” says the New Republic.

Larry Levitt of the Kaiser Family Foundation proposes that, “The biggest decline in the ranks of the uninsured is among young adults aged 19-25. This suggests that the Affordable Care Act (ACA) provision allowing young people up to age 26 to stay on their parents’ policies is succeeding at increasing the number of people with health insurance.”.

If Larry Levitt’s theory was correct, however, then the total number of people with private insurance would have increased. But the Census Bureau tells us that, “Both the rate and number of people covered by employment-based coverage in 2011, 55.1 percent and 170.1 million, were not statistically different from 2010.”

True, private coverage among people between 19 and 25 increased by 539,000 people. 40 percent (215,600) of those people obtained coverage through their parent’s health plan. But again, the total number of people with private insurance stayed the same–meaning there is little reason to assume the ACA has had any impact yet.

So how did the number of uninsured decrease by 1.3 million people?

Simple: people are getting older and poorer. Therefore, a much stronger case can be made that already existing government programs (Medicare and Medicaid), not Obamacare, are responsible for increased health coverage.

[Chart: Health Insurance Coverage Status and Type of Coverage by Age: 2010 and 2011 (click to enlarge)]

Unlike private insurance, “The number of people covered by government health programs increased to 99.5 million from 95.5 million.” Essentially, 2 million people were added to Medicaid (50.8 million) and 2 million people were added to Medicare (46.9 million) in 2011.

Steady poverty and unemployment resulting in decreased median income for everyone except the rich means more people are eligible for Medicaid (thus the 2 million person increase). The poverty rate remained at 15 percent, meaning 46.2 million people were living in poverty in 2011. Wages fell for the majority of Americans and inequality between the rich and poor increased. The Center on Budget and Policy Priorities explains that:

“For the 20 percent of households in the middle, average household income fell 1.7 percent, or $876. For the top 20 percent, average income rose 1.9 percent, or $3,286. For the top 5 percent of households, average income rose 5.1 percent, or $15,184. Incomes fell for the bottom four-fifths of American households, while rising only for the top fifth.”

Right now, Obamacare requires states to maintain their current eligibility levels for Medicaid (meaning they are not allowed to drop people from coverage), but all this does is maintain the status quo–it doesn’t insure new people. Income eligibility is supposed to increase to 133 percent of the federal poverty level by 2014, but the Supreme Court decision on Obamacare makes that unlikely to happen in every state. Therefore, decreased income and the steady erosion of employment-based insurance are likely the reason for increased Medicaid roles.

Medicare’s eligibility age wasn’t lowered and stayed at 65 under Obamacare so that’s not the cause for higher enrollment. According to the Washington Post, “The portion and number of Americans covered by Medicare continued to rise, as more baby boomers entered retirement age.”

Again, 4,000,000 people were added to Medicaid and Medicare (which have existed for 47 years) in 2011 while only 215,600 people were covered by the Obamacare’s young person provision (which has existed for 1 year).

It should be clear by now that major gains in health insurance coverage came from an increase in government health insurance coverage. Either way, we have a lot more work to do before we end the US healthcare crisis.

48.6 million people are currently uninsured. 48,000 people will die this year because they don’t have health insurance. Job-based insurance premiums for a family of four increased 4 percent last year and nearly doubled since 2002. This is a tragedy, not cause for celebrating Obamacare.

Even when Obamcare is fully implemented in 2014, the Congressional Budget Office estimates that 30 million people will still be uninsured. Healthcare and drug costs will continue to rapidly rise–as is happening under the Massachusetts plan from which Obamacare is modeled. And a dozen governors plan to ignore Obamacare‘s Medicaid expansion to 133% of the federal poverty rate in their states. Yet the Democrats have no plans to strengthen Obamacare.

According to the Democratic platform released at the Democratic National Convention this month, there are no calls for waivers to allow for state single-payer. There’s not even a mention of a public option. As Jon Walker of Fire Dog Lake says, “The platform of the Democratic Party is basically that the ACA is great how it is and there is very little need to improve it.”

We know it doesn’t have to be this way. With a national single-payer health program we’d cover everyone living in the US and save $500 billion a year. President Obama knows this is true and that single-payer is the solution.

Stuart Altman, President Nixon’s former health aid and advisor to Obama in the lead up to health reform recently recalled that, “Every once in awhile Obama would say, ‘Wouldn’t single-payer be simpler?’ The answer is yes. But America wasn’t ready for it.”

America is not only ready for a national, single-payer healthcare plan, it desperately needs one. Yet, despite all that Medicare and Medicaid has done to protect the most vulnerable, cuts to these programs loom no matter who wins the election next month. Those who believe in the right to healthcare should defend these programs at all costs.

Jeff Muckensturm is on the national staff of Healthcare-NOW!, a national network of single-payer advocates and organizations. Find out more about the single-payer movement at www.Healthcare-Now.org.

Again and again and again and again liberal pundits tell us that the Democrats will snap out of their centrist slumber if the Supreme Court strikes down the ACA. They’ll be radicalized and have no other choice but to turn to single-payer, so they say.

In “How Obamacare’s Rejection Would Lead to Single Payer,” Josh Barro writes: “SCOTUS striking down the law would also be likely to radicalize Democrats on the health issue… Rejection of Obamacare would likely lead to support for more radical policies among the liberal base and Democratic officeholders. They’ll be mad, and they’ll want to fight back.”

And “…with a bit of political jujitsu,” says Robert Reich, “the President could turn any such defeat into a victory for a single-payer healthcare system – Medicare for all.”

If only. But this line of thinking simply doesn’t fit President Obama’s history of consistently caving to the right for fear of being labeled a far-left socialist. In 2008 the Republicans wouldn’t bite on the public option. So, despite having a Democratic majority in the House and Senate, he moved to the right and supported the individual mandate (something he vehemently opposed before the 2008 election) and still didn’t get one Republican vote.

Those of us supporting a single-payer system must not be fooled by this argument. Winning national single-payer healthcare, no matter what the Supreme Court rules this summer, will be a battle fought tooth and nail against the for-profit health insurance corporations, the American Medical Association, and Big Pharma. It won’t simply be handed to us by President Obama or the Democratic party.

Same goes with the Employee Free Choice Act (dead), or closing Guantanamo (still open), or nixing the Keystone XL pipeline (we’ll build half of it), or ending the war in Iraq (18,000 troops still on the ground).

President Obama is a center-right leader, and we shouldn’t expect anything else.

Historical experience shows that a political defeat for the Obama administration won’t herald a radical shift to the left on healthcare policy. After Clinton lost his health reform battle (not even getting his bill out of committee in 1994) did he take a strong stance on single-payer–even though the single-payer bill in the House at that time had more co-sponsors than his own bill did? No. Instead, all we got was the State Children’s Health Insurance Program (SCHIP), which only covers about half of American children (Geyman, 226). A positive step, to be sure, but far short of an embrace of single-payer.

The overall message here is “do nothing.” Obama’s got this. Just get out and vote for him in November and everything will be fine. Don’t get mad at him and certainly don’t stay home on Election Day.

Don’t fall for it.

The Supreme Court’s decision won’t radicalize the Democrats or the President. Single-payer won’t be their only option. If the ACA goes down Obama will most likely drop the healthcare issue altogether or, less likely, rebrand the public option.

When liberal pundits say Medicare-for-all, they mean Medicare for all to buy–AKA a public option to compete in the market with private insurance. We know the public option won’t reduce costs or be universal or be equitable. Health Care for America Now, the $40 million health reform group, that supposedly backed a public option, and openly campaigned against single-payer, won’t come around so easily either. They’re busy trying to save face by backing Democrats and defending the individual mandate.

We want a truly universal single-payer healthcare system in which everyone in the US, undocumented immigrants included, have access to comprehensive coverage. A system with full women’s health benefits included. A system without copays or deductibles. Without for-profit hospitals, and without private insurance in the mix. As we know too well, the Democrats are quick to use women’s and immigrants’ health as a bargaining chip. We must not allow that.

It’s our job to continue to remind Congress and the President that there is an alternative to the status-quo. It will take a lot more marching, educating, and protesting before they hear us.

So we better keep organizing.

Jeff Muckensturm is on the national staff of Healthcare-NOW!, a national network of single-payer advocates and organizations. Find out more about the single-payer movement at www.Healthcare-Now.org or follow Healthcare-NOW! on Facebook and Twitter.

Camden, New Jersey went from a diverse and mighty industrial city–home to 55,000 of good paying industrial jobs–only to become the one of the nationʼs most segregated and poorest

In 2002, the New Jersey state government claimed it needed to take over nearly all of the cityʼs functions–legally disenfranchising every resident–only to leave a trail of failed development schemes and enough financial ruin that the city recently laid off half of its police and fire departments.

Join us for an intriguing discussion about capital flight, severe austerity, urban development, and political corruption.

Panelists include:
Dr. Howard Gillette – Professor of History at Rutgers University-Camden and author of Camden After the Fall: Decline and Renewal in a Post-Industrial City.
Tom Knoche – Community organizer, Camden activist, and author of Common Sense for Camden: Taking Back Our City.
Dan Sidorick – Adjunct Assistant Professor of History at Temple University and author of Condensed Capitalism: Campbell Soup and the Pursuit of Cheap Production in the Twentieth Century.

Part of the Philadelphia Industrial Workers of the World’s Philly Labor Talk Series.
Contact walt.weber.iww@gmail.com with questions. This event is FREE!

The U.S. and its cities are in the midst of a healthcare crisis caused by a broken system that values profit over quality, affordable care.

Cities faced with rapidly increasing employee health insurance premiums, including Baltimore, are cutting back on much needed services to balance their budgets.

City residents aren’t better off. Increasingly, people are going without insurance, while they put off care or rely on extremely expensive emergency rooms for preventable issues.

National, single-payer healthcare is needed now, more than ever, to free cities and families from the private health insurance industry that has profited from devastating levels of inequality in care and quality of life. It would reduce healthcare costs by removing profit and reducing wasteful spending on insurance paperwork that take up 30 percent of current costs ($230 billion nationally).

A single-payer system would make the federal government the sole insurer (the “single-payer” to doctors and hospitals) of all Americans. That’s full, universal coverage.

It would remove all for-profit insurers from the system, and require that all hospitals, which would remain private, convert to non-profit entities. Insurance industry greed, along with profiting from death and illness, would end under HR 676.

Profit Over Care

In 2007, the US spent $2.4 trillion on healthcare (4.3 times what we spend on national defense), while 46 million Americans went uninsured, including 8.1 million children.

According to the SEIU, between 2003 and 2007, the nation’s largest insurers “raised premiums, increased co-pays and deductibles; refusing coverage or charging exorbitant rates to people with pre-existing conditions; and even retroactively denied coverage to people with insurance.” Profits rose 170.2 percent, to $12.6 billion.

According to the National Coalition on Health Care, “Since 1999, employment-based health insurance premiums have increased 120 percent, compared to cumulative inflation of 44 percent, and cumulative wage growth of 29 percent during the same period.”

As premiums rise, employers expect employees to contribute more. Employee spending on health insurance has increased 120 percent between 2000 and 2006. Studies show that increased premiums directly correlate with families dropping coverage contributing to about 18,000 deaths every year

Cities, like families, are affected by increasing health insurance costs. Baltimore’s recently announced $65 million budget shortfall, partially due to rising health insurance costs for municipal employees, may force Mayor Dixon to cut police and fire budgets by 6 percent. According to Local 734 Fire Union President Bob Sledgeski, “This could have an immediate impact on citizens, resulting in less protection and longer response times.”

Maryland’s Governor, Martin O’Malley, plans to cut Baltimore’s school budget by $23 million as he deals with a $2 billion budget shortfall, partially due to rising health insurance costs. According to the National Conference of State Legislatures, more than 30 states face deficits totaling a projected $40 billion this year.
Increasing Insurance Costs Lead to Increasing Inequality

As health insurance becomes more of a commodity only available to the rich, income becomes the most important determinant to life expectancy. A 20-year life gap separates the city’s poorest from its wealthiest. The average life expectancy in Hollins Market, Baltimore’s poorest neighborhood, is 63, while in Roland Park, Baltimore’s wealthiest neighborhood, it’s 83.

A full life, it seems, is only available to those who can afford it.

Why We Need National, Single-Payer Healthcare

Single-payer healthcare (H.R. 676) will save families money. A median income family in Baltimore (making $37,000) would pay about $1,700 a year for healthcare under H.R. 676. Now, if they have insurance through their employer, they’re paying, on average, $3,300. That’s a savings of $1,600 a year.

It will save cities money. Baltimore spends 11.2 percent of its budget on healthcare for retired municipal employees (over $120 million). In fact, Baltimore City officials estimate they will need $2.9 billion to cover employee retirement health benefits for the foreseeable future. The City would not be liable for retiree health benefits under H.R. 676, since it covers all U.S. residents. The City would also save on the millions it now spends on current employee health benefits. Studies show H.R. 676 saves cities between 30 to 50 percent in health insurance costs.

45 municipalities across the country (including Baltimore), and the US Conference of Mayors, representing over 1,000 cities with populations over 30,000, have passed resolutions endorsing HR 676 because they realize that national single-payer healthcare will save them money while covering all of their residents.

A December 2007 Associated Press/Yahoo! poll found: “Sixty-five percent of those polled said the United States should adopt universal health insurance that covers everyone under a program such as Medicare that is run by the government and financed by taxpayers.”

Single-payer healthcare can save our cities by providing affordable, comprehensive, and universal coverage for every U.S. resident.

Jeff Muckensturm is an organizer and web developer for Healthcare-NOW!, an organization that’s organizing for national, single-payer healthcare. He can be reached through www.CityInvincible.org. Find out more about H.R. 676 at www.Healthcare-Now.org.

Today, groups representing doctors, nurses, healthcare advocates and labor unions are applauding the Philadelphia City Council for passing a resolution in support of national, single payer health care (HR 676) and two state single payer bills.

The resolution, sponsored by Councilman Greenlee and Councilwoman Tasco, makes Philadelphia the 28th city and 46th local government to pass a resolution in favor of HR 676, the National Health Insurance Act, sponsored by John Conyers (D-Mich.). The resolution also calls for the enactment of the two single-payer state bills, SB 300 and HB 1660.

Nearly 40 people watched the city council pass the resolution. One audience member, Walter Tsou, MD, MPH, former Health Commissioner of Philadelphia, said of the resolution, “Single payer is a win win for Philadelphia. It not only would give 160,000 uninsured Philadelphians health insurance, but it would redirect hundreds of millions of city dollars toward other important priorities, like libraries and fire stations.”

Jed Dodd, a Teamster Union official who represents railroad construction workers in the Northeast stated, “Single payer health plans ensure all people living in the United States access to quality health at a fair cost. Ninety-seven percent of the resources allocated to support these plans are spent on health care. All other plans waste 30% of these resources on insurance companies who provide no health care to anyone and ironically make more by limiting access to health care instead of making people well. We are heartened that the Philadelphia City Council has endorsed a health care plan for the people of America.”

A fact sheet circulated to Council members demonstrates that if HR 676 were enacted, the city would save $539 million a year, enough to cover its budget shortfall of $2 billion over 5 years. In addition, the bills would guarantee access to comprehensive healthcare at less cost than what average families currently pay for care.

Sabrina Nixon, a medical technologist at Temple University Hospital, and a member of PASNAP, said, “As a healthcare professional of 20 years and a parent, I see that HR 676 would not only fix the current healthcare crisis, but eliminate every parent’s worry that their child will not have access to quality healthcare once they turn 18 or as they move between jobs. If HR 676 were passed, the dream of universal healthcare will become reality.”

Groups that have signed on to a letter asking the Council to sign the resolution, many of which were present at the vote, include: Healthcare-NOW; Healthcare for All – Philadelphia; Pennsylvania Association of Staff Nurses and Allied Professionals; United Steelworkers Local 10-1; International Federation of Professional and Technical Employees Local 3; Faculty and Staff Federation of Community College of Philadelphia, AFT 2026; Pennsylvania Federation of the Brotherhood of Maintenance and Way Employees – IBT; American Medical Students Association; Physicians for a National Health Program; Philadelphia Chapter Women’s International League for Peace and Freedom; Citizen Access; and Leadership of Neighborhood Networks.

A coalition of major labor unions and liberal organizations has recently created what it calls “a national grassroots campaign organizing millions of Americans to win a guarantee of quality, affordable health care for all.”

Health Care for America Now (HCAN) is a project of three major unions, the American Federation of State, County, and Municipal Employees (AFSCME), the Service Employees International Union (SEIU), and the United Food and Commercial Workers (UFCW), along with MoveOn and the Association of Community Organizations for Reform Now (ACORN). Elizabeth Edwards is a spokesperson for the new coalition.

With its $40 million budget, HCAN could put a lot of muscle into the fight for a universal, single-payer system that would make the government the sole insurer (the “single payer” to doctors and hospitals). Unfortunately, instead HCAN favors a mixed public/private system that would allow Americans to “keep your current private insurance plan, pick a new private insurance plan, or join a public health insurance plan.”

While HCAN’s “health care for all” slogan will resonate with labor and the left, the group’s actual proposal has met with a skeptical response from, among others, the California Nurses Association and Physicians for a National Health Program. Both fault HCAN for failing to support the United States National Health Insurance Act (H.R. 676), aka “Medicare for All,” introduced in February by Rep. John Conyers (D-Mich.). The bill now has over 91 co-sponsors.

So why doesn’t HCAN support single-payer? According to Richard Kirsch, HCAN’s national campaign director, “One point of this approach [giving people the choice of private insurance or Medicare] was not to scare people away from reform or to make it easier for the opponents of reform to panic the public.” HCAN apparently thinks single-payer is not popular enough among labor, elected officials, or the public to be politically feasible—but they’re wrong.

H.R. 676 has significant labor support. To date, over 445 labor organizations, including 36 state AFL-CIO chapters, 110 Central Labor Councils, the United Steel Workers, the United Auto Workers, and at least 14 AFSCME and SEIU locals have passed resolutions supporting the bill. Interestingly, both SEIU and AFSCME have passed resolutions supporting H.R. 676 at national conventions, showing that there is strong rank-and-file support for single-payer.

Why? Because H.R. 676 takes health benefits off the bargaining table, allowing labor to focus on other key issues. A position paper from the New Jersey State Industrial Union Council explains: “H.R. 676 can create a real opportunity for white- and blue-collar workers. When negotiating a contract the final two issues always are wages and medical benefits. The benefits will always affect wages, and the employer will cry that their health insurance costs limit their ability to give raises.” With health care a non-issue, unions can concentrate on wages, safety, and organizing more workplaces.

And given the budget crisis states and municipalities across the country are facing, the support of AFSCME’s leadership for HCAN rather than single-payer is particularly questionable. According to the National Conference of State Legislatures, more than 30 states face deficits totaling a projected $40 billion this year. The U.S. Conference of Mayors, representing over 1,000 cities with populations over 30,000, unanimously adopted a resolution supporting H.R. 676, which, in their view, will save municipalities millions. According to Healthcare-NOW!, a national organization founded five years ago (not to be confused with HCAN), even a small city could save millions of dollars.

HCAN seems to be out of touch with the American public as well. People aren’t scared of a national health program—quite the opposite. USA Today reported the results of a December 2007 Associated Press/Yahoo! poll: “Sixty-five percent of those polled said the United States should adopt universal health insurance that covers everyone under a program such as Medicare that is run by the government and financed by taxpayers.”

While mixed public/private plans like Massachusetts’ are beset by problems and have left many uninsured and over-charged, single-payer has become increasingly popular. With HCAN’s full support, H.R. 676 could be even closer to becoming reality. It’s our only hope if we truly want quality “health care for all.”

Jeffrey Muckensturm is a freelance writer and activist living in Philadelphia.  He can be reached through www.CityInvincible.org.

Resources: Health Care for America Now, www.healthcareforamericanow.org; Jim Kuhnhenn and Trevor Tompson, “Poll: Economy, Health Care Top Issues,” USA Today, December 28, 2007; Richard Kirsch, “Why Not Single-Payer?,” the Now! Blog, blog.healthcareforamericanow.org, July 15, 2008; New Jersey State Industrial Union Council, “For HR 676 One Plan, One Nation Campaign And Regarding Health Care for America Now The Trojan Horse,” www.healthcare-now.org.

Note: This is the full article I had published in the October/November issue of Dollars and Sense.

Both AFSCME and SEIU were instrumental in creating Health Care for America Now (HCAN), a lobbying group whose chief objective is to support Barak Obama’s healthcare plan. HCAN is critical of private health insurance companies for their desire to put profit over the lives of their customers. But they won’t go as far as removing private insurance, as single-payer would, from the system completely.

Richard Kirsch, HCAN’s National Campaign Director writes, “One point of this approach [giving people the choice of private insurance or Medicare] was not to scare people away from reform or to make it easier for the opponents of reform to panic the public,” in his blog post “Why Not Single-Payer?“

Sadly, Richard Kirsch is wrong–Americans are ready for reform. 59% of the nation’s physicians and 65% of people nationwide believe that: “The United States should adopt a universal health insurance program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers.” Even the rank and file members of AFSCME and SEIU voted to endorse the most widely supported single-payer healthcare legislation, HR 676.

The labor issue of Dollars and Sense should be on newsstands soon. Please check it out.

Once again, I used WordPress to develop the site and redesigned, with my friend Brian, a theme by Brian Gardner. WordPress has been a joy to work with, and I plan on using it for future projects.

Let me know what you think of the new site.

It seems that “the declines occurred because HUD changed guidelines in late 2006 for counting the homeless, requiring an interview with each person counted. In 2005, counters could use their judgment to determine if a person was homeless.”

It’s easy for the the government to reduce the amount of homeless people by changing the definition to include less people. Some cities include people who are living with relatives, because they don’t have a permanent home. The Federal government, however, decided not to include them anymore. Problem solved.

Claiming that there’s less homeless people is dangerous because Bush will now claim that cities don’t need as much help or funding. HUD, and the right, shouldn’t be so quick to tout easily disputed “accomplishments.”