In 2009 when the Washington beltway was tied up with the health careÂ reform tussle, Montana Democratic Senator Max Baucus, chairman of the all-powerful Senate Finance Committee, said everything was on the table–except for single payer.
When doctors, nurses and others rose in his hearing to insist that single payer be included in the debate, Baucus had them arrested. As more stood up, Baucus could be heard on his open microphone saying, ÂWe need more police.Â
Yet when Senator Baucus needed a solution to a catastrophic health disaster in Libby, Montana, and surrounding Lincoln County, he turned to the nationÂs single payer healthcare system, Medicare, to solve the problem.
BaucusÂ problem was caused by a vermiculite mine that had spread deadly airborne asbestos killing hundreds and sickening thousands in Libby and northwest Montana. The W. R. Grace Company that owned the mine denied its connection to the massive levels of mesothelioma and asbestosis and dodged responsibility for this environmental and health disaster. When all law suits and legal avenues failed, Baucus turned to our countryÂs single payer plan, Medicare.
The single payer plan that Baucus kept off the table is now very much on the table in Libby. Unknown to most of the public, Baucus inserted a section into the health reform bill that covers the suffering people of Libby, Montana, not just the former miners but the whole communityÂall covered by Medicare.
They donÂt have to be 65 years old or more.
They donÂt have to wait until 2014 for the state exchanges.
No ten year roll outÂitÂs immediate.
They donÂt have to purchase a planÂthis is not a buy-in to MedicareÂitÂsÂ free.
They donÂt have to be disabled for two years before they apply.
They donÂt have to go without care for three years until Medicaid expands.
They donÂt have to meet income tests.
They donÂt have to apply for a subsidy.
They donÂt have to pay a fine for failure to buy insurance.
They donÂt have to hope that the market will make a plan affordable.
They donÂt have to hide their pre-existing conditions.
They donÂt have to find a job that provides coverage.
Baucus inserted a clause in the Affordable Care Act to make special arrangements for them in Medicare, and he didnÂt wait for any Congressional Budget Office scoring to do it.
Less than two months after the passage of the health reform bill on MarchÂ 23, 2010, Nancy Berryhill of the Social Security Administration in Denver joined personally in setting up an office in Libby to sign up these newly eligible people. ÂThis is a new thing,Â Berryhill told the Missoulian. ÂNo other groupÂ like this has ever been selected to receive Medicare.Â
Berryhill issued a nationwide alert to inform anyone who had lived or stayed in Lincoln County of their eligibility. She opened a storefront in Libby at the old downtown city hall where she signed up 60 people on the first day. She plastered the towns of Whitefish and Eureka with pamphlets explaining theÂ program and added three new staffers to the office in Kalispell.
Berryhill said she did not know how much the care would cost. That kind of analysis was beyond her directive to sign the people up. There have been no reports of competition from the private for-profit Medicare Advantage plans. The sick are not profitable.
No one should begrudge the people of Lincoln County. The mine wastes were used as soil additives, home insulation, and even spread on the running tracks at local schools. Miners brought the carcinogens home on their clothes. The W. R. Grace Company dumped much of the cleanup costs onto the federal government. A June 17, 2009, order by the EnvironmentalÂ Protection Agency, the first of its kind, declared Lincoln County a public health disaster. The Libby Medicare provision in the health reform law is based on the area covered by that EPA order.
Baucus gave his reasons to the New York Times for its only story on this unique benefit: ÂThe People of Libby have been poisoned and have been dying for a decade. New residents continue to get sick all the time.Public health tragedies like this could happen in any town in America. We need this type of mechanism to help people when they need it most.Â
Health tragedies are happening in every town. Over 51 million have no insurance. Over 45,000 uninsured people die needlessly each year.
Employers are cutting coverage and dropping plans. States in economic crisis are slashing both Medicaid and their employeesÂ plans. Nothing in last yearÂs reform law will mitigate the skyrocketing costs. Most insurance is threadbare and doesnÂt cover. More than 50% of us now go without necessary care. As Baucus said of Medicare, ÂWe need this mechanism to help people when they need it most.Â We all need it now.
Bill Clinton recently stated that the U. S. could give coverage to all for one trillion dollars a year less than we now pay if we adopted the systemÂ of any other advanced nation. (Unfortunately, he did not say this when it would have mattered most during the 1993 and 2009 health care reform debates.)
Other industrialized countries have found that to cover everyone for less they must remove the profit-making insurance companies. Congressman John Conyers has reintroduced HR 676, the Expanded and Improved Medicare for All Act, which does exactly that. There are 60 cosponsors. It would cover all medically necessary care for everyone including dental and drugs by cutting out the 30% waste and profits caused by the private insurers.
So as the Ryan Republicans try to destroy Medicare and far too manyÂ Democrats use the deficit excuse to suggest cuts in its benefits, let us counter with the Libby prescription to clean up the whole mess. Only a single payer, improved Medicare for All, can save and protect Medicare, rein in the costs, and give us universal coverage.
Medicare will celebrate its 46th birthday on July 30, 2011, and all are invited to join in the festivities. Medicare was passed in 1965 and implemented within less than a year. When we pass HR 676, this single payer bill, we can all be enrolled in the twinkling of an eye.
June 15, 2011