THURSDAY NIGHT IS HEALTH CARE CHANGE NIGHT: a weekly DailyKos Health Care Series
Transformation of our ailing health care system is a necessity apparent to every sector of American society but insurance companies and the current administration. Some Senate staffers have privately suggested to me that by doing nothing, the Senate is making systemic collapse (and implementation of Single Payer) inevitable. Although Americans openly despise private insurers, we remain unable to pass HR 676, Conyers' effort to establish a national public health service.
Even if we elect a new President, if we cannot infuse the Senate with a fresh crop of progressive faces, we will again fail to replace a health care system that monetarily rewards the denial of care. Representative Jeff Merkley, an Oregon Democrat, is one candidate who will champion health care transformation. I had the opportunity to interview him for ePluribus Media and Daily Kos at Netroots Nation. I will not pretend to be objective for the sake of this diary. The netroots should assist progressive candidates to win Senate seats.
More below the jump.
As speaker of the Oregon House of Representatives, Merkley has a history of backing progressive legislation to improve access to health care. He ushered The Healthy Kids Act (HB 2201), a universal access bill for children, through the Oregon House despite resistance from the tobacco industry. The payment source for the program would have been an increase in cigarette taxes, a policy proven by research to discourage youth from smoking. In the industry's euphemism, cigarette taxes hinder efforts to generate "replacement smokers," the new young addicts needed to take the place of older ranks killed by lung and heart disease.
In Oregon, if a bill does not pass with a super-majority, it is sent before voters. Merkley's bill passed the house 31-29 along party lines, with no Republican support. Big tobacco successfully spent $12 million on misleading ads to defeat the referendum in the public vote.
Merkley was undeterred in his desire to reform health care. He successfully pushed through a bill allowing small businesses to purchase prescription meds in bulk, lowering prices. He also saw passed HB 2700, a bill forcing insurance companies to cover birth control and mandating access to to emergency contraceptives for sexual assault victims. He sponsored a bill banning mercury-filled items such as thermometers, thermostats and novelty products etc.
Merkley's willingness to champion health care issues evolved out of his personal experience. "Health care almost forced me out of the Senate race," he told me. " Our family was on my wife’s health care plan, but she cut her hours from full to part time to take care of our children...they’re still small...while I’m campaigning. Next January her insurance runs out."
"I support HR 676," he continued. "I will absolutely sign that bill. But realistically, it is very hard to make a wholesale leap to Single Payer." Merkley is aware, from past experience, of the difficulties involved in defeating industry efforts to obfuscate health care issues. "For that reason, I also support Senator Wyden’s bill, the Health Care for Americans Act, which creates comprehensive, portable health care. It eliminates preconditions so people can access treatment for health challenges."
Many advocates of Single Payer oppose plans such as the Wyden Bill, that allow an option to choose between a public or a private plan. Critics fear that insurance corporations will not be adequately monitored, continuing abuses such as repeated claims denials, imposition of administrative hurdles to care delivery, and retroactive recension of policies in the wake of a catastrophic diagnosis.
"Unfortunately, it [the Wyden Bill] doesn’t really address the issue of cost," Merkley observed. "And it should include a provision allowing people to choose Medicare. Let people vote with their feet." Merkley favors the recent Medicare Bill, which cut payouts to private insurers, instead raising physician reimbursement rates. "It was a great idea," he said.
"I have dealt with lobbyists on almost every issue I addressed in Oregon," stated Merkely.
"Before diving into health care, I focused mostly on international relations and nuclear issues. I lived in Ghana, Mexico and India. I was an exchange student in Ghana when I was 16. It really changed my perspective to live with a family whose primary possession was a bicycle. I worked for two summers with the Quakers in Mexico in a village building and operating an environmental camp. My advice to you is: Don’t try to build buildings and work with children at the same time."
(In addition to interviewing Merkley myself, I was privileged to listen to his interviews with OrangeClouds115 (Lalocavida, DailyKos) and Sam Stein (Huffington Post). I found it interesting that he took time to discuss his personal experience with both OrangeClouds and me--two women-- before embarking on a discussion of policy, whereas he jumped immediately into discussion of war, troops and the economy with Stein. Perhaps this was because OrangeClouds and I each opened our interview by describing our areas of interest. Stein skipped the "fluff," jumping right into the war.)
Merkley said: "I spent two years working at the Pentagon. This administration is a complete disaster. You should be slow to go to war and fast to take care of vets. This administration is the opposite. In Oregon, we mandated that if you happen to die in the line of duty, your family members will receive four years of in-state tuition."
"We need multiple screenings for PTSD for our vets. We have to increase the amount spent on mental and general health care for vets. Mental health is swept under rug. We have to make multiple opportunities available to vets to have their mental health issues addressed. It takes time for issues to surface. You don't just come home and have symptoms show up that afternoon."
I asked him if he would support mental health parity for all Americans as well as vets. In America, mental illness is heavily stigmatized and many insurance companies do not adequately cover treatment. "In Oregon,we passed mental health parity at the state level," he responded. "We passed mental health parity mandating coverage by insurance companies."
Merkley also stated that treatment should be preferred over a militarized response to the substance abuse epidemic. As he related, "My wife, Mary, worked as a nurse at a homeless shelter in DC. Most of the people there were addicted to drugs or alcohol or were mentally ill. It was very hard to get them substance abuse or mental health treatment. We rented out our house in DC to a program for mentally ill homeless people."
Merkley defines public health broadly, believing the old adage, 'an ounce of prevention is worth a pound of cure.' As speaker of the Oregon House of Representatives, he passed a far-reaching Farm to School Program (HB 3601) making it easier for schools to purchase food supplies from local farmers and fishermen. The bill supports the local economy, reduces greenhouse gas emissions by reducing the distance food must be transported, increases the consumption of fruits and vegetables by children, and reduces diet and obesity-related disease.
"It was really an economic bill," said Merkley. "It was a farm bill. But we were able to easily pass it by making it about the kids. How can you be against feeding vegetables to children?"
Ironically, his opponent, Gordon Smith, called the Farm to School Bill "the fruit of a poisoned tree."