United Public Workers for Action

UPWA Healthcare Committee Report

United Public Workers for Action
Health care Committee Recommendations
(Some of this is quoted directly from Charles Andrew's article)

The Health Care Committee decided up front to advocate for a single payer plan. We spent some time discussing the different models out there, but we did not consider any options other than single payer because:

It is equal care as an entitlement for all rather than care for a privileged few. It also involves:

The group discussed the Medicare model as the best one to push for, while controlling for the private drug, insurers and hospital interests from preventing effective implementation of such a plan.

The group considered models of care delivered in Cuba and Vietnam, which provide for widespread community clinics, and lay “triage specialists” within community groups to help direct care to those clinics.

The group felt that these models, although ideal in many ways, would not be effective at this point in the United States given the current model of specialists and multidisciplinary teams. The community clinic models work best in places where a single “shaman-like” provider can address the whole person needs of an individual.

The current U.S. system, and therefore its professional resources are not trained to follow that model, so to address all the contributing health issues to a problem the model used here is a team approach with case coordination. The groups felt that Medicare was a single payer model that was actually being used and working in the current U.S. system, so would be the best model to recommend.

With the defeat of Prop 186 several years ago, it was clear there was little public consensus for or understanding of a single payer model. A decade later public opinion surveys showed a favorable view towards a single payer approach.

During the time since Prop 186, however, many public and private health care systems have been transitioned from a fee for service model to a prepaid capitated HMO or PPO managed care model.

At this point in our history many people are familiar with the concept of managed care, and understand its benefits, when managed deliberately and properly.

Our group felt this was the moment to reconsider introducing a single payer initiative using Medicare as its primary model. This would be recommended with the understanding that the current Medicare relationship with drug companies would have to be reconsidered.

Another important factor with the initiative would have to include a considerable transition component, including retraining of administrative skilled personnel to transfer from the decrease in administrative duties and to the increase in medical related duties that would be generated by switching resources to a single payer model.

Our model would also include the “health care provider mystique” that exists in our current system, to our advantage in the area of provider client relations and education through the transition and start up periods.

Based upon this discussion, our group, therefore, recommended the following actions: