Thursday, June 16, 2011

How Libby, Montana, gets Medicare for All

By Kay Tillow
In 2009 when the Washington beltway was tied up with the health care
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, "We need more police."

Yet when Senator Baucus needed a solution to a catastrophic health
disaster in Libby, Montana, and surrounding Lincoln County, he turned to
the nation's single payer healthcare system, Medicare, to solve the

Baucus' 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 country's 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 community-all
covered by Medicare.

They don't have to be 65 years old or more.
They don't have to wait until 2014 for the state exchanges.
No ten year roll out-it's immediate.
They don't have to purchase a plan-this is not a buy-in to Medicare-it's
They don't have to be disabled for two years before they apply.
They don't have to go without care for three years until Medicaid expands.
They don't have to meet income tests.
They don't have to apply for a subsidy.
They don't have to pay a fine for failure to buy insurance.
They don't have to hope that the market will make a plan affordable.
They don't have to hide their pre-existing conditions.
They don't 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 didn't wait for any
Congressional Budget Office scoring to do it.

Less than two months after the passage of the health reform bill on March
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. 
"This is a new thing," Berryhill told the Missoulian.  "No other group
like this has ever been selected to receive Medicare."  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 the
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 clean up costs onto
the federal government.  A June 17, 2009, order by the Environmental
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:  "The 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."

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 employees' plans.  Nothing in
last year's reform law will mitigate the skyrocketing costs.  Most
insurance is threadbare and doesn't cover.  More than 50% of us now go
without necessary care.  As Baucus said of Medicare, "We need this
mechanism to help people when they need it most."  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 system
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

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 many
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.

Distributed by:
All Unions Committee For Single Payer Health Care--HR 676
c/o Nurses Professional Organization (NPO)
1169 Eastern Parkway, Suite 2218
Louisville, KY 40217
(502) 636 1551