As high profile congressional committees debate Barack Obama’s health reform bill in Washington D.C., another parallel health care debate is playing out in the picturesque state of Vermont. The differences in both the tenor and the substance of the two debates couldn’t be more profound.

 

Di puseur debat nasional aya inohong kawas Max Baucus, kapala panitia Keuangan Sénat kuat, anu geus narima kontribusi leuwih ti industri kasehatan ti anggota kongres séjén: $3.9 juta saprak 2003.(1) Max Baucus sarua boga. geus hosting $10,000 a sirah hayam cordon dinners biru pikeun lobbyists di agam palatial na San Fransisco, bari rata Amerika néangan protés reformasi kasehatan nyata di luar.(2) Nalika dokter jeung perawat nyokong pikeun kasehatan payer tunggal anu blacklisted ti kasehatan Baucus 'Mei. hearings, aranjeunna nangtung di protés jempé di galeri tur Baucus geus aranjeunna ditahan.(3)

 

Panginten éta henteu héran pisan pikeun ngabela kasehatan nalika AP ngalaporkeun Senén: "Saatos minggu ceramah rahasia, tilu Demokrat sareng tilu Republik dina Komite Keuangan Sénat nuju ngadeukeutan kompromi anu henteu kalebet sarat anu dipilarian ku seueur Demokrat kongres. usaha badag pikeun nawarkeun cakupan ka pagawe maranéhanana. Atawa bakal aya rezeki pikeun pilihan asuransi pamaréntah, sanajan rojongan Obama pikeun rencana kitu, ceuk pajabat. "(4)

 

Aya ironi anu tangtu dina kanyataan yén Sénator anu ngagaduhan pamayaran pajeg-subsidi kasehatan universal anu ngaleungitkeun tagihan reformasi kasehatan tina pilihan asuransi umum. Samentara éta, hiji polling NY Times / CBS panganyarna kapanggih 72 persén urang Amerika ni'mat pilihan publik.(5)

 

 

Can Vermont Lead the Rest of the Country to Health Care Reform?

 

A world away from this pay-for-access system of influence auctioning, the state of Vermont has begun it’s own, and decidedly more grassroots, health care debate. Instead of millionaire lobbyists, the leading voices are small town health care providers like Dr. Deb Richter. Richter has practiced medicine for the last 23 years as a primary care physician in Cambridge, VT, population 3,186. Asked to describe the health care system in the US she says, "I feel like I’m in the foxholes. People are getting angry, they’re absolutely livid about the bailout for the banks – this apparent bailout for the insurance industry – while they are struggling to pay for shoes for their kids to wear. The people are ready for single payer, the people have had it, Medicare looks pretty good. Patients are saying I can’t wait to get old. The majority who get sick can’t work, I see them all the time in my practice. I kind of smell a revolution coming."

 

Buttressing Richter mangrupa laporan panganyarna ti NY Times nu kapanggih yén "diperkirakeun tilu-suku jalma anu kadorong kana bangkrut pribadi ku masalah médis sabenerna miboga asuransi nalika aranjeunna gering atawa anu luka." (6) Sedengkeun pikeun prospek tina DPR jeung Sénat crafting solusi kawijakan, Dr. Richter nyebutkeun, "Kuring teu nyangka ieu [pilihan umum] pikeun ngajawab masalah lamun ieu teu bade dilaksanakeun nepi ka 2013, ieu bade janten calamity a."

 

Asked for her critique of the debate happening inside Washington, Dr. Deb explains, "Our democracy is corrupt; it is not a true democracy. The debate started with including the insurance industry and that’s why single payer was immediately off the table. I don’t think the public option is going to solve the problem, the public will pay for the sickest people and the private will pay for the healthiest. Single payer would get an immediate cost savings, an immediate effect. A recent national study found that with single payer we could spend five percent less of our GDP (Gross Domestic Product) on administrative waste. In order to do single payer you virtually eliminate the insurance industry, but they subsidize congressional campaigns."

 

Perawatan Kaséhatan mangrupikeun Hak Asasi Manusa

 

On May 1st of this year Richter spoke at a Health Care is a Human Right rally of approximately 1,000 people at the Statehouse in Montpelier, Vermont‘s usually sleepy capital of 8,000. The Vermont Workers’ Center organized the rally and is building "a grassroots network to fundamentally change how we approach health care as a basic public good, as a human right," says its director James Haslam. The Vermont Workers’ Center describes itself as a "democratic, member-run organization dedicated to organizing for workers’ rights and living wages for all Vermonters."

 

"Aya seueur kasangsaraan sareng seueur pisan ketidakadilan anu urang bakal tetep ngatur buntut dugi ka urang tiasa meunang di Vermont sareng mugia nunjukkeun nagara-nagara sanés," saur Haslam dina wawancara anyar. "Tapi éta kedah asalna ti jalma-jalma anu ngatur di komunitasna sareng di lingkunganana, éta pasti moal asalna ti politikus karismatik anu nembé kéngingkeun undian urang sareng badé nyobian sareng damel sihir sareng pelobi perawatan kaséhatan jutawan ieu." Strategi Vermont Worker's Center kalebet "nyekel forum akuntabilitas umum sareng anggota DPRD di unggal tempat anu urang tiasa," sareng ngumpulkeun rébuan kartu pos konstituén pikeun dikirimkeun dina dinten mimiti sési législatif. Haslam nyatakeun yén kampanye éta narékahan pikeun nunjukkeun "yén aya langkung seueur jalma di luar anu percanten kana parobihan dasar tibatan anu percanten neraskeun status quo atanapi tinkering sareng sistem anu rusak."

 

VermontSénator SMP berambut liar Bernie Sanders henteu kantos janten salah sahiji pikeun ngintip sareng status quo. Anyar-anyar ieu Sanders nyerat "Hak Nagara pikeun Inovasi dina UU Perawatan Kaséhatan," tagihan di Sénat anu bakal ngamungkinkeun lima nagara pikeun ngatur sistem pamayaran tunggal (Tingali téks lengkep tagihanana di dieu). Anjeunna mangrupikeun salah sahiji sora utama anu nyorong ngalawan pelobi perawatan kaséhatan anu kuat, sareng ngajengkeun pamayaran tunggal di Sénat.  Ngeunaan parah krisis kasehatan, Sanders nyarios kieu dina redaksi panganyarna, "Hayu urang jelas. Sistem perawatan kaséhatan urang disintegrasi. Dina waktos nalika 46 juta jalma, kalebet seueur asuransi, henteu ngagaduhan aksés ka bumi médis, langkung ti 60 urang Amerika maot unggal taun tina panyawat anu tiasa dicegah sabab henteu dugi ka dokter nalika aranjeunna Ieu genep kali jumlah anu maot dina tragedi 18,000/9 - tapi ieu lumangsung unggal taun. "(11)

 

Kauntungannana dina Sakur Biaya

 

Sedengkeun Max Baucus 'tina debat dunya di aula marmer gilded kalawan lobbyists sarta CEOs, diness tina krisis kasehatan Amérika worsens unabated. Numutkeun LA Times, rumah sakit Los Angeles netep di luar pengadilan pikeun ngalungkeun langkung ti 150 pasien anu gering mental tina ranjang rumah sakitna kana léngkah-léngkah saung homeless Skid Row dina taun 2007 sareng 2008.(8) Pikeun maksimalkeun kauntunganana, rumah sakit. parantos nyiptakeun versi dunya globalisasi tina dumping pasien. Nurutkeun kana NY Times "Seueur rumah sakit Amérika anu nyandak éta sorangan pikeun ngabalikeun deui [deportasi] imigran anu parah atanapi gering kusabab aranjeunna henteu tiasa mendakan panti jompo anu daék nampi aranjeunna tanpa asuransi… , nyésakeun rohangan anu cukup pikeun pelanggaran hukum sareng étika dina dua sisi wates."(9)

 

Sénator Sanders nyerat yén ramalanna henteu pikasieuneun pikeun sadayana. "Ti 2003 nepi ka 2007, kauntungan gabungan pausahaan asuransi kaséhatan utama bangsa urang ngaronjat ku 170 persen. Jeung, bari beuki loba Amerika kaleungitan jobs maranéhanana sarta asuransi kaséhatan, nu executives luhur di industri anu narima pakét santunan lavish. ngan William McGuire, urut kapala Serikat Kaséhatan, anu sababaraha taun ka pengker akumulasi pilihan saham patut hiji diperkirakeun $ 1.6 milyar atawa CEO Cigna Edward Hanway anu nyieun leuwih ti $ 120 juta dina lima taun ka tukang, kanyataanana nyaeta CEO santunan pikeun luhureun tujuh. Perusahaan asuransi kaséhatan ayeuna rata-rata $ 14.2 juta."

 

Malah pisan média, anu sakuduna ngalaporkeun kritis dina prosés législatif sabudeureun reformasi kasehatan, geus diusahakeun rake dina kauntungan masif ku ngajual aksés ka politikus boga pangaruh katuhu. The Washington Post dijadwalkeun pikeun host $ 25,000 "salon" jalma pikeun ngahijikeun pelobi sareng CEO perawatan kaséhatan sareng para pembuat kabijakan anu nyusun tagihan kasehatan.(10)

 

 

Di sagigireun Baucus, Demokrat propil luhur anu sanés ogé nginjeumkeun namina pikeun nyababkeun maksimalkeun kauntungan Big Pharmaceutical, Asuransi, sareng HMO kalayan biaya réformasi nyata. "Ieu mangrupikeun jenis lingkungan anu masihan-sareng-nyandak, quid pro quo lingkungan," saur Tom Daschle, pilihan awal Présidén Obama pikeun sekretaris kaséhatan, anu masih janten panaséhat pikeun administrasi Obama ngeunaan kawijakan perawatan kaséhatan. "Kuring nyangka yén pamangku kapentingan [Industri Perawatan Kaséhatan] moal ngalakukeun ieu upami aranjeunna henteu nyangka aya anu aya pikeun aranjeunna." (11) Salah sahiji panaséhat pangdeukeutna Obama, Kapala Staf White House Rahm Emanuel, dina wawancara Wall Street Journal, nyatakeun, "Leuwih penting yén panerapan kasehatan nyuntik kompetisi kaku diantara rencana asuransi ti éta pikeun Kongrés nyieun pilihan murni-ngajalankeun pamaréntah."(12)

 

Jalan Maju

 

When asked about the trajectory for health care reform in Vermont, Haslam of the Workers’ Center responds with cautious optimism, "We still have our work cut out for us. Democrats who have been in power of the legislature have had excuses for not taking action and going the direction we need to go. Before it was ‘Governor Douglas could veto it’, which is true, but now they have overridden two vetoes. Now it’s ‘we need these waivers.’ So we’re not going to let them have excuses. We’re going to get so many people involved to make it politically possible. In the end if we do a good job there will be somebody, some ambitious politician who will see the writing on the wall, who will see the winds are changing and that people are ready for this, people are demanding it. People will take to the streets and do whatever we have to do to get [the politicians] to do what people have wanted for a long time."

 

Sedengkeun pikeun Max Baucus, Obama, sarta tarung pikeun reformasi kasehatan bermakna dina tingkat nasional, sapotong loba diantisipasi tina tagihan ti Komite Keuangan Baucus diperkirakeun minggu ieu.

 

Meanwhile, nine more health care activists, including doctors and an 11-year-old girl, and were arrested Monday, in a Des Moines, Iowa Blue Cross Blue Shield. According to the Des Moines Register, "The protesters, who were supporting creation of a single-payer health care system, denounced private insurance companies as ‘bloodsuckers’ and carried a sign decorated with pictures of tombstones and a declaration that ‘Insurance Profits Make Us Sick.’"(13)

 

Naha atanapi henteu Max Baucus anu kuat bakal ngadangukeun tetep kedah ditingali.

 

 

 

Catetan:

 

1. Puseur pikeun Pulitik Responsif - Top 20 Industri nyumbang ka Panitia Kampanye sareng Kapamingpinan PAC

 

http://www.opensecrets.org/politicians/industries.php?type=C&cid=N00004643&newMem=N&recs=20&cycle=2008

 

2. Industri Cash Flowed Pikeun Drafters of Reformasi

 

http://www.washingtonpost.com/wp-dyn/content/article/2009/07/20/AR2009072003363.html?hpid=topnews 

 

3. Plan Podomoro Baucus: Ditewak Dokter, Mantri

 

http://www.thenation.com/blogs/thebeat/435159

 

4. Top House Demokrat berjuang dina tagihan kasehatan

 

http://hosted.ap.org/dynamic/stories/U/US_HEALTH_CARE_OVERHAUL?SITE=MAHYC&SECTION=HOME&TEMPLATE=DEFAULT

 

5. Dina Polling, Rojongan Wide pikeun Kaséhatan-Run Pamaréntah

 

http://www.nytimes.com/2009/06/21/health/policy/21poll.html

 

6. Insured, tapi bangkrut ku Krisis Kaséhatan

 

http://www.nytimes.com/2009/07/01/business/01meddebt.html

 

7. Perawatan Kaséhatan mangrupikeun Hak, Henteu Hak Istimewa

 

http://www.huffingtonpost.com/rep-bernie-sanders/health-care-is-a-right-no_b_212770.html

 

8. College Hospital to pay $1.6 million in homeless dumping settlement

 

http://articles.latimes.com/2009/apr/09/local/me-homeless-dumping9

 

9. Immigrants Facing Deportation by U.S. Hospitals

 

http://www.nytimes.com/2008/08/03/us/03deport.html?_r=1&pagewanted=1&bl

 

10. Washington Post cancels $ 25,000 "salon" kalawan lobbyists

 

http://seattletimes.nwsource.com/html/entertainment/2009411897_apuspostconferences.html

 

11. poéna Kaséhatan bisa Harbour waragad disumputkeun 

 

http://www.nytimes.com/2009/07/08/health/policy/08health.html?hp

 

12. White House Buka pikeun deal on Plan Kaséhatan Umum 

 

http://online.wsj.com/article/SB124692407982802911.html

 

13. Salapan ditahan dina démo di Wellmark

 

http://www.desmoinesregister.com/article/20090728/NEWS/90727067/1001/

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