Portland City Council endorses single payer bill, calls for action from Congress and citizens

Chris Lowe

On Wednesday September 30, 2009, the Portland, Oregon City Council unanimously passed a resolution urging the Congress of the United States to pass HR 676, to transmit the resolution to President Obama and to the Oregon Congressional delegation, accompanied by letters urging them to work to adopt and implement HR 676, and affirming the Council's intent to use City resources to encourage citizen action in communicating their wishes and expectations regarding HR 676.

Two important opportunities for single payer supporters are open now in the House, whether specifically focused on it now, or focused on public plan options in a multi-payer system because they don't see single payer as immediately achievable, the Weiner Amendment and the Kucinich Amendment. See more at end of column.

Below the jump is the text of the resolution as it appeared on the City website for the Council's agenda, which was not amended, and further discussion.

RESOLUTION No. Urge Congress to enact the United States National Health Care Act sponsored by Representative John Conyers. (Resolution)

WHEREAS, all people deserve equal access to quality health care; and

WHEREAS, there is a growing crisis in health care in the United States of America, manifested in rising health care costs, increased premiums, out-of-pocket spending, and decreased international business competitiveness; and

WHEREAS, approximately one third of Oregonians lacked health insurance at some time in 2007-2008; and

WHEREAS, those insured now often experience burdensome medical debt; and

WHEREAS, half of all personal bankruptcies are due to illnesses or medical bills; and

WHEREAS, the rising costs of insuring city employees can best be met not by limiting their benefits or terminating their employment, but by expanding their health care benefits under a national, publicly-funded health care program; and

WHEREAS, the complex bureaucracy arising from our fragmented, for-profit, multi-payer system of health care financing consumes approximately 30 percent of the United States health care spending while Medicare has a 3 percent overhead; and

WHEREAS, United States Representative John Conyers introduced H.R. 676, the United States National Health Care Act, in the United States House of Representatives for the 111th Congress; and

WHEREAS, this Act would provide a universal, comprehensive, single-payer system of high quality national health care;
NOW, THEREFORE BE IT RESOLVED, that the Council of the City of Portland:

1. Respectfully urges the United States Congress to enact the United States National Health Care Act sponsored by Representative John Conyers.

2. Directs the City Attorney to transmit copies of this resolution to the President of the United States and to members of the Oregon congressional delegation accompanied by letters urging them to work to adopt and implement the United States National Health Care Act (Expanded and Improved Medicare for All Act) as defined in H.R. 676 to provide for comprehensive health care coverage for all United States residents.

3. Affirms that the Council of the City of Portland will use the City’s website, public meetings, news releases, and other forms of communication to encourage Portland residents to participate actively in the democratic process by informing their elected officials of their wishes and expectations regarding H.R. 676 and other matters of public concern.

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The three sponsoring members listed on the draft, Mayor Sam Adams, Commissioner Randy Leonard, and Commissioner Amanda Fritz, were joined in voting Aye by Commissioner Nick Fish. Commissioner Dan Saltzman was traveling on city business and unable to be at the meeting. The other commissioners acknowledged that Commissioner Leonard had taken the initiative in moving this resolution forward.

Commissioner Leonard began the discussion by giving an overview of the current crisis of the health care system in the country that identified three dimensions to it: lack of universality, exceedingly high costs rising much faster than inflation, and poor health outcomes for the money spent.

A panel of witnesses called by Commissioner Leonard gave lead testimony, including Tom Leedham, the principal officer of Teamsters Local 206, Dr. Herman Frankel, a Portland pediatrician, Tom Dwyer, small business owner of an auto repair shop. Leedham and Frankel are members of the Portland Jobs with Justice Health Care Committee (JwJHC) and both also belong to Physicians for a National Health Plan (PNHP), Leedham in his capacity as manager of his union's Taft-Hartley healthcare trust.

They were followed by 16 citizen witnesses, including two more PNHP doctors, a pediatric critical care nurse and co-chair of JwJHC, the executive director of Portland JwJ and a JwJHC member, more JwJHC members including the state coordinator of Progressive Democrats of America, and others. Much of the testimony involved individual stories of the ways that what Commissioner Fritz called the current lack of a system has harmed or threatened people and their families. There was also a bit of emphasis on the effects of super-inflating health care costs on labor-management relations and negotiations and the effects in making local public sector budgeting more difficult and crowding out other needs.

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The Oregonian gave brief, straightforward on-line account of the session, while The Portland Mercury's Matt Davis blogged a more cynical piece, apparently acting as a mouthpiece for Congressman Earl Blumenauer, by interviewing Blumenauer aide Willie Smith saying that the resolution will not influence Blumenauer's actions, but not talking to any resolution proponents or at any rate not reporting anything they said.

Had Davis happened to ask me -- I did testify, as a JwJHC member and PDA state coordinator, but mainly as Portland Public Schools parent -- here's some of what I might have said to him:

First, as I testified, I believe it is a legitimate and important function of local government to communicate to higher levels of government on behalf of their constituents, particularly on matters of profound local effect over which local government has little direct purchase. In Portland, a great many people see a single payer system as ultimately being the approach with the capacity to resolve our health system's triple crisis of lack of universality, huge costs increasing at super-inflationary ratees, and poor health outcomes especially considering the money spent. Many of us focus on advocating national health insurance now, many more focus on what they see as more achievable intermediate steps. But if the narrow political calculus that puts political realism above economic and health realism is ever to be changed, actions like that taken by the Council play a necessary role. This resolution speaks not only to the immediate current debate, but to the needs that will remain when the current process produces whatever inadequate outcome it does out of the narrow, inadequate range left.

Second, though the timeline isn't immediate, H.R. 676 or another tax funded single payer system would provide significant relief to local and state budgets that are required to balance budgets and face the same high and accelerating benefits costs other employers face. It would also thereby significantly improve the context for public sector labor negotiations, in which conflicts over benefits have become increasingly contentious. These are the considerations I testified about in terms of the potential beneficial effects for the Portland Public Schools, and they apply across the public sector.

Relatedly, Davis slates the Council for passing the resolution while facing an employment crisis in the Bureau of Development Services particularly and more generally, about which AFSCME 189 and a lot of allies were demonstrating outside at lunchtime. But the AFSCME folks were in the chamber supporting our resolution, and the single payer advocates stuck around to support the municipal workers. In both cases the issues involve basic fairness and using public resources to make a better, more decent community and society.

Third, barring a miracle, Davis is right that single payer is not apt to pass this Congressional session. But there are two concrete items in Congress that could advance the debate to which the Council resolution is relevant. The Weiner Amendment would substitute the text of H.R. 676 for the text of H.R. 3200 ("Tir-Committee Bill") after it is finalized. The Kucinich amendment would modify ERISA law to make state level single payer systems easier to create, which has passed one committee, but may not survive reconciliation by the Rules Committee & leadership.

Our Congressional delegation can support both of these. While the Weiner amendment is unlikely to pass, as strong showing would show support for the strongest possible reforms going into conference with the Senate, and representatives can vote for it without abandoning a later vote for H.R. 3200, without any more work than the vote. Keeping the Kucinich amendment in is a straightforward case of strengthening H.R. 3200 and opening the door for state level single payer programs.

Likewise those of out here who favor single payer can call upon our reps to take those actions. JwJHC provides requisite how-to information.

As with members of Congress themselves, calling on Congress to support these measures is open both to those of us who are advocating single payer directly, and those who see it as desirable eventually, but are pursuing a different immediate political path according to their best lights and judgments.

By Chris Lowe Oct. 02, 2009