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.

Comments

  • Mud Falcon (unverified)
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    Just another example of our Portland Mayor and City Council being out of touch with reality. Single payer is not being seriously considered in Washington DC-- it has no chance of passing-- period. Full-blown single payer with a dedicated funding mechanism was also presented to Oregon voters in 2003. Measure 23 was voted down 79% to 21%. Wake up Portland, this is not leadership.

  • Robert Collins (unverified)
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    Resolutions of this nature are disingenuous pandering on the part of the council members. The feds could care less what the PDX council thinks. If they did care, they wouldn't be forcing us to spend a ridiculous amount of money on a water filtration system we do not need.

    How about the city council take care of Portland's streets, sewers, water, parks, police and fire? Like the charter mandates. What a concept.

  • mp97303 (unverified)
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    and affirming the Council's intent to use City resources to encourage citizen action in communicating their wishes and expectations regarding HR 676.

    Just what does that mean? Are they planning on spending taxpayer money to lobby? WTH.

    (and yes, I support single payer)

  • William (unverified)
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    Mud, in point of fact, most Americans, including working doctors, support Universal Single Payer. There are multiple surveys that show this. As for any vote made by the people (and I'm not talking about Measure 23 in particular), it has been shown time and again that A) people's opinions change over time on issues, and B) if you're willing to spend a lot of money on ads, you can convince an awful lot of people to think a certain way about an issue.

    Robert, I agree with your points about pandering and about the indifference of the Feds. On the other hand, pandering is done to curry favor, so perhaps, if Wyden, Merkeley, Wu, and Blumenhauer see Portland's citizens more strongly support single payer, then they may decide to support it a bit more strongly so as to secure more votes for next time around. There are many people who, come election time, will strongly consider what happens with health care. So maybe some of the Feds do care. And maybe a vote or two will be swayed, after all.

    As for using city resources on this instead of on parks, streets, and public safety, do you really imagine the city will dedicate a lot of resources to this? I can't imagine that they would, and what little time they do give is fine with me (a taxpayer). This is one of the most important issues we're likely to see the gov't handle, and I think encouraging citizen involvement is wonderful. We wouldn't be in this mess if we'd been paying attention and speaking up all along.

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    MP97303,

    Not to lobby, but to encourage citizen participation in communicating to Congress. It is content neutral regarding what people's wishes may be.

    It would not be city government relations people lobbying.

    The only use of city resources particularly mentioned at the hearing was Nick Fish saying he intended to put something about why he voted as he did on his website along with Randy Leonard's opening remarks.

  • mp97303 (unverified)
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    @Chris Lowe

    Lobbying was clearly the wrong choice of words on my part. I was wondering just what city resources they had in mind and to what they intended to do with them. You answered that in your last sentence. Thanks--

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    Chris, this is great. I think some people misunderstand why this kind of action is important (paging Mud Falcon). In a democracy, policy follows public will. It's not likely that any progressive change will happen if progressives don't make their voices heard--loudly and often.

    For the past decade or more, political will has bent around the very vocal far-right. The media and politicians respond to what they perceive as popular opinion. This in turn creates popular opinion--as those who don't follow the issues take their cues from the media and politicians. In this way, those who are very vocal get to create "normal." They dictate what is later characterized as "mainstream."

    Good progressives have been complacent for these years, expecting somehow that Americans will magically abandon the far right when they see it's not mainstream. Well, how's that working?

    We are the architects of our own reality. By passing resolutions supporting single-payer, by attending rallies and writing blog posts and sending emails and talking to our families and friends, we begin to move America toward a "normal" we can live with.

    Thanks to the City Council for taking this step and to Chris for his constant insistence that single-payer be considered a reasonable, workable, humane alternative.

  • Lord Beaverbrook (unverified)
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    Sooo Portland! Can be summarized by "the resolve and consensus demonstrated by the City Council is inversely proportional to the consequentiality of their role in addressing the issue", and, "doesn't that sound great; proud to be a Portlander". Everything from the Sam recall to Broadway renaming can be understood in that single sentence.

    Genuine, progressive, results oriented government isn't that predictable, QED...

  • Miles (unverified)
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    I think some people misunderstand why this kind of action is important

    I think, Jeff, you misunderstand that this kind of action NOW is totally useless. That's the point that Blumenauer's staffer is making in Davis's article. The battlefield has narrowed and progressives are trying to get as much as they can in the current environment. This resolution probably made sense last fall after the election, or even in January or February when Congress was reconvening, or possibly in the spring when it became clear Obama would still push for health reform this year. But now? When the bills are 90% done and everyone in the country is arguing over the specifics of the legislation that is actually being discussed, which does not include single payer? It's absurd.

    I respect Chris Lowe's views on this issue, but I think this kind of action marginalizes the single payer advocates as aloof and out of touch. It doesn't seem to matter how the debate among the actual policymakers shapes up, or the fact that thousands of Americans were enraged over the idea of a public option -- much less radical than an actual single payer system. They just keep going back to the same talking points. The single payer debate is lost this year, and those of us working to get the best health care reform legislation that we can sure could use the energy of those pushing for resolutions like this one.

  • Cliff (unverified)
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    Miles, the single payer debate was not lost this year because no debate took place. The public option debate has taken place and has apparently lost. Yes, thousands of Americans were outraged over the public option idea. But, poll after poll finds deep, majority support for something akin to Medicare for all. People like Blumenauer are not leaders. They are motivated by one thing: Political expedience. Political expedience is affected by two things: money and voters. As long as the politically expedient believe that the money of special interests are more effective in influencing voters than the organization of citizens pushing on a particular issue, they will listen to the special interests. That is why the city council resolution is important. It sends a message about the desires and will of the citizens of this city and specifically voters in Blumenauer's district.

  • Garage Wine (unverified)
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    Matt Davis says: tl;dr

    Amen, Matt!

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    Thanks for the kind words Jeff. I agree with you about seeing advocacy as a medium and long term proposition as well as a short term one. Probably I would put more down to demoralization than complacency, as well as fragmentation; we could talk about that over a beer sometime, but I think the resonance of Barack Obama's all things to all people "Hope" speaks to that. But either way silence and disengagement is self-defeating.

    Miles, I respect your view too, and had the DP leadership reform strategists pursued a different strategy I'd have been more persuaded by your arguments some months ago. But as far as I am concerned they took a route that said I don't matter, defining the only politics that do matter as those inside Congress, and the only "realism" that mattered was their own cramped, pessimistic view of what was politically realistic, and health realism and economic realism be damned.

    I'm not just talking about single payer here, though as Howard Dean himself suggested, if they really wanted a strong public plan option (no longer something I'm sure I believe) bargaining against themselves by putting single payer off the table was a bad start. I'm taling about the reduction of the appeal to the public to "if you like what you have you can keep it." Not laying out what the full crisis is, and not going after the moral arguments involved, doomed it all to back room deal-cutting too weak to change much.

    Do you really want to tell me that if I had gotten actively involved with HCAN in March it would have stopped Chuck Schumer from selling out the most powerful features of a public plan, potentially, in April or May or whenever he did it? I just don't believe it. Schumer didn't give a rat's ass about what I think, or probably much of anyone in Oregon come to it. If I'd been in there pitching he still would have been accepting the insurance companies media amplified defintion of "level playing field," and if that's how the leaders of the public plan option were going to play it, not even arguing for a proper definition of level playing field, they weren't leading any movement I was or could be part of.

    Further, the public plan people were divided between those who said it was an incremental route to single payer, and those who forcefully denied that. So, would I have been putting my energy into furthering what I believe deeply is needed, or into blocking it?

    In April Earl B. said he wouldn't spend time or energy on something bound to fail. Today Anthony Weiner has done that work. All Earl has to do is cast a vote. Will he? Willie Smith suggests not. More on that in another post.

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    Oh, Mud Falcon, about 2003, one big piece of that was that the state AFL-CIO and pretty much all of its constituent unions came out against the measure, due to the funding mechanism.

    Today the Oregon AFL-CIO, at least 4 Central labor councils, and well over 20 Oregon unions have endorsed H.R. 676, as did the national AFL-CIO convention, unanimously, a couple of weeks ago (also unanimously voting to work for a public plan option in the short term). The crisis of the health system has deepened rapidly in the last six years, and it's not done yet. Unions and employers both are moving in unprecedented ways.

  • Emmit Goldman (unverified)
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    Re: "In a democracy, policy follows public will..."

    That's a good example of why we don't have a democracy. Polls have consistently shown that (as long as buzz words like "socialized medicine" aren't used), large majorities of Americans (and huge majorities of Democrats) have supported some form of Medicare For All for decades.

    The Portland City Council is supporting the will of the people, and that's the equivalent in DP circles of being "far left" and worthy of marginalization.

  • bradley (unverified)
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    Talk about meaningless political gesturing! Elsewhere on BlueOregon Chris and others were criticizing Wyden for voting FOR the Rockefeller public option amendment because allegedly he knew it wouldn't pass. I pretty strongly disagree with that reasoning, but if Chris is right, what do you call city council members who cast a vote for something that they know won't come close to winning in the House, and probably won't even get a vote in the Senate?

    Meanwhile, Earl Blumenauer has done a bang-up job fighting for strong reform in the House and somehow he's just another corrupt politician to you, Chris. Marginalize yourself like this all the time, Chris? I'd say your future is secure at JwJ.

  • Thomas Edgar Kennedy (unverified)
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    Enjoy it while it lasts. The city council up the road a few miles from me has taken the religious restrictions off prayers before council meetings . Mark my words, Stockton and Modesto will soon follow. Can Oregon be far behind? We WILL bring you into the fold, kicking and screaming or not.

    Some folks found the idea of a Christian hedge fund a source of amusement, when I mentioned it here. We're still going great; how 'bout you? This proposal is more liberal shooting yourself in the head. You really don't know which side you bread is buttered on! Besides the good old boy network, which finally is GOOD BOYS, our family's money comes from the fact that population will always increase. I've seen that questioned in this blog. Is progressive policy anything that screws yourself? Progressivism is mental masturbation.

    I, for one, would like to see Federal guidelines that explicitly restrict states and municipalities from concocting whatever legislation they dream up. How many real estate decisions, the stuff that grows your city and economy, were deferred for this?

    It's a privilege that you vote. Most people have nothing positive to do with growth. Only those that do should vote. Consider yourself lucky, and stop making the movers and shakers wait while you strike a pose for...well, only God knows who you do it for. Satan, maybe?

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    "Emmit Goldman"--a nod of appreciation for your beautiful nom.

  • Emmit Goldman (unverified)
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    bradley asked, "Marginalize yourself like this all the time, Chris?"

    This is a new low, even for Blumenauer Democrats. You're not marginalizing those to your left, are you? Rather, they are marginalizing themselves.

    Without guys like Lowe, the DP is just the RP without the balls.

    <h2>Jeff: I'll tell my mom that you like my nom.</h2>

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