NIGHTLIFE LEGEND JIM FOURATT TALKS WHAT REALLY HAPPENED AT STONEWALL AND BIRTHING DANCETERIA

Hello, Jim. Let’s start with the famed Stonewall rebellion of 1969, which came to define the modern gay movement. You have said that the presence of people of color at the rebellion is actually overstated.

Yes, I have said that, and there is a reason for me saying it. The way the Mafia, quote unquote, meaning organized crime, operated gay bars in the ’60s and ’70s was they had gay bars for people of color, mostly black gay people, but they were on 42nd Street and up in Harlem. In the Village–except for Keller’s, which was specifically aimed at black gay people and rough trade—most of all the other gay bars in the ’60s had very little mix of races. Of course, if you were a great beauty, no matter what color you were, you got in, but people of color weren’t catered to. It’s called racism. There was systematic racism. The problem I have is people trying to claim to be a part of something which they weren’t. The whole question of both drag queens and people of color at Stonewall…

The Stonewall Inn was pretty well known as a place where closeted gay men, usually married men, went to make arrangements with younger gay men, and the younger men, for the most part, were certainly not drag queens. There was drug dealing and prostitution, so all these romantic ideas of what happened did not happen. It was not a bar I liked particularly. It did not have a good dance floor. The jukebox was like every jukebox in every Mafia bar in the city. It was not a specialty jukebox. I know this goes against myth, but putting a straight ’60s template on what happened that night robs us of who we are and what actually did happen, which changed how lesbians and gays saw themselves. By no definition can what happened that night be called a riot. I’ve been in riots. They’re very scary events—people out of control, looting and robbing, the breaking of windows and turning over of cars. That did not happen the first night of Stonewall. The Stonewall rebellion actually started out quite small. I happened to be coming home from my job at Columbia Records. I saw a sole police car outside of the Stonewall Inn. I was out in the New Left movement and the anti-war movement and there was an incredible amount of homophobia—in the old and new left. Like a good ’60s radical, I went to see why that car was there. There might have been 20 people around—this was 10:30 at night. The door opens and out comes one police officer and a “passing woman”—a biological female dressed in men’s clothing. I’m using the language of that day. “Bulldyke” was said if you wanted to put somebody down, while “passing” was a nice term. She had been handcuffed. By now, about 40 or 50 people had gathered. It was a Saturday night, warm, June, summer. Her bulky body started rocking the police car. To the cheers of the crowd gathering, one of the doors had not been locked. She got out, and as bulky as she was and acted, she had small female wrists and was able to get out of her handcuffs. Given the cheering, she stepped up to play her passing woman masculine butch dyke role. She started throwing herself against the police car and it started to tilt almost to turning over, and that was a flashpoint. Something happened in that crowd that I cannot describe verbally. That’s why I call it a rebellion–they finally rebelled against their internal and external homophobia and repression and started to cheer. A police officer came out, to look at the crowd and went back inside. From what I understand, he called for reinforcement. Within 10 minutes, a number of police cars arrived. Contrary to what David Carter’s Stonewall book describes, there were very few arrests. The only arrest I actually saw was a folk singer, Dave van Ronk. He was drunk and saying “What’s going on here?” The cops said, “Get away,” but he was persistent.

Thanks for the insight. Let’s move on to your achievements in nightlife. You were instrumental in the legendary club Danceteria, which started in 1979, along with your then-business partner Rudolf Pieper. That club is where new music was broken, along with art and videos. It was a veritable culture emporium. Did you realize how magical it was?

You’ve known me a long time and our paths have crossed many times. My political work I’ve always seen as cultural work. I’ve been an actor and appeared in plays and at Caffe Cino. It was around that period of time that was very fertile in terms of alternative culture. I took over the dead disco Hurrah and made it very successful and that became the template I was working on as to how to maximize culture–high art, low art, and politics. When I had the opportunity to take over the space on 37th Street (the first Danceteria), which had been an after-hours gay black bar, where there had been many killings, I wanted to make a club similar to what had happened at Hurrah. I hired people who had worked for me, including security people who looked like the people I wanted to come. People who were incredible but unemployable, I gave them jobs. Keith Haring was a busboy, and so was [artist] David Wojnarowicz. Keith did art on the walls the first three months. It all predates MTV, AIDS, and crack cocaine because what happened to nightlife was MTV changed how people went about seeing live music–they wanted to see the bands they just saw on TV, usually a British band which was incapable of recreating the sound live because they hadn’t played that much.

Photo by Rhonda CorteWhen you opened the second Danceteria (on 21st Street), video became more prevalent.

Yes, video art began to come out of Downtown. I hired Kit Fitzgerald and John Sanborn, who were part of that scene, and I asked them to curate. It became the people who are now at the museum level of collection. The thing about New York that was different from L.A. and San Francisco is we all live for the most part in small apartments, and we all go out for social interaction, hoping to get laid essentially, straight or gay. I wanted to create an environment that was safe—no fights—and that was the purpose of the door policy. I also wanted a mixed club, and anyone was welcome who could behave in that mode. We started branching out in different kinds of programs—Word-Beat (spoken word) with Patti Smith and John Giorno, and Serious Fun (with people like Philip Glass and Diamanda Galas). The first club was three floors, and the second club was three floors and a roof. Once you were in, you had the option to do what you wanted to do. We did a whole lot of benefits–this is where the political stuff came in. With my door people—Haoui Montaug and Aleph Ashline—gay boys and women got in without any hassle. With straight guys, the test was they’d have to wait a few minutes and see if they didn’t get hostile. We never had a rape or a fight, or any of those kinds of things that happened in those kinds of clubs. It took a long time for John Argento to destroy that template. Many people went to Danceteria 3 after I’d been locked out by Rudolf and Argento. Those people didn’t know about the backroom drama going on, they just wanted to have a good time. I never criticized anyone if they had a good time under those circumstances.

The music at Danceteria was thrillingly good.

The DJs were the heart and soul of the club. The dance music that Mark Kamins and Sean Cassette did at the first Danceteria! I discovered Sean at the Mudd Club; he’s the one who introduced me to Rudolf. And Mark was recommended to me by Nancy Jeffries, who did A&R at RCA. Mark played every club I ever had. Sean stopped playing after the first Danceteria. Chi Chi Valenti was a bartender. These people needed jobs, and the bottom line is I was able to give people jobs. I had an open call like a Broadway show, and I was very proud of the staff.

Tell me something really offbeat that happened at the club.

At Danceteria 1, the boys in the backroom found a loophole where people would buy a ticket for liquor, and we’d stay open very late.

The mob guys?

Yes. You couldn’t do a club at that time that didn’t have organized crime involved. They’d apply for these one-day permits over and over again. It was quasi legal, but it was an abuse of the law. The headliner would play two shows and the opening act would play the middle show and the last show would go on around four in the morning, so people could come from the other clubs and see that artist. If I was the owner of the Underground [a rival club], I’d be pissed that I couldn’t do that. At the second Danceteria, the late show would be at three in the morning.

What’s your take on then and now?

It’s a different time. We don’t have those kinds of clubs I’m aware of anymore. It wasn’t as hard to survive in New York in the late ’70s and ’80s as now, though you still had to pay the rents.

Splash image: Photo by Ebet Roberts/Redferns

Rising death rate for middle-aged US workers driven by “deaths of despair”

By Niles Niemuth
24 March 2017

The latest research on rising mortality rates by Princeton University economists Anne Case and Angus Deaton, presented this week at the Brookings Institution, shines new light on the depth of the social crisis which has devastated the American working class since the year 2000.

Building off their initial 2015 study which documented a sharp rise in the mortality rate for white, middle-aged working-class Americans, Case and Deaton conclude that the rising death rate is being driven by what they define as “deaths of despair,” those due to drug overdoses, complications from alcohol and suicide. The mortality rate for these causes grew by half a percent annually between 1999 and 2013.

During the course of the 20th century, the annual mortality rate for all middle-aged whites fell from 1,400 per 100,000 to 400 per 100,000. The US experienced a 100-year period of almost uninterrupted improvements in death rates and life expectancy. In this context Case and Deaton identify the recent rise in middle-aged mortality as “extraordinary and unanticipated.”

Midlife deaths of despair across countries

The epidemic of deaths from drugs, alcohol and suicide was initially seen in the American Southwest in the year 2000 but soon spread to the Appalachian region and Florida and is now nationwide, affecting rural and urban areas alike.

While every region of the US has seen an increase in the rate of “deaths of despair” among middle-aged whites over the last 15 years, the hardest-hit states are in the South (Alabama, Kentucky, Tennessee and Mississippi). Large urban and suburban areas have been the least affected, rural areas the most.

The mortality rate for working-class whites was also pushed up by a slowing and then stagnation of the decline in deaths from heart disease for white Americans between 2009 and 2015. On top of this the decline in mortality from lung cancer, caused by smoking and occupational hazards, slowed for white men 45-54 between 2000 and 2014, while mortality actually increased for white women 45-49 between 2000 and 2010.

Case and Deaton found that midlife mortality for middle-aged, working-class, white Americans surpassed the midlife mortality for all African Americans for the first time in 2008, and by 2015 mortality for working-class whites was 30 percent higher than for blacks. More significantly, their data shows that the gap in mortality between whites and blacks in the working class has all but disappeared. This is the outcome of a general decline in mortality for blacks and a rapid increase for whites over the last decade-and-a-half, though in recent years the mortality rate for working-class blacks has begun rising along with that of whites.

Case and Deaton’s report is supported by the most recent Centers for Disease Control (CDC) data concerning suicides and overdoses.

The CDC found that after declining between 1986 and 1999 the US suicide rate rose gradually between 2000 and 2015, with the rate growing most rapidly in smaller cities and rural areas after the 2007-2008 economic collapse. Whites and Native Americans had the highest suicide rates, with both groups seeing noticeable increases. All told there were 600,000 suicides in the US between 1999 and 2015—the equivalent of the loss of a major city, more than the total estimated deaths in the Syrian civil war.

Another recent CDC report found that overdoses from all drugs has more than doubled since 1999, with middle-aged Americans having the highest rate of overdoses. The overdose rate for whites has more than tripled since 1999 and is now more than double the rate for blacks and Hispanics combined. Nearly 13,000 people died from heroin overdoses alone in 2015, more than four times the number of deaths recorded in 2010.

Midlife mortality by all causes in the US

The data collected and analyzed by Case and Deaton reflects a deeply sick society, the outcome of a social counterrevolution which has accelerated since the 2008 crash.

Their research makes clear that the American working class, regardless of race, is being made to pay the price for the failure of capitalism, exposing the lie repeated by pseudo-left groups and the practitioners of identity politics about the “privileged white working class.”

In the period reviewed by Case and Deaton, the Democratic Party completed its repudiation of a political program which in any way addressed the needs or interests of the working class, in favor of middle-class identity politics. This found its culmination in the election of Barack Obama, the first black president, who funneled trillions of dollars into Wall Street and expanded the wars in the Middle East. In the last year of his presidency, which had seen such catastrophes as the lead poisoning of Flint and the BP oil spill, and seven years of wage stagnation, Obama asserted that things were “pretty darn great” in America.

The immiseration of the American working class has also been made possible by betrayals of the trade unions which over the last four decades have collaborated with and integrated themselves ever more closely with the corporations in order to shutter factories, eliminate jobs and enforce wage and benefit cuts.

The period in which the American working class has been subjected to unrelenting attacks has seen the growth of historically unprecedented levels of social inequality. The resources of society and the wealth created by the working class have been plundered and funneled into the hands of an ever wealthier financial aristocracy. This process will only accelerate under Trump.

While it is claimed there is “no money” to pay for decent wages or social services in the US, the country claims eight of the world’s 10 wealthiest billionaires and spends more than the next seven countries combined on its military. The health care overhaul and budget cuts being proposed by the Trump administration are guaranteed to accelerate the social counterrevolution.

In this regard it is striking to note the overlap between the areas of the country particularly devastated by “deaths of despair” in the period examined by Case and Deaton and those with a large vote for Donald Trump in the 2016 election. The anti-working class policies pursued in the Obama years paved the way for Trump.

The residents of these areas, either rural or devastated by years of factory closures, voted for Trump not out of racial animus—an assertion often made by the mainstream media and pseudo-left—but as a cry of desperation, incipient anger and complete disgust with the political establishment.

These people have been at the frontlines of the onslaught against the working class, facilitated by Democrats and Republicans alike. As far as Trump identified himself as an outsider, opposed to the political establishment which facilitated the plunder of the working class, he drew significant support. These same working people are quickly being disabused of any illusions they may have held in the billionaire businessman.

The fundamental question raised by Case and Deaton’s research is the struggle of the working class against the capitalist system and for socialism. Social inequality has never been higher and the rich have never been richer. The working class is the only force which can reverse this counterrevolution. Workers must turn to socialism and fight to build a mass independent movement which will fight for political power and take control of the wealth plundered from them, putting it to use for the common good.

 

WSWS

Trumpcare, Ryancare, Trashcare: While the GOP celebrates its found money, the poor will get sicker and die

With the AHCA, the Republicans have put a price tag on the lives of America’s working class: $300 billion

Trumpcare, Ryancare, Trashcare: While the GOP celebrates its found money, the poor will get sicker and die
(Credit: AP/Susan Walsh)

Trumpcare, Ryancare, Trashcare — whatever you want to call it, the American Health Care Act is nothing more than a cheap stab at Barack Obama, a petty attempt on the part of grudge-holding Republicans, including President Donald Trump, to try to diminish Obama’s legacy. They can try, but that will be impossible — Trump’s follow-up act has been so bad so far that he’s making George W. Bush look practically Lincoln-esque. But let’s set legacies and agendas aside for now and focus on health care.

“We have come up with a solution that’s really, really, I think, very good,” Donald Trump has said. “It’s an unbelievably complex subject. Nobody knew that health care could be so complicated.”

I’m not a president or a billionaire. I could never afford the kind of routine checkups that Trump has access to from award-winning physicians with platinum stethoscopes and solid gold scalpels — or even a state-of-the-art Viking fridge stocked with spare teenage hearts and kidneys, all plump and ready to be inserted when Trump’s conk out. He’ll probably live to be 360 years old as a result. Most of us don’t have that experience, and the president, just like the congresspeople and senators who are aimlessly playing with the lives of their constituents by threatening to kill Obamacare, is taken care of. They have amazing health care coverage that we, the taxpayers, fund. Strangely, that never makes it into the conversation.

Is Obamacare perfect? Absolutely not. But it has already saved the lives of millions of people. People who would have never voted for Obama are calling him a hero, even as some die-hard right-wingers praise the Affordable Care Act for saving their loved ones, not realizing that it’s the same as Obamacare.

Trump loves his catchphrase, “Make America great again.” Obviously he doesn’t understand that “great” is a process that we must constantly work toward. Greatness is edited, nurtured and achieved after recognizing what works and what doesn’t. Scrapping Obamacare and replacing it with a trash plan that will leave millions of people who were born without the luxury of being Trump-level rich uninsured is not making anything great. It’s evil. According to the CBO analysis, the AHCA would “reduce federal deficits by $337 billion over the coming decade and increase the number of people who are uninsured by 24 million in 2026 relative to current law.” And every Republican is running to the cable news networks, bragging about saving $300 billion. What does that mean to the person the Wall Street Journal described, a 62-year-old person who makes $18,000 a year who will now face premiums of up to $20,000?

Imagine a sickly elderly woman running home from work to her family to share with pride that the government just saved $300 billion. There is nothing more important than that to the government, even if it means that you’re broke, your granddaughter is pregnant because she couldn’t get birth control, and your grandson overdosed and died because he couldn’t be treated for his prescription drug addiction, which he developed to self-medicate his depression over the factory jobs that Trump promised never coming. We should all celebrate because the government saved $300 billion? That’s $300 billion that regular people will never touch.

People will not be treated for their illnesses. Many will suffer, and some will die. But at least the GOP beat Obama!

D. Watkins is an Editor at Large for Salon. He is also a professor at the University of Baltimore and founder of the BMORE Writers Project. Watkins is the author of the New York Times best-sellers “The Beast Side: Living  (and Dying) While Black in America” and “The Cook Up: A Crack Rock Memoir.”

US health care debate: A bipartisan drive to lower life expectancy

16 March 2017

The new overhaul in the US health care system that is being prepared is a highpoint in a war against the working class in the United States. The debate in Washington and the media obscures the basic motivation guiding both big business parties: to restrict access to affordable health care and sharply reduce the life expectancy of American workers.

The divisions between the Democrats and Republicans are over secondary and tactical questions. Far from “repealing and replacing” Obamacare, the Republican proposal builds on its basic framework while driving up the number of uninsured workers, making health care unaffordable for older, lower- and middle-income workers, and accelerating the destruction of Medicaid and Medicare.

The aim is to free up resources for a massive increase in military spending, while funneling even more money to the stock market and the financial aristocracy. It is a continuation of a decades-long social counterrevolution, pursued regardless which party controlled the White House and Congress.

According to the Congressional Budget Office report released Monday, 21 million Americans will lose coverage by 2020, and 24 million by 2026. How many of these people will die as a consequence?

Under the Republican House plan, a 64-year-old worker earning $26,500 will see his or her premium increase from $1,700 to $14,600 by 2026 due to the disproportionate cuts in tax credits for older consumers. A 21-year-old earning the same amount would see his or her premium drop from $1,700 to $1,450.

In so far as overall premiums drop, this is because older workers—whose health care costs are higher—will simply leave the market because they can no longer pay for insurance. The result will be a sharp increase in mortality and fall in life expectancy, which is already on the decline in the US due to the rise in suicides, drug abuse and other social ills.

These changes are only a prelude to raising the eligibility age for Medicare to 67 and beyond and transforming it into a voucher program. At the same time, the Republican plan would slash funding for Medicaid—the federal entitlement program for the poor—by 25 percent by 2026, reducing the number of Medicaid beneficiaries by 17 percent, or 14 million people. Trump’s appointee to head the Center for Medicare and Medicaid Services (CMS), Seema Verma, has already tested out work requirements for Medicaid and health savings accounts in Indiana.

When Medicare was passed in 1965, a byproduct of a powerful wave of social struggles, the average life expectancy of a male in the US was 66.8 years, and for working class men it was even lower. At the time, the government program was designed to provide a couple of years of health care. But to the growing horror of the American ruling class, increased access to health care and major advances in science and medicine led to a significant increase in life expectancy, with the government paying out benefits for a decade or two longer than had been anticipated.

The mid-1960s was also the period when many workers secured pensions and won retiree health care benefits, which enabled them to live many years after they stopped producing profits for corporate America.

This has provoked ever-greater anger and bitterness in the ruling class. By the 1990s, there was a chorus of complaints about the aging population, and how out-of-control health care costs were undermining the global competitiveness of US businesses. In 2005, Delphi CEO Steve Miller complained that “people are living longer these days.” He declared that employer-paid benefits made sense only in an era when “you worked for one employer till age 65 and then died at age 70…”

Obamacare was the first significant effort to reverse this trend by undermining the system of employer-paid health benefits and shifting the costs of medical care from the corporations and the government onto the backs of workers. The plan, drawn up by insurance and medical business interests, rationed care and dumped low-income workers into barebones plans.

In opposition to all of those who claimed Obamacare was a progressive social reform, the WSWS explained that it was the opening shot of a health care counterrevolution aimed at stripping the working class of access to affordable and decent coverage, and substantially reducing life expectancy. This assault is now being vastly expanded.

The war against the working class in the US is inseparable from the criminal wars being fought abroad. In a major article in Foreign Affairs magazine in 2016, entitled, “Preserving Primacy: A Defense Strategy for the New Administration,” House Armed Services Committee Chairman Mac Thornberry and national security strategist Andrew F. Krepinevich Jr. concluded that expanding US military operations against China, Russia, Iran and preserving US military domination would require taking on “the expanding cost of entitlement programs.” The main confrontation the next administration would have would be on “the domestic front,” they wrote.

The assault on health care, like the attack on jobs and living standards, the attack on immigrants and democratic rights, and the drive to war, will provoke enormous social opposition. The fight against Trump requires a fight against the bankrupt capitalist system and both big business parties, which laid the groundwork for the most reactionary government in US history.

This requires the building of a revolutionary leadership to unite every form of social opposition in mass political movement of the working class for a workers’ government and socialism. This is the only way that profit can be taken out of health care and high quality medical coverage established as a social right for all.

Jerry White

 

http://www.wsws.org/en/articles/2017/03/16/pers-m16.html

Is Health Care Doomed?

PERSONAL HEALTH
The Republicans’ new plan to replace the Affordable Care Act is worse than many expected. John Marty has a better idea.

Doctor Discussing Records With Senior Female Patient
Photo Credit: Monkey Business Images/Shutterstock

As Donald Trump and the Republicans aim a bulldozer at the Affordable Care Act, supporters of the ACA are making a strong case for its successes. One of them is Jonathan Cohn, who has covered health care for years. In a long and persuasive essay, he calls on witness after witness to show that “real people with serious medical issues are finally getting the help they need.”

Cohn interviews a number of people who fell victim to “the old system at its callous, capricious worst” (before President Barack Obama took office) when “roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills.” The ACA was an effort to address their problems, and after seven years, he reports, the list of what’s gone right is long:

– In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.

– It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers rather than through employers.

– Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.

– The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory.

Overall, Cohn concludes, the number of people without health insurance “is the lowest that government or private surveys have ever recorded.”

Yes, there are problems. Cohn acknowledges where the Affordable Care Act has failed and why. Mostly because the president and his allies were so determined to succeed where those before them had failed, “they made a series of concessions that necessarily limited the law’s ambition:

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drug makers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.”

Cohn gives critics their due, especially those who focused on the law’s actual consequences: the higher premiums and out-of-pocket costs that some people face.

“The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A ‘rate-shock’ wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that ‘if you like your plan, you can keep it,’ while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.”

But remember: “When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-IA) described the program as a ‘starter home‘ with a solid foundation and room for expansion.”

Yet the Republicans, many of whom reject the whole concept of health care as a right, are determined to rip it all up. Giving scant attention to what’s gone right, they claim the Affordable Care Act is “a disaster.” Their now-leader, President Trump, turned directly to the camera Tuesday night in his address to Congress and announced that he still wants the ACA “repealed and replaced.” If Trump and his fellow Republicans could, they would end it altogether, but they are nervous about the political consequences of depriving millions of Americans of coverage and raising deductibles. As longtime health policy experts Steffie Woolhandler and David Himmelstein — both physicians — point out in the current Annals of Internal Medicine, proposals by House Speaker Paul Ryan and the new HHS Secretary, Tom Price, both Republicans, would slash Medicaid spending for the poor, shift the ACA’s subsidies from the near-poor to wealthier Americans and replace Medicare with a voucher program. This would likely lead to their rout at the polls in 2018 and 2020. The vast majority of Americans want to keep their health care coverage.

We are at a stalemate. Opponents of the ACA have no viable replacement and supporters have no power to stave off the Republican bulldozer.

Is the situation hopeless? In Washington, probably — at least for now. But there are alternatives. As I noted above, two longtime advocates for universal health care, Drs. Woolhandler and Himmelstein, have renewed their campaign for single-payer reform, which candidate Barack Obama applauded when he was campaigning and then rejected after his election as part of those compromises he made to win support from conservative Democrats and the medical and insurance industries. In their Annals article, the two reformist physicians offer evidence that single-payer reform could provide “comprehensive coverage within the current budgetary envelope” because of huge savings on health care bureaucracy. It’s worth reading.

So is a plan put forth by Minnesota State Sen. John Marty. Often described as “the conscience of the Minnesota Senate,” Marty has been an advocate for universal health care since he was elected 30 years ago. He has served as chairman of the Senate Health Committee and now serves as the ranking minority member of the Senate Energy Committee. Often ahead of his times, Marty introduced and eventually secured passage of the country’s first ban on smoking in hospitals and health care facilities. Long before public support had materialized, he worked to ban mercury in consumer products, create a legal structure for public benefit corporations and bring about a “living wage” for workers. In 2008, when he introduced legislation proposing marriage equality for LGBT couples and predicted it could pass in five years, colleagues dismissed him as a Don Quixote. Five years later Minnesota passed marriage equality legislation.

So this lifelong progressive has earned the right to chide his fellow progressives for “merely tinkering” with problems. He writes that “If 21st-century progressives had been leading the 19th-century abolition movement, we would still have slavery, but we would have limited slavery to a 40-hour work week, and we would be congratulating each other on the progress we had made.”

This timidity, Marty acknowledges, might be partially explained by decades of defeat at the hands of powerful financial interests and politicians beholden to those interests. But as a result, many politicians who espouse progressive change have retreated from a “politics of principle” to a “politics of pragmatism.”

Sen. Marty crisscrossed Minnesota to talk directly with citizens about what they need and want in health care. He has now proposed a universal health care system which he calls the Minnesota Health Plan. He’s distilled it into a small paperback book — Healing Health Care: The Case for a Commonsense Universal Health System. I asked him to write an essay for us summing up the plan’s basic principles and the case for it.

— Bill Moyers

A CALL TO ACTION
By John Marty

Our health care system is broken.

We have some of the best health care available in the world, but one of the worst systems for accessing that care. We squander outstanding health care resources — providers, clinics and hospitals, medical research and technology — on a broken system that makes it difficult and expensive for many people to get the care they need.

Our health outcomes, including life expectancy and infant mortality, are worse than most other industrialized countries.

President Obama provided hope during his 2008 campaign, saying health care “should be a right for every American.” Unfortunately, he never proposed universal health care, though the Affordable Care Act (ACA) was a big step forward. It reduced the number of people without health coverage by almost half. It made a (in some cases, literally) lifesaving difference for millions of Americans.

However, even if the ACA were beefed up, it would always leave some people without coverage. In addition, health insurance does not equate to health care — millions of Americans who have insurance still cannot afford the care they need due to exclusions in coverage, copays and deductibles. And because it added even more complexity to our already convoluted insurance system, the ACA is easy to attack.

Republican attacks during the 2016 campaign were wrong; the ACA is not the cause of the problems in the system. Nor is it the solution, despite the good it did for many people.

Now that President Trump has blurted out that “nobody knew that health care could be so complicated,” we will watch the ironic efforts of Republicans to replace the Affordable Care Act — an insurance-based plan, largely modeled on former Massachusetts Republican Gov. Mitt Romney’s “Romneycare,” which, in turn, was largely based on ideas from the conservative Heritage Foundation. We have Republicans attacking a Republican concept. It might be bizarre to watch, but lives are at stake.
We are headed in the Wrong Direction

Most of the health care “reforms” in recent decades aimed at saving money by making sure people don’t overuse health care, putting barriers in their way. These reforms included use of restrictive “networks” of providers, requiring “prior authorization” by the insurance company before treatments could be provided, copays and higher and higher deductibles. The Republican proposals this year head further down that path of adding barriers to care, especially when they cut Medicare and Medicaid.

After four decades of putting barriers between people and medical care, we do make fewer visits to the doctor than people in most other countries.

But it is hard to call this a success. About a third of Americans report that they fail to get the care they need, because they cannot afford to pay for it. Yet even after all those “reforms,” we are spending nearly twice as much as people in most other countries spend. That raises both an ethical and an economic question:

Why would any society make it difficult for its people to access health care? And, if our attempts to make health care less expensive through barriers to care isn’t working, shouldn’t we try a new approach?

Fixing these problems requires fundamental changes in our health care system. We need a new model.
Health care should be covered like police and fire

We could start by looking at other public services. Nobody goes without police and fire protection — nobody has to apply for new “police and fire coverage” each year, nobody has to worry that they may no longer be qualified, nobody has to worry about a $3,000 deductible before the fire department will come. Nobody has to worry that the local sheriff won’t accept their “police insurance” plan. And nobody gets a letter informing them that their police or fire coverage is being terminated, for any reason.

A civilized, humane society that takes care of its people with universal police and fire coverage needs to do the same with health and dental care.
Designing a new system

Before leaving on a trip it is important to know where you are going: Focus on your goals and where you are headed. The same is true for designing a health care system.

Here are some basic principles that need to be followed if a health care system is to serve the public well. The health care system must:

  • ensure all people are covered;
  • cover all types of care, including dental, vision and hearing, mental health, chemical dependency treatment, prescription drugs, medical equipment, long-term care and home care;
  • allow patients to choose their providers;
  • reduce costs by cutting administrative bureaucracy, not by restricting or denying care;
  • set premiums based on ability to pay;
  • focus on preventive care and early intervention to improve health;
  • ensure there are enough health care providers to guarantee timely access to care; and
  • provide adequate and timely payments to providers.

These principles offer an entirely different approach to health care reform. Instead of trying to design a health care system that restricts care, we design a system that keeps people healthy and helps them get care when needed.

Perhaps counterintuitively, that logical health system actually saves money. To illustrate why a system focused on health is less expensive than one based on insurance, consider an analogy between schools and hospitals:

If schools were funded the way we fund hospitals, each teacher would need to spend a half hour or more each day calculating and reporting how much time was spent with each student, along with the amount of supplies each student consumed. Those calculations would be forwarded to the school’s billing office, where a portion of janitorial costs, facility costs, and administrative overhead would be allocated to each student.

The billing office would bill each student’s “education insurance plan,” at a highly inflated price (Hospitals call it a “chargemaster” rate.). Each education insurance plan would negotiate with the school, ultimately reducing their cost by about two thirds. Those families who don’t have any “education insurance” would be liable for the full, inflated “chargemaster” price. Many families would struggle to pay. As a result, the school would also need a collections office.

Would this improve education? No. It would make it worse, shifting teacher and administrator time from education to billing.

Would it save money? No. It would cost much more, adding these significant administrative duties.

We would never want to fund schools the way we fund hospitals.
Our proposal — A Minnesota Health Plan

I have introduced legislation to create a Minnesota Health Plan (MHP), a proposal designed to meet all of the principles mentioned above. The MHP would be governed by those principles, setting it apart from other health systems in its focus on public health and well-being instead of profit or politics. While this plan is designed for Minnesota, a similar model could be used in other states.

The MHP would be a single, statewide plan that would cover all Minnesotans for all their medical needs. Equally important, it would reduce the need for costly medical care through public health, education, prevention and early intervention. It would be governed by a democratically selected board that would be legally bound to those governing principles.

Under the plan, patients would be able to see the medical providers of their choice without network restrictions, and their coverage by the health plan would not end when they lose their job or switch to a new employer.

Dental care, prescription drugs, optometry, mental health services, chemical dependency treatment, medical equipment and supplies would all be covered, as well as home care services and nursing home care. Consumers would use the same doctors and medical professionals, the same hospitals and clinics, but all the payments, covering all of the costs, would be made by the MHP, and everyone would be covered.

There would be no filling out of complex application forms, no worrying whether a provider is “in network” or not, no worrying about whether the treatment was covered or how you are going to pay for the drugs.

The MHP would be prohibited from restricting or denying care to save money, but would lower health care spending through efficiency, the elimination of billing and insurance paperwork, and through public health prevention.

The MHP would restore medical decision-making to the doctor and patient, removing health insurance companies from making treatment decisions. The plan would end not only access problems caused by cost, but also access problems caused by an inadequate number of health professionals and facilities around the state, because the health plan would be required to ensure sufficient providers to meet medical needs around the state.

The plan would be funded by all people, with premiums based on the ability to pay, and a payroll tax on employers, along with existing state and federal funds that have been committed to health care. Those payments would replace all premiums currently paid by employees and employers, as well as all copayments, deductibles and all costs of government health care programs. The premiums paid by all but the wealthiest would be less than the premiums, copays and deductibles they currently pay.

Although the MHP is not cheap, it is significantly less expensive than our current system, and it would provide a full range of health care services to everyone, improving the health of Minnesotans.
The politics of health care reform in 2017

Republican gains in recent years show that progressives need to spell out solutions that would actually fix our problems. We cannot win policy battles by negative attacks against the other side. We will win when the public realizes that our solutions will improve their lives. Thus, when fighting against Republican efforts to eviscerate Medicare, Medicaid and the ACA, saying “no” isn’t enough. We need to articulate a solution.

Republicans typically describe health reform proposals they don’t like as “government health care.” But that is not an accurate description of this plan. The MHP is a patient-directed health plan. It lets people choose the providers they trust, and medical decisions are made by patients and their doctors, not government or insurance companies.

The MHP is publicly governed, which means that it is more accountable to patients than insurance companies. It encourages competition and innovation among doctors and hospitals based on an efficient financing system in the background.

Finally, let’s not forget the ethical dimension. What does it say about a society that allows some of its people to suffer from untreated health crises? Should profit and individual wealth continue to determine who gets care, or should health care be available to everyone?

The proposed Minnesota Health Plan and the principles that underlie it are nothing more than what any caring society would desire in order to ensure good health for all of its people. It is time to replace health insurance for some with health care for all.

 

Bill Moyers is the managing editor of Moyers & Company and BillMoyers.com.

Sen. John Marty has been a Minnesota state senator since 1987. He is former chair of Minnesota’s Senate Health Committee and is currently the ranking member of the Energy Committee.

http://www.alternet.org/personal-health/health-care-doomed?akid=15289.265072.-2n41U&rd=1&src=newsletter1073670&t=30

The Republican House of Horrors Offers a Terrifying Health Care Vision

Republicans have exploited the repeal-and-replace meme with paybacks to some of their wealthiest friends.

NATIONAL HARBOR, MD – MARCH 6, 2014: Congressman Paul Ryan (R-WI) speaks at the Conservative Political Action Conference (CPAC).
Photo Credit: Christopher Halloran / Shutterstock.com

Halloween arrived early this year featuring the Republican house of horrors seeking to fulfill their long lust to repeal the Affordable Care Act.

While there are legitimate criticisms of the ACA—notably the 28 million still uninsured and its failure to limit escalating out-of-pocket costs—the coverage gains made through the ACA, through Medicaid expansion and the crackdown on insurance abuses, are largely eviscerated by the GOP plan.

Instead we have a plan that again fetishizes a market-based health care fundamentalism that saw the U.S. plummet in a wide array of health care barometers, including infant mortality and life expectancy rates and people skipping needed care due to cost compared to the rest of the developed world, especially before the ACA.

With the hodgepodge plan hurriedly released Monday night, the House majority attempts to straddle growing public support for a government role in establishing health security for the American people and approval of the Tea Party crowd that views any fingerprints of public protection as akin to Satanism.

The bill fails on both counts, while also betraying promises made by candidate Donald Trump that “we’re going to have health care for everybody” that is “far less expensive and far better.”

The principal effect of the new bill will be the loss of existing health coverage for tens of millions of people, without any restraints on health care industry pricing practices that add up to massive health insecurity for the American people.

Pretending to retain popular components of the ACA, the bill offers refundable tax credits to replace the ACA subsidies to buy private insurance, temporary continuation of the ACA Medicaid expansion, and requiring insurers to sell insurance to people with pre-existing conditions. But it’s like fools gold, each component sabotaged by the not-so-fine print.

Some lowlights:

  • Medicaid expansion, the mechanism of most of the ACA expanded coverage, is temporarily retained, but open ended federal funding would be ultimately replaced by a cap on federal payments that would encourage financially strapped states to slash eligibility of those covered and sharply cut covered services.
  • Refundable tax credits would provide less financial support than the current ACA subsidies, and by most initial analyses provide far less help for low and moderate-income people.
  • A 30 percent premium penalty surcharge on people who allow their “continuous coverage” requirement to lapse completely undermines the false promise that the bill retains the ban on insurers denying coverage for people with pre-existing health conditions. Even through the ACA health exchanges, insurers routinely change plan designs yearly in ways to increase out of pocket costs and limit patient choice through narrower networks. The surcharge will increase insurer incentives to engage in these practices.
  • Cuts in minimum covered health benefits, services now required by the ACA. Those would expire in 2020.
  • Elimination of funding for Planned Parenthood is a significant attack on women’s overall health care. Planned Parenthood clinics provide a wide array of needed health services.
  • Reduced funding for public health. Elimination of the ACA’s Prevention and Public Health Fund will disproportionately harm low-income people and patients with chronic illnesses like diabetes and heart disease that will worsen the health of communities and facilitate the spread of infectious diseases. As reported today by Vox, affected programs include the federal vaccines program, and programs to reduce heart disease and hospital acquired infections.

The architects of the new bill have exploited the repeal and replace meme with paybacks to some of their wealthiest friends and donors.

The draft bill includes a roll back of most corporate and high income taxes used to pay for the ACA, and, “as Rep. Keith Ellison has noted, a tax cut for wealthy people’s investment income and tax deduction for health care CEOs making more than $500,000 a year.”

If you follow the rhetoric of the repeal-and-replace crowd, they pay a lot of lip service to restoring “freedom” and “liberty.” But their approach to health care restricts freedom in the most personal aspect of our lives: health care.

Freedom to choose junk insurance has nothing to do with getting the care we need. In fact, it is the false choice of a faux freedom. This bill lets insurance shape what procedures doctors do, what drugs we take, and even which doctors we can see.

Nurses know there is only one real fix for our broken, dysfunctional, profit-focused health care system—an improved Medicare-for-all system, much as the rest of the developed world assures health care for its people.

NNU’s California affiliate, the California Nurses Association, is sponsoring a bill in California that could become the national model as an alternative to both the ACA and the fraudulently named GOP American Health Care Act.

http://www.alternet.org/economy/aca-replacement-terrifying?akid=15277.265072.oPECsp&rd=1&src=newsletter1073557&t=8

12 Glaring Omissions, Contradictions and Lies Bernie Sanders Spotted in Trump’s Address

NEWS & POLITICS
The Vermont senator slammed the president’s speech in a video response.

Former Kentucky governor Steve Beshear issued a formal Democratic response to Trump’s address to Congress Tuesday. But the most blistering reply may belong to Vermont Senator Bernie Sanders, who took to Facebook shortly thereafter. “I wanted to say a few words about what [Trump] didn’t say, because when you analyze the speech sometimes what is more important is what somebody does not say as opposed to what they actually say,” he began.

Below are 12 glaring omissions, contradictions and lies Sanders spotted in Trump’s address.

1. Social Security and Medicare

“At a time when over half of all older Americans have no retirement savings, I did not hear President Trump say one word, not one word about Social Security or Medicare,” Sanders pointed out.

“During the campaign, as we all remember, President Trump promised over and over and over again that he would not cut Social Security, Medicare or Medicaid. But in his first address [to Congress], he didn’t even mention Social Security or Medicare once, not a single time.”

While Treasury Secretary Steven Mnuchin insisted the programs would not be touched in an interview this past weekend, President Trump’s budget director, Mick Mulvaney, has defended such cuts.

“I urge President Trump, keep your promises, tell the American people, tweet to the American people that you will not cut Social Security, Medicare and Medicaid,” Sanders said.

2. Income and Wealth Inequality

Trump’s speech to Congress briefly touched on poverty in America. However, Sanders “did not hear President Trump mention the words ‘income and wealth inequality’ or the fact that we now have the widest gap between the very rich and everyone else since the 1920’s.”

3. Campaign Finance

“I did not hear President Trump mention the fact that as a result of the disastrous Citizens United Supreme Court decision, a five-to-four decision, we now have a corrupt campaign finance system that is allowing billionaires to buy elections and undermine American democracy,” Sanders said.

To the first-time politician who has repeatedly boasted about funding his own campaign, Sanders asked, “How could you give a speech to the nation and not talk about that enormously important issue?”

4. Voter Suppression

In his speech, President Trump used the phrase “guided by the well-being of American citizens.”

“[But] not only did President Trump not mention the issue of voter suppression, what Republican governors are doing all over this country to make it harder for people to participate in our democracy, but the truth of the matter is his administration is now working, working overtime, with Republican governors to make it harder for young people, low-income people, senior citizens and people of color to vote,” Sanders explained. “That is an outrage.”

5. Climate Change

Perhaps most astoundingly, at a time when the scientific community is virtually unanimous in telling us that climate change is real, that it is caused by human activity, that it is already causing devastating problems in our country and all over the world, I did not hear President Trump say one word, not one word, about the need to combat climate change, the greatest environmental threat facing our planet,” Sanders hammered.

Not only did Trump not mention climate change, “he pledged to increase our dependency on fossil fuels,” Sanders added.

6. Criminal Justice

“At a time when we have more people in jail than any other country on earth, disproportionately African American, Latino, Native American, I did not hear President Trump say one word about how he was going to fix a broken criminal justice system,” Sanders pointed out.

“Yes, we must support the hard work of men and women in the police departments, in the sheriff’s departments all over this country, but we must also end the disgrace of having more people in jail than any other country on earth,” he added.

7. Higher Education

“At a time when we need the best-educated workforce in the world to compete in a highly competitive global economy, I did not hear President Trump say one word, not one word, about the need to lower the cost of college and to do what countries all over the world are doing, and that is to make public colleges and universities tuition-free,” Sanders said.

8. ‘Drain the Swamp’

“During his campaign, President Trump told us that he was going to take on Wall Street and ‘drain the swamp,'” Sanders reminded viewers. “Well, the swamp, big-time, is now in his administration, which has more millionaires and billionaires than any presidential administration in history.”

“Amazingly enough, for somebody who was going to ‘drain the swamp,’ who’s going to take on Wall Street, his chief economic adviser, Gary Cohn, is the former president of Goldman Sachs, one of the major financial institutions that pay billions of dollars in fines for their illegal activity,” Sanders added.

9. Glass-Steagall Act

“I did not hear President Trump say one word about another campaign promise that he made to the American people, and that was to reinstate the Glass-Steagall Act.”

In his speech, President Trump proposed a $1 trillion investment in American infrastructure, “but the specifics of the financing plan that he has provided us with so far are absolutely wrong,” Sanders concluded. “We cannot rebuild our infrastructure by providing billions of dollars in tax breaks to Wall Street and large corporations.”

10. Clean Water Rules

“Donald Trump said tonight that we need to ‘promote clean air and clean water.’… I had a difficult time not laughing out loud when he said that,” Sanders admitted, since, “On this very, very day, he signed an executive order rolling back President Obama’s clean water rules and has appointed the most anti-environmental EPA administrator in our nation’s history.”

11. Military Spending

“President Trump said [Tuesday night] that he wants to substantially increase funding for the Pentagon,” Sanders recalled. “What he didn’t say tonight is that he will come up with that $84 billion in increased funding for the Pentagon by slashing programs that benefit the working people of this country, that benefit the elderly, that benefit the children, the sick and the poor.”

12. Prescription Drug Costs

“As he did during his campaign, Donald Trump claimed that he would bring down the cost of prescription drugs,” Sanders told viewers. “A few weeks ago, he even said that the pharmaceutical industry was ‘getting away with murder,’ but if Donald Trump really wanted to take on the pharmaceutical industry, he would have told his Republican friends in the House and the Senate to pass legislation, which I [re]introduced today with 20 senators allowing Americans to import safe low-cost medicine from Canada.”

http://www.alternet.org/news-amp-politics/12-glaring-omissions-contradictions-and-lies-bernie-sanders-spotted-trumps-address?akid=15250.265072.TIYkRl&rd=1&src=newsletter1073104&t=2