As of today, June 8, 2020, there have been 7 million cases of COVID19 worldwide and 402,555 deaths. The US has the worst COVID19 track record with 2 million cases and 110,514 deaths. Although the US has 4.25% of the world’s population, we have had 28% of the cases and 28% of the deaths.
Why does the US have such a dismal track record in fighting the novel coronavirus? I thought we had the “best healthcare system in the world.” We have the most expensive healthcare system in the world, but when you look at our public health data and our response to COVID19, we definitely do not have the best system in the world.
The United States is the only developed country in the world that does not have a national health plan that guarantees care for all residents. The Affordable Care Act (ACA) was a nice try, but its efficacy and affordability have been whittled away by Republicans in Congress.
Why is the US response to COVID19 so disorganized and inadequate? Before the pandemic, we had an over-priced, inequitable system based upon profit and a just-in-time supply chain of personnel, equipment and beds. The novel coronavirus turned the spotlight on inadequacies and inequities of our health care system. In the United States, the health care you get depends on your income and your ZIP Code– not your needs. If you’re a resident of the United States you should have access to the same healthcare across the country. A person living in Chinle should have the same access to care as a person living in Paradise Valley. Now the person in Chinle not only does not have adequate medical care, they may not have running water or passable roads.
If you often scratch your head at the bad bills that the Republicans pass in Congress and in the state legislatures and wonder what their end game is, you should read Democracy in Chains by Nancy McClean.
What you may think are random bad ideas that have somehow gotten into law are actually part of a grand scheme that has been playing out since Brown versus the Board of Education attempted to desegregate public schools in the United States.
An academic, McClean has studied the articles, books and letters of James Buchanan, the economist not the former president. Buchanan was the primary theorist of public choice theory. In the 1950s, public choice theory was used as a rationale to close all of the public schools in the state of Virginia (rather than comply with desegregation) and is being used today to support state-funded vouchers for private and religious schools. In Virginia in the 1950s, the state gave money to white parents for private school vouchers and allowed hundreds of black children to go uneducated for years. Needless to say, this was a travesty of justice.
In the Health and Human Services Committee, we have heard a few different insurance plans that would be cheaper and less comprehensive alternatives to the Affordable Care Act (ACA).
With SB1105, healthcare moves into the gig economy. SB1105 covers direct primary care agreements, a non-insurance alternative to the ACA. In Arizona, people are already allowed to make one-on-one contracts with a healthcare provider for certain services for a designated mount of money per month.
This bill clarifies existing law and says that these contracts are not insurance and, therefore, not regulated by the Arizona Department of insurance. It also says that you can have contracts with doctors, physicians assistants, nurse practitioners, nurses, dentists, and physical therapists.
If you take this to it’s illogical extreme, you could have multiple contracts with different providers for different menus of services. Unless you are really good at contract law, you could end up having several contracts, paying monthly bills to each of these providers and still not getting the care that you need. Since these plans are not insurance, you would not be able to take your complaints to a bureaucrat at an insurance company or at the Department of Insurance.
Direct current primary care agreements are supposed to fill a niche in the healthcare market. The ACA is too expensive, particularly for sole proprietors. These are business people who are their business. Professional people, consultants, artists and musicians could all be sole proprietors.
In the Health and Human Services Committee on Thursday, Feb 14, we are hearing a long list of bills including two about health insurance.
HB2375 would extend short-duration insurance to three years. This insurance is currently capped at one year because it is seen as a stop-gap measure for people who are between jobs or disconnected from insurance for some reason.
HB2376 relates to association health care plans for small businesses and sole proprietors. This bill allows them to band together and buy insurance as a group. A concern with this idea is regarding the quality of insurance that will be purchased and how that will impact workers who will be included under these plan.
Will association health plans cover essential health benefits, like the Affordable Care Act does? Will they cover people with pre-existing conditions? Will they have lifetime insurance caps? Will coverage be determined by the employer’s “deeply held religious beliefs”?
Progressive candidates across the country are challenging the status quo. I was honored to be interviewed for the “It’s Our Money with Ellen Brown” progressive talk radio show this week.
You can hear the hour-long podcast here. During the first segment, public banking guru Ellen Brown interviews Tim Canova, a law professor and Federal Reserve Bank expert, who is running against embattled Congresswoman and DNC Chair Debbie Wasserman-Schultz in Southern Florida.
The cornerstone of my economic reform ideas is establishment of public banking at the state, county, and/or municipal levels.
In a nutshell, public banking advocates believe that austerity is a lie and that budget-cutting and layoffs by governments is unnecessary and harmful to citizens. There is plenty of money. The problem is that our taxpayer funds are held in too-big-to-fail banks on Wall Street and invested for the benefit of the banks’ shareholders– instead of being held here in Arizona and invested for the benefit of the citizens of Arizona. Public banks invest on Main Street for the public good — rather than allowing OUR MONEY to be gambled (and potentially lost… again) on Wall Street.
There are many ways a public bank could be constituted. For example, in my speech to the LD9 precinct committee members, I suggested taking 10% of the state’s surplus rainy day funds and using that to establish an infrastructure bank. This state bank could self-fund much needed improvements and new roads to make the state more competitive and easier to traverse. It also could lend money to counties and cities to build their projects. In turn, the state would make a modest interest rate on the loans.
Creation of a state public infrastructure bank would address several economic problems in one fell swoop…