Archive for the ‘Social Justice’ Category

By Sabrina Morello

“If equity and social solidarity in access to health care and financing health care were fundamental goals of a health care system, the single-payer system provides an ideal platform for achieving these goals” said Tsung-Mei Chen, MA Health Policy Research Analyst at the Woodrow Wilson School of Public Health at Princeton University. Last week, Chen and other experts, including those from Canada, Denmark and Taiwan, provided testimony outlining the benefits of single-payer health care systems in their respective countries to members of the U.S. Senate Health, Education, Labor and Pensions Committee’s Subcommittee on Primary Health and Aging.

Subcommittee chair U.S. Senator Bernie Sanders (I-Vt.) began the hearing by laying out an array of issues with our current fragmented health care system, with an emphasis on the fact that we are the only major industrialized nation that does not guarantee health care as a fundamental right. Senator Sanders cited 2012 data showing 15 percent of our population (more than 48 million Americans) are left uninsured and even more have high deductibles and co-pays or caps on coverage that end up driving citizens into bankruptcy.

This statistic stands out sharply from countries like Taiwan, which established a single-payer system in 1995, and currently has more than 99.6 percent of its population covered by national health care, according to Dr. Ching-Chuan Yeh, former Minister of Health for Taiwan, Professor at the School of Public Health, College of Medicine at Tzu-chi University. Dr. Yeh’s testimony was a poignant example of a far more equitable system than exists in the U.S.: “[a]ccess to health care is an inalienable right in [Taiwan’s] constitution. Residents living in remote mountainous areas and offshore islands, and the poor, the disabled, the aged get pretty much the same access and health care as anyone else.”

In addition to being inequitable, the care we do provide in America seems to lag behind single-payer nations in regards to health outcomes. Victor Rodwin, PhD, MPH, Professor of Health Policy and Management at the Robert F. Wagner School of Public Service at NYU, notes that among 19 Organization for Economic Cooperation and Development nations, France, a single-payer nation, has the lowest rate of avoidable mortality (an important indicator of quality of care) while the U.S. has the highest rate. Our nation could avoid about 101,000 deaths if we were able to decrease our avoidable mortality levels to those seen in France.

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By Samantha Aster

Although the U.S. Chamber of Commerce has said it will abandon its feverish efforts to repeal the Affordable Care Act (ACA), it appears to be fighting to block funding for the law rather than trying to kill the program outright. With an eye toward making the ACA unworkable, The Chamber is now focusing on repealing two key funding components: the medical device tax and the annual fee on health insurance companies.

Were the Chamber to succeed in removing funding, parts of the law would cease to function properly and would eventually fail altogether. Public Citizen does not endorse the ACA, but we do support the law being fully funded in order to move toward state-level single-payer systems, which the law’s waiver process enables. States that want to establish stronger programs can do so using this mechanism, and by establishing state level single-payer systems we hope to clear a path to eventually move toward Medicare-for-all at the federal level.

The Chamber in its lobbying efforts and messaging argues the ACA imposes substantial financial burdens on employers and individuals, and frequently labels the law a “job killer.” In making these claims, the Chamber consistently relies on exaggerated and overstated data which, when given a second look, undermine the integrity of its argument.

The medical device tax: A necessary revenue stream

The ACA is funded in part by a 2.3 percent excise tax on manufacturers and importers of medical devices. The medical device industry and the Chamber argued that the tax would increase costs, “suppress innovation” and “kill jobs,” but this could not be further from the truth.

Not only can the medical device industry afford the tax – with estimated total sales of over $100 billion – but the industry has been accused of relying on anti-competitive practices that result in almost no price competition in the market. The lack of transparency in pricing and the industry’s coziness with physicians stifles innovation, since manufacturers have little incentive to create or improve devices that increase quality of care. This tax, coupled with the ACA’s focus on cutting costs, may provide incentives for manufacturers to find ways to deliver more cost-effective care.

The U.S. Chamber pointed to a recent survey to support its opposition to the tax. The survey, conducted by the Advanced Medical Technology Association, the trade group representing medical device manufacturers, claims that the tax has forced medical device manufacturers to eliminate jobs, reduce innovation and move jobs overseas.

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The joy of parenting a newborn is irrefutable. But unfortunately the support that parents receive from Maryland employers is dismal, and, to make matters worse, occupational safety and health is at risk. In Maryland an estimated 300,000 workers do not receive parental leave under federal or state law. This requires new mothers to return to work immediately after having a baby, when they should instead be resting and caring for their newborn.

The Family Medical Leave Act requires an employer to have 50 employees before providing parental leave. This archaic threshold leaves a majority of Maryland businesses without any obligation to require parental leave to new parents.

The Maryland legislature so far has failed to offer direction to small sized employers under these circumstances, and the implications for the safety and health for working parents is overwhelming.

According to the Mayo Clinic, it takes four to six weeks for a cesarean section (C-section) incision to heal. More than 34 percent of all babies in Maryland are born through cesarean section. This means many new mothers are forced to work with surgical stiches or staples.

After a C-section, simply transitioning from sitting to standing is not only painful, but also very hard to do for the first couple of weeks. But workers in Maryland do more than just get in and out of chairs; these women stack boxes, clean hotel rooms and work in fast-food restaurants.

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To some Americans, the word “tax” is akin to a “four-letter-word,” and the profanities heard around tax time can prove that public bent.

Though admittedly overly-complex and onerous to file, most people understand the necessity of taxes to pay for the valuable services provided by our government like Social Security, Medicare, education, public safety, roads and the like. But with Congress’s recent game of chicken around the government shutdown and the debt ceiling, as well as the grave impacts of the sequester on needed public services — to keep those services, it’s clear we need to raise revenue somehow.

I’m not sure why there’s an aura of animosity when it comes to taxation since, when one examines public opinion polling, it’s clear that Americans are not against taxes themselves, only unfair taxes. Fair — now that’s a loaded word. While some would argue that fairness means corporations must have a tax rate that maximizes their ability to compete in a global market, most people would say that fair means treating people equally. An example of this idea can be found in the fact that, unlike the average Joe (or Jane), corporations are able to subsidize their tax bills by making use of loopholes that allow them to deduct certain types of pay, like performance-based bonuses for CEOs who make over a million dollars a year. I think you can agree, that’s just not fair.

In addition to making sure that CEOs and corporate entities are paying their fair share in taxes, another important way to bring in needed money to fund the government’s budget and reduce the deficit is to end international tax loopholes that incentivize corporations “sheltering” their profits in tax havens (other countries with lax tax rules) instead of bringing those dollars back to the United States. While you and I are letting fly a few expletives as we bemoan the filing of our annual taxes, huge corporations like GE, Exxon-Mobil and Citigroup that are making billions per year in profit get away scot-free, without paying a single cent in federal income tax. And, of course, armies of industry lobbyists aim to keep it that way.

This inequity is why many welcomed the recent tax proposals released by Senator Max Baucus (D-Mont.), Chairman of the Senate Finance Committee. One of the discussion drafts in his scheme for overhauling the tax code aims to close international tax loopholes along with two other proposals that would reduce fraud and increase simplicity of the tax code. Though these proposed changes would begin to address some of the worst problems with international tax-dodging practices, the proposals themselves have been deemed “revenue-neutral” and are not expressly aimed at funding the government services upon which even multinational corporations depend.

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Barclays should “take its medicine” and pay the $435 million civil penalty to the U.S. Treasury and $34.9 million in unjust profits that federal regulators say it owes to low-income families primarily on the West Coast, whom it harmed through market manipulation for two years, seven organizations said today in a joint statement.

Barclays is one of several banks found by the Federal Energy Regulatory Commission (FERC) to have manipulated energy markets between 2006 and 2008. In July, FERC ordered Barclays to pay a penalty as well as a refund to families in California, Arizona, Oregon and Washington. Barclays has refused to pay.

FERC also imposed fines on JPMorgan Chase and Deutsche Bank as well for manipulating the California energy market; those banks paid their fines.Yesterday, FERC took Barclays to federal district court to force it to pay up. Some of the money owed is to go to help low-income families with energy bills.

“Millions of working families pay their bills on time. Why can’t Barclays?” asked Tyson Slocum, director of Public Citizen’s Energy Program. “Barclays should pay up and not drag this case out as the winter approaches, which is when families will face thin budgets and decisions between food and heat.”

FERC issued an 85-page order on July 16 describing how Barclays engaged in complex “financial swap” transactions by manipulating West Coast power prices for two years. It noted that Barclays’ physical trades weren’t responding to supply/demand fundamentals but rather allowing the bank to profit on artificially high prices from its related financial swap positions.

FERC also released excerpts from messages written by Barclays traders involved in the price-manipulation that reveal full intent and knowledge of the malfeasance. This message from 2006, for example, refers to the California market: “I just started lifting the piss out of the [P]alo [Verde Hub, a key price-point for the state’s electricity market].” The trader commented, “was fun. need to do that more often.”

The manipulation continued for at least another two years, with FERC estimating a market cost to consumers of $139.3 million. Despite costing the market so much, Barclays, worth about $2.4 trillion, has been told only to refund ratepayers $34.9 million, its profits during that time. The refund represents .0015 percent of Barclays’ net assets.

Recognizing the harm to consumers caused by Barclays’ market manipulation, FERC ordered all of the unjust profits to go to the four affected states’ Low Income Home Energy Assistance Programs (LIHEAP), which provides critical assistance for struggling families to help pay utility bills. This critical program has already suffered severe cuts of 36 percent in federal funding since FY 2010.

“There is an urgent need for LIHEAP to help to struggling low-income families pay their energy bills,” said National Consumer Law Center attorney Olivia Wein. “These funds will help the most vulnerable households in California, Arizona, Oregon and Washington, which include low-income elderly and families with small children at a time when the federal LIHEAP program is severely underfunded.”

“Barclays essentially defrauded countless families, and at the end of the day will get to keep much of the profits it made that way,” said Slocum. “If we allow banks like Barclays to simply make fines a cost of doing business, we can expect to continue being gouged by unscrupulous corporations engaging in market manipulation.”

“FERC should not allow unscrupulous energy traders to continue to prey on Californians,” said Mark Toney, executive director of The Utility Reform Network (TURN), California’s nonprofit consumer advocacy organization. “Barclay’s, one of the wealthiest companies in the world, owes California consumers millions of dollars and should return its ill-gotten gains immediately.”

Noting how many bank manipulation schemes have been revealed recently – reflected in recent FERC actions against Barclays, JPMorgan and Deutsche bank – the organizations signing the joint statement argue that FERC should undertake an evidentiary hearing to examine whether or not the organized markets deliver just and reasonable rates.

“There is nothing in these settlements that addresses whether the inherent structure of the markets is adequately protecting consumers,” the letter says.

The letter also calls for the creation of an office of consumer advocate at FERC that would authorize funding for groups that represent household consumers, thereby providing critical assistance for consumers and enhancing the representation of households before FERC.

The joint statement, written by Public Citizen; Americans for Financial Reform; Arizona Community Action; A World Institute for a Sustainable Humanity (AWISH); Citizens’ Utility Board of Oregon; National Consumer Law Center (NCLC), on behalf of its low-income clients;, The Utility Reform Network (TURN), and is available here.

Tyson Slocum is Director of Public Citizen’s Energy Program. Follow him on Twitter @TysonSlocum

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