Why We Need Improved Medicare for All:
Without the security of basic health care, all else fails.

Cities and counties (and their residents) face huge problems and cannot be successful without dramatic health care reform. The COVID-19 pandemic highlighted the many failings of how we finance individual health care and our national public health care programs. The institutional racism built into our health care system needs to be addressed. We have tried incremental change for decades. It is not producing the results we need.

Everyone is aware that our ridiculously expensive and complicated current for-profit health care financing system directly impacts residents of our communities. Bankruptcies triggered by health care bills, the high cost of prescription drugs, and the opioid crisis produce a lot of local pain.

However, what is not always as obvious is how our health care system robs people of the freedom to live the lives they want to live and makes it harder for them to take responsibility for themselves and their families. Below are some additional reasons why local governments need to support Improved Medicare for All:

1. No one should ever have to say, “The only reason I am still in this job is because of the health benefits.” The COVID-19 pandemic clearly demonstrated that affordable access to high quality health care should not be tied to employment.
2. No one should have to worry about losing affordable health care when making decisions about marriage or divorce or about providing care for elderly, sick or young family members.
3. The Medicaid “financial cliff.” In Colorado, almost one in four people are on Medicaid, the program for low-income members of our community. Unfortunately, Medicaid can also lock people into a life of poverty. Those on Medicaid must closely watch how much money they make each month or risk losing their health care. Individuals who would like to accept overtime hours, accept a promotion with a raise or be willing to work a second job can be pushed off Medicaid. They must make thousands of dollars more just to “break even” when they must pay for some or all of the cost of an insurance policy. Or, they bounce on and off Medicaid based on changing income, a real headache for them and their doctors. This results in an increase in demand of local government public services.
4. Affordable housing. The high cost of health insurance and out-of-pocket health care expenses is a significant factor in the inability of residents to find affordable housing.
5. Help for the homeless. How much more successful would programs designed to help the homeless be if physical and mental health services were readily available. How many people could avoid homelessness if their medical needs could be met affordably?
6. Restrictions on business and our economy. Local businesses of all sizes struggle to plan, not knowing how much more they will need to spend over the next 3-5 years on health insurance for employees. Small businesses without employee health benefits struggle to attract and retain employees, because employees usually look for a job that provides health care coverage.
7. Restrictions on potential entrepreneurs. How many people would love to turn their big idea into a new business but cannot leave their existing job because they would lose their health insurance and put themselves and their family at risk?
8. City and county budgets are dramatically impacted by the cost of providing health care coverage for their employees. By eliminating the unnecessary administrative waste in our current health care financing system, cities and counties would have more money available for other services their citizens need without raising taxes. Even governmental entities that are self-funded will see significant savings when the profit motive and the waste due to extreme complexity of health care are removed.

Much of the high levels of stress being experienced by individuals and society in general can be directly tied to our dysfunctional health care financing situation. The ultimate solution may be national, but the current pain is very real and very local. That is why cities and counties need to adopt a resolution supporting Improved Medicare for All.

 How to win Local Government Resolutions of Support

For Improved Medicare for All

11-01-2022

Without the security of basic health care, all else fails. The COVID-19 pandemic has put this reality on steroids. Local elected officials should demand that their state and national elected representatives support Improved Medicare for All (IM4A).

A national campaign entitled “Medicare 4 All Resolutions” is headed by Public Citizen and supported by 22 partnering organizations. More than 100 US cities including Denver, Fort Collins and Jamestown, Colorado have now passed resolutions for IMFA! Public Citizen has a very helpful tool kit that can be found  at http://www.medicare4allresolutions.org/. It provides strategy suggestions and copies of resolutions already passed by several cities.

This paper provides suggestions for approaching local elected officials. Click here for a PDF sample resolution on the Colorado Foundation for Universal Health Care website.

Click here to download a version you can edit in Word.

Elected officials may be willing support a resolution given the pandemic and accompanying racial disparities in health care, the failure of tying health insurance to employment, and the lack of a viable national public health system.

First set the stage: The ultimate solution is national, but the current pain is very local. That is why local governments need to take a position on IM4A.

1. Research city goals—find the links. Most cities or counties will not be able to meet their goals for economic and social sustainability without real change in the form of IM4A. Review the adopted city or county goals in advance. You should be able to find several that tie directly to the points made in the “Why” tab to show the pain being felt locally. The key is to show how the major social and financial problems impacting their residents are directly tied to our dysfunctional and extremely expensive health care system. A resolution for IM4A is very consistent with their already adopted goals. The health of the city or county is directly tied to the physical, mental, and financial health of its residents.
2. Show them this is really is a local problem demanding local leadership. Their initial reaction may be that this is a national problem and nothing that the city or county can fix. Remind them about the history of social change in America. Local governments have always taken the lead, even on national issues: women’s right to vote, the civil rights movement, women’s equal rights, elimination of smoking in public places, gay rights and climate change are examples. Congress is always the last to accept the change.
   
3. Meet individually with the local elected officials. Start with the person you think will be your “champion.” No more than two volunteers should be at these meetings. Let the elected official know you are a volunteer working on a national effort to get resolutions of support for IM4A. How do they feel about the current health care system? How is it impacting his/her family? Are they familiar with the concept of IM4A? The key point of the initial meeting is to let them talk. You may find they are already informed and supportive. If so, they can help frame the language and strategy that will work best for themselves and the governing body.
4. Find your champion. Hopefully, your individual meetings will identify the most likely champion on the elected board. This person will not only be supportive of IM4A but will understand the best way to get a resolution on the board’s agenda, the timing and how to secure the votes.
5. You are not alone; this is part of a national movement. You are asking them to do something that other cities have already done, see the Medicare 4 All Resolution toolkit. This (IM4A) is “the next big thing” that is required if cities and counties are to be healthy and prosperous in the future. Seattle, San Francisco, Cambridge, Philadelphia, Ann Arbor, and others have already passed resolutions.
6. Make sure you have the votes. It is better to not bring a resolution forward if you do not have the votes to support it. We do not want cities on record appearing to vote against IM4A.

Second, describe the local pain. Everyone is aware that our ridiculously expensive and complicated current health care financing system directly impacts residents of our communities. Bankruptcies triggered by health care bills produce a lot of local pain. The high cost of prescription drugs and the opioid crisis each show the need for strong voices at the local government level.

However, what is not always as obvious is how our health care system robs people of the freedom to live the lives they want to live and the ability to be responsible for themselves and their families.  Refer to the examples in the Why tab.   

Why would we allow a system that is so unfair, so expensive and causes so much pain to remain in existence? What kind of country do we want to live in?

Much of the high levels of stress being experienced by individuals and society can be directly tied to our patchwork of dysfunctional health care financing systems. The pain is very real and very local. That is why cities and counties need to make their support for IM4A known to their state and federal elected officials.

We have done this before. As a country we have successfully gone through major change when it became obvious that something was very wrong. We have always produced a better society by willing to go through the transition. History shows us that disruptive social change is needed to eliminate a blatantly unfair and harmful situation. We have been trying to incrementally fix a system based on meeting the needs of the for-profit health insurance industry for decades. Incrementalism is not working!

We want to touch people’s hearts, not win a debate.  Eventually the resolution will be in front of the city council or board of county commissioners. Personal testimony about our harmful health care situation is enormously powerful. It is more persuasive than philosophical arguments or technical details. Make sure you have people prepared to come to a city council or county commissioners meeting to describe how they are impacted by the current situation.  During the pandemic, it may be phone calls or Zoom appearances. Work with your city council champion on the timing to approach other city council members to encourage their support of the resolution.

Send a thank-you note. Thank the elected officials for passing a resolution in support of a state or national model of IM4A. Elected officials receive more complaints than notes of appreciation for the work that they do. A personal handwritten note addressed to each elected official is always appreciated.

Contact Rich Shannon (Fort Collins) at rshannon(at)frii.com for coaching.

Sample resolution for Improved Medicare for All

Download sample resolution for IM4A as a Word doc

For more information contact Rich Shannon at rshannon(at)frii.com.