Policy, Politics and Power: Building And Passing Our Health Access Law

1
Policy, Politics and PowerBuilding And
Passing Our Health Access Law

• Ellen R. Shaffer PhD MPH
• Center for Policy Analysis
• www.centerforpolicyanalysis.org
• Raising Womens Voices April 18 2008

2
Policy

• State reforms are important
• Make a real difference in peoples lives
• Build a base
• Health coverage systems
• Health care delivery systems
• Advocates
• Illustrate limits of state powers
• National proposals timely in 2008

3
Politics

• Presidential Campaigns igniting the policy debate
• Proposals will have to go before
• Congress Some have their own bills
• The public
• Special interests The Industry, Business
• Us Women, Unions, Users
• Debate now Mandates Health Savings Accounts
• Debate in Jan. 2009 ????

4
More Politics 2009

• Medicare Part D will destabilize, privatize,
  defund Medicare
• SCHIP funding will expire

5
Power

• Elections mobilizing women, communities of color
• New Voters, New Voices
• Opportunity to build a base for reform
• Influence support candidates now
• Hold them accountable in 09
• Articulate alternatives beyond incremental
• Why affordable, comprehensive, quality are key
  concerns for women

6
What Policies Build Power?

• Who Is Mobilized to Support
• Who Is Mobilized to Oppose

7
Womens Principles

• Quality, Affordable Health Care for All

8
San Francisco Womens Working Group RWV

• Access to affordable, accessible, high quality,
  comprehensive health care for all residents,
  independent of income, employment, gender,
  sexuality, ability, immigration, incarceration or
  health status

9
SF WWG RWV

• Comprehensive benefits.
• Equitable, culturally and linguistically
  appropriate care, with particular attention to
  vulnerable and underserved communities.
• Affordable for individuals and families in
  relation to income

10
Debate Point Financing Cost Control

• Fairly financed and establishes mechanisms for
  controlling costs without impeding access.
• Should we spend more money on health care vs.
  other priorities?
• We know budgets in single payer systems control
  costs.
• Alternatives?

11
Organizing Point Link Health Reform to Economy,
Equity?

• Community as well as individual health.
• Universal coverage in itself removes an important
  source of social and economic inequality for
  women and girls.
• But eliminating health disparities and improving
  health for women and girls also requires
  comprehensive strategies that affect the social,
  cultural, environmental, and economic
  determinants of health.

12
Equity Policies

• Related policies include living wage, equal
  rights, employment opportunities, workplace
  representation, safe and healthy natural and
  built environments, absence of domestic and civic
  violence, affordable housing, access to safe and
  nutritious food, adequate public health
  infrastructure, and civic participation in
  democratic decision-making.

13
Con Pro

• Not immediately attainable
• Excites mobilizes activists
• Health care reform in context of big picture
  issues important to women

14
AlternativesIncur Anger at Health Insurance

• Expense
• Denials of coverage Pregnancy
• Sicko
• Focus on McCain market-based proposal

15
Homework Whos In Congress?

• Senate Kennedy, Clinton, Obama, McCain
• House
• Conyers HR 676
• Lee HR 3000
• McDermott HR 1200
• Stark, Dingell, others

16
Program 2008-9

• First 100 days
• Fix Medicare
• Fix SCHIP
• Build a national bill that
• Achieves womens goals
• Can pass
• Because we make it happen

17
Discussion How Can Women.

• Policy Define our issues
• Politics Assure our issues are addressed
• Power Move health care reform in 2009