How Libby, Mont., got Medicare for all

In 2009, when the Washington beltway was tied up with the health care reform tussle, Montana Democratic Senator Max Baucus, chairman of the all-powerful Senate Finance Committee, said everything was on the table - except for single payer.  When doctors, nurses and others rose in his hearing to insist that single payer be included in the debate, Baucus had them arrested.  As more stood up, Baucus could be heard on his open microphone saying, "We need more police."

Yet when Senator Baucus needed a solution to a catastrophic health disaster in Libby, Montana, and surrounding Lincoln County, he turned to the nation's single-payer healthcare system, Medicare, to solve the problem.

Baucus' problem was caused by a vermiculite mine that had spread deadly airborne asbestos, killing hundreds and sickening thousands in Libby and northwest Montana.  The W. R. Grace Company that owned the mine denied its connection to the massive levels of mesothelioma and asbestosis and dodged responsibility for this environmental and health disaster.  When all lawsuits and legal avenues failed, Baucus turned to our country's single payer plan, Medicare.

The single payer plan that Baucus kept off the table is now very much on the table in Libby.  Unknown to most of the public, Baucus inserted a section into the health reform bill that covers the suffering people of Libby, Montana, not just the former miners but the whole community-all covered by Medicare.

They don't have to be 65 years old or more.

They don't have to wait until 2014 for the state exchanges.

No ten-year roll out - it's immediate.

They don't have to purchase a plan - this is not a buy-in to Medicare - it's free.

They don't have to be disabled for two years before they apply.

They don't have to go without care for three years until Medicaid expands.

They don't have to meet income tests.

They don't have to apply for a subsidy.

They don't have to pay a fine for failure to buy insurance.

They don't have to hope that the market will make a plan affordable.

They don't have to hide their pre-existing conditions.

They don't have to find a job that provides coverage.

Baucus inserted a clause in the Affordable Care Act to make special arrangements for them in Medicare, and he didn't wait for any Congressional Budget Office scoring to do it.

Less than two months after the passage of the health reform bill on March 23, 2010, Nancy Berryhill of the Social Security Administration in Denver joined personally in setting up an office in Libby to sign up these newly eligible people.

"This is a new thing," Berryhill told the Missoulian.  "No other group like this has ever been selected to receive Medicare."  

Berryhill issued a nationwide alert to inform anyone who had lived or stayed in Lincoln County of their eligibility. She opened a storefront in Libby at the old downtown city hall where she signed up 60 people on the first day. She plastered the towns of Whitefish and Eureka with pamphlets explaining the program and added three new staffers to the office in Kalispell.

Berryhill said she did not know how much the care would cost.  That kind of analysis was beyond her directive to sign the people up. There have been no reports of competition from the private for-profit Medicare Advantage plans. The sick are not profitable.

No one should begrudge the people of Lincoln County.  The mine wastes were used as soil additives, home insulation, and even spread on the running tracks at local schools. Miners brought the carcinogens home on their clothes. The W. R. Grace Company dumped much of the clean up costs onto the federal government. A June 17, 2009, order by the Environmental Protection Agency, the first of its kind, declared Lincoln County a public health disaster. The Libby Medicare provision in the health reform law is based on the area covered by that EPA order.

Baucus gave his reasons to the New York Times for its only story on this unique benefit: "The people of Libby have been poisoned and have been dying for a decade. New residents continue to get sick all the time.  Public health tragedies like this could happen in any town in America. We need this type of mechanism to help people when they need it most."

Health tragedies are happening in every town. Over 51 million have no insurance. Over 45,000 uninsured people die needlessly each year. Employers are cutting coverage and dropping plans. States in economic crisis are slashing both Medicaid and their employees' plans. Nothing in last year's reform law will mitigate the skyrocketing costs.  Most insurance is threadbare and doesn't cover. More than 50 percent of us now go without necessary care.  As Baucus said of Medicare, "We need this mechanism to help people when they need it most."  We all need it now.

Bill Clinton recently stated that the U. S. could give coverage to all for one trillion dollars a year less than we now pay if we adopted the system of any other advanced nation. (Unfortunately, he did not say this when it would have mattered most, during the 1993 and 2009 health care reform debates.)

Other industrialized countries have found that to cover everyone for less they must remove the profit-making insurance companies. Rep. John Conyers has reintroduced HR 676, the Expanded and Improved Medicare for All Act, which does exactly that. There are 60 cosponsors. It would cover all medically necessary care for everyone including dental and drugs by cutting out the 30 percent waste and profits caused by the private insurers.

So as the Ryan Republicans try to destroy Medicare and far too many Democrats use the deficit excuse to suggest cuts in its benefits, let us counter with the Libby prescription to clean up the whole mess. Only a single-payer, improved Medicare for All, can save and protect Medicare, rein in the costs and give us universal coverage.

Medicare will celebrate its 46th birthday on July 30, 2011, and all are invited to join in the festivities. Medicare was passed in 1965 and implemented within less than a year. When we pass HR 676, this single-payer bill, we can all be enrolled in the twinkling of an eye.

Kay Tillow is coordinator of the All Unions Committee For Single Payer Health Care -HR 676.

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  • I am very happy for the MANY people of lincoln county, Montana! That said, I found myself very angry that Baucus Had the nerve to slip that issue into the medicare reform bill!! Especially unbeknownst to any other american's!! This is the exact type of behavior, that makes most americans not trust congress, regardless of the party one is affiliated with!! Although I'm an american, I've lived overseas and have seen first hand, how universal medical care systems, in almost every developed country, covers every citizen, while at the same time, lowers the cost of medical care, rids it's system of Extreme, Fraudulent waste! As long as america continues to allow medical care for profit to exist and continues to allow medical care for profit insurance companies, to totally run and dictate Americans Medical care coverage, our country will continue to pay overpriced medical care coverage, and grossly over priced medications, which all other countries pay far, far LESS for! The bottom line in this medical care debate, within Congress and among american citizens, the political parties (especially the REPUBLICON'S), the money for profit insurance companies, pharmaceutical companies, and of course the highly paid Lobbyists, Come down to 1 word..."GREED"!! Even with all the information, Factual Statistics, and visibly medical care systems in many other developed countries, actually working, the corporate GIANT'S Rolling around in all of their Billions of Dollars, and laughing all the way to the bank are REFUSING to let go of 1 single dollar! Thus refusing to be stopped without an Enormous Fight to the bitter end, regardless of how many people continue to die every year from not having insurance coverage, and what's best for american citizens!"GREED" for more and more money, appears to be the root of ALL EVIL! This makes me sad and ashamed to be an American Citizen, Because the world overall, doesn't differentiate between the common american citizen and the evil, money hungry Corporate Insurance GIANT'S! "WE Common American Citizens" are viewed equally with these Abhorrent, Evil, "Greedster's"! If we want our country to continue to lead the world by example, the types of practices MUST STOP! America is already On a downward Spiral, Because of the republican party and their lack of sympathy and empathy for ANYONE that stands up against them for those American's less fortunate monetarily, viewing them as "UNEQUAL'S"! Mark Tillman, Concerned, Democratic Citizen.

    Posted by Mark Tillman, 06/23/2011 12:56pm (4 years ago)

  • While on an extended trip to the US (from Canada) during the health care debates (if you can call it a debate, it seemed to mostly be lies and twited facts pushed onto the public as truth.) I discussed the Canadian medicare system with many Americans. They called it socialist, backwards, unworkable and my favorite 'un-American". Ok, I conceed that our system is not flawless by any means, but we do provide, after a fashion, health care for all. You don't have to decisde which finger to reattach because the ring finger is cheaper than an index. You don't have to worry about how much a cancer surgery will cost. If you walk into a hospital, homeless, without a penney or a fixed address and you have cancer, aids, hepititis or just the flu, we will treat you.
    I guess that treating everyne is "un-American" which. conversly means that letting old and infirm or young and poor suffer is "American". How nice not to live in such a country where misinformed, lobby driven idiots rule.

    Posted by Zodiac, 06/23/2011 12:45pm (4 years ago)

  • Remove the profit motive from health care. Put the private companies out of business and implement the Libby model nationwide.

    Anytime profit raises its ugly head, the people are screwed.

    Posted by Ronald Humphrey, 06/22/2011 10:51am (4 years ago)

  • INSURANCE CO. INSURE BEYOND BASIC CARE IN OTHER COUNTRIES THEY ARE NOT OUT OF THE PICTURE.. MEDICARE IS NOT EVEN BASIC CARE.. IT NEEDS TO BE IMPROVED... THIS COUNTRY LIKES WEAPONRY AND DRUGS NNOT HEALTH CARE

    Posted by j, 06/21/2011 12:34pm (4 years ago)

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