Medicare for all: SF’s gift to the nation

By David Talbot, The San Francisco Chronicle, March 28, 2017

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 Manuel Balce Ceneta, AP / Copyright 2017 The Associated Press. All rights reserved.
Photo: Manuel Balce Ceneta, AP

From left, Sen. Bernie Sanders, I-Vt., Sen. Amy Klobuchar, D-Minn., and Sen. Heidi Heitkamp, D-N.D., listen during a news conference on Capitol Hill in Washington, Tuesday, March 14, 2017, about the Family Act.

Happy days are here again, for now. The Trumpcare fiasco last week produced many joyous results — like reviving the single-payer health care option, the choice of most enlightened countries in the world. Within hours of the Republican health plan’s catastrophic collapse, Sen. Bernie Sanders was telling a Vermont town hall meeting that he will introduce single-payer legislation in Congress “within a couple of weeks” — to deafening applause from the 1,000 or so citizens crowded into a high school gym.

On Sunday, Sanders repeated his announcement on CNN, calling on President Trump to “come on board. Let’s work together.” Yeah, that’s not going to happen anytime soon. But maybe the man who stakes so much on ratings should start paying attention to the numbers.

The buzz around “Medicare for all” is growing by the day — as is the popularity of its chief proponent. A recent Pew Research survey showed that 60 percent of Americans now support a single-payer plan. Meanwhile, Trump’s numbers continue to plummet — hitting 36 percent in the latest Gallup poll — as Sanders’ popularity is soaring. According to a recent Fox News survey (that’s right — Fox), Sanders has the highest approval rating of any politician in the country, at 61 percent.

A national health insurance program — under which a federal agency takes responsibility for health care financing but the delivery of care remains primarily in the hands of private doctors and providers — is clearly the best way to go. Studies show that a Medicare-for-all plan could deliver quality care at a much lower cost than our current system, by eliminating much of the administrative waste and profiteering as well as the lobbying and advertising costs associated with the private insurance and pharmaceutical industries.

President Barack Obama’s Affordable Care Act took a step in the right direction, but still left too much control of our health care system in the hands of corporations whose primary concern is their profit margins, not the well-being of the patients they serve.

During the Obama-era battle over national health care, the single-payer option was dismissed by Democratic and Republican leaders alike as politically unfeasible. But this eminently sensible solution is now rising like a phoenix from the ashes of Trumpcare.

Medicare for all is backed by many of the grown-ups in the field, including Physicians for a National Health Program, Healthcare-Now and the California Nurses Association. A 2007 Annals of Internal Medicine poll found that 59 percent of doctors supported national health insurance.

California could take the lead, once again, in the national battle for humane and responsible public policy. Here in our progressive social laboratory, two Democratic state senators — Ricardo Lara of Bell Gardens (Los Angeles County) and Toni Atkins of San Diego — have introduced a bill that would create our own version of Medicare for all. The bill, SB562, would replace private medical insurance with a government health care system for all Californians, including people living here without legal permission.

In the wake of Trumpcare’s implosion, the American people are faced with a stark choice. Do we want the kind of rational health care system now enjoyed by only certain segments of our population — the elderly and veterans? Or do we want to continue to be at the mercy of the corporate jungle?

San Francisco pioneered the once radical concept that “health care is a right, not a privilege.” It was a young graduate of UCSF Medical School named David Smith who rose to his feet during a heated discussion of community health needs at UCSF in May 1967 and proclaimed this now famous medical mantra.

At the time, the city’s medical establishment was staunchly resisting the opening of a clinic in the Haight-Ashbury neighborhood, insisting that it would encourage the flood of young hippies into the city.

But “Dr. Dave” — as he became affectionately known to the many young patients he treated — refused to surrender. And on June 7, 1967, the Haight Ashbury Free Clinic opened its doors on the second floor of a scruffy Victorian at 558 Clayton St., and the rest, as they say, is history.

Smith and his staff — some of whom were medics from the battlegrounds of Vietnam — not only took care of everyone from young runaways to rock celebrities Janis Joplin and Jerry Garcia, they put the principle of health care as a human right into practice, day after day.

Now, 50 years later, the Haight Ashbury Free Clinic has grown into a community health empire known as HealthRight 360, overseeing five neighborhood clinics and several other health facilities. HealthRight360 is run by Vitka Eisen — a “real visionary,” in Smith’s words, who overcame her own heroin addiction to help others.

It’s been a long, strange trip, Smith told me. “I can’t believe the Free Clinic is still going strong. I wasn’t even sure it would survive the Summer of Love. But I’m proud that we stayed true to our principles.”

Smith is celebrating the end of Trumpcare, which among other “terrible things” would’ve stripped federal funding from drug addiction treatment — a field that he pioneered — at a time when many pockets of the country are “being ravaged by an opioid epidemic.”

At 77, he is now semiretired, but Smith continues to teach and to help oversee addiction treatment programs in Marin County. Among his projects is a fellowship program he’s creating with Bonnie Simmons of the Bill Graham Foundation to encourage nursing students to devote themselves to careers in community medicine and addiction treatment.

“Before we finally got federal funding, we built the Free Clinic on rock and roll — with money that Bill Graham raised for us from benefit concerts. It’s all coming full circle,” Smith said. “That San Francisco spirit still lives.”

 

San Francisco Chronicle columnist David Talbot appears Sundays, Tuesdays and Thursdays. Email: dtalbot@sfchronicle.com

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