Policy, Politics and Power: Building – And Passing – Our Health Access Law Ellen R. Shaffer PhD MPH Center for Policy Analysis Raising Women’s Voices ~ April

April 18, 2008 Center for Policy Analysis 2 Policy State reforms are important Make a real difference in people’s lives Build a base –Health coverage systems –Health care delivery systems –Advocates Illustrate limits of state powers National proposals timely in 2008

April 18, 2008 Center for Policy Analysis 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: ????

April 18, 2008 Center for Policy Analysis 4 More Politics 2009 Medicare Part D: will destabilize, privatize, defund Medicare SCHIP funding will expire

April 18, 2008 Center for Policy Analysis 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

What Policies Build Power? Who Is Mobilized to Support Who Is Mobilized to Oppose

April 18, 2008 Center for Policy Analysis 7 Women’s Principles Quality, Affordable Health Care for All

April 18, 2008 Center for Policy Analysis 8 San Francisco Women’s 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

April 18, 2008 Center for Policy Analysis 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

April 18, 2008 Center for Policy Analysis 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?

April 18, 2008 Center for Policy Analysis 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.

April 18, 2008 Center for Policy Analysis 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.

April 18, 2008 Center for Policy Analysis 13 Con & Pro Not immediately attainable Excites & mobilizes activists Health care reform in context of big picture issues important to women

April 18, 2008 Center for Policy Analysis 14 Alternatives: Incur Anger at Health Insurance Expense Denials of coverage: Pregnancy “Sicko” Focus on McCain market-based proposal

April 18, 2008 Center for Policy Analysis 15 Homework: Who’s In Congress? Senate: Kennedy, Clinton, Obama, McCain House –Conyers HR 676 –Lee HR 3000 –McDermott HR 1200 –Stark, Dingell, others

April 18, 2008 Center for Policy Analysis 16 Program First 100 days: –Fix Medicare –Fix SCHIP Build a national bill that –Achieves women’s goals –Can pass –Because we make it happen

April 18, 2008 Center for Policy Analysis 17 Discussion: How Can Women…. Policy: Define our issues Politics: Assure our issues are addressed Power: Move health care reform in 2009