it's really a pleasure to be here and see such a good crowd they actually moved it out of one room into this room because they needed more they knew they were going to need more space and i think what it says is that there are a lot of people who are interested in this issue and  a pleasure to be the honorary chair of this chapter since its inception in twenty two thousand and five i've generally been here except one congressional business kept me away from it i'm pleased to be here both came from chicago university cook county and all the rest he's a little older than i am but he's been fighting for it even before i got to medical school and i want to i'm very pleased to have him as an ally during the ninety three ninety four efforts with mrs clinton he didn't quit that one thing you learn about this business is if you quit they win clinton's city i think is the greatest testament to what has to happen as we try and change this system in this country now i've introduced as you heard the internet twelve hundred since i got to congress it's basically a single payer system state by state with national standards and national financing but let states develop their own mechanism the reason for that it's very simple i was in medical school when the most famous canadian  tommy douglas started with one province and spread it across canada and made it all to billy happen in the whole country and it is a model that i still think is the way it's go happen in this country i do not think it's going to happen from washington d c i wish it did but i've been there long enough and i'm listening of people to realize that what's going to happen is it's going to happen state by state now i particularly was disappointed when the president came into office and immediately took a single player off the table when you saw that you realized that it was going to happen nationally and i think that  whatever his reasons were he'll have to explain to you but i think he was wrong i think it should have been kept there a public our your own dr flowers murder flowers raised hell of the senate finance committee about its refusal to hear witnesses a single witness about single payer they wouldn't even listen to it and in my view that tells you the resistance at the national level so we're going to do it at the state level one  we also decided however that we had to work with the president to get as much done at the national level as we could my colleagues on the ways and means committee and in the progressive caucus it was hard it's hard to give up your ideal and be very pragmatic but that's what we did we said we're going to get everything done we can with this mechanism that we've got in front of us and they say politics is the art of the possible is clearly that it is not a perfect piece of legislation by any stretch of the education but in spite of the shortcomings perhaps the greatest step forward was made in a hundred years of our trying we got to the beaches it was d day we got on the beaches now we didn't have very much of the country yet and we've been fighting to stay on the beaches ever since as you can see from these last session this to watch and listen for the proceedings in the supreme court the case is going to be argued and it is my belief that it's very hard to think that ultimately they are not going to affirm the right of the congress to control one sixth of the economy of this country if they say that we have no control over it and it can run wild the free enterprise system  can go without it i think we are in serious trouble because economics will force a change in what's happening in private insurance either by replacing it with a single payer plan or by tightly regulating private insurance companies some countries have gotten to universal coverage by sort of a utility method the same thing we do with our utility prices through our utility commissions you can do it that way or you could do it through a single payer system if you watch if you read the newspapers occasionally if find some truth in them it's not every day but every once in awhile but there's a recent article by is eco manual who is in the new york times a few weeks ago predicting he's a physician i was in the white house in the in the obama white house and he predicted that private insurers will be extinct extinct this prediction in a speech last week and admitted that insurance companies would have to change radically to merely survive in the post health care reform era they know it in the industry they can see is coming and don't ever lose sight of the fact that they recognize we're out there and common form because they recognize it and this is one of the most lucrative providers of health insurance in the country and he's willing to say something like that in public so what's next well with the current political climate in d c it's clear to me that single payer advocates should focus on the state level i think you ought to be working as they are in vermont as they have in california and i recently had a long talk with governor schweitzer of montana and he said jim can you believe it if i had on the federal money coming into the state of montana i could do the same thing there do an instance catch a one right north of me i could cover everyone if they just give me control of all the federal money that comes into the state of montana so there are people out there who are thinking this and i expect that the states shouldn't expect the congress to be very helpful very quickly but i'm working on a bill to make it possible for the federal government to give waivers to states to do their old single payer system the idea behind the bill is to funnel of dollars from all the federal health care programs directly into a participating state remove the legal barriers or risks and others that block a state from operating a single pa system and impose outcome goals to ensure that the state achieves the necessary benchmarks both in coverage and in quality well some of you remember there's probably a few gray hairs in here  is not a single payer system in this country or in this state is that a risk prevents the state from getting large employers into the system so the bill that we're putting together will give this pathway a legal pathway so that places like for my aunt and others will probably be a will be able then to launch a single payer system i know they can do some things they can be more unified but without some changes in federal law they are going to have a very difficult time and in my view the canadian experience is really worth remembering their system started in one nine hundred forty seven and in one province as i said it's a sketch one and it wasn't ratified until one thousand nine hundred sixty seven twenty years later it took to progress across canada started with the schedule in british columbia and then there were several others and finally the guys or not it was said you know some going on here the model for that is you're seeing it right before your very eyes played out right now that's this whole question of same sex marriage is taking a similar course just last year maryland new york and now of course or this year and state of washington full sense of equality will not come until probably there's ten or fifteen states and then the congress will figure out you know some i think i hear something out there maybe better do something about it and the dominos will start to fall now health reform complex and regardless of your differences in philosophy and we all have our own view of what's right in the world but we really need to work together we have to work on all fronts in my view and i think that th state has as had a very vibrant walk in and other things have worked very well in keeping people aware of the benefits of a single payer system and i think that we need to do that as we implement i believe that the next session of congress twenty thirteen when we implement the affordable care act will be one of the most important sessions of congress in probably fifty years sixty years since one thousand thirty five there will be nothing that come here's what happens when we put together the affordable care act and push it out there secretary sebelius is already designing a system because there's a lot of states that are saying well we're going to wait and see what the courts are going to do we're not doing anything so there are lots of states that are not preparing this state has worked at it but sebelius is ready to take a federal system into those states that have sat and done nothing so it is it's going to happen in two thousand and thirteen and i i'm excited to be there in the congress we need people like you out in the streets talking about it going to clubs going all over the place speaking everywhere i really think that this is a crucial time for the democracy in this country health care is the last thing that we have not provided in this democracy we got so security we got unemployment insurance we got lots of things for foster kids and we've gotten welfare and all these kinds of things but health care remains the single most disturbing issue i fly every week to washington thirty five times a year i started flying in one thousand nine hundred eighty twenty four years ago and the flight attendants who were flying with me then were thirty years old and now they're fifty four and more than half of those women flying his flight attendants are flying because their husband has a job without health care benefits and they have to hang on to that job not because of the pension because they lost a pension in the bankruptcy they haven't had a salary increase in six years but they got their health care benefits and now recently as they brought in knighted and continental together they said to them ok girls we got a deal for you we'll give you twenty five hundred dollars for every work for the company e effort in this country for the last sixty years people who are under served in that area in the nineteen seventies medical community for human rights also did the same thing alongside the people fighting the war against against the war in vietnam across the country and that was medical committee for human rights providing  services to people who were injured in demonstrations just like the occupy seattle street medics are today visit i think it was a nine hundred eighty two i don't know if you can see that but this is a poster work when was the keynote speaker at a cartridge there was put together by a health care call ition which was fighting to keep the u s public health service hospital open when president reagan was trying to close a nine hundred fifty two so i would just like to read the title of quentin stark then to show you what a fighter he is and what he has no eighty eight the title is strategy for saving public health care in the  nice donation to our chapter on our effort i'd also like to say that when it's really the godfather or a midwife to our chapter here in seattle and i'd like to give you a very short history of how it got started in two the lowest but the community clinics that take care of every citizen and that country and every resident in their country and i also should say we visited the latin american school of medicine which is training four thousand doctors from underdeveloped countries across the world free of charge and  thin there are at least one hundred fifty medical students from the united states that are getting that care and they're going to go back to their communities of the under served so well and i were down there quentin challenged you and i and he said well if seattle are such a great progress of case place how come you don't have a chapter of physicians for a national health program and  to form a exploratory committee and the rest is history a few months later we had our first public meeting such as we have are having tonight and this is our seventh one so come on up quite and today and sit down so you can hear some really interesting speakers the when i was training the a m a was the dominant voice in american medicine it had been founded in one thousand forty seven in exactly it was over a m a objection but johnson being very very skilled wily politician made it happen now they were only partially successful medicare covers people over sixty five and later people fear of any contradiction that medicare is an extremely popular program makes a huge difference unlike the delta elite people let me give you one example of what that comes out to about today in america there are about sixteen percent in poverty defined by their income and the cost of living and the fear that's going up but if you took their medicare benefit away did nothing more but that that number would rise to thirty two percent that's how powerful medicare for all seniors has been and it's an enormous asset to those of us in the fight for a single payer because we don't have to point to canada or western europe or any of the other thousand countries that have adopted successfully and much more cheaper if you please than we systems that are popular and with better results than we have with our costly system and  aspirin to less than the hospital for that year now we look at a system last year that caused two point seven brace yourself trillion dollars eighteen percent of the whole gross domestic product we can important from the point of view of humanity of solidarity of care for the l something the traditions and in american medicine american society but we took a wrong turn when we put in the hands the power of corporations to control the system and that two point seven trillion includes literally tens of millions of dollars in executive salaries thirty four percent of that money that goes to marketing and the plate word for what they do marketing their product and i think it's very important for those of us who are advocates to recognize this is a problem in america we have other ones of great magnitude but this is a problem that has the resources in place the hospitals the physicians they have the money if and we would not have the ignominy of a fifty million americans without any insurance at all another fifty million with very poor insurance  does horrible things in terms of the whole society specifically one million every year one million americans go into personal bankruptcy that's one half of the total two million each year that's what the health system is turned into and to many people who have illnesses and and have to rely on their limited insurance often are no insurance this is a real catastrophe and those of us who practice medicine know importance to people that have access to it i'm confident that they won't be economically to destroyed by my own major illness they are with us indeed we have a popular idea over sixty nine percent of americans been polled answer yes to the question do you support a federal government support for the taxes of the health system and and in the word they define give a single payer option nine hundred sixty nine percent of americans today say yes this is a change but that what more interesting and important you should grasp this fact doctors now in their majority support single payer fifty nine percent of doctors say yes to  americans doctors i thank you for the applause but what they've learned and this is really important in everything we do these days they learn there's something more fearsome than government doctors are very conservative group and they have the usual taboos about government and government answers to questions but they found out that that the corporations are much worse than govern of us who try and keep up with that the dollars involved are breathtaking they have thirty four percent of a two point seven trillion dollars enterprise and they're not afraid to spend it and under the recent supreme court rulings about corporations that you know this are people and they can spend money billions against the modest amounts we're able to raise so it's a unequal fight and i can't say with absolute confidence how it's going to turn out but i have a reputation for being optimistic sometimes in the country but i rather think we'll win this one american people take seriously their health care and cherish it and i think  congressman pointed out they'll be signs of this this will wish for decent health care and i do agree with him that it will almost certainly be through the states at first and if i may give you a brief lesson th american political history that's how most important things we have to place a state with a progressive state like washington or wisconsin where we've had women suffrage was a popular idea the end of slavery was a popular idea but it didn't happen until it became a movement and that's a really a real entity that we have to conceive we are in the foothills in the base of a becoming a movement single payer effort glad to give it to you well i just i've been asked to touch on a few other things which are trying to do before i use up on my time but it's what's the saying that the b do derive an enormous advantage which are not economically necessary and into davi asli a class thing if you're poor that co pay and deductible is ominous and maybe you're unwilling to seek health care because you can't afford that and  and so we have a battle there to the so we always say we're for medicare for everyone but improve medicare without the co pays and deductibles with a comprehensive preventive program and we know that this will work is amazing  paradox that american science is way ahead of american economics and if i didn't tell my certain anybody in this audience that they filled the hole upstairs that's terrific but but we have to have a situation where people are allowed to express themselves and i agree with the congress in completely that several states are going to make it happen first and let me describe what our view and p h p nationally were the strength is the three states that are in action and actually on the eve of of in the in acting as a single payer in their state vermont where the governor ran and got elected a single payer program or both houses of of their electorate of the legislature have passed enabling legislation i don't want to leave you with the idea they've got a single payer system they don't but they're doing all the necessary steps theorists a waiver for example that you heard a earlier another's say pretty close to you all this is california as long as swartz and nader was in place and sure to veto it they pass it regularly post house by significant matter now they have a liberal voted against it they just went to the bathroom and that's in terms of of next month that's as much as rallying against it so the people of california have a task i just come from there and i want to show you they they recognize the test and they're going some years has been in favor of it so that island in the pacific may well be leading the way and be one of the states that the congressman told us about that will be stepping stones to a national system but i do want to emphasize that with the single payer legislation but it's far from being an actor in that we have to work hard in all of those states but the whole concept and the take home message i think for this for this evening that we're going to enact and serve in several states a i pray that that washington is among them and i can see it happening you have a very progressive tradition and yes wisconsin it says about the  republican governor may well be zooms to that state's role is a progressive one so this is the excitement of the next period and i'm sure everybody knows recognize i can't guarantee that this is going to be successful but i think it will me and i because we listened to the challenge over the decades i'm old enough to have been part of the civil rights movement and the war movement which finally succeeded but let's not forget women's suff the early part of the last century and even slavery we had a grim war the american people finally had their popular will expressed and so it is with the single payer effort  to be here to share a stage with national experts and to be in a room with all of you to make sure that we are fighting together for health care and economic justice for all i'm honored to be here with you tonight thank you for having me my name is teresa most data i am the legislator and policy director for the washington state labor council and proud to be chair of the healthy washington coalition this state's largest health care advocacy coalition with labor unions community groups and provider associations fighting for health care for all how many of you guys know about the healthy washington coalition yeah and for those of you whose this is the first time you've heard about it find me afterwards because i want your voice as part of that coalition you're around fighting for justice but also in olympia fighting for health care policies that improve access so i want to be clear that while i am here tonight and speaking behalf on behalf of the labor council in healthy washington i am proud and i am privileged to be also a member of the governor's health insurance exchange board though i do not speak tonight as a board member nor do i i speak for the board what i was asked to do tonight is speak on behalf of labor and the consumer polish and when it comes to trying to figure out where we're out in this cause to get health care for all at the state level and where we're at we're trying to implement the federal affordable care act so what have we seen so far in washington state we've seen that we are not immune to what other states and what the nation has experienced we have seen all too well that there are cuts that are being directed at the working class at the poor out women on people of color and on immigrants as an excuse and as a way to get us out of this recession and it is misguided and it is immoral and we are not immune and we will fight back as waves of anti labor and anti worker and anti people legislation sweep across the nation we say that this is this is immoral because it is coming at the exact same time when people need these services the most right when people are losing their jobs or having their hours cut they are losing their health care as well and what happens they no longer have the health care and social safety net to fall into because that social safety net has been riddled with holes after years and years of cuts and this recession what they do is that they find that they come to a state where there have been forced cuts because of deficit we've seen the painful cuts have been imposed on populations but these painful cuts have come at a time when corporate america has seen record profits the very health insurance industry that cried when we passed the affordable care act at the national level who who claimed that they would be forced into bankruptcy so record profits last year in may the new york times reported that the health insurance industry made record profits for the third year in a row actually and the first quarter of the first quarter earnings the came back and twenty eleven showed that they beat analyst expectations by an average of thirty percent so the pockets of the c e o s are lined with our premium dollars and these companies continue to push for double digit premium rate increases shareholders on wall street have seen their gains and their bonuses increased all while working families go without care are denied care and do not seek care out of fear that they cannot afford it this is class warfare when you see the one percent and greedy corporations making record profits while working class remains without jobs without health care without the decency of knowing that our tax dollars are going back into our system and  our communities this is warfare and we won't stand for it instead of our tax dollars going in to serve the people who paid those dollars into the system those dollars are being spent on endless corporate welfare and less warfare it is not a question of whether there is enough money it is a question of where people's priorities are these are our dollars we want them in our communities we want them to be spent on jobs and health care and affordable housing and making our communities healthier not sicker more stressed and impoverished what's going on here in washington state because of the recession because of the cuts we've seen increases in the number of people who are without health insurance over one in seven people in this state does not have health coverage that's about a million people in this state alone without any health insurance are states uninsured when they get kicked off the rolls of their company if they're lucky enough to have coverage if they can no longer afford coverage that they were buying out of their own pocket they can no longer turn to our state's basic health program why can't they turn their because after years of cuts that program is nothing but a wait list right now we have a few people on that program thank goodness but there are four times as many people on the lists for basic health than there are on the program let me give you just a little bit of context of what we were headed into for this legislative session as you heard we are deep in the battle in olympia right now during this legislative session as we headed into this legislative session we said please do not make additional cuts you have to raise revenue instead we cannot stand for another all cuts budget since the beginning of the recession we've seen ten point five billion dollars in cuts already imposed in this state and three billion of those dollars have been direct cuts to health care since two thousand and nine we've seen sixty thousand low income working adults who have lost their health coverage we have seen forty thousand elderly and disabled adults who are now getting less care in their homes where it is more affordable and more appropriate and we have seen over one hundred eighty thousand people that have been affected by cuts to critical medical services and devices like eyeglasses and hearing aids these people have been eliminated from these services and i want to bring one more card into the room that i know a lot of you are painfully familiar with a decision a budget and policy decision was made last year and it said the medicaid agency will no longer pay for certain visits for medicaid clients in the emergency rooms they said that this new policy would go into effect on april first and for about five hundred specific diagnoses the medicaid agency will no longer pay the doctors and the hospitals for these services so for example if you're on medicaid and you have a serious issue that you go in and seek treatment for maybe it's an infection maybe a mild burn maybe a sprain maybe a severe bruce if you go in and you meet the criteria on one of these five hundred diagnoses after you've been screened the medical provider is not going to get paid and implementation of that policy is going cause fear and confusion in the community and people are not going to get healthcare it is immoral and it isn't just and we are working as a coalition with providers and hospitals to say this cannot go forward thallus before i get to the policy cuts that are under way this year i think that if people are truly concerned about overutilization and the emergency room then we as a society we ought to think of ways to curb that over utilization we've got to figure out a way to make sure that people have access to preventative care that they have access to jobs they have access to affordable housing they have access to stress free and pollutant free communities and that they are able to seek care when they need it instead of when it becomes an emergency that's what we ought to do that will drive down costs that session again we stress the importance of understanding the context of the cuts that have already taken place some of the legislative members you know they turn over every two years so we wanted to make sure that everybody knew the consequences of the cuts that have already been imposed by all cuts budget and we made sure that they heard the cry and not just from labor but from the healthy washington coalition every single time there was an opportunity for hearing and last week and then the week prior to that we were actually surprised the house and the senate put out a budget that did not decimate health care services dramatically like we've seen in future years it protected the basic health program the budgets protected disability life plan for the most vulnerable population that can't work because they're disabled protected maternity support services interpreter services and after we cried about public health eventually came back and protected much of public health and we started writing a note saying thank you for what you did we need to do more we need to raise revenue but thank you for what you did let's keep working let's keep going this is a good first step before the ink was dry on those thank you notes everything changed last night everything's changed through you right wing democrats aligned with the right wing republican party who is the minority and they hijacked the floor of the senate last night these three democrats lined with the minority party in the in the senate brought a budget to the floor and forced a vote on a budget that has never had a public hearing that has never seen the light of day that hasn't had the opportunity to have public input or debate or discussion let alone opportunities for us to send letters and to send calls to go and testify they forced a vote within hours of showing the opposite party of this budget and the consequences will be detrimental i will do that thank you this is  coup and this is a coup that deserves accountability and recognition we have to hold these people accountable and their names are senator demo the three democrats that all name are senator tom of medina senator kas a few hours and senator sheldon of potlatch so if you are constituents of these folks you please call them if you are not constituents please call them and tell them that their effect their consequences of their actions will affect the rest of the state because of the cuts that they impose so they pull the bills to the floor because they now have the majority write this kook brought bills to the floor in their hijacked efforts and they proposed a budget that decimates health care it kills funding for disability lifeline program medical services it cuts forty four million dollars from the k twelve system it cuts thirty million from higher education it cuts around three hundred eleven million from social services and health care programs and this is all that i could the few hours that we had a chance to review it this also cuts critical services at places like harper view our state's only level one true trauma center in this state this is catastrophic if this budget goes forward and there is a pattern to these cuts these cuts come on top of their cut on their cuts to the working poor there are cuts to the working poor to women in this continues the attack the republican attack on services for pregnancy services for women this eliminates decimates programs for food services for the poor or and it cuts medical services for the disabled this is not something that we can live with so the timing of this conference is essential i really hope that everybody everybody in here makes a pledge to take action can i hear from the plods if you plan to call or make your voice bill the budget bill that was brought to the floor was just the first of four bills that they brought forward the other bills attack pensions they attack funding for jobs for public works they attack funding for local government and they did all of these bills within about a ten hour period the senate did not adjourn until this morning at two am so this fight is new this fight is just beginning and this fight is not over until we get those programs so my last call the action would be that i think that these look like wisconsin style attacks and what we need is a wisconsin style response i hope implications for this policy wise these are programs that are providing health care to people who are just about to receive actual health care as soon as the affordable care act takes effect for the most part in two thousand and fourteen these are programs for the poorest people who will get coverage through medicaid program once that program goes into effect in two thousand and fourteen so if they call themselves fiscal conservatives but they're cutting off programs for the people who need health care now there are those who are going to cause those people to go without health care for two years they will be sick they may die those dollars will be put on to our premium dollars because the sicker those individuals are when they finally get coverage on medicaid that has consequences not just for society and not consequences just for you know human being loss of human life but also the consequences fiscally so it's a it's a bad decision it's a bad budget it doesn't make sense it's not a fiscally wise decision and it's morally bankrupt so what we need to do when it comes to the implementation of the affordable care act there are a great comments that were made earlier i think that this is step one this is a stepping stone and by all means we should recognize that there is much more work still to be done but there is well funded opposition that was working heavily at the federal level that i and fortunately have seen replicated in the last two or three months down here in terms of well funded opposition to anything we want to do at the state level to implement the affordable care act i believe that we were right to applaud ourselves for the pieces of the fordable care act that we were able to pass and i absolutely believe that we are correct in saying that enough was not done but we must recognize that as we saw the battle go down in d c where there was compromise after compromise that same process is being replicated in olympia where the industry individuals the corporations the lobbyists who do not want to see the affordable care act be implemented anywhere in this country are alive and well down in olympia and we need your voice we need your voice now more than ever to help implement some of those policies from the outset you heard legist heard the lobbyist from the industry say that they would be fine with going forward and  having health care reform you actually heard some of the industry lobbyists say that that they would not stand in the way how many of you remember a press conference that obama had in two thousand and nine and i think it was in march two thousand and nine where he brought in a big table and it was televised and it was a commitment to begin working on health care reform and the a hip group america's health insurance plans said and i quote you have our commitment to play to contribute to help pass health care reform this year we heard almost those exact same words from the industry lobbyist all throughout legislative session this year they came to the table they said we want to play and then they did everything they possibly could to defeat the implementation of the affordable care act piece of legislation that we had this year everything they possibly could they testified against that they walked out of negotiation discussions they walked out of rooms and they lobbied in a pack you saw the association of washington businesses along with the health insurance underwriters along with the brokers along with  era and along with regions walking together lobbying as a pac trying to do everything they could to defeat the law and there were some concessions made but at the same time those individuals were walking around as a pac we were walking around as a proud group of individuals who represented consumers saying we have to have some legislation this year we must begin to work forward towards implementing the insurance exchange film and many of you may be familiar with the exchanges the exchange  a new marketplace for lack of a better word that will be providing premium assistance to individuals who are middle income below four hundred percent of the federal poverty level and who are the working poor are not eligible for medicaid above one hundred thirty three percent of the federal poverty level the theory is that you provide premium assistance and tax credits to those individuals that health coverage can finally be a for but a lot of this is left down to the states to implement and we've seen states like california be brave and say to insurance companies that there are certain regulations that they're not going to continue to play on the outside in the status quo that they need to come in and they need to offer in this new and insurance exchange i would say that the instance exchanges in theory have the opportunity to force companies to compete on quality access value and health outcomes instead of what they do right now just on price and avoiding the risk but i would also say that the insurance exchanges have been now a centerpiece of the health reform act simply and in large part due to the amount of concessions that were made at the federal level because they took out the public option and some other key pieces that i know a lot of us wanted this has now become the piece of legislation that's the center piece for trying to improve health care so while it is not the best model it is a model to begin to improve access to care and it has a lot of our hope a lot of opportunity for making sure that people get those tax credits that they get those dollars in their pocket and that they can finally go get health coverage but when we try to implement this little piece of legislation in the state echoes we saw repeating attacks on health coverage implementation like we saw in d c many concessions were proposed by the legislative members because of the attacks from the and insurance industry but we were successful in doing a few things i'm i'm happy to report that as the industry started to say we need this we need that we need this we need that and some concessions were made they kept coming back to the doors pounding and asking for more finally the naked truth was exposed finally people be a will be able to see that that all they cared about was their bottom line and protecting the status quo they wanted a minimalist approach something that  skeleton of the federal law and we were able to push back in the final hours and get a few things implemented this year so i'm happy to report that on thursday after some political posturing was played actually by the same people who  holding up the budget and forced their republican budgets to come down we finally actually got a piece of legislation passed the senate on thursday and four o'clock today the house passed it it is on its way to the governor's office  and this is important for people like j j who came down and testified on behalf of the mainstream alliance and the healthy washington coalition is mother from spokane who had her brother and the uncle to her kids die after months of being sick not being able to get into the doctor had a doctor's appointment the next day he died the evening before his doctor's appointment the health insurance exchange could help provide premium assistance to that individual so they could finally get coverage it's important for people like me keeney who owns plumpy stroke here in seattle who came down to testify to say i want to provide health coverage to my employers in my employees because they deserve it but she cannot find an affordable and comprehensive option on the market right now and the insurance exchange small group market should be able to help or it's important for people who are like us wanting to work towards incremental changes so that we can implement a better system a real system a true system of reform and this is one step so well well we have a lot more to do we need your voice we need your voice to be added to the individuals who are down there we had a huge group of healthy washington activists down there and we've got some major pieces in there what we saw was that on the senate side the public option was included twice in two pieces of legislation twice that was added back in and then it finally got cut on the chopping room floor we saw the the fight for the basic health option which provides coverage for people below two hundred percent of the federal poverty level we fought to keep that in because it really made health coverage affordable because those individuals it's questionable whether or not their health care will be affordable we saw that language they and then it got cut at the end we're going to have to come back and fight for full implementation in tw thirteen though some informant to show what happened this year but the two major things i want to leave you with in terms of wins this war this will allow us to create a quality rating system for to hold insurers accountable so we can compare apples to apples how long was the wa t time how much do things really cost was the true out of pocket cost and we can build that quality rating system together and the final significant policy piece is that people can no longer offer catastrophic only coverage on the outside market and then if they offer a crummy low value plan they also have to accompany it by offering higher quality value plans this is not the savviest thing to talk about but those are pretty big policy wins after getting shut down piece after piece by the insurance lobbyist so i would say that every piece of it is sure and six change legislation was a hard fought battle and it is not going to get easier these guys have a lot of money are premium dollars and they're going to come back and fight and fight and fight and nothing in the federal law will get implemented this at the state level so we desperately need your voice we want you with our wolf pack we want you to be part of the voice that goes around and actually talks about the people that would benefit from coverage so i look forward to working with you on three fronts in closing i want to see if there are people here who are interested in working on three fronts with me one is to demand an end to corporate welfare and endless warfare we must oppose right wing budgets and the corporate politicians reign on both side of the aisle and we must make sure that they do not continue to undermine our safety net and our society through cuts imposed and misguided policies you i want to work with you to fight to protect and implement components of the affordable care act because corporate interests are chipping away at the federal statute and chipping away at the intent of the federal law making sure that they are just playing r politics and they are trying to do everything we can to undermine what's currently there it is a stepping stone it is not perfect but i think it's a possibility if we keep working on it and three is to continue to advance single payer as this is true health care reform my last words would be you have inspired me i want to work with you to make sure that we have a health insurance system where you get health coverage because you are human because health care is a human right thank you for everything you do