HR-676 is dead. What now?

In this episode of Wine, Women, and Revolution, Heather interviews healthcare icon Dr. Margaret Flowers. They talk about the death of the Medicare for All “gold standard” HR-676. Then, they discuss where the fight for Medicare For All has to go next.

Why Become An Activist?

Dr. Margaret Flowers started her career as a pediatrician in Maryland. During her time in practice, she saw firsthand, our broken healthcare system. It is difficult for patients and providers. The only ones it serves are the healthcare industry. In 2007, she left her practice and became a full time activist.

A Time For Direct Action

In 2009, Dr Flowers volunteered for Physicians For A National Health Program as a congressional liaison. She met with congress members and advocated for comprehensive single payer program. To her surprise, when the hearings began in May of that year, congress shut her group out completely. Congress barred doctors and experts from testifying. They only allowed the insurance industry. Her group stood up in the Senate Finance Committee hearing and demanded to testify. Police arrested these doctors and escorted them out of congress.

A Temporary Success

Direct action yields satisfaction. During the next hearings, doctors testified along with industry insiders. Senator Kennedy personally invited Dr Flowers to testify. For the first time, doctors took the chance to tell the truth about our broken healthcare system. Senator Sanders brought a single payer bill to discussion on the Senate floor. Sadly, they eventually passed the Affordable Care Act instead of Medicare For All.


HR-676 (The Expanded and Improved Medicare For All Act) was first introduced to Congress in 2003. John Conyers sponsored the bill. Top healthcare experts wrote this bill. It was a comprehensive package that covered everyone from cradle to grave. For the next 16 years, Congressman Conyers reintroduced that bill as HR-676. After he left in 2017, Keith Ellison took over the sponsorship. Then, Keith Ellison left too.

A Failure Of Leadership

Next, Congresswomen Pramila Jayapal decided to pick it up. At first, things seemed fine. Eventually, early on in 2018, she decided to back Senator Sander’s current bill instead of HR-676. His bill had a number of serious flaws in comparison to the gold standard. Dr Flowers and her group urged Ms. Jayapal to introduce HR-676 as is, or if she made changes to only make it stronger. The Congresswoman decided to rewrite the entire bill and allow 676 to die. Pramila Jayapal decided not to disclose early drafts of her bill publicly. Based on what is leaking, we should have serious concerns about her bill.

Bullshit Power Games

HR-676 is effectively dead. This year, house bill 676 is a resolution in support of NATO. This brand, that so many fought for, is no more. Because Congresswoman Jayapal is a very powerful figure, no congressperson has the courage to go against her. She co-chairs the congressional progressive caucus, and is seeking more leadership roles. Now we are seeing groups like Move On and Indivisible supporting a watered down version of single payer. Powerful healthcare lobbyists are screwing patients and doctors all over again.

What Does a Good Bill Look Like?

The gold standard bill protected everyone from birth to death. Senator Sander’s watered his bill down from the beginning. He threw out long term care protections. He kept the for profit providers in the game. Sanders threw out cost controls supplements to hospitals. He added in Value Based Payments which actually discourages doctors from treating low income patients.

3 Lessons From Being A Congressional Fellow

Dr Flowers uses the acronym ICU to describe the lessons she learned in her time as an activist.

I. Be independent of political parties.

C. Be clear about what you are asking for. Politicians use confusing language. They make it seem you are getting when you asked for, when in reality its the opposite

U. Be uncompromising.  On issues like medicare for all, if you compromise you a literally sentencing some people to death. Sometimes you just cant be a centrist.

Get In Touch

Dr Flowers has started her own advocacy group called HOPE which stands for Health Over Profit for Everyone. Their national website is here . They organize education and advocacy meetings. They work to be the watchdogs for Medicare For All. You can join the local NJ group here

Update: After the recording of this interview Pramila Jayapal has introduced her version of Medicare For All H.R.1384. It does not yet appear on Congress.Gov but it will eventually appear here.

In an important departure from Senator Sander’s bill, this does include long term care facilities. As this is a very new bill, our experts are busy analyzing what made the cut and what didn’t. It very important to read the contents of the bill rather than just assuming it gives us what we need.

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