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Dave Lindorff

Dave Lindorff

Posted: September 22, 2009 10:27 AM

The New York Times Trashes Single-Payer Health Reform

What's Your Reaction?

In an article in the Sunday New York Times, headlined "Medicare for All? 'Crazy,' 'Socialized' and Unlikely," reporter Katherine Q. Seelye did her best to damn the idea of government insurance for all with faint praise.

To begin her article, Seelye quoted from a 2005 episode of the NBC drama West Wing, in which two presidential candidates, a Democrat played by Jimmy Smits and a Republican played by the always loveable Alan Alda, are discussing health care reform. The Smits character says his "ideal plan" would be Medicare for all. "That's crazy" counters the Alda Republican. Then Seelye segued to an opinion piece recently penned by real-life one-time Democratic presidential candidate George McGovern (a noble figure who nonetheless has long-since been type-cast as an out-of-touch extreme liberal loser), who favors expansion of Medicare into a national single-payer system.

Turning to the real world, Seelye then trotted out several economists, ostensibly to give a broad spectrum of arguments about the idea of single-payer, but in fact carefully avoiding including anyone who actually supports the idea of expanding Medicare.

As her representative liberal, she quoted Brandeis economist Stuart Altman, an Obama adviser during the presidential campaign, who said that while he is not "ideologically uncomfortable" with expanding Medicare, such a move would be "disruptive." Going then to what she described as "the other end of the political spectrum," Seeley quoted Robert E Moffit, of the right-wing Heritage Foundation, who claimed Medicare would mean too much government power over health care." Finally, seeking what she could call middle ground, Seelye turned to Dartmouth economist Jonathan Skinner, who claimed that expanding Medicare would be good because it would cover everyone, but bad because it would mean tripling the Medicare tax, currently 2.9% of paychecks. If we were looking at a political yardstick here, Seelye started at the 16" mark (Altman), then went to the 36" mark (Moffit), and finally went to the 24" mark (Skinner).

But where was an economist from the real left end of the political spectrum, over in the single digits of that yardstick? Altaman, representing the private insurance-based Obama approach, was hardly it!

Seelye might have gone to her colleague, columnist Paul Krugman, a Nobel Prize-winning economist at Princeton, who has on a number of occasions written and stated that a single-payer system such as Medicare for all would be "far cheaper" than any private insurance-based system. Krugman, at least, would be over by the 10" or 12" line on a political yardstick.

Never has the Times really analyzed the true costs and benefits of the plan espoused in a bill, HR 676, authored by House Judiciary Chair John Conyers (D-MI), which would expand Medicare to cover every American. Seelye mentions Rep. Conyers' bill, but says innocently that it is "going nowhere" in the House. In fact, his bill, despite having been co-sponsored by 86 members of the House, has been blocked from getting a public hearing in committee by Nancy Pelosi and the House leadership, at the behest of the Obama White House, which is dead-set against a single-payer reform of health care.

The reason the Times and the insurance industry-besotted White House and Congressional leadership don't want that analysis is that it would show clearly that a single-payer system would mean vast savings for all Americans.

Seelye quotes economist Skinner as claiming that Medicare expansion to cover every American would mean a tripling of the Medicare payroll tax -- currently set at 2.9% of wages. But even if we accepted Skinner's math, it is meaningless without looking at the savings side.

Sure expanding Medicare would mean higher Medicare taxes, but what about the following:

  • Medicaid, the program that pays for medical care for the poor, and is funded by federal and state taxes, would be eliminated, saving 400 billion a year.
  • Veterans' care, currently running at 100 billion a year, would be eliminated.
  • Perhaps two-thirds of the300 billion a year spent by federal, state and local governments to reimburse hospitals for so-called "charity care" for treatment of people who have no insurance but don't qualify for Medicaid, would be eliminated.
  • Individuals and employers would no longer have to pay for private insurance.
  • Several hundred billion dollars currently spent on paperwork by private insurers would be eliminated.
  • Car insurance would be cheaper as there would no longer have to be coverage for medical bills.
  • Federal, state and local governments would no longer have to pay to insure public employees.


In short, if every person were on Medicare, the overall savings would overwhelm the small increase in the Medicare payroll tax of 5.8%.

The bottom line is that Canadians, who have Medicare for all, devote 10% of GDP to health care. Americans, who have private-insurance-based health care except for the elderly, devote 17% of GDP to health care.

Seelye and the Times have never mentioned any of this. Neither does President Obama or the Democratic Congress.


Dave Lindorff is a Philadelphia-based journalist. His latest book is "The Case for Impeachment" (St. Martin's Press, 2006). His work is available at www.thiscantbehappening.net

 
 
 
 
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11:55 AM on 09/24/2009
Extending Medicare to everyone, including the rich republicans, is a no-brainer. Insurance companies were started to spread the risk. They are a socialist mechanism to make the many pay a little to save the few. But that is not what they are doing now. Now they are a capitalist mechanism to spread the risk to everyone except the insurance company owners.

Obama, the choice is this, Medicare for all or pitchforks in the street!
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OliverTwist
Contrarian advocate for truth and justice
07:47 AM on 09/24/2009
This is why I no longer buy the New York Times.
01:12 PM on 09/23/2009
Single payer is the only affordable way to do it.

We need to loudly denounce the bill they have now. If we can't stop this we are going to be in very big trouble.
Why do politicians say we can't afford anything and then say we can afford the planets most expensive health system.
12:52 AM on 09/23/2009
Politicians will NOT fly in the face of their "finaciers!" That is why this so-called reform has hit the mats. It's simple as outlined herein - remove the profit motive, and stop CMS from paying any for-profits; purchase DME directly from manufacturers (Even Japan told Toshiba there MRI was too d . . . . expensive and make a less costly one - they did at 1/10 the cost several years ago, which we will be getting in the US next year!).

To make a profit, see cars, homes, carpeting, farm products, planes, services, etc . . . but leave life and health ALONE!
08:57 PM on 09/22/2009
If we adopted a single-payer universal system, the savings would be extraordinary.

Assumptions:
- We spend over 1/6 of our annual GDP ($14 trillion) on health care:
"National health spending is expected to reach $2.5 trillion in 2009, accounting for 17.6% of the gross domestic product (GDP)."
http://www.nchc.org/facts/cost.shtml
http://www.bea.gov/newsreleases/national/gdp/gdpnewsrelease.htm

- We spend $7,000/year for every man, woman and child ($2.5 trillion divided by 360 million people).

- Medicare has a 4% operational overhead.

Discussion:
We spend twice what the French spend for their "#1 in the world" health care (they spend $3,600 per person, covering 100% of their citizens).

Where is our extra expense coming from? At least 30% of our "cost" is from profit taking & operational costs (which include advertising, lobbying and executive pay).

If we eliminated "health insurance" overhead, and simply covered all Americans under Medicare (without changing another thing), we would save an instant 26%.

Costs would drop to $5,180 per person, or $1.8 trillion. That's 12.8% of GDP. A savings of $700 billion a year. Eliminating now-redundant programs (like Medicaid) saves billions more. We gain additional savings by leveraging our bargaining power for lower drug costs, etc.

Imagine if 5% of our GDP was freed up. $700 billion returned to our pockets, or available to reduce deficits, repair roads, schools, etc.

It makes good, economic sense too.
12:00 PM on 09/24/2009
About $2000 per person (700,000,000,000/360,000,000) would be a big economic stimulus right where it is needed, to the people.
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Dale Larson
07:46 PM on 09/25/2009
Keep the messages coming!

It makes so much sense that something has to be wrong with it, right?? ;-)

Folks need to step back and understand that the solution is simple and fair for all.

What's going on in congress is a bribe fest.
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Laws456
Don't believe the Hype
06:09 PM on 09/22/2009
The fact that we don't have a serious conversation about single payer shows that the masters of Corporatism control the levers of power in this country.
04:58 PM on 09/22/2009
If we tripled the Medicare tax to 8.7% that would be a huge bargain for most people, just compare the 5.8% of wages to current health insurance costs. If a family's insurance currently costs $14k, they'd need to be making over $240k for this to cost them more.

Note: Skinner also didn't say if that would uncap the amount of taxable income from $100k.
05:02 PM on 09/22/2009
Forget that "Note." Obviously I was thinking about the Social Security cap.
02:20 PM on 09/22/2009
Great article, but unfortunately too many people in this country have an irrational paranoia over anything that slightly resembles "socialism."
12:48 AM on 09/23/2009
That is called Propaganda, NCAVsub2. The irrational paranoia is nothing but revangism - neither Conservative or Democrat - just loud protestors to anything, about anything.
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Dale Larson
01:02 PM on 09/22/2009
** SINGLE PAYER LINK-O-RAMA **

http://hr676.org (Web site for HR 676)
http://johnconyers.com/hr676text (Text of HR 676)
http://www.medicalnewstoday.com/articles/8800.php (Single Payer analysis)
http://www.pbs.org/moyers/journal/05222009/watch2.html (Single-payer on Bill Moyer)
http://www.pbs.org/moyers/journal/08282009/watch.html (Money driven medicine)
http://www.rollingstone.com/politics/story/29988909/sick_and_wrong/ (Rolling Stone - Sick and Wrong)
http://ushealthcrisis.com/2009/09/real-canadians-talking-real-health-care/ (Canadians talk about health care) http://www.pnhp.org/news/2008/february/10_myths_about_canad.php (Canadian System Myths)
http://www.health.gov.bc.ca/msp/infoben/benefits.html (BC Canada Benefits)
http://www.health.gov.bc.ca/msp/infoben/premium.html (BC Canada Premiums)
https://secure.avaaz.org/en/health_care_stories/ (Universal care stories.)
http://www.youtube.com/watch?v=t4tc-q5rtqE (The Choice)
http://www.youtube.com/watch?v=OMSV0wXGT48 (Health Insurance Challenge)
http://www.youtube.com/watch?v=sTh-Yu9RfF0 (Amendment to kill Medicare)
http://www.youtube.com/watch?v=H0fA2DfwFn4 (Agreement to allow house debate and vote for HR676)
http://www.youtube.com/watch?v=VmlDZXCrWRE (Morning Joe and Weiner)
http://silverbuzzcafe.com/?p=2836 (Proof That Socialized Healthcare Works Better Than Our System)
https://www.madashelldoctorstour.com/Mad_as_Hell_Video.html (Mad as hell docs)
http://www.nytimes.com/imagepages/2009/06/21/health/policy/21poll_graphic_ready.html (NYT Public Payer Poll)
http://sickforprofit.com/ (like the title says)
08:12 PM on 09/22/2009
Great roundup Dale!

Passing it on to everyone I know....
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Dale Larson
01:01 PM on 09/22/2009
Hey.. This sounds like HR676! ;)

It's time to end our "risky experiment" of "For-profit health insurance". It's a proven failure.

HR676 (http://hr676.org) Single Payer system that is proven, pro-business and pro-people:

* Slashes at least 30% of costs off the top by removing private insurance overhead.
* Companies take health care expenses off their books. Stock value increases. Better able to compete internationally.
* Small companies could have access to higher skilled workers because previously they couldn't compete in the labor market by offering similar benefits.
* More entrepreneurial ventures will launch since they have more money and less unrelated risk.
* Dramatic drop in bankruptcies.
* Dramatic drop in lawsuits. Most of these lawsuits are simply to obtain money to cover health care if something interrupts their coverage.
* Reduced system complexity. Greater efficiency due to fewer regulations.
* Savings from employees not having to fight with their insurers during work hours.
* HSA and MSA dollars redirected back into the economy for goods and services.
* Additional money to spend from not having to carry "uninsured motorist coverage" on your auto policy.
* Contract employment is more viable for workers since they are guaranteed access to health care.
* People are covered when unemployed. No chance of being wiped out financially if you lose your job.
* Health care providers (doctors, hospitals, therapists...) see increase in business with much less administrative expense.
01:54 PM on 09/22/2009
I'm with you all the way on single payer. Appreciate the facts you bring to the discussion. They can be hard to come by these days. I believe that true HC reform will come when we have a single payer system in this country much like all advanced democratic countries do. I'm disappointed in Obama and Congress's stance on single payer. This country needs to commit to covering everyone. Then, and only then, should we figure out how to do it. I'm not seeing that basic committment. What I'm seeing is selfishness, me, me, me committment not a unified, one national voice and serious committment to doing the right thing - cover each and every American. I wish Obama would use his considerable communication skills to influence unity around coverage for everyone rather than constantly fending off his critics on the 'how tos'.

What I can't figure out is why all the fear and drama around, what should be a straightforward committment to true equality for all in this country. Someone move 'Their Cheese' (fear of change for those of you who haven't read the book) or is it just plain old ordinary selfishness?
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Dale Larson
03:40 PM on 09/22/2009
"This country needs to commit to covering everyone. Then, and only then, should we figure out how to do it. I'm not seeing that basic committment."

True. In fact if this were approached as an Engineering problem (my occupation) you would start with a set of requirements (The first of which is you've given above.) and devise a system that achieves those requirements.

It really doesn't need to be invented as there are many functioning examples in the world. The problem with the current approach is Obama setting requirements like: "Now, I have no interest in putting insurance companies out of business. They provide a legitimate service, and employ a lot of our friends and neighbors." (what legitimate service?)

Keeping the for-health insurance industry intact cedes about $300 billion to waste right out of the gate. Deals with Pharma adds more. Why do we care about them? Just set the laws and they'll follow them right to the edges. Oh wait... It's the legalized BRIBERY that makes them care about those corporations over U.S. citizens!

We're are working with bad requirements and because of this we will get a bad and certainly more costly outcome.
10:50 AM on 09/22/2009
I'm glad someone finally explained how Medicare for all would SAVE money. There is also workmen's comp medical bills, and federal health insurance costs.