All Health Reform Created Equal, Except Single-Payer

On Tuesday, eight courageous activists stood up to Sen. Max Baucus and demanded that single-payer national health insurance be considered. The confrontation, which drew police to the chamber, occurred during a roundtable discussion on health reform held by the Senate Finance Committee, which Baucus chairs. This was one of the few times that single-payer has been covered in the mainstream press, and it's shameful it took something as dramatic as the arrest of physicians and other activists to make it newsworthy.

Baucus has taken the lead on shaping health reform legislation in the Senate this year, in part due to Sen. Ted Kennedy's ailing health, and he is arguably the most powerful Democrat in Congress on this issue. After the activists were removed by the Capitol Police, Baucus made a brief statement in which he said that "everybody in the Congress deeply deeply respects the views of all members of the audience, and all Americans who feel deeply about health care reform, especially those who are worried about a single-payer system or public option who really do fervently believe that is the proper result."

However, from the beginning Baucus has declared single-payer "off the table" and he has refused to allow even one single-payer supporter to testify before the Senate Finance Committee, even as the chief lobbyist for the private insurance industry and trade organizations that oppose fundamental reform made repeat appearances. The incongruity of Baucus' recent statement and his actions over the past year are almost Orwellian -- he will consider all opinions on health reform, except for single-payer, which, by the way, he deeply respects. The final roundtable discussion on health reform takes place next week, on May 12, and once again, no supporters of single-payer have been invited to participate.

The moons are aligned for health reform this year. We are in the midst of an economic recession that has exposed more clearly than ever the failure of our patchwork system of private health insurance, which has left nearly 50 million Americans without coverage and has driven the price of care beyond what millions of insured Americans can afford. Our president has made health reform a top legislative priority. Even the private insurers and their lobbyists concede that our current system is unsustainable and agree that the time for reform is now.

What a pity if we were to waste this opportunity to catch up to the rest of the industrialized world and create a national system of health insurance that covers everyone, comprehensively and equitably. We may not get another one for decades.

Comments

[TheBurdicks]

I am perplexed at the continuing debate over the form to be taken in a Change of our patchwork (non) system of medical care.
This issue is clearly resolved. Our patchwork (non) system is an abject failure, costing twice what it should, producing abysmal statistics, emphasizing intervention over prevention, and disliked by most of the public and a significant number of doctors. The only extant model producing measureable efficiency and acceptable statistics, emphasizing prevention over intervention, and satisfying the majority of consumers and doctors is universal single payer health care.
What is there to debate?
Health care, like education, police and fire protection, the judicial system, and others, is a public right and a government responsibility. A right which must not be denied to even the least among us.
If we are xenophobic enough to be unwilling to look to Canada and Europe, we have a successful model in the U.S. The VA meets all logical requirements of a successful system, is already in place, and could be expeditiously expanded to universal access.
If Max Baucus is unwilling to lead, or follow, then we should push him out of our way.

[jmpurser]

We either get a viable single payer health care plan or we don't get health care reform. The rest are simply new ways to pump federal dollars in to the ongoing disaster that is privatized health care.

[Confused1]

Typical Wahington tactics. They make up their collecitve minds to go in one specific direction and there is no stoping them. They will not listen to the people who voted them in and pay their salaries. They won't even discuss a 1 payer system, just like they refuse to have a debate on 'global warning (climate change)' that includes credible opponents to their stance. Our 'illustrious' congress doesn't care one iota what we think It is time to vote EVERYONE out and start over. Term limits are the only answer to career polititians who have come to believe that THEY know what is best--we are merely idiots. Yet every one of them is corrupt, every one of them has benefited financially from their positions. The longer they stay in, the more their personal wealth grows and their influence increases.

[Mugzi]

Please check out 1payer.nett" website in support of single payer system. There are many easy petitions to complete and they're e-faxed to key congressmen. There is also a short video by Mike Farrell. We must be heard. There many activities going on next week and we must be heard over insurance company lobbyists!!!!

[TomFox]

Dr. Floyd:

I think it is important to ease the legacy insurance companies into new ventures and out of health-care delivery. i suggest that the approrpriate model is yet to be developed or will be developed based on best practices of our European counterparts. The citizenry needs to understand that the legacy providers represent the old way of doing business. In a new model, all will have access to affordable care.

The use of the phrase is deliberate. I work in IT and we talk about legacy systems all the time, some of those systems are less than ten years old. Legacy carries some connotations that could move us forward.

[PlaceboStudman]

Just as I thought, people don't have answers, so they forbid you from asking the questions. People are dying and angry and trying to find some measure of hope, and everyone just keeps telling us to sit down and shut up

[James Floyd, M.D. - Huffpost Blogger]

People are not responding to you because your comments do not make sense, and are not relevant to the post, which was about the failure of Congress to include different perspectives in the debate on health reform. There are definitely problems with the drug approval process and the quality of care that is already delivered, and the best way to deal with them are through a cohesive national system that is accountable to the public. Our patchwork system of private insurance makes it even more difficult to regulate the quality of care. Please stop being disruptive and try to stay at least somewhat on topic, or stop posting here.

[elmerfude]

I have noted that some Democratic Senators are taking any public option for coverage off the table. The reasoning is that the government will end up squeezing out private insurance because the government is large enough to negotiate better prices with drug companies, etc. This is like saying Walmart must go out of business because it is big enough to negotiate low prices. If the government can offer coverage at lower overhead rates, so be it. I am very happy with Medicare except for the fact that some of you doctors won't take it. But then some of you won't take my private supplemental insurance either that happens to be a non profit HMO. You no doubt have your reasons, but my main objective is to stay covered and not necessarily keep insurance companies in business.

[jinsei]

I appreciate your supportive actions beyond words. Having benefited as an American from two separate national insurance schemes in two different countries, I am deeply distraught that I cannot receive adequate coverage in the U.S., and be in a constant state of alarm at every ache and pain.

I am writing letters and making phone calls to my reps and senators, as well. Again, thank you.

[Jimmy1920]

Congress and everyone else needs to stop viewing the health care crisis as an insurance issue and start seeing the crisis as a workforce issue. De-coupling health care from life status (e.g, age, work status, income status, etc.) will have a liberating effect on employment, economic development, and, yes, health care delivery.

There are far too many tragic stories of people who are denied health care, or who are forced into bankruptcy paying for it. But these are not just stories of physical, financial and emotional stress. They are stories of people who have been denied the opportunity to become productive members of the economy.
http://thehealthcaremaze.wordpress.com

[PlaceboStudman]

There are just as many people who have access to care who are dying from abuse and neglect or outright negligent homocide by the FDA and pharmaceutical companies and the horrible state of the drug and treatment we receive in this country that are all FDA approved because BigPharma pads the FDA's pocket in order to push unsafe often untested drugs that are only taken off the market AFTER a certain mortality rate is reached.

[Samalabear]

I'm trying to figure out how many thousands have to die or have their lives totally destroyed by SSRI anti-depressants before somebody either bans these drugs or puts them under strict controls for usage, prescribing them only to people who might benefit and then with strict monitoring.

[patricksmom]

This discussion is about covering people-providing healthcare. Your issues are important and also need to be addressed, but are not the point of this article.

[PlaceboStudman]

Look. I don't give a damn anymore how much I pay, or who pays for what, if no one is going to be honest and start talking about just what the hell we're paying for in the first place. Not a single word is being said about the abysmal state of actual care for some of us in this country, and until that sad horrific issue is dealt with, insurance reform won't matter one iota.

[CitizenT]

And you really think that will happen while the insurance corporations are forcing the healthcare "industry" to focus on profit margins? The first priority should be to break the insurance stranglehold. Then focus on the actual state of care.

[PlaceboStudman]

Fine, then as far as I'm concerned, those people (the taxpayers) who want to focus on padding their pocketbooks by saving a few bucks on insurance costs so they can buy a new house, a new car or a new yacht, (which IS what they will use their health care savings for) without worrying about the fact that it will cost more later to reform actual care than if they did it in conjunction with insurance reform will have the blood of millions of people like me who are dying from the lack of quality care, who were smart enough not to over indulge and buy stuff we couldn't afford or put money into gambling the stock market that has worse odds than vegas

[burndtdan]

You probably wouldn't think that way if you were approaching the topic from the viewpoint of someone without health care at all.

[Paradym]

Yeah, this is a huge "WTF". Corporate interests blocking what is good for our country. I see no reason why we can't study what other countries have done successfully, and where they have troubles, and develop our own single-payer system. It makes economic sense and it's the humane thing to do.

Write to your representatives, people.

[love2lindy]

IMO, because of corporate influence peddling, us regular folks don't really have representatives anymore. Politicians want our votes on election day, but it's obvious their only real constituents are those who give them the big bucks - when it comes to health care reform that would be insurance companies.

I'm not cynical, not at all ;)

[PlaceboStudman]

Most people aren't nearly cynical enough actually. They're mostly just mildly aggrivated, because they only see the POTENTIAL for this crisis to come to a head. However, some of us are downright mad as hell and not going to take it anymore, because we are facing emminent death, (90% chance of less than 5 years to live for me) and no one, not even the public taxpayer is listening, let alone anyone in The Feds because they are all so worried about saving a few bucks on health care so they can buy a new house, a new car, or a new yacht...Wh­ich IS *exactly* what will happen when universal health care reform goes through, and everyone is paying $10 instead of the $100 we're paying now, but the same number of people, or more people are still dying unnecessarily, not because of lack of access to care, but because of the actual poor level of care we are receiving

[James Floyd, M.D. - Huffpost Blogger]

Agreed. Most single-payer advocates are proposing a "uniquely American" system, as Sen. Baucus likes to state. Single-payer for financing, but leave actual delivery up to physicians and patients. This would be in contrast to the the National Health Service in the U.K., the VA system we have in the U.S..

Probably the most important actions people can take at this moment are to contact Sen. Baucus and the Senate Finance Committee to let them know they want single-payer invited as part of the discussion, and to contact their Congresspersons and ask them to support single-payer bills HR 676 in the House and S 703 in the Senate. To find out how to do this:
http://action.citizen.org/t/6693/content.jsp?content_KEY=5220, or
http://www.healthcare-now.org/takeaction

[RoloTomassi]

Well Doc, I think deep down you know what is happening here--we saw a different version of such efforts back in 1993--and it boils down to the fact that healthcare insurers have a place at the table...wh­ich, in all likelihood, means they OWN the table.

Call me a pessimist if you like [many do and it's no longer offensive to me], but from my POV any negotiation that includes health insurance providers is wrong-minded and likely stacked against any significant reform, and without a doubt was predesigned to exclude single-payer discussions.

As the addage goes, money talks and BS walks, and as far as our congress is concerned any effort that doesn't pad their pocket is BS.

I expect reform at the end of this process to be mostly lip service to the label of "reformed healthcare," and not much more than that....

[TomFox]

Here's an idea:

Perhaps the question of healthcare delivery can be approached as a marketing issue. There is clearly a market for universal healthcare. I bet the employed would be willing to even pay a little more for the kind of coverage Europeans receive to have a little piece of mind.

That said, there is probably a "market" for people who want their coverage from "legacy insurance" companies. In fact, "legacy insurance companies" should make its way into the vernacular. This suggests that there is going to be a better way to have health care.

If the legacy insurance companies have to compete with a Universal Health Care system, they will either adjust or go out of business. The legacy insurance companies are afraid of this possibility and if they are afraid, then that means the market is not working. In which case the legacy insurance companies can go the way of the dinosaur just like buggy whips and electric streetcars, etc. I believe there is a market for universal coverage.

[BlueHeeler]

TomFox:

First, I tend to agree with Naomi Klein. There are some areas that "for profit" companies should not be in - education, health & retirement / pensions. There's an inherent conflict of interest. The only way one could reasonably allow those companies in, would be under heavy & scrupulous regulation & oversight. Something that those companies would be fighting at every chance for the rest of their existance. You would also pay for that additional oversight - more costs.

Second, I would doubt that the employed would have to pay a little more than Europeans. The employed are already paying for the insurance company's administration & profit; from my understanding, an additional 40%. If you get rid of the health insurance companies, the USA would save approximately $400 billion per year.

If there's anything that should learned from this point in American history is: Capitalism is
1) a very, very powerful force that has to be tightly regulated or it will devour its own customers. Thank you J.K. Galbraith & J.M. Keynes.
2) and, it is NOT the solution to everything.