One of the many frustrations for advocates of single-payer health care is the relentless drive to marginalize us, not only by conservatives but also by members of our own party.
Case in point: the accounting arm of Congress, the Congressional Budget Office, has yet to perform a financial analysis of the cost of implementing single payer, a system whereby taxpayers--businesses and individuals--pay into a single general fund which covers everyone's health care for the rest of their lives, regardless of job or health status. Studies in California and Colorado have shown that a single payer system would save money for businesses, families, and government by eliminating private insurance overhead and creating enormous purchasing power that would drive down the costs of care.
I wanted to know why we don't have federal government cost projections for single payer, so I called the Congressional Budget Office -- and reached an answering machine.
Two days later, Melissa Merson, the Communications Director with the CBO, called me back and left a polite message, explaining that the CBO takes its orders from Congress, specifically the leadership, (House Speaker and Senate Majority Leader), as well as the chairs of various committees:
Finance (H-Barney Frank, D. Massachusetts; S-Max Baucus, D. Montana)
Health, Education, and Labor (S-Ted Kennedy, D. Massachusetts)
Budget (H-John Spratt, D. South Carolina; S-Kent Conrad, D. North Dakota)
Appropriations (H-David Obey, D. Wisconsin; S-Daniel Inouye, D. Hawaii)
Ways and Means (H-Charles Rangel, D. New York)
Energy and Commerce (H-Waxman, D. Los Angeles)
"We are fully aware there are members of the public who would like us to provide a cost estimate of single-payer," said Merson, "but we are inundated with requests from committees of jurisdiction. The priorities are set for us by the Congress."
Now, single-payer activists, rallying behind Progressive Democrats of America and the California Nurses Association, are demanding the congressional leadership request a CBO analysis of single-payer. Not projecting the costs is another way to marginalize the growing single-payer movement.
On the other hand, we do know the cost projections for the current proposal, the Affordable Choices Act, a hybrid concoction of private insurance and the so-called "public option" which funnels $2 billions into private for-profit insurance companies. In a June 15th letter to Senator Kennedy, the primary sponsor of this legislative effort, Douglas Elmendorf, the Director of the Congressional Budget Office, estimated the proposal would result in a trillion-dollar federal deficit over a ten year period. And that amount could only be offset by increased taxes, payment penalties for the uninsured, and cuts in Medicaid--hardly the way toward health care for all.
Instead of taxpayer money paying for actual health care under the public option, most of it, according to the CBO letter, would pay insurance companies to pay for health care. To make matters worse, this subsidy to the insurance industry requires dramatic cuts in Medicare, a program that should be expanded, not curtailed.
But here's the real kicker. At the end of the decade, in 2019, under a private insurance/public option proposal, 36,000,000 Americans, as opposed to the current 45,000,000, would still be uninsured, according to the CBO. Because the draft legislation includes an "individual responsibility" clause, anyone who couldn't afford to pay for coverage could face steep fines. Much like mandated drivers' insurance, this system would be a boon to private insurers reaping the benefits of the new law requiring everyone to get health coverage.
On top of that there would be more marginalization. Cancer patients who couldn't get private insurance coverage on their own would be pushed onto the public rolls, thereby saddling taxpayers with having to subsidize insurance policies for the seriously ill. In time, the public option, weighed down by this tax burden and unable to fully exercise bulk purchasing power, would collapse amidst a fiery congressional storm over the cost of the public option, thus legitimizing arguments that publicly-funded health care is a failed idea.
Which begs the question, why is the health insurance industry pushing back if the public option would be such a bonanza? Is it because the insurance industry is scared of the unknown or is it because the industry would prefer to narrow the debate to two choices: the public option or business as usual? I would argue the industry's biggest fear is a frank and open discussion about the merits of single payer -- a system that would put health insurers out of business. Hence, the insurance industry, in Academy-award winning style, paints the public option as the false boogie man and bores in for the kill -- the death of anything public.
HCAN (Health Care for America Now) television commercials pitching the public option urge Americans to embrace this hybrid solution--a moderate, reasoned approach--because others "would like the government to take over health care." We know who those marginalized "others" are -- the single payer advocates who can tell a snow job when they see one.
For those hoping the "public option" will be a vehicle for getting single payer, Health and Human Services Secretary Kathleen Sebelius recently set us straight.
From National Public Radio:
Asked if the administration's program will be drafted specifically to prevent it from evolving into a single-payer plan, Sebelius says, "I think that's very much the case and again if you want anybody to convince people of that, talk to the single-payer proponents who are furious that the single-payer idea is not part of the discussion."
Does that strike you as an *incentive*?
The PBS website will post the full show soon at: http://www.pbs.org/moyers . Between this interview and Michael Moore's "Sicko", I feel the insurance industry has operated in a criminal fashion.
I have lived in England, France and Sweden, and have used their health coverage. I can assure you that it is far superior to what we have here.
Hopefully, your tenure in Congress will provide an example of what the Rep. for a Democratic district should truly be.
All I can add is an anecdotal aside to your comment ...
'...instead, we must marginalize those who make a killing off of health care.'
By 'those' I would assume you mean the big insurance companies, like Aetna and United.
Insurance companies make the largest single amounts but most American medicine is delivered by individual and small group practices that, aggregated, make more profits from health care than even the insurers.
As a private practice health care provider myself, I see duplication, over-utilization, self-referral and plain of waste that adds costs daily.
30-40% of costs in these settings is estimated to be 'fat' that can be cut from the system without compromising health outcomes, without rationing and without increasing taxes. (Gawande, The Cost Conundrum, June 2009).
The current administration is loathe to change a system that works well for most of the people who participate - thus single payer is seen as a solution that 'breaks' the current system.
If the public option in the Affordable Choices Act passes in 2009 then Obama will need a second term to finish the job (ie: purchasing power reforms).
Tim
timrichpt@physicaltherapydiagnosis.com
www.physicaltherapydiagnosis.com
Right on! I sent you a little money. I wish you were my Rep. I think you are so correct in your analysis. I wish you well in your Congressional race. I'll send more money as I can. Thank you for your voice and actions. We are with you in the struggle to get single payer.
I'm uninsured and a healthcare practitioner! Sad. and scary....
I call and email my Senators and Representative daily and pass on some comments I read here. They are more eloquent than I could ever be.
We need a BIG MARCH on DC ! I'm 60 , never been in one yet, but I'm ready. It needs to be soon.
waving the placard that reads, "Health Care for People, Not for Profit!"
I'll look for you, JustBNice. Best wishes, Marcy
I think you're engaging in wishful thinking. Actions speak louder than words. Single-payer has been blocked by our president and congressional "leaders". When "everyone" was brought to the table, single-payer advocates didn't even get a seat at the children's table.
I understand your skepticism, as change -- real systemic change -- often seems impossible to implement. We must always remember, however, that our history is the history of ground-breaking grassroots change, from the abolitionist movement to the suffrage movement to the civil rights movement. Never give up, never surrender, onward! Marcy
One risk pool, everybody in, nobody out, everyone pays something (including seniors), pharmaceutical companies outlawed from charging US citizens more for medicine than they charge in other country's markets.
Further, everything required to administrate such a program is already in place and for the most part already working successfully. (Medicare) The only thing required that I see is to reverse the changes made by the republitards (Specifically, part D) and to include prescriptions at a reasonable co-pay.
Some simple math: If 261,800,000 out of 308,000,000 people currently have insurance at a cost on average of $7,500.00 per year, that's $1,963,500,000,000.00 currently available to fund a single payer plan. That's not money currently being spent on health care services. No, that's just for insurance premiums! In Canada, their citizens are currently spending approximately $720.00 per year. If we add in the uninsured at that premium amount we'd realize a savings on insurance premiums alone of a whopping $1,739,892,000,000.00!
That's trillion with a "T" folks.
The money saved could be used to actually purchase health care services. (Or increase wages for the middle class)
Simple. Problem solved. No negotiation with the health care industry required. No bipartisanship required.
Private insurance companies could then get into banking to continue to scam the general public and maintain their exorbitant salaries, dividends, profit margin, and 30% administrative costs.
more importantly we need you on the Hill, walking those numbers into the offices
of committee chairs, then over to the White House. With numbers like those, who
can argue with single-payer? I mean besides the health insurance industry. Hmm ...
Keep calculating. Best wishes, Marcy
Still if I just take the per person savings and divide by four that's still $434,973,000,000.00 in savings. Enough for a pretty capable peace time defense budget anyway.
So . . . That's still . . . Billion with a "B" folks!
And that ain't chump change around these parts . . .
Just moments ago I learned my Congressman, PUBLIC SERVANT Henry Waxman, is resting comfortably in Cedars Sinai Hospital where he's undergoing tests after fainting. As with all who fall ill, I hope the Congressman recovers quickly. I also hope Mr. Waxman considers what it would be like if he were amongst the millions of uninsured and considers extending his same quality healthcare to every American through a single payer system. Healthcare, after all, is OUR RIGHT as much as his.
One more thing, Marcy, thank you for running against blue-dog Jane Harman. Our Congress needs heroes like you!
blog posts on the war crimes of the Bush administration. I appreciate your
cheers on the campaign trail -- one that promises to be replete with grassroots
activism. We have over 400 precincts to staff in a year, so we're off and running.
Best always, Marcy Winograd Winograd4Congress.com
And congress takes its order from the corporations through their mouthpieces (lobbyists).
Think we'll ever see a single-payer system in America in your lifetime?
More likely to see "euthanasia machines" for the chronically ill....
20 or even 30. Okay, 50ish. We may see single-payer in the states first, then
the federal level. In California, we're just waiting for Governor Schwarzenegger to
go back to Hollywood and then we can elect a Democrat who believes in health care
for all. In the meantime, let's make sure the politicians in Washington don't cut
backroom deals that pre-empt the states. Best wishes, Marcy Winograd4Congress.com