Co-written by Jonathan Stone
While the Affordable Care Act is being deliberated in the Supreme Court -- with no decision expected until the end of June -- progressives and all other rational human beings should ramp up their efforts to build the movement for single-payer and work to ignite the Occupy movement on this issue. The Occupiers are expected to become more visible at the beginning of July, and they could and should become a single-payer force. They could even join the loud chorus coming from the GOP to overturn the ACA and its mandate. Finally, something on which the left and right can at long last agree -- for very different reasons, of course.
The right wants to privatize health care, while the left wants a real national health plan as exemplified by a single-payer model. To date, we have still not seen a coherent health care proposal emerge from the right, while the left has been less than visible in voicing their distaste for the ACA. Too many Dems and so-called progressives in and out of Congress -- including unions -- have flaked out and publicly supported the ACA, while privately loathing it. It is the nature of politics to accept and vote for half measures and Band-Aid solutions to accomplish "something rather than nothing." Standing one's ground on principle is a foreign concept. Where are those 590 local union organizations, including 140 Central Labor Councils and Labor Federations and 40 State AFL/CIO's on this issue? All of them support single-payer and Rep. John Conyers' H.R. 676 bill, The United States National Health Care Act. The unions keep signing on in support of this bill, but have they taken their numbers to congressional leaders or the White House? Are they rallying in the streets? Obviously not.
A huge opportunity was lost when President Obama took office almost four years ago and all three houses were controlled by the Dems. Yet the silence from the unions even then was deafening. With nothing drawing them to single-payer, the Obama administration kept it off the table in its ill-timed health care debate. Our president said in those early days that if he was "starting from scratch," he would go to single-payer. Where was the will to do the right thing? Instead, the insurance industry was allowed to write the legislation, using Mitt Romney's Massachusetts health care plan as a template, which he created with the aid of the Heritage Foundation. As a result, they gave us a system that increases health insurers' control over people's health care decisions and will deliver some 31 million new customers into a system that is rotten at its core and does not essentially change how health care is delivered or paid for. The money continues to flow to the insurers, while delivering less in services each year and shifting more costs to the insured. People are downsizing their use of health care due the unmerciful costs, which remain un-contained. It is not hard to imagine the long-term effects of delayed or ignored health care. We see it every day in hospitals across the country.
Even corporations that have provided health insurance to workers for decades are scrambling to get out of the insurance game, so fewer and fewer have insurance on the job, which has kept untold numbers locked in jobs for decades they would prefer to leave. I'm sure they would bolt in a heartbeat if a comprehensive health care plan such as single-payer were helping not only to give them freedom of choice in the job market, but also bolstering the economy. The core of the ACA is to offer subsidies or Medicaid, which is costly and unsustainable. Corporations have every incentive to end on-the-job insurance and let employees fend for themselves, a truly GOP philosophy. We are the only industrialized nation that hinges health care to the job. It makes no sense now, but it did make sense during World War II, when labor was scarce and a great enticement was needed to bring those remaining at home into the factories. Health care coverage was the hook.
Now we wait for this activist Supreme Court to render its decision and put its stamp on health care policy for years to come. It will either let the ACA survive in bits and pieces, or find it unconstitutional as a whole and throw it out. While the right has yet to unveil an alternative plan, neither does the Obama administration have a "Plan B," as it is certain it will prevail and the bill will be found constitutional -- a foolish stance with the Roberts court in control.
If the GOP and so-called conservatives are sincere about cutting costs, fraud and waste in health care, they should embrace single-payer. After all, it would cut $400 billion yearly from health care costs, money that could certainly cover all Americans and be used for other national needs, other than further military buildups. Imagine the efficiency of rolling Medicare and Medicaid into one system of Improved and Expanded Medicare For All, all while operating at greatly reduced cost. The structure is already in place, with the current administrative cost of Medicare at a modest 3 to 4 percent. Better health care and lower costs -- what a revolutionary concept. Not to mention that single-payer would put an end to those 50 percent of bankruptcies that occur due to illness and medical bills. A healthier, more solvent middle class would emerge.
If the ACA is thrown out, President Obama should breathe a sigh of relief and finally push for single-payer. He would be vindicated and have a real opening, and the American people would support him and his bold new stance. Our president would be in his final term and free to finally deliver on that "change" he promised so long ago.
Right now, single-payer advocates are working in several states to institute single-payer programs. Even New York Assembly Chair of Health Dick Gottfried recently introduced his resurrected single-payer bill, which he first put forth in the early 1990s. Ever the politician, he feels there is a growing movement and support for such a bill right now and wants to get in on the action. Indeed, the single-payer movement as a whole must grow and become much more cohesive and effective if it is to play a role in reshaping the health care debate if the ACA is found unconstitutional. We all know that the first group to be thrown under the bus in any "compromise" legislation drafted to replace the ACA would be those folks with pre-existing conditions. Even within the ACA itself are cuts that will allow our government to essentially turn its back on the most vulnerable among us, like the little item of cutting $4.9 trillion from Medicare part A and B between 2014 and 2033.
There has to be -- and is -- a better way, and every effort must be made to continue to build the Single Payer movement, regardless of the outcome in the Supreme Court, for it is the only rational solution to our many national economic woes. Now, the single-payer movement must ramp up its efforts and become much bolder in its demand for a truly comprehensive national health plan. The American people have waited long enough.
Ethan Rome: More Hypocrisy From GOP's Crack Team of Health Care Con Artists
Michele Somerville: United States Catholics: A Church Divided
Allying with the Occupy movement is extremely important. Mostly a young people's movement, they will inherit the current woes of this broken system, gravitating toward jobs that offer health care instead of realizing their own talents and dreams.
We are going to have go on the Offensive with this and Occupy could be that non-partisan bridge to other Americans that will allow us to demand this. No government, state or federal is going to give it to us, no matter how much fiscal sense it makes. They are 100% corrupted by their campaign contributions.
I'm sure you are aware of the 50 doctors who signed an amicus brief to the Supreme Court, also asking that the mandate be ruled unconstitutional. One of these, Dr.Margaret Flowers has connected with the Occupy movement through 'October 2011' .... you might want to contact her.
The straight facts of Single-Payer, Medicare for All need to be out there clearly:
---Medicare for All
---birth to death
---everybody in, nobody out
----includes vision, dental and mental health
---not connected with employment
---funded by employer/employee payroll taxes, a surtax on those making over $250K and a stock transaction tax.
Thank you again for your excellent article!!
I also am aware of the 50 doctors and their amicus brief to the Supreme Court. Good for them, but why isn't that a brief by thousands of doctors which would have registered with the S.C? If we could only get doctors out there in great numbers joining with their nurse colleagues. On the streets from coast to coast, but they are caught up in the daily grind of working in a non functional system that poorly serves all of us and will only get worse. What will it take? And yes, yes we must do a much better job in informing the public as to the merits of single payer.
Money could be raised as you stated but also by getting rid of those insurers who provide no health services and do their best to deny services to prop up their corporate profits for themselves and their share holders. Health care as a commodity stinks.
Profit, that reaches into many of our lives in the form of public pension plans, 401Ks, IRAs... our nest-eggs for retirement. Perhaps the stock transaction tax should come solel from this sector.... you can profit off health care delivery but you must give back to fund universal health care.
The Market Cap today is $39 trillion in shares time share prices of value in Health on the Market. I have seen it over $70 trillion.
http://biz.yahoo.com/p/5yied.html
Benefits have been a tradition in Labor for over 50 years and many unions
won't give up their efforts easily. I am a union supporter, but I can also see where this tradition has to change.
Somehow the unions must be convinced to focus on Job lock and realize that ultimately dissolving the -employment-health care connection will give them much more freedom in their lives.
http://en.wikipedia.org/wiki/Job_lock
One more item .... there's actually a pilot Medicare program happening in Libby, MT and maybe eventually other Super Fund sites that we should be looking at..spnsored by Sen. Max Baucus (Mr. nay on Single Payer).
https://www.noridianmedicare.com/ard/docs/affordable_care_act_section_10323.pdf
Here's the web site enlisting people to sign up:
http://www.ssa.gov/libby/
I can tell you that the large national unions are just as corrupt at the top leadership circle
as the Democratic party is in it's top leadership circle.
More often than not, the rank and file have to go against their ''leadership'' in order
to effect real change.
I have both the Veterans medical care and the traditional medicare.
I prefer the traditional medicare, except that it is getting harder and harder to find doctors
who accept medicare.
The VA does it's best, but given the large numbers of veterans,
it is more like a factory health care system.
The unions continue to fail to lead as you pointed out. How do we get them to unite on this mission at least in rising up and demanding a single payer system? My blog certainly shows there are countless unions that support such a system. They must come out from the shadows and show some guts and muscle and lead as they did so many decades ago. But they are are rapidly diminishing breed under constant assault. Look at Wisconsin. Rank and file must press and also show some spine. If we lose unions we lose America's heart and soul. They must survive and rebuild. A fight worth having for all of our sakes.
Pleased your site in Pa. is on the single payer issue and out there. Keep building it.I see one of my post's is up there on health care. Thanks for cross posting.
Glad you agree that indeed single payer should be a bipartisan issue. Glad you pointed out that among those bankruptcies 75% were insured at the time a health care crisis struck. This isn't even an issue in countries that have national health programs.
The unions need leadership and to resurrect their labor roots on the streets with picket signs.Have they forgotten that during after World War 2 they lifted all boats and so gave birth to the middle class?
Actually it was not govt. who gave us the convoluted pricing. It was the AMA who created those 7800 code numbers for every health care service imaginable, I have long been a foe of fee for service which fosters theft, greed, inefficiency and more. Markets as a source for pricing is the problem. Health care should not be a market driven product. It fails time and time again yet we keep using the same failed system.
Major health care inovations and discoveries have come from the VA which has benefited countless numbers.
We see the failure of market driven health care every day. That paradigm has failed and we keep right on using it.
One of my earliest posts was on the failure of a fee for service system. Check it out in my archive. Over 2 years ago.
Consider the IMMEDIATE and measurable savings brought about by extending Medicare to all...
1. No sales force required of 50 health insurance companies...you just register on the Internet
2. No advertising expenses of 50 health insurance companies
3. No bloated managerial salaries of 50 health insurance companies
4. No attorneys in 50 health insurance companies
5. 1 Computer system not 50
6. 1 universal records system not 50
7. 1 coverage and rate structure not 50
8. Fewer claims adjusters
9. Not required to manage 50 health insurance stocks
10. 1 accounting structure not 50
11. Transparency & Portability everywhere
12. 50 HMO/PPO health care rationers are reduced to a single health care standard
13. The medicare structure is already in place and well-accepted
The supreme court may do us a favor. Let's make SinglePayer Medicare the law of the land.
1. Those who like their existing program should stick with it
2. I think there needs to be a single national standard so people don't move from state to state shopping their coverage...Cancer in Georgia should be treated the same in Florida IMHO
3. In terms of making health care universal, it is a cost of living in a great nation. "life...and the pursuit of happiness" starts where health care starts.
4. My fundamental point above, perhaps not made very well, is that the demographics of the world war II population bubble, can only be dealt with by stripping out the massive duplication of cost in the for profit system. Making health care a government program, like Medicare, which is already treating millions, is the only reasonable way of dealing with this population bubble.
5. I have personal experience with existing private market coverage that is both inefficient, heartless, and borderline brutal. I would give up my private coverage for Medicare in a second based on that experience.
6. The way to expand Medicare to make it more universal would be to progressively allocate the costs of the poor to the rest of the subscribers in a "buy-in". Those not buying in, however, should be required to stay with their private market coverage at 65 and beyond when they will discover the reality of dealing with the "for Profit" free market system.
Thanks for your thoughts.
I suspect waiting for heart surgery here for a month would not be considered overly long. In emergencies in Canada the patient is treated quickly. We do have a shortage of heart surgeons here and other high level specialists. But with the high cost of these procedures you can bet they are scheduled as rapidly as is possible with the need determining the treatment. The same for Canada. With more prudent use in Canada since doctors are salaried with no incentive to do excessive or perhaps unwarranted surgeries.
report a total waiting time of 19.0 weeks between referral from a
general practitioner and elective treatment in 2011—the longest total wait
time recorded since the Fraser Institute began measuring wait times in 1993.
Patients in Ontario experience the shortest wait (14.3 weeks) followed by
British Columbia (19.3 weeks), and Quebec (19.9 weeks)
Patients wait longest to undergo plastic surgery (41.6 weeks) and wait
least for medical oncology treatment (4.2 weeks)
After an appointment with a specialist, Canadians wait nearly 3 weeks
longer than what physicians believe is “reasonable” for elective treatment.
Throughout the provinces, in 2011 people are waiting for an estimated
941,321 procedures. Assuming that each person waits for only one
procedure, 2.8 percent of Canadians are waiting for treatment
Only 9.4 percent of patients are on waiting lists because they requested
a delay or postponement
As for the VA program, Oh please were not talking great healthcare here.
Just one small correction. The only pure single payer countries are UK, Canada and I believe Taiwan. The rest use a public- private system that is non profit. Canada used our Medicare system and is so named as its template.