Giving Single-Payer a Second Look
As President Obama prepares to address the nation about his vision for health care reform, we should not overlook the last, best truly transformative change to our health care system: Medicare. We have been staring so intently at the lessons of 1993 that we may have forgotten the universal rule of successful lawmaking: "keep it simple."
During the eleven town hall meetings I've held around my district, I've had some direct experience with the anxiety this debate has produced. Much of the fear comes from two groups: those who have Medicare and don't want it changed and those who have never had a government-run reimbursement system like Medicare and are worried about the impact it will have on their quality of care.
In both cases, a calm, reasoned and vigorous defense of the American single-payer plan is just what the doctor ordered.
The truth is that the United States already uses single-payer systems to cover over 47% of all medical bills through Medicare, Medicaid, the Veterans Administration, the Department of Defense and the Bureau of Indian Affairs.
Understanding that these single-payer health programs are already a major part of our overall health care system should help us visualize what an actual public plan would look like. These institutions also provide health care to millions of satisfied customers in every community who would heartily agree that the government can build and run programs that work quite well.
Medicare also provides us with a case study in the hypocrisy of our Republican friends who have built their party on a 44-year record of undermining this popular program. And now their Chairman sees no irony in ripping "government run" healthcare while publishing an op-ed opposing changes to Medicare.
If Medicare has been such a success, why not extend it? Why not have single-payer plans for 55 year olds? Why not have one for young citizens who just left their parents or college coverage?
So far, the answers we hear to these questions have simply not been very convincing.
At one town meeting the President responded that that he was worried about its "destructiveness."
Really? Americans would still go to the same doctor and the same neighborhood hospital. Sure, they would be able to delete the 1-800 number of their insurance company from their cell phones. And doctors would have to get rid of all those file cabinets full of paperwork while their assistants who spend time fighting with insurance companies would be able to actually speak to patients.
But everyone would adjust, I'm sure.
The real reason we haven't seen the Democratic Party embrace the obvious and simpler idea is that it boils down to pure beltway politics.
We've been reluctant to tackle the real inefficiency in the current system, namely, the very presence of the private insurance companies. Too many in Washington would rather stay friends with the insurance and drug companies when real reform probably can't be achieved in a way that makes these powerful institutions happy.
That's not to say we should vilify the industry. When they pocket up to 30% in profits and overhead (compared to 4% for Medicare) or when their executives take multimillion dollar salaries, insurance companies are doing what their shareholders want them to do.
But let's leave it to the Republicans to defend those actions. I, and most Democrats, should not join the chorus that sounds like we care more about insurance companies than taxpayers.
The same is true for Big Pharma. If Wal-Mart can pool its customers to be able to offer the $4 prescriptions, why shouldn't the federal government drive the same hard bargain on behalf of the tax payers so they too get the best prices under Medicare? I pose this exact question at every town hall meeting I attend and if my colleagues and the President did the same on Wednesday night, they would mix good policy with good politics. Instead we have watched a puzzling dance as policymakers have effectively limited the savings we would find in the enormous drug expenditures that are a fixture in our current system. Is it any wonder citizens are confused?
I have no delusions about the muscle needed to overcome resistance from the insurance and pharmaceutical industries. But I believe that for every American we may lose to a slash-and-burn TV ad funded by these businesses, we will gain five among those who are looking for a clear rationale for what we are trying to accomplish and an example for what it may look like.
We also achieve something else: realignment of the political universe. Democrats understand the role of government and are proud of our signature achievement: Medicare. The Republicans care most about big business.
I'll take that fight any day. And I'm hoping that the President will tell us on Wednesday that he is willing to do the same.
Anthony D. Weiner is a Democrat representing New York's 9th Congressional District.
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Rep. Weiner is becoming the most vocal champion for single payer health care in the house. He alone is responsible for recently growing the number of co-sponsors, and he even managed to get a guarantee from Waxman and Pelosi that HR676 will be brought to the house floor for a full debate and a vote. He's awesome!
This bill is an excellent alternative to the monstrous HR3200 (I challenge anyone to claim they know everything that's in HR3200, and all that it implies). It's only 3 pages long. Everyone should read it, before judging it.
With single payer health care, we can reduce the costs of our premiums, reduce the cost of health care and medicines, eliminate bankruptcy due to medical costs, and ensure that every American has health care. And do this for less than we spend on health care today. That leaves more money for other things that matter. More in our pockets, more for roads, schools, hospitals, and more actually going to our health care!
Answer these simple questions:
What does private for-profit health insurance do? What value do they bring exactly? What do they do exactly to "earn" the 30% they take off the top of our premiums and put into their pockets?
Medicare has a 4% overhead, and provides for all health needs efficiently and affordably. It just makes sense to extend Medicare to all Americans.
Rich investors in banking and medical industry say, "Don't regulate us... Trust us... We will control you... We will protect you... Without us you could hurt yourself."
Insanity for those rich and powerful, if we don't regulate them surely they will enslave us, on their operating tables and by their drugs destroy us.
single payer is the only civilized way. It is the only way to protect all Americans and it is the only way to have consistent data on people that are sick due to toxic exposure in our environment. Currently those sickened by toxic exposure like those in the article about water on HP today are disenfranchised from medical documentation of what has happened to them as soon as they are too sick to work. This is very convenient to polluters and one of the main reasons big oil is behind groups like Americans For Prosperity and Patients First. They have motive and NO ONE is talking about it. Kaiser Permente is Kaiser Coal, Steal, and Aluminum. Yes they are the same people and they are involved in hundreds of law suits for poisoning people. Why are these people demanding control of our medical system. Think about that for awhile and then check out the net. The proof of what I say is abundant and easily found. Start here. http://en.wikipedia.org/wiki/Henry_J._Kaiser
excuse me, the number is more like tens of thousands of law suits if not hundreds of thousands..
A tid bit from my neck of the woods.
http://www.theledger.com/article/20090321/news/903215038?Title=No-Answers-in-Toxic-Well-Suit
"Generations of people have been getting very ill, and now the cause is known
After the company filed for bankruptcy, Clyne said, "we learned that Kaiser has been polluting the area for decades, which accounts for a high rate of cancer among Fuller Heights residents."
For profit health insurance is immoral. The only way to maximize profits, and that's what Wall Street demands, is to raise premiums and deductibles and deny claims. As a result HUMAN BEINGS DIE. The insurance companies are the death panels we already have. The top 20 health insurance and drug executives earned $285 million in 2008. JUST TWENTY PEOPLE!
PER HOUR PAY FOR DRUG AND HEALTH INSURANCE EXECUTIVES:
Miles White - Abbott - $17,395
Fred Hassan - Schering- Plough - $15,677
Bill Weldon - Johnson & Johnson - $13,022
Ron Williams - Aetna - $12,656
H. Edward Hanway - CIGNA - $6,373
Angela Braly - WellPoint - $5,127
For American's to continue spending billions and billions of dollars a year for obscene salaries, bonuses, perks and profits is unconscionable. Single payer is the only answer to our health care crisis.
And surely a fake morality, as making a profit off the misery of the sick would corrupt the most honest man on earth.
There is absolutely no excuse for expecting Americans to accept this. NONE. Do not let people tell you that we have to accept this or that because some dirt bag like Baucus has decided.. Stand up like men and women. WE are not children and we are not going to do as we are told when we are being asked to die and suffer for an egregiously callous group of people to be rich.
Those rich and powerful, if we don't regulate them surely they will enslave us, on their operating tables and by their drugs destroy us.
Capitalist Republic -- Can it compete with social democracy?
In just six years Venezuela has reduced poverty by 30%, reduced inflation from 14.7% down to 7.3% and created a national healthcare system that is free to all. And surely not because Hugo Chávez is the dictator of it, as the majority pushed him into it. For when the CIA tried to kill Chávez in the coup of 2002, it was the outraged millions that stormed the palace who saved his skin and restored him to office.
Whereas our capitalist Republic, even with half the wealth on earth, is doing all it can to keep 25% of us in total poverty. And doing its best to block any regulation that would reduce profits in their capitalist medical industry.
Of course single payer is the only way to go. But the health care profiteers will never let anything like that happen. We are not even going to get a public option. Instead, the bottom half and eventually the bottom two thirds of Americans are going to be stripped to the bone to try and get their families basic health care. The raping of Americans by the health care profiteers exposes the fraud and destruction of unregulated capitalism.
Rep. Weiner, thank you so much for your determination and for keeping this debate truthful and on point.
Our multinationals have used their Empire USA to plunder half the wealth on planet earth, and why they want to run the risk of a rebellion by denying us good healthcare, this I cannot figure out.
Yes a 2.3 trillion yearly gross from capitalist medicine is temptation irresistible, but surely they must remember what happened to the nobility during the French Revolution.
With a Democratic majority in the House of Representatives, we may be able to win a Single-payer vote and not know it. Let's put a simple question in advance of a vote to each representative. "If you thought a Single-payer vote could pass, would you vote for it?"
OHHHHHHH Forbidden talk.
We want HR 676, improved Medicare for all, or a strong open-enrollment public option that can lead to it by patients voting with their feet.
Nothing else is acceptable.
Obama must fight for a real public option at minimum.
If the Centrists obstruct, we must purge them from the party.
Ah, please, at least READ HR676 before shilling for it (it's only 50 pages, fer gawd's sake). HR676's provisions dictating Government determined salaries for health care professionals, forbidding health care professionals to accept payment for services EXCEPT form Government till, and forbidding private insurers to offer duplicate health insurance coverage to that offered by Government go WAY beyond simple "single payer" options, and all the way to a National Health System more reminiscent of Cuba or the old USSR than even what the Brit's employ! I'm in favor of single payer, but HR676 goes WAY too far!
Under Medicare for All, would Medicare coverage then be extended to cover 100% of all medical expenses, instead of the 80% it currently covers?
Just a question.
http://emiliawahoo76.blogspot.com
http://myspace.com/virginiadem
"dictating Government determined salaries for health care professionals,"
This is incorrect. HR676 only requires that health service providers be non-profit. The profits do not go to doctors but to investors who own hospitals and health care facilities. Usually these are banks and private investors who have no relation to the medical field. Doctors' salaries are not regulated by HR676. Non-profit organizations can pay higher salaries than for-profit ones.
On the other hand I don't support HR676 in its current form. It's too restrictive but the best thing about it is that it's clear and unambiguous - the way every legislation should be. It can be used as a start and it can be significantly relaxed and improved.
Healthcare must operate in the same environment that our fire and police services do. Everyone shares in the expense of those services and those services are provided to all at cost. We never hear anyone complaining about the service that the fire department or the police department provides because they contribute a very valuable service that protects lives and keeps our society functioning, healthcare should be no different. We are already paying for healthcare for all, the only difference is we aren't receiving it due to the 30 to 35% premium we all pay for advertising, marketing, salaries, bonuses, and profit associated with the Health insurance and Pharma for-profit industries.
The Senate just recently passed legislation under the cover of darkness that granted big pharma an extention on the patent term for several classes of drugs to 12 years. That means an extention of the highest prices and enormous profits associated with those drugs before they can be marketed by generic drug makers. A strange version of free market capitalism in this country that is subsidised by society, it certainly isn't free for the taxpayers !
I participated in Rep. Dennis Kucinich's (D,OH) conference call last Thursday night concerning the current state of the healthcare debate in Congress.
Rep. Kucinich basically said that Single Payer is dead and that his amendment to allow individual states to adopt Single Payer healthcare programs is our best chance to achieve a Single Payer system over the long term. This is how Canada eventually got their national healthcare system. He did mention that Rep. Weiner's (D,NY) Single Payer vote, promised by House Leader Pelosi, should be canceled. He thinks that this is a ploy to discredit Single Payer by handing Rep. Weiner a disappointing loss in the public/political forum of Congress.
Rep. Kucinich also said that it appears that the Public Option is also dead, a view that has been expressed by many in Washington.
One thing he did say that was very disturbing is that, "whatever is passed for healthcare legislation, it would be four years before it was even implemented". When you consider that 20,000 Americans die each year due to lack of access to any healthcare, that means that 80,000 more Americans will die before any new healthcare legislation is put into service, a national disgrace !
Not to mention that during the four years of unfettered insurance company greed, almost 25 million more people will be uninsured.
And nobody knows how many people are going to die during the coming flu season because of a delayed flu vaccine and a scaled back, cost reduced, healthcare system that will not be able to handle the massive influx of patients. The government's response, "Wash your hands" while we bailout the billionaires !
Rep. Weiner, thank you for speaking out about what is needed for health care reform, honestly, loudly and clearly. You are MY voice, and I appreciate your efforts.
Is there any way I could convince you to move to Ohio?
Congratulations, congressman. I loved your youtube video where you "double-dared" the Republicans to vote against Medicare. Indeed, this is the issue. I would understand and not complain if health care was entirely private. The current system (and the Baucus-Obama bill) separates the high-risk groups from the low-risk groups. There is no risk spreading and the whole purpose of insurance is defeated.
The elderly (Medicare) and poor (Baucus-Obama bill) are given to the government to pay for - of course this is a bankrupt-on-arrival proposition. The high-profit groups like the young and the working middle class are given to the insurance industry to fatten their profits. This is robbery, plain and simple. Also more insurance options means more insurers - that leads to less risk spreading, more overhead, higher prices and lower quality. So "an Exchange" can only lower the affordability and quality of health care.
There are only two alternatives, single-payer or a fully private insurance. Anything in-between is a daylight robbery and an insult to common sense. Once people understand this we can ask what they prefer.
Speak the truth and it shall set US free; also one politician should consider running for 2012.
I will support this representative for as long as he wants to run on this topic. God Bless You.
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