WASHINGTON, DC - December 17 --
DAVID HIMMELSTEIN
STEFFIE WOOLHANDLER
Himmelstein and Woolhandler are professors of medicine at Harvard University and the co-founders of Physicians for a National Health Program. They just had an oped in the New York Times in which they write: "In 1971, President Nixon sought to forestall single-payer national health insurance by proposing an alternative. He wanted to combine a mandate, which would require that employers cover their workers, with a Medicaid-like program for poor families, which all Americans would be able to join by paying sliding-scale premiums based on their income.

"Nixon's plan, though never passed, refuses to stay dead. Now Hillary Clinton, John Edwards and Barack Obama all propose Nixon-like reforms. Their plans resemble measures that were passed and then failed in several states over the past two decades."

The piece examines the promises and disappointments of the "mandate model" as versions of it have been instituted in Massachusetts, Oregon, Minnesota, Tennessee, Vermont and Washington State.

The piece concludes: "The 'mandate model' for reform rests on impeccable political logic: avoid challenging insurance firms' stranglehold on health care. But it is economic nonsense. The reliance on private insurers makes universal coverage unaffordable.

"With the exception of Dennis Kucinich, the Democratic presidential hopefuls sidestep an inconvenient truth: only a single-payer system of national health care can save what we estimate is the $350 billion wasted annually on medical bureaucracy and redirect those funds to expanded coverage. Mrs. Clinton, Mr. Edwards and Mr. Obama tout cost savings through computerization and improved care management, but Congressional Budget Office studies have found no evidence for these claims.

"In 1971, New Brunswick became the last Canadian province to institute that nation's single-payer plan. Back then, the relative merits of single-payer versus Nixon's mandate were debatable. Almost four decades later, the debate should be over. How sad that the leading Democrats are still kicking around Nixon’s discredited ideas for health reform."
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