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Put Single-Payer on the Table
A study just released by Fairness and Accuracy in Reporting, a media watchdog group, found that in the week before Obama's health-care summit, of the hundreds of stories that appeared in major newspapers and on the networks, "only five included the views of advocates of single-payer-none of which appeared on television." Most opinion columns that mentioned single-payer were written by opponents.
Congress is considering H.R. 676, "Expanded and Improved Medicare for All," sponsored by John Conyers, D-Mich., with 64 co-sponsors. Yet even when Rep. Conyers directly asked Obama at a Congressional Black Caucus meeting if he could attend the White House health-care summit, he was not immediately invited. Nor was any other advocate for single-payer health care.
Conyers had asked to bring Dr. Marcia Angell, the first woman editor in chief of The New England Journal of Medicine, the most prestigious medical journal in the country, and Dr. Quentin Young. Young is perhaps the most well-known single-payer advocate in America. He was Martin Luther King Jr.'s doctor when King lived in Chicago. "My 15-minute house calls would stretch into three hours," he told me.
But he came to know Barack Obama even better. Though his medical partner was Obama's doctor, Young was his neighbor, friend and ally for decades. "Obama supported single-payer, gave speeches for it," he said.
This past weekend, hundreds turned out to honor the 85-year-old Young, including the Illinois governor and three members of Congress, but the White House's response to Conyers' request that Young be included in the summit? A resounding no. Perhaps because Obama personally knows how persuasive and committed Young is.
After much outcry, Conyers was invited. Activist groups like Physicians for a National Health Program (pnhp.org) expressed outrage that no other single-payer advocate was to be among the 120 people at the summit. Finally, the White House relented and invited Dr. Oliver Fein, president of PNHP. Two people out of 120.
Locked out of the debate, silenced by the media, single-payer advocates are taking action. Russell Mokhiber, who writes and edits the Corporate Crime Reporter, has decided that the time has come to directly confront the problem of our broken health-care system. He's going to the national meeting of the American Health Insurance Plans and is joining others in burning their health-insurance bills outside in protest. Mokhiber told me, "The insurance companies have no place in the health care of American people. How are we going to beat these people? We have to start the direct confrontation." Launching a new organization, Single Payer Action (singlepayeraction.org), Mokhiber and others promise to take the issue to the insurance industry executives, the lobbyists and the members of Congress directly, in Washington, D.C., and their home district offices.
Critical mass is building behind a single-payer system. From Nobel Laureate in Economics Joseph Stiglitz, who told me, "I've reluctantly come to the view that it's the only alternative," to health-care providers themselves, who witness and endure the system's failure firsthand. Geri Jenkins of the newly formed, 150,000-nurses-strong United American Nurses-National Nurses Organizing Committee (nnoc.net) said: "It is the only health-care-reform proposal that can work. ... We are currently pushing to have a genuine, honest policy debate, because we'll win ... the health insurers will collapse under the weight of their own irrelevance."
Dr. Young has now been invited to a Senate meeting along with the "usual suspects": health-insurance providers, Big Pharma and health-care-reform advocates. I asked Young what he thought of the refrain coming from the White House, as well as from the leading senator on the issue, Max Baucus, that "single-payer is off the table." "It's repulsive," sighed Young. "We are very angry." But not discouraged. I asked him what he thought about Burn Your Health Insurance Bill Day. "Things are heating up." he chuckled. "When things are happening that you have nothing to do with, you know it's a movement."
Denis Moynihan contributed research to this column.
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135 Comments so far
Show AllWe must remember that Obama distinctly told us that we must "make him" do the will of the people. Now's the time to make your voice heard. Peaceful rallies, letters, news worthy events,... let's be creative and make our president bring America the health care we all need and want.
He invited us to activism with his "Make Me..."
We don't have to be enemies of the status quo or see enemies behind every corner to get involved - we just need to stand on every corner and declare that NOW is the time for an American Single_Payer Health Care System.
Live Simply So That Others May Simply Live
You're confusing Obama with FDR, who did say to progressives at the beginning of his administration, "I agree with you. Now go out and make me do it." Obama never said this. He may have vaguely implied something of the sort, as he always does, being a master of the vague and empty promise, but he never actually told any progressive groups to make him do anything. Least of all single-payer advocates.
If he didn't even want Dr. Young at the table, he's sending a very clear message that he won't even consider single-payer, regardless of his support for it when he was an Illinois senator. He was also opposed to the Iraq war as a state senator but immediately changed his mind once he was elected to the national senate, when he saw clearly which way the political winds were blowing.
Obama has a sharp eye and ear for where the real power is, so he caved immediately to the demands of the big health insurers and Big Pharma, turning his back on what the people want, single-payer. He's an opportunistic politician, not a champion of the people, contrary to the wistful myth built around him for the past two years. He won't permit populist healthcare advocates to tamper with corporate domination of the whole dysfunctional medical delivery system. Not unless a large enough movement is able to really make him do it, and we haven't seen a big, well-coordinated movement like that in this country for longer than any of us can remember.
If there is one issue that college students should be protesting en masse, it is the employer-based medical insurance system that is unique to the US. That system is reducing their opportunities for post graduate employment.
I and millions of other 55-64 year olds are prepared to retire tomorrow and turn our family wage jobs over to twenty and thritysomethings...mostly jobs that require a degree. While a few government agencies and companies provide free or affordable retiree medical insurance, the ONLY thing that is keeping most of us from retiring is the fact that our employer either provides retirees insurance at an exhorbitant cost that keeps increasing, or doesn't provide it and we have to buy it at exhorbitant cost on the open market.
When the 2012 election rolls around will those young people who voted for Obama in 2008 vote for him again if they are unemployed because so few 55-64 year olds are able to retire and vacate the family wage jobs ?
Bill Walz
Yes. do this.
Further proof that Barack Obama is nothing more than another corporate shill, posing as president..
Sometimes I can tell the future. Like if I don't have my teeth cleaned I will lose them. And I know that if these money grubbing shit eating insurance lobbies get a toe under the tent they will wind up writing the insurance plan for the nation just like they have for the last eight years, and just as sure as they do this economy will find out what it means to hit bottom.
I'm only sorry for the misery it will cause. This economy deserves to fail. No special interest will let go of their gold to prevent the ship from sinking. Karma is a bitch.
This country was founded by rich white men, built on the backs of slaves and destitute immigrants, and wage slaves, and exists only for money and power for the rich.
"History is a remorseless creditor. Eventually it demands that all accounts be settled in full, sometimes in a currency harder than anyone could have imagined."
You people are wondering why Obama is not putting single payer on the table?
Take some Valium and take a look at this shit:
http://spectator.org/archives/2009/03/11/ostracized-by-obama/
Take a look at the related articles at the bottom, too, if you dare.
Now multiply it by several million.
So now I am confused. The article above, and most news reports note the refusal of Obama to consider a single payer option:
"Congress is considering H.R. 676, "Expanded and Improved Medicare for All," sponsored by John Conyers, D-Mich., with 64 co-sponsors. Yet even when Rep. Conyers directly asked Obama at a Congressional Black Caucus meeting if he could attend the White House health-care summit, he was not immediately invited. Nor was any other advocate for single-payer health care."
Yet the link you provide suggests exactly the opposite:
"President Obama has used events such as community discussion groups and last week's summit to foster the impression that he is soliciting opinions from all angles of the health care debate, but the reality is a lot different. Obscured by the Administration's theatrics is the fact that it has kept at bay those who advocate free-market solutions rather than government-run health care.
The guest list to the summit was a telling sign. Despite having representatives from 169 different labor, industry, and policy organizations, the White House did not invite any organizations that advocate a consumer-based free-market approach to health care."
This seems a dichotomy and one of these reports is simply wrong. As the Spectator is a magazine for young conservatives, and as the conservative movement in America has been usurped, not by conservatives but by fanaticism...Me Im going with Conyers on this one.
It caught my attention too, that conservatives not only have their own opinions, but they also have their own "facts", which is really puzzling. After reading that article, one is really left with the impression that we are one step away from "socialized medicine":
". . . there's no way the Obama administration is going to pursue free-market health-care reform. On the other hand, it's a bit of play acting to say they're reaching out and open to all ideas and that sort of thing. They're not."
The last sentence however, could have just as well come from a progressive. The truth is probably somewhere in the middle and, sadly, both camps are probably living in their own bubble. And yes, I'm afraid most people here won't like to hear it, but I think that progressives live in a bubble too, and we seriously overstate the support for single payer by the general public.
The general public would most definitely support it, if people took time to really get all the information and carefully considered the facts, but when was the last time that happened in regards to any issue? In reality, the insurance industry and some brain-dead conservatives will put all their resources into convincing people that it's bad for them, as their "freedom" and "choice" are being taken away. They are already doing it, as evidenced by the garbage in the Spectator, even while progressives claim that the single payer option is not on the table. Can you imagine all the distortions, screams and fear-mongering if it was the only option?
I think the best Obama can do right now is to introduce single payer, but make it optional. Like he says - if you like what you have, there is no need to change it. Eventually, there is no way the insurance industry will be able to compete with the government, unless, of course, the system is seriously underfunded.
I believe that the overriding purpose of any information from the right has the intention of defaming the Democrats, Obama in particular, and regaining power as rapidly as possible.They will probably succeed to some extent in the 2010 elections too....
I agree that it is impossible for the general public to make intelligent choices when they are exposed to a steady stream of propaganda designed to keep them malleable little consumers. Nevertheless, the progressive stance on single payer is the correct one, bubble or no bubble.
The real pity is that there is no powerful and public voice for the progressive agenda available to combat the steady stream of crap that becomes fact to the public through sheer repetition. Just look at some of that stuff being repeated here.
Healthcare: Offer Americans a Choice
Where private health insurers only focus on the bottom line, Medicare is instead concerned about the health care of its members. And to supply better health care for less cost is a very worthy goal.
Private, for-profit, insurers spend more than 15 percent of collected premiums on administrative costs, where Medicare’s are only about 2 percent. And a universal Medicare system would not need to spend money on advertising or marketing
For-profit insurers are fighting the idea of Medicare for all, not in calling it “unfair, but in attacking it as “socialism.” Another tremendous advantage, economically, in providing a Medicare program available to all, would be its benefit to businesses, large and small, by removing the cost of health coverage from the shoulders of employers. Small business companies are having to abandon offering it to their employees. Many big businesses are in trouble, General Motors for instance, has a deficit of over $50 billion in its health care fund, and is considering cutting coverage to its white collar employees in an attempt to forstall bankruptcy.
Nicholas Kristof wrote that “American businesses are at a competitive disadvantage when they have to pay for health care and foreign companies don’t
Today’s conservatives are attempting to rewrite the history of the thirties, some saying that FDR’s New Deal had nothing to do with bringing the country out of the depression, that it really was World War II.
They all were agreed that the President’s spending money on all the New Deal attempts to get us out was the wrong approach, just as they are saying today.
Relief, they claimed, could only be brought about by giving tax cuts to the wealthy and allowing laissez faire to reign.
Actually, the depression began long before FDR became president, and his attempts to reverse it by pumping millions of dollars into programs like the WPA and CCC in order to get people working again began to take effect, but very slowly.
By 1937 there was significant progress, and the government then convinced the President to stop spending more money that it didn’t have. As a result the country dropped back into recession and WWII war production finally brought the nation back up out of its financial problems.
President Obama’s plan is to maintain for-profit healthcare’s status quo, asking only that it be tweaked a little. He is now being repeatedly accused ofpromoting “European-style socialism,” even though he appears to have succumbed to conservative dictates in regards to healthcare.
Charles Geisst, financial historian of Manhattan College wrote, “The right would use ‘socialist’ against Franklin Roosevelt all the time in the 1930s. To hear him referred to as Comrade Roosevelt during that period was not unusual.”
On Thursday, March 5, President Obama called for a White House forum on health care in order, he said, to give voice to all… “Every voice has to be heard. Every idea must be considered… The status quo is the one option that is not on the table.”
Bold words. But a look at some of those invited and allowed to speak duringthe smaller White House sessions were PhARMA, Pfizer, AHIP and others dedicated to stop any deviation from the status quo.
There appears to be much confusion between what the President is promoting as a public/private policy and a truly public Medicare for all. Senator Kennedy has signed on to Obama’s plan, while Senators Kucinich and Conyers are promoting the latter.
One big difference between Obama’s attempts and Roosevelt’s is the 24/7 media coverage that didn’t exist during the 1930s. There was probably just as many Republican attacks then as now but they did not receive blanket news coverage as today. President Roosevelt’s fire-side chats encouraged the public to believe they could eventually survive the depression. There is little similar encouragement today.
ThePresident’s plan would be similar to Massachusetts’.
Larry Pius, Director of HR 676.org wrote to me that the “new and expanded Medicare under HR 676 is NOT government run health care…” Confusing. And to add to the confusion there is another program called Medicare Advantage, where private insurance companies have invaded Medicare.
My vision of an expanded Medicare would be totally government run as it presently is, and I see it competing with private, for-profit, health insurance, so that the American public would have a choice.
“They [the conservatives] attacked Roosevelt as a socialist,” writes Harold Meyerson, “as they are now attacking Obama, when in fact Obama, like Roosevelt before him, is engaged not in creating socialism but in rebooting a crashed capitalist system.”
We will never stop the rising health care costs until we get over our irrational fear of being disparagingly called socialists and inaugurate a truly Medicare-for-all.
Excellent summary of the situation. You've nailed it, Whitman.
"For-profit insurers are fighting the idea of Medicare for all, not in calling it “unfair, but in attacking it as “socialism.”
There are a lot of Americans that think that socialism is unfair and unjust.
"President Obama’s plan is to maintain for-profit healthcare’s status quo, asking only that it be tweaked a little. He is now being repeatedly accused ofpromoting “European-style socialism,” even though he appears to have succumbed to conservative dictates in regards to healthcare."
He would be breaking a campaign promise if he installed a single-payer system. He was very clear in differentiating his plan from Hillary's saying that he didn't think people needed to be forced to buy healthcare.
"My vision of an expanded Medicare would be totally government run as it presently is, and I see it competing with private, for-profit, health insurance, so that the American public would have a choice."
It is a little tough to compete when you can't force the public to partially subsidize you. If Medicare had no money coming in from taxpayers, then your plan would be great. The problem then is that only the sickest least insurable people would join and Medicare wouldn't be able to compete.
“They [the conservatives] attacked Roosevelt as a socialist,” writes Harold Meyerson, “as they are now attacking Obama, when in fact Obama, like Roosevelt before him, is engaged NOT IN CREATING SOCIALISM but in rebooting a crashed capitalist system.”
Single payer healthcare is socialized healthcare. If Obama creats single payer health care Obama is creating socialism.
This right wing myth is among the saddest and least believable in a very long list. When you believe govt run health care to be "socialist" you simply accuse most industrialized nations of supporting socialism, which of course they mostly do not. The USA ranks 37th in the world in providing health care to its citizenry, barely two places above Cuba, yet spends over 2.5 times as much as any nation on health care. All your rants about scary socialism pales before this single fact.
The fact is that private for profit health care has had its chance, has let this nation down and is due for a boot in the ass. When we as a antion are 13th in infant mortality rates I think your empty accusations fall flat on its face.
"The USA ranks 37th in the world in providing health care to its citizenry, barely two places above Cuba, yet spends over 2.5 times as much as any nation on health care."
Well, if it is good for the whole then individual rights don't matter right? The end justifies the means? You said above that paying for single-payer is optional. I already commented above that I am okay with the government creating a pool that is voluntary and NOT subsidized by taxes(which aren't voluntary). If that is so, then it will be different then all of the countries whose health care you are comparing to ours. I don't share the pack mentality that the total wealth of all individuals in a given country is the property of the country as a whole to do what the collective will desires. If such a society was created with voluntary association, then that would be great. That is a crucial difference--you as an individual get to choose whether or not to take part in such a collective, no private property society.
"When we as a antion are 13th in infant mortality rates I think your empty accusations fall flat on its face."
I am not arguing about the efficacy of single payer when viewed as a societal average, I am arguing about the morality of coerced participation.
By the way, socialism mean that the workers own the means of production. The government is owned by the people. If the government runs healthcare, that is socialism. This is true in many industrialized nations.
I believe your position to be radical and simply wrong. You spend so much time fearing some imagined coercion into a health care system that debate is simply impossible. You are going to see single payer health care in America, whether in five years or fifty years it will come. It simply works everywhere else and our system works not well at all, we cannot afford it any longer.
You are also equally wrong about single payer health care being socialism, and besides, there is nothing wrong with an amalgam of controlled capitalism and socialism where applicable. Sweden seems rather comfortable with that scenario. I advise you top read up on the subject, your great grandkids will be living with it.
"I believe your position to be radical and simply wrong."
Okay, why is it wrong? Why is it justified to force participation at a rate dictated by income? Radical by what standards? Most people would say that being taxed to fund a state church is unethical, even if most wanted it. Are they radical too? Is Chomsky a radical right winger too? Because he doesn't believe in forcing people to participate in organized society(or any aspect thereof). I think that there are positive and negative externalities that justify many taxes, but I cant see the justification for FORCING a health plan on every individual, just because the majority wants it.
"Single-payer is the system that removes private insurance companies from the picture; the government pays all the bills, but health-care delivery remains private. People still get their choice of what doctor to go to and what hospital to use. Single-payer reduces the administrative costs and removes the profit that insurance companies add to health-care delivery."
Why doesn't everybody who wants single payer form a cooperative health insurance pool? It should have all of the benefits listed above for single payer. It would actually be better than single payer because participation would be VOLUNTARY. We all know that is what makes it impossible. What makes single payer work is that the wealthier citizens end up subsidizing the health care of the poorer. There are plenty of wealthy democrats out there though. Maybe they would be willing to voluntarily join such a pool and have their payment rate dictated by their assets and their income.
Those opposed to single-payer are right to call it socialism. It absolutely is socialism. However, it doesn't need to be mandatory state-socialism that limits the freedom of individuals. If peoples owned health care is truly better, it should win out without a mandate requiring everyone to take part--at a rate dictated by their income rather than their health(a flat rate seems better than either).
Until Americans understand that the fascism (private insurance/drug cartel) to which they are being subjected is far worse than socialism, the fascists will continue to control the debate.
I agree with what you are saying. The question is then, "how do we fix this?" It seems to me that we are acting in the spirit of Lenin("the people are too stupid--they can only develop a consumer consciousness") if we force people against their will to join the one big giant health care pool and say that the end will justify the means (coerced participation). It would be better to lead by example. As I said before though, it is difficult when you can't charge people in proportion to their wealth.
RDC, I would suggest adding government to your fascist definition. Perfect example: HMOs, created by Nixon & Congress in the 1973 Health Maintenance Organization Act. Now we are to believe that the government will again be the solution? To the problems it creates?
TX Progressive,
I agree with you. Participation in the single payer health-care system should be totally voluntary. If you want to continue paying $12K + deductible + co-payments to for-profit insurance companies and go bankrupt anyway if you get sick, you should be free to do it. You should even be entitled to a $3K tax deduction.
And you know what? When you get tired of it, discover that it doesn't make sense to pay 4 times more than everybody else IN PREMIUMS ONLY, and finally decide to join, you'll be welcome.
If that is the case, that sounds great and also sounds like what I advocated. I was being serious, even if it may have sounded sarcastic. I think it would be great for the government to do the bureaucratic work of organizing a health-care pool and if it is truly more efficient than what the market can offer, then fantastic. I question how that will work when all of the sickest high risk people will join the government pool at the same rate that the healthy people pay. It just seems to me that the market could offer the healthy guy something better for that money since they are excluding high risk folks. Using your numbers, it just doesn't seem right that the government can offer the same services for $3K (you meant that the govt gives you 3K back, NOT a 3K deduction which would translate into roughly $400 extra on a tax return) that the market charges 12K for. If so, great!
If you read all my posts, I don't ever make claims about the efficacy of single-payer, rather I only have problems with taxes(which are not voluntary) subsidizing such a program. It sounds like we are on the same page.
Perhaps I am just completely ignorant on how health care works in other countries, but isn't it true that health care is paid for through taxation in Canada, England, France, etc.? If so, are there any that are just voluntary and not partially subsidized by tax dollars?
“I question how that will work when all of the sickest high risk people will join the government pool at the same rate that the healthy people pay.” If you knew that a couple years from now you will get cancer, a heart attack, and MS, your wife/ husband will get diabetes, and your kid will get leukemia, all at the same time, would you still question it? You might be a “healthy guy” today, but that might not be the case tomorrow.
What you are also overlooking is that you already subsidize health-care for the “sickest high risk people” through programs such as Public Aid, as well as for a large segment of the population working for the federal, state, and local government.
The whole idea of ANY insurance is that you pay a relatively small amount of money, so that you don’t have to be on your own and lose everything when you are out of luck.
The government has an advantage, because of its size. Any time risk is spread between 300 million people, it is more cost effective than when it is spread between 300 hundred people. Under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all health care costs, including vision and dental care.
As for your questions - why don’t you find out how health care works in other countries.? You know how to use Google, don’t you?
"If you knew that a couple years from now you will get cancer, a heart attack, and MS, your wife/ husband will get diabetes, and your kid will get leukemia, all at the same time, would you still question it? You might be a “healthy guy” today, but that might not be the case tomorrow."
See my argument just above about uncertainty and risk. But more to the point, I was making an economic argument, saying that many people will only join the single-payer pool once they are screwed. Now that I think about it, it is similar to the government having to buy all of the banks toxic assets. The single-payer pool might end up just paying for sick people who don't start paying in until they are sick. I personally would volunteer to enter a single payer pool(healthy or not), I am just not sure everyone else would and that was my point.
"What you are also overlooking is that you already subsidize health-care for the “sickest high risk people” through programs such as Public Aid, as well as for a large segment of the population working for the federal, state, and local government."
The government workers health care isn't subsidized any more than any other part of their wage compensation is. Suppose we the people need x secretaries to work at the state capital. Then we, through the government need to compete with other businesses who want to hire secretaries. It may be in our fiscal interest to offer lower wage but better health benefits(since we have such a large pool). So in summary, government health care can't be looked at any differently than any other wages that are paid to govt. employees. It isn't the same as forcing the whole country to join a common health care plan.
You know what subsidize means, don't you?
If the government hires a secretary, the government pays her/his wages, and the cost of her/his health insurance. The money comes from taxes collected from . . . yes, you.
"I was making an economic argument, saying that many people will only join the single-payer pool once they are screwed." Fortunately, not everybody has your mentality.
"Fortunately, not everybody has your mentality."
Are you kidding me? I said in the post that I would personally sign up and I was making an argument for why that might not be the case for everyone. I might say the same about you since you clearly have no problem taking extorting money away from citizens using the voting booth.
"You know what subsidize means, don't you?"
In the case of the secretary, My tax dollars are going to compensate his/her for the public service he/she provided. So health benefits are part of wage compensation, they weren't free for being born on American soil. This is very different than subsidizing the health care of somebody because they are a citizen of the same country as me.
I see. So you are just arguing "hypothetically". Makes sense.
"The government has an advantage, because of its size. Any time risk is spread between 300 million people, it is more cost effective than when it is spread between 300 hundred people. Under H.R. 676, a family of four making the median family income of $56,200 per year would pay about $2,700 for all health care costs, including vision and dental care."
That is absolutely right, but the relationship between efficiency and number of people in the pool is not linear. In steady state you need more money coming in each month from the entire pool than is going out(on average) due to the fraction that is sick. In addition, at any given time, there are fluctuations about the average rate of output. The size of those flucuations (relative to the size of the average output number) determines the size of the buffer you need(extra money coming in). These fluctuations scale as 1 divided by the square root of the number of people in the pool. So if you have only 100 people in the pool, the expected fluctuation size is much larger than if you have 1000(1/100 vs 1/1000). However, once the number is really large(say 1 million), there is only a marginal change in the size of the fluctuation. This means you need only a marginally smaller buffer amount of cash in the pool. It is insignificant compared to other factors. If you were talking 30 people vs. 1 million, then the larger pool would make a huge deal. But 1 million vs. 300 million is a much smaller gain.
"You know how to use Google, don’t you?" Yes, and from what I have found, all of the countries that people compare to the US have the health care paid for by taxes.
TX Progressive says: "What makes single payer work is that the wealthier citizens end up subsidizing the health care of the poorer."
I'm afraid you are mistaken here. What makes it work is the healthy subsidizing the sick, and it could be my turn today and yours tomorrow. The poor being taken care of is just a fringe benefit.
"I'm afraid you are mistaken here. What makes it work is the healthy subsidizing the sick"
yes, but health insurance companies and voluntary non-profit health care pools take advantage of this fact as well. When I say "what makes single payer work" I mean work better than the other available options.
What makes single payer work better is, among other things, that you don't have to go bankrupt if you get sick. Nobody will deny you health-care, there are no pre-existing conditions, waiting periods, exclusions, pre-approvals, etc. Try to get an insurance now if you had a heart attack or cancer. Perhaps none of this applies to you, but are you sure it never will?
Insurance companies are businesses and they need to be profitable. The best way for them to do it, is to accept your money, and limit their own expenses, i.e. your benefits.
What makes single payer work better is that you are not married to your job - can't quit, because you'd lose your insurance and you won't get it anywhere else, because of a pre-existing condition.
What makes single payer work better is that it allows businesses to be more competitive with their foreign counterparts that don't have to add the cost of health insurance to their product.
Final point - it's cheaper, as it eliminates profit.
This list is by no means comprehensive. There is an excellent article on universal health-care in Newsweek. It's a little old, but still pertinent. Here is the link:
http://www.newsweek.com/id/32858
"Insurance companies are businesses and they need to be profitable. The best way for them to do it, is to accept your money, and limit their own expenses, i.e. your benefits."
To be profitable, they also need to be competitive. If someone else (an actuary say) can find a way to offer you more benefits for the dollar, then they will do it. If they have 1,000,000 customers and on average, 10 cents per month goes to profit from each customer, then they are doing well. If they are making huge profits, then other investors will enter the market and compete. Also, you mention "limit their own expenses". I would say that the free market would be more dynamic, in general, than government in this regard.
"Try to get an insurance now if you had a heart attack or cancer. Perhaps none of this applies to you, but are you sure it never will?"
I am not sure. But that is my business and my problem, not yours(you being a generic fellow citizen). You can't really call people free if they aren't free to take risks. If the government FORCES me to pay for health care safety net, then I am not free to take risks with my money. I may want to spend all of my money on lotto tickets and booze--or I might buy every type of insurance available so that even if a volcano erupts, I am not in trouble. That is my decision.
And finally, I am not arguing against voluntary single payer. I am arguing against tax subsidized single-payer which you are against as well right?
Wow. It looks like you really like the current system.
I am not against tax-subsidized single payer health-care, but I agree that you should be able to opt out. No use dragging anybody in screaming. Don't want it - stay out. However, can you give us an example of a country which reverted to an insurance-based system from a single-payer one? The reason why I say you should be able to opt out, is that I am confident that, eventually, you won't want to.
"Wow. It looks like you really like the current system."
Our system is clearly very inefficient and everyone knows that. The harder question is "what is the proper solution?" and I really hope Obama comes up with a good plan. I don't know exactly how much of a factor malpractice lawsuits are, but that has to weigh in. You also have to consider the fact that the American Medical Association enforces strict limits on how many doctors a given AMA certified school is allowed to accept. This has the effect of limiting the number of manpower hours available and thus raising prices.
I don't think that taxpayer funded health care is a moral solution because health care is not a justified tax. If everyone's taxes increased by the exact same amount to pay for the system and you could be fully reimbursed by that amount if you wanted to opt out of it, then that would be great. However, there are a lot of people who don't even pay taxes, so I am pretty confident that any single payer system we got would not charge every citizen an equal amount. I also have the feeling that if you wanted to opt out, you would be given a write off(say $3000) which would translate into getting about $400 of your money back from the government. I.e. you are paying for the system without your consent.
"However, can you give us an example of a country which reverted to an insurance-based system from a single-payer one?" Well, when you have small minority paying partially subsidizing the health care of a much larger segment of the population, then the popular vote is always going to support that.
Amy,
Thank you on behalf of my wife and my 7 year old daughter, born under 2 pounds, surviving multiple operations (including a nine hour operation when she was 1 pound 11 ounces and extremely ill from sepsis), who is now alive, seven years later, with a disability. I'm a teacher. I had full coverage by Healthnet. But, as it turned out, they would only pay 80%, if we went out of network. Unfortunately, due to the extraordinary nature of one of the operations, it could only be performed in Children's Hospital in Boston. I know that because her issue was brought up before a symposium of surgeons, and only one surgeon believed he could do it So, we had to go on state insurance and argue that the operation could only be performed there.
I know more than most people about private insurers and the cruelness deep in the system's heart. I know for example that we were taken to a hospital via Life Star helicopter when my daughter was four years old. She was comatose and she was saved and then from the E.R. room she was admitted to the hospital. You can imagine the trauma a parent is under. I did not call the insurer for twelve hours after our arrival. My insurer then refused to pay the claim because we were not pre-approved before she was admitted, even though she was admitted via the E.R. room. In fact, I got more sympathy from bill collectors on that particular incident than I did the insurer.
Therefore, it is impossible for me to thank you enough for raising this issue. My wife and I listen to you every day. You are a brave, good person. You remind us of some of the nurses that helped take care of our daughter during our four years.
It's the people you don't see that Obama hurts and that's what worries me about him and the fact that he has neutralized many liberals. I would count my daughter as one of those he will hurt. We have set up a special needs trust for her so that she will be able to get health insurance when she's older, if these private insurers are still here, as Obama appears hellbent on making happen. I would count the children the drone killed as some of those. I would count the many starving children around the world too, in part due to his ethanol advocacy.
It takes a brave person to cover the truth. You are doing that. And so we thank you.
What broken healthcare system? It's working perfectly, and if we can get the 47 million without health care signed up to an insurance company it can only increase profit for the insurance and pharmaceutical companys, it seems this is the only goal of our health care system.
Well, then buy stock in insurance and pharamaceutical companies. Risk free profits right? Then you can use those profits to do good!
To add insult to injury, big pharma has learned from the financial industry that it pays to be big, not only to be able to pay bigger bribes to elected officials, but when you are "too big to fail", the politicians can just tell the taxpayers that you are "too big to fail", thereby justifying handing over boatloads of US taxpayers' money to you.
Look for the US Government to approve more mega pharma mergers in the near future.
Keep fascism alive to keep the socialist menace from infecting our homeland.
Single payer health care is "too big to fail" but in a different way. When single payer fails to provide health care that you are happy with, you don't have any other options--so in a sense they are too big. I guess you could pay for health care twice by purchasing private insurance while paying the tax dollars that go to single payer.
So RayDelCamino, it sounds like you truly are going follow my investment advice?
How can something that doesnt exist be too big to fail? How can you criticise as a failure something that has yet to be a reality? Why do you lie about single payer being forced upon you when you will certainly be free to opt out and get your own care? Typical right wing distortions and phobias, and this is especially sad in the face of the current health care crisis in our nation. It makes you, in fact, rather hardhearted about the real damage our current system is inflicting on our citizenry. 45 million with no care, 50% of all bankruptcies health care related..etc.,etc.,etc.
You are almost getting creepy in your denials, sorry to say. Facts about our health care dilemma:
http://www.grahamazon.com/sp/whatissinglepayer.php
"How can something that doesn't exist be too big to fail"
I am talking about the future that Amy Goodman is advocating when it does exist.
"Why do you lie about single payer being forced upon you when you will certainly be free to opt out and get your own care?"
I was not aware that this was the case. Are you sure? I was under the impression that everyone had to pay for it and then if you wanted supplemental care you would have to pay above and beyond that which is taken by taxes. The fact that it is forced is my whole problem with it.
If it isn't forced then what is the difference between single-payer and the plan Obama has of allowing everyone to buy into the healthcare pool that federal workers have?
I've heard Obama say over and over that if you like your current insurance plan you'll be able to keep it.
Federal workers have Blue Cross Blue Shield, or whatever it's called right now - I think they slightly changed their name last year. They pay $3763 a year for a family plan, the rest (I think, somewhere between 9 - 10 thousand dollars) is paid by the government. They have $600 deductible + co-payments. That insurance doesn't include vision or dental care.
You can buy into it any time you want to.
No, I am in favor of Obama's plan--at least what I know about it. That sounds really good. Everyone else on this site is basically saying that he knows that single payer is better and is just afraid of evil corporate masterminds. Thus, they are implying that there is no argument at all against their position and it is essentially a conspiracy preventing single-payer from becoming reality.
What 'I' am saying is that Obama will not consider single payer because he depends upon the many millions in campaign contributions from the health care industry, as do the Senators and Congresspersons as well.
Of course it is a better plan than we currently have, that is why it is found in so many nations today. That is why people in those nations do not face bankruptcy when experiencing catastrophic illness, that is why companies thrive better when they do not have to pay outrageous and steadily rising costs to insure their workers.
I have yet to see any of your comments addressing the justification for forced participation in single payer. If it is better, then you don't need to force people. You have rejected my status as a progressive for being in favor of a voluntary health care pool rather than one where you are forced to pay in at a rate dictated by your income. Now, why is it okay to force people to participate?? Because it is good for the pack/whole/average/collective? Because the ends justify the means?? Because individuals are too stupid to do what is best for them so we must force them?
We are free individuals first and foremost, who may or may not want to be part of a collective organization--whether it be a co-op grocery store or a group health care plan.
My last words to you.
You go on and on and on and on about a "forced health care system" until I fear for your sanity. Noone is forcing anyone and you are simply unreasoned and unreasonable..Tata.
As I have said repeatedly, if it indeed is not forced (you can opt out of the system and get full reimbursement of what you put in), then I am all for it.
Amy Goodman was one of the several progressive journalists who supported Obama during the campaign, knowing fully well that he was just another Democrat, which means Republican, corrupt, self-seeking and corporatist.
His health-care "reform" will never betray some of his closest allies, the drug and insurance companies. Her hope that, unlike McCain, Obama's at least someone one can argue with, is just pure stupidity.
So, all the good that Amy does is forfeit because she supported Obama? When did progressives become so intolerant of other perspectives?
What's next--- an oath of progressive purity?