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TechnoratiA Singular Solution for Healthcare
A single-payer healthcare system would more effectively control costs than any other plan that Congress is considering as it moves toward a reform bill. And by controlling costs, existing resources could be allocated more equitably, especially for the benefit of women.
First, single-payer plans eliminate the $300 billion to $400 billion that insurance companies spend annually in administrative overhead and waste. Second, single-payer plans are best positioned to take on the enormous challenge of reducing or eliminating the financial incentives that have led to so much overtreatment and undertreatment.
Maternity care illustrates this phenomenon: We spend far more per capita than any other industrialized country and yet do worse on most birth outcome measures than most of these other countries. So-called best practices - medical practices already demonstrated to improve outcomes - are well described in the medical literature, but they are not widely implemented, even though doing so would lower costs and improve the health of mothers and babies.
For example, nearly one-third of all US women deliver their babies by caesarean section, a rate that is far higher than medically necessary. One of the reasons is that most obstetricians and hospitals are paid far more for a surgical delivery than for a vaginal birth. Such incentives not only raise costs, but ironically often produce worse health outcomes.
By reducing the ability of for-profit companies to siphon off huge sums of money for private gain, a single payer system is better able to expand best practices. Why? Because the motivations to over-treat those who are well-insured and to undertreat those with limited or no insurance coverage will no longer be built into the medical care system.
Women in particular have much to gain from single-payer healthcare. Our country has an excess of medical specialists, and is in desperate need of more primary caregivers - such as general internists, family practice physicians, nurse practitioners, and licensed midwives - who are often more aptly trained than specialists to provide the comprehensive services women need. A single payer plan would eliminate the financial incentives that have been obstacles to training more primary care professionals. It would also eliminate the need for so many medical malpractice lawsuits, as people would not have to worry about paying for medical care whenever they experienced bad outcomes.
The only national plan for healthcare reform that explicitly includes women's reproductive health services, including abortion, is one sponsored by Representative Barbara Lee, a California Democrat. Other sponsors of single-payer plans are also amenable to including women's reproductive health services.
Coverage with a single-payer plan is independent from employment. Because women are more likely to be self-employed, to work part time, and to move in and out of employment outside the home, they are now more likely either to lack coverage through work or to lose insurance when changing jobs.
Medical debt is an enormous concern for many women, and single-payer plans effectively address the cost issues that send women into debt and even bankruptcy. A 2009 Commonwealth Fund study found that 45 percent of women accrued medical debt or reported problems with medical bills in 2007 compared with 36 percent of men. Under Rep. John Conyers' single-payer bill, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs - with no deductibles or copays or concerns about catastrophic costs.
Since a single-payer plan may be the only approach that will successfully contain costs, it was a good sign that Congress finally held hearings on a single-payer system last week.
Although many progressive members of Congress now support a proposal that includes a "public insurance option" as an alternative to private insurance industry plans, numerous critiques demonstrate how this approach could fail. Unless designed to mirror the effective Medicare system - by automatically enrolling the majority of the population and using Medicare's cost control levers - the public option will not be affordable for all.
When polled, a majority of physicians as well as the public support a single-payer plan. For example, a 2007 AP-
A whopping 65 percent said yes to that question. By political standards, this is a landslide. It is time for Congress to pay attention to the voters, not the well-funded lobbyists.
17 Comments so far
Show AllDemoks/Repuks are telling USans that only a tiny minority of USans want Single Payer, while the polls say 65% want Single Payer. If something doesn't give, these USans will vote Demoks/Repuks into office yet again in 2010 after being denied Single Payer healthcare yet again.
LA Times:
"Rep. John Dingell (D-Mich.) said that a public insurance plan should be a part of any overhaul because it would force private companies to treat consumers fairly or risk losing them."
The lesser evil Demok Dingell has it completely backwards. Private insurers will be happy to lose the most unhealthy/expensive healthcare consumers to the public option.
Although this is a clear and strong statement about how sensible a choice Single Payer is, it is merely preaching to the choir. What is necessary is to make other, bigger and more powerful, constituencies realize how much Single Payer is in their own interests and how it will cost us all less, not more.
Many local and state governments, companies, and unions are facing major financial crises because of health care obligations, while hospitals are closing because of unsustainable emergency care they are required to provide yet do not get paid for. Universal Single Payer insurance would completely relieve them of those burdens freeing public bodies to address other public needs while making companies that had been providing the most generous insurance for present and retired employees more competitive with far more stingy companies. The potential combined clout of these entities could, and should, play a pivotal role in combating the misleading propaganda of insurance companies and other forces opposing the public good.
It is critical for the public to become aware that not only will Single Payer provide better health care for all and at lower cost, but there is a way it can be done with no new taxes! At present all 'unearned income' - income from rents, profits, interest, etc. - is 100% exempt from both Social Security and Medicare taxation. Closing this one loophole would, combined with existing Medicare revenue, provide sufficient income to not only fully fund a Single Payer national health care system for all Americans, but perhaps dental and optical care as well! And as a fringe benefit the purported Social Security shortfall would be eliminated as well - especially if the $105,800 cap on taxable Social Security income was eliminated at the same time!
Although public awareness of how much sense Single Payer makes, until and unless these two factors are included in the discussion there is little likelihood of more than reluctant, token progress - especially given the degree to which Obama has reversed his earlier pro Single Payer position!
Dreamers all! Three issues that will not change:
1 Campaign finance reform.
2 Gun control.
3 Health care reform.
In Australia we have a mixture of private and public based funding. We spend approx 8.8% of GDP on health care compared to the US which I believe spends around 15.3%? About two thirds of that spending is public and the other third private expenditure. We probably spend a larger amount of money out of pocket on health care, but only half of what the US spends overall. We have one of the lowest mortality rates for amenable diseases among all industrialized nations, our wait times for surgery are identical to the US, and our citizens in general never have to worry about the cost of visiting a doctor of filling a prescription.
I’m disappointed for you all that single-payer looks off the table. I’m very grateful to live in a country that provides basic coverage to all its citizens, free treatment at public hospitals and either free or subsidized treatments provided by the government. We can choose the doctor we want, at the hospital we want, either public or private.
I would say based on what I know of the Canadian health care system, that ours is much better and I honestly think Americans would prefer a system to similar to ours, one that doesn’t force to operate within the public system. We have the option of private insurance to cover what the basic government system lacks. It’s not employer based, anyone who can pay the insurance bill must be accepted by the private insurer and the costs are relatively all the same – between $300 - $350 per month for the top level plan which covers ambulance, dental, massage, gym membership reductions, optical, OB’s and even deductions for weight loss programs like Jenny Craig.
Single-payer is off the table. The so called Public Option is just hanging on by a thread and God only knows what it will look like even if it survives? It's highly likely it will be so shaped in such a way as to actually make things worse, especially if a mandatory Health Ins. feature is passed as the Ins. companies want. The devil as they say is in the details.
The day money became equal to free speech, we and our health care became commodities for sale to the highest bidder.
Maybe we will get our government back, maybe not.
My primary concern with Single Payer is that we take the government out of the administration of the program.
Medicare, one model for single payer, has suffered for years due to congressional oversight.
Prior to 2003, major health insurance companies benefitted from the sale of Medicare Supplements - why were they needed in the first place?
If you didn't pay hundreds of dollars per month for your Medicare Supplement (to large insurance companies) you were at risk. The leading cause of senior poverty and bankruptcy was costs not covered by Medicare (including deductibles and co-pays)
In addition, there were no provisions for long-term care and limited provisions for preventative health and screening.
For example Original Medicare gives you a free physical only when you enroll. Not annually.
Rather than fix medicare, Congress gave us Medicare Part D and Medicare C (Advantge programs) which were more expensive and which completed unfairly with Original Medicare. Health Insurers made massive profits off these "reforms". Where was Congress?
Congress has had oversight (through CMS) on Traditional Medicare, Medicare D and Medicare Advantage. Why are these programs such a mess? Why have they ignored the single payer option to the advantage of the for-profit plans? And now that the public wants Single Payer - why are they putting up so many roadblocks? Why should we trust Congress ?
And now - read HR 676 closely - the President will have a major impact on the administration of a "Single Payer Plan"
The President will appoint and Congress will confirm the Secretary of Health, who will appoint the directors of the new health system - massive opportunity for influence.
The President will appoint the Committe which Oversees the health systeme - 15 members - read HR 676 - once again opportunity for influence.
We may "trust" Obama today - but do we want to give him and Congress all this power over "Single" payer.
As you remember - Obama's first choice for secretary was Tom Dashiell - almost as corrupt as Backass.
And if we end up with a populist like Reagan - can we take this chance?
I know Conyers and Kucinich have their hearts in the right place - I'd just feel a lot better if we could take the government out of the administration of single payer through modification of HR 676.
You raise a valid point. Our public institutions are corrupt, our private institutions are corrupt. We are witnessing social decay, economic decay, and the rise of the Far Right.
Given this dire situation, I would still trust the public sector, rather than private sector; after all the system we have is much worse than the problems single payer will present.
But then again this point is moot, it is very clear we are not getting single payer.
I wish President Lyndon B. Johnson were still alive, so I could thank him for the Civil Rights Act, Medicare, and Medicaid.
And I wish President Obama were old enough to remember LBJ, a president who actually FOUGHT for civil rights and healthcare for Americans. Yes, he let himself be trapped in the war in Vietnam, and yes, I was one of the protestors chanting, "Hey, hey, LBJ, how many kids did you kill today?"
But 40 years from now, what is anyone going to thank Obama for? At the same time that he is expanding wars, he is acting the coward on single payer health care, which he has admitted is the best system. I suspect that in 40 years, we will be thanking Obama for NOTHING.
With Single Payer congress is less likely to take corporate bribes to poison entire towns and regions for a few dollars more. The Single Payer would have to clean up the carnage. That saving is huge.
I think we're at a "teachable moment." Today's article about corporate personhood is especially timely in this context.
Talk it up, people. Spread it around.
According to Howard Zinn, Chomsky and others, a majority of the US population has been in favor of single-payer, universal, Canadian-style health care for decades. However our elected crooks routinely marginalize and ingnore this in favor of taking lots of money from the Illness and Death Industry and Corporate Drug Pushers.
And once again, we are not going to get single payer. What else is new?
Correct tammons. Unfortunately with the current crop of corporate friendly incumbents, there is absolutely no chance of adopting a single-payer, universal insurance plan. The only way to break from this pattern is if the majority of Americans learn to reject corporate stooges who run for office. This seems unlikely in the near future do to the deep pockets of this corrupt elite.
To the authors of this well written article I must also comment that unless we eliminate the insurance industry completely from the equation, the government plan would find itself constantly under-funded, under attack by right-wing hate radio programs and placed in a light that 'anything the government does is bad'. I'm afraid if the insurance companies find themselves one day with the real possiblity that the general public wakes up and demands universal healthcare, that the medical industrial complex will agree to a system as long as they still get to essentially run it.
The Yahoo poll should be amended to read: "The United States MUST adopt a universal health care program in which everyone is covered under a program like Medicare that is run by the government and financed by taxpayers."
And since this is opposed by many of the major donors to our elected officials, we must heed the advice of tammons and FIGHT BACK!! Contact your three Representatives--two Senators and one Member of the House (their numbers and addresses are in the phone book or on line) and warn them that they may not be re elected if they vote for the insurance companies and against the people of this nation.
But when I talk to or correspond with my Congressman or Senator he tells me I am in a tiny minority, that most people are happy with their health care. They fear no consequence from disregarding what they see as minority of the voters. It's no use to argue or reason with them, "please please pretty please listen to my ideas." They know that we are politically weak. They believe they will suffer no blowback or consequence when they dismiss us. They are wise to the ways of the world. They know that the U.S. is not really a democracy where public interest is served. They know who got them into Cngress and who they must serve--corporate interests. They know all this better than we do and see us as naive. Most of Congress is hopelessly self interested and corrupt. The contempt they show us is the contempt we should show them. The only way they will listen is if they think that we could be a threat to their incumbency. It's not time to talk. It's time to fight.
I wholeheartedly agree. The rightwing forces have been successful at getting their Congress. It's time for the progressives, liberals, and true moderates and independents to unite for a better Congress for a change.
Most people are sooo happy with their current health insurance that an estimated 119 million of them will switch to a non-profit insurance option the second they get the chance.