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'Public Option' Pales Next to Single Payer
The following remarks were delivered to a closed-door meeting the Congressional Progressive Caucus on June 4, 2009:
Today the Congressional Progressive Caucus faces a choice. That choice is whether Members should maintain their unflinching support for single-payer, or to accede to intense political pressure to support the plan currently being developed in Congress under the direction of President Obama: a mandate for Americans to purchase an insurance plan from a massive new regulatory “exchange,” with one plan potentially being a “public option.”
The difference between these choices could not be more stark: single-payer has at its core the elimination of U.S.-style private insurance, using huge administrative savings and inherent cost control mechanisms to provide comprehensive, sustainable universal coverage.
The “public option” preserves all of the systemic defects inherent in reliance on a patchwork of private insurance companies to finance health care, a system which has been a miserable failure both in providing health coverage and controlling costs.
Elimination of U.S.-style private insurance has been a prerequisite to the achievement of universal health care in every other industrialized country in the world. In contrast, public program expansions coupled with mandates have failed everywhere they’ve been tried, both domestically and internationally.
Many progressives accept that the “public option” is inferior to a single-payer system, yet support it because of its perceived political expedience. It is my aim today to convince you that the “public option” program currently being developed is not only bad health policy, but bad health politics.
On two separate occasions last month, physicians and nurses were dragged from the Senate Finance Committee in handcuffs for demanding that single-payer be considered in our nation’s health reform debate. These were American doctors and nurses, people who care for patients, people who want to practice medicine, not protest and disrupt Congress.
But these professionals risked their careers and their freedom. They did this not because they thought that the “public option” was “good” and single-payer “better.” They did it because they are firmly convinced, by well-established health policy science, that the so-called “public option” has no hope of remedying the systemic defects that cause their patients to suffer and die, sometimes before their very eyes.
Millions of dollars have been spent by political advocacy groups to commission polls and statistics “proving” that their health reform is “politically feasible.” Yet political winds do not make good health policy. Careful examination of science and experience do. And it is in the science and experience that we see that single-payer offers the only way to truly comprehensive, universal and sustainable health care, and that “public option” schemes offer only more of the same: tens of millions of uninsured, rapidly deteriorating coverage, an epidemic of medical bankruptcy, and skyrocketing costs that will eventually cripple the system.
First, because the “public option” is built around the retention of private insurance companies, it is unable - in contrast to single-payer - to recapture the $400 billion in administrative waste that private insurers currently generate in their drive to fight claims, issue denials and screen out the sick. A single-payer system would redirect these huge savings back into the system, requiring no net increase in health spending.
In contrast, the “public option” will require huge new sources of revenue, currently estimated at around $1 trillion over the next decade. Rather than cutting this bloat, the public option adds yet another layer of useless and complicated bureaucracy in the form of an “exchange,” which serves no useful function other than to police and broker private insurance companies.
Second, because the “public option” fails to contain the cost control mechanism inherent in single-payer, such as global budgeting, bulk purchasing and planned capital expenditures, any gains in coverage will quickly be erased as costs skyrocket and government is forced to choose between raising revenue and cutting benefits.
Third, because of this inability to control costs or realize administrative savings, the coverage and benefits that can be offered will be of the same type currently offered by private carriers, which cause millions of insured Americans to go without needed care due to costs and have led to an epidemic of medical bankruptcies.
Supporters of incremental reform once again promise us universal coverage without structural reform, but we’ve heard this promise dozens of times before.
Virtually all of the reforms being floated by President Obama and other centrist Democrats have been tried, and have failed repeatedly. Plans that combined mandates to purchase coverage with Medicaid expansions fell apart in Massachusetts (1988), Oregon (1992), and Washington state (1993); the latest iteration (Massachusetts, 2006) is already stumbling, with uninsurance again rising and costs soaring. Tennessee’s experiment with a massive Medicaid expansion and a public plan option worked - for one year, until rising costs sank it.
The Federal Employee Health Benefit Program (the model for a health insurance exchange) leaves hundreds of thousands of federal workers uninsured, and has proven unable to contain costs.
Negative results in a recent series of randomized trials explodes the hope that chronic disease management will cut costs. And the CBO has thrown a wet blanket on the notion that electronic medical records save money.
As Drs. David Himmelstein and Steffie Woolhandler, co-founders of Physicians for a National Health Program, have remarked, a public plan option does not lead toward single-payer, but toward the segregation of patients, with profitable ones in private plans and unprofitable ones in the public plan. A quarter-century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field. Despite strict regulation, private insurers have successfully cherry-picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan - which started as a single-payer system for seniors and have now become a funding mechanism for HMOs - and a place to dump the unprofitably ill.
Progressive supporters of the “public option” readily concede that single-payer is a superior system. Indeed, their response to evidence that their plan won’t work is to commission more charts and graphs emphasizing its political feasibility.
The “public option” is truly the embodiment of health policy designed by sound bytes, cobbled together from snippets of information gathered from focus groups and public opinion polls, and centered around well-polling buzzwords such as “choice” and “shared responsibility.”
Such a plan may be enough to excite the political classes in Washington, who care more about what they think can pass the Congress than what will actually deliver universal, comprehensive health care for all. But doctors and nurses, the people who actually work in the health system, see right through it. They are going to jail because they know that this plan won’t work for their patients.
Nobody is going to jail for the “public option,” because the American people cannot be inspired by band-aids and half-measures it is impossible to believe in.
These doctors and nurses are the manifestation of a social movement, millions strong, that is waiting to be mobilized by the leadership of the Members in this room. Polls consistently show that two-thirds of the American people want single-payer. At a recent hearing in Montana convened by Sen. Max Baucus, only 10 people of three hundred said they were happy with the insurance they have. Sixty percent of physicians support single-payer, as do the U.S. Conference of Mayors and 39 state labor federations and hundreds of local unions across the country.
We’re told that holding out for single-payer is politically unwise, but to compromise and accept a bad plan at precisely the time when popular support and grassroots energy are on the side of true reform is the real political miscalculation.
The history of great social achievement is rife with instances in which the forces of institutionalized power told social movements - as they now tell this one - that what they wanted was too much, or too fast, or too soon. I think, of course, of the abolition of human slavery, the enfranchisement of women, the Civil Rights Movement, Social Security, the minimum wage, an end to child labor. In each of these instances, social movements held fast to their principles and soon discovered that they had been told was “politically unfeasible” one moment was political reality the next.
We currently have a better chance to pass single-payer than Lyndon Johnson had when he passed Medicare. Unlike the public option, single-payer - because it holds the potential to finally realize universal, equitable health care - can be a vehicle to inspire the American people for progressive change.
The voices of doctors and nurses can achieve extraordinary resonance when they speak selflessly in their patients’ interest. But your leadership is crucial to inspire the American people. It is my hope that you’ll see fit to provide it.
- Posted in
52 Comments so far
Show AllPlease explain why you believe "We currently have a better chance to pass single-payer than Lyndon Johnson had when he passed Medicare".
Today we have a medical cartel (insurance/pharma/AMA) that has a huge campaign warchest, funded in part by corporate welfare that the best Congress that money can buy keeps doling out. We have a brain dead electorate that will believe any BS the corporate media throws their way.
Although the political environment was not super progressive in 1965, the cartel was not quite as powerful, Congress not as corrupt, and the electorate was a little more willing and able to look at the facts.
I agree. Why? Cogress has shown no interest in a real health care solution. Their exclusion of single payer is evidence of that.
Does anyone really believe that congress needs you to call them to tell them that there are people without health care? Somehow they don't know? Not very easy to believe that.
If Americans are going to call their reps, tell them that instead of voting for the usual suspects, next time you will vote for someone who wants single payer as much as you do. 'Cause leaving messages on their phone, and then voting for them again doesn't make much sense to me.
There is a broad and deep sentiment in favor of single payer among the citizenry, and an even more militant majority that favors it among physicians. The key is to tap it by persistent organizing. We have the corporate liberals on the run on this one--Baucus's belated meeting with the single-payer advocates and their appearance before the House committee give ample evidence of this mounting grass-roots pressure. Now it the time to redouble our efforts, not to indulge paralyzing cynicism.
As the old song lyric has it, "There's nothing to it but to do it." We have to DO IT. Not doing it is a self-fulfilling prophecy of defeat. Doing something--anything--brings us that much closer to a possible victory. Yes, victory IS possible if we all do something. Victory is impossible only if we do nothing.
Here are some good places to start:
www.singlepayeraction.org
http://www.healthcare-now.org
www.pnhp.org
Mr. Skala writes: "These doctors and nurses are the manifestation of a social movement, millions strong, that is waiting to be mobilized by the leadership of the Members in this room."
There is no real or effective "social movement" waiting to be mobiledfor single payer or any other policy that truly serves the people. Given how the private sector and the government have screwed things up, you'd think Americans would be out with pitchforks by now.
Of course, the case for replacing the current system with single payer is compelling. Why else do you think that they won't give it a fair hearing?
q
The insurance companies will die under single payer. That's a lot of lobby money.
The insurance companies pay into political campaigns on a tit-for-tat basis. In a system in which election is determined by publicity and publicity is purchased or delivered to those who favor moneyed elites, few elections can be won by genuinely populist or even moderately honest politicians.
Nader related an interesting story about Al Gore on Democracy Now! a year or two back. He claimed that Gore was thrilled to be free of office because he could operate without catering to the lobbies. Amy Goodman pointed out that Gore had abandoned all the ideas he fought for out of office when he entered the vice presidency, and Nader replied that Gore would again if he had the vice presidency again, in effect that such hypocrisy is a condition of office.
Someone closer to this might fill me in, but I'm not sure why anyone would believe that this is not the major mechanism.
What should a long term strategy be--I think we should peel off from public option and when it fails--move again on Single Payer? It would be wonderful to have one state pass Single Payer and see it succeed while the public option plan fails. I am afraid it will not work that way. When the public plan fails that will be "proof" that public alternatives to private insurance are doomed to failure--In fact maybe that is what the public option is being designed to do. Am I too cynical?
Depends on the state. I'm from Illinois, and if you've read anything about our attempts to pass reform legislation after getting rid of our incredibly corrupt governor, or if you've heard anything about how horribly far behind we've been for years on paying Medicare and Medicaid, you'd know that no one in my state would want to put their health in these people's hands.
The only "single payer" plan we need is the one our precious congressmen and senators have that covers everything until death, and no, they should not be taxed on the value of it. The rest of us will have to make do with the best we can get, which is the public option plan. It must sound pretty good or the insurance companies would not be so scared of it. They say they can do better than the government, so why not show us how that is true. Obama is doing his best, but may not have a solid connection with God like Bush, so it goes slower.
This comment is so right on. Conversely, wouldn't it be great if Congress was forced to accept the average private company healthcare plan? You'd see great movement towards single payer then methinks. Also, wouldn't it be great to see Congress have pay limited to the median income of U.S. households? Then they'd see what an average $7,000 of household income devoted to healthcare expenses would do to their disposable income. Perhaps then we could get real change. Wishful dreaming....
It does not take a rocket scientist to look at the facts and easily come up with an iron-clad case for a single-payer healthcare system for the American people. For one brief and fleeting moment, let us set politics aside and opt, instead, for true statesmanship.
Our political system is as corrupt and self-serving as it has ever been, and our society, in general as depraved as it has ever been. Both are harbingers of a total breakdown of our system of government and the social order of this country. People are smart enough to see the tremendous disparity in the largesse for Wall Street, big money, powerful corporations and the bottomless pockets of our politicians vs. the crumbs the average person is this country is still waiting for in these difficult times. For just once, it is time to give the common person a share of the pie, cut off the testicles of the corrupt healthcare providers and move on to a real, meaningful and far superior system of healthcare in a single-payer system.
We have had enough of deception and stealing by the powerful and affluent. Do the right thing this one time. In the end, morality and basic human decency does matter.
Fabulous, Nicholas Skala. The corporatocracy won't cry for the progressives if they fail to understand what is at stake and instead "compromise and accept a bad plan at precisely the time when popular support and grassroots energy are on the side of true reform is the real political miscalculation."
"And the CBO has thrown a wet blanket on the notion that electronic medical records save money."
This is an untold story in itself. It is a plan to spend billions of tax dollars to gain more control over the existing corrupt system AND outsource medical jobs. It's an outrage. I haven't looked yet, but I'd guess that the $100B he wants to spend in education is similarly at cross purposes with the welfare of the American people and only serves to enrich those who can pay to play.
And just for chuckles, someone mentioned that Daschle had been up for HHS. Anyone recall that Blogojevich wanted the job? Does that not speak volumes?
Somebody make my day and mention that if we want to control costs, we'd better hire some fraud investigators and start prosecuting.
Health care options are as tightly constrained as so-called discussion on CNN.
I think the first step is to take away the health plan that congress people and senators have currently. Remove it and make them all go on Cobra. THEN you will see things change. Maybe if these idiots have to pay $1400 a MONTH, they will understand.
As it is, they insist that those of us who want single payer are in "a small minority". A small minority of 70%. No wonder they can't balance a budget, or come up with numbers that come close to reality. With geniuses like that, it's not surprising that we are in such miserable shape.
It's time for congress to actually do the RIGHT thing instead of the politically expedient thing. And the part of this that just kills me is that the democrats aren't smart enough to understand that with the passage of Social Security, the democrats held power for 40 years. If they pass this, the republicans will be toast for the next 40 years. How incredibly short sighted these people are.
"Maybe if these idiots have to pay $1400 a MONTH, they will understand. "
Nice idea, but of course, you guys give them an expense account like no other. 1400 dollars is the price of one of their lunches.
And it would probably be "written off", as Seinfeld's Kramer once said, as a business expense. To paraphrase Paul Simon, there must be fifty ways in the fine print that elected representatives could write off or recoup such expenses.
It's unfortunate that the authors of the Constitution didn't anticipate that greed and lust for power would cause supposedly "honorable" elected representatives to hijack the legislative process and transform it into an opaque process in which nefarious "omnibus" laws are launched: bloated, deliberately complex and user-unfriendly, and typically written by lobbyists and special interest groups, then handed to the politicians to enact, unread.
Think of the pitiful "reforms" that have occasionally percolated through Congress, ostensibly to reduce or restrict representatives and lobbyists from feeding TOO greedily from the trough. Or the "vows" to pass laws limiting the salary of our parasitic bankster class.
When all is said and done, more is said than done. The reforms always vanish with scarcely more than a shadow remaining; the pols merrily employ their franchise in the business meaning of the term, using the License to Steal that comes with their office to feather their own nests and the nests of their patrons and sponsors-- which, needless to say, does not include the common voter.
· Yr Obd't Servant
Bbbut President Obama has solved the cobra problem. He's offering to have taxes pay two thirds of it. We'll pick up $924 of the subsidy to the insurance companies. Problem solved! Now if they could get the ranks of the unemployed to stop growing by half a million a month...
Re: the dems. The way they're looking at it is that if they go against the FIRE, they will be toasted in the next elections. Between the money spent and the media control, it's a tough call. CNNFOXMSNBC will go ballistic. For politicians to be loyal to the country instead, they'd have to believe that we could see through it all. Tough call. Course, they could just do the right thing and let the chips fall.
In all this health care discussion, especially in the media - NO ONE has countered the GOPers puffery by reminding them that they get free, government sponsored healthcare that WE PAY FOR with our taxes.
Some of you have touched on it - how do we make this front page and center?
I would be willing to bet that most people are not aware of this particular government freebie.
Now that you bring it up ... can you or anyone tell me exactly what the health benefits are for Federal elected officials?
Is there a succinct, detailed explanation anywhere out there?
I need it to counter some of the mindless arguments I face on this issue.
I've been told a few things, which I find hard to believe.
In the interest of sanity, can anyone tell me what the plan entails?
I've heard for instance, that even if they are elected for a single term and are then defeated, they still get their benefits continued for life.
I've heard it not only covers them, but their immediate family.
I've heard that it is beyond being simply comprehensive.
Everything is covered: dental vision prescriptions, etc.
What other premium benefits are there?
Is any of this this true?
If it is, how can we possibly expect a person with such premium health care coverage to understand the perils of those without it, much less fight for it?
Co-opted and compromised - our President and our Legislature.
comment withdrawn for faulty context problems
OK so all of us that want single payer health care, which is the vast majority of citizens, can stay where they are and those that like the system the way it is now can move to Texas and they can pay through the nose for their health care while the rest of us can enjoy truly good health care for everyone. They can even succeed from the rest of the United States and become the new nation of Greed.
you would be amazed how many people-on-the-street are adamantly opposed to single payer/national health care.
Those damn immigrants/welfare recipients/etc are going to get the same thing I am! I'm busting my butt at a job I hate and *those* people are getting the same "reward" as I am! yeah yeah.
I've actually spoken to entrepreneurs and showed them the maths - they pay less, and don't have the administrative overhead head aches. They respond the same way - But the government has the power and I'm paying for free loaders!
But but but the insurance companies have the power over you today, and instead of subsidizing poor people you are subsidizing CEOs who make 10x more than you do (idiot).
They don't care, for some reason I don't understand people like competing with welfare recipients...low aspirations I guess
Good post. Couple of nice shots I intend to use in talks with neighborhood boneheads.
If the Dems spoke with one voice in favor of single payer, if they systematically debunked the "one-world-socialist-government" fear frenzy of the Repubs, if they recruited the sector of the business class that supports single payer, if somebody in a position of power, influential enough to withstand the psychotic shit storm that Fox, CNN, etc will unleash, maybe we'd have half a chance. As it is...
Anecdotal evidence of the kind you offer here may be hazardous to your political perceptions.
Poll after poll shows that a decisive majority of Americans favor single-payer Medicare for all. See the following:
http://www.healthcare-now.org/wp-content/uploads/pdf/polling.pdf
Please go to these Web sites and find out how you can begin to start DOING something to mobilize the gathering pro-single-payer sentiment:
www.singlepayeraction.org
http://www.healthcare-now.org
www.pnhp.org
The option is socialism for all, or socialism for the corporations when it comes to health care reform. Why is anyone surprised that the congress will support socialism for the companies rather than for the people?
The only good thing is that with all of the other costs and bills coming in these days, the usa will be forced to go to a single payer system. Or it'll go the other way and just not pay for health care at all, even medicare would have to be cancelled.
this morning on npr, secretary sebelius stated that single payer is not an option, and any new laws re: health insurance would be worded so that it never becomes an option.
oh, and by they way, we (those 50 million of us who fall into that category) will be "fifty million new insurance customers." so she claims. the scam continues.
As she gets ready to deliver 50 million new customers, formerly known as citizens, trussed to the FIRE spit, will anyone ask the former insurance commissioner of Yes we Cansus whether the stock option compensation of management should be limited for companies receiving so much of their income from taxes?
I for one prefer the "unamerican" single-payer system to the American system we have now - which is a criminal failure.
The byzantine twists and turns performed by various members of our government to keep the health profiteers profitable are really incredible, and a national disgrace. I would have hoped for better from Secretary Sibelius. Another disappointment.
At some point the American public is going to have to stop acting like a flock of lobotomized sheep and get interested and active. Some are beginning to catch on, but it's not a rapid process.
We need to sharpen our pitchforks and get ready for a trip to Washington, soon. And keep on agitating and explaining.
It will be a national disaster if a single-payer bill does not pass.
We do have a "native" American single-payer system that has worked quite well: Medicare.
Is the lesser evil going to ratchet up the evil with the "public option"? It captured the throne by writing blank checks for imperial slaughter of one million Iraqis. The electorate seems willing to accept ongoing value erosion in the healthcare, education, transport, and other sectors in exchange for more cellphone features and ice cream flavors.
The challenge seems to be convincing the people to associate the opiates, and the elite pushers, with the pain of chronic disease, physical, mental, spiritual. And to to associate their own thoughtfulness with progress. Make the associations and achieve Single Payer Healthcare this year.
Even though I totally agree that single payer is the best option, I find the whole discussion just as superficial and glib and left brain as any talk show-- there's a horrid language here that exceeds the stance that anyone takes on any issue.
What is this crap about how public option won't work? Does anyone actually know that? No, they guess that. And they have a great faith in their expectations that I don't.
What if the option business is done correctly? Wouldn't it be a great surprise to all the glib know-it-alls if the vast majority of Americans-- and a far greater number than anyone
could imagine-- chose public option as the closest thing available to single payer? Then we would have single payer,
something nobody really wants to articulate except the loonies on the far right, who are always up for morbid discussions of their greatest fear.
Personally, I would laugh like hell. Believers in competition my butt.
The trouble with an article like this and most of the posts following it is that it's all conceptual and off the (well, won't say top of the head because I want to stick with the left brain idea). Left brain is where most human ugliness comes from, and it does so even when there is some truth in what someone is urging.
Political and conceptual are two different realities.
I just returned from a two day health conference with 300 allegedly progressive health professionals, on the subject of "Diversity in the Healthcare Professions." I took the trouble to talk with a number of them about their views on a single payer system. Not one could describe it accurately and not one was in favor of it. They were afraid that the government would take away their "choice." Sigh.....
And yes, the public option plan has failed in the states in which it has been tried. I think that the insurance companies are protesting it much as Brer Rabbit protested being thrown into the briar patch. Once the "public option" fails on a national scale, they will have buried the single payer threat for a generation or more.
All the more reason for you to join with a single-payer activist group to educate people about what single payer is to combat the corporate disinformation campaign.
"bottle":
Please explain how you believe the public option will function--and please be specific.
Then please explain how you think it would or could compete against the private HMOs.
Lots of people have some vague, amorphous notion of a public option that could be really grand. It seems beautiful from a distance--but when you look at it up close, you see all the disconnected dots.
So you, with your cocksure, dismissive attitude toward the critics, must have thought this through rather thoroughly and have all the answers. But pardon me if I carp a bit--your post seems to be a lather of style that conceals a paucity of substance--perhaps a laziness toward mastering all the complex and difficult details. You complain about the superficiality and "glibness" of the discussion, yet you don't dirty your hands with a single nugget of policy detail--this is most hypocritical and unbecoming. This kind of posturing just won't get the job done.
So let's hear it in detail: what would this public option look like, how would it work, and how would it vanquish the HMOs. Do tell.
If a public option passes, the populace will have another tool with which to fight for single payer.
The insurance companies cannot lobby without funds. They get funds from peoples' accounts.
Those who want single payer should go to public option to starve the giants.
bardamu--
What public option? Do you think there's only one Platonic public option floating out there in the ether? Or are there several such proposals? Have you thought about the details, and how such a public option might eclipse the HMOs? If so, is this a public option of your own devising, or are you referring to someone else's proposal?
Please tell us exactly how this "public option" would work so we'll know how it will provide leverage to fight for single payer. No hazy evasions--we need specific details, please.
Here are a few things. I'm not saying they're good or bad, just providing info for you.
www.bhcjournal.com/News/FromtheHill/tabid/260/Default.aspx?ArticleId=29298&PageNumber=1
http://www.dailykos.com/story/2009/6/14/742341/-Keep-Health-Options-Open
http://www.youtube.com/watch?v=kO5l-YVzjL8
The 2nd site listed here has a poll at the bottom of it. As of 11 a.m. CST, 6/17/09, the "strong public option" is winning over "single payer or nothing." Vote!
I'm afraid you have still provided NO details in any of these sources on how this is supposed to work. For example:
1. www.bhcjournal.com/News/FromtheHill/tabid/260/Default.aspx?ArticleId=29298&PageNumber=1
This citation provides no details--just an INTENTION to provide "quality, affordable healthcare" for all--the usual rhetorical hocus-pocus code for "keep the private insurers in the game."
2.http://www.dailykos.com/story/2009/6/14/742341/-Keep-Health-Options-Open
Again--no specific details of how these plans would operate.
3. http://www.youtube.com/watch?v=kO5l-YVzjL8
Same as above.
You are advocating a "public option," which is pretty much like advocating "peace and love." We need to know the details of what you're supporting--would it charge premiums? Would it impose deductibles? Would it have to be self-sustaining, or could it accept government funding? Would it base its fees on Medicare, or would it have to offer higher fees?
These are all CRITICAL details, and my sense is that you, like nearly all public option boosters, don't have a clue about the answers or what this plan is supposed to look like--you just like the sound of the phrase "public option."
I've studied the details, and I can tell you that there's no variant of this plan that will work--it's been tried in five states and has failed everywhere it's been tried.
If you can explain the details of what YOU mean by public option, which variant of it you support and which variants you oppose, and how it would give citizens an advantage over private plans, please do so--in your own words.
If you can't, that means you have no idea what you're supporting, other than a vaguely good intention that means nothing.
Sorry, don't have it -- I'm all for single payer and not ready to give it up.
However, let me be at least be more specific about my intended level of generatlity:
ANY public option has at least one advantage that ANY plan with no public option lacks. That is the possibility of SOME insurance that does not contribute to the coffers of lobbyists.
To ever get coverage for everyone, someone will have to break lobby control. I see 2 possibilites.
1. Electoral reform, starting locally with propositions directly before the voters to stop election spending altogether. Everyone gets the same sized piece of the same publicity pie.
2. We starve the insurance companies out by not buying insurance. That's a lot to ask people who run health risks -- which means any of us, ultimately, right? Having a public option reduces the risks of boycotting the private companies; it reduces it less or more depending on how well or poorly it's run.
That's all I have.
Since it appears obama never supported single payer and never did-at least he has no problem with people suing their Drs and insurance companies.
Lawyers line up there will be thousands of lawsuits waiting. As the boomers age and the insurance companies practice denying people the care that they have paid for for 30 years or more-not to mention the care we paid for the ww2 generation-at least we will make some money somehow.
No, the insurance companies have that one figured out too, at least here in California. They bought the state legislature with their campaign donations and then had the legislature pass laws capping the amount patients could sue for. The cap is so unrealistically low, that most lawyers can't afford to take the malpractice cases. They would have to front huge sums of money to mount the lawsuit, and then would not recover their costs.
So...what is the big hurry - Obama wants a sweeping reform by the end of summer - what's the hurry?
Since this involves every resident of the US - why are all the decisions made small committee meetings?
EVERY American should have a say - EVERY American should have the opportunity to participate in the process.
We need more education - town hall meetings - and time.
Obama wants this in less time than it took to write the Consititution - Whta's the hurry?
We have an election year coming up in Congress in 2010.
A year of town hall meetings - a year of internet forums - a year of education and proposal development.
Then an election where we know the clear potion of our elected officials - Hold them accountable.
So ...what's the hurry - Where are "the people" - We need clear information and we need to know where representatives stand.
I don't get this. There is room for private health care insurers in a single payer or "universal" health care system. For example Canada's health care system has private insurers selling all kinds of coverage, dental, presription drugs, "enhanced" hospital room, elective procedures and all of the items which are NOT covered by basic health care. This insurance can be bought by consumers and/or provided by benefit plans at work. Some companies pay all of the premiums, some pay a portion with the employees paying the rest - it depends on the type and quality of what is offered by the employer. A lot of employees have no access to this supplemental insurance through work as either the employer does not offer it or the employee is ineligible (part time, contract employee for example).
The main thrust of the Canadian system is basic health care is provided. You will not go broke because of a catastrophic event and you will be properly cared for. I believe this is the sytem the U.S. could use as one of the templates for discussion.
THAT is gorgeous! I want to post that on the sides of buses! Hey, if atheists can pay for messages like "Science can fly you to the moon. Religion can fly you into buildings," why can't single-payer supporters put a statement like "Vote for single payer with option for enhanced care through private insurance"? Doesn't that take pull the rug out from under the argument?
That is such a good point, and that's all I'm asking for: basic care and protection from medical bankruptcy.
It's important, however, to keep this distinction in mind: any participation by private insurers in Canada and Europe is supplementary, at the margins. The main sources of funding are public and nonprofit--that's why those systems work and ours doesn't.
Besides--the best system would be total coverage by single payer. The reason most people cling to private insurance is the fear that they will be "rationed" or deprived of "choice"--both of which are canards. It's better to refute those canards than to start introducing complications about private insurers.
And yet, today, Michael Medved was ranting on the airwaves about how it's not the government's "responsibility" to provide health care to everyone--and he griped that his employer doesn't provide health insurance, so he spends his own money to provide coverage for his family. He complained that people who are responsible and buy insurance should not have to pay to provide insurance to anyone else, and shredded a caller (an albeit ignorant one) who said he wants a system like Canada's (calling it "socialized medicine"). The point of all of this is that the anti-Single Payer crowd has much more support in the media than those of us who support Single Payer. I'm sorry, but we're doomed.
Michael Medved is just one right-wing talking head--he's not the entire media. Ed Schultz has a much bigger audience--on both TV and radio--and he's been talking up single payer.
These "doom" posts are self-fulfilling prophecies of people looking for an excuse not to get engaged.