Published on
Billings Gazette (Montana)

Why is Single-Payer Health Reform Not Viable?

Mike Dennison

HELENA, Mont. - When it comes to health care reform in America, there is a
relatively simple solution that will cover everyone's basic health
care, control costs and save businesses, most people and the country a
lot of money.

It's called a single-payer health plan, where the
government collects taxes to finance national health insurance. The
government, which is the "single payer," covers all citizens and pays
the bills when they visit private (or public) doctors, hospitals and
other facilities for medical care.

All would have basic
coverage, regardless of whether they have a job, or where they work.
Nobody gets billed for basic care. No-body goes broke because of
medical bills.

Yet this option has been declared "off the table"
by Sen. Max Baucus, D-Mont., who's among those leading the charge for
health care reform in America.

Top Democrats who will be
deciding policy in America in 2009, including Baucus and
President-elect Barack Obama, say single-payer is "not politically
feasible," because the public won't strongly support it.

they really mean is that when it comes to health care reform, they
don't want a political fight with some of the nation's most powerful
financial interests, which have the resources and the motivation to
turn public opinion against meaningful reforms.

These interests
include the health insurance industry, pharmaceutical drug companies,
some hospitals, highly paid medical specialists, medical suppliers and
others who now profit handsomely from our current system - and who
could no longer command those profits under a single-payer system or an
alternative form of a national health plan.

There's no doubt
that it would be a huge political battle to attempt to install a
single-payer or other national health system in the United States.

But single-payer is not without its prominent supporters.

which would create national health insurance and a single-payer system,
was introduced last year by Rep. John Conyers Jr., D-Mich. and has 93
co-sponsors in the U.S. House. It has not even had a hearing.

500 labor unions from across the country have endorsed the bill, as
have AFL-CIO units in 39 states, including Montana. There is a national
coalition supporting single-payer, led in part by the California Nurses
Association (CNA), which has 85,000 members.

Michael Lightly,
director of public policy for CNA, said single-payer is "the most
fiscally conservative approach" to health care, because by having one
payer/insurer (usually the government), you eliminate the profits of
private health insurers, you negotiate bulk purchases of drugs, you
negotiate reasonable fees with health care providers and you have
global budgets for hospitals and large clinics.

Single-payer or
a regimented national plan also is how nearly all other developed
countries run health care and cover everyone - and at a lower price
than we do, because it's more efficient.

Yet Democratic leaders
in Congress, who want to reform health care, say single-payer won't be
an option, because it doesn't "poll well."

They cite polls
showing that the public thinks single-payer equates with "big
government" and taking away what insurance they already have. A
majority may like the idea, but that support erodes when asked if
they'd pay higher taxes to support it.

This polling is testing
the obvious lines of attack that single-payer's political opponents
would employ: big government, higher taxes, less choice.

single-payer is packaged in that context, of course it's a loser. But
as any skilled politician knows, if you craft a better message and get
it out there, you win.

Higher taxes? Not if single-payer all but eliminates the health insurance premiums that you and your employer currently pay.

government? In America, the government is the people, and you tell it
what to do. It has to be more responsive than big insurance.

choice? With single-payer, no doctors or hospitals are out of the
network, because there is no network. It's one system. Everyone gets
the same basic care. You might have to wait for specialty care or some
tests, but that's not exactly a deal-breaker.

"The only reason
it's not on the table is because there is a belief that it's not
politically viable," Lightly said. "That is a miscalculation in our
view. We believe that a real policy debate means single-payer must be a
part of that debate."

Lightly also said that even the mild
reforms proposed by Baucus and Obama are going to face a political
fight from insurers and other interests.

If you're going to have a fight, why not fight over something worth winning? he asks.

there's the simple question of morality: In America, an incredibly
wealthy country, shouldn't we join the modern world and guarantee basic
health care for all, regardless of the ability to pay?

As health
care writer T.R. Reid told a Helena audience a week ago, our neighbors
are suffering and dying because they don't have decent health coverage.

don't believe that? Just open a newspaper or walk into your local
grocery store. Every week, you're bound to see a flier or advertisement
for a fundraiser for someone who's been horribly injured in an
accident, or stricken with cancer or other debilitating disease, and
can't pay thousands upon thousands of dollars of medical bills.

Under a single-payer system or other national health care plan, that wouldn't happen.

But unless citizens apply the pressure to our political leaders, it won't even be considered.


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