NYT Slams Single-Payer

The New York Times devoted some rare space on September 20
to discussing single-payer (or Medicare-for-all) health reform. The
result? A one-sided account of why such a system couldn't work.

With a headline like "Medicare for All? 'Crazy,' 'Socialized' and
Unlikely," readers probably had a sense of what the Times had in mind
with the piece, which was the latest in a series titled "Prescriptions:
Making Sense of the Healthcare Debate." Reporter Katharine Seelye
wrote: "Extending Medicare to all has seemed like a good idea to
many--except to those who call it 'socialized medicine.' Or crazy."

The Times seemed to want to express single-payer opposition
in more gentle tones, explaining that the idea is, from the start,
politically impractical: "Beyond a liberal base in the House, there is
little support for expanding Medicare." And outside of Congress, wise
minds seem to agree: "But even experts of diverse ideological views say
expanding Medicare would be far more complicated and politically
difficult than it might appear."

That led to the first claim: "For one thing, they say, Medicare
reimburses doctors and hospitals at much lower rates than private
insurance companies do. So, in general, healthcare providers oppose
extending Medicare because they fear being driven out of business."
It's not clear how serious this fear might be, since most doctors
participate in the Medicare system without going bankrupt. Any attempts
to reduce the skyrocketing costs of the healthcare system involve cuts
of one form or another; most single-payer proposals discuss how to do
this without shortchanging physicians. (U.S. doctors make, on average,
almost three times the median physician salary in other wealthy
industrial countries--Ezra Klein, 4/19/06.)

It's worth noting that thousands of doctors have voiced support for a
single-payer system (see, for example, Physicians for a National Health
Program's letter
to Barack Obama), in part because they believe they spend too much on
the administrative costs associated with private insurance companies. A
survey of physicians published in the Annals of Internal Medicine (4/1/08) found that 59 percent supported government-sponsored national health insurance.

Seelye also wrote that Medicare for all "would almost certainly mean a
big tax increase on the middle class," before noting in parentheses:
"Supporters argue that a tax increase would be somewhat neutralized by
the elimination of premiums that people pay now to insurance
companies." Actually, single-payer advocates argue that a payroll tax
on businesses (many of which currently pay for private insurance for
their employees) and a small income tax increase that would likely
amount to less than what most citizens currently pay out of pocket
could fund a single-payer program. By calling a "big tax increase" a
near-certainty and treating the savings on insurance premiums as a
claim made by advocates, the Times told readers which side it was on.

Seelye cited Stuart Altman--identified as "a Brandeis economist who
specializes in health care and who advised Barack Obama in his
presidential campaign," but not as a director of a managed-care company
that offers health insurance plans (WhoRunsGov.com)--to
make a similar point about potential tax increases, and then went to
"the other end of the political spectrum" to quote Robert Moffit of the
conservative Heritage Foundation: "I don't see popular support for it
beyond liberals.... It's a philosophical question: Do you want to give
the government that kind of power?"

Of course, one might point out that public polling for years has
demonstrated that support for single-payer is much broader than merely
a liberal sliver of the population (FAIR Action Alert, 3/12/09);
a July 2009 tracking poll from the Kaiser Family Foundation found 58
percent support for Medicare for all. But a piece detailing the
deficiencies of a "crazy" single-payer system is an unlikely venue for
that.

Seelye quoted Moffit saying that single-payer "would not save taxpayers
money," while another academic suggested it would "require a tripling
in payroll taxes just to pay hospitals alone." These are stark claims
that are at odds with the research of single-payer advocates and
experts. Physicians for a National Health Program, for example,
calculate the annual savings on administrative paperwork under a
single-payer system at more than $350 billion. International surveys of
health systems generally show that nations that have adopted public
plans spend far less than the U.S., and achieve better results (BMJ, 5/26/07).

So why couldn't the Times quote sources who would take issue with these claims? From the looks of it, balance wasn't the point here. The Times
collected a litany of criticisms of single-payer healthcare--in effect
rebutting claims that the paper rarely allows its advocates to make in
the first place.

ACTION:
Ask New York Times public editor Clark Hoyt why the Times
ran a piece devoted to undermining the case for single-payer healthcare
without allowing advocates to make the case in support of Medicare for
all.

CONTACT:
New York Times
Clark Hoyt, Public Editor
public@nytimes.com
Phone: 212-556-7652