The Single-Payer Solution

As the media coverage of the Democratic presidential race continues to focus on lapel pins and pastors, America is ailing. As I travel around the country, I find people are angry and motivated. Like Dr. Rocky White, a physician from a conservative, evangelical background who practices in rural Alamosa, Colo. A tall, gray-haired Westerner in black jeans, a crisp white shirt and a bolo tie, Dr. White is a leading advocate for single-payer health care. He wasn't always.

He told me in a recent interview: "Here I am, a Republican, thinking about nationalizing health care. It just went against the grain of everything that I stood for. But you have to remember: I didn't come to those conclusions with lofty ideals of social justice."

In the early 1990s, his medical group started falling apart. White, a keen student of economics and the business of medicine, determined that it wasn't just his practice but the system that was broken.

"You're seeing an ever-increasing number of people starting to support a national health program. In fact, 59 percent of practicing physicians today believe that we need to have a national health program. I mean, that's unheard of, even 10 years ago. It's amazing to see a new generation of physicians coming up who are disgusted with our current health-care system. You know, we're trained to be advocates of patients, we're trained to save lives, we're trained to practice medicine. And instead, what we're doing is we're practicing Wall Street economics."

Single-payer is not to be confused with universal coverage, which Hillary Clinton and Barack Obama both support. In fact, in a recent debate, when Clinton raised the issue of single-payer, the audience interrupted with applause. She immediately countered, "I know a lot of people favor [it], but for many reasons [it] is difficult to achieve."

Why? One of the most powerful industries in the country opposes it-the insurance industry. Under universal coverage, insurance profits are preserved. Under single-payer, they are not. Dr. Rocky White, who now sits on the board of the nonprofit Health Care for All Colorado, has switched his political affiliation. He also has updated and reissued Dr. Robert LeBow's book on single-payer called "Health Care Meltdown: Confronting the Myths and Fixing Our Failing System."

He described possible solutions: "There are a lot of different types of single-payer systems-you could have purely socialized medicine. That's kind of like what England has. The government owns the hospitals, the government owns the clinics, the government finances all the health care, and all the doctors work for the government. That is truly socialized medicine, as opposed to the Canadian system, where the financing comes through their Medicare program, but all the doctors are in private practice."

The economics are complex, but this plain-spoken country doctor explains it clearly:

"You know, this industry is a $2-trillion industry, and the profits in the for-profit insurance industry are so huge and it's so deeply entrenched into Wall Street ... but until we move to a single-payer system and get rid of the profit motive in financing of health care, we will not be able to fix the problems that we have."

What would it take? Dr. White has spent his life dealing with the high winds on the high plains, from Nebraska to Colorado, and describes the challenge the country faces in familiar terms:

"I think that our current presidential candidates understand that ideally single-payer would be the best, but they don't have the political will to move that forward. Their job is to feel which way the wind is blowing. Our job is to turn that wind."

Amy Goodman is the host of "Democracy Now!," a daily international TV/radio news hour airing on 650 stations in North America.

(c) 2008 Amy Goodman