50 doctors for single payer urge Supreme Court to strike down individual mandate

By Single Payer Action

WASHINGTON — Fifty medical doctors who favor a single-payer health insurance system today urged the U.S. Supreme Court to strike down the individual mandate.

In a brief (pdf) filed with the Court, the 50 doctors and two nonprofit groups – Single Payer Action and It’s Our Economy – said that the Patient Protection and Affordable Care Act’s (ACA) individual mandate is unconstitutional.

The individual mandate is the provision of the ACA that requires Americans to purchase health insurance from private insurance companies if they do not otherwise have coverage.

The doctors are challenging the government’s claim that the individual mandate is necessary to reach Congress’ goal of universal coverage.

“The court should decide the constitutionality of the individual mandate based on the best available evidence,” said attorney Oliver Hall. “That’s why it is so important that these medical doctors provide the court with the information in their brief, which demonstrates that Congress can address the United States’ health care crisis by adopting a single-payer system.”

“It is not necessary to force Americans to buy private health insurance to achieve universal coverage,” said Russell Mokhiber of Single Payer Action. “There is a proven alternative that Congress didn’t seriously consider, and that alternative is a single-payer national health insurance system.”

“Congress could have taken seriously evidence presented by these single payer medical doctors that a single-payer system is the only way to both control costs and cover everyone,” Mokhiber said. “Instead, Senator Max Baucus (D-Mont.), chair of the Senate Finance Committee which drafted the law that became the ACA, had two of those doctors – Dr. Margaret Flowers and Dr. Carol Paris – arrested and thrown in jail. Those doctors are now two of the 50 who have signed onto this brief challenging the constitutionality of the ACA.”

“If the U.S. Congress had considered an evidence-based approach to health reform instead of writing a bill that funnels more wealth to insurance companies that deny and restrict care, it would have been a no brainer to adopt a single-payer health system much like our own Medicare,” said Dr. Margaret Flowers. “We are already spending enough on health care in this country to provide high quality, universal, comprehensive, lifelong health care. All the data point to a single-payer system as the only way to accomplish this and control health care costs.”

“People will have the greatest control of their own health care if the insurance industry is removed from between doctors and patients,” said Kevin Zeese of It’s Our Economy. “And, people will no longer be threatened with increased premiums, decreased coverage and financial ruin caused by a health crisis.”

Read the full brief here.


  1. Bill Mahan on February 23, 2012 at 1:05 pm

    America has allowed health insurance companies to apply their best free enterprise techniques to our healthcare and as a result produced the worst healthcare “system” in the developed world. We must rid ourselves of these evil, cruel, socially destructive, parastic middlemen that add only cost and complexity to our healthcare system. Yes, yes, yes to single payer, improved and enhanced Medicare for All!

  2. Ricardo on February 23, 2012 at 1:12 pm

    It would be wonderful if the alternative to the ACA was a sinle payer system but unfortunately that is not the case. The ACA is a step forward and doesn’t keep us for struggling for a single payer system. The ACA will not work without the individual mandate. Without the individual mandate, people will wait until they need healthcare and then sign up for health insurance. The individual mandate increases the number of healthy people in the insurance pool and will lower cost. People who have incomes below 133% of the poverty level will have Medicaid. Right now Medicaid covers people below 41% of the poverty level on average. Under the ACA people who’s incomes are below 400% of the poverty level but higher than 133% of the PL, will have a healthcare tax credit that will help them pay all or a substantial amount of their premium. To oppose the Individual Mandate is to play into the hands of the right wingers who oppose the ACA and a single payer system. Opposing the individual mandate is a step backwards not forwards.

    • van mungo on February 23, 2012 at 7:16 pm

      ACA is NOT a step forward–it’s a shameless boondoggle that serves only the interests of the big insurers and big pharma, not the needs of the American people–see my comment below, in response to “Judy.”

      Instead of parroting DNC talking points, you ought to study the facts. A good place to begin is the FAQ at the following Web site:


    • dianne on February 24, 2012 at 2:28 am

      Ricardo and Judy,

      Obamacare is most certainly several steps backwards. Perhaps you are not familiar with the failed MA plan which was used as the marketing tool for Obamacare. MA powerbrokers claim there are more than 98 percent insured in MA but that is simply not true. The state hired a firm that agreed to use a different income methodology to slant the figures. As of the 2010 MA census, there were 316,xxx uninsured which doesn’t include the number of residents at 150 percent and less FPL who don’t have to pay a penalty and have remained uninsured. It also doesn’t include people who don’t file a tax return. When the MA plan began about 6 years ago, there were 10.3 percent uninsured. If you do the math against the current population, there are 4.08 percent uninsured on the books plus the situations I gave above which are not included and most likely make the number of uninsured in MA at least 5 percent. So after 6 years and billions of dollars, half of the original uninsured are now insured. And 75 percent of the uninsured who are eligible for SUBSIDIZED plans can’t afford the premiums.

      ALSO, premiums have continued to increase in MA along with health care costs. No cost containment in the MA plan and none in Obamacare either. People who are struggling to pay the premiums – subsidized or not – can’t afford to USE the insurance. People in the subsidized plans have difficulty finding docs who will take them. That is due to the low reimbursement rate, and the no. of docs who will not take subsidized patients has increased each year.

      The MA Connector dumped 37,000 paying customers from their subsidized plans in 2009 WITHOUT their consent. This was to save the state $150 mil. Approx. 2 months ago, the MA SJC found the MA legislature (and I include MA Gov. Patrick b/c he makes his wishes known to the lawmakers) guilty of an illegal action and judged that these 37,000 be reinstated in their plans. So the state has to come up with $150 mil at least and doesn’t have the money.

      Fast forward to Obamacare and consider the items I’ve mentioned above for the entire country – not just the tiny state of MA – and you have an expensive mess that serves only to keep the insurance company making mega profits and the lawmakers collecting payola.

      People will have to choose between heating, eating, paying for lodging, education loans, property taxes, etc. and health insurance which many will not be able to afford or a tax penalty for being uninsured which will be enforced by the IRS (and that they can’t afford either).

      Americans found eligible for Obamacare’s expanded Medicaid will be dumped into that crappy plan with no other choice except to pay a penalty. Those who use Medicaid benefits at age 55 and up will be subject to the federally-required estate recovery program (OBRA 1993). When Medicaid was expanded to use as the dumping ground to this segment of the population, Medicaid regs were changed and one of these was: THE ASSET TEST WAS DROPPED. So many will be getting a mandated collateral loan. That is exploitation to say the least.

      The mandate must be repealed if for no other reason than the adverse effects that this scheme will have on the working class and poor.

      Basically, the way the MA plan and Obamacare works is the people who the politicians claim will be helped become the funding mechanism for this scheme. The tax credits (subsidies) go to the insurers – your tax dollars at work. And when more money is needed by the gov’t, the Exchanges (high-flying salaries and bennies for many tied to the industry) and the insurers, up go the premiums including those in the subsidized plans, so more people can’t afford to pay and are then taxed for being uninsured. A win-win for the gov’t and insurance companies b/c less people in the system to subsidized and more penalty money to pay for this unsustainable mess. That’s how it works, folks.

      It’s a Byzantium sinkhole. Perhaps a few will be helped, but how many is it OK to exploit in order to benefit a few?

      Coercion is deliberate violence and is inhumane. (Ghandi)

      The cheapest plan in the Exchange that is being considered will be 60/40 and the deductible will be high. If someone can afford better, than the next plan might leave them less underinsured.

      We need a single-payer system in America so everyone will have access to affordable care with UNIFORM benefits. Obamacare can’t provide that.

      P.S. If you want to call this Medicare for All, you must used the word IMPROVED b/c Medicare is not what it’s cooked up to be. Ask some SHINE counselors and many seniors.

  3. Judy on February 23, 2012 at 2:33 pm

    Those fifty doctors are idiots. We can always build on the affordable health care, but if we lose it we are back to where we were before and I have not forgotten the fighting that went on for a year before we got what we have now.

    • Emmy Dingler on February 23, 2012 at 3:10 pm

      I couldn’t agree more! Those doctors I guess, didn’t get enough of the old game in town.

    • van mungo on February 23, 2012 at 6:56 pm

      I see you’ve gotten your emotional catharsis for the day by flinging a cheap insult at some of the country’s most dedicated and brilliant progressive physicians.

      But Obama’s ACA is NOT a platform to build on, but a swamp through which we will all sink deeper into the clutches of the rapacious private insureres–the new law REINFORCES the insurer’s chokehold on the system by requiring that everyone buy their lousy, overpriced, undercovered products.

      And the so-called protections afforded by ACA are so tenuous and riddled with loopholes that they provide no real security in the face of the insurance pirates callous profiteering.

      Moreover, the two most desperate crises of our healthcare system go unaddressed by this law: soaring costs and massive gaps in coverage. Insurers are free to raise premiums to their stockholders’ greedy content, and even by the most optimistic estimates, some 25 million Americans–probably more–will remain without ANY coverage–a barbarity in the world’s richest nation.

      ACA is an unconscionable consumer fraud–a 2,000-page monstrosity authored by the health-sector lobbyists who lavished $16 million on Obama’s campaign in 2008 (more than all the other presidential candidates combined) and more on the Congressional Democrats than on the Republicans.

      You get what you pay for in Washington–and the Democrats, right down to the fake “leftists” Kucinich and Sanders, gave them their money’s worth–while you and I and the rest of the working stiffs of the country continue to suffer under the worst health-care system in the industrialized world (per the World Health Organization).

  4. Jane Jaehning on February 23, 2012 at 2:47 pm

    If change is to happen incrementally, making insurance companies nonprofit may be the next logical step.

  5. - bill on February 23, 2012 at 2:50 pm

    Of course the ACA will work (to the degree that it can be considered to ‘work’ at all) without the individual mandate: the resulting shortfall from those who elect not to purchase insurance will simply come out of general taxation (for those who are subsidized) and from individual pockets (for those who can afford it without subsidy). In fact, if tax brackets return to the more progressive levels of the past there’s at least a small up-side to using more general taxation to fund the program.

    Will higher taxes and/or out-of-pocket premiums to support the program jeopardize it? Perhaps, but even WITH the mandate a distressing amount of tax revenue and premium dollars will be funneled into it, so it will be in jeopardy anyway. And the more people dislike its cost, the more incentive there will be to seek better alternatives like Medicare for All.

    In fact, axing the mandate may actually make the argument that the ACA constitutes a step toward single-payer while temporarily at least establishing a commitment to more universal coverage more credible – by increasing the visibility of the need to take that next step, and take it soon.

    So enough of the ‘criticizing Obama (or in this case Obamacare) means you’re supporting the Republicans!” hogwash. Obama and Obamacare deserve a lot more criticism from the left than they’ve yet gotten, and I hope they continue to receive it. If they don’t like it, they know what they have to do to make it stop.

    • dianne on February 28, 2012 at 10:09 pm


      People not supporting Obamacare, or Obama for that matter, doesn’t mean they support Republican hogwash.

      I don’t support Obamacare. It is the failed MA plan on steroids. It is involuntary servitude. It is depostism disguised as health care reform.

      And, and I don’t support Republican idealogy either. That said, people in MA – Democrats and unenrolled – voted for Scott Brown b/c he was the 41st vote to filibuster Obamacare. That’s all we cared about b/c we know firsthand how the MA plan is regressive and oppressive for many and didn’t want this for the national plan.

      Doesn’t mean we support everything Scott Brown says – we had an agenda and his win was a referendum on nat’l health care reform. Democrats were calling other Democrats to vote for him. We didn’t want Coakley b/c she was the 60th vote the Senate needed to pass this POS nat’l plan. Only problem is, Pelosi gave MA voters the middle finger by using reconcilation.

      After that and all the lies about how great Obamacare will be, I’ll never vote for a Democrat again. But that doesn’t mean I’ll vote for a Republican.

  6. Keith on February 23, 2012 at 5:14 pm

    Good for them! Imagine if we financed fire and police protection like we do health insurance? Everyone would purchase a “policy” for the same price no matter where they lived or how much they earned, yet that’s exactly what the new health care legislation requires–and as a liberal I hope the Supreme Court decides the individual mandate is unconstitutional, so we can have an honest discussion about expanding Medicare to every citizen and legal resident. The American Medical Association coined “socialized medicine” to attack Truman’s Medicare proposal, and big business and unions bought in even though they understand employees in Europe, Asia, and Canada receive better coverage at far less cost than the U.S.

    Ten years ago the big three automakers and the Canadian Autoworkers Union signed a joint letter stating, “Publicly funded health care also enhances Canada’s economic performance in several important ways…The public health care system significantly reduces total labour costs for automobile manufacturing firms, compared to the cost of equivalent private insurance services purchased by U.S.-based automakers; these health insurance savings can amount to several dollars per hour of labour worked…It is vitally important that the publicly funded health care system be preserved and renewed, on the existing principles of universality, accessibility, portability, comprehensiveness, and public administration.”

    We should pay for health insurance like most regions finance police and fire protection through payroll or property taxes and let a handful of existing insurance companies administer the program with a couple conditions. 1. Insurance companies must operate as highly regulated non-profits and accept all applicants into a single risk pool. 2. The medical community must accept all insurance plans.

    We cannot continue paying over twice what most countries pay and receive far less service if we want to remain a global player. Health insurance cost more than most people pay for housing now, and the only way out is to pool our resources like we’ve always done during hard times.

  7. Daniel on February 23, 2012 at 8:52 pm

    In a free enterprise system competition serves to keep prices low. Because of this, most businesses try to set their prices lower than the competition to attract customers. At the same time, they try to offer more, or better, services than the competition to attract more customers. The mandate REMOVES this important economic driving force! The mandate will provide a customer base that the health insurance companies don’t have to compete for! If you think health insurance is expensive now, just wait until the little bit of competition we have now is removed. There is no possible way this will make insurance cheaper.
    The way to get health insurance costs to go down is the complete opposite of making it mandatory that everyone purchase insurance. The cost of medical care, and insurance, would go down if it was mandatory that everyone DROP their insurance. Most hospitals and doctors will give a 60%-70% discount on the bill if you tell them you are paying cash. In many cases, this amount is far less than the cost of insurance, and sometimes even less than the copay! The more people that discover this and drop their insurance, the more the insurance companies will have to reduce the cost, or increase services, just to stay in business.

  8. Alice Knapp on February 24, 2012 at 12:48 am

    As a former health insurance regulator in Maine (which enacted many of the ACA’s key reforms in the early 1990’s) who has watched where incremental reform has gotten us, I regularly point out that I have never heard an uninsured person argue in favor of incremental health reform. My contempt for the ACA flows from the fact that: 1) it is NOT universal healthcare and throws 10% of our population overboard (I point out that, in my view, accepting “reform” that leaves 10% of the population uninsured is the moral equivalent of endorsing legislation that would have freed only 90% of the nation’s slaves); 2) it is profoundly inequitable (I can’t see the ACA in any way changing our 55th place WHO global health care system ranking on equity); 3) it absurdly perpetuates our wildly inefficient, expensive, fragmented health care financing system; and, 4) the language used by the ACA’s supporters to promote and defend the law is reprehensibly dishonest (e.g. “shared responsibility”). An individual over 400% of the Federal Poverty Level ($43,560 in 2011, about what the average Maine teacher earns) does NOT qualify for any premium subsidy, and the only coverage available in Maine’s individual market for the likes of me (age 52) that would cost someone earning $45,000 less than 8% of their gross income has at least a $10,000 deductible (the ACA’s only nod to those thrown to the tender mercies of the for-profit insurance market and left to fend for themselves is that there is no penalty for failing to comply with the mandate if the cost of some as-yet-undefined mandated level of benefits would exceed 8% of gross income). The dishonesty around the mandate lies both with trumpeting the availability of subsidies for households making up to near $90,000, without explaining that the $90,000 figure represents 400% of FPL for a household of four so good luck if you’re a household of one (a steadily growing demographic nationally), coupled with the insulting suggestion that the uninsured are somehow irresponsibly costing the rest of us when they use the ER. This both perpetuates the fiction that one can get all the care one needs for free through the ER (conveniently ignoring the studies concluding that 3,000 uninsured Americans die monthly for lack of access to needed care), and it also ignores the fact that most of the uninsured work full-time but can’t afford decent coverage. I also regularly point out that in our system of what I call “selective socialism” in which 50%-60% of the population enjoys free or heavily subsidized government funded health care (e.g., Medicare, Medicaid, military healthcare, government employees, etc.) the uninsured and underinsured, through their taxes, help provide benefits they and their families need but can’t afford to someone else, which is like paying for public education but your kid can’t go.

  9. JJ on February 24, 2012 at 3:29 pm

    There are other questions about this mandate that have gotten little attention:
    1) It may constitute Compulsory Speech with no acceptable way to opt out (as it is with auto insurance…by not buying a car). To escape the insurance costs and the IRS penalty, one would have to deplete income to below that poverty level, leave the country, or commit suicide.

    2) Since insurers spend fortunes of our health care money on lobbying (for legislation we favor?), “customers” would be compelled to thereby support legislation that may be the cause of ones grievances. Right to Redress of Grievances would be undermined.

    3) Insurers spend more fortunes of our ostensible health care money funding political candidates… often opponents of our preferred candidates. “Customers” would thereby be compelled to undermine their own voting rights.

    4) For-profit insurers invest billions in health-damaging industries, from cigarette manufacturing to fast food and oil, fracking and coal on to nukes, pesticides, and military weapons. This creates a big incentive for insurers to do as little as possible to search for, expose or even properly provide for treatment of diseases caused by their investment properties.

    5) And, of course, private insurers are duty-bound to grow forever thus continuing the system of providing as little service as possible at the highest possible cost. That is an unacceptable adversarial situation, one that would not exist with Single Payer.