“Dems Have Super-Majority To Demand Single-Payer Universal Health Care”
On The Ed Show, Vermont Senator Bernie Sanders talks about the Arlen Specter defection to the Democrats, and how the grassroots now has to rise up and demand single-payer universal health care if they want it.
Our country needs single payer healthcare for all. The for profit health care is a failure and it is time for the people to rise up and demand change. The change to single payer will serve all the people, rich, middle class and the very poor. We need it.
Members of Congress are not only afraid of losing health industry campaign money for themselves and their party, they also fear that industry will fund candidates to run against them, if they “step out of line”.
If Members of Congress are going to do the right thing, they will need a safety net, an alternative source of campaign money – publicly funded elections.
Read about the Durbin/Specter “Fair Elections Now Act” at
http://www.commoncause.org/site/pp.asp?c=dkLNK1MQIwG&b=4773857
Ed:
Read this op ed I published, and then have me on your show. I’ll knock the single payer interstate health insurance issue out of the ballpark.
Reprinted From: ‘On Call’ The Journal of the Palm Beach County Medical Society
Nov-Dec, 2007
On Line: http://www.pnhp.org/news/2008/february/what_government_does.php
What Government Does Better: Health Insurance
Howard A. Green, MD, FACP, FAAD, FACMS
You’ll listen to me because I’m your doctor. I only have your health interests in mind. I have written this article without ‘prior authorization’ from any insurance companies.
There are some intuitively obvious services that the government runs more productively and efficiently than private for-profit enterprises. For example, our armed forces and GI’s conquer and hold and protect territory more effectively and at a fraction of cost of private militias such as Blackwater USA and the Crescent Security Corporations. In addition, the government rules and regulations which our governments’ military adhere to insure an ethical cohesive fighting force compared to the unregulated for-profit corporate armies. Our GI soldiers assigned to kitchen duty prepare and cook meals at a fraction of the cost of identically prepared meals from the private for-profit logistics divisions of the Halliburton or Kellog Brown and Root Corporations. Government regulated public education in America such as the undergraduate and college systems of the City of New York and other large metropolises have for over a century produced more CEO’s, doctors, lawyers, accountants, engineers, chemists, poets, philosophers and military officers than any private school system, and at a fraction of the cost compared to all the private schools in the country combined. Take away the government grants, government tax breaks, and government sponsored free overseas labor from Americas top private Colleges and their classrooms and graduate programs would most likely shut down, no matter how large their private endowments. The government run and regulated public school systems of Israel, India and China are churning out competent engineers, scientists and entrepreneurs at a quality and rate much greater than that of any collection of private schools in any country in the world. These non-American people, highly educated by their government run school systems, have formed a new collective worldwide labor arbitrage system which is fueling the productivity of intercontinental private business. The Marshall Plan, Interstate Highways, Space Program, Peace Corps, and the GI Bill all demonstrate successful government run bureaucracies of their time.
In a similar fashion, our mammoth government-run health insurance company (Medicare) operates at a fraction of the cost of private insurance corporations such as Aetna, Cigna, United, Blue Shield Blue Cross, Kaiser Permanente and Humana. Medicare, the government health insurance for the elderly uses only 1-2% of your dollar to achieve rates of morbidity (sickness) and mortality (death) among their patients which are identical to those of the private health insurance corporations. However, private insurance corporate bureaucracies inefficiently siphon $500-$750 billion per year, or 20-30% of your hard earned dollars away from doctors, hospitals and patient care into the pockets of their executives, administrative employees, shareholders and politicians. The recent stock option fraud perpetrated by the CEO of United Health Care demonstrates the negligent disdain the private insurance corporations have for physicians, hospitals, health care workers and patients. Since their founding 40 years ago, private health maintenance insurance corporations have failed to deliver what their business plans always promise; lower rates of morbidity and mortality associated with low costs to the patients. These insurance companies are financially profitable for their shareholders and executives, but medically bankrupt for their patients. Without their own massive government subsidies, government protection from malpractice lawsuits, and a government ban on collective bargaining by physicians the private health insurance corporate bureaucracies of Aetna, Cigna, United and Humana, and hundreds of other smaller health insurance companies of the health insurance industry would undoubted fail to exist. Most elderly people who call themselves Republicans, and conservative physicians in this Country have recognized the efficacy of our government regulated Medicare health insurance corporation and have enrolled themselves and utilized this Government run health insurance company for their own medical needs (despite the shrill cries of socialized medicine from their leaders). 40 years ago we heard these same shrill cries from organized medicine and Republicans concerning the establishment of Medicare. After accepting hundreds of billions of dollars in Medicare Insurance payments over the ensuing 4 decades, one can only wonder why conservative physicians still rally like Quixote against this government run insurance product.
The following 9 steps will simply suggest how, without the inefficiencies and burden to productivity of private insurance corporations, we can deliver efficient and effective comprehensive health care with great savings and no sacrifice of jobs. In fact, we may be able to decrease morbidity and mortality in this Country with one coordinated system which cares for all Americans, and concurrently analyzes optimal diagnoses and treatment modalities through its integrated computerized billing system. The savings incurred insuring all Americans through the more efficient Medicare system will benefit all citizens of our Country.
9 Steps to Comprehensive Quality Health Care in America
1) Shut down the private health insurance corporations.
2) Enroll all Americans (including Veterans) and the 40 million uninsured citizens into the Medicare Health Insurance Corporation. Since the current functioning Medicare Insurance Company is already accepted by almost all physicians, Hospitals and clinics in the Country, hardly any infrastructure investments on the health care delivery end will be necessary. Have all private businesses pay a Medicare premium for their employees instead of private health insurance premiums. Let employees as well as businesses contribute a fixed premium amount based on their age up until 65 for their Medicare services and drugs. Freeze current premiums for all Americans over 65 and adjust in the future according to the cost of living index. These premiums paid by businesses to Medicare for their employees should be less than that paid to current private insurance companies because of the lower overhead costs of the Medicare Corporation and improved risk distribution.
3) Hire the now unemployed former private health insurance corporate bureaucrats to actually deliver and not inhibit health care by working in hospitals, doctors’ offices, clinics and nursing homes around our Country. Demographically, the percentage of elderly Americans is rapidly increasing. With every American now insured through Universal Medicare Insurance, real health care workers will be in desperate need. For the first time in the brief but bloody history of managed care, these former private insurance corporation employees will actually touch and improve care for patients by working in physical therapy, nursing, home health care and other ancillary patient care capacities.
4) Obtain by eminent domain (for the public good) the best of the intellectual property protected computer codes which the closed private insurance businesses previously used to monitor patient care and doctors utilization and performance. Private health insurance companies have used these computer programs exclusively for the purpose of strong-arming their contracted health care providers into doing less for their patients and increasing the premium costs for sicker patients in order to achieve higher corporate profits. Medicare on the other hand can use these same computer programs for the common good; to monitor, collect data and eventually improve the efficacy of diagnoses and the treatment of diseases and medical outcomes every time a doctor submits a bill. For example, wouldn’t it be nice to know as a medical consumer (patient) which oncology groups in Boston, New York or Houston have the highest cure rates for stage III breast cancer or Stage II prostate cancer? All those numbers currently exist in cancer registries nation wide and just need to be collected and honestly disseminated. Currently, instead of medical data which delineates morbidity and mortality and outcome performance, the medical consumer when choosing an oncologist must rely on word of mouth, physician referrals or advertisements in the local papers which show photographs of smiling doctors in white coats who claim to be the ‘best’ doctors in town. Solid medical outcome and prevention data would foster a beneficial marketplace competition between physicians and hospitals which currently doesn’t exist due to the complete lack of outcome revelations by the private insurance companies. In addition to garnering invaluable instantaneous epidemiologic data on diagnoses and treatment of diseases based on severity and other variables, a strong Medicare based utilization review computer code would also allow Medicare to monitor doctors and hospitals who abuse a fee-for-service billing system. Any physician, institution or service found to abuse the Medicare fee for service billing system after proper review and appeal should be dealt with severely through stiff penalties and loss of their Universal Medicare provider contract.
5) Freeze Medicare physician, hospital and ancillary services reimbursements at current 2008-2009 levels. Adjust reimbursements for future services yearly by Cost of Living increases, or in the event of a deflationary economy a decreases in doctor and hospital payments. Ask any physician and they’ll tell you they would accept current reimbursement rates with COLA over the current mysterious illogical fee adjustment system of Medicare, or the physician population density reimbursement formula used by most private insurance corporations. Two tiered medical systems separating the “haves and have not’s” of society have and will always exist. Therefore, we must allow physicians to practice medicine without enrolling in or accepting the Universal Medicare reimbursement. With private medical insurance no longer available, and no performance based evidence for improved morbidity and mortality among their private for-pay patients, these extraordinarily expensive private ‘VIP’ practices will be limited.
6) Allow Medicare, much like the current Veterans Administration System and every private health insurance company and government health care system around the world, to bid on medications from pharmaceutical corporations for its Medicare drug formulary. Every physician recognizes that we don’t need a choice of a dozen redundant drugs in each pharmaceutical category. For example, we need only 2-3 statins for cholesterol, a handful of antibiotics for infections, 2 beta blockers for hypertension, and a few pain killers. Once the Government bids on pharmaceuticals for the Medicare Corporation formulary, macro economics will force prices to massively decrease to levels identical to that which all the other people of the world outside of America are paying for the same medicines. Since it has not effectively decreased morbidity or mortality in this Country, and only wastes money, we should also prohibit pharmaceutical companies and their workers from contributing to political campaigns or buying commercials on the public airways. We need to also prohibit the current practice whereby your local pharmacy and pharmacist sells your private medical diagnoses and your doctors private prescribing drug information to pharmaceutical companies so the pharmaceutical companies in-turn can directly pressure-market physicians. Prohibit pharmaceutical companies from contributing to organized medicine societies, colleges or associations because the doctors can’t rely on soft bribes or free lunches to prescribe what’s best for their patients. Prevent pharmaceutical representatives from visiting doctors’ offices or hospital pharmacies directly. Allow delivery of Medicare formulary approved sample medications for patients to physicians’ offices via post office mail only. Allow pharmaceutical companies to market products to physicians only via peer reviewed publications delivered by email or snail mail.
7) With the savings incurred from closing the private insurance corporations and paying less for drugs, have the American government fully fund the National Institutes of Health (NIH) and the National Cancer Institute (NCI) and Small Business Innovative Research (SBIR) programs. Emphasis should be placed on basic bench research carried out at not-for-profit American Institutions which employ or utilize a majority of American Citizens in their laboratories and clinics. Too often American Universities rely on free overseas labor to conduct bench research. Clinical trials should emphasize new drugs and devices which have promise to significantly decrease morbidity and mortality for any disease, including orphan diseases. Since a large percentage of private funding for drug and device studies will originate in the expanding financial liquidity and innovations and patients of the emerging developing world, we should allow the FDA to utilize research data obtained by reproduced laboratory and clinical studies performed overseas as well as in this Country.
Corruption of honest academics should be curtailed. Force all investigators to release reproduced publicly funded scientific data for all scientists to review on the internet via the Freedom of Information act (The Senator Shelby Amendment). Prohibit rights of first refusal on scientific data for private companies performing research in non-for profit institutions which receive public funding. Any rights to profits obtained from intellectual property and patents invented with combined funding from government and private sources should be split fairly among the contributing government institutions and any other private corporations funding the research, as well as with the individual inventor. Prevent organized medicine societies, associations or colleges from contributing to political campaigns since campaign donations have no relevance for physician performance or patient morbidity or mortality.
8) Offer physicians the same legal protection from malpractice lawsuits which have been established for commercial health insurance corporations during the last 3 decades. This will
allow family practitioners and internists to fulfill their role as primary care physicians efficiently and productively tackling dynamic illnesses without prematurely referring their sicker patients to expensive specialists. Limiting med mal lawsuits will also allow physicians to use the national EMR and outcome data for the common good, thereby improving underperforming hospitals, doctors and therapists instead of simply suing their scrubs off.
9) The quality of current medical records software lags two decades behind business software. Therefore, we need to fund and challenge America’s best software corporations to finally develop standardized electronic medical records software for use in doctors’ offices and hospitals in order to increase the efficiency and productivity of physician charting, billing and prescribing. We should use the integrated medical records system to instantaneously and confidentially gather important epidemiologic data on physicians’ performance, patient diseases, and treatments. With new potent viruses and unsophisticated biomedical and nuclear warfare on the horizon, this system will be absolutely necessary for rapid National Security responses. Protect patient confidentiality at all costs to prevent the commercialization and abuse of patient data like that which the pharmacies trade today.
Lastly, some argue that Universal Government run health care in America will result in delays in diagnosis and treatment similar to those experienced in Britain and Canada. One can not simply compare the massive extremely functional Medicare insurance corporation based infrastructure which seamlessly delivers private health care to tens of millions of people yearly in the USA to the government run and owned westernized health care systems of Canada and Britain, France, Switzerland, Netherlands, Scandinavia, and Israel. America, for the last 40 years, thanks to the government run health insurance corporation-Medicare, has built an incredibly dense and fluid public insurance system involving almost all private doctors’ offices, private hospitals, private clinics and private ancillary services. The Medicare system dwarfs in breadth and actual private practitioners and efficacy the lesser insurance systems established in all other countries. The billing and reimbursement bureaucracy for private health care providers contracted with Medicare Insurance is already relatively streamlined and efficiently centralized in America thanks to 40 years of private physician, private hospitals and government cooperation.
We all know that the medically bankrupt private health insurance corporations and medical malpractice lawsuit threats have caused many disheartened physicians to quit practicing or downsize their practices in America. A continuation and technological upgrading of our most fair Universal Medicare based health insurance Corporation based on the concepts outlined above would undoubtedly motivate those disenfranchised physicians to return to the profession and bright younger physicians to invigorate the field. If patients, physicians and the Medicare Corporation continue to work together, without the deleterious interference of private for-profit health insurance corporations, malpractice threats and overt pharmaceutical marketing, the future for American health care will be healthy indeed.. A continuation of the status-quo mixture of a government subsidized private health maintenance insurance industry operating parallel to and within Medicare is wasteful, and will continue to provide no potential future health improvements for America.
Dr. Green graduated from the George Washington University and obtained his medical degree from the Boston University School of Medicine. He completed a 3 year residency in internal medicine at Thomas Jefferson University Hospital, Philadelphia, PA and is certified by the American Board of Internal Medicine. He completed four years of residency training in dermatology at Harvard Medical School which included specialty training in the dermatology departments of Boston’s Massachusetts General Hospital, Beth Israel Hospital, Children’s Hospital, Lahey Clinic, New England Deaconess Hospital, Brigham and Women’s Hospital, Boston’s Veterans Administration Hospital and Harvard Community Health Plan. Upon completion of his training at Harvard, Dr. Green was certified and has been recertified by the American Board of Dermatology. Dr. Green also completed a one year specialty fellowship in Mohs skin cancer and dermatologic surgery at the Boston University Medical Center.
Dr. Green has published dozens of scientific papers on mutagenesis, skin cancer, lasers and wound healing, and has several medical patents. Dr. Green is the founder and managing partner of Dermatology Associates, PA of the Palm Beaches. For the past 12 years Dr. Green has been selected by his peers and Castle Connolly Medical, LTD as one of Americas Top Doctors.
Any post that says “listen to me because I am a Doctor” is clear warning of an impending one-sided, circular argument.
By what you wrote it is clear you have never bothered to look at other countries’ health systems, and let your political dogma cloud your views.
Nice Job H. Green, MD.!!! This is a necessarily lengthy topic and I was happy to see someone else cover some of the topics that actually make this argument interesting. I’ve found that the more one learns about the current system, the more fundamentaly sound the single payer option becomes. I’ve discovered people saying that they don’t want someone (a bureaucrat) between themselves and their Doctors, oblivious to the fact that there is already someone (a capitalist) there to help the Insurance Company save money. They do this by mitigating their expenses, which translates into denial for services and or coverage, period. Corperations are bound by law to make money for their share holders! It is a disturbing fact that we as Americans ever allowed this to happen to begin with. Millions have probably died by now from routine check-ups that never happened or illnesses that went too far before being identified by Emergency Room visits. In my opinion, as long as there is Private Money to be made on American Illness, there will be a premium on health that the wealthy will win. I don’t understand why it’s so hard for some people to see that they’re being swindled. If some people chant Freedom these days we’ll do anything…we’ll go to War, we’ll abandon our core principles of due process and privacy (which is the weirdest) and we’ll have the word Freedom without it’s meaning.
Close the Public Schools, shut down the Armed Forces, Close the Police and Fire Departments and let the free market run wild and see how many of these ridiculous blowhards stick around! The Government can’t do anything indeed!!!
Single payer is the only plan that will contain costs and cover everyone. Any plan that leaves us with a plethora of private insurance companies will leave millions of Americans without health care (even if they have insurance) and continued skyrocketing costs.
There isn’t a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care? Quick, try to think of one government office that runs efficiently. Fannie Mae and Freddie Mac? The Department of Transportation? Social Security Administration? Department of Education? There isn’t a single government office that squeezes efficiency out of every dollar the way the private sector can. We’ve all heard stories of government waste such as million-dollar cow flatulence studies or the Pentagon’s 14 billion dollar Bradley design project that resulted in a transport vehicle which when struck by a mortar produced a gas that killed every man inside. How about the U.S. income tax system? When originally implemented, it collected 1 percent from the highest income citizens. Look at it today. A few years back to government published a “Tax Simplification Guide”, and the guide itself was over 1,000 pages long! This is what happens when politicians mess with something that should be simple. Think about the Department of Motor Vehicles. This isn’t rocket science–they have to keep track of licenses and basic database information for state residents. However, the costs to support the department are enormous, and when was the last time you went to the DMV and didn’t have to stand in line? If it can’t handle things this simple, how can we expect the government to handle all the complex nuances of the medical system? If any private business failed year after year to achieve its objectives and satisfy its customers, it would go out of business or be passed up by competitors. The military? Nope. look at the money that’s been “lost”, not to mention wastes.
In his book A Critique of Interventionism, Ludwig von Mises wrote, “Authors of economics books, essays, articles, and political platforms demand interventionist measures before they are taken, but once they have been imposed no one likes them. Then everyone—usually even the authorities responsible for them—call them insufficient and unsatisfactory. Generally the demand then arises for the replacement of unsatisfactory interventions by other, more suitable measures. And once the new demands have been met, the same scenario begins all over again.”
No words could more accurately describe the nature of America’s health-care crisis. After decades of governmental intervention into the health-care arena, the failures are apparent for all to see. But rather than root out the cause of the problem, Americans are demanding that government do something about it.
Why Is There No Car Insurance Crisis?
by Wayne Dunn
Is there something special about health insurance that makes it crisis-prone? I mean, we never hear about the horrible “house insurance crisis” or the “spiraling cost of auto insurance.”
It wouldn’t be too hard to create such a crisis though. In fact, let’s try to map one out.
Just imagine if politicians resolved that, since automobiles are vital for getting people to work, companies ought to provide for the care and maintenance of its employees’ vehicles.
So political pressure is applied to employers– maybe through the tax code, or perhaps legislation is passed outright; and, before long, auto insurance is restructured to cover not merely accidents, but routine maintenance and service. For a monthly premium and a $10 or $15 “co-pay,”
your car insurance would cover the cost of an oil change, tune up, new tires, whatever it needed.
Something odd would begin happening though. Mechanics would stop hearing the now pervasive, “How much will it cost?”
Why? Because if all you had to do is plop down ten or fifteen bucks and your insurance paid the rest, why would you care what the mechanic charged? Heck, you’d start taking your car in for an oil change every 1000 miles instead of every 3000. Rather than getting your tires rotated, you’d just have new ones put on. And that rear electric window that won’t lower, you’d not think twice about having fixed.
The influx of customers seeking what would be virtually free service means, however, you’d have to wait days, even weeks, to see a mechanic.
Costs would skyrocket. Since comparison shopping would be a thing of the past, auto service centers would have no pressure to lower prices.
Moreover, they’d have to buy more equipment and hire more employees to accommodate the heavier workload, driving costs still higher.
Insurance companies would have to raise premiums. Some people wouldn’t be able afford it. So politicians would trot out new government programs — Car-aid, Car-care– to help the “disadvantaged.” We’d see another deduction on our pay stubs. The numbers of “disadvantaged” would swell.
Resultantly, auto shops would have to hire more clerks to manage all the red tape generated by the government programs and regulations, making costs even higher. Perhaps by then an oil change might run $200 and a brake job $1000.
Before long, we’d hear speeches about our alleged “right” to affordable car insurance. Some would even propose putting everyone on the government dole with “universal” car care coverage.
Now in the midst of all this, imagine that some “radical” suggests the
following: that people would be able to afford car insurance and maintenance costs if only government would reverse everything it’d done to cause the mess in the first place.
How would that likely be met? Probably with screams of “You don’t care about the poor!” and “Do you expect people to pay for oil changes out of their own pockets? Have you seen how expensive they are?”
See how easy it is to kick off a crisis? Just add a little government control in the “right” area, and the thing practically runs on cruise control.
America doesn’t have a health care crisis. It has government crisis. Or, put another way, it has a freedom crisis.
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In a nutshell:
Pros:
1. The number of uninsured citizens has grown to over 40 million.
2. Health care has become increasingly unaffordable for businesses and individuals.
3. We can eliminate wasteful inefficiencies such as duplicate paper work, claim approval, insurance submission, etc.
4. We can develop a centralized national database which makes diagnosis and treatment easier for doctors.
5. Medical professionals can concentrate on healing the patient rather than on insurance procedures, malpractice liability, etc.
6. Free medical services would encourage patients to practice preventive medicine and inquire about problems early when treatment will be light; currently, patients often avoid physicals and other preventive measures because of the costs.
Cons
1. There isn’t a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care?
2. “Free” health care isn’t really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.
3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.
4. Government-controlled health care would lead to a decrease in patient flexibility.
5. Patients aren’t likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.
6. Just because Americans are uninsured doesn’t mean they can’t receive health care; nonprofits and government-run hospitals provide services to those who don’t have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.
7. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.
8. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.
9. A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.
10. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.
11. Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
12. Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.
13. Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.
14. Like social security, any government benefit eventually is taken as a “right” by the public, meaning that it’s politically near impossible to remove or curtail it later on when costs get out of control.
And here’s a place that has many references of how it’s not so “good” in other countries.
http://www.angelfire.com/pa/sergeman/issues/healthcare/socialized.html
First, the car-insurance comparison is really not a fair analogy. We hear frequent comparisons of health insurance to car insurance, especially by those who would like to further enrich the insurance companies by mandating that people purchase private health insurance. However, there is no reasonable way to fairly compare an unfeeling metal and plastic object to a living, breathing human being. When someone’s precious child or lifetime partner is dying, when a terminally ill person is trying to come to terms with leaving behind everything is familiar, when a person is suffering, when pain is intractable, what kind of a society turns its back and says, “I’m sorry, you didn’t buy a ticket for admission, or you have the wrong kind of ticket, or your ticket has run out?” At some point, we are going to have to decide what kind of nation we are going to be. If we continue to treat the essential need of care for the sick, helpless, and most vulnerable as a commodity, we are blatantly admitting that we worship money at the cost of our souls, or that we are only willing to empower those who do.
I also feel that I must make some counter-arguments to the “cons” of single-payer health care listed in the post above. I have listed them as numbered above and responded.
1. There isn’t a single government agency or division that runs efficiently; do we really want an organization that developed the U.S. Tax Code handling something as complex as health care.
The inefficiencies that we sometimes see in government programs are usually not the result of inefficient administration by federal employees in the field. More commonly, they are the result of for-profit, private industry intervention into and undermining of these programs that has come about because of the ability of private corporations and affiliated organizations to unethically influence our elected officials with huge campaign contributions, promises of future high paid lobbying jobs, etc. Private industries are efficient at making a profit; they are often not so efficient in contributing to the well-being of average Americans. The private sector is not always better. Where would those who have lost their retirement funds to the financial crisis be now without Social Security? As another example, concerning education, the misallocation of resources that should be used for smaller class sizes, tutors for young children with reading problems, etc. to the companies that now profit from the testing craze has come about because of the lobbying of the Business Roundtable and the testing companies, not because of employees that work directly in the delivery of education. What is needed is comprehensive election reform, campaign finance reform, and media reform, even if it means changing the Constitution to retroactively reverse the disastrous Buckley vs. Valeo Supreme Court decision that contributed to our current “money is speech” boondoggle by essentially legalizing bribery. The answer is to reshape the election process so that our representatives actually represent us. The answer is not to allow the government to abandon its obligations. Some things, such as fire protection, police protection, and education should be rights of citizenship. Would you really want fire department protection only for those who can afford it? Don’t forget that the wind can carry your neighbor’s fire to your house. In other 1st world countries, health care falls into the same category as fire protection. It is viewed as a public good, and that is the way it should be here.
2. “Free” health care isn’t really free since we must pay for it with taxes; expenses for health care would have to be paid for with higher taxes or spending cuts in other areas such as defense, education, etc.
Single- payer health care would require payroll taxes, but these would replace the premiums and out of pocket costs we now pay, and most of us would end up paying less than we are paying now. This could be done with establishment of an employer/employee payroll tax of 4.75% each (includes present 1.45% Medicare tax) as is suggested by HR 676, or with an employer/employee payroll tax of 7.25% on employers and 3.25% on employees, which has been suggested by some single payer advocates. John Conyers, Jr., a co-sponsor of HR 676, states, “under the plan created by H.R. 676, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. No deductibles, no co-pays, no worrying about catastrophic coverage.” It is not true that there would have to be spending cuts in other areas such as defense and education. This would only be necessary if we choose an expensive subsidized private insurance plan to try to achieve universal coverage without converting to a single-payer system.
3. Profit motives, competition, and individual ingenuity have always led to greater cost control and effectiveness.
The argument that the private industry is the more efficient financer of health care simply does not hold water. “Costs of Administration in the U.S. and Canada,” a 2003 New England Journal of Medicine study, revealed that the cost of keeping private health insurance involved in health care is at least 350 billion dollars a year. That’s half the cost of the bank bailout everyone has been wailing about, and we continue to endorse this waste, year after year. Traditional Medicare runs with lower overhead costs than the Canadian system, so it is likely that the savings would be even more. It is unacceptable to pay so much for so little. The only way we are going to be able to care for everyone, with quality care, is to retrieve the dollars that are currently being wasted on the paperwork, corporate profits, and executive compensation that are associated with the private insurance system.
4. Government-controlled health care would lead to a decrease in patient flexibility.
Single-payer health care is not government controlled. It returns the role of decision making to physicians (with peer review), wrestling it back from the insurance companies that are now attempting to control doctor’s decisions for the sake of their profit margins. We would still have private doctors and private hospitals, and we would have more patient flexibility because we would no longer be trapped within HMO and PPO plans that limit our choices of doctors and facilities.
5. Patients aren’t likely to curb their drug costs and doctor visits if health care is free; thus, total costs will be several times what they are now.
Most people work, tend to homes and loved ones, and have busy lives. They do not have time to spend in doctors offices when they are not sick. If we are worried about the overuse of nonessential medications, we could pass legislation to curtail television advertizing. In fact, the limitation on doctors visits that we now have, due to lack of insurance and high out-of- pocket costs, contributes to late diagnoses of serious illnesses, which is far more expensive than preventative care and early treatment of diseases such as cancers.
6. Just because Americans are uninsured doesn’t mean they can’t receive health care; nonprofits and government-run hospitals provide services to those who don’t have insurance, and it is illegal to refuse emergency medical service because of a lack of insurance.
Where are these nonprofits and government run hospitals that provide free care to those that don’t have insurance? I know someone who needs one right now. I was at a health care reform meeting a week ago. A man spoke about his former job as a plant supervisor, and about how he had been let go because of his refusal to “get rid” of workers over 50, who were increasing the company’s group health insurance rates. He now works as a nurse at a low income health facility. Recently, they diagnosed a woman with cancer. She has no insurance, and she makes only $8.00 an hour. They can’t find anyone to treat her cancer. Yes, at some point, when she is screaming from excruciating pain, she will probably be seen in an emergency room, but it will be too late to save her.
While it is illegal to deny emergency care, people do get billed for it, and one emergency room bill, which would be catastrophic to a low-income family, would make it likely that there would never be a future visit. Many people will not go to the emergency room under any circumstance, due to fear of the potential bill. More importantly, emergency rooms do not provide the preventative and early diagnostic care and treatment that could keep illnesses from getting out of hand, and they do not provide follow-up care. By the time uninsured and underinsured people reach emergency rooms, it is often too late to help them, and if they are helped, the costs are astronomical, when they could have been more reasonable. For lack of a more accurate term, this is, quite frankly, a stupid way to run a health care system.
Six times more people die, every year, due to being uninsured, than died in the September 11th tragedy. Private insurance companies, with their rejections, exclusions, denials, and high out-of-pocket costs, have also contributed to the deaths of huge numbers of Americans. If a foreign country engaged in an activity that led to the deaths of this many of our citizens, we would be at war with that country. This is a whispering holocaust, but the media is, for all practical purposes, silent about it, because the bodies aren’t all piled in one place, and because some of the corporate owners and sponsors would be displeased if the issue were made a matter of public discussion. I applaud Ed for having the courage to speak up.
7. Government-mandated procedures will likely reduce doctor flexibility and lead to poor patient care.
The government would be more likely to consider the long term well being of the patients than insurance companies are. Patients who are not cared for properly, in the short term, will need more expensive care, in the long term. They are more likely to end up on disability, and if they die, they may leave children and widows/widowers who will need Social Security benefits. The government also feels some pressure to do the right thing due to the potential wrath of the voters. In contrast, insurance companies know that they will usually not have to bear the long term costs of caring for patients for whom they have denied or discouraged effective care. These patients often lose their jobs, and thus, their insurance. Once they have lost their insurance, the insurance company that contributed to the problem is freed from responsibility.
Our current situation, actually, is that insurance companies are running our health care system, and they are running it over the edge of a cliff. Doctors are often afraid of being dropped from plans if they displease the insurers too much, and this pressure often has a negative effect on their ability to practice medicine in the best interest of their patients.
Five years ago, my husband was hospitalized, about 8 weeks after breaking a leg and several weeks after an accidental pneumonia diagnosis, due to a massive pulmonary embolism situation. Days earlier, I had taken him home from a minor emergency center with a diagnosis of “leg cramp” after describing the classic symptoms of a DVT and pulmonary embolism. By the time he landed in the hospital, my husband was in a dire, life-threatening situation, but the hospital staff doctor seemed more worried about the fact that he needed to be out of the hospital in 4 days (according to our insurance company’s rules) than he was concerned about my husband’s medical condition. He was demanding that the respiratory therapist “walk him”, and she was bravely refusing, because of his excruciating pain and her concerns that remaining clots in his deep vein might also move up to his lungs. When we thought the hospital was about to send him home, in a state of panic, I called the night shift doctor and begged to have a Doppler done on his leg. (This had originally been ordered by the emergency room doctor, but my husband’s assigned doctor had canceled the test.) I wanted the test done because I was frightened that if I took him home, more clots might move up to his lungs to the point that he would suffocate. The next day, the staff doctor angrily stormed into my husband’s room and reamed me thoroughly. He said that I had been “teasing doctors into performing unnecessary tests that were not in my husband’s best interest and that our insurance might not pay for. I cried for a long time after he left because I was afraid that I had turned this doctor against us, and I didn’t think we would be allowed to have another doctor. Luckily, my husband had a relative who worked at this hospital, and I was able to acquire the number of a patient advocate to whom I could express my concerns about my husband’s condition. Once specialists were assigned to his case, it was revealed to us that he had one huge blood clot from his ankle to his hip. One of his lungs was so full of clots, there was only a nickel sized area free. The other lung also had a large amount of clots, and there was a large clot in his pulmonary artery. A procedure was done to drip blood thinner into the worst affected lung. Because of that, he is still alive, but due to the delay in proper treatment, he now has scar tissue in his lungs and a permanent heart rhythm problem.
This is only one story. The statistics tell a larger story, and they do not lie. There are occasional tragedies and medical accidents that are going to occur in any health care system, but we have the worst statistical health outcomes in the industrialized world, even though we pay the most.
8. Healthy people who take care of themselves will have to pay for the burden of those who smoke, are obese, etc.
I frequently get frustrated with this “blame the victim” argument. My husband has never smoked, he does not drink alcoholic beverages, and we have been more careful about our diets than most Americans are. Nevertheless, he has been in the hospital 4 times in the last 9 months. I would like to see more of a focus on prevention and wellness, and we could start be revamping the school lunch program. However, many health conditions are genetic or circumstantial. There are even genetic factors that contribute to the tendency toward obesity, and although most people do not want to believe it, there are genetic factors that contribute to various addictions. I don’t smoke. I exercise when my schedule will allow it, and I try to avoid junk food. However, I would consider it heartless to leave someone writhing in pain in the street, and even if that person were obese, an alcoholic, or a drug addict, I would consider it immoral to do so.
This tendency to blame the victims of illness has a long history. It was common even in biblical times. People shunned lepers, not only because of fear of the disease, but because they believed that lepers were somehow being punished for some deficiency in themselves or because of something wrong they had done. When I was a child, I used to recoil in horror at the Bible story of the rich man and Lazarus because I was dismayed with the concept of a God that would sentence someone to “eternal” punishment. I have since learned that the Greek word that was translated to mean “eternal” actually means “that which befits God, belongs to God, or is characteristic of God.” When I think of what kind of punishment might be characteristic of God, I remember the words from the book of Matthew, “as you measure, it will be meted to you again.” With that thought, the story of the rich man and Lazarus begins to make sense. If I close my eyes, I can envision a time, more than 2,000 years ago. The sun is beating down mercilessly, and a poor, sick man, covered with sores, too weak to even crawl, lies beneath it. Every day, a wealthy man, clothed in purple silk, walks by, paying no heed to his cries. The sick man is so light, so shockingly thin; he could easily be picked up and carried to the soothing shade of a nearby olive tree. One day, the sick man, consumed by miserable thirst, begs the rich man ardently for a cup of water. Desperately, as he is about to pass by, he grasps the hem of his purple robe and begs for just a drop of water. Then, the rich man, annoyed by this embarrassment and intrusion on his time, spits on the sick man, Lazarus, and says, “There is your water”. So when he died, the rich man, to learn from his mistakes, had to experience the misery of unbearable heat and unquenched thirst. This is the story Jesus told to those who believed that sick people should be forced to bear their pain as punishment.
9. A long, painful transition will have to take place involving lost insurance industry jobs, business closures, and new patient record creation.
I always hate to see people lose jobs, but why are health insurance related jobs considered more sacred than the manufacturing jobs that are lost because businesses collapse or leave the country as a consequence of unreasonable health insurance rates? Where is this concern about the loss of jobs when we continue to push through “free trade” agreements that almost always result in a net loss of jobs in the United States? At least after implementation of HR 676, former health insurance company and billing company employees wouldn’t lose their health care when they lose their jobs, which is what happens to almost everybody that gets displaced now. HR 676 does provide for retraining of those that would lose jobs as a consequence of the country transitioning to a single-payer system. There would not be a net loss of jobs because there would be a greater need for people to work in the actual delivery of care.
10. Loss of private practice options and possible reduced pay may dissuade many would-be doctors from pursuing the profession.
Doctors are also becoming very frustrated with our current system. Polls have indicated that approximately 59 % of doctors now favor a single-payer system. Also, while the AMA, an organization to which a minority of doctors belongs, is still officially opposed to single-payer, some of their members are dissenting. The American Medical Students’ Association is officially in favor of single-payer health care.
11. Malpractice lawsuit costs, which are already sky-high, could further explode since universal care may expose the government to legal liability, and the possibility to sue someone with deep pockets usually invites more lawsuits.
Malpractice lawsuits only amount to about 4 % of costs, and the expense of malpractice suits could be greatly reduced if people no longer felt the need to sue for the expenses associated with future medical care.
12. Government is more likely to pass additional restrictions or increase taxes on smoking, fast food, etc., leading to a further loss of personal freedoms.
The government might or might not place additional taxes on cigarettes and fast food, and they could do this with or without a single-payer system. Even if they did raise such taxes, people would still be free to choose to smoke and eat fast food; they would just have to pay more for it. In the long run, many people who have unhealthy habits really want to give them up, and the extra incentive that this tax burden would provide could be a deciding factor. If some people think we have to “punish” people for unhealthy lifestyles, this is a much fairer way to do it than by preventing them from getting needed care when they are sick.
13. Patient confidentiality is likely to be compromised since centralized health information will likely be maintained by the government.
I also have serious concerns about patient confidientiality, but again, electronic medical records are being proposed by people in both major parties, and this is something that can happen with or without a single-payer system. While electronic medical records could improve the coordination of care between primary care doctors and specialists, electronic records, without a single-payer system, could increase the risk of insurance companies, potential employers, and current employers trying to hack into the system to determine which patients might be expensive to insure. If we are going to have electronic medical records anyway, and it appears that we are, it is essential that we have a single-payer system.
14. Like social security, any government benefit eventually is taken as a “right” by the public, meaning that it’s politically near impossible to remove or curtail it later on when costs get out of control.
Health care should be a right, in a decent society, as Social Security is a right. Social Security costs would not be out of control if we would remove the cap, so that incomes above $200,000 would also be subject to the tax, as President Obama suggested during the campaign.
In closing, I would like to refer readers to a book that explains the severity of the problems of the uninsured and underinsured better than I can. The book, Sick, by Jonathan Cohn, published by Harper Collins Publishers in 2007 (ISBN – 10: 0-06-058045-3) contains many references about how health care is not so “good” here in the United States.
Great response Cheryl!!!
Cheryl,
Thank you for your well thought out reply to a error and BS filled commentary. You made my wading through the gross misinformation of C.S. worth while.
Boy are you Libs brainwashed by MSNBC and the Blowhards that spout out these blatant lies. If you knew anthing about what is really going on, you would see that there is wide reaching support against a Single Payer Health Ssystem at these Town Hall Meetings, not for. In fact, if you believe this drivel, you would think that’s what the majority of the people want. Too bad you’d be wrong in that thinking. Just type in Health Care Town Hall meetings in google, particulary Arlen Specter, and you tell me who wants this crap. No rational free thinkers, that’s for sure. It seems that the only ones who want it are either using it to buy votes, want to destroy Capitalism in the US (to be read as Socialists)or those who have always enjoyed their “free” healthcare in the past. Responsible people just simply don’t want it. By the way, if you don’t like the current system and it’s so bad, why don’t you do your Employer a favor, waive the coverage they give you and pay for your healthcare out of your own pocket. Oh I know why you won’t, you’re just a bunch of hypocrits who don’t want to pay premiums nor taxes as long as someone else can do it for you, that’s why.
Healthcare shouldn’t be about profit, because profit means spending the least you can on people that need preventive care. Healthcare should be a right for all, it’s about life and death, not ipods and movies, etc…
A Single Payer System will never be instated in this country without everyone being under the same flag,that includes elected officials most of all,unions and any other special interest groups are mandated to enroll in the very same plan that everyone else are mandated to enter.
Rick
Mr. DeMatteo,
This is a late reply, but for the record, I am not brainwashed by MSNBC or anyone else. Neither am I a liar. My opinions about health care are based on painful life experiences, research, and sound reasoning.
Also, I have never enjoyed free health care in the past. I have had to pay for my part of our huge for-profit system with hard earned money, and with blood, sweat, and tears.
It is also not true that all single-payer supporters are liberals. There is a group called Republicans for Single Payer and a group of Small Businesses for Single Payer. Google it.
In 2009,I did attend a health care rally where a lot of anti-health care folks were present. There were not more of them. They were just yelling louder, drowning out the intelligent and well thought out speeches of a neurologist, an emergency room physician, a physical therapist, a professor, and a mayor.
At that rally, I spoke softly to one woman who was vocally protesting universal health care while carrying an “Abortion is not Health Care” sign. I told her that when me nephew’s wife got pregnant, she lost her job, and thus, her health insurance. Luckily, my sister was able to keep her on Cobra. However, since it was not “family plan”, the baby would not be automatically covered after the first month. My sister tried and tried to find a policy for the baby, in case she might be born with some type of problem. No insurance policy would sell her an advance policy before the baby was a month old. They had to be sure, first, that the baby was free of any pre-existing conditions. I asked the woman with the anti-abortion sign whether she thought God also loved babies after they are born. She quieted down. She didn’t know what to say.
Mr. DeMatteo,
This is a late reply, but for the record, I am not brainwashed by MSNBC or anyone else. Neither am I a liar. My opinions about health care are based on painful life experiences, research, and sound reasoning.
Also, I have never enjoyed free health care in the past. I have had to pay for my part of our huge for-profit system with hard earned money, and with blood, sweat, and tears.
It is also not true that all single-payer supporters are liberals. There is a group called Republicans for Single Payer and a group of Small Businesses for Single Payer. Google it.
In 2009,I did attend a health care rally where a lot of anti-health care folks were present. There were not more of them. They were just yelling louder, drowning out the intelligent and well thought out speeches of a neurologist, an emergency room physician, a physical therapist, a professor, and a mayor.
At that rally, I spoke softly to one woman who was vocally protesting universal health care while carrying an “Abortion is not Health Care” sign. I told her that when my nephew’s wife got pregnant, she lost her job, and thus, her health insurance. Luckily, my sister was able to keep her on Cobra. However, since it was not “family plan”, the baby would not be automatically covered after the first month. My sister tried and tried to find a policy for the baby, in case she might be born with some type of problem. No insurance policy would sell her an advance policy before the baby was a month old. They had to be sure, first, that the baby was free of any pre-existing conditions. I asked the woman with the anti-abortion sign whether she thought God also loved babies after they are born. She quieted down. She didn’t know what to say.