Single-payer health system could save billions

Because of the current financial crisis, many observers see no point in discussing an expansion of health care coverage this year — either federal or state.

Indeed, it is true that the current crisis is adding greatly to our public debt. And it is true that total health costs in the United States are already twice as high per person per year as those of any other nation and rising faster. If we were to start paying to insure our 50 million uninsured — plus an estimated 40 million Americans who are underinsured — costs would escalate hugely.

Believe it or not, there is one proposal that could cover all Americans for all needed services and save money. And it is now that we must explore that proposal. Studies have shown that national savings would amount to $350 billion per year.

At the national level, this proposal is called Medicare for All, and it is embodied in Congress as Bill HR676. In New York state, it is called Single Payer New York, and it is one of the options now being studied by the governor in Albany.

The propagandists call it “socialized medicine.” But it is not — because most doctors and hospitals would be private and working in their own facilities.

How could covering more people decrease total expenditures? The difference is in “administrative costs.” Private insurance companies have such costs totaling 15 percent to 30 percent. Medicaid is at 5 percent and Medicare at 1 to 2 percent. “Administrative costs” include advertising and shareholders’ profits, as well as the billing and collecting costs of hospitals, doctors’ offices, labs and X-ray facilities. These become a nightmare as patients change among a variety of insurers, or when they lose insurance by changing or losing their jobs.

HR676 is an expanded Medicare for All, and it is brief, simple, uncluttered: Everyone in the country is covered. Everyone has one card. Present costs disappear completely. The patient may go to any doctor or hospital. The entire health system is paid for by taxes on corporations and a progressive income tax. It is administered by a public or quasi-public body. Health providers do their jobs and receive a fee for service with the fee scales negotiated annually.

Do private insurance companies suffer? Yes. Their roles would be limited. That part is controversial, and that’s where the fight begins. Many feel that it’s impossible to beat the insurance industry. But if this is truly a democracy, who should decide such a basic public policy as this? The people or the corporations?

My own opinion, after 40 years of organizing to change the health care system, is that the private insurers have had decades in control. They have had their chance, and they have left us in a mess: We’re ranked 37th in the world by the World Health Organization for health care delivery; one-third of our population is uninsured or under-insured. Costs are higher than in any other nation; many parts of our population have worse care, higher morbidity and mortality rates than any other developed nation. It’s time to fight! President-elect Obama’s health proposal is not close to Medicare for All. But he is a good listener who encourages the grass roots to speak up.

Peter Mott, a retired professor of medicine at the University of Rochester, is a member of the Interfaith Health Coalition of the Greater Rochester Community of Churches.

This article is by Peter Mott and appeared on


  1. Dan on December 14, 2008 at 3:06 pm

    Facts that are believed to exist regarding the present U.S. Health Care System-

    This may be why about 80 percent of U.S. citizens want our health care system overhauled:

    The U.S. is apparently ranked number 42 related to life expectancy and infant mortality, which is rather low.

    U.S. is ranked number one in the world for spending the most for health care- as well as being number one for those with chronic diseases. About 125 million people have such diseases. This is about 70 percent of the Medicare budget that is spent treating these terrible illnesses. Health Care cost presently is over 2 trillion dollars of our gross domestic product. One third of that amount is nothing more than administrative toxic waste that does not involve the restoration of the health of others. This illustrates how absurd the U.S. Health Care System is presently. Nearly 7000 dollars is spent on every citizen for health care every year, and that, too, is more than anyone else in the world.

    We have around 50 million citizens without any health insurance, which causes about 20 thousand deaths per year. This includes millions of children without health care.

    Our children.

    About 70 percent of citizens have some form of health insurance, and the premiums for their insurance have increased nearly 90 percent in the past 8 years. About 45 percent of health care is provided by our government- which is predicted to experience a severe financial crisis in the near future with some government health care programs, it has been reported. Most doctors want a single payer health care system, which would save about 400 billion dollars a year- about 20 percent less than what we are paying now. The American College of Physicians, second in size only to the American Medical Association, supports a single payer health care system. The AMA, historically opposed to a single payer health care system, has close to half of its members in favor of this system. Less than a third of all physicians are members of the AMA.

    Our health care we offer citizens is sort of a hybrid of a national and private health care system that has obviously mutated to a degree that is incapable of being fully functional due to perhaps copious amounts and levels of individual and legal entities.

    Half of all patients do not receive proper treatment to restore their health, it has been stated. Medical errors desperately need to be reduced as well, it has been reported. It is estimated that we need about 60 thousand more primary care physicians to satisfy the medical needs of the public health in the United States. And we have some greedy corporations that take advantage of our health care system. Over a billion dollars was recovered for medicare and Medicaid fraud last year through settlements paid to the department of Justice because some organizations ripped off taxpayers. These are the taxpayers in the U.S. who have a fragmented health care system with substantial components and different levels of government- composed of several legal entities and individuals, which has resulted in medical anarchy.

    Thanks to various corporations infecting our Health Care System in the United States, the following variables sum up the U.S. Health Care System, which is why the United States National Health Insurance Act (H.R. 676) is the best solution to meet our health care needs as citizens. We would finally have, as with most other countries, a Universal Health Care system that will allow free choice of doctors and hospitals. It should be and likely will be funded by a combination of payroll taxes and general tax revenue:

    Access- citizens do not have the right or ability to make use of this system as we should.

    Efficiency- this system strives on creating much waste and expense as it possibly can.

    Quality- the standard of excellence we deserve as citizens with our health care is missing in action.

    Sustainability- We as citizens cannot continue to keep our health care system in existence , or tolerate it as it exists today any longer,

    Dan Abshear

  2. Patty McCredie on December 15, 2008 at 1:29 pm

    I WANT SINGLE PAYER. We’re paying already for people not covered by “insurance”–that is to say, companies who want to deny us health care if they can for larger profits. I don’t want a company owned by corporations, all the way up to decisions about life and death.

    We will save money with a single-payer system. Put people first, not insurance companies and profit! Extend Medicare to all.