Single-payer healthcare: better care, lower cost

By Josh Starcher –

Healthcare has already been proclaimed the central issue of the 2012 Presidential election, just like it was hailed the central issue of Obama’s presidency. It was also a central issue during the 2010 election, and the 2008 campaign. So why don’t we ever hear the end of it?

Our leaders still have not solved the problem with our nation’s healthcare crisis. Even with the passage of Obama’s Affordable Care Act, there will still be millions of Americans under-insured and without insurance.

America’s healthcare debate showed there are only two ways we’re willing to go: expand the for-profit health insurance industry by mandating everyone buy insurance, with its over-priced premiums, co-pays, and deductibles; or expand Medicare for all, providing universal healthcare through a single-payer system that lowers costs.

In a for-profit model you’re essentially paying for healthcare, as well as CEOs’ rising salaries, massive administrative costs for denial-of-claims departments, and those DTC advertisements we all love so much.

In the non-profit single-payer healthcare model individuals and businesses pay less in taxes than they’re currently paying in co-pays, premiums and deductibles. The administrative costs are also less, because medical records and “billing” would be on a National Healthcare Card. With a single-payer healthcare system everyone has a better healthcare plan — and access to it — than most anyone could afford now.

Lessons in America’s healthcare debate

Poll after poll shows the majority of doctors, nurses and consumers support expanding Medicare for all. During the “Healthcare Debate” a 2009 CBS/NYTimes poll reported that 59% of Americans agreed that the government should provide national health insurance.

Single-payer healthcare was also the deciding factor in Democrats winning the 2008 election and losing it in 2010. In ’08, many thought Obama would make demands for a system that covered everyone. Indeed, during the campaign a video emerged from 2003 where then-State Senator Obama proclaimed to the Illinois AFL/CIO: “I happen to be a proponent of a single-payer universal health care program.” To leave out any confusion, Obama followed that with the movement’s own mantra “everybody in, nobody out.” Many hoped that was a signal of change to come.

Sure, there was change, but not the kind most were expecting. Soon after taking office, he then said this: “If I were designing a system from scratch, then I’d probably set up a single-payer system … Medicare would be an example of a single-payer system, if everybody was in Medicare. But the problem is we’re not starting from scratch. We’ve got a system in which most people have become accustomed to getting their health insurance through their employer.”

Obama’s explanation simply doesn’t stick. Not only is Medicare a part of the system, expanding Medicare for all would have more people paying into it as Baby Boomer after Baby Boomer turns 65. Moreover, employer-based health insurance is one of the worst aspects of private insurance. In-doctor networks cause people to become trapped in their jobs. Doctor / patient relationships are also immediately destroyed when insurance plans change.

Why are Democrats and Republicans not making the right choice between healthcare and health insurance? It’s because they’re getting paid way too much to support the problem and not the solution.

According to the Center for Responsive Politics “about $31.6 million in contributions to candidates and committees during the 2010 election cycle” (and nearly $30 million during the 2008 cycle) came from the pharmaceutical and health industry. As Senate Finance Committee Chair Max Baucus said in 2009: “single-payer is off the table.” Apparently, the insurance and pharmaceutical giants paid for the table.

The Democrats’ base lost all hope, and by 2010 the Democrats lost their majority in Congress, essentially because they didn’t stand up for real reform. Americans don’t tolerate half measures and compromise when it comes to healthcare.

Real change starts with a single-payer

A single-payer, universal healthcare system can be set up so that it’s publicly funded yet privately delivered, particularly through the example of Medicare. No matter how many Tea Party candidates rant about “Obamacare,” or universal healthcare being “socialism,” doctors and nurses will not be government employees in a single-payer system.

For those who say, “I don’t want the government rationing care!” Right now, the insurance industry is profiting from denying them care they’re paying for. A single-payer system will give you more freedom of choice: your choice of doctor, the ability to afford the medicine you need, and access to more care. This means no co-pays, no premiums, no deductibles, no out-of-pocket costs and no medical bankruptcies.

For those who are concerned about the “publicly funded” part, I have one question: do we really want to mandate or even continue to implement a health insurance system where we pay such high premiums, co-pays, and deductibles that it leaves millions of people under-insured, or without healthcare altogether?

States lead the conversation

Candidates can win elections on a single-payer, universal healthcare platform.

California passed single-payer healthcare at the state level twice, but it was vetoed by then-Governor Schwarzenegger in ’06 and ’08. Vermont passed a single-payer healthcare bill this year, signed by Governor Peter Shumlin, who recognized local organizing efforts by the Vermont Worker’s Center. Vermont’s success, still in progress, appears to set the standard.

In a hotly contested debate this year, Rep. Kathy Hochul (D, NY) stood up in support for Medicare and won in a special election against the Republican challenger Jane Corwin, who supported Medicare cuts. This election, as mentioned by the New York Times, was in “one of New York’s most conservative districts.”

One fact remains: the insurance and pharmaceutical industry can pay off national candidates, but they can’t pay off millions of Americans suffering through medical bankruptcy or living with the burden of having no healthcare at all.

Passing single-payer universal healthcare bills at the state level would far exceed the ACA’s best qualities, but it will take standing up for single-payer and good ’ole grassroots organizing to get it done. This localized approach to organizing only makes the national movement stronger.

There are now groups in 23 states working on organizing around single-payer bills at the state level. If we can learn anything from the previous election cycles, and can understand the impact of state bills on national policies, it’s this: healthcare remains a central issue, and a single-payer plan is a winner.

Josh Starcher is a Volunteer Coordinator for Healthcare-Now! NYC.


  1. David B on October 9, 2011 at 10:13 pm

    For those who ask me why I am entitled to healthcare, I will simply say that the government is the reason why I can’t afford healthcare – driving up prices with expensive regulations. My tax dollars aught to come back to me instead of going to bank bailouts, golden parachutes, and a perpetual war machine in which corporations make billions off of death, desease, and war. Furthermore, I would be able to afford it myself if the government didn’t take so much from me, to give to others who are better off and less deserving.

  2. Joe T P on October 14, 2011 at 12:17 pm

    Selfishness by many members of congress seems to be the problem. They and their families are covered for healthcare. That is all they seem to care about. They don’t seem to care about the working people with little or no coverage. Poor people are already covered by Medicaid.

  3. Ilona Anderson on January 28, 2012 at 12:27 pm

    Single Payer healthcare is the only solution. Since we can’t do it on a national level, we need to do it on a state level to achieve good quality affordable healthcare with emphasis on prevention, and not on health insurance. Plenty of good examples to follow in Europe, though not Canada. Vermont already has it, all states need to follow through.