Top Ten Enemies of Single Payer

By Russell Mokhiber of Single Payer Action

Most people, when they arrive in Washington, D.C., see it for what it is – a cesspool of corruption.

Two reasonable reactions to the cesspool.

One, run away screaming in fear.

Two, stay and fight back and bring to justice those who have corrupted our democracy.

Unfortunately, many choose a third way – stay and be transformed.

Instead of seeing a cesspool, they begin seeing a hot tub.

The result – profits and wealth for the corporate elite – death, disease and destruction for the American people.

Nowhere does this corrupt, calculating transformation do more damage than in the area of health care.

Outside the beltway cesspool/hot tub, the majority of doctors, nurses, small businesses, health economists, and the majority of the American people – according to recent polls – want a Canadian-style, single payer, everybody in, nobody out, free choice of doctor and hospital, national health insurance system.

Inside the beltway cesspool/hot tub, the corrupt elite will have none of it.

They won’t even put single payer on the table for discussion.

Why not?

Because it will bring a harsh justice – the death penalty – to their buddies in the multi-billion dollar private health insurance industry.

The will of the American people is being held up by a handful of organizations and individuals who profit off the suffering of the masses.

And the will of the American people will not be done until this criminal elite is confronted and defeated.

(Remember, virtually the entire industrialized world – save for us, the U.S. – makes it a crime to allow for-profit health insurance corporations to make money selling basic health insurance.)

Before we confront and defeat the inside the beltway cesspool/hot tub crowd, we must first know who they are.

To wit, we present the Top Ten Enemies of Single Payer (listed here in alphabetical order):

American Association of Retired Persons (AARP). AARP, one of DC’s most powerful lobbying groups, has worked inside the beltway for years to defeat single payer. Why? AARP makes about a quarter of its money selling insurance through its affiliate, United Healthcare Group, the nation’s largest for-profit insurance company. AARP must defeat single payer – which if enacted, would wipe out that revenue stream.

America’s Health Insurance Plans (AHIP). The private health insurance industry. Public enemy number one. The health insurance corporations must die so that the American people can live. Of course, facing the death penalty, AHIP is the most aggressive opponent to single payer. No compromise with AHIP.

American Medical Association. With a shrinking base of doctors (only 25 percent of doctors nationwide belong) – the AMA is the most conservative of the doctors’ organizations. I just returned from a health care policy forum at the Center for American Progress. As usual, not one of the panelists mentioned single payer. Only during the question period did a self-identified patient/citizen ask the single payer question. And a pit bull-like Nancy Nielsen, president of the AMA, ripped into the questioner. “Sounds more like a statement than a question,” Nielsen said. “And clearly you have a point of view about that. And I don’t happen to share that point of view.” Clearly she doesn’t. But just as clearly, the majority of doctors, probably even a majority of doctors who belong to the AMA, support single payer. Nielsen is in denial and must be defeated.

Barack Obama. He was for it when he was a state Senator in Illinois. Now, ensconced in the corporate prison that is the White House, he says single payer is off the table. To get off the list, Obama needs to put single payer back on the table.

Business Roundtable. Dr. David Himmelstein, co-founder of Physicians for a National Health Program (PNHP), was at a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience – made up primarily of representatives of big business – to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: “In private, they support single payer, but they’re also thinking – if you can take away someone else’s business – the insurance companies’ business – you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it’s also a cultural thing – we don’t do that kind of thing in this country.”

Families USA. A major inside the beltway liberal foundation and long-time foe of single payer. It’s chief executive, Ron Pollack, was once an advocate for single payer. But no more. In November 1991, Pollack was at a Washington hotel debating Yale University professor Ted Marmor in front of then Arkansas Governor Bill Clinton. Marmor was making the argument for single payer. Pollack against. A November 1994 article in the Washington Monthly, co-authored by Marmor, reported the result this way: “After the two advocates finished, Clinton looked thoughtful, pointed to Marmor and said, ‘Ted, you win the argument.’ But gesturing to Pollack, Marmor recalls, the governor quickly added, ‘But we’re going to do what he says.’ Even considering the Canadian system, everyone in the room agreed, would prompt GOP cries of ‘socialized medicine’ – cries that the press would faithfully report.”

Health Care for America Now. The largest coalition of liberal groups promoting a choice between a public plan and private insurance companies. “They are saying – we can’t do single payer because Americans don’t want it,” said Kip Sullivan of the Minnesota chapter of PNHP. “That’s based on junk research conducted by Celinda Lake for the Herndon Alliance. It is bad enough to say we can’t do single payer because the insurance industry is too powerful to beat. But it is just plain insidious to say we can’t do single payer because the American people don’t want it. In fact, polling data indicates that two-thirds of Americans support a single payer system. And that level of support exists despite the fact that there is little public discussion about it.”

Kaiser Family Foundation. One of the most prestigious liberal inside the beltway think tanks on health reform policy. Saul Friedman is a reporter for Newsday. In February, Friedman wrote an article for Newsday arguing that single payer is suffering from a conspiracy of silence. And he says Kaiser is the most culpable of the co-conpsirators. Kaiser, funded initially by insurance industry money, regularly keeps single payer off the table, Friedman says. When single payer advocates released a study in January asserting that Congressman John Conyers’ single payer bill (HR 676) could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers, “the Kaiser Family Foundation’s daily online report on health care developments at didn’t mention it,” Friedman reported. “Nor has Kaiser, the most comprehensive online source of health care information, made any mention of single-payer or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls.” After a number of insistent inquiries, Kaiser told Friedman that they would publish charts in March comparing the Stark and Conyers bills. They never did.

The Lewin Group. The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option, showed that the insurance industry would lose 32 million policy holders if a public plan is enacted. Lewin’s health reform policy guru, John Sheils, told the Associated Press: “The private insurance industry might just fizzle out altogether.” What the mainstream press didn’t report was that The Lewin Group is a wholly owned subsidiary of Ingenix, which is in turn owned by UnitedHealth Group, the nation’s largest health insurance corporation. Lewin Group has conducted studies on single payer at the state level – and their studies consistently show that single payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676 – which would create a single payer for the entire country and drive The Lewin Group’s parent – UnitedHealth Group- out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said – “the President didn’t propose single payer, did he?” No, he didn’t. That’s why he too is on this list. (Sheils says The Lewin Group has studied national single payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill – including one by Congressman Pete Stark (D-California). Stark’s bill would give every American the option of opting into Medicare. But that’s not single payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. “The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.” Sheils says that of all the plans studied, the Stark bill saves the most money.)

Pharmaceutical Research and Manufacturers Association of America (PHRMA). PHRMA chief executive Billy Tauzin says that under single payer, the government would become a “price fixer.” By which he means, the government, as a single payer, will have the power to negotiate drug prices downward, thus costing the drug corporations millions in excess profits. In recent years, PHRMA has infiltrated liberal sounding groups like America’s Agenda – Health Care for All. PHRMA’s Vice President for Government Affairs and Law, Jan Faiks, now sits on the board of America’s Agenda and PHRMA contributes money to the group – which has worked in recent years to undermine single payer at the state level. (America’s Agenda Mark Blum won’t say how much money PHRMA gives to his group.)

We have met the enemy.

And they ain’t us.

Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime Reporter. He is also founder of


  1. AynRandWasRight on April 20, 2009 at 5:37 am

    LOL if you think Single Payer will make things better.

    The government runs NOTHING well.

    What you will see is docs retiring earlier, shortages, etc.

    I suggest you read ATLAS SHRUGGED by Ayn Rand.

    Best wishes,

    • Elaine on April 28, 2009 at 4:00 pm


      What part of the postal service, roads, libraries, police and fire doesn’t run well? Those are certainly good examples of what the government can do, and do well.

      • Tina on April 28, 2009 at 6:25 pm

        >>What part of the postal service, roads, libraries, police and fire doesn’t run well? Those are certainly good examples of what the government can do, and do well.<<

        Really? Libraries, police and fire departments are funded locally, not federally, which is why they run better than they would otherwise. The condition of roads is questionable; perhaps they’re better wherever you are than here in Chicago, where potholes have names, addresses and regularly eat cars. You’re right about the post office, though, in that it is federally run. And, at last count, they lost $2.8 billion in 2008 alone. Your assessment of “doing well” must be a relative term.

    • Cato on May 7, 2009 at 10:19 pm


      I suppose Citibank, Bank of America, Bear Stearns, Merrill Lynch, Lehman Brothers, Wells Fargo, Countrywide, etc., etc. were all run well, and the fact that they were run so well was the reason they ran to the Gov’t. for money to keep making the same mistakes. I’ve read Atlas Shrugged, and Objectivism doesn’t work when the people in question are crooks. We in fact have a single payer rationed system of healthcare now. The single payer is the health insurance industry and the rationing comes in when some high school dropout decides you don’t need the test your doctor recommended and you can’t afford the $17,000 to pay for it yourself. I’d rather have a system that is run for the benefit of all instead of for the profit of a few at the expense of the many.

    • Phil on July 26, 2009 at 3:03 pm

      If you are citing Atlas Shrugged as ammunition AGAINST hr676, you should take a close look at the insurance industry and lobbyists.

      You consider hr676 dangerous as it may benefit the moochers. Let us not, however, ignore the issues with the current system. The looters. (again, using terms of Atlas Shrugged). In other words, the pharmaceutical companies and insurance industry as a whole are the looters. This is especially true of a mandate for citizens to buy private insurance!

      The U.S. health care non-system, in its present state, rewards the looters a great deal more than the hr676 system would award the moochers. If we consider every citizen falling into hr676, this reward (relatively speaking) virtually disappears.

      The truth is (and it’s taken a number of years for me to fully acknowledge this): Government actually is better a running SOME things. Things such as highways across our country, national defense, health care, fire departments, systems of justice, law enforcement, etc.

      Having written a number of papers on Ayn Rand and Atlas Shrugged, I felt it necessary to point out your oversight.

  2. George H. on April 20, 2009 at 8:51 am

    Your conclusion is not correct. One of the biggest ememies is still unfortunately “us”. We are part of the problem by continuing to pay for health insuance. The day employers and individuals stop paying for health insurance is the day all this mess will end.
    Who do you think pays for alternative health care now? Do you hear of any of them complaining about costs? Individuals will pay the market price for results in any business. The same system can work for all of our health care available. Don’t let the insurance companies tell you otherwise.

  3. PolishKnight on April 20, 2009 at 11:06 am

    I would like to thank Russell for this list because now I know which organizations to support. Thanks bunches! I’m especially heartened by the fact that the AARP seems to have a stealth agenda to kill single payer health care. This is one of the most powerful lobbying groups ironically supported by socialist social security and medicaid! Nature fighting each itself! Gotta love it!

    Why do I oppose single payer? Hmm… lessee: As a straight, middle class white male, I’m enemy number 1 for class warfare socialists that have thrown men such as me under the bus as a scapegoat to curry favor with racist special interest groups looking for handout entitlements. The sewer Russel refers to IS socialism. That’s what it’s all about: Goodies for one group at the expense of another. Demonize some group and rob from them. What warlords of the past did without guilt, hypocriticial leftists do without shame.

    Tee hee. Oh, and good luck with tree hugging to replace fossil fuels to keep your lights on and power going. That and other Jimmy Carterish policies will backfire in less than a few months and then a hardcore Ronald Reagan type will sweep into office. Keep up the good work folks!

    • J on April 20, 2009 at 11:51 am

      So, PolishKnight, your opposition to single payer has nothing to do with healthcare whatsoever, and is entirely about this phony, pathetic, whiney “white male victim” crap. At least you’re dumb enough to post it there for all to see.

      • PolishKnight on April 20, 2009 at 12:36 pm

        And J, your hypocrisy is on display for all to see as well. Calling someone “dumb” is a playground tactic. (If you were smart, you’d say stupid, but it would still be a dumb insult.)

        Yeah, white males are so “dumb” except that leftists expect them to pay the taxes to keep the whole commie utopia fantasy going. Check out the main male Demographic of Sweden sometime…

  4. Goran on April 20, 2009 at 12:06 pm

    I am just an average California Joe and do not belong to any of the evil organizations above. I gather from the article that almost all of America is united in wanting this communist boondoggle. So I would like to suggest a few things
    1. Could you please add me to the list above? I am a mortal enemy of communism and statism. As much as I can appreciate you romanticized ideals of Soviet Union, Cuba and China, as a refugee from those very systems of workers’ “paradise” please make sure that you add me to your list of obstructionists and “evil doers”, or whatever the term is nowadays.
    2. In order to appeal to a wider audience, maybe you should use this slogan for your efforts: If you like DMV, you will LOVE socialized medicine.
    3. I just read “on the internets” that the number of immigrants to America (like myself), dwarfs the number of immigrants to Canada. We have been duped! Inside the beltway conspirators have suckered us all into thinking that USA is the land of opportunity where really it is Canada. Thank you for pointing that out. I trust I will be seeing you at the embassy as we leave this crap-hole to go to the promised land?
    4. Just to clarify it for you Russell. I do not want something for nothing. I want liberty. I don’t want free treatment for my infertility nor free medicine for my chronic HepB. I want liberty. Liberty to earn it, liberty to buy it. Dignity to ask others for help and moral agency to decide not to take it from them by force. While I understand I am but a tiny minority that has to live under your statist thumb, you are right that you have met the enemy and it is “ain’t us”. It is me, even if I am the only one left…

  5. Steve on April 20, 2009 at 12:20 pm

    So you morons think that small businesses who pay over twice the premiums for group premiums should have the burden? How can they afford to hire more people and CREATE MORE JOBS? I bet you idiots like ” FEELING PROTECTED’ by being in favor of unnacountable defense spending too. Guess what you aren’t in the club where 2 trillion can’t be accounted for/ are in special interest pockets and NOT YOUR.

    • PolishKnight on April 20, 2009 at 12:39 pm

      Steve, I have had discussions with leftists on blogs on the washingtonpost and they sneered that they had “friends” in government jobs via a good ol’ boy system that would discriminate against people for their political views leaving people such as yourself to be, they sneered, “entrepreneurs”. Yeah, basically the world to them are people who butt warm desk jobs at schools that produce illiterate children and run rat hole NHS hospitals in Britain and “losers” who actually do real work such as plumbing, making TV’s, etc. In other words, a world upside down.

      It worked great in the Soviet Union too, for a short while.

  6. David from Charleston on April 20, 2009 at 12:57 pm

    It is remarkable how passionate people seem to be on this issue. One of the problems that lead to the banking crisis was the ability for financial institutions to shop around for a regulator. Health insurance is even worse. It is regulated 50 different ways by the states. How anyone can sit pat while costs pass 17% of GDP and 40 million are uninsured is beyond me. When one of the blowhards losses their job and can’t get coverage for a preexisting condition perhaps they will realize that if we don’t hang together we will all hang separately.

  7. PolishKnight on April 20, 2009 at 1:42 pm

    David, leftism is all about hanging, literally, members of an unpopular group as “whiners” and “phony” and “stupid” while pretending to be about “equality” and “fairness” for their so-called disadvanted groups which get news coverage of their supposed suffering at the hands of society (including themselves) on a daily basis. It’s wonderfully audacious.

    Much of that 17% cost of GDP is due to medi-uncare and medicaid, goverment programs, that are scheduled to become insolvent along with social insecurity in the next few decades. In addition, much of the costs of hospitals is from illegal immigrants who undercut working class labor and then demand more than the difference from the taxpayer. Government in this case, like with housing, caused the problem.

    I know that’s all politically incorrect and offends the cherished beliefs of people who want to feel smug and self-important, but it has to be said. Sorry.

    • David from Charleston on April 20, 2009 at 2:51 pm

      Glad to hear you don’t feel “smug and self-important”.

      The Institute of Medicine (IOM) feels strongly that the best way to control costs, increase access to care, and improve quality is a single party payer system.

      Foreign-born people in the U.S. are, on average, healthier and utilize little health care – about half of the health care (per capita) of U.S.-born persons. Surprisingly this is true whether or not they have insurance. Immigrant children receive very little care, 74 percent less overall than other children. So, if the foreign born are less than one-quarter of the uninsured, only one-eighth of health spending on the uninsured is going to the foreign born, which translates into a tiny fraction of all U.S. health spending. In fact, most immigrants have health insurance coverage, and 30% of immigrants use no health care at all in the course of a year. Undocumented immigrants are politically unpopular and hence a convenient target, but they are not the cause of rising health care costs. (Physician’s for National Health Plan)

      When administrative costs consume 31% of healthcare spending (CBO) compared to Medicare (3%), technology spending is overused (IOM) and companies overcharge to make up for the uninsured, we end up with runaway costs.

      Curious what your answer is? Tax cuts, Health Spending Accounts, less government?

      • PolishKnight on April 20, 2009 at 4:11 pm

        David, I like the way you used the PC term “undocumented immigrants” to obfuscate the fact that you’re referring to illegal immigrants. If they’re merely undocumented, why don’t they just go down the INS and ask for their documents? Is a burglar breaking into your home an “undocumented” tenant or stealing your car an “undocumented driver?”

        Your claim that private healthcare plans spend more on admistrative costs than single-payer medicaid/medicare is a non-sequitur. It doesn’t change the fact that these programs are much more expensive than the private plans they are being lumped in with meaning that even if the private plans were nationalized, the percent of GDP spending would probably continue to increase if not balloon AND/OR services to the elderly would have to be rationed. I’m sure your objective is to leave that part “undocumented” (pun intentional) so the senior citizens sign off on it and then break the news that they’ll have to wait a few years to get a heart bypass.

        Finally, I doubt your claim that administrative costs for medicaid/medicare are so minor include the massive retirement plans and union benefits that are now already threatening to bankrupt many state and city governments for their government workers. I’m chuckling at how these governments are telling their laid off constituents that they’ll have to pay higher taxes so that their union workers can warm up a desk. Yep. In the meantime, real estate prices are falling and I’ll pick up on their homes for pennies on the dollar. I’ll be sure to tell them to thank you!

  8. Mike on April 20, 2009 at 4:41 pm

    We indeed have been duped. Duped, that is, into thinking that national health care is socialism. Let’s see – is public law enforcement socialism? What about public fire and safety? Public roads and bridges? Schools, parks, libraries, and museums?

    Imagine if you needed special insurance coverage to call a cop or report a fire. Health care is just as basic a need.

    Why do people pretend that those of us who call for national health coverage expect it to be “free”? Expecting your employer to cover your insurance is no less “socialist” than expecting the government to provide it. And please don’t throw the word “entitlement” around. I am sure that many of you feel entitled to health care from an employer or a spouse’s employer, just as you feel entitled to coverage for all manner of medical treatment when you wave your insurance card.

    Of course national health care wouldn’t be free. We’d have to find a way, through taxes no doubt, to fund it. No matter how we accomplish that, it likely would not be nearly as bureaucratic, inefficient, and expensive as the current “private” system is – and at least we’d all be covered. Meanwhile, the cost burden of the premiums would be removed from employers, especially small businesses, making it easier for them to hire more workers.

    As another person pointed out, just wait until you or someone you care about loses your employer-sponsored, “free” healthcare – or you are denied coverage just when you need it. I hope that doesn’t happen to you, but it could.

    Meanwhile, it’s worth nothing that we already have public health care. Anyone employed by the government has it. As does anyone receiving a welfare check or charity care. We taxpayers foot the bill for that. As our current system gets worse, those costs will keep rising – just as more of us lose our own coverage. We’ll keep paying for something that more of us need but can’t use.

    Had things gone differently in the 1940s, the so-called conservatives would be the ones arguing to keep our government-sponsored health care. This is madness. It’s clear we need to change our system. Let’s stop slapping labels on each other (e.g., right-wing, leftist, liberal) and recognize that this problem affects us all. Let’s find a collective and constructive solution.

    • PolishKnight on April 20, 2009 at 10:36 pm

      You’re absolutely right, Mike! Since government is so much more efficient and fair than the private market, perhaps the government should also control all newspapers and blogs. Also, instead of private webcams we could have the government control them for public safety. As you point out with healthcare where if you lose a relative then you instantly wish you had big brother to take care of you, I’m sure you’d feel the same if you were attacked in your own home without the supreme leader to rush to your rescue.

      You’re also correct that government employees, the same great minds and workers that produce the lowest illiteracy rates in the western world at the highest cost get great health care and union pay. Their inability to not get fired is responsible for that great efficiency record they have. Social security and medicaid are also well known to be fully funded even as the baby boomers retire. All the different political interest groups will surely cooperate and share their government entitlements, er, fairness, or even give it up to keep the system going. Good luck with that.

      Silly me, I feel entitlement to benefits I have earned and taken an indirect pay cut to receive rather than the welfare recipients and “undocumented” people who are clearly more entitled to them than me based upon their voting record for the politicians who dole out the goodies. I surely will get behind you in supporting someone robbing me blind to help them out. Just hold your breath and wait!

      Finally, I have other ideas for things the goverment out to run. The food supply. The nice socialists that the left worshipped during the 1930’s to 1950’s helped send between 50 to 80 million Ukrainians and Slavic people to their death due to food shortages. (They weren’t in a PC group so this wasn’t that big a deal to the media then or now.) Other great things the government has controlled is housing. In the USSR, you could get a 1 bedroom apartment, if you expressed your freedom of thought in agreeing with the leader of course, to share with your whole family! Also, in the states we had the government order banks to make risky loans to unqualified members of special interest groups and that has worked out fantastic as well.

      Thank heavens such intelligent, smart, caring people who are quick to toss me and other people that are non-useful to them over the bus continue to believe these things no matter what I just said. That’s what makes them reasonable unlike religious fanatics.

      • Mike on April 20, 2009 at 11:47 pm

        Such uplifting sarcasm. I hope you don’t bother voting, because obviously your disdain for government suggests that no politician or public employee can be trusted.

        Meanwhile, I guess you’re right – the venerable captains of industry that run our current system have proven themselves extraordinarily trustworthy and ethical. No problems with rationing or denying needed care. Ours is an efficient, economical, and orderly healthcare system – the envy of the world!

        You must hum a happy tune when you make that premium payment each month (assuming you really do pay for your own healthcare), confident that your medical expenses are more than adequately covered.

        • PolishKnight on April 21, 2009 at 8:20 pm

          Indeed Mike, you have illustrated one of the key personal differences between your position and mine: I don’t even trust the politicians I vote and that’s how the constitution was constructed with it’s checks and balances. It’s rather amusing that the same people here that shriek about GW Bush and evil corporations torturing people and giving their money to billionaires then think that THEIR politician is going to be any different. Yeah, they only lie to OTHER people, baby. You’re DIFFERENT.

          But let’s say for a moment that the politician was telling the truth and really did give you the Canadian style health care you want. Is it really worth it to sell out on so many things and overlook all the other corrupt shenanigans they engage in just for some lower cost health care? It comes across as cultish like drinking the cool aid and joining a religion.

          Regarding our inferior system. If you think we’re that bad, move. I’m not resorting to a simplistic “love it or leave it” putdown but rather observing that there are few places like the USA but LOTS of places like Canada. When I look into it further, I find out that the commies don’t want to move because they can’t get a job in their western European socialist utopia.

          FYI, I don’t pay premiums since I have a medical savings plan paid for by my employer (but indirectly by me via a lower salary than if I went 1099). It’s great. I don’t pay a DIME out of pocket and even get an extra weeks vacation credit. If something drastic happens, I am covered at 80%.

          • Mike on April 23, 2009 at 1:54 pm

            It’s not cultish to think as I do, nor is it unreasonable to consider universal health care a worthy and achievable goal. I have no plans to move out of the United States, but that doesn’t mean I think that nothing here needs changing.

            You would have made a good Loyalist back in the days of the American Revolution. I guess that those who supported separation from King George were a cult, too.

          • MJP on May 7, 2009 at 7:36 pm

            Of course if the revolution had not succeeded and we were all her Majesty’s loyal subjects, we would probably have universal health care like the British. Having lived in England for nearly 20 years, I have to tell you that the National Health Service would be a great improvement over the way we run health care in this country (and it is not even the best of the single payer systems).

            This is making me wonder. Maybe the revolution wasn’t such a good idea as it seemed?

            Certainly we need a health care revolution now.

  9. Iceobar on April 20, 2009 at 8:32 pm

    Eventually when the economics get even worse with unemployment at 25%+ will “we” realize that a 50% savings in medical costs will be worth the sacrifice of feeding the “blood suckers” to the fire. We might even entertain the metric system and rejoin the world…

    • PolishKnight on April 21, 2009 at 8:27 pm

      I don’t doubt that under our new superleader, we will see 25% unemployment and skyrocketing inflation (if we’re lucky.) Yep, I’m sure he’ll do just as great a job as David Dinkins did in NYC. Just like in the PRC (People’s Republic of California), there will be rolling blackouts as no new evil Nuclear, Coal, gas or oil power plants are built and power costs shoot through the roof. He will point to the heavens and command the seas to part and… they won’t.

      I remember everyone saying similar things such as Hope and Change about… Bill Clinton! He was going to give us “free” everything (well, free for some people at other people’s expense.) That worked out real great!

  10. Canuck Doc on April 21, 2009 at 9:22 am

    Facts about single payer as I experienced it having practiced medicine in both the US (7 years) and Canada (currently):

    1. Except in major academic centres, the quality of Canadian health care is mediocre. Equitable? Yes. Low or no out of pocket cost? Yes. Want latest treatment options or equipment? Sorry, you’re SOL. I am not talking about fancy stuff, I’m talking about techniques and equipment that I used to use in a COUNTY hospital in Texas. The illegal immigrants that I treated while I was there got BETTER treatment than fellow Canadians I’m treating now! See, the problem is that the system is chronically underfunded. Yet no private options are allowed so people who are willing and able to pay will have to seek treatment frequently in the US. The result? No comparison, no competition, so no need to improve. Look at us, our great Canadian health care system is SO much better than that of the US. COMPLACENCY. That’s what we’re proud of.

    2. Inefficiency and under-utilization – When I first returned to practice in Canada, one thing always puzzled me. I was frequently told ‘There are no beds available’ in the hospital. Yet the ward looked almost empty. The nurses were chatting and didn’t seem to be busy at all. They told me there were no beds because there weren’t enough nurses to staff the beds. “But they didn’t look too busy,” I queried. “Well, for safety’s sake, each nurse can only take care of four patients. If more beds were to be made available, the government would have to hire more nurses.” Guess who decides what the ‘safe’ nurse to patient ratio should be? The nurses’ union. Enough said. I guess doctors must be practicing ‘unsafe’ medicine since they frequently take care of eight to ten patients on the ward.

    3. Perverse incentives – to control costs, the government negotiate fees for services with doctors that are frequently insultingly low. The results? 1. doctors leave to practice in the US or elsewhere. 2. doctors boost volume by frequently bringing patients back for recall whether there is a real need or not. 3. Some doctors perform procedures that are not necessary (but not harmful except for standard procedural risks) to increase income.

    Bottom line? A single payer system can only work favourably under the following circumstances:
    a. In a rich country (the US is NOT a rich country anymore because of its humongous DEBT).
    b. In a place where the public is fair minded and cost conscious and where people have a strong work ethic. Can’t have lazy employees always thinking they’re overworked and underpaid regardless of reality.

    Communism failed because it required too much noble human qualities for it to work. We are not hardwired to be saints.

    So, for fans of a single payer system: be careful what you wish for!

    • Mike on April 21, 2009 at 10:24 am

      The U.S. has some of the latest medical technology, to be sure, but many of our citizens don’t have access to it. You need to be wealthy or well-covered to participate fully, and an increasing number of us don’t fall into either category.

      I wouldn’t be surprised that people from other countries come here for treatment, though. Some of those people get that treatment for free; others do well because of exchange rates. Plus, when you have a system like ours that shuts out a significant number of its citizens, there are likely to be shorter wait times for medical treatment – because many Americans simply can’t afford such treatment, and don’t even try to get it.

      People who oppose single-payer may fear that they’ll have to share their access to medical care with everyone, instead of having relatively unchallenged access to it; they’d no longer be in the privileged category of having decent health coverage if we all had it.

  11. Lazaro on April 21, 2009 at 9:43 am

    Single payer is the right way to go for a couple of big reasons as far as I can see.

    I am a big fan of free market capitalism where it makes sense (most places). The free market does seem to have difficulty figuring out what to do when we are speaking about that area of economics called “the commons”. Public health falls into the category of the commons. One huge indicator of this is the current state of healthcare in this country. A free market system it is not. We are trying to create the illusion of a free market health care system in order to avoid ticking off leftophobes and vested interests. The huge amount of bureaucracy and red tape (and additional expense) is to avoid the consequences of a true free market on healthcare and the ensuing social turmoil it would cause. At some point anyone who was ever seriously ill or at risk of chronic illness (obese, smokers, carriers of specific genetic markers…) would simply be denied health care coverage or forced to pay prohibitively high rates, leaving only the well in the system.
    This has been happening already but existing laws and regulations have slowed the rate. At some point we will be exposed to a serious pandemic that will be difficult to stem due to the large percentage of persons that do not have access to adequate health care.

    Another point to be made is that US corporations, especially small businesses, are paying a much higher percentage of their costs into health care under our current system than manufacturers from other industrialized nations, this puts US manufacturers at a competitive disadvantage in a global market place. Even when higher corporate tax rates in those countries are taken into account, the HUGE inefficiencies of our current health care system combined with the fact that health care coverage is attached to employment can actually make doing business in the US more expensive than in many so-called socialist countries. (Unless companies stop offering healthcare to their employees, which seems to be happening more frequently of late.)

    • PolishKnight on April 21, 2009 at 8:33 pm

      Lazaro, lemme see if I can sum up your argument: You’re saying that health care is a “commons” domain because the government already largely controls it and it does a bad job due to government and corporate corruption and to please different political groups. So the solution is… more of it! When you dig a hole and you’re gasping for air, dig deeper.

      Then you quote this rediculous 2% claim of medicaid costs. I don’t see any source of justification for this claim, but I can guess it’s because the payouts are so enormous that the government worker’s salaries seem small by comparison. Am I right? This is hardly a good argument. The private industry spends money to reduce costs so your argument that somehow our system would use less money if government spending were to increase seems counterintuitive.

      Let’s try this on for size: The US military is also incredibly efficient considering how much it spends in regards to how low the employees are paid. So let’s quadruple the budget for the military. How can we go wrong with that?

      • Lazaro on April 25, 2009 at 10:52 am

        1. Healthcare is in the commons domain because a lack of adequate healthcare in a society impacts all members of that society in a negative way, even the healthy and the prudent. The less healthy a population becomes, the fewer productive hours there are to apply to productive enterprise in general. The fewer members of a society there are with access to adequate healthcare, the greater the chance of a pandemic that will effect all members of the society.

        2. I made no claim regarding Medicaid, costs. You must have mixed my post with another.

  12. care4all on April 21, 2009 at 1:43 pm

    There are two main arguments in favor of single payer health care.


    The first is the ethical moral argument. Health insurance companies make their profit by denying health care to sick people. That is immoral and unethical.


    The second compelling argument is economic. Our current system of for-profit corporate health insurance has created an unbearable economic burden on the nation.
    There are over 100 separate health insurance companies operating under different sets of rules creating a huge 30 % administrative overhead. For comparison, administrative overhead for Medicare is only 2%.

    By converting to a single payer system, we immediately save 300 billion dollars in administrative overhead.

    As a nation, we are now paying twice what other countries pay for health care, yet we do not have universal health coverage here in the US. 50 million Americans are without healthcare and 87 million Americans without health insurance at some point in the past 2 years. Almost half the bankruptcies currently filed in the United States are because of medical bills.
    Despite the costs we pay, the United States ranks LAST on a list of 19 industrialized nations in preventable deaths, and 29th of 37 in infant mortality. The World Health Organization ranks the US at 72nd for healthcare accessibility and efficiency. We can no longer maintain the status quo for the ways we currently provide and pay for health care.


    These two arguments in favor of a single payer heath insurance system (moral and economic) are so compelling, that one must conclude the only reason we don’t have single payer now is because of lack of representative government. The obvious conclusion is that our government does not serve the people who elected them. Rather, our elected government officials serve the special interests of the health insurance industry and other corporations who make massive campaign contributions

  13. Canuck Doc on April 21, 2009 at 4:03 pm

    Question: What is the most valuable thing in your life?

    Answer: My health.

    Question: If health is so valuable to you, why are you not willing to pay for it? Why did you buy that McMansion, SUV, big screen TV, instead of saving up money in case you needed it to take care of your health?

    Hypocrisy, anyone?

    • Mike on April 21, 2009 at 10:01 pm

      Who said anything about not wanting to pay for health care? Of course we expect to pay for it. In return, we expect a fair and complete system. A single-payer system can be public – or it can be private. If it’s to be private, though, we need to find a way to cover everyone. And we can’t have the kind of rationing and incomplete coverage we see now in America.

      Before you accuse people without health insurance of not wanting to pay, think about the person who can’t get coverage because of a chronic or pre-existing condition. How moral or ethical is that?

      • Canuck Doc on April 22, 2009 at 10:18 am

        I understand both sides of the argument because I have worked in both countries (US and Canada). My word of caution is: beware of the unintended consequence of an overall decline in the quality of care. We should absolutely get rid of the profiteering within the system by insurance companies and big pharma. The moral and ethical argument is understandable but moot – the math has to work. Start a revolution, by all means.

        • Mike on April 22, 2009 at 11:00 am

          Agreed. As long as we find a way to cover everyone and make basic care more accessible and affordable, it wouldn’t matter to me whether healthcare operated under government or private industry.

          Perhaps we could have a basic public healthcare system, mandated federally but operated on a state or regional basis. That would ensure that everyone here can go to a hospital or clinic without risking bankruptcy. Alongside that, we could have a private healthcare system.

          As such, if you’re paying for private health coverage, you’d get a nice tax break (to compensate those who will say they shouldn’t have to pay for a public system if they don’t use it).

          Whatever the case, it’s clear we need to reform our current system. I’m open to good ideas.

    • Anthony on April 22, 2009 at 2:12 am

      Health Care should be affordable.

      Health Care suffers in Canada because they underfund it constantly, its not a priority. I don’t live in Canada I can’t comment on it, but even for all the complaints they wouldn’t want to have our style of health care that’s for sure.

      This country seemingly has an anti-French vibe that does nothing but prove how foolish Americans tend to be when we automatically think we are the best country in the world, when several proven statistics tell another story.

      We have the worst health care system in the industrialized world, period. I didn’t say we have the worst health care technology and THAT’S why Canadians come down here, not for basic care, let’s get that story straight.

      Technology is expensive, thus another source of increased cost.

      The real reason we don’t have single payer and its largely off the table because its based in racism wrapped in class warfare. Most people in America especially PolishKnight don’t give two shhh about the least among us and that would largely be people of color and people in rural America.

      To preserve whatever quality of life he has, he’s willing to make sure the status que stays in place because for HIM it works, he could care less how it works for somebody else.

      Obama isn’t really the enemy, we have to force him to change his tune. We can do that by marching on Washington and demanding health care. If a million Americas showed up and demanded Single Player, he would change his tune.

      That’s what we should be doing. We have done as much as we can with phone calls and email campaigns, it times to take it a step further, instead of waiting for somebody in Congress to stand up and demand it for us.

      • Canuck Doc on April 22, 2009 at 10:53 am

        The common ailment is the sense of entitlement.

        The public feels entitled to health care (yet don’t do enough to take care of their own health through lifestyle modification).

        The doctors and nurses feel entitled to good pay and a light workload.

        Insurance companies feel entitled to huge profits.

        Everybody whines, nobody wins.

        • Mike on April 23, 2009 at 2:25 pm

          I think that sense of entitlement would be present whether a system is public or private. However, regarding people who “don’t do enough to take care of their own health”, I’ve known uninsured people who don’t go for medical care because they don’t have the money. And they’re concerned that reporting a medical condition might qualify that condition as “pre-existing”, if and when they manage to get health insurance at a later time.

          At least if everyone were covered, neither money nor access would likely be the central issue in preventive care – and perhaps more people would take better care of themselves.

        • Lazaro on April 25, 2009 at 10:57 am

          Entitlement is a funny thing…

          Are we entitled to clean drinking water, a safe food supply and clean air? Are we entitled to safe streets? Are we entitled to have access a functional educational system?

          We are clearly entitled to some things, we as a society need to find an agreement on what those things are.

  14. Paul Nicklas on April 27, 2009 at 1:05 pm

    My friend Ron Ross commented about this with more clarity than anything I have seen to date. “Much of the debate is superficial -why is health care a right and other essentials not a right”.

    Single payer suggests ONE standard level of healthcare for everyone. Food is an essential. Must we all eat from a common menu at the “national chain” ? Single payer is not the answer. We are on our way to a shortage of doctors and nurses because you can not force them to give what we can not pay for. We must do something about lawsuits because half of the medical consumption is nothing more than a defense against possible litigation.

    A 2 tier medical system recognizes our limited ability to deliver unlimited care for everyone:
    (1) humanitarian basic care for those living day to day (2) higher levels of healthcare for those willing or able to pay through private insurance which is “society’s way of pooling risk”

    People must have the right to choose and be responsible for their choices. Many people who can afford it would choose to pay for nothing more than level 1 even if they could afford to pay insurance to have level 2 available to them. Lets provide a humanitarian level of healthcare for everyone but not force people to buy insurance.
    One exception: Lets do take good care of all children. I am a grown child from a family that required public welfare. I got nothing beyond the basics until I was able and willing to work.

  15. HarleyBUD on May 7, 2009 at 4:43 pm


    Polish Knight…what do you do for a living and what do you pay for your healthcare a month?

    My thoughts on these questions is this…

    I stumbled onto this today and see nothing but you defending an indefensible position to exclude the uninsured from any sort of coverage when in fact YOU (if you pay taxes) are covering their healthcare at exorbitant rates in emergency rooms all over the country when they could be served at regular rates through the healthcare system that YOU use(if you do use it).

    Now if your employed…or retired…then you maybe have healthcare insurance supplied by your employer or the government(but you would never take such a socialist handout).

    SO what do you and your family do for healthcare insurance and healthcare in general?

    PS…if your in fact Polish then why are you denigrating other minorities…it’s like a Mexican picking on a Black man…whats the point.
    Mean selfish people spouting the corporate spiel are just amusing to no end.
    Go look at the system in Poland today…it has been destroyed by forced insurance fees and has less than half the capacity for care than even France or Germany…all in the name of consolidation and efficiency…no wonder your a bitter man.

  16. Katie Huebner on May 9, 2009 at 4:03 pm

    In my view, the multple labels of all dogmas and known “isms” in the world i.e. socialism, communism, fascism, etc have all been replaced by “corporatism” as the government is no longer by the people and for the people. Our Federal government has been taken over by the elitists of Corportate Governance as demonstrated so recently at the Congressional hearings on Health Care Reform Tuesday. We need to wake up and see that we now have a democracy that is based upon exclusion rather than inclusion.