Category Archives: single-payer system

If US is Serious About Debt, There’s a Single-Payer Solution

St. Louis Post-Dispatch Editorial

August 14th, 2011

If America truly is serious about dealing with its deficit problems, there’s a fairly simple solution. But you’re probably not going to like it: Enact a single-payer health care plan.

See, we told you weren’t going to like it.

But the fact is that everyone who has studied the deficit problem has agreed that it’s actually a health care problem — more specifically, the cost of providing Medicare benefits to an aging and longer-living population. The bipartisan National Commission on Fiscal Responsibility and Reform reported last December: “The Congressional Budget Office (CBO) projects if we continue on our current course, deficits will remain high throughout the rest of this decade and beyond, and debt will spiral ever higher, reaching 90 percent of GDP in 2020.

“Over the long run, as the baby boomers retire and health care costs continue to grow, the situation will become far worse. By 2025 revenue will be able to finance only interest payments, Medicare, Medicaid, and Social Security. Every other federal government activity — from national defense and homeland security to transportation and energy — will have to be paid for with borrowed money.”

That being the case — and nobody argues that it isn’t — there are two broad ways for the government to address its spiraling health care costs. One, shift more of those costs to recipients, by trimming benefits and/or extending eligibility ages and indexing eligibility to personal income. This is politically unpalatable, particularly to most Democrats, President Barack Obama being a conspicuous exception.

The second way for government to address its health costs is not to shift them, but to reduce them. This is what a single-payer health care system would do, largely by taking the for-profit players (insurance companies for the most part) out of the loop.

The advocacy group Physicians for a National Health Program estimates that “private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.”

Once everyone is covered, the government would have the clout to bring discipline into the wild west of health care spending. It could insist that providers be paid for quality of service, not quantity. Health facilities and equipment could be managed by regional boards. Medical services could be “bundled” — rather than paying hospitals and doctors and laboratories separately, there would be fixed prices for treatments. And so on.

The Patient Protection and Affordable Care Act passed in 2009 contains many pilot programs designed to test cost-reduction strategies. Most of them won’t kick in for another six to eight years, by which time health care costs will be approaching 20 percent of U.S. gross domestic product. The combined state and federal share of that will be 49 percent, up from 45 percent today.

Indeed, a study published this month in the journal Health Affairs estimates that while the Affordable Care Act will pay for itself by 2020, it won’t actually “bend the cost curve,” as the Obama administration had hoped. But the study, done by the Actuary Centers for Medicare and Medicaid Services, says the ACA will significantly slow the rise of health care costs to state and local governments.

But consider those two findings: In effect, they say that if reducing overall health care costs is the goal, then the ACA didn’t go far enough. Thirty million more people will be insured and government costs will grow more slowly. But overall health care costs will continue to explode.

Sooner or later, a nation serious about controlling spending must take broad control of the health care system.

It surely won’t be sooner. Compared to the political fight that would erupt over a single-payer plan, the congressional battle over the Affordable Care Act would seem as tame as resolution praising mom, the flag and apple pie.

The ACA was a compromise. Mr. Obama brought everyone to the table — doctors, insurance companies, drug companies, hospitals — and came away with a “best we can get” kind of bill. Many of those at the table turned around and lobbied against it or sought special favors once the bill came before Congress.

It passed by narrow margins, and Congress is decidedly more conservative now. Indeed, the new House majority has voted to repeal the ACA and challenges to its constitutionality continue to work their way toward the Supreme Court.

But now, like a baby discovering its toes, Congress has discovered the deficit. And the plain fact is that unless you want to commit political suicide and cut Medicare to the bone — as Rep. Paul Ryan’s, R-Wis., budget plan would do — the best way to seriously address long-term deficits is to get control of health care costs through a single-payer plan.

In 2008, when health care costs amounted to “only” 16 percent of U.S. gross domestic product, Great Britain was spending 8.7 percent of its GDP on health care, and Canada was spending 10.4 percent. Both nations have single-payer plans. Quality of care scores in both nations are at least comparable, and in most cases, better.

Eventually, the United States will have a single-payer plan. But we’ll waste a lot of money and time getting there.

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Filed under America’s Affordable Health Choices Act, baby boomers, Congressional Budget Office, GDP, health care reform, Medicaid, Medicare, single-payer system, Social Security, St. Louis Post-Dispatch

>Greens, Labor, and Healthcare Conference To Be Held 2/27/11.

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By guest blogger David Petrovich

For almost 30 years (the last 12 as executive director for a non profit consumer advocacy) I’ve worked closely with families who are at-risk of mortgage foreclosure, bankruptcy, and loss of homeownership. Though each situation has its own unique set of hardships, the most common of hardship which precipitate foreclosure and bankruptcy include loss of, or reduction in employment, loss of health insurance, and out of pocket medical expenses. Intangible hardships include the trauma or stress of losing one’s job, the inability to pay bills as they become due and then past due, the uncertainty/fear of losing the roof overhead, and the physical and emotional toll these hardships exact upon our health.

Appealing to mortgage lenders who act with arrogance and impunity is a circuitous, inneffective game I call Foreclosure Relief Roulette. Frankly, mortgage foreclosure is a (toxic) symptom of a larger, systemic problem. To curb foreclosure, we need to look at the larger picture.

Our war economy has ten million folks who face foreclosure, 20% unemployment, one in seven who live in poverty, and millions of stressed out folks without healthcare. However, Healthcare industry profits have never been higher, Wall Street bonuses have never been as outrageous, and “too big to fail” banks have never had it so good. What’s wrong with this picture?

We need jobs. We need affordable healthcare. In my view, replacing our for-profit healthcare delivery system with a sensible, cost effective single payer system would provide unfettered access to improved healthcare for all citizens (working, unemployed, retired, youth, sick, or healthy) while saving (NJ) taxpayers about three billion dollars in its first year. A single payers system would all but eliminate our fifty seven billion dollar pension funding deficit for health benefits, reduce the costs for homeowners insurance, auto insurance, and workman’s comp insurance. Do you hear that Governor Christie?

Implementing a single payer system would jumpstart our economy by enabling small and mid size businesses to operate without the staggering costs of healthcare, and through job creation.

When President Obama used his State of the Union address to tell people to “let him know” if there’s a better approach that “will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare and stop insurance company abuses,” the Labor Campaign for Single Payer (LCSP), a network of local and statewide union leaders, responded with a letter stating that single-payer system “would be far more cost effective than any of the proposed current reforms based on the continuation of for-profit, market-based insurance.”

So what happened? Our corporate-lapdog government, intent on protecting corporate profits for HMOs, and Big Pharma, outlawed single payer thru 2019.

Vermont is seeking a waiver so it can be the first state to implement an improved Medicare for All.

What do labor unions, 18,000 physicians from across the USA, and Vermonters know that we don’t?

You sure won’t learn much by watching or reading corporate owned media. Except single payer is anti-American, Socialistic, Communistic or whatever the pejorative “ism” du jour.

Get the facts. Attend “Greens, Labor and Healthcare Conference” at the Berkeley Oceanfront Hotel on Sunday, February 27th. It promises to be a fact filled, entertaining luncheon with national speakers, top flight live music, and good food.

Register and you’ll also receive, “Sticker Shock: Non Profit Hospital Accounting Practices – A Rip Off Report” an indictment of what’s wrong with the business of healthcare delivery.

Email me for details (njdGreen@aol.com) or visit the conference’s home page: http://tinyurl.com/6x848w6

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Filed under health care conference, health care reform, organized labor, payer, single-payer system, the Green Party

Health care is a right, not a privilege

by U.S. Sen. Bernie Sanders

June 8, 2009
Let’s be clear. Our health care system is disintegrating. Today, 46 million people have no health insurance and even more are underinsured with high deductibles and co-payments. At a time when 60 million people, including many with insurance, do not have access to a medical home, more than 18,000 Americans die every year from preventable illnesses because they do not get to the doctor when they should. This is six times the number who died at the tragedy of 9/11—but this occurs every year.

In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on health care than any other nation—and health care costs continue to soar. At $2.4 trillion dollars, and 18 percent of our GDP, the skyrocketing cost of health care in this country is unsustainable both from a personal and macro-economic perspective.

At the individual level, the average American spends about $7,900 per year on health care. Despite that huge outlay, a recent study found that medical problems contributed to 62 percent of all bankruptcies in 2007. From a business perspective, General Motors spends more on health care per automobile than on steel while small business owners are forced to divert hard-earned profits into health coverage for their employees—rather than new business investments. And, because of rising costs, many businesses are cutting back drastically on their level of health care coverage or are doing away with it entirely.

Further, despite the fact that we spend almost twice as much per person on health care as any other country, our health care outcomes lag behind many other nations. We get poor value for what we spend. According to the World Health Organization the United States ranks 37th in terms of health system performance and we are far behind many other countries in terms of such important indices as infant mortality, life expectancy and preventable deaths.

As the health care debate heats up in Washington, we as a nation have to answer two very fundamental questions. First, should all Americans be entitled to health care as a right and not a privilege—which is the way every other major country treats health care and the way we respond to such other basic needs as education, police and fire protection? Second, if we are to provide quality health care to all, how do we accomplish that in the most cost-effective way possible?

I think the answer to the first question is pretty clear, and one of the reasons that Barack Obama was elected president. Most Americans do believe that all of us should have health care coverage, and that nobody should be left out of the system. The real debate is how we accomplish that goal in an affordable and sustainable way. In that regard, I think the evidence is overwhelming that we must end the private insurance company domination of health care in our country and move toward a publicly-funded, single-payer Medicare for All approach.

Our current private health insurance system is the most costly, wasteful, complicated and bureaucratic in the world. Its function is not to provide quality health care for all, but to make huge profits for those who own the companies. With thousands of different health benefit programs designed to maximize profits, private health insurance companies spend an incredible (30 percent) of each health care dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for far less.

In recent years, while we have experienced an acute shortage of primary health care doctors as well as nurses and dentists, we are paying for a huge increase in health care bureaucrats and bill collectors. Over the last three decades, the number of administrative personnel has grown by 25 times the numbers of physicians. Not surprisingly, while health care costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. And, while more and more Americans are losing their jobs and health insurance, the top executives in the industry are receiving lavish compensation packages. It’s not just William McGuire, the former head of United Health, who several years ago accumulated stock options worth an estimated $1.6 billion or Cigna CEO Edward Hanway who made more than $120 million in the last five years. The reality is that CEO compensation for the top seven health insurance companies now averages $14.2 million.

Moving toward a national health insurance program which provides cost-effective universal, comprehensive and quality health care for all will not be easy. The powerful special interests—the insurance companies, drug companies and medical equipment suppliers—will wage an all-out fight to make sure that we maintain the current system which enables them to make billions of dollars. In recent years they have spent hundreds of millions on lobbying, campaign contributions and advertising and, with unlimited resources, they will continue spending as much as they need.

But, at the end of the day, as difficult as it may be, the fight for a national health care program will prevail. Like the civil rights movement, the struggle for women’s rights and other grass-roots efforts, justice in this country is often delayed—but it will not be denied. We shall overcome!

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Filed under health care reform, Medicaid, Medicare, Senator Bernie Sanders, single-payer system, The Hill, World Health Organization