Category Archives: St. Louis Post-Dispatch

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

St. Louis Post-Dispatch, Toledo Blade, Pittsburgh Post-Gazette For Obama

Three battleground newspaper endorsements for Barack Obama. Each is located deep in the heart of the white working class constituencies Obama needs to win in November.

St. Louis Post-Dispatch– “Over the past nine months, Mr. Obama, the junior senator from Illinois, has emerged as the only truly transformative candidate in the race. In the crucible that is a presidential campaign, his intellect, his temperament and equanimity under pressure consistently have been impressive. He has surrounded himself with smart, capable advisers who have helped him refine thorough, nuanced policy positions.
In a word, Mr. Obama has been presidential.”

Toledo Blade – “For guidance in arriving at this momentous decision, the election of the next president of the United States, we can look to the sober lessons of history. Without exaggeration, the country faces a transformational election on Nov. 4, not unlike that of 1932, which prefaced Franklin Delano Roosevelt’s New Deal and a long slog out of the Great Depresssion.
Like the choice 76 years ago, next month’s election is one in which voters have the power to cast aside the failed, greed-driven principles of governance and economics that have led to the current downturn and return to an equilibrium in which hard work is again rewarded by a decent standard of living for the average American.
To be sure, the path to recovery won’t be easy for the next president. There are ominous signs that the economy will continue to falter before confidence can be restored in the financial system. The leadership required to contain and reorder the economic mess created by eight years of heedless deregulation will have to be both inspired and inspiring.
We believe the person best equipped by temperament and intellect to firmly grasp the reins of government and guide it safely forward in these uncertain times is Barack Obama.”

Pittsburgh Post-Gazzette– “Mr. McCain is not the steady hand he purports to be, and nothing proves it more than his reckless selection of Sarah Palin, whose lack of knowledge to take over as president has becoming increasingly obvious and embarrassing. If Mr. McCain had chosen one of the many accomplished women in the Republican Party, his candidacy would have the stamp of seriousness. Instead, it bears the superficial imprint of pandering populism.
But this election is not just about the shortcomings of Mr. McCain and Ms. Palin and the failed legacy of a philosophy that they seek to perpetuate under the hastily erected banner of maverick.
It is about the strengths of Barack Obama, whose rise to prominence is not a fluke or national infatuation but the consequence of his remarkable skills — a keen intellect, noble intentions and the wit and grace to express them in ways that have inspired millions across the country. He has a rare gift exactly suited to the fearful times — he knows the language of reassurance and hope.
…Americans will be called upon to make an exceptional judgment worthy of the times. The forces of history appear to invite boldness and the Post-Gazette believes they should be heeded by voting for the only authentic, fresh agent of change in this race, Barack Obama.”

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Filed under 2008 Presidential Campaign, Barack Obama, endorsement, Pittsburgh Post-Gazzette, St. Louis Post-Dispatch, Toledo Blade

>St. Louis Post-Dispatch, Toledo Blade, Pittsburgh Post-Gazette For Obama

>Three battleground newspaper endorsements for Barack Obama. Each is located deep in the heart of the white working class constituencies Obama needs to win in November.

St. Louis Post-Dispatch– “Over the past nine months, Mr. Obama, the junior senator from Illinois, has emerged as the only truly transformative candidate in the race. In the crucible that is a presidential campaign, his intellect, his temperament and equanimity under pressure consistently have been impressive. He has surrounded himself with smart, capable advisers who have helped him refine thorough, nuanced policy positions.
In a word, Mr. Obama has been presidential.”

Toledo Blade – “For guidance in arriving at this momentous decision, the election of the next president of the United States, we can look to the sober lessons of history. Without exaggeration, the country faces a transformational election on Nov. 4, not unlike that of 1932, which prefaced Franklin Delano Roosevelt’s New Deal and a long slog out of the Great Depresssion.
Like the choice 76 years ago, next month’s election is one in which voters have the power to cast aside the failed, greed-driven principles of governance and economics that have led to the current downturn and return to an equilibrium in which hard work is again rewarded by a decent standard of living for the average American.
To be sure, the path to recovery won’t be easy for the next president. There are ominous signs that the economy will continue to falter before confidence can be restored in the financial system. The leadership required to contain and reorder the economic mess created by eight years of heedless deregulation will have to be both inspired and inspiring.
We believe the person best equipped by temperament and intellect to firmly grasp the reins of government and guide it safely forward in these uncertain times is Barack Obama.”

Pittsburgh Post-Gazzette– “Mr. McCain is not the steady hand he purports to be, and nothing proves it more than his reckless selection of Sarah Palin, whose lack of knowledge to take over as president has becoming increasingly obvious and embarrassing. If Mr. McCain had chosen one of the many accomplished women in the Republican Party, his candidacy would have the stamp of seriousness. Instead, it bears the superficial imprint of pandering populism.
But this election is not just about the shortcomings of Mr. McCain and Ms. Palin and the failed legacy of a philosophy that they seek to perpetuate under the hastily erected banner of maverick.
It is about the strengths of Barack Obama, whose rise to prominence is not a fluke or national infatuation but the consequence of his remarkable skills — a keen intellect, noble intentions and the wit and grace to express them in ways that have inspired millions across the country. He has a rare gift exactly suited to the fearful times — he knows the language of reassurance and hope.
…Americans will be called upon to make an exceptional judgment worthy of the times. The forces of history appear to invite boldness and the Post-Gazette believes they should be heeded by voting for the only authentic, fresh agent of change in this race, Barack Obama.”

Leave a comment

Filed under 2008 Presidential Campaign, Barack Obama, endorsement, Pittsburgh Post-Gazzette, St. Louis Post-Dispatch, Toledo Blade