Single-payer "not-for-profit" versus Multi-payer "for-profit" healthcare
Single-Payer “Not for Profit” versus Multi-Payer “For Profit” Healthcare
Stephen Falgout, Psy.D and Joanna Clark
So long as heath care is attached to employment and the profit-driven insurance racket the U.S. will remain at a competitive disadvantage, but here we have President Obama touting the established tradition of employment-based insurance, saying we must build on what we have. It’s like adding a second story onto a house that's already riddled with termites.
The U.S. government currently funds more than eight health care programs through our tax dollars, beginning with the establishment of Medicare and Medicaid in 1965. In the ensuing years, Congress has established a virtual alphabet soup of programs to meet the health care needs of the American public at large–e.g.: Military Health System, TRICARE, the Department of Veterans Affairs (VA), the Indian Health Service, the State Children’s Health Insurance Program (sCHIP), the Emergency Medical Treatment and Active Labor Act (EMTALA), and the Federal Employees Health Benefits Program (FeHP). These programs cost the American taxpayer more than $762 billion annually. Further, instead of raining in health costs, costs continue to escalate.
The big questions are “How much could be saved by going to a single-payer universal coverage plan?” and “Can we trust the health insurance industry to come up with a solution?”
In regards to the first question, a 1994 New Mexico study showed that “Single Payer could save $151.8 million and cover all of the uninsured.” A fiscal study of single-payer in Delaware by Solutions for Progress found that Delaware could “save $229 million in the first year (1995). In ten years, the cumulative savings would exceed $6 billion, over $8,000 for every person in Delaware.” A March 1995 study conducted by Lewin-VHI for the Minnesota legislature found that “single-payer with modest co-pays would insure all Minnesotans and save Minnesota over $718 million health costs each year.” Two fiscal studies of single-payer for the Massachusetts Medical Society showed “a single-payer system would achieve significant administrative savings [between $1.8 and $3.6 billion] over the current multi-payer system. Secondly, these savings are of such a magnitude that the available funds would be sufficient to insure universal coverage in the state and provide comprehensive benefits including outpatient medications and long-term care and eliminate all out-of-pocket payments (co-pay-ments, deductibles).” Yet, President Obama and Senator Max Baucus refuse to include single-payer in any discussion.
In regards to the latter question, the answer is “Apparently Not,” Nobel laureate Paul Krugman, writing in the New York Times on May 22, 2009 said – “Indeed, it’s now clear that even as they met with the president, pretending to be cooperative, insurers were gearing up to play the same destructive role they did the last time health reform was on the agenda.” Bill Moyers reported that the health insurance industry had already committed more than $512 million to defeat President Obama’s health plan. With that kind of funding, they should have no trouble buying off any member of Congress coming up for reelection in 2010.
In 1988, Marty Russo introduced H.R. 1300. The bill would have provided single-payer universal health care to all Americans. It was widely supported by the unions, but it was shot down by seniors when the for-profit health insurance industry convinced seniors they were going to lose Medicare. They utilized similar tactics to kill the Clinton’s attempt at reform, and they will do the same to side-track Obama’s initiative unless we put a stop to them.
Our choices today are clear. Either we continue fiddling with the present chaotic mess that exists not for a healthy nation but for the profits of a few at the expense of the nation, or we summon the courage and will to do what is needed and establish a national single-payer healthcare plan. It can be built around healthcare providers in private practice, privately owned clinics run as non-profit organizations, and not-for-profit hospitals.
The fee-for-service trap must be replaced with a schedule of professional salaries that uncouple medical practice from economic worries of both patients and providers. Drug and medical equipment companies will also be members of this great enterprise, but they, too, must be closely regulated so that their duty to serve the public good as chartered corporations is not overshadowed by the desire for greater profits.
The longer we wait, the longer we dither about and moan about established traditions, the greater our problems will become. Let us fervently hope we do what we must before the problems become so overwhelming that disintegration overtakes tradition.
How much better would our position in the global economy be if employers no longer had to worry about insurance costs or employees too sick to work because of healthcare needs postponed too long due to excessive costs? How much better would our position be in the community of nations, in our own families, if our infant mortality rate improved from its present third-world level? How much better will our schools perform and our children learn if from birth there is wellness care that strives to stay ahead of problems before they become debilitating? How much longer will we make ourselves wait?
Stephen Falgout is a psychotherapist who worked for many years in mental health and has taught psychology. In addition, he has been an activist working on civil rights and environmental causes.
Joanna Clark is a human rights and environmental activist who served 19 years in both the US Navy and US Army Reserve, including Vietnam. Employed as a Project Coordinator on the Safeguard/Sprint antimissile defense system in the early 70's, she has spent the last two decades working on global AIDS prevention education.
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New Healthcare idea isn't for all.
Why will the new single-payer health care be for some Americans but, not all? I'm getting withen a decade of nearly being a Senior Citzen, and I'm disabled.
Under the current proposial People like me will not participate in the new expanding Health Care proposial.
Children and people of working age Without Disabiltys are the only people who could use the New Health Care.
If its as wonderful as I would hope it would be, Why exclude some people. Why leave aged and disabled with only medicare?
Leave us with only Medicare?
Leave us with only Medicare? I believe that you have it exactly backwards.
Medicare IS single-payer healthcare, and the current Democratic push is to expand Medicare-type coverage ("the New Health Care") to everyone. In other words, children and working age citizens will be stepping up to the same (or similar) single-payer coverage which is now provided to only Medicare recipients.
I have some family in NY
I have some family in NY that don't have benefits the new system would help them a lot but for now they are on a program called Healthy NY for low income individuals or families with no benefits so for around $330 a month they get health care coverage which is pretty good. One uncle who was near the WTC had to get major treatment of depression from a few docs for 2 years and had it covered.
Why do you think Single
Why do you think Single payer wouldnt help you. Single payer would cover mental, dental, vision, long term nursing home and every other kind of care. Medicare doesnt do that. I have medicare, I pay out of pocket for all those other ailments, to the tune of thousands a year. I had to have dental work done on my social security of less than $1000 a month. The dental work cost me $15,000! out of pocket. Had to have new glasses...cost me $300. I pay for my crestor because they wont pay for it? We are paying thousands of dollars extra all of which would be covered under a single payer system and still save the country billions. I have a son with autism. No insurance company will insure him for less than $3000 a month? We are at the mercy of the for profits who take all our money for CEO's millionaires, advertising for viagra, cialis and other unnecessary drugs (which were covered under medicare). No longer. Single payer will be of help to every man, woman and child, it will never be taken from you, and you will not pay out of pocket. It will keep our jobs in america. We wont have companies running to other single payer countries or countries who do not provide health care. This is a win win for the people, small business and large corporations.
Confusion about what healthcare reform means & what's needed
So many people are confused about what healthcare reform means, what it could be. One has to suspect that the opponents of reform, the healthcare swiftboaters, are among those promoting this confusion. They and their cohorts have grown obscenely wealthy from the present healthcare situation (it cannot properly be called a "system" since it is in reality a chaotic mess), and they expect to keep this scam going for as long as they can. Thus we are subjected to a constant barrage of horror stories about the failures of "socialized medicine" in Britain and Canada. These anecdotal reports ought not be dismissed out of hand, but they do not tell the whole story.
Our present healthcare situation is unsustainable. Employer-based healthcare insurance is a major reason why General Motors is in its death throes, and this is only the tip of the iceberg. The solution, no matter what it's called, will in the end require that great profits and great fortunes no longer be built from the foundation of human suffering, malady, and disease. This means changes not only in how healthcare is delivered, but also in how the economy is shaped, how agriculture is practiced, how food is raised and delivered to our tables.
In sum, we need to create a better lifestyle for ourselves. I-me-mine and Devil take the hindmost are not the principles that can sustain our democratic republic. The longer we wait, the longer we dither about, the more we are mislead by the deceitful robber barons who profit so much from the present mess, the greater the problems will become. Half measures will not do. Real solutions will require courage and confidence.
Excellent Post Stephen and Joanna
The house/termite example was most excellent.
I am a former health care worker. Senior programmer analyst to one of the
largest pediatric hospitals in the US. I worked primarily with
corporate staff. I quit and walked away from my career in health
care because I knew then what we are experiencing now.
The corruption of HMO's claiming they were to manage health care was a lie
from the start. What was intended was to destroy our private doctor
patient relationships. When I was in health care, you selected a
doctor from the phone book. When he decided you needed a
procedure, you got it. Insurance companies had no say in the
matter. The decision making was strictly between you and the
doctor. If the doc said you needed a procedure, he made sure the
insurance company paid for it. The doctors were at the top of the
pyramid. This is the true politics that goes unsaid in this country.
In those days, yes, there was some
abuse. But not nearly as bad as it was portrayed to be by the
then hopeful insurance companies. They took the rare abuses and, by way
of the media, sensationalized them to manipulate and pursuade the
masses to let the insurance companies manage health care (aka, Health
Management Organizations - the new name for insurance companies - sugar
coating a pill so people will swallow it).
The
insurance companies (banker and MBA types) won the day because they are
the ones who played the unethics so common in Washington DC. Politics
and business go hand in hand in regards to corruption. And they used
the media to spill their filth and manipulate the public to win their
support. Doctors in general in those days were mostly ethical people.
So it was inevitable they would lose the fight against the unethical
tactics of insurance companies. For one, the doctors of those days were
unwilling to fight in a like unethical manner. If the people ate
the sugar coated pill of 'managed health care' and were pursuaded to
empower the HMOs, the TRUE doctors lost faith and hope and left their
careers. And so, doctors lost and were placed under, rather than on
top, of the pyramid. The roles were reversed and Insurance companies
now dictate what doctors do rather than the way it used to be.
It was a power stuggle folks. Plain and simple. And the ethical side lost and the corruption is now apparent.
Ethics of doctors is not the case anymore. Most have been preselected by the
health care education system. Good ethical doctors over the years
became disgusted with the system and went on to other careers. The
result is that the good people in health care were diluted until it is today
mostly unethical doctors that remain... or at least a much higher
majority of unethical types. You do not become a doctor today unless
your beliefs are in line with the insurance companies. Otherwise, you
do not pass the tests. Regardless of how smart or competitent you are.
As the result of this malicious selectivity, today as in no time
before, doctors are more concerned with their own personal wealth and
profiteering (the corporate business way) than they are in helping
people who are suffering. They were selected for by the Insurance
companies. There is an analogy here with natural selection, but of
course this is anything but natural and would properly be called unholy
selection (aka, mammon). No matter the lies spewed by people today,
doctors in those days really did care more about people. Sure, there
were bad doctors. But not so many as we now have today. It is a
corrupt system that purpetuates itself to utter decay (as we are seeing
now).
Ken Boettger
Ellensburg, Washington
Former Senior Programmer Analyst (early 90's)
The Children's Hospital
Denver, Colorado
Sustainable Health Care
The entire issue of "cost" is fundamentally the wrong way to come at the issue of Health Care. Just as it would have been when thinking about having a revolution against England back in 1775. Instead what is needed is a free choice as to how we want to be. Once we see where we would like to be then make the leap of faith and go there in a revolutionary manner.
I say leap of faith because that is what is required to make a paradigm shift this large and this sweeping. If we all ignore other fear inducing POV, and instead decide matters in an entirely free manner, where there are no consequences or influences, and we could just chose how we would want to be as to providing ourselves and our fellows with Health Care, I think most of us thru our good will would want a sensible and careful SINGLE PAYER system.
To get there will require us to abandon a paradigm that has been ingrained in our personal cultures, as well as our poular culture for hundreds of years. Not an easy thing to do but not impossible either as our own Nations existance proves very well. So lets let go of "PROFIT MOTIVES" in this one arena and give our better angels the chance to live up to our desires for each and all and everyone PUSH together to obtain this one benifit of our UNION for all of us, We the People.
SINGLE PAYER and NEGOTIATED PRESCRIPTION DRUG PRICES need to happen folks, it takes you to get it done. GET LOUD and GET BUSY!
I disagree, but I think you'll agree ;)
It's not about giving up the "profit motive", it's about understanding it!!!
The naive notion that increased profits always lead to increased productivity is simply false.
Jim
LICENSE TO STEAL
There is a great book that has been out for years. "License to Steal", it covers everything you want to know about this for profit sicko system which was put in place by Richard Nixon. It was never meant to cover more than basic care, no pre existing conditions, and gave these companies the right to hire "beancounters who get a commission" to over rule your doctor and his preferred treatment. The PR guy for CIGNA testified to Congress how these companies were stealing our health care dollars. They are using our premiums to hire 350,000 more lobbyists to make sure we never have a public option. That on top of the 40,000 K Street lobbyists already filling the pockets of the Congress and Senate.