By Dave LIndorff

As I wrote months ago in an article titled America’s Stupid Health Care Debate: Keeping Some Ideas Off the Table and several subsequent pieces on my website,
President Obama and the Democrats who currently run Congress have been
hoist on their own collective petard by their craven and gutless
refusal to consider adopting a Canadian-style single-payer system to
finance health care in the US, or simply to expand Medicare, which is a
successful single- payer program, to cover everyone, instead of just
people over 65 and the disabled.

Instead, because they are the recipients of hundreds of millions of
dollars in legal (and probably plenty of illegal) bribes from the
health care industry, they have cobbled together a “reform” in name
only, which preserves not just the central role of the vampire-like
health insurance industry, but also ensures the continued rapacious
profitability of the other segments of the medical-industrial
complex—the hospitals, the pharmaceutical industry, and the specialist
doctors.

Now, like Hillary and Bill Clinton before them, these weasels and
slimeballs who pose as the people’s advocates are left with nothing but
a Potemkin Health Plan that looks on the outside lie a reform, but that
changes little or nothing, leaves vast numbers of Americans uninsured,
forces tens of millions to buy crappy plans from private companies, and
that will end up doing nothing to halt the continuing rise in health
care costs that is bankrupting the people, employers and the country.

Nice going guys!

Let’s for a moment consider what could have happened.

Medicare, which is wildly popular among seniors and the disabled
according to every poll I’ve seen, currently covers 45 million of the
highest-cost segment of this country’s 300 million people—its elderly
and its permanently disabled. It does this at a cost of $484 billion.

Now that’s a heck of a lot of money—about 13% of the federal
budget—but it’s money well spent. We’re talking about our parents and
grandparents here, and because they’re all covered by a government
single-payer plan that pays virtually all of their doctors’ and
hospital bills, we don’t have to pay those bills for them out of our
own pockets. Okay, there are problems—the drug industry managed during
the Bush/Cheney dark ages to get a prescription drug law passed that
bars Medicare from negotiating group discounts for drugs, and that has
added enormous rip-off costs to the program, but that’s just another
example of corporate scamming of the system that needs to be fixed. The
important point that needs to be made is that according to Medicare
analysts, 10 percent of Medicare beneficiaries account for fully two
–thirds of the total annual cost of Medicare.

What that tells you is that the cost of treating that 10% of the
elderly is $320 billion, while the healthier 90% of the elderly—roughly
40 billion people--only cost $160 billion a year to care for.

Now, given that the rest of the population under 65—about 255
million people—need on average far less care than the 90% of seniors
who are in that lower-cost group, extending care to them all would
clearly cost less than $1 trillion. Add in the cost of the 10% of
high-cost elderly, and you’ve got a total bill of $1.34 trillion to
care for everyone in America.

That’s a big number, but now you need to subtract out the total
cost of Medicaid—the crappy program that, primarily funded by the
states through income and sales taxes—pays for the crappy care of the
poor. That would be about $400 billion in 2009. So now we’re down to
$944 billion to care for all Americans. But from that we need to
subtract the cost of Veterans health care—another successful
single-payer program that already cares for veterans (or at least some
of them—it’s grossly underfunded). If we had a single-payer system for
all, we could just fold the Veterans Hospital system into the national
program. That would mean eliminating another $100 billion that would be
saved (because remember, we calculated that original expanded Medicare
budget for covering all 300 million of us. So now we’re down to an
annual budget of $844 billion for a single-payer program to cover all
Americans. Finally there is uncompensated care provided by hospitals to
those 47 million Americans who have no health insurance but who don’t
qualify for Medicaid. This care is funded in two ways—one by state and
county revenues, which come out of state income and sales taxes and
also out of local property taxes, and the other is in the form of
higher hospital charges and insurance premiums and Medicare costs for
the rest of us. Uncompensated care is estimated to cost about $200
billion, all of which would be eliminated if we had a single-payer plan
for all.

Okay, so now we’re down to a total net cost for a national
single-payer program of just $644 billion. Now remember, we’re talking
about expanding a single-payer program that we already have in place,
that doctors and hospitals are already familiar with, and that the
people who use it already like. And expanding it to cover everybody,
instead of just the old and disabled would only cost an added $160
billion, or just 33% more than it costs now to cover only the old and
disabled. In these days of trillion-dollar Wall Street bailouts, $160
billion is almost chump change—heck, it’s less than the cost of a year
of war in Afghanistan.

Sure it would still mean a modest tax increase for everyone (to
figure out how much, just look at your check stub, find the Medicare
tax deduction, and multiply it by 1.33. Then double that to account for
the employer share of the added funds). But wait, all you tax freaks!
Before you start freaking out at a tax hike and waving those little
teabags Fox TV got for you, there are more savings we haven’t
considered.

If everyone is covered by Medicare, that means no more out of
pocket payments by you for doctor bills. No more co-pays. No more
deductibles that you have to pay out of pocket before your health
insurance kicks in. No more employee contributions to health insurance
premiums, which these days more and more employers are forcing us to
pay. That’s a lot of money. For many families, it adds up to thousands
of dollars a year. But there’s more. Your employer, if the company is
one of the one in three that still provides and pays at least something
towards health benefits for its workers, would be off the hook. That
would free up a lot of money that could go to higher wages and salaries
for workers (especially if you have or get yourself a union to make
sure that the managers pass the savings on to you and don’t just pocket
it or pass it along to shareholders). We’re talking about big savings
here.

So while yes, your taxes would go up a bit to expand Medicare to
all, it wouldn’t be by much, and on the plus side, you would be saving
an enormous amount of money, making the added tax bite easy to swallow
(and remember, your state and local taxes could be reduced).

Why didn’t Obama and the Democrats tell you all this? Why does
Obama continue to diss single-payer, as he did to the American Medical
Association, and as he continues to do, claiming it is not in the
American addition, as though he never heard about Medicare?

Well, as a matter of fact, some people in Congress, notably Reps.
John Conyers (D-MI), Dennis Kucinich (D-Oh), Anthony Wiener )D-NY) and
83 other members of the House are pushing a bill, HR 676, which would
do exactly what I’m suggesting—expanding Medicare to cover everyone.

It is being opposed by the Congressional leadership to the point
that advocates at one House committee hearing were ejected and arrested
for even mentioning the term single-payer. With the blessing of the
White House.

Clearly, Obama and the Democrat Party and Congressional leadership are in bed with the health care profiteers.

There is no other excuse for failure to do the obvious, and have
America adopt some version of the kind of health care system that has
been proven to be more effective and far, far cheaper than our own in
every other developed nation in the world—and in many less developed
nations, too.

My question: How long are we going to stand for this crap?
____________________

DAVE LINDORFF is a Philadelphia-based journalist. He is the
author of “Marketplace Medicine: The Rise of the For-Profit Hospital
Chains” (Bantam, 1992) and more recently of “The Case for Impeachment”
(St. Martin’s Press, 2006). His work is available at www.thiscantbehappening.net