Why Single-Payer is the
ONLY Sensible Health Care Reform (Explained in Plain
English)

By Carmen
Yarrusso

Health care is special

Health care services are in
a special category of “services”. Unlike almost all other services in our “free
market” economy, most health care services (just like police and fire services)
are necessary for all residents—often
a matter of life and death.

Incredibly, we treat most
health care services as if they were optional for some residents. The extreme
costs, the multiple inefficiencies, and the shameful injustice of our current
health care system are the guaranteed results of treating heath care services as
optional for some residents.

As a civilized nation, we
would never tolerate a system where police or fire services were treated as
optional for some residents. To understand how utterly absurd our private health
care system is, imagine life in America if we treated police and fire services
the way we now treat most health care services.

If police and
fire services were optional for some

Instead of groups pooling
their resources and providing everyone with police and fire services, where each
dollar spent provides a dollar’s worth of services (minus the cost to administer
payments), imagine introducing a middleman—police and fire insurance
companies.

Like our current health
care system, about 30% of every dollar we spend wouldn’t provide any police or fire services whatsoever,
but instead would go to other insurance company
expenses.

Aside from administrative
costs to pay for services, insurance companies would pay billions to
shareholders as profits, plus spend billions more for advertising, lobbying
Congress, huge executive salaries, and paying a large staff whose main job would
be to find ways to shift costs to purchasers and providers and to maximize
profits by minimizing services.

Like our current health
care system, maximizing profits would mean charging the highest possible
premiums (money in) while spending as little as possible on actual police and
fire services (money out). This is simply smart
business.

Insurance companies would
compete to enroll residents likely to require the least police or fire services,
while trying to avoid residents likely to require the most police or fire
services. Like our current health care system, this would guarantee that residents who need these
services the most would be the least likely to get them (this is simply smart
business).

Those residents unfortunate
enough to need services “too often” would be denied, dropped, or charged
unaffordable premiums. Those who live in “dangerous” (low profit) areas would
simply be denied police or fire services due to “pre-existing conditions” (this
is simply smart business).

Insurance companies would
have great profit incentives to find myriad ways to deny services or to shift
costs because any money spent providing actual services comes right out of their
profits. Like our current health care system, this would guarantee millions of residents would
have no police or fire services at all (this is simply smart
business).

In a civilized society,
most health care services are no more optional than police and fire services.
It’s patently absurd to put a middleman (whose profit incentives are plainly
against the interests of the American people) between us and our health care
providers.

A middleman
makes no sense for health services

It’s clearly
counterproductive to put a middleman between providers of necessary services and those who need
these services. This guarantees disastrous results.

Providing real estate
services using a middleman (agent) makes sense. A real estate middleman has
profit incentives to provide purchasers with reasonably priced products because
if prices are too high, purchasers won’t buy and the middleman gets nothing.
There’s no profit incentives to deny purchasers what’s being provided. Thus
middleman profit incentives benefit both purchasers and
providers.

But providing health care
services using a middleman is an unambiguous con game. A health care
middleman clearly has profit incentives to charge excessive prices precisely
because these services are necessary
(pay or die). But even worse, a health care middleman has great profit
incentives to deny us necessary
services because every health care service denied is pure profit (this is simply
smart business).

In addition to diverting
billions of our health care dollars to profits and other non-health-care
expenses, encouraging excessive premiums, and making it very profitable to deny
us necessary services, using a middleman also adds hundreds of billions to our health care
costs by forcing hospitals and doctors to maintain vast armies of administrators
who must battle hundreds of insurance companies (with thousands of different
medical plans) all with great profit incentives to deny us as many health care
services as they can get away with (this is simply smart
business).

It’s beyond foolish to
expect insurance companies to act against their profit incentives. A
single-payer system is the only
reform that can end this devastating rip-off of the American
people.

A “public
option” would only make things worse

A public option (or a co-op) would simply add another
player to our inefficient, fragmented, dysfunctional, multi-payer system. The hundreds of billions we now waste on
multi-payer administrative costs would continue
unabated.

But worse,
a public option would soon be overwhelmed with the sickest (most costly)
residents. Why? Because insurance companies compete by discarding the sickest
residents (while marketing to the healthiest), a public option would quickly
shift even more of the costs of our sickest residents to taxpayers, while
freeing insurance companies to compete for healthier (more profitable)
residents.

We eventually pay for everyone's health care anyway

The government already
funds more than 60% of all health care spending. We taxpayers already pay a lot
for “other people’s” health care. Tax subsidies for private insurance alone cost
taxpayers nearly $200 billion a year. We taxpayers give insurance companies
about $100 billion a year to provide health care for public employees (such as
teachers and police officers).

We all pay when uninsured
residents must use expensive emergency rooms. In most cases, had they been given
regular preventative care, they would have required much less total health care
and thus cost us much less.

An Institute of Medicine
study says 18,000 of us pay with our lives each year because we lack health
insurance—a shining example of how private health care “saves taxpayers money”
(this is simply smart business).

An American Journal of
Medicine study says 62% of all bankruptcies (about two million a year) are
linked to medical bills (80% had health insurance). When we count the
excessive burden our absurd private health care system adds to all businesses, and other such hidden
costs, single-payer would be much less expensive and provide much better care (exactly
what other countries with single-payer systems have
experienced).

Multiple studies show
there’s more than enough money in our health care system to serve everyone if it were spent wisely (e.g. 1991 GAO
report, 1993 CBO report).

Preserving
profits with lies, damn lies, and propaganda

Insurance companies know
very well they’re running an extremely profitable con game. They won’t give up
their massive profits without a ruthless political
fight.

They tell us “government
insurance” would mean rationing, bureaucrats getting between us and our doctors,
and excessive costs to taxpayers. In fact, these things are much worse now in
our private system. Insurance companies don’t really want us to carefully
compare their products with single-payer Medicare, which is rated very highly by
its 45 million users.

In a national Commonwealth
Fund survey, Medicare users were significantly more satisfied with their health
care than people using employer-sponsored plans (even though the elderly require
by far the most intensive health care services among us). For example, 70% of
those with single-payer Medicare said they “always” get access to needed care
(specialists, tests, treatment) compared to only 51% of those with private
insurance.

Doctors consistently report
having few problems with single-payer Medicare, and frequent problems with
private insurance companies. A “government bureaucrat” has no incentive to deny
us necessary services because he’s spending “other people’s money”. If he denies
us a service, the money “saved” just goes toward another’s care. But an
insurance company bureaucrat has great incentive to deny us necessary services
because the money “saved” goes right into his
pocket.

Unlike honest “service”
providers, who seek people needing
their services, health insurance companies seek those who don’t need their services (while doing
all they can to avoid those who do). Insurance companies pretend they’re in the
business of providing health care,
when their true business is denying
health care.

Each year two million of us
are bankrupted by medical expenses. Each day, 14,000 of us lose our health
insurance. Most of us are just a pink slip away from this horror. Compare this
to the peace of mind we’d have with a single-payer system that would always be
there for us (all of us).

Why does this
blatant con game continue?

Because our government is
for sale to the highest bidder. Our government “representatives” thrive on
special interest money. They would be severely punished politically (and lose
millions) if they were to put the interests of the American people ahead of
influential insurance and drug companies.

The health care industry is spending $1.4 million
dollars per day to lobby against reform ($126 million in just the first
quarter). This is precisely why our
“representatives” (Democrats and Republicans) aren’t seriously considering the
only sensible way to provide high-quality health care in America—a tried and
tested single-payer system.

Our “representatives” are
diligently keeping single-payer “off the table” for one reason only:
single-payer would easily win in any honest, open debate. Once again our
"representatives" are selling us out to special
interests.

A long habit
of not thinking a thing wrong, gives it a superficial appearance of being
right—Thomas
Paine

Private insurance for necessary health care is just plain
wrong and it’s been just plain wrong for a very long
time.

We the people must unite
and take back our government—it
surely won’t be given back
voluntarily.