Posted on October 23, 2003

ABC News' on single payer for our "critical condition"


ABC News
Oct. 21, 2003
Critical Condition

Excerpts from Peter Jennings interview of ABC News’ Medical Editor Dr.Tim Johnson:

Jennings: The conventional wisdom is Americans like to think that we have
the best health-care system in the world.

Johnson: And we do, certainly for people that are very rich or who have very
good health insurance and who have very good connections into the health-care system. But for too large a number, 43 million, and many who are underinsured, it is not the very best system in the world.

Jennings: So what was notable in that regard in this poll this time?

Johnson: What was notable is that 62 percent of our population said that
they would favor a system of universal health insurance financed by the government, paid for by the tax payers, as opposed to the system we now
have, the employer based system where many people are uninsured. I was
stunned by that figure.

Jennings: I think conventional wisdom has it that in America, land of the free, that the marketplace is where the price is best established.

Johnson: That’s true for commodities like a car, where you can go in and make choices and you can even walk out of the showroom if you want. You can’t do that when you’re sick. You can’t do that with health care. So, for health care, you’re talking about a service and here I think the private sector has some real shortcomings. They have to spend a lot of overhead on sales and marketing and choosing the patients they’re going to serve. They shuffle a lot of paperwork.

Jennings: Now, I think that the conventional wisdom is still the single-payer system, as you and others have described it, is socialized medicine and that isn’t for the U.S.

Johnson: Socialized medicine means that the government both finances health
care and owns and operates the doctors and the hospitals.

Jennings: Like Britain?

Johnson: Like Britain. In Canada, it’s a split system. The government indeed
does collect the money and disperse it. They run the financial part of health care. But the delivery system is free. People can choose whatever doctor or hospital they want to go to. So, we have a system like that in this country. It’s called Medicare. That’s exactly what happens with Medicare. So, to call the Canadian system socialized is to call Medicare socialized. I think it’s a pejorative word and inaccurate.

Jennings: When I walk past people who know that we’re doing this series
this week and I mention the single-payer system, they just say, “Never in

Johnson: I’ve talked to elderly people who say they love Medicare but
they don’t want the government involved. They forget that the government has
a role to play in setting standards, maybe in handling the money with lower administrative costs. It would be a tragedy for the government to try to run the health-care system in terms of delivery.

Jennings: On top of which, many Americans hold it to be conventional wisdom
that private is better than public. Period.

Johnson: In fact the government does a few things well. And I’ll hold up one example in the health-care system: The NIH, the National Institutes of Health, is the shining gem of medical research in this entire world. It’s owned and run by the government. They can do some things well, especially when it comes to health care. Not everything, but some things.

Jennings: Who in the health-care industry, and by that I mean to include the
pharmaceutical companies as well, who in this industry agrees with the notion of reform that you advocate and who doesn’t ?

Johnson: Almost everybody that I know has now agreed that we have a horrendous problem with the uninsured in this country. I know of nobody who says that that’s a good thing to have 43 million uninsured. There obviously is disagreement about the solution. And it really breaks down along philosophical lines. Among those that think the marketplace can do a better job. Those that think the government at least in part can do a better job. And that’s a perennial battle. I have had health-care experts just in the past two weeks look at me and say, “I don’t care what the solution is, we have to do something about the uninsured.” It’s a national scandal.

Jennings: But we’ve tolerated the uninsured for a very long time, and still you have a large body of political opinions, much of it centered in the Republican Party, which says that we don’t wish to have a national single-payer system.

Johnson: And the Republicans in general are very much opposed to that. But at the same time, they realize that Medicare is an example of something that works in part. It needs to be reformed, we need to have a drug benefit, we need to improve the services. They’re behind the times. We need to probably spend more money, believe it or not. At least on some of the administration.

But, the same Republicans who don’t want a single-payer system would be loathe to say to our senior citizens, “We’re going to take away from you the one single-payer system we do have” - it’s called Medicare.

Jennings: We’re coming into an election year. It’s clearly a hot political subject. Do you think there is the political will in the country to compromise and provide a system with which all people of all political ideologies would agree?

Johnson: I would like to think so. I’m probably pessimistic about it, but with the latest poll results from our own poll, I’m more optimistic because all of a sudden we have a majority of people who are thinking in that direction. And that is what it’s going to take -a political majority to put pressure on Congress. I think the heart of the American people want to do something right, in terms of the, uninsured, and I think that the politicians will be dragged along.

Comment: Will the will of the majority be enough to drag the politicians along? Let’s see if democracy really does work.

Message: 2
Date: Wed, 22 Oct 2003 11:17:45 -0700
Subject: qotd: Video of the ABC News report on single payer

For a five-minute video of the ABC News report on single-payer reform, cut and paste the following link into the address box of your Internet browser:
(Requires RealPlayer)

The video features Peter Jennings, Tim Johnson, Marcia Angell and Drew Altman.