^{Posted on August 1, 2005}

Single-payer health insurance is gaining traction

By Ronnie Cohen
Pacific Sun (Mill Valley, CA)
April 22-28, 2005
Vol. 43, Iss. 16, p10

Abstract

“The momentum is building, and it’s really exciting to finally see that there’s a serious look at single-payer universal healthcare,” says Marin County supervisor Susan Adams. A longtime universal healthcare advocate and a nurse practitioner with a doctorate in nursing, Adams will participate in the Now forum. Other participants include Tom Peters, Marin Community foundation president; Esther Wanning of Health Care for All; and Dr. Sheldon Whitten-Vile, medical director of Marin County Community Mental Health Services.

“The association does not feel that the common approaches to single payer are the right solution,” says Dr. Michael Sexton, a Novato doctor who works for Kaiser, speaking as president of the state medical association. “There are tremendous problems with government run systems.”

Whitten-Vile views the medical community’s fears about universal healthcare as largely unfounded and generational. He says older doctors see the government as an intrusion into their private practices. “They fail to see how much more intrusive insurance companies have become,” he says. “With public control over healthcare financing, we can create a different model. It’s hard for people to even envision having control over this issue. We are so used to surrendering control to the market and for-profit insurance companies.”

Full Text

Not long ago, single-payer health insurance seemed like nothing more than a pipe dream for left-of-liberal politicos. But increasing frustration among both consumers and healthcare workers with the existing system - together with spiraling costs, a growing number of uninsured and millions of bankruptcies related to insufficient insurance - has elevated a single-payer system to a possible reality. Proposed state legislation called the California Healthcare Insurance Reliability Act would replace private health insurance plans with one publicly funded plan. The act would extend coverage to millions of uninsured Californians while retaining the existing private healthcare-delivery system.

The bill’s main architect, former bedside nurse Judy Spelman of Inverness, believes the state Legislature could adopt a single-payer plan to cover all Californians by next year. Spelman will join other single-payer healthcare advocates in a forum on the subject, sponsored by the National Organization of Women (NOW), at 7pm Friday, April 29, at the College of Marin.

Spelman wrote the single-payer bill for state Senator Sheila Kuehl, D-Santa Monica. Details of the plan remain in flux, Spelman says. She says a state agency might administer the program, or a public-private partnership might do the job. In any event, consumers would remain free to choose their doctors, and healthcare workers would continue to work independently of the government.

“It’s not a socialized medicine system,” Spelman says. In that regard, the system would more closely resemble Canada’s than England’s.

While some physicians are so sick of the existing system that they support a single-payer setup, the California Medical Association, the state’s voice for doctors, opposes single-payer healthcare.

Under a single-payer system, consumers would be taxed for healthcare in proportion to their incomes, and employers would pay in proportion to their worker’s wages. Advocates say most Californians would pay less for healthcare under a single-payer system than they currently pay. Moreover, a study by the Lewin Group, a Virginia consulting firm, shows that universal coverage would reduce health spending in California by about $8 billion in just the first year of a single-payer system. The savings would come from slashed administrative costs and bulk purchasing of prescription drugs and medical equipment, according to the Lewin Group.

The Lewin Group projects billion of dollars in annual savings, although health coverage would extend to millions who are currently uninsured and would include more care. The proposal includes all hospital care and doctor visits, full prescription-drug, dental and vision coverage with no co-payments and no deductibles.

Dr. Whitten-Vile says he supports single-payer healthcare “because it is the most rational approach to healthcare financing.”

“We spend more than twice as much as every other country in the world, and we have 48 million uninsured,” says the county’s medical director for mental health services. “There is no reason to have a parasitic middle-man health insurance company between consumers and healthcare providers. Our system is broken, and there is a good fix.”

Sexton says he fears a single-payer system inevitably would lead to shortfalls, which would leave legislators to choose between increasing taxes or cutting benefits. Sexton predicts the powers that be in Sacramento would refuse to raise taxes and would cut benefits.

“The California Medical Association in no way is supporting the status quo,” Sexton says. “We feel the abuses of the for-profit managed-care industry are egregious. It’s our belief that the issue of limited access to care and the increasing number of uninsured is at a level that can’t be tolerated.

But, in Sexton’s opinion: “The single-payer approach with the government being in charge simply does not work.”

The California Medical Association is working on putting together proposed legislation that would mandate people buy health insurance, like drivers must buy vehicle insurance. Assemblymen Joe Nation, D-San Rafael, and Keith Richman, R-Northridge, have proposed a bill that would make it illegal for Californians to be without health insurance.

Spelman sees the Nation-Richman bill as another Band-Aid on a wound needing major surgery. “The healthcare system is in die straits,” she says. “The need for some kind of a change is widely recognized. There are going to be problems with every big system.

Government systems do have problems. But let’s keep our eyes on the prize.”