Single-Payer Comeback?
Marilyn Werber Serafini
(mserafini@nationaljournal.com)
National Journal
June 17, 2006
Rep. John Conyers, D-Mich., is plotting the comeback of a liberal idea that’s been locked in a closet for more than a decade. Even some opponents acknowledge that the concept of single-payer health care is again drawing attention, and others contend that it may be the first sign of push-back against the conservative, free-market, consumer-driven health care movement that has dominated discussions in Washington for 15 years.
Last week, Conyers launched the Congressional National Health Insurance Caucus in the House; Reps. Dennis Kucinich, D-Ohio, Barbara Lee, D-Calif., and Jim McDermott, D-Wash., will co-chair. The caucus will conduct briefings, unofficial hearings, and seminars on single-payer health care, which is usually defined as a system in which the government reimburses some part, or all, of everyone’s medical costs. Already, Conyers has 70 Democratic co-sponsors on a bill to extend Medicare-style health care coverage to all Americans.
Since the early 1990s, a few lone Democrats in Congress — namely Conyers, fellow Michigan Democrat John Dingell, and Sen. Edward Kennedy, D-Mass. — have introduced bills to keep the idea of government health care for all from disappearing. But interest was weak.
Indeed, sweeping health care reform of any sort hasn’t had an audience since President Clinton’s effort to enact health coverage for every American failed in 1994. When Republicans won control of Congress that year, even most Democrats began limiting themselves to pushing for small health care fixes.
So what makes Conyers think he can revive the idea now? Especially when Republicans, who control Congress and the White House, are pushing market-driven programs that place greater responsibility on individuals?
For starters, there’s the appeal of the new Massachusetts law that promises universal health care coverage for residents of the Bay State. And Conyers cites a groundswell of grassroots support for national health care, mostly because carmakers and other large corporations say they just can no longer afford skyrocketing health care costs for their employees. “Collective bargaining is taking it on the chin” when it comes to health care benefits, Conyers said in an interview.
Grace-Marie Turner, president of the Galen Institute, a free-market-oriented research organization that focuses on health and tax policy, has also noticed an “ever more organized and louder call from people who want a larger role for government.” Although Turner supports the free-market approach, she acknowledges that the single-payer message was undeniable at recent hearings conducted by the Citizen’s Health Care Working Group, which Congress established in 2003.
“In meeting after meeting, there was strong support for a national health plan, financed by taxpayers,” Turner said. “Granted, many of those who showed up were encouraged to attend by groups that have a vested interest in government-funded programs. There was a strong feeling that, if the profit motive in the health sector just could be eliminated, all of these goals could be achieved without any other trade-offs.” The hearings gave “Conyers the impetus to say, ‘Let’s go for [single-payer] again,’ ” Turner said.
Polls by the Kaiser Family Foundation consistently show that one-third of Americans embrace a single-payer system, and that 15 percent name it as their top choice, said Drew Altman, Kaiser’s president. “There’s a growing frustration with the problems of health care, and so it doesn’t surprise me that that base of support is revving up again,” he said. “It’s not that we’re being swept up in a new wave of single-payerism. It’s a sign of push-back to the consumer-driven approaches.”
Single-payer could get a boost if Democrats win control of the House or Senate in November. In the House, Conyers would likely chair the Judiciary Committee, Dingell could chair the Energy and Commerce Committee, and Rep. Charles Rangel, D-N.Y., would probably get the gavel at the Ways and Means Committee.
If Democrats win the Senate, Kennedy would probably retake the top spot at the Health, Education, Labor, and Pensions Committee. Already on the Senate side, Sens. George Voinovich, R-Ohio, and Jeff Bingaman, D-N.M., have introduced the Health Partnership Act of 2006 to allow states to apply for federal grants to experiment with single-payer systems, health savings accounts, and other new approaches.
“There’s a general and slow revving up for what will be another national health reform debate after the 2008 election,” Altman said. “The direction that it will take will depend heavily on who wins the election.” In the end, Altman said, he doubts that the direction will be purely single-payer or purely market-driven. “But the energy has been with the Right, and now we’re seeing some push-back from the Left .”
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