Single-Payer, or Medicare for All, Only Way To Go
by Alison Landes
Palm Beach Post
Sep 23, 2007
Excerpt
Dr. Richard Rodman’s Aug. 26 commentary, “Universal coverage, but rationed care,” misses the pivotal distinction between universal and single-payer health care. Universal care, the catch-all reference touted in political debates, glosses over the major element that sets the two apart.
Single-payer, detailed in HR 676, The United States National Health Insurance Act pending in Congress, highlights the difference. Single-payer, based on expanded and improved Medicare for All (not socialized medicine) eliminates for-profit health insurance companies. Universal care retains them through convoluted means, including subsidizing to reduce costs and premiums and providing incentives to employers to lower costs. But it all boils down to this: Keeping insurance companies in the equation means more profits for the companies, bigger campaign contributions for politicians and less care for patients.
U.S. health care is already rationed; note the exclusion of 45 million to 75 million uninsured and 50 million underinsured for myriad reasons: inability to pay as costs rise, loss of job, preexisting conditions, chronic diseases and employers hiring part-timers, circumventing benefits entirely. HR 676 ensures that all Americans and all residents living in the U.S. territories are covered.
Coauthored and introduced by Reps. John Conyers, D-Mich., and Dennis Kucinich, D-Ohio, HR 676 is cosponsored by 78 representatives and endorsed by Physicians for a National Health Program, the California Nurses Association, the National Nurses Organizing Committee, the Alliance for Retired Americans and hundreds of labor unions nationwide.
Under HR 676, all medically necessary services are covered - primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long-term care, mental-health services, dentistry, eye care, chiropractic and substance-abuse treatment. Patients get to choose their physicians, providers, hospitals, clinics and practices with no co-pays or deductibles, and private health insurers are prohibited from selling coverage duplicating these benefits.
Transition to not-for-profit health care would take place over a 15-year period through the sale of U.S. Treasury bonds. The hallmark is fairness for the greatest number of people. Displaced employees are the first hired and retrained for employment, reimbursement rates are set annually for physicians, and pharmaceutical companies, no longer given free rein, will negotiate prescription-drug prices.…
Proposed financing includes a modest payroll tax on employers and employees of 3.3 percent each, added to the 1.45”percent payroll tax each pays now, totaling 4.75 percent each. There is a 5 percent health tax on the top 5 percent of income earners; 10 percent tax on the richest 1 percent and a small tax on stock and bond transactions amounting to one-third of 1 percent. Closing corporate tax loopholes and repealing the Bush tax cut for the highest income-earners add up to an estimated savings of $56 billion.
For-profit health insurance and pharmaceutical companies’ prosperity is enhanced by each dollar saved in treating or in denying treatment. Medicare’s 3 percent administrative costs are far less than the for-profits’ 20 percent to 30 percent. And, not surprising is opposition to HR 676 from the 20 largest HMOs ($10.8 billion in profits in 2005) or the 12 top HMO executives (combined $222.6 million in compensation).
The top seven insurers together earned $10 billion in 2006. In 2004, top executives of the 11 largest health insurers made $85 million in combined income; the world’s 13 largest drug companies had $62 billion in profits; and the top 12 drug companies’ executives collected $192.7 million. At the close of 2005, Dr. William McGuire, United Healthcare’s former CEO, had an $8 million salary and $1.6 billion in stock options. What’s wrong with this picture when one person’s salary could cover health-care costs for 34,000 people?
Health care is or should be a basic human right. It is incumbent upon the government to ensure accessibility to all Americans and that it is not rationed according to ability to pay.