^{Posted on July 6, 2009}

Left out of the discussion

Single-payer advocates still trying to be heard

By Gregg Blesch
Modern Healthcare
Jun 8, 2009

Lawmakers trying to get sweeping health care legislation passed this summer have made a point - and a show of keeping disparate industry and advocacy groups engaged in the discussions. The only ones with no seat at the large table are those who believe private insurance companies should lose theirs, but supporters of a single-payer health system are still fighting to be heard.

Last week, researchers who are members of Physicians for a National Health Program publicized two studies they say bolster the argument that any system that includes insurance companies is doomed to fail in both of its primary pursuits: to reduce costs, both to taxpayers and consumers, and provide every citizen with quality coverage.

David Himmelstein, an associate professor at Harvard Medical School and PNHP member, was the lead author on one study and co-author on the other. He said it’s a coincidence that they arrived the same week and at a time when they and other advocates of their cause are trying to storm the gates on a process they’ve been shut out of. “We have no way of dictating journal schedules,” he said.

One study, appearing in the American Journal of Medicine, finds that 62 percent of American bankruptcies in 2007 had a medical cause. The research is a sequel to results published in 2001 that about half of bankruptcies examined were caused in part by medical bills or illness, and the finding has been repeated often by advocates of health care reform, including on several occasions President Barack Obama.

“We did the study back in 2007- planned it in 2006 - and nows the time to publish,” Himmelstein said. “We’re pleased it comes out at a time these matters are of great interest.” The study also finds that a majority of those debtors had health insurance when they filed. “What’s on the table in D.C. does virtually nothing for those people.”

The New England Journal of Medicine, meanwhile, published a letter from Himmelstein and two other PNHP members that reports a finding that several life and disability insurance companies still hold about $4.5 billion worth of tobacco stocks. The letter begins, “The Obama administration is proposing a major overhaul of the U.S. health care system, and the insurance industry is poised to play a major role in the process. Insurance firms, like any business, are driven by profit, and this fact compromises any health care plan that includes them.”

A handful of protesters were arrested last month after complaining during a Senate Finance Committee hearing on health care reform that Chairman Max Baucus (D-Mont.) convened a 15-member panel that included two people speaking for the insurance industry but no one arguing for a single-payer system.

On June 3 Baucus met with single-payer advocates, including members of the California Nurses Association/National Nurses Organizing Committee. The nurses union reported that Baucus agreed to hold a hearing on their proposal and otherwise treat it seriously. Baucus spokeswoman Erin Shields responded to a query about those claims with a statement that didn’t directly address them.

“Sen. Baucus met privately with single-payer advocates and discussed their shared goals of providing quality, affordable health care to every American,” Shields said. “Sen. Baucus asked them to work together with him to pursue that goal this year.”

Himmelstein, who also attended the meeting, said he was not convinced Baucus is about to let him and his allies into the circle. “It left me encouraged he felt like he had to meet with us, but he’s not prepared to rectify it yet,” Himmelstein said. He added, “Pressure works, but we haven’t applied enough pressure yet. We don’t have money, so the only other thing we have is mobilizing people, and that we have lots of.”