Single-payer health advocate tells Congress: 'Start from scratch'

Statement of Dr. Margaret Flowers on the House and Senate health bills

'The pending legislation is a turkey,' physician says, adding lawmakers need to 'start from scratch with a Medicare-for-All approach'

Nov. 25, 2009    

Margaret Flowers, M.D.,
Mark Almberg, PNHP, (312) 782-6006,

WASHINGTON - "The current health insurance reform legislation passing through Congress amounts to a massive bailout of the profit-making health industries, which will enrich them and increase their ability to lobby and otherwise influence legislators in the future," said Dr. Margaret Flowers, a pediatrician and Congressional Fellow for the 17,000-member Physicians for a National Health Program, today.

"At the same time, patients will receive little in the way of long-lasting protection or ability to afford needed health care," she said. "The legislation is designed to fail. In the meantime, it will waste billions of dollars and delay the process of creating effective health reform.

"We at Physicians for a National Health Program call on Congress to start from scratch. Improving and expanding Medicare to all people would save over $400 billion annually on insurance overhead and bureaucracy, enough to cover all 47 million uninsured Americans. It is the simplest and quickest way to achieve our goal of universal and financially sustainable health care.

"The pending legislation is a turkey," she said. "It closely resembles health reforms that have already been tried and have failed at the state level."

Flowers cited 10 additional reasons why the draft legislation "is not the reform America needs on this Thanksgiving eve":

1. During the time that it will take for the health insurance legislation to begin (2013 in the House version and 2014 in the Senate version), tens if not hundreds of thousands of Americans will die.

2. Once the insurance reform takes effect, people will still be left without health insurance. Whether it is the 17 million left out of the House version or the 24 million left out of the Senate version, we find this unacceptable. We know that the actual number of uninsured people is likely to be higher than these estimates and we know that people without insurance have a 40 percent higher risk of death than those who have insurance.

3. Medical bankruptcies will continue to occur as families will face out-of-pocket costs on covered services of up to $10,000 in addition to the cost of premiums and the cost of uncovered services. The average medical debt that causes insured families to become bankrupt is $18,000.

4. People who are uninsured will suffer the further indignity of being forced to pay a fine which may be as high as 2.5 percent of their income (House version).

5. The number of people who are underinsured will increase with this legislation. People will be required to purchase health insurance or face a penalty. There is no guarantee that premiums will be affordable even for those who qualify for federal subsidies. Health insurers have already predicted that the cost of premiums will rise because they are being required to stop the practices of excluding pre-existing conditions and rescissions. The public insurance is estimated to be more expensive than private insurance plans. A similar reform in Massachusetts has resulted in a rise of patients who forgo needed care because they cannot afford the co-pays and deductibles once they have paid for their premiums.

6. People will continue to be consigned to only receiving the quality of care that they can afford. Instead of a standardized benefit plan that covers all necessary care, people will have to choose from a tiered set of plans. The least expensive plans will cover only 60 percent of necessary care and patients will be required to pay the balance.

7. The legislation will not control health care costs and will in fact increase the waste in health care spending. The regulation of insurance companies, which has failed to date and is predicted to fail again by industry whistleblowers, will be expensive to enforce. And the "exchanges" will have to be created from scratch. The exchange will add another level of bureaucracy which in Massachusetts has added a 4 percent charge to each insurance premium. Unfortunately, this legislation does nothing to reclaim the hundreds of billions of dollars that are currently wasted on administration, paperwork and marketing for the hundreds of health plans in existence.

8. The legislation transfers hundreds of billions of public dollars to private insurance companies. People will be mandated to purchase health insurance whether they can afford it or not, so the insurance companies benefit by having millions of new enrollees. In addition, between $447 billion and $605 billion in public dollars (depending on the Senate or House version) will be given to the private insurers in the forms of subsidies to help people purchase their defective product.

9. The legislation protects the outrageous profits of the pharmaceutical corporations. The majority of Americans will not see any improvement in the costs of medications and the pharmaceutical corporations have already raised prices on brand name prescriptions by 9 percent this year. Biotech firms receive a windfall 12-year patent on new pharmaceuticals.

10. The legislation continues to allow discrimination based on age and immigration status. Older enrollees can be charged up to twice as much as younger enrollees. And enrollees will be required to prove citizenship in order to receive subsidies. Non-citizens will be required to bear the full cost of purchasing insurance.

"We urge support for Senator Bernie Sanders' single-payer, Medicare-for-All bill, S. 703, as a replacement for the current Senate bill," stated Flowers. "We urge people who support real health care reform to join with us in this movement."


Dr. Margaret Flowers is a Maryland pediatrician with experience as a hospitalist at a rural hospital and in private practice. She is currently the Congressional Fellow of Physicians for a National Health Program. In addition to her activity with PNHP, she is a board member of Healthcare-Now! Flowers obtained her medical degree from the University of Maryland School of Medicine and did her residency at Johns Hopkins Hospital in Baltimore.

Physicians for a National Health Program ( is an organization of 17,000 doctors who advocate for single-payer national health insurance. To contact a physician-spokesperson near you, visit or call (312) 782-6006.