'We can do better'

Single-payer plan is the best option, one local doctor says

The Pueblo Chieftain (Colo.), Feb. 15, 2010

Proponents of a national health plan are disappointed that bills that emerged last year from the U.S. Senate and House didn't include a national health plan.

Critics of the measures are optimistic that both will be buried in political haggling.

But most on both sides of the debate agree that efforts to reform the nation's health care system, stalled for now by partisan politics, is critical.

They may even agree that now is the time to take a longer, harder look at what the problems are and how they can best be solved.

They see the current stalemate as a chance to start over and do it right, even if they don't agree on what is "right."   Dr. Anne Courtright, a local board member of Health Care for All Colorado, said she was deeply disappointed in the bills that came out of House and Senate committees and now await some sort of melding process, or a slow death.

During his campaign and through most of the past year, President Barack Obama repeatedly said the only way to provide medical care for all Americans is through a single-payer system "and that if he were starting a new system from scratch, that is the way he would go,"  Courtright said.

She and others hope he'll be more insistent in the second go-round.

"At the very beginning of the discussion about health reform bills, it was stated, basically, that 'single-payer is off the table.' While it has never officially been on the table, they have never really been able to get it totally off of the table. My question is, if single-payer is such an awful idea, why are they scared to have it publicly discussed? The obvious answer to me, of course is, is that it is the only plan that meets every one of President Obama’s criteria."

Aside from Republican resistance to an Obama victory on health care, and outlandish lies about single-payer proposals from the Tea Party movement and other detractors, she said, there was tremendous pressure from the insurance industry not to consider a single-payer plan, or even a public option that would compete with private insurance.

The voice of single-payer proponents eventually was drowned out in the clamor, but are determined to be part of the debate now.

"The reality is that you cannot provide economical health coverage for all with for-profit insurance companies providing insurance coverage," Courtright said.

"You can do it with an individual mandate and non-profit insurance companies which are tightly controlled and told to offer uniform policies with the government picking up the tab for those who cannot afford to buy a policy.

"You can do it with a socialized  plan in which the government owns the hospitals, nursing homes, etc. and hires the providers.

"Or you can do it with a 'Medicare for all' system, in which the government collects the money and puts it in a trust fund and care is provided privately, and the providers are privately owned but non-profit. Providers would bill the trust fund, which would pay the bills."

  With a single-payer system, Courtright added, "it would be easier to see what is working well and what is not, and also much easier to spot potential fraud or misuse of the system. It is also easier to enforce best practices and patient safety protocols.

  "Yes, decisions have to be made about what is covered. But let’s make those decisions with a doctor/patient/ hospital administrator board, not a for-profit insurance company focused on making a profit. This is what they have to focus on, or they will go out of business."

The best thing to come out of last summers rancorous public debates and the ugly wrangling in Congress, Courtright said, is that "the principle on which all of the debate has been based is: 'How do we get everyone covered in an economical manner?' " may mean something a bit different to different political groups, but it's the core of the problem.

"The first decision that we as a country have to make is, do we believe that everyone should be covered? Is health care is a right? We say everyone has a right to life, liberty and the pursuit of happiness. Don’t people deserve health care just as much as they deserve police and fire protection and basic education?

"Every other industrialized democracy has made the decision that they believe everyone should have the same quality health care coverage. That is what the single payer movement believes and that is what we are fighting for. That is what repeated polls have shown the majority of the American people believe.

"I think that is why the majority of the American people are opposed to the current House and Senate health care bills, which are seen, I believe, as a sellout to the insurance companies and offer no relief to the rising cost of health care for the American people."

Courtright said it is unimaginable that, despite having many of the world's best doctors and medical schools, and the latest technology and research, Americans die every day of treatable diseases — and survivors lose their homes in medical bankruptcies.

"We have excellent medical care available, but too many of us cannot afford to access that excellent care. I don’t like being told that our health care system ranks 37th worldwide. We can do better if we get our priorities right," she said.