Single-payer system provides security

By Thomas P Clairmont, W. Jost Michelsen and Patricia A Locuratolo
Letters, Portsmouth (N.H.) Herald, May 22, 2011

We read with interest the article on the Leadership Seacoast event on health care costs (Herald, May 5, 2011).

Identifying smoking, drinking and inactivity as contributing factors to these costs is exactly right. Unfortunately, the state has diverted every penny of the tobacco settlement money to be used for education of children about the dangers of smoking. Now they want to reduce the price of cigarettes to encourage even more of this disease-causing habit. Closing public pools and gyms are on their list, too. And they wonder why costs are rising.

Then there was a discussion about seniors, a group which has 10,000 members turning 65 every day for the next 20 years. At the end there will be 76 million of us. Are we really going to cut Medicare benefits for those who served/saved our country in World War II? That is just not right.

Finally, there was a discussion about Accountable Care Organizations of which the Mayo Clinic said "they would not participate, because the rules as written are so onerous it would be nearly impossible for them to succeed."

There was absolutely no mention, as usual, of a publicly financed but privately delivered approach — also called single-payer or Medicare for All. Dr. David Himmelstein of Physicians for a National Health Program said reducing administrative overhead to Canadian levels would save $400 billion annually, "more than enough to cover our uninsured." This is what most other countries do and they cover all of their citizens at a cost of less than half of the United States.

No one mentioned our neighboring state of Vermont, where Harvard Professor William Hsiao said "our research and analysis shows a single-payer system can immediately reduce health care costs in Vermont by 8 to 12 percent and reduce health care costs by an additional 12 to 14 percent over time." His plan would cover every Vermont citizen.

No one mentioned the work of Dr. Jack Wennberg of Dartmouth, who said "bringing health care costs down to the level of Minneapolis or Seattle would save up to 40 percent, more than enough to offset any increase in public spending that might result from extending insurance coverage to the uninsured." It is unbelievable that cost-saving research like this goes nowhere and gets no press at all. In testimony to the Portsmouth City Council in February, we said that extrapolating the Vermont data to Portsmouth would result in savings to local taxpayers of more than $1.5 million every year.

Those of you who "don't want the government involved in my health care" must prefer the only alternative, Wall Street Medicine. You must be especially pleased with the current results. The CEO of United Health Care made $101.96 million last year and has a net worth approaching $1 billion. All seven of the leading insurance companies had huge profits and shareholder earnings in the first three months of this year. Of course, this wasn't enough.

The New York Times, in a feature article on New Hampshire, demonstrated increases in health care premiums for various businesses of 20 percent to 43 percent for this year. Keep in mind that inflation in 2010 was 1.6 percent.

More than 130,000 of our fellow New Hampshire citizens have no insurance.

So here is our plan for you and your children. Note that health care will not be free. For about 5 percent of your income, taken out of your paycheck or paid from your other income sources, you will get comprehensive coverage with choice of doctor and hospital, and no additional out-of-pocket costs. There will be no manuals to read, and you will never have to raise funds to cover your health care. No one will make those obscene amounts of money ever again. And you will sleep well, knowing you and your family are fully covered for life.

If this health security appeals to you and your family, then question the candidates about what they are going to do, and push them, like in every other country, toward a universal system that makes sense and will improve the health of all Americans.

Thomas P Clairmont, MD, W. Jost Michelsen, MD, and Patricia A Locuratolo, MD, are members of the Physicians for a National Health Program and practice in Portsmouth, N.H..