By Kay Tillow
FORsoot, October, 2011
Hope is alive and well for placing national single payer health care on our nation’s agenda. On August 10, 2011, the St. Louis Post Dispatch editorial board published its opinion on solving both the debt and the health care crises—adopt a single payer system.
The Post Dispatch asserts that one way to address spiraling health care costs is to shift those costs to recipients, cut the benefits, extend the eligibility age of Medicare and index eligibility to income.
“The second way for government to address its health costs is not to shift them, but to reduce them. This is what a singlepayer health care system would do, largely by taking the for-profit players (insurance companies for the most part) out of the loop,” said this heartland, mainstream newspaper.
The editorial was quickly reproduced in the Cleveland Plain Dealer, the Kansas City Star, and papers in Fort Worth, Texas, and West Hawaii. The Charleston Gazette (W. Va.) ran a similar editorial on August 17, 2011.
No matter how many times the insurance and pharmaceutical industries and those political leaders who yield to
those vast corporate powers declare single payer “dead in the water,” “not feasible,” or “off the table” the idea pops up again. That’s because the health care bill passed in 2010, the Affordable Care Act, will not cover everyone, will not make coverage and care affordable, and will not bend the cost curve either for patients or for the nation.
Instead, the health care crisis is worsening. Last week Kyle Willis, a 24 year-old Cincinnati father, died from a tooth infection because he could not afford the antibiotics prescribed. He is one of about 45,000 people in the US who die each year, not because their conditions are incurable, but solely because they have no insurance coverage.
Over 60 million people were uninsured for all or part of 2010 and 23 million will remain uninsured in 2019 when the Affordable Care Act is fully in place, if that happens. Over 49 million people spend more than 10 percent of their income on health care and premiums, meaning they meet the definition of underinsured.
In the U.S., 62% of personal bankruptcies were linked to medical bills or illness, and three fourths of those bankrupted had health insurance when they got sick. About 54% of Americans reported delaying care in 2010 because of costs.
Medicaid, the plan for the poor and disabled, is supposed to pick up about half of the people who will be newly insured under the Affordable Care Act. Yet, because Medicaid pays so little, many on Medicaid cannot see specialists. Medicaid will become even stingier as it is turned over to profit making companies. That’s the trend, and Kentucky just did it, too. The Commonwealth Fund’s recent study shows that more money is wasted on administration and the quality of care is lower under such forprofit Medicaid managed care companies.
U. S. health spending is the highest in the world, an estimated $8,649 per person, or 17.7 percent of our Gross Domestic Product. That’s about double what the rest of the industrialized countries spend on health care, yet other countries’ outcomes in life expectancy, infant mortality, and other measures are better than ours. Our
nation’s five top for-profit health insurers netted $11.7 billion in profits in 2010, up 51 percent from 2008.
Even former President Clinton remarked recently that the US could save $1 trillion dollars a year if we adopted the health care system of any of the other advanced nations.
Joseph Stiglitz, Nobel Laureate Economist and former head of the World Bank is also “pitching for a single payer system.” When asked why, he stated: “Insurance companies innovate at finding better ways of discrimination. They are inefficient because they are trying to figure out how to insure people who don’t need
the cover and keep out people who need it…. The incentives are all wrong, and the transaction costs are very high, and you have to give them a high profit…. Competition does not work in healthcare especially in the health insurance market.”
Clinton and Stiglitz for single payer? How silent they were when their voices could have counted during the health reform debate of 2009. Yet, their current statements show that single payer is becoming mainstream.
Then there is the real possibility that the Supreme Court will rule the individual mandate in the Affordable Care Act unconstitutional, throwing the whole bill into a tailspin. John Nichols of “The Nation” says that will just move us closer to adopting an improved Medicare for All, a single payer plan that has no constitutional problems and will really make coverage and care universal.
Physicians for a National Health Program estimates that “private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $400 billion per year, enough to provide comprehensive, high-quality coverage for
all Americans.”
The math works. So does the humanity. As Marcia Angell, former editor of the prestigious New England Journal of Medicine says: “If you keep health care in the hands of for-profit companies, you can do one or the other—increase coverage by putting more money into the system, or control costs by decreasing coverage. But you cannot do both unless you change the basic structure of the system.”
It is clear what we have to do. We must build a movement to make the democratic will of the people into the law of the land and pass HR 676, Expanded and Improved Medicare for All. We will have to do what the suffragists did, and the abolitionists did, and the civil rights movement did.
We will have to recruit our families and our neighbors and put our feet in the streets. Health care is life and death and ending needless suffering. It is close to the hearts and passions of all of our people.
Kay Tillow is Director of Organization of the Nurses Professional Organization and an activist with Kentuckians for Single Payer Health Care. The group provides free presentations on single payer. (502) 636-1551, nursenpo@aol.com, kyhealthcare.org, pnhp.org.