The politics of health care

By Sara Stalman, M.D.
Bangor Daily News, Aug. 22, 2012

To write about health care and politics is to write about the sacred and the profane.

Our word “health” has the same etymological root as our words “whole” and “holy.” It reflects ancient awareness that we are designed and guided by forces — sacred forces — that, although beyond human comprehension, we know to be greater than ourselves and to be good. “Health” has “the Sacred” at its very root.

“Politics,” on the other hand, refers to activities related to governance. Our present political realities foster the greatest disparity of wealth between rich and poor that our country has ever known. One in five Mainers do not seek medical care because they cannot afford it. Many have health insurance but, with high monthly payments and high deductibles, they see doctors only in emergencies.

At the same time Maine is hemorrhaging health care dollars to out-of-state insurance profiteers. In 2002, between 38 cents and 50 cents of every dollar spent on health insurance left Maine, never to return. It’s only gotten worse.

Working people pay for everybody’s health care. That’s the reality. In a single-payer health insurance system those monies would go into a single “pot” directly paying all health care costs: minimal overhead, no insurance company profiteers, direct purchase of medications for the cheapest negotiated price. Our veterans receive health care through a single-payer system. Minus the prescription-drug nonsense, Medicare, too, is a single-payer system.

In 2001, Maine was the first state to be standing within a hair’s breadth of legislatively passing a single-payer health insurance system. By a vote of 76-54, “single-payer” passed with strong bipartisan support in the House. With the Senate set to vote in favor along party lines (18-16) then-Gov. Angus King vowed to veto the bill. The final senate vote of 15-17 precluded the governor’s veto but in no way changed the fact of his position.

The tremendous economic impact a single-payer health insurance system would have for Maine can be seen in the results of a feasibility study funded in 2002. Maine is a small state with an aging population and high incidence of chronic disease. Even so, a single-payer healthcare “pot” composed of just 4 percent of Maine working people’s income and 7 percent of business payroll could pay for everyone’s healthcare (individual choice of doctor, preventive care, medical and surgical care, eye and dental care, prescription drugs, and home care) and save $350 million in the first year alone. Minimal copays assessed on a sliding scale would be required, but the maximum individual expense would be $1,000 per year, with no family paying more than $2,000. (With single-payer health insurance, businesses, of course, would no longer have to pay the health care costs of Workers’ Compensation Insurance.)

With Maine’s population of 1.35 million people, $350 million would mean that, for each of us, $260 currently unavailable now would be spent in the local economy — buying food, clothing, textbooks, whatever. Money would be changing hands, Mainers’ hands, improving our quality of life and increasing our local tax base. Moreover, local school budgets would no longer be burdened with the costs of employee health benefits.

Demonstrating we could afford a single-payer health insurance system (and could pass legislation to create that system) put Maine in the sights of those monied interests still working to undermine health care reform. In 2002, the National Heritage Foundation arrived in the guise of the Maine Heritage Policy Center. Pouring money from around the country into our state, those interests continue to dominate Maine electoral politics — underwriting, for example, the candidacy of now-Gov. LePage.

In writing the Declaration of Independence, our American founding fathers asserted that government should recognize “Life, Liberty and the Pursuit of Happiness” as inalienable (Sacred) rights of humankind. Our Democracy was the first modern government based on that principle. Because powers of wealth and economic violence have threatened its founding principle since our Country began, our American Democracy (honored worldwide by men and women trusting that principle) remains a work in progress. Today, that threat can be seen at its most dangerous in the political battle over health care reform.

True Democracy demands a healthy electorate. It demands an electorate able to experience the Sacred, trust the Sacred, and act on that trust. Those opposing quality health care and a single-payer insurance system are typically accused of acting from profit motive alone.

More profoundly, opposition to health care reform is opposition to true Democracy: Democracy of the People, by the People, and for the People. All the People.

Sara Stalman practiced neuropsychiatry for 18 years. Her clinical research investigating the relationship between early childhood experience and adult chronic depressive disorders is available to both lay persons and health care professionals on her website,