Why the silence from the sponsors of the superior Full Medicare for All?
By Ralph Nader
The Nader Page, Nov. 1, 2013
With the Tea Partiers relentless attacks on each of the troubles besetting Obamacare since its complicated, computer glitch-ridden startup on October 1, 2013, the compelling question is: Why aren’t the Congressional sponsors of H.R. 676 – full Medicare for all with free choice of physician and hospital – speaking out as strongly on behalf of this far superior universal health care coverage?
There are fifty-one members of the House who openly favor the single-payer solution for many good reasons. Legislators behind H.R. 676, such as Reps. Robert Brady (D-PA), Michael Capuano (D-MA), Donna Christensen (D-VI), Judy Chu (D-CA), Yvette Clarke (D-NY), Wm. Lacy Clay (D-MO), Steve Cohen (D-TN), Elijah Cummings (D-MD) and Danny Davis (D-IL) know that single-payer insurance with private delivery is by far more efficient, saving $400 billion a year just on administrative simplification.
Physician, scholar and advocate, Steffie Woolhandler, co-founder of Physicians for a National Health Program (PNHP) says that, “complexity is baked into Obamacare.” What does “complexity” mean beyond thousands of pages of legislation and many more pages of regulations? Over forty years ago, Canada’s single-payer system was enacted with a 13 page bill that covers everyone for less than half of the cost per capita than the U.S.’s waste-ridden, profiteering, corrupt medical-industrial complex that drives honest practitioners up the wall. And, the Canadian system produces better health outcomes at this reduced cost.
Unfortunately complexity means endless opportunities for insurance companies to game the system with fine print, tricks, confusing pricing and lobbying to get out of requirements and standards through waivers. Complexity means ongoing confusion for consumers and patients who go into these exchanges, either because they’ve been thrown out of their existing but substandard insurance policies or do not have any insurance.
Every year, these same consumers have to figure out whether their income has changed enough so that they can report any difference to get a higher or lower subsidy.
Moreover, the public insurance option – Obama dropped that even before he was elected, anxious to not antagonize the powerful insurance companies and their allies – is missing. In West Virginia there is only one insurance seller! Other states have either one, two or more companies that will soon begin confusing consumers in different ways.
So far, the young consumers aren’t signing up at anywhere near the number necessary to actuarially balance off the more costly older consumers. The expected signup rate for middle-aged consumers is way behind projections. And the fine print trap doors keep getting discovered week after week.
Contrast this when Medicare was launched in 1966, as Dr. Woolhandler writes: “Using index cards,” (they didn’t have computers then), Medicare,
“enrolled over 20 million people in six months. And because it was a simple system based on Social Security records, you didn’t have hundreds of people programming in the state of Oregon, thousands of different plans, tons of different co-pays, restrictions and deductibles. You had one single payer plan, which is what we need for all Americans to give Americans the choice they want – which is not a choice between insurance company A and insurance company B. They want the choice of any doctor or hospital like you got with traditional Medicare.”
Additional co-sponsors of H.R. 676 know all this. They include Reps. Michael Doyle (D-PA), Donna Edwards (D-MD), Keith Ellison (D-MN), Eliot Engel (D-NY), Sam Farr (D-CA), Chaka Fattah (D-PA), Al Green (D-TX) Raúl Grijalva (D-AZ), Luis Gutiérrez (D-IL), Alcee Hastings (D-FL), Rush Holt (D-NJ), Michael Honda (D-CA), Jared Huffman (D-CA) and Eddie Bernice Johnson (D-TX).
All the co-sponsors, including the lead sponsor, Cong. John Conyers (D-MI), know that the great majority of the American people, as well as the majority of physicians and nurses prefer the single-payer, full Medicare – everybody in, nobody out – system. Most doctors want to practice medicine, not bookkeeping with page after page of computerized bills loaded with hospital overcharges and code manipulations. Most Canadians never see a bill.
Other co-sponsors of H.R. 676 know how much fraud is concealed in these complex, inscrutable bills that people and insurers receive. The leading expert on health care billing fraud and abuse, Harvard’s Malcolm Sparrow (author of License to Steal), conservatively estimates that 10 percent of all health care expenditure is drained away by billing fraud. That’s over $270 billion this year!
Additional co-sponsors of H.R. 676 including Reps. Henry Johnson (D-GA), Barbara Lee (D-CA), John Lewis (D-GA), Zoe Lofgren (D-CA), Alan Lowenthal (D-CA), Carolyn Maloney (D-NY) and Jim McDermott (D-WA), like their colleagues, know that 45,000 Americans (according to a Harvard Medical School peer reviewed study) die every year because they cannot afford health insurance to get diagnosed and treated in time. Nobody dies in Canada, Germany, France, Sweden, Italy and other western countries due to no insurance; because everybody is insured from the moment they are born at half the per capita cost of that in the U.S.
All the co-sponsors, including Reps George Miller (D-CA), Gwen Moore (D-WI) Jerrold Nadler (D-NY), Richard Nolan (D-MN), Eleanor Holmes Norton (D-DC), Chellie Pingree (D-ME), Mark Pocan (D-WI), Charles Rangel (D-NY), Lucille Roybal-Allard (D-CA), Bobby Rush (D-IL), Linda Sanchez (D-CA), Loretta Sanchez (D-CA) and Janice Schakowsky (D-IL) know that most of their Democratic colleagues favor single-payer, but have not signed on due to their reluctance to embarrass President Obama (who used to favor single-payer) or their avoidance of lobbying hassles from their contributors for a bill they believe has no chance of passing. How’s that for leadership?
So the spotlight has to shine on the lawmakers who have stood publically for H.R. 676, but have not taken on the Tea Partiers and their corporatist backers with this superior alternative. Consequently, the media just reports on the Tea Partiers vocal opposition and nothing on the silent backers of full Medicare for all.
Around the country, there are groups pressing for full Medicare (visit www.singlepayeraction.org). This weekend, the Physicians for a National Health Program, (with over 15,000 physician-members) is meeting in Boston to debate whether they should mount an offensive for full Medicare in the midst of the Obamacare imbroglio. Their revered mentor, Dr. Quentin Young, a former Chicago friend of Obama’s, argues in his new autobiography, "Everybody In, Nobody Out: Memoirs of a Rebel Without a Pause," why Obamacare is worse than nothing.
All the H.R. 676 co-signers, including “Bobby” Scott (D-VA), José Serrano (D-NY), Mark Takano (D-CA), Paul Tonko (D-NY), Peter Welch (D-VT), Frederica Wilson (D-FL) and John Yarmuth (D-KY), should press Senators Bernie Sanders, Sherrod Brown, Elizabeth Warren, Barbara Boxer and others to introduce in the Senate a similar single-payer bill to H.R. 676.
Senator Sanders’ office informs me he is finally ready to do so in a couple of weeks. With over 100 Americans dying each day due to lack of insurance, there’s no time to lose.
Please call your members of Congress at 202-224-3121.