By Garrett Adams, M.D., M.P.H. The following text reflects the prepared remarks given to a session of the Healthcare-NOW strategy meeting in Nashville, Tenn., on Oct. 5. Dr. Adams, a pediatrician, is immediate past president of Physicians for a National Health Program. The United States has the greatest wealth gap of all industrialized countries and the gap is surging. We also have the worst health and societal outcomes. As Richard Wilkinson and Kate Pickett demonstrate in their book titled “The Spirit Level, Why Greater Equality Makes Societies Stronger,” income inequality is divisive and socially corrosive. As income inequality increases, the range of social problems increases. The Reverend Dr. Martin Luther King Jr. once said, “Of all the forms of inequality, injustice in health care is the most shocking and inhuman.” A national, publicly financed single-payer health plan would be the best thing that could ever happen to this country. In one fell swoop on at least one level – health – everyone becomes the same. We not only improve the nation’s health status, we seriously commit ourselves to a true democracy with liberty and justice for all, and we build the better society that more equality can bring. What exactly is single payer? “The Proposal of the Physicians’ Working Group for Single-Payer National Health Insurance” (JAMA, August 2003) and Congressman John Conyers’ House Resolution 676, the Expanded and Improved Medicare for All Care Act, are the road maps to single payer. The message is that single payer replaces the health insurance industry and substitutes cost-efficient central planning for market-based health care profiteering. The term “single payer” means that one fund, administered by a nonprofit government agency accountable to the public, would make payment for all medical services. Period. Is single payer politically feasible? Yes. When asked if they would support “a universal health insurance program in which everyone is covered under a program like Medicare, run by the government and financed by taxpayers,” two-thirds of Americans say they would. Tell me a politician that wouldn’t be thrilled to have that level of approval. That’s political feasibility. In 2007, 5,000 physicians randomly selected from the AMA Masterfile were asked, “In principle, do you support or oppose government legislation to establish national health insurance?” Fifty-nine percent said yes. In some specialties, 83 percent supported national health insurance. Why the disconnect between popular opinion and congressional voting? Corporate power and campaign financing. We must shine a spotlight on the profiteering of the medical-industrial complex. Single payer is politically feasible; but it has been blocked by medical profiteers. Is single payer financially feasible? Yes. Professor Gerald Friedman recently showed that if H.R. 676 were in force in 2014, the U.S. could save an estimated $592 billion by slashing the administrative waste associated with the private insurance industry ($476 billion) and reducing pharmaceutical prices to European levels ($116 billion). The savings would be enough to cover all the uninsured and upgrade benefits for everyone else. “No other plan can achieve this magnitude of savings on health care,” he said. What do we do now? We advocate and educate for single payer, so that when the Affordable Care Act crumbles, people understand there is a solution. While the ACA has positive points, it is fatally flawed because of its inability to control costs and profiteering. Paradoxically, because of the ACA, single payer now has more and more recognition in the general public. We should take advantage of this inflection point in single-payer awareness. As my dear friend and courageous single-payer activist the Rev. David Bos said, “We need to keep our eyes on the prize.” Healthcare-NOW is the original single-payer coalition, founded by Marilyn Clement from the civil rights movement and Dr. Quentin Young of PNHP as the “Campaign for a National Health Program.” Importantly, the original coalition also included an African American leader of Pastors for Peace – repeat: an African American leader of Pastors for Peace. Well over 900 groups have endorsed H.R. 676. One especially useful group today has a very informative listserv is One Payer States. Public Citizen gives invaluable support. In addition to the many statewide coalitions, a national coalition called the “Leadership Conference for Guaranteed Health Care” functioned quite well in the run-up to the 2010 reform. That coalition included PNHP, Healthcare-NOW, National Nurses United/California Nurses Association, Progressive Democrats of America, the Labor Campaign for Single Payer Healthcare, and the All Unions Committee for Single-Payer Health Care – H.R. 676. Minority groups suffer the most from health inequities and disparities. These disparities are the worst in Southern states. We particularly need to take the single-payer message to them. This movement will not succeed without the enthusiastic support of everyone, white, Black, Asian and Latino.
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