Two falsehoods on single payer

By David Lotto, Ph.D., and Michael Kaplan, M.D.
The Berkshire Eagle (Mass.), July 22, 2014

On July 10, Mr. Jim Balfanz wrote a letter to the editor titled: "Dangers of single-payer on display" in which he makes two claims. The first is that what he calls the "Veterans Administration health care corruption scandal" happened because the VA is a government-run single-payer program. The second claim he makes is that the Affordable Care Act (Obamacare or the ACA) is on the road to creating a single-payer system for everyone in the country.

As Daniel Moynihan said "we are all entitled to our own opinions but not to our own facts." The main cause of the extended wait times at some VA facilities is because there are too many patients in need of care and not enough staff to provide the care in a timely manner. The corruption part comes because of the VA's enthusiastic pursuit of the latest craze in business circles -- pay for performance. This system creates financial incentives to report short waiting times. The temptation to lie to get their bonus money was evidently too much for some supervisory staff at the VA.

The basic problem is that the VA has not been given the funds to hire the staff necessary to do the job. The main reason for this is that the Republican-controlled House of Representatives didn't authorize the necessary funds.

The second claim is truly absurd. Obamacare is a thoroughly privatized system first proposed and supported by Republican legislators. It is not a government-run program. None of the recipients of money, insurance companies and health care providers work for the government. Supporters of a single-payer system regard the passage of Obamacare as furthering the privatization of the health care system and a major handout of our tax dollars to pay for profit-driven health care which was chosen to provide subsidized insurance for income-eligible people.

Obamacare is really a national version of Romneycare, the state health care expansion. However the ACA has given free reign to the private insurance industry to restrict benefits through patient cost-sharing and narrow networks limiting access to care for those who need it most. Even though not a Republican voted for the plan, it is the plan the Republicans originally proposed. It is possible that the severe restrictions placed on people getting insurance through the exchanges may make voters realize a single-payer health care system is the only way everyone can get fair coverage when they need it and not have the U.S. spend any more than we do now on health care.

It is the wacko birds (John McCain's term) of the Republican Party, like the ones in the House of Representatives who wasted valuable time to vote for the repeal of Obamacare no less than 54 separate times, and claim that the ACA is leading us toward socialism when it is the opposite, who trumpet these kinds of false claims in total disregard of actual realty.

Voters in all parties should demand a single-payer health care system, an improved, expanded Medicare for all, that will provide generous benefits for all Americans.

David Lotto, Ph.D., resides in Pittsfield. Michael Kaplan, M.D., resides in Lenox. Both are members of Physicians for a National Health Program,