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Single Payer Moment

By David Swanson

While a Democratic polling firm has just found, as pollsters always do, dramatic public support for public health coverage, Democratic leaders on Capitol Hill appear divided, as they have always been, over whether to take a comprehensive approach to health care.

House Majority Whip James Clyburn (D-S.C.) said on C-Span on Sunday that incrementalism would suit him better "than to go out and just bite something you can't chew." Clyburn said he opposes any comprehensive approach in 2009. Meanwhile House Majority Leader Steny Hoyer (D-MD) made a long speech about healthcare at a conference in D.C. on Thursday in which he said "I am committed to helping bring comprehensive reform to the floor of the 111th Congress."

Now, on Capitol Hill, phrases like "comprehensive reform" and "universal healthcare" can mean almost anything, including proposals that would likely require comprehensive reform themselves by the time the ink was dry. But there is an opening right now for serious healthcare reform of the sort that has succeeded in almost every other wealthy country on earth: single payer. Here are three reasons why this is a moment in which single payer health coverage (private medicine paid for by the government, and the elimination of all health insurance companies) has become possible.

First, the partisan dynamics have changed in Congress. While some Republicans might vote for single payer, they wouldn't need to. The Democratic leadership could persuade enough Democrats to vote Yes to pass it without a single Republican, if they chose to. In the House, where the Democrats seriously worsened an economic stimulus bill this week in order to win irrelevant Republican votes and then didn't get a single one, they might be in the mood to wake up and begin behaving as the majority they are. In the Senate, there is the ever-present scourge of the filibuster, which allows senators representing 11 percent of the public to block legislation, but the Democrats could change the rule to rid our republic of that antidemocratic blight if they choose to. This will require placing a great deal of pressure on Democratic senators to persuade them that losing important battles in which they vote well but don't play to win will hurt them as much as it hurts the Republicans who vote against the public will.

That's where the second reason comes in. A massive, well-organized public movement has been built that is pressing right now for single-payer. In the House of Representatives, the leading advocate is Congressman John Conyers whose bill H.R. 676 had 93 cosponsors in the last Congress. Conyers provides a useful FAQ on single payer here, and Physicians for a National Health Program has provided a longer one. Other advocates include Labor for Single Payer, Healthcare Now, the California Nurses Association, and the Leadership Conference for Guaranteed Health Care which boasts dozens of major organizational members. Progressive Democrats of America has mobilized tremendous grassroots pressure through its Healthcare Not Warfare campaign. This is essentially a campaign for single payer health coverage, but it both organizes the peace movement to participate and communicates an important selling point. The financial cost of creating a single payer system would be a fraction of what we spend each year merely on the occupation of Iraq, which Congress and the president have committed to ending. Compared to the cost of wasteful programs at the Pentagon or bailouts for bankers or even the new economic stimulus bill, single payer is a bargain, doesn't kill anyone, saves and improves lives, and even stimulates the economy better than most of the measures being used toward that end. The movement for single payer has organized a lot more than numbers; it's also marshaled persuasive arguments.

The third reason that this is the moment for single payer is that it is so obviously the best solution. When put into consideration with other proposals, single payer wins the debates hands down. The alternative to single payer is multiple payer. That means massive waste and inefficiency, not what a new government ostentatiously looking for solutions that really work should settle on. It also means maintaining the only things in America less popular than Dick Cheney: health insurance companies, and funding them with public money as well as money directly from citizens. In a multiple payer system, one of the payers is YOU. If you can't pay, you may be out of luck. If you can and do pay, you are often out of luck as well. And the bureaucratic waste extends to your own life. You fill out forms for the privilege of paying through the nose for the privilege of being told you can't be helped unless you get a second mortgage. Talking about "universal" systems that are "affordable" is all well and good, but they cannot actually exist as long as the for-profit health insurance companies are running the show. How does this alternative sound for affordable: go to whatever doctor you choose and then go home with no bill and no paperwork. What if such a system could be paid for with taxes on businesses that amounted to less than what most of them currently pay for health care? What if the removal of the profit motive allowed a shift to preventive and truly comprehensive medicine? This is not a dream. It's far more possible right now than giving trillions of dollars to bankers would have seemed a year ago or polite debates over which torture techniques are acceptable would have seemed eight years ago.

Here's what you can do. Listen to the Thom Hartmann Show on Friday. During the first hour, Thom will talk with Senator Bernie Sanders, who was a cosponsor of H.R. 676 when he was in the House. During the second and third hours, Thom will talk about how we can get single payer through Congress. And he'll ask everyone to do two things on Friday:

Call Congressman James Clyburn and ask him to whip his colleagues for H.R. 676: (202) 225-3315.

Call your own Congress Member and ask them to cosponsor and promote H.R. 676: (202) 224-3121.

You can also help by signing the Healthcare Not Warfare petition.

Van courtesy of True Majority.
Photo courtesy of California Nurses Association.

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incorrectly considered "mental illness" by some insurance companies, and is not covered as a neurological disorder:

"Parents rally for autism insurance bill"

All the Democrats want their bribes to keep rolling in from the health care insurance companies. They don't mind blowing money on wars and bailing out Wall Street crooks who keep sending their bribes. Get real.

Either form a third party or quit shilling for Democrats.

This is financial ruin for some of us out here. You won't believe how many specialized doctors don't take Medicaid. I have to keep my son on my work insurance with higher payroll deductions , and one of his doctors accepts neither one! I will shill anyone who will make this system a public insurance system.

bob reynoldsOne approach to building support would be to present to business and individuals a
detailed analysis, an itemization, of all the ways they are paying for healthcare.
Its in the employee/employer taxes; the employer health insurance payments; the co-pays;
medicaid and the taxes to pay for it; the health aspects of all the property and
casualty insurance sold in the US including auto PIP, any liability coverage,
workman's compensation; the pricing of hospital care because of indigent non
reimbursable care, all cited just as examples. I doubt that most individuals or businesses
are truly aware of the total they are currently paying for health care or the
not readily identifiable costs that go along with the basic care itself. For instance
the cost of disputing medical care on Workmen's Comp. My career was in the
Life and Health Insurance industry and I find it difficult to itemize all of the ways
we pay for health care and all the associated costs of the system.

Along with this they could identify where reform is needed. Its not just the new
MRI equipment that generates dubious referrals its the whole corporate medical
service. More and more individual practices are being absorbed into corporate
practices, unrelated private practices now under a corporate umbrella. They are
schooled to maximize profits and referrals to other corporate entities (the
cardiologist to the vascular surgeon for angioplasty for instance). Not only that,
and I have personal knowledge of this from a doctor relative, they administratively
maximize payments by insurers and others. The one I'm familiar with has a
program that knows exactly what each company will pay for a particular service
and how they define the service. These are oncology patients by the way where
insurers have lots of copays and the treatment and drugs are extremely expensive, so the patient gets screwed
too. One company may say basic treatment A includes b,c, and d in the fee.
Another might allow separate billing for b and/or c and/or d. They bill accordingly. The result is they
always obtain the maximum payment available under the coverage provided.
To you and I this may appear an abuse of the system and unethical but to
a corporation and the doctors who benefit in dollars its legal and allowable.
If you don't like it change the system is what I was told by my relative.

And of course we have the uncontrolled cost of drugs and the prohibitions on
Medicare bargaining for a set price. Its not just that the drug may sell for
one price in the US and less elsewhere, studies have shown that the same
drug may cost twice as much at ABC drugs as it does at DEF drugs.
They also allowed to push new drugs through advertising in the media and
corruption of doctors and politicians. I'm sure you are familiar with Gardisil
for instance. My son having two teen age daughters has run an analysis
of this and the number of potential cancers that might be avoided in
a million girls is miniscule and that's ignoring that there are 30 or 40 strains
of the virus and as with the flu, the vaccine protects only from 4 or so.
But the dangers to the teen getting the vaccine offset even the small
benefit that may or may not be present sometime in the future.
Now they are recommending this for boys to avoid testicular and
penis cancer. A manufactured need and one that provides little benefit
but maximum potential profits.

Even Medicare with its Medicare Advantage program is a mish mash of
coverages that on the face of it shows how insane the system is. I'm on
it by the way and in an HMO. In my county there are something in
excess of 40 plans available to me. They provide different benefits and
different charges. I could pay $57 a month for a basic plan with one
company but go to another for better coverage and get my Part B
$96.40 a month premium refunded. Does that make any sense?
Is that cost effective? How badly is the government getting screwed and by

Hillary Clinton tried to put together a system that would make everyone "somewhat"
happy and it didn't work because by doing so it was a monster and readily
attacked by the industry and the ideologues, and so complex that the average
individual or business owner couldn't understand it or its supporters able to
explain its benefits.

Incremental changes are just going to perpetuate a system that is failing
and out of control. But I really don't see anyone capable of putting together
a new system without doing the same thing Clinton did and having the same

Does Obama have the cojones to say "we are going to have a single payer
system that will cover all health care in the United States. No more
compromising , no more Frankenstein bills". And then create a commission
to put it together and force an up or down vote in Congress. No amendments,
no input for Congress and its lobbyist friends. I don't think so.

Great comment, especially your last paragraph.

Obama must be GIVEN the 'cojones' to say, "we are going to have a single payer system that will cover all health care in the United States...," by the majority of US citizens who want it. However, I agree it won't happen by putting a commission together and forcing an up or down vote in Congress...

It must be mandated by the people in a Special Election in order to bring the US into the 21st century. I believe States can call special elections for something like this, and I'd be willing to bet every State in the lower 48 would jump on this bandwagon if the choice was made available to abolish health insurance in favor of a single payer system.

Health Insurance companies don't have to go out of business... they can sell policies to the rich for their 'elective' and cosmetic surgery needs. Their number of customers may go 'way' down, but their profits will likely stay the same.

If China can start single payer....
What a world-wide embarrassment this country and its Capitalist Pig ways continue to be.


Called both congressman Clyburn and my rep and got right through----that is not a good sign, you must get off your ass and call, let them know this is important.
Lone Vet----Portland Oregon

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