Single payer roundup: Everybody In, Nobody Out!

Chris Lowe

AMERICA'S health-care system is the costliest in the world, gobbling up about 16% of the country’s economic output. Comparisons with other rich countries and within the United States show that its system is not only growing at an unsustainable pace, but also provides questionable value for money and dubious medical care.

-- The Economist June 26, 2009

(hat tip to Marty Hart-Landsberg at Lewis & Clark College.)

Last week was a busy one for single payer advocacy with Oregon ties. Significant events took place in Congress, in Multnomah County, and in Oregon performances of a West Coast musical fundraising tour:

(continued below the jump)

In Congress
Senator Jeff Merkley in the Senate Health, Education, Labor and Pensions Committee voted to support an amendment by Senator Bernie Sanders of Vermont that would have allowed two states per year to adopt state-level single payer plans. Unfortunately Sanders' amendment was defeated. But Jeff Merkley was one of four committee members who voted in favor of it, along with Sanders, Tom Harkin of Iowa and Sherrod Brown of Ohio.

Senator Merkley has repeatedly promised, both during the election campaign and since taking his Senate seat, that if a single payer bill makes it to the floor of the Senate, he will vote in favor of it.

His vote for the Sanders amendment represents his first step beyond support in principle to actually taking legislative action to open the door to single payer reform. It is a small step, but a real one, taken even while he continues to focus his main efforts on supporting a public plan option in health reform legislation.

Kudos to Senator Merkley. I encourage single payer advocates to contact him and thank him for supporting the Sanders amendment. (The front page of his website has local and D.C. office phone #s and there is a link to a web e-mail comment form).

At the same time, we should encourage Jeff to take the next step and co-sponsor Senator Sanders' bill S 703, which would provide a framework making it easier for states to adopt state-level single payer systems.

Meanwhile, over on the House side, Rep. David Wu was AWOL on a similar amendment proposed by Rep. Dennis Kucinich in the Committee Education and Labor. Voting neither yes nor no, Wu "passed" twice on casting a vote on the amendment. Unlike Sanders' effort, the Kucinich amendment passed, with both support and opposition being truly bi-partisan and mixed.

Again, I would encourage single payer advocates to contact Congressman Wu and express disappointment with his failure to support the amendment.

Meanwhile, over on the House side, Rep. David Wu supported a similar amendment proposed by Rep. Dennis Kucinich in the Committee Education and Labor. Unlike Sanders' effort, the Kucinich amendment passed, with both support and opposition being truly bi-partisan and mixed.

Again, I would encourage single payer advocates to contact Congressman Wu and express thanks to him for supporting the amendment.

[See apology for major error at end of post. CL]

Multnomah County
On the metro Portland scene, last Thursday the Multnomah County Board of Commissioners endorsed a single payer health care system.

The endorsement came as part of a broader resolution calling on Congress to make comprehensive health reform. In supporting single payer, the Multnomah County Commission joined those of Coos and Curry counties.

The Commission vote was the result of quiet persistent persuasion motivated by Dr. Herman Frankel, a Portland pediatrician and member of the Portland Jobs with Justice Healthcare Committee and Physicians for a National Health Plan. Dr. Frankel drew the attention of single payer advocates associated with those groups and the networks of Single Payer Action to the fact that the general resolution calling for comprehensive health care reform was on the Commission's agenda. Numbers of persons evidently wrote to the Commissioners, according to a comment by Commissioner Jeff Cogen, and five persons testified asking the Commission to support single payer health care reform: Eliana Machuca, representing Jobs with Justice who spoke about rapidly growing support for single payer in the labor movement, myself speaking as a public health graduate student and representing Progressive Democrats of America/Oregon, and three PNHP doctors, Dr. Frankel, Dr. Nancy Crumpacker, a Portland oncologist, who spoke about effects of the current system on her patients, and Dr. Gene Uphoff, who gave a succinct and cogent summary of the arguments for single payer.

The resolution offered was one crafted by the National Association of Counties that adduces a number of excellent principles about how federal health reform should interact with county governance, a matter of importance since counties typically are responsible for providing many public health services, educational efforts and regulations.

Without otherwise changing the resolution, Commissioner Jeff Cogen, citing written correspondence and the testimony presented, offered an amendment inserting a new clause stating simply "The Board believes that a single payer system would provide the best access to affordable health care for all Americans." Commissioner Judy Shiprack seconded the motion, Commissioner Deborah Kafoury indicated that she would support it, while Commissioner Diane McKeel said that she would not. County Chair Ted Wheeler made some thoughtful remarks, especially about the importance of ensuring that whatever form health reform takes, it should protect the most vulnerable among us, for whom the county has particular responsibility. When the vote came, Wheeler joined in voting yes, so the amendment passed 4-1, then the overall resolution carried unanimously.

Again, thanks to commissioners from single payer backers are in order.

(BTW the JwJ page links to video of a recent single payer demonstration outside of Ron Wyden's office, with remarks from Dana Welty, an OHSU neonatal critical care nurse and co-chair of the JwJ Healthcare Committee, Dr. Paul Gorman of PNHP, and a PSU public health grad student who was became a health care refugee from the U.S. non-system in Japan.)

Sing Out for Single Payer!
Finally for last week, on Saturday night labor and folk singer Anne Feeney brought her lively and rousing Sing Out for Single Payer! chautauqua style road show to the SEIU 49 hall on SE 26th Avenue in Portland, a tour of more than a dozen musicians including several from Oregon that began in southern California on July 2 and has been barnstorming up the coast. In Oregon the tour so far has stopped in Ashland, Bend, Florence, the Oregon Country Fair, Corvallis, Coos Bay, Yachats, Newport, Eugene, Portland and Salem, with more performances tonight in Astoria and tomorrow night in Vancouver, WA, moving thence further north into Washington to finish in Bellingham.

In Portland, over 100 and perhaps as many as 150 people attended the event organized by Jobs with Justice, hearing and participating in a mix of folk, bluegrass and eclectic acoustic style songs. Many songs addressed the topic of the evening, the need for single payer reform of the health system, sometimes using new lyrics to familiar tunes. Others took on aspects of the economic crisis or labor and social solidarity and uplift themes, including a couple of brilliant original songs by SEIU 49 staffer Al Bradbury; some readers may know her from her work as a activist with the Transit Riders Union and the Jobs with Justice Economic Crisis Committee. Feeney had gained financial backing for the tour prior to starting it, and the event was a great success in raising funds for local single payer organizing and outreach.

Update and apology In my post as originally published, I erroneously asserted that Congressman David Wu had "passed" on the final vote on Dennis Kucinich's amendment to HR 3200 in the Education and Labor Committee's mark-up. In fact Congressman Wu voted for the amendment. (Thanks to Congressman Wu's office for that link.)

When I wrote in error, I was relying on sources that I thought authoritative. Clearly I was wrong about that. It is my guess that what seemed to be multiple sources go back to one common error. I will be following up with those sources to make sure they are aware of the error and fix it, and will not rely upon them without checking by other means in the future.

In the meantime, I offer sincere and heartfelt apologies to Congressman Wu, who did not deserve to be blamed for what he did not do, but to be praised for what he did do, as the emended text above now reflects. Albeit belatedly and in embarrassing circumstances, I also thank him for his vote on the amendment.

  • Urban Planning Overlord (unverified)

    Beware relying on the Economist to promote a left-wing political agenda! Although to be fair, the Economist was attacking a proposal that is not a single-payer plan.

    I'm sure you're aware that a number of developed Western nations do NOT have a single-payer plan, and seem to be doing just fine.

  • Bill R. (unverified)

    Dream on! Single payer is not on the table before this Congress. Some pilot state programs .. maybe in the years ahead.

    We have not yet established in this country the moral principle that every person has a right to health care. That can and must happen this year. We can continue to argue about the best way to do it, but until that principle is into law, this is all fantasy.

    For now, we have the principle that American citizens over the age of 65 have the right to (minimal)health care. Members of Congress and elected officials have the right to health care. But the people who elect them and pay the bills don't. I haven't seen any serious confrontation with our elected officials on this point.

  • OregonScot (unverified)

    I would much rather we quite all this tinkering about the edges stuff and of course trying hard to ensure the Insurance companies benefit greatly from any "reform" Rather have nothing ..maybe another 8 years of worsening and more exspensive health insurance will make Single Payer or similar the #1 option Im hopeing now Wyden and co do destroy any reform this time.

  • (Show?)

    Chris, I’m not opposed to a single payer system at either the national level or state level. I do think it is unlikely to emerge from the current effort. Nor do I think it would solve all our problems if it did emerge, so I not rooting hard for it.

    As I see it, assuming public options are in, what is emerging is hung up over how to fund the $1 trillion in costs over ten years. Do the single payer proposals offer any useful revenue ideas? How are they paid for?

    There is the specific revenue question of whether to tax health benefits either entirely or over some cap. To me, such a tax is a good policy option but possibly bad politics. A dilemma. How would the tax exclusion of health benefits fare under the single payer proposals?

  • Bill Bodden (unverified)

    "(BTW the JwJ page links to video of a recent single payer demonstration outside of Ron Wyden's office,..."

    This is the fifth health care thread since Jo Ann's on 7/17 in which Wyden has taken flak, yet no one from his staff has seen fit to (been capable of?) defending him.

    "As I see it, assuming public options are in, what is emerging is hung up over how to fund the $1 trillion in costs over ten years. Do the single payer proposals offer any useful revenue ideas? How are they paid for?"

    Here is one way to fund health care. Quit empire building and its blowback costs. Quit squandering more money on the bloated budgets requested by the war (defense?) department and the Pentagon. Tell Admiral Mullen to forget about the three or four percent a year increase he wants in that budget.

    Here is another. Have people who would prefer to switch to a single-payer system give their money to the government instead of the insurance corporations that return only a fraction of that money to their policy holders. Cut out the administrative waste.

  • Bill Bodden (unverified)

    "The (Multnomah) Commission vote was the result of quiet persistent persuasion motivated by Dr. Herman Frankel, a Portland pediatrician and member of the Portland Jobs with Justice Healthcare Committee and Physicians for a National Health Plan. etc."

    If a genuine national health care plan is to be developed we will most likely need more conferences such as the one Chris described above at state and national levels. If such conferences were led by non-political entities like Physicians for a National Health Plan and the people were made aware of them then this nation could finally get its long-overdue system of health care for all.

    There is little prospect of politicians influenced by campaign donations and other legal bribes developing a successful plan.

  • (Show?)


    Thanks, I understand The Economist's general outlook pretty well, I think. As with much of British journalistic culture, they eschew spurious efforts at "balance," as well as the common U.S. pretense that objectivity in the sense of complete viewpoint neutrality can be achieved, although "objectivity" is a better standard than "balance" insofar as it refers ultimately to realities and not just the relationships of expressed views.

    Rather, they tend to use a kind critical thinking that is based on an outlook developed over a long time, but recognizes that in promoting interpretations based on that outlook, the strongest arguments tend to based on taking on opposing arguments in a way that treats them with intellectual honesty rather than misrepresentation, and that seeks to identify and account for inconvenient facts.

    Without claiming consistency or great success in pursuing that sort of thinking, it also is what I aspire to do. Of course, the really big issues tend to arise at the foundational assumptions of the broad outlooks.

    I have a pet theory, quite sucked out of my thumb, that the characteristics of (some) British journalism just identified are promoted by the institution of "Question Time" in the British Parliament.

  • (Show?)

    Bill, I’m with you on cutting the defense department budget. I’ve repeatedly call for it on my own blog. It just not going to happen soon, so we can’t fund health care from the savings now.

    Just how hard the defense budget is to cut, even a little and with Pentagon support, will be seen tomorrow (Tuesday), last I knew, with the scheduled Senate Armed Services Committee vote on $1.75 billion in F-22 funding. That’s a significant vote.

    You need to find another source of health care funding.

  • Bill Bodden (unverified)

    "You need to find another source of health care funding."

    Better still, we need to get the American people to wake up and quit bending over when Congress wants to screw them.

  • Joe Hill (unverified)

    How did Rep. Blumenauer vote on Kucinich's single payer bill?

  • (Show?)

    Bill, IMO you overestimate the susceptibility of the system to popular influence and blame "the American people" more than they deserve.

    Dave, the funding mechanism for the national single payer system proposed by John Conyers & co-sponsored by Kucinich and over 80 oher reps in HR 676 is



      (a) In General- The USNHC Program is to be funded as provided in subsection (c)(1).
      (b) USNHC Trust Fund- There shall be established a USNHC Trust Fund in which funds provided under this section are deposited and from which expenditures under this Act are made.
      (c) Funding-
            (1) IN GENERAL- There are appropriated to the USNHC Trust Fund amounts sufficient to carry out this Act from the following sources:
                  (A) Existing sources of Federal Government revenues for health care.
                  (B) Increasing personal income taxes on the top 5 percent income earners.
                  (C) Instituting a modest and progressive excise tax on payroll and self-employment income.
                  (D) Instituting a small tax on stock and bond transactions.
            (2) SYSTEM SAVINGS AS A SOURCE OF FINANCING- Funding otherwise required for the Program is reduced as a result of--
                  (A) vastly reducing paperwork;
                  (B) requiring a rational bulk procurement of medications under section 205(a); and
                  (C) improved access to preventive health care.
            (3) ADDITIONAL ANNUAL APPROPRIATIONS TO USNHC PROGRAM- Additional sums are authorized to be appropriated annually as needed to maintain maximum quality, efficiency, and access under the Program.

    There would be no premiums or subsidies, all residents of the U.S. would be eligible to enroll and get a health care card. The bill is called "United States National Health Care Act or the Expanded and Improved Medicare for All Act," and it would fold in Medicaid, Medicare and a bit later the Indian Health Service. The V.A. and military systems would remain separate, with integration of the V.A. system to be evaluated after 10 years.

  • backbeat (unverified)

    Right on Merkley and Wu! Senator Wyden, where are you?

  • Unrepentant Liberal (unverified)

    Healthcare for everybody. No exceptions!

  • Bill Bodden (unverified)

    "Bill, IMO you overestimate the susceptibility of the system to popular influence"

    Not really. No more than other people throughout history when they began long, very long struggles for human and civil rights.** Those struggles never end, nor must the people give up if they want a better world. We may not gain ground, with luck we might hold ground, but if we don't engage the opposition we lose.

    "and blame "the American people" more than they deserve."

    Well, if we can't blame the American people for the contempt the oligarchs in the Democratic and Republican parties and their satraps in Congress show them, who else can we blame?

    ** I'm sure I don't need to cite examples for you and others who know their history.

  • AdmiralNaismith (unverified)

    Keep fighting for Single Payer!

    The worst case scenario is, we don't get it, while we make the strong public option into the middle of the road compromise. Without Single Payer, the public option seems to be the far left choice.

  • (Show?)


    Kucinich's amendment was in the Education & Labor Committee (chair, George Miller). Earl Blumenauer is not on that committee, so he didn't vote.

    The draft bill is HR 3200 (link goes to Libary of Congress, link to draft bill is right up on front page) that Kucinich got amended as part of the markup in the E & L committee. The bill has also been referred to the Ways & Means Committee (chair, Charles Rangel) and the Energy & Commerce Committee (chair, Henry Waxman), which will do separate markups. Blumenauer is on Ways & Means.

    I'm not sure how the different versions will be reconciled, and I don't know if any counterpart to Kucinich's amendment will be put forward in the other committees. I suppose we could ask Earl to offer one ;->.

    Nor do I know how the different versions of the bills are reconciled within the House -- possibly by the Rules Committee? The bill has to go there too. Anyway there's a chance that the amendment could get stripped out again before the House is done, probably a pretty good one, and if it survives that, another chance it could be sripped out in the reconciliation process with whatever the Senate puts forward.


    Bill, Herman was mainly drawing attention to it over e-mail. There wasn't a conference -- the groups I mentioned are continuing advocacy groups.

    Actually PNHP on a national level has had a great deal to do with the formulation of Conyers' H.R. 676, which is backed by the major s.p. advocacy groups, many now united around the Leadership Conference for Guaranteed Health Care.

    PNHP is non-partisan, but I wouldn't say non-political. It is true that if we can break the media blackout on discussing the substance, doctors and nurses make particularly effective advocates.

  • (Show?)

    Chris, thanks for posting the funding of HR 676. I could support such a bill, but I don’t think that’s where we’re headed now.

    We are now looking for revenues or cost cutting to get some version of the current bills passed. I note that, while HR 676 does not propose eliminating the tax exclusion for health benefits, it would effectively do that. As I understand it, under HR 676 all employer based health insurances would be eliminated and everyone would get a basic health care plan from the government. Is that right? Perhaps, there would be some employer based health insurance coverage for care beyond the basic national program. But there would not be much of a role for labor negotiated health care benefits under HR 676. Or would there?

    I further note that “instituting a modest and progressive excise tax on payroll and self-employment income” would be a tax on the middle class, much as a tax on now tax excluded health benefits would be. So, were Congress to get serious about HR 676, it probably would run into the same funding problem we’re in now. The combined efforts to tax the rich and cut costs are not enough to pay for fully expanding health care coverage. Some tax on the middle class may be needed, and none of those are popular.

  • (Show?)


    You're right that there are Western European systems that aren't single payer, or socialized medicine either, but they don't look much like ours.

    The German system (which I think the Japanese may resemble) may be where Ron Wyden got some of his ideas. The insurers are called "sickness funds," a name which reflects their origins as trade-union cooperative institutions, like burial funds -- poor working people pooling their resources against hardship. Bismarck used them to build the foundations of his social insurance schemes.

    They are private, but not for profit, and people are members of them. There used to be hundreds of them, and employers contracted with particular ones, a choice often subject to labor negotiations. A while ago individuals were given the freedom to join whatever fund they liked that operates in the federal state where they live, and there has been a great deal of consolidation.

    The sickness funds are funded by obligatory joint contributions by workers and employers that are collected for the funds by the government, in what looks a lot like a payroll tax (U.S. social security was modelled on the Bismarckian system to a degree). Everyone with a job in the bottom 2/3 of the income distribution is required to belong to a sickness fund. Upper income people can join one or buy private insurance more like the U.S. market. A bit less than half those eligible (i.e. about 15% of the total working population) buys on the private insurance market, a bit more than half join a sickness fund voluntarily.

    The funds are heavily regulated and must pay for a wide range of required services, which limits the terms competition as well as keeping the risk pools similar (i.e. preventing cherry-picking and dumping). The Wyden plan would be similar, and the Exchange idea is most of the proposed reforms as well, except that none of them (or Wyden) require that 2/3 of the population be in the Exchange.

    Doctors are associated with hospitals, and they are paid on a fee for service basis mostly, BUT unlike the U.S., fees are negotiated at the level of the federal states (lande) by an organization representing doctors and an organization representing sickness funds in a process organized and overseen by the government -- similar to wider German tripartite corporatism where unions and employers negotiate by sector under government supervision. So doctors fees are uniform across states and the negotiation process helps control them to a degree. I am not quite sure how the hospitals work, I think they may be public and locally controlled but could be wrong.

    So, quite right, not single payer or socialized medicine. But not much like our system either. No premiums, rather a set % of income payroll dedctions and employer contributions collected by the government, with retirees covered as part of social insurance pensions and care for the unemployed and indigent funded by general taxes.

  • Bill R. (unverified)

    I don't understand why more of the business community isn't in favor of single payer. American businesses are strapped with health care costs. My uncle and his adult sons have owned a car dealership for a number of decades. A few years ago, my life-long Republican uncle, who ostensibly hates government, uttered in exasperation, "it's time for socialized medicine." That was his word for single payer. I have to think there are many more like him out there, but are afraid to speak up because of their Republican peers.

  • Payday Loan Company (unverified)

    Payday loan companies offer tools to use during emergencies, not long term solutions – their services only plug the crack in the dam, so to speak. This is true! America is in a great distress of economical status. It would be hard for America to cope with this situation because seems to be in depth of debts and financially unstable. A payday loan company can give you the fast financing for the short term you might be in need of.

  • David from Eugene (unverified)

    "You need to find another source of health care funding."

    The short answer is to collect a health care premium from all Residents of the United States. Supplemented by payments from the Federal Government for those covered under SCHIP, VA, Medicare, Medicaid, Retired Military and similar government programs. Depending on the final amount of the premium the Federal Government may also need to assist low income individuals in paying for coverage.

    The long answer

    To start with, the bulk of American’s who currently have health insurance either get it as a part of their compensation package they receive from their employer or they pay for an individual health insurance policy. Under this funding system, the payment responsibility would rest with the individual; employers would no longer be responsible for providing health insurance. The first year employers currently providing health insurance would be required to raise their employee’s cash compensation by either the amount the currently pays for their health insurance or the new annual premium amount which ever is less. The result being that while those currently getting health insurance from their employer would now be responsible for paying for it directly they would see their income increase such that they would not loose ground. Those that are paying directly for individual coverage would continue to do so.

    As to the 47-50 million currently without health insurance; as a part of the enrollment process anyone eligible for an existing government program would be enrolled in that program. Those Legal Residents of the United States not eligible for those programs would be expected to pay a premium like everyone else. Legal Visitors from countries who offer free treatment to Americans traveling it their county would receive free treatment (as the single payer program would not be paying for the health care of Americans traveling in those countries it should be a wash). Other legal visitors could purchase travel coverage or would be billed for services rendered. Medical care for Foreign Diplomatic Personnel would be the responsibility of their respective nation, who could either pay a premium for each employee and dependent or be billed for services rendered. That leaves illegal residents (i.e. undocumented aliens, illegal aliens) as it is the responsibility of the Federal Government to enforce immigration laws, it should be their responsibility to pay for the health care of those they fail to keep out. So the Federal Government would be billed for unpaid medical services provided to illegal residents.

    As I indicated above some low income people may need assistance paying their individual premium. I propose that that a new federal tax be levied on those employers paying less then a living wage. The revenues from that tax as well as a progressively graduated surtax on incomes over $250,000 would be used to provide assistance to those whose annual income is less then the living wage.

    For a variety of reasons the premium for a single payer system should be less then equivalent coverage from a private insurance carrier. First, as the administrative overhead for a single payer system should be less then that of the private insurers, there should be 20-25% reduction. Second, as everyone is in the risk pool the basic premium would be lower then with individual coverage. Third as everyone is covered Hospital Costs would be less as there would no need to include unpaid care in the overhead figure used to establish billing rates. Additionally there should be substantial reduction in Automobile and Homeowners (or Renters) Insurance premiums individuals and employers pay as the Insurers would no longer be responsible to pay for medical care. So when those savings are included, the amount individuals would pay would be less then they do now for better coverage. And that is before reductions in Doctor’s and Hospital compensation rates made possible by reductions in office overhead, workman’s compensation premiums and malpractice coverage are factored in.

  • GWeiss (unverified)

    Single payer programs work for health care only if the single payer is not the "single decider" about who gets access, treatment, and for how long. Fee for service is a model that can only bankrupt any system eventually--whether it's single payer or multiple payer, or, if you will, the tax payer. The Ron Wyden I used to vote for understood this. The Ron Wyden of today seems to have forgotten this lesson.

  • Bill Bodden (unverified)

    Dean Baker has an article at CounterPunch - Séance on Wall Street - giving good reasons why we should be skeptical of an opinions emanating from that den of avarice on topics such as social security and health care.

  • Bill Bodden (unverified)

    Common Dreams has an article - Industry Cash Flowed to Drafters of Reform. No surprise that Senator Max Baucus (D-MT) is a leading recipient.

  • Reggie Greene / The Logistician (unverified)

    We have a tendency in America to argue for or against a concept based on our own personal philosophy or view of the world, what advances our personal interests, or the interests of our party, family, organization, or region. Perhaps viewing the issue from a management or systemic perspective might result in innovative approaches to the issue. The American national mindset, citizen philosophy, lack of citizen motivation to be proactively healthy, and governance model make the socialization of health care in America very problematic, particularly at this point in time. A country needs to know its limitations.

  • Bill R. (unverified)

    @ Reggie Greene

    A great job of obfuscation, but what is not sustainable, and what is not sound systems management is spending 30 cents of every health care dollar, and growing, on corporate profits, stockholders, and CEO bonuses for insurance companies. What is sustainable is spending resources on actual care. We have decided to do single payer "socialized" care for seniors, military, veterans, disabled, and politicians, but somehow doing it for the taxpayer is not "American"?

  • Bill R. (unverified)

    Question: Can county or city govt. entities sponsor single payer health coverage?

  • Bill Bodden (unverified)

    "Question: Can county or city govt. entities sponsor single payer health coverage?"

    Kucinich Amendment Allows States to Seek a Federal Waiver was intended to make it possible for STATES to offer single-payer plans.

  • Bill Bodden (unverified)

    In case you missed this link - Single Payer Action - in Chris's opening post, check it out. It has excellent articles and links to others. Unfortunately, if you get into some of these articles you will discover that what you hear from Obama on health care is not what you might think you are getting. Change? What change?

  • Wrench Monkey (unverified)

    From Single Payer Action ( website:

    On Single Payer, Himmelstein Says Howard Dean is a Liar

    Dr. David Himmelstein says Dr. Howard Dean is lying about the Obama health care proposal.

    Himmelstein is a founder of Physicians for a National Health Program and is an associate professor of medicine at Harvard Medical School.

    Dean is the former head of the Democratic National Committee and is making the television talk show rounds promoting Obama’s health care reform.

    Himmelstein says that Dean is portraying Obamacare as something it isn’t.

    It isn’t single payer – as Dean said it is.

    And it doesn’t give Americans the option to opt into a single payer system – Medicare – as Dean said it does – most recently last week on Democracy Now.

    “He’s a liar,” Himmelstein told Single Payer Action yesterday.

    Dean told Democracy Now’s Amy Goodman last week that Obama’s public option plan is best thought of as Medicare or single payer.

    “For the average American, they should best think of it as Medicare,” Dean said.

    According to Dean, under the Obama plan, the American people will have a choice to opt into a single payer system.

    “Look, you decide for yourself,” Dean said. “We’re going to allow people under sixty-five to sign up for what people over sixty-five have. And you make the choice.”

    Dean said that the Obama plan will give Americans the choice “between whether they would like a single payer for themselves and their families or whether they would not.”

    One problem: Obama’s plan is not single payer.

    Another problem: It’s not like Medicare.

    “He’s a liar,” Himmelstein says.

    “He knows that the public option plan is not single payer and he says it is to try and confuse people,” Himmelstein said. “He goes on Democracy Now and other shows and says that people can buy into Medicare when he knows that what is in the plan is not that.”

    “Medicare doesn’t have to compete,” Himmelstein said. “That’s why it’s so efficient.”

    And it’s definitely not single payer.

    Himmelstein says that the Obama plan would mandate that people buy insurance from competing private plans – and one denuded public plan.

    The private health insurance companies would cherry pick the young healthy patients, while the sick older patients would opt into the public plan – making the public plan unsustainable.

    Himmelstein says the upcoming Congressional vote on the Obama health care reform has little significance because it does not represent fundamental reform.

    “It’s like giving aspirin to a patient who has cancer,” Himmelstein said. “Instead of asking – what can we do to treat your cancer?”

    Himmelstein says that when the time comes to vote on the Obama health plan, members of Congress should abstain.

  • Charles Eggen (unverified)

    In many respects, 40+ years ago our health care system was better. That was when hospitals were non-profit and medical insurance was not considered a high profit division of the insurance business. Before the bureaucracy of Medicare and for-profit insurance, doctors did not need a large staff to handle claims and billings. It also did not cost as much to get through medical school as today and we were not as litigious a society as today, thereby keeping the doctors liability insurance lower.

    We need to encourage hospitals and clinics to be non-profit, by making them tax free and taxing the for-profit ones. We need to encourage more people to school for general practice, where we have shortages, by subsidizing them over the specialists. But most of all, we need to stop for-profit basic medical insurance. If someone wants a private room, elective surgery and other non-essential extras, they can pay for them directly or by taking out insurance to cover such.

    As with basic education through high school, we should all have basic medical coverage, regardless of where we live or work. It would be paid for by a percentage deduction from our income, with no cap. Not only from wages, but from all forms of income whether $10,000 or $10,000,000 per year.


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