No Reason to Demonize U.S. Single-Payer Health: John F. Wasik

Commentary by John F. Wasik

<http://www.bloomberg.com/apps/news?pid=newsarchive&sid=ao58otXrmrPM>http://www.bloomberg.com/apps/news?pid=newsarchive&sid=ao58otXrmrPM

March 11 (Bloomberg) -- It's time to stop kicking sand in the face of 
single-payer health care. It may be the strongest solution around to 
insure every American at a lower cost.

After decades of industry campaigns against this model -- dubbed by 
its critics as "socialized" medicine -- it's important to stop 
whining and evaluate the many economic benefits. Health care is a 
fundamental human right.

If 
President 
<http://search.bloomberg.com/search?q=Barack+Obama&site=wnews&client=wnews&proxystylesheet=wnews&output=xml_no_dtd&ie=UTF-8&oe=UTF-8&filter=p&getfields=wnnis&sort=date:D:S:d1>Barack
 
Obama wants real change in American health care, he will have to get 
over the fear of even mentioning single-payer concepts. At his 
health-care summit last week, only the threat of a demonstration 
garnered late invitations 
for <http://www.med.cornell.edu/research/otfein/>Oliver Fein and 
Congressman 
<http://search.bloomberg.com/search?q=John+Conyers&site=wnews&client=wnews&proxystylesheet=wnews&output=xml_no_dtd&ie=UTF-8&oe=UTF-8&filter=p&getfields=wnnis&sort=date:D:S:d1>John
 
Conyers, two leading proponents of the single-payer plan.

Health-care costs have become a crippling personal-finance burden for 
45 million uninsured and 25 million underinsured Americans. Those 
outside of the fractured employer-based system are only one illness 
away from financial ruin.

Lose your job and most likely your health coverage will disappear 
unless you want to pay exorbitant rates. And it's getting worse. 
Because of the growing jobless rate, some 14,000 Americans are losing 
their coverage daily, according to 
the <http://www.americanprogressaction.org/>Center for American 
Progress Action Fund.

A single-payer plan would cover everybody regardless of employment 
situation and save money by cutting out middlemen.

$400 Billion

Fein, president of <http://www.pnhp.org/>Physicians for a National 
Health Program, said a single-payer program would offer $400 billion 
in annual administrative savings and provide "effective cost 
containment provisions such as bulk purchasing and global budgeting."

Obama has said he would keep an open mind on health-care solutions. 
Yet when asked on March 5 about why he was against single-payer 
medicine, White House 
spokesman 
<http://search.bloomberg.com/search?q=Robert+Gibbs&site=wnews&client=wnews&proxystylesheet=wnews&output=xml_no_dtd&ie=UTF-8&oe=UTF-8&filter=p&getfields=wnnis&sort=date:D:S:d1>Robert
 
Gibbs replied: "The president doesn't believe that's the best way to 
achieve the goal of cutting costs and increasing access."

The mainstream media have similarly been sheepish about touching the subject.

Most media outlets covering last week's summit didn't even mention 
the idea of a single-payer proposal, according 
to <http://www.fair.org/>Fairness and Accuracy in Reporting, a New 
York-based group.

While Obama's team has strategically avoided backing a specific 
proposal, under the administration's 2010 fiscal year budget outline, 
the burden for whatever plan that emerges will be shared by creating 
a $634 billion pool.

New Levies

Letting Bush-era tax cuts expire on the 2.6 million highest- earning 
Americans and imposing new levies on corporations and oil companies 
will pony up some funds needed for a national plan. The preferential 
tax rate 
on <http://www.irs.gov/newsroom/article/0,,id=170634,00.html>capital 
gains and dividends would be raised to 20 percent from 15 percent.

Even when employers cover most medical expenses, workers are paying 
an increasing share that isn't financed by personal-income growth. 
Premiums for employer-sponsored health care have risen four times 
faster than workers' earnings since 1999.

-- Since 1999, average premiums for family coverage have climbed 119 
percent, according to 
the <http://www.kff.org/medicare/index.cfm>Kaiser Family Foundation, 
a non-profit that tracks health-care issues. Out-of-pocket 
contributions for workers have more than doubled in that period.

-- Employers are asking more from employees and covering less. More 
than 93 percent of workers with family coverage need to contribute to 
the total premium.

-- Without universal health-care, the number of uninsured will rise 
to 54 million from 45 million today over the next decade, according 
to the <http://www.cbo.gov/>Congressional Budget Office.

-- Every 30 seconds, someone in the U.S. files for bankruptcy because 
of their medical bills. An estimated 18,000 Americans die each year 
from lack of insurance.

Grace Period

How would market economics work with a single-payer model? Legislate 
a grace period in which Americans would have a choice between private 
plans and the expanded Medicare buy-in model.

In a "Medicare-for-all" program, care would be publicly financed and 
privately delivered. You would keep your own health- care providers 
and hospital. The government wouldn't dictate who your doctor is or 
choose your hospital. It would be acting more like a huge purchaser 
bargaining for the best treatment and drugs at the lowest price.

Of course, you would have to level the playing field by eliminating 
health-care tax deductions for employers and give every individual a 
tax <http://www.irs.gov/individuals/article/0,,id=109960,00.html>credit.

There would be a national market and regulation for health policies 
and no one could be denied affordable coverage. No more 
"cherry-picking" of only the healthiest people and rejection of the 
sickest or those with chronic conditions.

Working Model

A good working model would be 
the 
<http://www.pnhp.org/publications/united_states_national_health_care_act_hr_676.php>National
 
Health Insurance Act, which was introduced in 2007 by Conyers, a 
Democratic representative, and had 93 co-sponsors in the 110th 
Congress.

Neighborhoods and communities are imperiled when health-care expenses 
drive everyone to economic ruin. More than 1.5 million families lose 
their homes every year to foreclosure due to medical bills.

The urgency is there, but the Obama team needs to get even more 
aggressive if it wants to craft a fiscally sustainable program. 
Medicare earnings limits and subsidies for drug companies and managed 
care should also be on the table.

If Congress doesn't act soon, the fiscal and social sacrifices in the 
future will be draconian.

Single-payer haters don't like the idea of seeing who will provide 
the highest-quality, low-cost coverage and will do anything to shut 
down the discussion. But let's at least put this free-market 
comparison to the test.

(<http://search.bloomberg.com/search?q=John+F.+Wasik&site=wnews&client=wnews&proxystylesheet=wnews&output=xml_no_dtd&ie=UTF-8&oe=UTF-8&filter=p&getfields=wnnis&sort=date:D:S:d1>John
 
F. Wasik, co-author of "iMoney," is a Bloomberg News columnist. The 
opinions expressed are his own.)

To contact the writer of this column: John F. Wasik in Chicago 
at<mailto:[email protected]>[email protected].

Last Updated: March 11, 2009 00:00 EDT

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