Thousands rallied June 25 in front of the Capitol in Washington in favor of healthcare reform. The idea of a single-payer system paid by the government hasn't gone far here, though it exists in Europe and Canada.
(Andrew Councill/MCT/Newscom)Photos (1 of 1)
ECONOMIC SCENE: The missing piece of the healthcare debate
The idea of a government-paid national healthcare system hasn’t gotten very far in the Washington debate.
By David R. Francis | Staff Writer/ July 1, 2009 edition
If no one is paying any attention, create a fuss.
Maybe that explains why 13 doctors and nurses got arrested last month when they disrupted a Senate hearing. Their protest: The committee wasn’t considering a single-payer solution to fix America’s healthcare system.
In fact, as healthcare reform works its way through Congress, the idea of a government-paid national health-insurance system hasn’t gotten very far in the Washington debate.
Perhaps it’s too politically radioactive. Or too difficult to pass. For whatever reason, neither the most Democratic Congress in decades nor the most liberal president since Jimmy Carter have opted for a sweeping national health-insurance system, as exists in Europe and Canada, where private insurers disappear and government pays the tab.
“There are countries where a single-payer system works pretty well,” President Obama, a onetime single-payer supporter, told the American Medical Association June 15. “But I believe … that it’s important for our reform efforts to build on our traditions here in the United States.”
That stance leaves single-payer advocates in a political quandary.
“We haven’t yet applied enough pressure to get done what has to be done,” says David Himmelstein, cofounder of Physicians for a National Health Program (PNHP). Maybe, he added, “we will have to give strong consideration to civil disobedience.”
Why are single-payer advocates so passionate? For one thing, many of them see medical healthcare as a civil right for all Americans.
Call up the Internet home page of Rep. John Conyers (D) of Michigan and immediately, without further clicking, a video shows the congressman talking on the House floor about one of “the biggest challenges of the 21st century” – healthcare reform. His bill would provide national health insurance to every person with no deductibles or copayments for medical treatment. Uncle Sam – via citizens – would pay the bill.
Prospects for his bill in Congress don’t appear strong, although 80 House members have signed on to his bill and 59 percent of physicians back national health insurance, according to a new poll.
Public support has also grown over the years. In 1979, 40 percent of Americans thought the federal government should provide national insurance; last month, 72 percent supported the idea, according to CBS News/New York Times polls.
“Things have gone very well for us,” says Quentin Young, PHNP’s national coordinator. “There has been a new surge of support in the last few months.”
Economic stress may explain some of that shift. In 2007, even before the recession, medical bills were the cause for more than 60 percent of bankruptcies, a new Harvard study finds. More than 75 percent of these bankrupt families had health insurance, but it wasn’t enough, Dr. Young points out.
Reformers of every stripe figure that today’s system is unsustainable in the long run. The Congressional Budget Office projects national healthcare costs to rise from today’s 18 percent of gross domestic product, the total output of goods and services in the nation, to more than 30 percent in 2030 and 50 percent by 2080. That assumes modest cost-cutting measures are imposed. Without them, healthcare costs would consume nearly the entire economy by 2080, an impossibility.
Compromise reforms under consideration in Congress are economically “not feasible,” Dr. Himmelstein says, “The likelihood we can afford what they are offering is nil.”
So he figures a single-payer plan is essential. Just cutting the system’s bureaucratic overhead from today’s 31 percent of total expenditures to Canada’s level (1 percent) would save nearly $400 billion annually, more than enough to cover the 48 million now uninsured, he argues.
So why hasn’t Congress moved toward a single-payer system? The financial and political clout of health industries, charges Himmelstein.
And who was the top recipient of their largess in the 2008 election cycle? Mr. Obama.
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Comments
2. M. W. MCSHAN | 07.01.09
I urge all readers to read “Healthy Competition: What’s Holding Back Health Care and how to Free It” by Michael F Cannon and Michael D Tanner. More than 800,000 Canadians are on waiting lists for medical treatment. British National Health Service cancels up to 100,000 surgeries every year because of resource shortages. Government-run medical services fail patients due to procedural delays and lack of proper funding. Real & not imagined competition could make higher quality health care available to more Americans at much lower costs. Current systems, in order to “help” more people gain access to health care has actually drastically limited American’s choices about their insurance coverage and medical care.
3. John Greenbaum | 07.02.09
Representative Conyer and those who espouse a single payer solution modeled on the current Medicare/Medicaid programs should listen carefully to the comments of the CMS head who states that they can barley manage the population they courrently povide coverage to. Does Representative Conyer believe that providing coverage to all Americans without deductibles or copayments will be paid for by eliminating the insurance industry. If so he evidences a deep misunderstanding od the healthcare delivery system, it is the action of acquiring care with no cost and thus no perceived economic value that has us in our current predicament.
4. Rocko Delray | 07.02.09
If Obama says that our “tradition” is not single payer then the REAL missing piece is TORTS REFORMS!!!
Our system is doomed as long as the legal/insurance industry keeps chugging away and devolving health care into something out of a Hollywood SciFi doomsday scenario where only the rich will be able to have any kind of health care and the rest of us will have nothing but the emergency room.
5. DSEdwards | 07.02.09
If, and only if, all of Congress, all of the Executive Branch, and all of the Judicial Branch, are under the same Healthcare Plan as the common citizen will a Healthcare system for ALL be possible. Those legislating the Healthcare system have access to the best and the brightest at the drop of a hat. The rest of us do not. To allow those in the Federal Government evolve a healthcare system they will not have to use is not sensible or logical.
6. Ian MCloud | 07.24.09
It is not overtly mentioned or noticed that some of the proposed funding for the health care reform be derived from the wealthy — at first those whose family incomes are $250,00 to $350,000 and now one million. There is a lot of truth in the old adage that “those who have the gold make the rules”.
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1. G. Davis | 07.01.09
Just for the record, Healthcare in Canada is not a Federally operated scheme, but is managed by the provinces individually in adherence to the requirements of the Federal Healthcare Act.
Services provided and funding for healthcare come from the Provinces, NOT the Federal Government. In almost every case, provinces are running in the red over healthcare, including Alberta which is currently the richest province in Canada.
Healthcare costs in Canada per capita are equal or greater than the costs per capita for military spending in the United States.
Average waiting times for Emergency Care are between 9 and 14 hours, depending on the severity of the patients condition.
Women giving birth, including those by caesarian section are allowed to stay in hospital only 1-2 days, and most other surgical patients are released within a day or two, due to chronic bed shortages.
Bed shortages are caused by spending constraints and nurse shorttages, not by bed shortages as there are many hospital wards available but shutdown due to staff shortages, not bed shortages.
Overall healthcare quality is ranked below many developing nations due to cost considerations.
You may want to think twice about so-called “Universal” or “single payer” healthcare, if you live in the U.S.
Many of us in canada wish we could have private healthcare back again!
G. Davis