Single-Payer Prescription for What Ails Obamacare

By: Amy Goodman

Amy Goodman has the perfect answer when asked who she represents: “Democracy Now.” As host of the only national radio/TV news show free of all corporate underwriting, she is able to present a range of independent voices not often heard on the airwaves. “Dissent,” she explains, “is what makes this country healthy.”

I'm going to start with a quote just for all the anti-ACA crowd. One that will be spun into anti-government rethoric and hysteria.

“We apologize for the inconvenience. The Marketplace is currently undergoing regularly scheduled maintenance and will be back up Monday 10/7/3013.” You read it right, 3013. That was the message on the homepage of the New York state health insurance exchange website this past weekend.

Yes, the Affordable Care Act (ACA), popularly known as Obamacare, is going through difficult birth pains, as the marketplace websites went live only to crash. The government is not giving out numbers, but informed observers speculate that very few people have succeeded in signing up for any of the plans so far.

My point in doing this is to point out that 'liberals' (I use the term guardedly) are not thrilled about ACA - in fact it is a 'conservative, libertarian, big-business' creation from the beginning. Liberals, socialists, unionists, all those other scary compassionate people wanted a Single-Payer System as used successfully throughout the Civilized World (I use that term guardedly as well).

Whereas liberals will accept 'progress rather than perfection' (to quote anonymous sources) in working towards their ideals; the other side of the coin tends to the 'all or nothing' phiosophy (don't know where that comes from - maybe Ayn Rand Science Fiction Fantasies that are the bible for so many).

When I say Red/Blue, I say it to simplify discussion, not to imply that any extreme of the spectrum applies to any individual. Mostly people are made up of various traits and ideas and some, some people actually decided on issues independantly of the Blue/Red sound machine.

“When Medicare was rolled out in 1966, it was rolled out in six months using index cards,” Dr. Steffie Woolhandler told me Monday. “So if you have a simple system, you do not have to have all this expense and all this complexity and work.” Woolhandler is professor of public health at CUNY-Hunter College and a primary-care physician. She is a visiting professor at Harvard Medical School and the co-founder of Physicians for a National Health Program, or PNHP. PNHP is an organization with 17,000 physicians as members, advocating for a single-payer health-care system in the U.S.

An exceedingly good point with implications for debate about the cost of mechanical systems vs human systems of creating wealth.

What is single-payer? Critics denounce it as “socialized medicine,” while ignoring that single-payer is already immensely popular in the U.S., as Medicare. A 2011 Harris poll found that Medicare enjoyed 88 percent support from American adults, followed closely by Social Security. Woolhandler explained that with a Medicare-for-all system, “you would get a card the day you’re born, and you’d keep it your entire life. It would entitle you to medical care, all needed medical care, without co-payments, without deductibles. And because it’s such a simple system, like Social Security, there would be very low administrative expenses. We would save about $400 billion [per year].” Dr. Woolhandler went on, rather than “thousands of different plans, tons of different co-payments, deductibles and restrictions—one single-payer plan, which is what we need for all Americans to give the Americans really the choice they want ... not the choice between insurance company A or insurance company B. They want the choice of any doctor or hospital, like you get with traditional Medicare.”

Single Payer is a good way to go:

1) - it would be less expensive for businesses (less admin - HR costs, their accounting systems for their and their employees contributions to SS and Medicare are already in place and quite simple). No cost of providing any health care to anyone.
2) The VA administration could be folded into the system simplifing government systems and cutting cutting costs.
3) It would cover everyone cutting administrative costs once again by doing away with complex and time consuming 'qualification' decisions.
4) It would be portable - employees would not be slaves to an unsuitable job just to retain Health Care (Big Business wants employees terrified and powerless and dependant on them - google 'company towns')
5) Worker's Comp would be rolled in again simplifying systems and cutting costs.
6) The downside is lose of lots of jobs - many and mostly lower scale jobs - would be picked up by government or independant agencies administering the larger system (hey - we could contract out much of the work - with regulation requiring accurate reporting of finances and expendatures) Most of the jobs lost would be Executive and Sales.

Some quotes to consider:

About compassion (didn't Bush I say something about compassionate conversatism?)

While the ACA was deemed constitutional by the Supreme Court, the opinion gave states the option to opt out of the Medicaid expansion, which 26 states with Republican governors have done. A New York Times analysis of census data showed that up to 8 million poor people, mostly African-Americans and single mothers, and mostly in the Deep South, will be stranded without insurance, too poor to qualify for ACA subsidies, but stuck in a state that rejected Medicaid expansion.

And in closing:

So, while partisan bickering (between members of Congress who have among the best health and benefits packages in the U.S.) has shut down the government, the populace of the United States is still straitjacketed into a system of expensive, for-profit health insurance. We pay twice as much per capita as other industrialized countries, and have poorer health and lower life expectancy. The economic logic of single-payer is inescapable. Whether Obamacare is a pathway to get there is uncertain. As Dr. Woolhandler summed up, “It’s only a road to single-payer if we fight for single-payer.”

reply to post by FyreByrd


Seems like a good idea that should have been implemented in the first place. I has always bothered me a great deal that in one of the richest countries in the world it's citizens were at risk of being sick and not receiving medical care.

This is especially true with the very poor who do not qualify for Obamacare.

Don't know if it will ever happen though with the big insurance company lobbyists all over DC. We can hope.

Don't forget Single Payer was originally what Obamacare was aiming for but it was one of the compromises that had to be made for Republican support. Hopefully it will be implemented in the future. ACA isn't pretty but its a start and is better than the alternative road we were going down.

I think it went like this:

Democrats: "We want a single-payer!"

Republicans: "Hell no!"

Democrats: "Fine, we'll change it, make it super crappy and when it fails people will be begging for single-payer"

It would seem to me the Dems planned Obamacare to suck from day 1 -- more and more people are thinking like the OP.

MrStyx
Don't forget Single Payer was originally what Obamacare was aiming for but it was one of the compromises that had to be made for Republican support. Hopefully it will be implemented in the future. ACA isn't pretty but its a start and is better than the alternative road we were going down.

PPACA had zero Republican support.

No Republicans in Congress in 2009 voted in favor.

Obama, Democrats, and most Left Wing NGOs were in favor.

And Democrats removed the 'public option' too.
If they had really wanted it, they would have left it in the PPACA.
They had the Democrat votes.

.. just keeping the table level.

Makes people wonder just *who* is really on the side of Corporatism ?

Hmmm.
______________________


reply to post by FyreByrd


Maybe MediCare for all works ?

Right now, they take 1.45% from paychecks and that gets equaled by employers (total = 2.90%) I think.

How much would it cost to include everybody ?

That's what you need to explore.

The insurance companies could easily underwrite some of the costs and administrate.

They already do some of that now.

reply to post by xuenchen


The democrats removed the single-payer option in an effort to garner GOP votes. The GOP still didn't go for it.

I don't know if you remember or not but the GOP eventually stopped trying to negotiate altogether (even went so far as to filibuster every vote they could), forcing the democrats to require 60 votes rather than 51.

reply to post by xuenchen


Rep Joe Cao R from Louisiana voted in favor so I found that single vote lol. But I do see your point. Republicans didn't outright support it, because they knew it would pass and nobody wanted their name on it. Just like they say now. That they have the Republican votes to close the debt ceiling deal, but nobody wants their name on it lol. I'll correct my statement to say the rhetoric leading up to the vote in 2009 died down once Single Payer was removed.

Greetings,

"Single-Payer"?
This is a joke, right?
That's like saying (with a smile):

"I'm only going to shoot myself in the head once and not three times like I was supposed to..."

-Wake Up-

Eryiedes
Greetings,

"Single-Payer"?
This is a joke, right?
That's like saying (with a smile):

"I'm only going to shoot myself in the head once and not three times like I was supposed to..."

-Wake Up-

Well progress is progress anytime you get to cut out those extra steps it's a good thing. Even if it's shooting yourself in the head :-)

MrStyx
reply to post by xuenchen

 

Rep Joe Cao R from Louisiana voted in favor so I found that single vote lol. But I do see your point. Republicans didn't outright support it, because they knew it would pass and nobody wanted their name on it. Just like they say now. That they have the Republican votes to close the debt ceiling deal, but nobody wants their name on it lol. I'll correct my statement to say the rhetoric leading up to the vote in 2009 died down once Single Payer was removed.

The final votes that passed show Mr. Cao voted NO.

House PPACA votes

Senate PPACA votes

This was Obama's Socialist plan all along. He knew everyone would freak out when Obamacare was implemented.
Now that the general population has seen how bad it is, everyone will scream until they get socialized medicine.

It's like leading lambs to the slaugther.

How about this scenario? Doctors and hospitals charge norma prices for medical care?

reply to post by xuenchen


I pulled it from Here

Seems a mistake was made

MrStyx
Well progress is progress anytime you get to cut out those extra steps it's a good thing. Even if it's shooting yourself in the head :-)

False dichotomy.
Dead is still dead be it one shot to the skull or a double tap.
Better to go back to the old healthcare system rather than refinance your own slavery.
Anything less is a step in the wrong direction.
But this is just one man's opinion.

-Amitaba-

reply to post by Eryiedes

No way the old system was better. It was a sinking ship. In this case, joining the rest of the world was a better option. With costs rising and people having to pay for the uninsured every time they have to hit an emergency room or call and Ambulance. Jobs dropping insurance all together or reducing coverage. Having everyone get it will lower costs, and spread it around, as it should be. Do i like how its been implemented? No. Do I even like it in its current state? No, but its here so lets fix it step by step. Your fooling yourself if you think doing nothing would have been better.

reply to post by MrStyx


So screwing over everyone harder and longer is better?
We agree to disagree.
I come from a country with socialized healthcare and it's an absolute nightmare.
You will soon discover just how much of a nightmare it can be.
Just remember once you are in a bind and discover you can't get the care you need despite paying more for it...that this is exactly what you asked for. I only hope you don't lose those close to you in the process as I did.

-Amitaba-

reply to post by xuenchen

Makes people wonder just *who* is really on the side of Corporatism ?

Both parties, FDR, Clinton, Tony Blair, the bankers and corporate CEOs are all in favor of the Fabian Socialist "Third Way"

It completely mystifies me that those that call themselves 'Socialists' are completely unaware that most bankers and corporate CEOs are very much in favor of 'Socialism' too... As long as they control it of course.

reply to post by PlatinumShatinum

Now that the general population has seen how bad it is, everyone will scream until they get socialized medicine.

I think that they are giving the US public too much credit or not enough. Most low information voters will think Obamacare IS SOCIALIZED MEDICINE (heck that is what I thought it was) and after tangling with the red tape will run screaming. They LIKE the present system. Walking in, answer a few question, get treated, don't pay.

Everyone forgets that hospitals HAVE to treat you if you show-up PERIOD. That is based on actual evidence. My husband is alive not dead despite us both being out of work when he became very ill and almost died.

People know this since like us they or a friend or family member has had to at some time use a hospital without insurance or the ability to pay. Why do you think US health care is twice the cost it is else where?

Obamacare is for the insurance companies. It is supposed to give them a captive market.