Only Single-Payer Can Save Us
Posted in General Topics, Health Care June 20th, 2009 by admin

Here’s some statistics for you to chew on:

  • Currently, health care costs account for approximately 20 percent of our GDP. It is estimated that by 2025 that number will increase to 25 percent. By 2040, it will be 34 percent.
  • By 2040, the number of uninsured will jump from 42 million today to 76 million.
  • From 1996 to 2006, the cost of health care in this country has doubled.
  • Today there are more than 1,300 insurance companies operating in the US.
  • A recent study found that insured families are paying a “hidden tax of more than $1,000″ a year to help cover the cost of treating the uninsured.

These are stark figures and they only begin to paint a picture of just how much trouble we’re in with our current health care system.

Among the industrialized world, patients in the US pay more for their health care than any other. Among the industrialized world, the US is home to more uninsured than any other. And, according to studies conducted by the Organization for Economic Cooperation and Development and the Commonwealth Fund, not only do we pay more for health care than any other first world country, but that high cost doesn’t necessarily translate to better care.

For instance, patients who receive a kidney transplant in the US have a much lower five-year survival rate than England, Canada, Australia, or New Zealand. In fact, with the exception of breast cancer survivors, the US ranks from the middle to the back of the pack for five-year survival rates for a number of serious illnesses. Let me say it again; we are paying far more for health care than people in those countries mentioned above, nearly twice as much, in fact.

There are no uninsured people in those countries, either. According to the Urban Institute, an estimated 22,000 people died in 2006 because the didn’t have any insurance.

Cost and lack of insurance aren’t the only problems with our current health care system. It all might not seem so bad if salaries had increased at the same rate as health care costs, but we all know that’s not the case; health care costs have severely outpaced salary rates in the last ten to 20 years. What’s more, a New York Times article states,

Research by Katherine Baiker and Amitabh Chandra of Harvard have found that, on average, a 10 percent increase in health premiums leads to a 2.3 percent decline in inflation-adjusted pay. Victor Fuchs, a Stanford economist, and Ezekiel Emanuel, an oncologist now in the Obama administration, published an article in the Journal of the American Medical Association last year that nicely captured the tradeoff. When health costs have grown faster of the last two decades, they wrote, wages have grown slowest, and vice versa.

Simply put, while a family’s pie is getting smaller, the health cost portion of their pie has grown quite large.

As the Obama administration and Congress battle against each other to find a solution, as legislation is being drafted, one option has been largely and conspicuously absent: a single-payer system.

It seems there are two general solutions emerging from the debate on health care reform. One is a public option, though the specifics vary. The other is to require every american to have health insurance, providing subsidies for those low-income people and families that can’t otherwise afford to purchase it on their own. These are both bad ideas for a number of reasons.

The worst of these options is the requirement for everyone to get insurance. Consider this excerpt from an article on

The approach taken by the Kennedy-Dodd bill and considered for the House bill is, rather than eliminating health insurance companies, expanding them by making insurance mandatory and subsidizing its purchase. While this approach is favored by the insurance companies, which have been among the primary participants in the White House and Congressional health care forums this year, it is not supported by other corporations that would rather not be required to provide health insurance to employees.

I can’t help but ask what seems to be an obvious question. How is propping up a broken system with subsidies to private insurance companies not socialism, as some claim a single-payer system to be? What’s more, it doesn’t look like it would change much of anything. Sure everyone would have insurance and access to health care, but those people and families who cannot, on their own, purchase insurance, will get assistance from taxpayers. Essentially, on some level, this is what happens now. So you and I would be required to have health insurance for ourselves and our families while also paying into a public subsidy for low-income families. In principle, I have no problem with this. It is a society’s responsibility to take care of the less fortunate among us.

As I mentioned at the beginning, families are already spending roughly $1,000 a year to provide health care to those without insurance. There are two differences, that I can see, between what’re doing now and the proposed mandated insurance option. The first is just that. Taxpayers and insureds are already subsidizing the uninsured in emergency rooms and high cost illnesses, the difference here is that the government will be “officially” subsidizing those who can’t currently afford insurance, thus funneling money to private insurance companies, who will continue to make huge profits; of course, the insurance companies love this idea.

The other option being floated by some in Congress, as well as by the President, is a public option which, as I understand it, is essentially government-provided health insurance. To be clear, this is not single-payer. An article found at puts it quite succinctly.

The “public option” preserves all of the systemic defects inherent in reliance on a patchwork of private insurance companies to finance health care, a system which has been a miserable failure in both providing health coverage and controlling costs.

While a poll conducted by the Kaiser Family Foundation “found that 67% of the public supports the creation of a ‘government-administered public health insurance option similar to Medicare to compete with private health care plans,’” the question is misleading. It presumes that such a solution will actually work.

In the last 20 years, similar private/public combined mandates have been tried around the nation and have, time and again, failed to repair the broken health care system.

Plans that combined mandates to purchase coverage with Medicaid expansion fell apart in Massachusetts (1988), Oregon (1992), and Washington state (1993); the latest iteration (Massachusetts, 2006) is already stumbling, with uninsurance again rising and costs soaring. Tennessee’s experiment with a massive Medicaid expansion and public plan option worked – for one year, until rising costs sank it.

If we are to learn from mistakes of the past, then it seems clear that a public option, like the one President Obama floated, it is doomed to fail.

Additionally, a public option that competes with private health care providers will not lead to a single-payer option, as some believe. Instead, it will lead to a segregation of patients, with the healthy ones staying unrolled in private plans and the sick being funneled to the public plan. Returning once again to the article,

A quarter-century of experience with public/private competition in the Medicare program demonstrates that the private plans will not allow a level playing field… [P]rivate insurers have successfully cherry-picked healthier seniors, and have exploited regional health spending differences to their advantage. They have progressively undermined the public plan – which started as a single-payer system for seniors and has now become a funding mechanism for HMOs – and a place to dump the unprofitably ill.


The “public option” is truly the embodiment of health care policy designed by sound bytes, cobbled together from snippets of information gathered from focus groups and public opinion polls, and centered around well-organized buzzwords such as “choice” and “shared responsibility.”

There is now doubt the system, under the status quo, the establishment are working to sweep the idea of a single-payer system under the rug.

I’ve already begun to lay out the arguments in favor of a single-payer solution to our abysmal health care system, but let me now delve a bit deeper.

Recently, the Congressional Budget Office published a report that concluded the Kennedy-Dodd bill would cost us at least $1 trillion over the next ten years, while still leaving 36 million people without health care by the year 2017. As a reminder, this is the mandated insurance solution.

I’m sorry, let me say that one more time. One of he options floated by Democrats will cost $1 trillion and not even cover everyone. I can’t help but ask; is this really the solution Americans are expected to swallow?

Americans are currently spending more than that. Actually, the figure is in excess of $2 trillion annually and this figure comprises roughly one-fifth of the american economy.

Obama’s plan isn’t any better. His public option is also expected to top $1 trillion. The President has already set aside $650 billion in his budget for a “down payment” toward the overall cost, while finding another $200 billion by cutting expected reimbursements to hospitals. To help pay for a health care solution, part of the President’s plan is to pay hospitals less? Obama has said the rest of the funds will come from “common-sense changes.”

It seems to me, the only common-sense solution to our health care problems is a single-payer solution. Wrapped up in the more than $2 trillion we spend on health care each year is roughly $400 billion of waste, fraud, abuse, and bureaucracy of the health insurance industry. Put another way, nearly 20 percent of health care premiums go to marketing, executive salaries, and administrative costs. Compare this figure to the three percent for administrative costs in Medicare.

This means that the funds necessary to not only improve the quality of care, but to also insure everyone, are already being poured into a system that is universally understood to be broken. A single-payer system can use the same amount of money, or less, to do a much better job.

With a single-payer system, the pool of insureds is much, much larger: 300 million americans. A government provided insurance plan, would, again, save on administrative costs, marketing costs, etc., but would also have greater bargaining power with the pharmaceutical companies, adding additional savings.

According to Congressman John Conyers, a “uniquely American” single-payer system would cost just 3.5 percent of a taxpayer’s income.

If the cost savings alone doesn’t convince you, how about the estimated 2.6 million jobs that would be created. According to Geri Jenkins, the co-president of the National Nurses Organizing Committee, “employment overall would increase given the increased demand for medical professionals.”

The big question seems clear to me; why is our President and Congress so adamantly opposed to a single-payer solution that they don’t even want to talk about it? While in the Illinois State Senate, Obama supported a single-payer solution to our health care woes. He said single-payer would only be possible after the Democrats took back control of the White House and both houses of Congress. Well, we’ve done it, largely with his help, so where did his support go?

At different points in the last few weeks, both House Speaker Pelosi and newly confirmed Health and Human Services Secretary Kathleen Sebelius have said the single-payer option isn’t even on the table for discussion.

“On June 3, Senator Baucus met with advocates of single payer and told them he was wrong to have excluded them. But he said he would continue to do so.”

Separately, Speaker Pelosi “said she is for single payer and encourage us to keep on doing what we were doing. She said that a single payer option cannot pas this year in the Congress. She said she was fighting for a meaningful public option.”

What I don’t understand is how can Speaker Pelosi know it cannot pass this year if she hasn’t even tried? Hell, they haven’t even talked about it, let alone made any kind of effort to get it passed. If polls consistently show the majority of americans support not only a solution to the health care crisis, but a single-payer option, why do our President and representatives in Congress insist it isn’t possible?

After all my reading, I’ve come to the conclusion that we cannot be willing to settle for any of the costly options being floated on the hill. Experience tells us they won’t work. We must insist on nothing less than a single-payer solution. Spread the word and start fighting for a better health care system.

« « « Leave a comment » » »


  1. jacksmith says


    It’s official. America and the World are now in a GLOBAL PANDEMIC. A World EPIDEMIC with potential catastrophic consequences for ALL of the American people. The first PANDEMIC in 41 years. And WE THE PEOPLE OF THE UNITED STATES will have to face this PANDEMIC with the 37th worst quality of healthcare in the developed World.


    We spend over twice as much of our GDP on healthcare as any other country in the World. And Individual American spend about ten times as much out of pocket on healthcare as any other people in the World. All because of GREED! And the PRIVATE FOR PROFIT healthcare system in America.

    And while all this is going on, some members of congress seem mostly concern about how to protect the corporate PROFITS! of our GREED DRIVEN, PRIVATE FOR PROFIT NATIONAL DISGRACE. A PRIVATE FOR PROFIT DISGRACE that is in fact, totally valueless to the public health. And a detriment to national security, public safety, and the public health.

    Progressive democrats and others should stand firm in their demand for a robust public option for all Americans, with all of the minimum requirements progressive democrats demanded. If congress can not pass a robust public option with at least 51 votes and all robust minimum requirements, congress should immediately move to scrap healthcare reform and demand that President Obama declare a state of NATIONAL HEALTHCARE EMERGENCY! Seizing and replacing all PRIVATE FOR PROFIT health insurance plans with the immediate implementation of National Healthcare for all Americans under the provisions of HR676 (A Single-payer National Healthcare Plan For All).

    Coverage can begin immediately through our current medicare system. With immediate expansion through recruitment of displaced workers from the canceled private sector insurance industry. Funding can also begin immediately by substitution of payroll deductions for private insurance plans with payroll deductions for the national healthcare plan. This is what the vast majority of the American people want. And this is what all objective experts unanimously agree would be the best, and most cost effective for the American people and our economy.

    In Mexico on average people who received medical care for A-H1N1 (Swine Flu) with in 3 days survived. People who did not receive medical care until 7 days or more died. This has been the same results in the US. But 50 million Americans don’t even have any healthcare coverage. And at least 200 million of you with insurance could not get in to see your private insurance plans doctors in 2 or 3 days, even if your life depended on it. WHICH IT DOES!

    Contact congress and your representatives NOW! AND SPREAD THE WORD!

    God Bless You

    Jacksmith – WORKING CLASS

    June 21st, 2009 | #

  2. PDHblog » Support Booming for ‘Public Option’ says

    [...] in fact, i’ve laid out a good argument picking apart the other options currently being floated, including obama’s public option, in support of single-payer. check it out. [...]

    June 22nd, 2009 | #

RSS feed for these comments. | TrackBack URI

please sign my guest book