Health Care?
~By Marge duMond

Our health care system is broken. Our president says so[1], and many Americans agree. The World Health Organization ranks the U.S. health-care system 37th in the world, just above Slovenia, Cuba, and Brunei, for fairness and quality.[1] “All the other rich countries do better than we do, and yet they spend a heck of a lot less," notes Washington Post reporter T.R. Reid.[2]

For many Americans, living without health insurance means going without needed health care[3] and, in 2007, “nearly 46 million Americans … were without health insurance.” Rising costs and rising unemployment are driving that number even higher[4]. Yet health insurance is no guarantee of good health care; Michael Moore’s 2007 film, Sicko, shows the financial and physical woes of many Americans who have had insurance and been ill-served and abused by insurers.

Health-insurance companies routinely deny care to patients, cancel coverage, and delay or diminish payments to providers, while their profits and returns to shareholders multiply[5]. In the United States, we spend one-sixth of our GNP on health care, twice the proportion other countries spend. “Health insurance premiums have doubled since 2001, [and] industry profits have soared 428% in that same time.”[6] And how do they spend their money? Discrediting alternative health-care systems,[7] identifying costly patients to dump from their rolls,[8] and buying the protection of key legislators in Congress.[9] In addition, at least 30 cents of every health-care dollar goes to administrative overhead.

SINGLE-PAYER IS THE ANSWER

In Sicko, Moore visits France, England, Canada, and even Cuba, to see how the national health plans in those countries function, and he argues that we must remove the profit motive from the U.S. medical system. Moore is not alone. According to Fairness and Accuracy in Reporting (FAIR): “Many experts see single-payer national health insurance as the most sensible solution to expand coverage to the uninsured and to reduce costs.” In a January survey (New York Times/CBS, 1/11-15/09), the public “preferred it two-to-one over a privatized system.” “It is also preferred by 59 percent of physicians, according to … the Annals of Internal Medicine (4/1/08).” The Conference of Mayors in 2008 “unanimously endorsed HR 676 [The United States National Health Care Act], as a financial no-brainer.”[10]

The term "single-payer" generally refers to a system in which health care is financed not through private, for-profit insurance companies, but through one large, government-run nonprofit insurance organization. (Medicare works this way.) “That organization pays all the doctor, drug and hospital bills—it is the ‘single-payer’ of all medical bills. In most single-payer plans, every American would be enrolled and would pay into the fund through taxes.”[11]

Rep. John Conyers, D-Mich., a longtime champion of single-payer, is the sponsor of H.R. 676, “The United States National Health Care Act,” or “Expanded & Improved Medicare for All,” which has nearly 100 co-sponsors. The bill’s summary says: The United States National Health Care Act … would create a publicly financed, privately delivered health care system that improves and expands the already existing Medicare program to all U.S. residents, and all residents living in U.S. territories. The goal of the legislation is to ensure that all Americans will have access, guaranteed by law, to the highest quality and most cost effective health care services regardless of their employment, income or health care status. In short, health care becomes a human right.[12]

In the Senate, the independent Sen. Bernie Sanders of the great green state of Vermont has introduced S.703, the American Health Security Act of 2009. As of July 19, it had no co-sponsors. The bills differ, but each eliminates the private-insurance companies and provides for universal health care, privately delivered and publicly funded.

In the words of one expert, the health-insurance industry, “...adds cost to the system, but contributes no value at all—it’s a parasite … on the health-care system.”[13] So why haven’t we already scrapped our failing system and created the same kind of national health plan that serves the citizens of every other industrialized country, at lower cost and with better health outcomes? You guessed it—money. The health-insurance industry donates heavily to key legislators, lobbies hard (spending more than $1.4 million a day[14]), and runs advertising campaigns—remember “Harry and Louise”?—to keep Americans fearful of “government-run health care” and “socialized medicine.”[15]

But now single-payer is making real progress. Five committees (three in the House, two in the Senate) have been holding hearings and writing legislation this year, and single-payer advocates have testified before four of them. A House committee has passed an amendment enabling states to set up their own single-payer systems. According to activist Margaret Flowers, M.D., “We are making it into more and new media markets. We are seeing new energy across the nation.”[16] What an exciting time this is, when real change is possible.

TAKE ACTION

WHAT CAN YOU DO? EDUCATE YOURSELF AND OTHERS

Read Uninsured in America, by Susan Starr Sered and Rushika Fernandopulle (UC Press, 2005); it documents wrenching stories of Americans stranded without health insurance, and sets them in a context of culture, class, and caste.

Read Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It, by John Geyman, M.D., Common Courage Press, 2008. The title says it all.

Sick Around the World, a PBS Frontline episode, shows how five other industrialized countries provide health care. You can watch the program here: www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

Ed Schultz, a liberal Air America and MSNBC commentator, is a strong advocate for single-payer; get talking points here, on The Ed Show, www.youtube.com/watch?v=Jbu7mgnpEO8, and send the clip to your friends.

Bill Moyers Journal, on May 22, 2009, explored single-payer with Dr. David Himmelstein, a founder of Physicians for a National Health Program and Harvard professor of medicine; and Dr. Sidney Wolfe, acting president of Public Citizen. Watch it here: www.pbs.org/moyers/journal/05222009/profile2.html.

A 20-minute video, HR 676—The Single-Payer Solution features eloquent advocacy by legislators, doctors, nurses, and other experts standing up for single-payer at a health-care forum hosted by Rep. John Conyers, author of HR 676. See it here: www.youtube.com/watch?v=ZAuwaKl3-nU&feature=related. Send it to others.

This summer, the Movie Channel and TMC Xtra are re-airing the Oscar-nominated documentary, Sicko, Michael Moore's film about the U.S. health insurance industry and the single-payer systems that work in other countries. Check the schedule here www.sho.com/site/schedules/product.do?episodeid=131802&seriesid=0&seasonid=0], or rent the film from Netflix, and invite your friends and neighbors over for a Sicko viewing party.

GET ACTIVE; VOLUNTEER; DONATE.

If you support single-payer, tell your senators and representative you want them to support it. Find out here thomas.loc.gov/cgi-bin/bdquery/z?d111:HR00676:@@@P whether your representative is a co-sponsor of H.R. 676; if yes, thank him or her; if no, urge action. Go here www.govtrack.us/congress/bill.xpd?bill=s111-703 to see whether your senators are co-sponsoring Sen. Bernie Sanders’s S. 703; then get contact information here www.senate.gov/general/contact_information/senators_cfm.cfm, so you can urge them to sign on.

Go to Health Justice www.1payer.net/, a nonprofit organization working for single-payer. From this site you can send free faxes to your representative and senators, urging them to sign on to single-payer legislation, or to send H.R. 676 to the Congressional Budget Office for scoring, so we will have an official evaluation of how much it would cost and how it would be paid for.

Go to Physicians for a National Health Program, www.pnhp.org/news/action_alerts.php, for single-payer history, news, and action alerts.

Another nonprofit is working to raise money for a national advertising campaign to tell the American public the truth about single-payer: hr676.org/.

To see what else you can do right now, go to www.healthcare-now.org/ for the
latest updates and actions.

This issue is critical to the health and well-being of millions of American men, women and children. Educate yourself on the specifics of current legislation and then take action. 

Footnotes:
1.  “Surcharge Is Set in a Health Plan,” NYTimes, 7/15/09
2.  www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/
3.  Uninsured in America, by Susan Starr Sered and Rushika Fernandopulle, UC Press, 2005, pp. xv-xxii, 29-39.
4.  National Coalition on Healthcare, www.nchc.org/facts/coverage.shtml
5.  Do Not Resuscitate: Why the Health Insurance Industry Is Dying, and How We Must Replace It, John Geyman, M.D., Common Courage Press, 2008, pp. 40-46, 135, 160.
6.  E-mail from Sen. Charles Schumer, 7/21/09
7.  Bill Moyers interviews Wendell Potter, former health-insurance executive: http://www.pbs.org/moyers/journal/07102009/watch2.html
8.  http://www.prwatch.org/node/8441
9.  http://act.credoaction.com/campaign/gang_of_6/?r_by=5220-1889107-_7KPOTx&rc=confemail
10.  Maryland Single Payer, 7/21/09;
usmayors.org/resolutions/76th_conference/chhs_03.asp
11.  Bill Moyers Journal, May 22, 2009: www.pbs.org/moyers/journal/05222009/profile2.html
12.conyers.house.gov/index.cfm?FuseAction=Issues.Home&Issue_id=063b74a4-19b9-b4b1-126b-f67f60e05f8c
13.  Leonard Rodberg, Ph.D., Physicians for a National Health Plan, in HR 676—The Single-Payer Solution, video by Talking Eye Media.
14.  “Health Industry Lobbying Tops $1.4 Million Daily,” by Eliza Krigman, NationalJournal.com, June 24, 2009.
15.  Do Not Resuscitate, pp. 163-165.
16.  Margaret Flowers, M.D., Maryland Single Payer.org e-mail, 7/21/09.