Eugene Weekly : Coverstory : 7.16.2009

Don’t Let Electile Dysfunction Leave Health Reform Limp. Ask your congress about
Single Payer
by Alan Pittman

Diane Sciacca beat cancer, but she couldn’t beat Blue Cross Blue Shield. 

“They jacked my premium up to more than I could afford. I had to drop them,” she said. Sciacca joined about 40 other protesters July 9 on the U.S. Courthouse steps calling for single payer health care reform. “It’s really scandalous,” she said of the current U.S. health care system.

Dianne Sciacca is uninsured.

The U.S. spends more than any other nation on health care but gets far less for its money. The cost of the nation’s health care system has ballooned 10-fold since the 1960s into a $2.3-trillion behemoth that swallows a fifth of the nation’s economy, according to numbers compiled by the Washington Post. If the growth rate continues, it could ingest about half the economy in another decade. But the hugely expensive system still leaves 47 million people uninsured, 100,000 dead per year from hospital infections and 1.5 million harmed per year by medical errors, the Post reports.

Other nations with single payer health care insurance systems run by the government spend about half as much per person with no one uninsured and far better results. Of 37 industrialized nations, the U.S. ranks 29th in infant mortality and has some of the world’s worst rates of preventable deaths, obesity and heart disease, according to the Post

“We should have a single payer health care system,” said Karl Eysenbach at the Eugene courthouse rally. “The only country that has this cockamamie system is the U.S.” 

With health care a worsening national disgrace, even some of the insurance lords who strangled previous reform efforts in the crib are talking about the need for universal coverage.

To get there, President Barack Obama and leading Democrats in Congress are struggling to push a complex reform package involving requiring everyone to buy insurance, requiring insurers to refuse no one, government subsidies for insurance buyers and an expansion of Medicare for the poor and some cost controls and regulations.

Progressives argue that instead of the Democrat’s mish mash or the current system, a European-style single payer system where the government directly insures everyone would be far superior. 

Single payer supporters argue that this is why:

Cheaper. As previously noted, single payer countries spend far less on their health care. In the U.S., the popular Medicare program, a government single-payer program for the elderly, has successfully controlled health care costs for decades. Government health insurance won’t bear the burden of the billions of dollars private insurers waste on big executive salaries, profits and advertising. 

“We’re paying for all those Viagra ads and other stuff,” said Nancy Forrest, who’s organizing single payer support for the Eugene Springfield Solidarity Network (ESSN).

Because health care costs represent such a huge drag on the economy (medical bills contribute to half of all bankruptcies), big reductions could provide the nation a much needed economic boost. A California Nurses Association study estimates a $317-billion boost to the economy and 2.6 million new jobs from single payer reform. 

Obama says he’s gathered pledges from insurance companies and others in the health care industry to reduce their high costs. But skeptics are unsure if real savings will materialize. It’s not like the big health care companies are reducing their executive salaries, payrolls or profit projections. 

Compared to the current system and other reform proposals, Nobel Prize winning economist Paul Krugman told a New Jersey gathering last month, “all the evidence is single payer is cheaper.”

Better. Studies have repeatedly shown that countries with single payer systems have healthier people. Governments direct health care spending into care that provides the greatest benefit to the greatest number of people rather than refusing, delaying and rationing claim payments and coverage to provide the greatest profits.

Japan spends about two thirds less per person than the U.S. on universal government health care while enjoying a preventable death rate a third lower, according to the Post.

Eugene courthouse protester Kyle Yamada said he’s lived with health care in the U.S. and Canada and far prefers the Canadian system. The Canadian system cost only a small fraction of what insurers charged in the U.S., and “it’s top notch,” he said. “We never had to wait.”

Less Bureaucracy. The current private insurance system has a huge bureaucracy that consumes an estimated one out of every three health care dollars on paperwork. Eliminating this cost alone would generate enough savings to provide coverage to all of the uninsured.

Eysenbach said he used to work in the health industry sifting “mounds” of paperwork. “The message was clear,” he said. “The single most equitable way, the cheapest way, was through the single payer option.”

Simplicity. Efforts to appease the health care industry and other special interests have added baffling complexity to the Obama proposal, leaving most voters confused and ignorant about what they are buying. But single payer would be easier and straightforward — expanding Medicare for everyone. 

Doable. Obama is struggling to get his plan through Congress. The original timetable of getting it done this summer may be slipping. Pundits are speculating that insurance industry opposition may force Obama to drop a key component — a public option of government insurance designed to assure competition. 

Insurers, drug companies and their Republican allies have attacked the public option as socialized medicine. Industry opponents would make the same argument about single payer. But while the confusing Obama plan hasn’t generated much grass roots excitement, single payer has the energetic support of the activist Democratic base to push it through. 

Progressives have a long list of arguments for single payer, but most haven’t been heard. Single payer supporters don’t enjoy the seats at D.C. hearings and negotiating tables the insurance and health care industry lobbyists bought. The industry spent $167 million on campaign contributions last year, according to the Center for Responsive Politics (CRP). 

Just over half the campaign contributions went to Democrats. Obama brought in $19 million. Oregon Sen. Ron Wyden, criticized for pushing a plan that doesn’t include a public option, was among the top 10 percent of health care industry beneficiaries in Congress with $1.4 million in contributions. 

The health care industry is also spending $1.4 million a day, almost a half billion dollars a year, to lobby Congress using a battalion of former Congressional staffers and Congressmen, according to CRP. The lobbying effort runs so deep that the Washington Post was recently scandalized by a scheme to allow lobbyists to pay for access to its journalists.

“They [insurers] take our money and then use it to lobby against us,” said Ruth Miller at the Eugene rally. Miller said she was denied insurance due to diabetes and forced into an inadequate high risk plan that consumes most of her income. 

“If you have anything wrong, they’re going to deny you,” said Janet Barker, who’s also struggled to find affordable insurance. “I’m so mad.”

Although many leading Democrats admit to the advantages of a single payer system, they continue to marginalize it. At a town hall meeting on health care reform last month, Obama responded to a call for single payer from a small businesswoman. The President said, “There are some appealing things to a single-payer plan, and there are some countries where that’s worked very well.” But he joked, “There have been proposals to have, essentially, Medicare for all, a single-payer plan for all Americans, and — that person likes it.”

Actually, polls show as many as two-thirds of Americans like a single payer system over the current system. 

“There’s more people willing to step up now; the problem is Congress,” said Forrest who’s helping to organize a single payer rally and fundraiser for Friday, July 17 (see sidebar). “We want them to start talking about single payer and stop talking like there’s no votes.”

Many at the Eugene courthouse protest said if they can’t get single payer, Obama’s public option could be a step in the right direction to an eventual single payer system and a strategic compromise. “Shoot for single payer, and they’ll compromise down from there,” said Ken Rivernider. 

But five decades of failed attempts at health reform may show money still counts more than votes in American politics.  

Local grassroots activist Ruth Duemler, who’s campaigned on the issue for decades, said a failed Oregon single payer initiative was drowned in opposition spending in 2002. “There’s too much money against it,” she said. Duemler said she’s focusing now on a campaign finance reform amendment to the state constitution. “Campaign finance reform is what we need now. We’d be heard instead of just money.”         



Rally & Sing

Local single payer activists have planned a rally and fundraiser concert for Friday, July 17.

The “Single Payer Now” rally in support of House (HR 676) and Senate (S 703) bills now before Congress is planed for noon Friday at the U.S. Federal Courthouse, 405 E. 8th Avenue. The rally is sponsored by the Eugene Springfield Solidarity Network (ESSN), the local branch of the Industrial Workers of the World (IWW) and the local AFSCME union. 

That same night, the “Sing Out for Single Payer, Health Care Roadshow” is coming to Eugene. The “donations welcome” event features labor singer Anne Feeney as well as Adam & Chris, Raina Rose, Jason Luckett, Trevor Smith and Patrick Dodd. 

The Sing Out begins at 8:30 pm, Friday July 17 at the Very Little Theater, 2350 Hilyard Street. Sing Out sponsors include ESSN/Jobs with Justice, Health Care for All Oregon, Universal Health Care for Oregon and AFSCME. Email or call 736-9041 for information.