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Single-Payer: The Right Solution

It’s Time for Real Health Care Reform in the United States

Dr. Sidney Wolfe, acting Public Citizen president and
director of the Health Research Group at Public Citizen

It has been said that the definition of insanity is doing the same thing over and over again and expecting different results.

In this case, the insanity of doing the same thing repeatedly and expecting different results is the 20-year history of state health insurance reform legislation in the United States.

Since the late 1980s, seven states have tried to “fix” health care by offering new public subsidies or expanded Medicaid for poor and near-poor people. All left the majority of private health insurance arrangements undisturbed. All failed to have a lasting effect on the problems of uninsured people in those states.

In 2006, Massachusetts embarked on its second health care experiment with a goal of providing universal coverage to all. Now, everyone in the state is required to have health insurance. But the experiment has bombed: Not only is the new system far more expensive than anticipated, but not everyone is covered, and $150 million has been siphoned from safety-net providers such as public hospitals and community clinics. Many low-income residents now face burdensome new costs that prevent them from getting care. (See our story.)

Massachusetts shows us precisely how not to address health care reform.

The only viable solution, when you examine all the numbers, is to eliminate the insurance industry altogether and create a system paid for by the government with money that goes further because of the hundreds of billions of dollars of annual administrative waste eliminated by not having insurance middlemen. This proposed system is known as “single-payer.”

You would think that the experts gathering in Washington, D.C., to figure out how to reform health care nationally would want to hear about it.

You’d be wrong.

Public Citizen and Physicians for a National Health Program issued a report detailing why the Massachusetts system should not be used as a model for the country, but few here in the capital took note. The White House continued planning its health care summit without inviting any single-payer advocates. The media sniffed around but declined to write much about the report’s findings.

Why? Probably because several powerful members of Congress have declared that a single-payer solution is “off the table.” Journalists don’t want to waste time reporting about something that isn’t a serious consideration.

You’d think that having President Barack Obama in the White House at a time when polls clearly show Americans are ready for dramatic changes in the health care system would help progressives like us push the single-payer option.

Again, you’d be wrong. It has been harder this year to get congressional lawmakers to sign on to a single-payer bill. (We have 64 co-sponsors compared to 93 in the last Congress.) Why? Because Obama reportedly isn’t seriously entertaining a single-payer system, and Democrats don’t want to be seen as opposing Obama.

I suspect this has something to do with the power of the health insurance lobby, which, according to a recent Washington Post story, contributed $2.2 million to 10 key lawmakers since 2005.

The thing is, the public is as ready as ever to embrace a single-payer system. In a January CBS News/New York Times poll, 59 percent said the government should provide national health insurance. In a poll taken in the fall, 50 percent said the health care system needs fundamental changes. Those are telling numbers.

Hope exists, however. After single-payer advocates planned a protest in front of the White House to publicize our exclusion from the summit, a few representatives were permitted in. Still, it will be an uphill battle to get crafters of the new system to do any more than pay lip service to the single-payer voice.

That’s where you come in. After the economy, health care reform is perhaps the most critical issue on this country’s plate. We don’t have to tell you the horror stories about the health care system; I’m sure you have plenty of your own.

Public pressure made the White House include the single-payer voice in the summit, and public pressure will help the single-payer voice become louder and be taken more seriously.

Want to help? Call or write your representatives in Congress and tell them you want the single-payer solution considered. Sign up for our action alerts and learn more about the single-payer option here.

This is not the time to impose on everyone in the country the kind of health insurance program that has failed multiple times. It is time to wake up from this insanity and enact single-payer health insurance for all.