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U.S. Health Care System, Dominated by the Insurance Industry, Must Be Replaced With ‘Medicare-for-All’

Sept. 29, 2009

U.S. Health Care System, Dominated by the Insurance Industry, Must Be Replaced With ‘Medicare-for-All’

Statement of Robert Weissman, President, Public Citizen

It is appropriate that filmmaker Michael Moore returns us to first principles, because the big picture of health care reform has been so badly obscured during the political theater of the past many months. Those first principles are: Health care is a right, and the private health insurance industry must be replaced. It is too cruel, too inhumane, too arbitrary, too bureaucratic and too inefficient.

With our private health insurance industry-dominated system, the United States spends far more than other wealthy nations on health care (at least 50 percent more than every country except Luxembourg) but sports middling health indicators. Our private health insurance industry-dominated system permits 45 million people to live without health insurance, denying them access to preventative and routine care, resulting in the death of at least 35,000 people a year. Our private health insurance industry-dominated system tolerates private health insurance companies making life-and-death rationing decisions for millions of people with only minimal accountability. Our private health insurance industry-dominated system lets private health insurers refuse to take sick people as customers and engage in endless manipulations to discard its customers if they do become sick. Our private health insurance industry-dominated system features a system in which medical bills and illness contribute to almost two of every three personal bankruptcies – even though three-quarters of these bankrupt people had insurance when they became sick.

Not least, our private health insurance industry-dominated health care system translates into a private health insurance industry-dominated political system. As a result, too many politicians refuse to consider real solutions.

There is a cure all for these ills. It is a Medicare-for-All, single-payer system, in which the government pays medical bills (thus operating as the “single payer”).

In a Medicare-for-All system, health care is available as a matter of right. No one is denied treatment because they can’t pay. No one is mandated to buy coverage. No one is denied coverage because of pre-existing conditions. No one goes bankrupt paying medical bills.

In a Medicare-for-All system, we save $400 billion in costs – enough to cover all of the uninsured. No scandalous CEO pay packages. No money siphoned out of the system by rent-seeking middlemen. No needless paperwork and bureaucracy.

In a Medicare-for-All system, we succeed by doing away with the private health insurance industry.

Unfortunately, instead of advocating this approach – which President Obama supported as a state senator, and which he still says would be superior if the system was being designed from scratch – the Obama administration has sought to reach an accommodation with the insurance industry, as well as hospitals and Big Pharma.

This had led to a policy debate that has spiraled downward into ever more trivial reform proposals while diverting attention from the underlying problem: the rip-off insurers, price-gouging Big Pharma and increasingly profit-hungry hospitals.

Fortunately, the grassroots movement for Medicare-for-All – animated by the idea of everybody in, nobody out – has refused to accept official Washington’s determination about “political feasibility.” Thanks to patients, nurses, doctors and everyday people talking to their neighbors, calling and e-mailing their members of Congress, writing letters to the editor, rallying, researching, testifying, conducting civil disobedience and more, Medicare-for-All is gaining momentum.

Rep. Dennis Kucinich (D-Ohio) has successfully introduced an amendment in one of the House health care bills that would facilitate states’ adopting their own single-payer system.

And Rep. Anthony Weiner (D-N.Y.) has obtained assurances that he will be able to introduce H.R. 676, the stand-alone Medicare-for-All proposal in the House of Representatives, as an amendment in full House consideration of health care legislation. This will represent the first time either the full House or Senate has voted on a Medicare-for-All proposal.

We are hopeful as well that Sen. Bernie Sanders (I-Vt.) will be able to secure votes on both a states’ rights amendment and on a Medicare-for-All proposal.

Medicare-for-All is the only solution to the twin problems of escalating health care costs and the epidemic of the uninsured.

Medicare-for-All is supported by a majority of nurses, a majority of doctors and a majority of the public. It is only a matter of time before it is supported by a majority of members of Congress.