How to Cling to a Corpse

The White House convened its Forum on Health Care Reform last week. Advocates for a single payer health care program were conspicuously absent because they were conspicuously not invited. This despite a bill before Congress with over 90 cosponsors that would create just such a system—the bill is HR 676, the so-called Medicare for All Act authored by John Conyers and Dennis Kucinich. Neither author nor any of the co-sponsors was invited to the forum—even when they asked. Nor were representatives from organizations such as Physicians for a National Health Program that advocate single payer.

Instead, we were told that single payer is off the table by President Obama and congressional leaders, in particular Senator Max Baucus, chair of the Senate Finance Committee and the apparent gatekeeper on this issue.

I believe it’s time that we citizens not only put single payer back on the table but got up on the table with it and stay there until people like Senator Max Baucus stop clinging to the corpse that is our current medical insurance system.

No doubt timed to coincide with the White House Forum on Health Care Reform, the Business Roundtable released what should have been a very disturbing report. As I’m sure you’re all aware, the US spends more money on medical care per person than any industrialized country. The Business Roundtable went a step further and systematically compared the US to the G-5 nations (Canada, France, Japan, Germany, and the United Kingdom) and to the top three industrializing nations: Brazil, India, and China.

The study compared medical costs, the health status of the working age population, and the relationship between the two in a systematic way—in essence, identifying the bang for the buck. It’s not surprising that the US was worse than the G-5 countries. But the US is worse than the industrializing nations as well: health that is worse for each dollar spent.

The Business Roundtable has a particular worry in this regard, and it’s not humanitarian. It’s worried about the excessive cost and poor outcomes of our medical care system because of its effect on US competitiveness in the global market. It would be one thing to have expensive medical care that keeps American workers highly productive. It’s quite another to have expensive medical care that results in lowered productivity compared to global competitors because of on-the-job injuries, medical mistakes, shortened life spans, and other medical failures.

For a real economic solution, one only needs to turn to the analysis of the HR676 single payer plan by the Institute for Health and Socioeconomic Policy. The Institute is the research arm of the California Nurses Association and the National Nurses Organizing Committee. Their report is subtitled “An Economic Stimulus Plan for the Nation” because, while total medical care costs would increase, that cost would be almost totally covered by increased taxes from the growth in business activity and the over 2 million jobs that would be created by a single payer system. These are net jobs, by the way; jobs after you account from the jobs that would be lost when the medical insurance industry disappears.

One of the conservative assumptions made in this study is that utilization of medical services would remain about the same after a single payer system goes into effect. What the Business Roundtable study suggests is that average utilization is likely to go down for a wide variety of reasons. Obvious examples come to mind: people without insurance won’t wait until they’re on death’s door before getting medical care. Less obvious examples include the reduction in stress-related illness that results from increased medical and with it financial security.

Instead of this, we’re treated to the promotion of the so-called Massachusetts plan which essentially punishes people who can’t afford insurance, delivers care that is worse than before its implementation, and has costs still escalating so seriously that the governor of Massachusetts is threatening to cut payments to hospitals and providers. However, the Massachusetts plan has the virtue of keeping insurance companies fat.

Why are Max Baucus and Barack Obama clinging to this corpse?

In Senator Baucus’s case, David Himmelstein of the Physicians for a National Health Program suggests an obvious the answer: the huge campaign contributions made by the insurance industry. But there also seems to be more to it than that. Based on his experience promoting the single payer study by the Institute for Health and Socioeconomic Policy through the halls of Congress, Michael Lighty witnessed an almost irrational fear of single payer. In other words, ideology is at work—even among business groups that would benefit.

Barack Obama is another matter. Not long ago, as an Illinois State Senator, he publicly endorsed single payer. Now he’s on the table, clinging to a corpse. Whether he’s been corrupted, gone mad, making a stupid political calculation, or strategically provoking us to force him to do what’s right, what we need to do plain is to see.

Put single payer on the table, get up there with it, and don’t get off until we get what we need. In addition to the website for HR 676, a focal point for this campaign is the website where you’ll be able to sign a petition demanding single payer now and find information about the single payer movement. We have the link on our website as well as a link to the site for Physicians for a National Health Program. And somebody, please call the morgue to get the corpse of our current medical insurance system off the table. It’s stinking up the place.