Single Payer Spearhead

by Stephen Fleischman

Grab the bull by the horns! Not the Merrill Lynch bull, that’s already been slaughtered—but the horns of the raging bull known as the Health Insurance Industry. That’s what Barack Obama must do in his first hundred days in the Oval Office.

With the economy in free-fall, instituting a single-payer health plan would go a long way in slowing that fall and would win back the support of his base, the liberal and progressive wing of the Democratic Party that won him the election. Single Payer should be the spearhead of his promised humongous stimulus package. And it would be easy. The infrastructure is there. All he has to do is tell Congress to extend Medicare to all citizens and he would sign the bill. It would be a bold move. In a single stroke, he would create a great legacy for himself. His only problem—he would have to bite the hand that fed him. He took millions from the Health Insurance Industry to finance his campaign. They gave him the money to insure that those two verboten words “single payer” would never be mumbled. And they weren’t—during the entire campaign.

Now, it is true that back in 2003, when Barack was an Illinois state senator, he spoke to an AFL-CIO group and told them, “I happen to be a proponent of a single payer universal health care plan. I see no reason why the United States of America, the wealthiest country in the history of the world, spending 14 percent of its Gross National Product on health care, cannot provide basic health insurance to everybody.” Those were his exact words. It’s in the public record. When Obama threw his hat into the ring in 2008, and the long primary battle with Hillary Clinton for the nomination began, Obama’s sentiments seem to have morphed from single payer to “affordable” health care. That means working in alliance with the Health Insurance companies. None of the candidates have ever used the term “single payer”. They had all kept the specifics of their health plans very vague, fudging words like “universal” and “national” and for a very good reason. There was a raging bull out there listening to every word.

Hillary learned her lesson back in 1992 when she and Bill tried to finagle some kind of Rube Goldberg health insurance plan. It angered the bull and the Health Insurance Industry dropped a bomb on them in the form of a TV commercial with Harry and Louise sitting around the kitchen table talking health plans and calling Hillary and Bill’s plan “socialized medicine”. Heavens to Betsy! Horrors! Socialized Medicine! Hillary and Bill got off that tack real fast and became the Bonnie and Clyde of politics in other areas.

Are we going to go on talking the talk and getting ripped off by Big Insurance and Big Pharma forever? Why can’t we have what every other industrialized nation in the world enjoys—some form of national health insurance run by the government, yes…socialized medicine? The current health insurance system in America violates the very essence of the principle of insurance. Here’s how it’s supposed to work: you pay a small premium for a large benefit. The more people paying into the pool, the lower will be the premium. The larger the pool, the more efficient the system. So why not the whole country? In the current US system, there are literally tens of thousands of different, and overlapping health care organizations generating a blizzard of paperwork in an administrative wilderness creating enormous waste. There are thousands, if not millions of people pushing paper around. The overhead is estimated to be over 30%; whereas Medicare operates on an overhead of around 3 or 4%.

A look back at the endless squabble over health care in this country will reveal where this timidity about single payer comes from. “Socialized Medicine” were the scare words. They were used the way George W. Bush now uses “the war on terror”; to scare the American people into accepting two useless, endless wars in Iraq and Afghanistan. It was the American Medical Association (AMA), after World War II, that raised the bug-a-boo of “socialized medicine” when they saw something new blowing in the wind—pre-paid medical plans. Organized medicine saw these plans as a threat to their “fee for service” system. (You go to a doctor, you get a service, and you pay a fee) That’s the way they wanted to keep it, by God!

It was Henry Kaiser, the auto maker and ship builder, who came up with the idea of a Health Maintenance Organization for his employees—a prepaid medical plan (You pay a small monthly fee, you get your entire medical and hospital needs free of any other charges). The City of New York jumped right in with HIP (Health Insurance Plan of Greater New York), a pre-paid health plan for the city employees. “Socialized Medicine!” screamed the AMA. Physicians and surgeons manned the battle stations. Many saw their seven figure incomes taking flight. Other HMOs mushroomed around the country. And, then, in 1965, President Lyndon Johnson made “medical care for the aged” part of his “Great Society” package. We know it today as “Medicare”. Then, came Medicaid, medical care for the indigent. The flood gates were opened. For the first time, huge amounts of government money started pouring into the health care system.

The insurance companies knew a good thing when they saw it. Organized medicine, the AMA and its state and county medical societies, did not—paralyzed by their fear of government intrusion. Insurance companies relished the enormous cash flow of government money emanating from Medicare and Medicaid and other government programs like Champus, medical coverage for servicemen and their families. Insurance companies set up their own private plans, yes, HMOs, to sop up all that loose cash. They turned pre-paid plans into their opposite, not “socialized medicine” for the people, but corporate welfare for the insurance companies. Through the years, they increased premiums and cut services, raking in billions of dollars in profits instead of providing not-for-profit medical services to their subscribers. The doctors allowed themselves to be co-opted and blind-sided. They allowed the pre-paid plans to get away from them. The fear of “socialized medicine” dimmed their vision. So instead of “socialized medicine” the doctors got privatized sweatshops where some doctors cannot make medical decisions without the approval of an HMO bureaucrat. Managed care became mismanaged medicine.

Is this the system Barack Obama wants to continue with his “affordable” health care plan, begging the Health Insurance companies for the few crumbs falling from the table while they continue to rake in whopping billions in profits off our backs? Or will he be a man of principle, take the bull by the horns, come forward with his true beliefs as he expressed them in 2003, and give us the change we can believe in?

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