Labor's Voice for Change (46) June 23, 2009

Should Health Care Be a Commodity or a Right?
The ‘Single Payer’ Plan Offers Best Deal for All

By Harry Kelber

The United States spends more money on health care than every industrialized nation, and gets less for its money than those other countries do. While some 45 million people are without health insurance, and the escalating rise in premiums and co-payments continues, there is a national consensus that our health-care system needs drastic reforms.

Currently, there is heated debate in Congress and outside about the various health insurance plans, with two of them calling for universal coverage. But among the many troubling, unsettled issues are the cost of each plan, and who will pay for it.

A highly-popular plan is the United States National Health Care Act (H.R. 676), introduced in Congress by Rep. John Conyers (Dem-Mich.). H.R. 676 would provide every resident in the United with an expanded and greatly improved Medicare plan that now offers health-care benefits to 40 million elderly and disabled people.

H.R. 676 would cover every person for all necessary medical care, including prescription drugs, hospital, surgical and outpatient services, as well as dental, substance abuse, mental and other health problems. No one would be rejected because of previous or existing health problems. No insurance company bureaucrat would come between you and your doctor.

Under H.R. 676, a single public payer, the federal government, would replace the many hundreds of for-profit insurance companies, each with a high-salaried bureaucracy and a different set of rules, that are focused more on making money for the company rather than the health of its customers.

H.R. 676 has been endorsed by more than 500 labor organizations in 49 states, including 39 affiliated state federations, 125 central labor councils and hundreds of local unions, despite the efforts of AFL-CIO President John Sweeney to downplay Single Payer and deny it publicity on the Federation’s website.

The Sweeney camp believes that Congress won’t pass a bill for universal health-care coverage without a clear role for the powerful insurance companies. On the other hand, the Single Payer advocates say that the insurance companies are part of the problem, not part of the solution. Letting them participate in any health plan would retain the abuses and shortcomings that many people currently encounter in dealing with for-profit companies.

Enthusiasm for a Government-Run Public Insurance Company

The latest idea in a Senate heath-care bill proposed by Democrats is that competition from a government-run public insurance company will diminish or eliminate the abuses and excesses of the for-profit companies. A conference of 1,500 mostly Progressives was ecstatic about the new health-care option. Anna Burger, Chair of Change to Win, revealed that a war chest of $80 million had been raised to campaign for the option, even before anyone knew what a government-run public insurance company would look like and how it would compete against rivals.

Sweeney said that the Senate’s “strong draft bill” shows a “commitment to comprehensive reform that the country needs to finally win quality health care for all.” He particularly praised the Senate measure for giving people both the “freedom to choose to maintain their current insurance or pick a public health-care option that will increase competition in the market and lower costs.”

Sharply disagreeing with Sweeney, Rose Ann DeMoro, executive director of one of the AFL-CIO’s top health-care unions, the California Nurses Association, called the Senate bill a “sham” that wouldn’t work to control costs and provide universal care. She declared that Single-Payer, by eliminating the insurers’ overhead, duplicative tests, forms and paperwork, advertising, high CEO pay and profit motives, would cut down on the nation’s annual $2.3 trillion health-care bill by at least $300 billion.

Problems of a Government-Run Competitor to Insurance Firms

The proposed health care option of setting up a government-run public insurance company to compete with existing for-profit ones makes several untested assumptions, and raises several unanswered questions.

(1) How much funding would it require and how long would it take to set up a functioning government-run insurance company?

(2) Would this not require a new agency with a new bureaucracy to manage it? How large a staff would it need? Would it be subject to review by an oversight committee?

(3) What would its goals be? How would we measure success or failure?

(4) What if the experienced, for-profit companies managed to get an even greater share of the insurance business in an expanded market that included at least 95 percent of the population?

It’s even possible we might end up bailing out our government-run public insurance company if it can’t meet the competition.

Lots of questions. Too few good answers.

Article 47 of “Labor’s Voice for Change” will be posted on Thursday, June 25.