In September, Governor Arnold Schwarzenegger vetoed a bill that would have resulted in a single-payer health care system in California saying that he " cannot support a government-run health care system."
While the recently re-elected executive is running from the right on several issues, most notably Climate Change, it appears signing off on something that could be described as a single-payer plan was just too much for this GOP moderate.
But Arnold is tackling the issue again with a new proposal to provide "universal" coverage for California that reflects a growing trend among state governments to reform health care. In many ways similar to health care legislation passed in Massachusetts this spring, the proposal requires consumers to buy insurance while expanding subsidies for low-income families.
Both measures have been praised by many as creative bipartisan ways to provide coverage and in sparking a conversation about the need to reform our countries dismal health care policies, which leave more than 46 million Americans uninsured.
But do these plans offer a real solution? And will they provide "universal coverage" as their architects claim? And should progressives, thinking pragmatically, support such measures as opposed to the single-payer system?
Not according to Dr. Steffie Woolhandler, associate professor of medicine at Harvard University and co-founder of Physicians for a National Health Program who says it is pure "fantasy" to say either of these bills will result in universal coverage.
"Both the MA and CA plans are based on ' individual mandates' ... the idea that the uninsured can buy their way out of their predicament," Woolhandler said in an e-mail. "A good family policy in MA costs $12,000 per year. How many uninsured families have even a fraction of that in hand to purchase coverage? Many families will be forced to buy stripped-down/bare-bones insurance plans, which will have lower (although still unaffordable) premiums, but will leave them unprotected in the event of a major illness."
These new, highly touted state plans, shift the burden onto patients, while letting business off easy. As Art Pulansky, secretary-treasurer of the California Labor Federation, said in a press release following the announcement of Schwarzenegger's plan: "the proposed employer contributions is so low that even Wal-Mart, a corporation known for its minimal employee healthcare coverage, already exceeds the requirements."
Worse, there is reason to be concerned that these state plans could serve to stifle the fight for a national universal health care system. "Finally, the single-payer canard is gone," boasted then Massachusetts's Governor Mitt Romney to The New York Times when the Massachusetts plan passed, seemingly pleased the parameters of the debate on this issue have been narrowed considerably.
Unfortunately, many Democrats seem content to help him do it. "I think the Democrats are concerned lest they seem too radical," said Rep. Pete Stark, (D-CA.) to The Seattle Times. "We've [The Democrats] got to win again in 2008, and I don't think we want to come out and talk about universal coverage or anything that sounds like socialized medicine."
Today's political landscape, however, seems to be begging for progressives to start making the case for drastic reforms. Especially given the folly of President Bush's latest proposal, which, unlike the state plans, does not even pretend to provide universal coverage. "Bush's reform plan - fiddling with the tax system and peddling skimpy private health plans - will fail miserably," said Dr. Oliver Fein, Professor of Medicine at Cornell University in a statement released in response to Bush's State of The Union speech. He also noted that, like Massachusetts and California proposals that rely on private insurers, "it would leave millions without coverage."
Consider that in September, an ABC News/Kaiser Family Foundation/USA Today survey found that 56 percent of Americans preferred a government-run universal health system "like Medicare" to our current system-a development that Marcia Angell called the unsung development of 2006 in an op-ed for The Boston Globe. "They want a single-payer system," she wrote. "We are the only advanced country with market-driven private health care. Other countries spend about half as much per person, cover everyone, and get better health results. Shouldn't this option be on the table?"
The recent elections have placed some well-known single-payer advocates in positions of prominence, and with enough pressure from constituents they could help to advance the debate. Rep. John Conyers, (D-MI), for example, is has reintroduced key single-payer legislation to Congress.
One of the bill's cosponsors, Rep. Barney Frank, (D-MA) is now the chair of the House Finance Committee and has been a longtime supporter of the single-payer model. On Jan. 3, in a speech in front of The National Press Club he said, "If we were to have a universal single-payer health care system, which took health care out of the wage system ... we would begin to reverse the inequality."
While the two leading 2008 presidential candidates, Barack Obama and Hillary Clinton, do not advocate a single-payer system, there are some candidates (and potential candidates) who have shown an enthusiasm for it, such as Rep. Dennis Kucinich (D-Ohio) and General Wesley Clark.
Michael Corcoran is a freelance writer who has been published by The Boston Globe, Common Dreams and The Nation. You can read his blog at: www.michaelcorcoran.blogspot.com
The views expressed in this article are the sole responsibility of the author and do not necessarily reflect those of this website or its editors.
The Current Politicos Have No Intention of Helping
The most salient observation in your piece was the one that stated that by Woolhandler "Both Democrats and Republicans get oodles of money from these industries (i.e. private health insurance industry and the pharmaceutical manufacturers), and are understandably loathe to take them on...". This is the lynch pin of the problem.
The legislators that we send to Washington, DC are NOT there to serve our interests in any other than the least significant ways. Most of them want to spend their time in Congress until they have made enough contacts to be marketable to DC lobbying firms or to the industries that they used to 'regulate'.
I will give you a perfect example. One of the two equally 'useful' senators from my state of North Carolina sat on the committee that oversaw the writing of the Medicare-D legislation. In point of fact, it has been widely reported that the legislation was drafted by PhRMA lobbyists for the greatest part. I do not doubt this. Senator Burr (R.- NC) was one of the biggest recipients of pharmaceutical largesse in Congress during his last campaign. What a shock!
There has been a full-court press by the mainstream media to tout Medicare-D as a wonderfully effective piece of law. Well Folks, I am on Medicare-D and it is not wonderful at all. The pharmaceutical industry is raking in billions each year as a result of Medicare-D that it would not have made under the plan where there was no Medicare coverage for out-patient medication. Why the difference? you may ask. Because, before Medicare-D many of those under Medicare who could not afford medication got them free from the pharmaceutical manufacturers' Patient Assistance programs. The post Medicare-D situation forced them into private plans that they could ill-afford or not afford at all with other attendant expenses in many cases (with taxpayer assistance in some cases to pay these costs for those who cannot pay). The pharmaceuticals are being paid by individuals and taxpayers for the drugs that these folks used to receive free. Yet another good idea from inside the DC beltway.
Expecting to get help with real universal health coverage in the United States with those who would have to craft and pass that legislation is like expecting the fox to keep a really good eye on your hen house for you. With some notable exceptions, there are very few in the House or the Senate who care whether or not all Americans have reasonable access to decent health care.
The mindset of these lawmakers is all the more confusing when there is empirical evidence that universal heath care provides better health care at lower costs as your essay so correctly points out. The key to it all though is that under such a scenario arises this question: What would happen to all the campaign dollars the lawmakers used to get from the leeches in the pharmaceutical and insurance industries? No need to try to answer that one. It will NOT be happening.
Our national government is firmly in the hands of corporate influence peddlers. Until we elect a Congress that will pass laws to eliminate (NO,I did not say regulate) lobbying and outlaw corporate funding of our Congressional politicians we have no hope of a universal health care system in the United States.
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Michael Weaver-Robbins (0 articles, 0 quicklinks, 0 diaries, 30 comments) on Tuesday, Feb 6, 2007 at 4:56:13 AM
Did you compare Governor Arnold Schwarzenegger's plan with Hillary Clinton's plan which she proposed at the beginning of President Clinton's first term?
This is one of the most important pieces of legislation we will do, the most important since Medicare and Medicaid and being on the same line of importance with the graduated income tax and Social security, so we had better do it right. When Bush and the economical radical right wing began to talk about national health care, I get worried.
I heard John Edwards last Sunday on "Meet the Press," I like his plan despite Tim Russert's snide criticisms. He lambasted Edwards for his vote to give Bush authority to go invade Iraq. As if that right wing puppet has any right to lambaste anyone. He was one of Bush's strongest supporters.
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pratliff94 (0 articles, 0 quicklinks, 0 diaries, 972 comments) on Wednesday, Feb 7, 2007 at 1:56:28 PM
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