So docs and hospitals continue to operate as they always have, although for-profit facilities must convert to non-profits. The truly revolutionary change is that now the feds foot the bill via a progressive tax that hits the rich hardest and the poor not at all.
Single-payer: the basics
The following is the nature of any single-payer health care system. Simple, direct, universal, free. And having tried the alternative and found it wanting in that it's currently killing around 18,000 people a year because making gobs of money is incompatible with covering subscribers' medical costs, it seems about time to admit our errors, dismantle the current tragicomedy and move all the way into the 20th Century. Single-payer means:
One nation, one payer
Everybody in, nobody out
No exclusions for pre-existing conditions
No doctor bills
No hospital bills
No deductibles
No co-pays
No in network
No out of network
No corporate profits
No more medical bankruptcies
How to get there from here
The relationship of health care to health insurance is manufactured out of thin air by the US obsession with applying market-based, privatized solutions to nationalized, systemic problems. Therefore, it seems that to get to single-payer, we first need to abandon the propaganda and separate the idea of health care from the idea of health insurance.
Health care is what happens when patients and health care professionals interact to successfully diagnose and treat a medical condition or injury.
Why would anyone want to give a single penny to some parasite intermediary that skims billions while doing absolutely nothing to provide health care?
Unfortunately, it takes a lot more than pennies to keep the beast fed. While Medicare, our unofficial single-payer system, runs at an annual overhead of about 3 percent, for-profit insurers typically squander between 25 and 40 percent of an estimated $2.2 TRILLION annual market. And that 25 to 40 percent – which translates into between $550 billion and $880 billion each year – does absolutely nothing to enable these companies to perform their alleged function, which is supposed to be covering medical expenses for their ratepayers.
But all that frivolity does put a serious dent in ratepayers' pocket books; in a 2004 World Health Organization study of annual health care-related costs worldwide, the US wins the wastrel award for both public and private spending: $2,725 and $6,092, respectively. In comparison, Canada's numbers are $2,120 and $3,038; France, the WHO's worldwide leader in quality of health care systems, comes in at $2,715 and $3,464; number two Italy is a bargain at $1,936 and $2,580; and so on.
The unbearable lightness of Democratic politicians
Equally unfortunate is the unwillingness of our elected representatives to even consider single-payer among the options for US health care reform. Among the Democratic presidential candidates, only Dennis Kucinich has advocated single-payer from the start. The rest are all talking about something called "expanded coverage," which is just code for "let's invite the single most destructive element in the old system to play a key role in the new one."
That's a bit like expecting a shark to develop qualms of conscience, renounce killing and turn vegan, despite millions of years of evolution that dictate its natural role as a rapacious, heartless, omnivorous predator. Kind of like an average American for-profit corporation.
Any new system that subordinates health care to the for-profit model carries the seeds of its own destruction. If insanity is doing the same thing repeatedly and expecting different outcomes, then allowing these soulless gatekeepers to continue preying on the people of this country is truly insane. Such a system is virtually guaranteed to evolve into a new version of the same old deadly scam once the insurers stop glad-handing and get down to the serious business of making money. They may play nice at first, promising to mend their rapacious ways and act like humanitarians, but once they're inside the tent, they'll revert to form as certainly as that shark will continue to eat seals.
But that hasn't kept our alleged representatives in Congress and on the campaign trail – Kucinich the lone exception – from avoiding any mention whatsoever of the single-payer option. In 2003, Rep. John Conyers of Michigan introduced H. R. 676, dubbed the United States National Health Insurance Act, in an effort to remove private insurers from the US health care maze and install a national single-payer system in their place. The new system is essentially a well-funded version of Medicare, minus the age restriction.
It languished in committee for two years; Conyers then re-introduced H. R. 676 in 2005 and, according to information gleaned from Thomas.loc.gov, it has resumed its slow fall to the bottom of the House agenda. Like impeachment, single-payer remains "off the table," despite poll numbers that say more than 70 percent of Americans want an end to for-profit medicine and want to replace it with single-payer.
And why is it off the table? For one illustrative example (and unfortunately not the only one), let's take a look at Hillary Clinton's campaign contributors. The early leader for the Democratic nomination and among the favorites to become the next president is an insurance industry money magnet.
According to campaign finance figures submitted to the Federal Elections Commission and reported by Opensecrets.org, through the first nine months of 2007 she leads all presidential candidates, Democrats and Republicans, in money accepted from the insurance industry ($2.675M). She also leads the pack in money accepted from hospitals and nursing homes ($375K); from HMOs ($247K); from pharmaceutical companies ($274K); and from medical industry lobbyists ($570K).
As Bob Dole said way back in 1983, before he became the Senate's leading recipient of special interest money, "When these political action committees give money, they expect something in return other than good government." So that explains why true health care reform in a Clinton presidency is highly unlikely, and virtually guarantees that any Clinton-sponsored health care "reform" plan will bend over backwards to accommodate the needs of the for-profit medical insurance industry.
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