Single payer witnesses show the common sense path, but Congress listening to industry donors
Yesterday, as Senator Tom Harkin (D-IO) left the health care hearing room he leaned over to me and said:
“I used to sell insurance. The basic rule is the larger the pool the less expensive the health care. Today we have 1,300 separate pools – separate health care plans – and that is why health care is so expensive; 700 pools would be more efficient and less expensive and one pool would be the least expensive. That’s why single payer is the answer.”
Nothing like common sense.
But, common sense was not on display in the Senate yesterday. Instead, the senate is seeking a path to the goal of universal coverage by protecting the least efficient model – the for-profit insurance industry that through waste, fraud, abuse and bureaucracy eats up 31% the cost of health care.
Chris Dodd (D-CT) who chaired the hearing, standing in for the ailing Ted Kennedy, has received $2.1 million from insurance industry throughout his career, another $547,000 from the pharmaceutical industry, and $467,000 from health care professionals. Dodd opened the hearing stating the stark facts:
We spend more than $2 trillion on health care every year- more than 18 percent of our GDP. By 2040, 34 cents of every dollar we spend could be on healthcare. That is not simply unacceptable – it’s unsustainable. Premiums and out-of-pocket costs for individuals and families alike continue to skyrocket.
It was evident, throughout the day that money was on the mind of the senators. But, they could not look into the face of the obviously most efficient path, single payer, instead they were going through contortions to protect their benefactors from the insurance industry.
The senators and witnesses showed there is a lot of division over financing health care and no easy solution – so long as the first goal is to protect the insurance industry. Business groups wanted to tax employee benefits not take away the business tax credit for companies that provide health care. These are the only two big pots of money the senate sees. There was also talk about making Americans healthier to save money, certainly a good goal. But, Sen. McCain (R-AZ), probably correctly if rudely, mocked witnesses who said health care could be paid for by doing away with inefficiencies and wellness programs. McCain favors taxing health care benefits.
Of course, both the business tax credit and not taxing health benefits are two reasons the health insurance industry is able to acquire massive wealth. These are annual, indirect taxpayer giveaways to the insurance industry that demonstrate how government is already paying for health care. Taxpayers are just doing so in the most inefficient way. Rather than actually using tax dollars to pay for health care, they are used to pay for insurance and all the profits and waste that goes with it.
Senator Bernie Sanders (I-VT), the sponsor of S.703, the single payer bill in the Senate, finally got his chance to speak and railed against the waste of the health insurance model, criticized their massive profits and emphasized that health care was a human right. He pointed his question to the lone witness advocating for single payer of the dozen testifying, Dr. Margaret Flowers of Physicians for National Health Plan.
Flowers, who had been arrested just six weeks ago for protesting the exclusion of single payer from discussions in the Senate Finance Committee, went into a long list of reasons why the multi-payer system is so expensive – inefficiencies built into the system, insurance companies making massive profits while people died from lack of health care access, hospitals needing massive billing departments creating bigger administrative staff than nursing staff, doctors spending 20% of their overhead on dealing with the insurance industry, fee for service payments that lead to unecessary treatments and expensive, often unneeded tests, malpractice litigation because patients do not have access to health care to bad health care outcomes. . .
Flowers was still going strong, the list was incomplete, when Sanders cut her off, saying I only have a few minutes for questioning.
Sitting next to Flowers was the CEO of Aetna Insurance, Ronald Williams. The senators fawned over him, except for Sanders who pointed out Medicare was more popular that Aetna. Williams makes anywhere from $13 million annually in salary and stock according to Insurance Industry News to $30.86 million annually according to Forbes. Insurance Industry News reports that if Aetna grows by 15% by 2010 Williams gets an addition $4.3 million. Is he not the perfect example of what is wrong with health care in America? Profits are the top priority of corporate interests, and usually short term profits. Should the insurance industry be striving to grow so rapidly when they already gobble up too many health care dollars?
The senate also struggled with how to make sure everyone is covered with health insurance. Again the divisions were obvious. Business groups said there should not be an employer mandate, but rather an individual mandate. Unions said there should be an employer mandate not an individual mandate. Big businesses said there should be no subsidy for small businesses that would be unfair to big businesses. Republicans scoffed at the idea of expanding Medicaid to more of the working poor – too expensive, unaffordable, they pointed out. The public insurance option was described as unfair to the insurance industry and too expensive to implement. The Democrats squirmed uncomfortably at choices that they know will upset some powerful interest group.