New York Times' columnists Gail Collins and David Brooks did something that almost never happens: they discussed
why single-payer is never even considered by mainstream media and
Washington politicians. The absence of even occasional debate over the
merits of single-payer is especially disheartening given the fact that
is the most obvious cure for what Republicans and Democrats alike agree
at the two most fundamental problems with US healthcare today: the
skyrocketing costs and the fact that so many are left without insurance
at all.
But
the debate, held as part of a recurring online feature, was
incredibly problematic. While Collins rightfully acknowledges that
since "a third of the cost of health care is in administration, and the
problem with reorganizing health care has to do with all the
multitudinous plans and policies, a single-payer system would be far
and away the most cost effective answer."
"We
don't talk much about it because it isn't politically possible. But it
isn't politically possible because we don't talk about it," she said.
Brooks response, however, is very short-sighted.
"Democratic
politicians throw around statistics claiming that Medicare has much,
much lower administrative costs than private insurers. I've been told
by various economists that this claim is three-quarters trickery. It's
a lot cheaper to administer a targeted population that uses a lot of
care than it is to administer a large population that uses little care
per capita. Plus you can save a lot of administrative costs if you
don't actually regulate treatments that much," he said.
But
what about every other industrialized nation in the world? Many of them
-- Canada, the UK, Tawain (which is based on Medicare) -- have a
single-payer system, while all other developed countries essentially
share the basic idea of single-payer: a centralized funding mechanism
that guarantees coverage to all while controlling costs.
In each of these instances, the countries pay significantly less
than the United States on healthcare as a percentage of GDP and on
administrative costs. The United States spends now about 16 percent of
GDP on healthcare, while the average expenditure for a country in the countries in the Organization for Economic Co-operation and Development, is about half of that.
Brooks
claims that the sheer size of the US makes single-payer non-viable, but
he doesn't explain why, only claiming that, "There is no way something
that big and complex and dynamic can be run out of Washington."
Why
not? He does not say. Having a large population is a factor in
healthcare spending, and healthcare needs -- although when pooled
together it also provides leverage that smaller countries do not have
-- and it obviously isn't working to have for-profit private insurers
run the show. But he seems not only willing, but adamant, that this
system must be preserved. This is despite the fact that government-run
systems within the US - Medicare and the Military healthcare system -
are the most efficient and have the highest satisfaction levels.
A
national Commonwealth Fund survey, for example, found "Medicare
beneficiaries reported greater overall satisfaction with their health
coverage, better access to care, and fewer problems paying medical
bills than people covered by employer-sponsored plans. The findings
bolster the argument that offering a public insurance plan similar to
Medicare to the under-65 population has the potential to improve access
and reduce costs."
It
is sad that Brooks is perpetuating this myth that preserving for-profit
private insurance companies -- bound by law to put the bottom line for
shareholders above all else, including the public good -- to be the
primary vehicle for health insurance is vital, without providing any
evidence. Given how infrequently this topic is discussed in the US media, even though the public supports single-payer in virtually every public poll taken on the subject, that the concept was dismissed so fallaciously by a columnist for an elite national paper is rather troubling.
As a report done by Fairness and Accuracy Reporting showed in a survey of articles about healthcare for a week in March:
As a report done by Fairness and Accuracy Reporting showed in a survey of articles about healthcare for a week in March:
Over the past week, hundreds of stories in major newspapers and on NBC News, ABC News, CBS News, Fox News, CNN, MSNBC, NPR and PBS's NewsHour With Jim Lehrer mentioned healthcare reform, according to a search of the Nexis database (2/25/09-3/4/09). Yet all but 18 of these stories made no mention of "single-payer" (or synonyms commonly used by its proponents, such as "Medicare for all," or the proposed single-payer bill, H.R. 676), and only five included the views of advocates of single-payer--none of which appeared on television.Why the media is so complicit in narrowing the debate so it favors the interest of insurance companies is worthy of examination. The fact that the public supports single-payer -- even in the face of this media blackout -- is also rather telling of how persuasive the argument for single-payer truly is.
Of a total of 10 newspaper columns FAIR found that mentioned single-payer, Krauthammer's syndicated column critical of the concept, published in the Washington Post (2/27/09) and reprinted in four other daily newspapers, accounted for five instances. Only three columns in the study period advocated for a single-payer system (San Diego Union-Tribune, 2/26/09; Boston Globe, 3/1/09; St. Petersburg Times, 3/3/09)."
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