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OpEdNews Op Eds    H3'ed 7/27/09

What is Single Payer Health Care and how it would affect YOU.

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Message Mary Birmingham
Single Payer Health Care is a system where all citizens have access to medical care and providers bill the government for services provided. It eliminates insurance companies, which currently account for 1/3 of our health care costs, while often providing less than sufficient coverage. So, what would this look like given context of real lives?

What would this reform mean to you?

Meet Meg. The Oregon Medical Plan currently covers Meg. She has to hunt for doctors who will take the plan, and is treated like a second-class citizen when she accesses health care. When she moved from one city to another (within the same state), well she has not, after two months, been assigned a new physician, yet she needs post cancer surgery follow-up care. With a one-payer system, most all physicians would accept government funded medical care patients. A patient would not have to fill out a bunch of paper work and wait for a new physician when they move to a new city or a new state.

Meet Dave. Dave is a self-employed songwriter who cannot afford health care insurance. If you are self-employed like Dave and do not make enough to cover the high cost of health insurance, big deductibles and co pays; then you could use single payer.

Meet Mary and Orville. They are also self-employed and have health insurance, but it is not a very good plan. Every time one of them needs care it can cost them thousands. They are getting old and health care is eating up the savings they will need for retirement. They could benefit from a single payer system.

Meet Patrick. Patrick is a service-connected veteran. He gets free health care from the V.A. He has no ability to access a second opinion. He often must travel up to five hours to access needed medical care. In emergencies, he must decide when to travel two hours for urgent care or access civilian care 15 minutes away. If he makes the wrong choice, he will be stuck with the bill. He is currently in just such a conflict over a bad dog bite that went to the bone. With a one-payer system, Patrick could use the local hospital with the confidence that he will not end up with a big bill he cannot afford to pay.

Meet Mary. Mary is also a vet. She suffers PTSD from military sexual assault. She is well aware that male vets are twice as likely to be convicted of a sexual offense as the general population. She knows the Military has a long history of medical staff violating women patients. She knows that the V.A. gives preference to these same men in hiring. She knows that males make up a larger percentage of staff in the V.A. She knows the V.A. has a history of providing insufficient care for women, while using them as breathing cadavers to train gangs of 6-12 medical interns, residents, nursing and medical students to perform pelvic, breast, and rectal exams, while under anesthesia. She knows that the V.A. will leave her alone while sedated in male care. She knows that no amount of altering consent forms, demands for female only care, or begging will stop them from this abuse. She knows women are going in for surgeries and coming out with STDs. She would benefit from a single payer system in that she can find more female friendly health care.

Meet Amber. Amber has sick parents and would like to stay home and take care of them. However, Amber needs health care. Therefore, she went out and got herself a union job, one with a good medical and dental plan. She had to work for six months before her medical plan would kick into effect. One month before her medical plan was to kick in; Amber received a letter from her union. Kroger (she worked at Fred Myer) did some fuzzy accounting and had not paid their fair share into the health care plan and so now, the employees would have to make that deficit up by paying more for the plan, higher deductibles, and a lower level of coverage. She quit her union job and now is paid a higher wage but has to pay for her own health care. Amber would obviously benefit from a single payer health care plan.

Meet Joe. Joe has a good health care plan. However, Joe's plan is the same as the woman who works at the desk next to him, Anne. When Anne was diagnosed with cervical cancer, the insurance company refused to cover her medical care costs because she had not listed a yeast infection she had while pregnant with her first child over ten years ago on the form she filled out when hired two years ago. Anne is now deep in debt, has sold her house to pay for medical bills, and can no longer access the care she needs as she has not means to pay, but makes too much money for government assistance. She is talking about quitting her job, and going homeless (as she will have no means to pay the rent) so she can get medical care. Joe listens to Anne's story and fears getting ill himself. He wonders what little thing he may have forgotten to list. Joe could be worry free with single payer, and Anne could get the care she needs.

Meet Bob. He had a good job, but a child was born ill and in need of much care. The insurance company refused to pay. The bills were more than Bob made. He had to quit his job and sell his home to qualify for the state funded medical care his daughter desperately needed. If single payer were in place, Bob would still be employed today, he would still have a home for his family, and his daughter would be getting all the care she needs.

Meet Sally. Sally is rich. She gets all the medical care she needs and then some. She has reconstructed her breast, had several face-lifts and botoks injections. The implants have presented several problems and thus several surgeries were required. Now rather than the cute but small breasts, she has large well-scared and physically malformed breasts. She is going in for her sixth surgery on her breasts at the end of next month. She has also had problems with other elective procedures, but single payer will not help Sally much. She will continue to purchase more medical care than is good for her on the free market.

Meet Jane. Jane is a primary care physician. She likes the idea of not having to fight with insurance companies to be paid. She likes the idea of billing a single payer for all her patients' care. It will save her thousands over the year in administrative costs.

Meet Max. Max is a surgeon. He gives kick backs to primary care physicians for referrals. He has investments in imaging companies, and labs. He sends his patients to the facilities in which he has financial investments. He has made deals with pharmaceutical companies to research side effects of their drugs on patients and often prescribes these medications for this reason including to patients who do not have the condition for which the medication is intended. Max often violates any sort of meaningful notion of informed consent as he works for a medical school. He tells patients he will be performing a surgery, but post sedation, a team of two interns perform the surgery while a resident supervises. Max is in charge of five O.R. rooms at once, so is not really in full attendance in any one. He bills for services on all five surgeries.

While single payer will not in itself take care of the likes of Max, it will end the divisive system that allows the likes of Max to practice unchecked. When we are all in the same boat sink or float, when the government shares our interest in good medical care at a fair price, when the public has more power than the physicians and their medical boards, then collectively we can do something about the likes of Max.

Meet Sam. Sam is a C.E.O. of a multi-national insurance company. He has rec'd a seven digit income for the last 10 years. He is not going to benefit from a single payer and is putting a lot of money into a misinformation campaign, and into paying off your representatives to secure his gross profits driven by greed and denial of benefits to millions of sick Americans.

So, there you have it. My guess is that a one-payer system would benefit you. As an economist, I am convinced that people will act in their own economic self-interest once they know what does and does not serve that interest. Insurance companies do not serve our interests. So unless you are heavily invested in the insurance industry, or are like Dr. Max up there, you will benefit from a one-payer system. Even stupid Sally would at least likely get better information on the problems and temporary nature of breast implants, face-lifts and the likes from research NOT funded by the manufacturers of the implants.

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Just one citizen struggling to regain American Democracy. I am a bit of a intellectual jack of all trades master of none. I have studied, economics, sociology, philosophy, womens studies, and political science at a graduate level.
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