Wednesday, August 19, 2009

Time to Talk About Single Payer Again

As someone who has been avidly following the health care reform issue, I was stunned and angry to hear about President Obama backing off from the Public Option that he previously said was so important.

In a previous posting
The Continuing Battle Over Health Insurance Reform, I concluded with these thoughts:

If indeed the promised health insurance reform turns out not to have a public option, we will then know that President Obama not only made a deal with the devil — but that the devil in the form of the health insurance industry came out the winner. Which would make losers of all the rest of us!


I still feel the same way today.

The ‘deal with the devil’ refers to a concession made by Obama where he agreed to take a single-payer plan off the table in exchange for cooperation from the health insurance industry in getting a public option passed. So when ‘the devil’ reneged on his deal and instead fought the public option, Obama then offered another concession to placate the insurance reform opponents? What was he thinking of?

Compromise is a necessary part of the political process but it has become obvious that the only way that President Obama is going to get real health care reform is to fight for it! A sign of real leadership is being willing and able to fight for a cause that deserves it. The story about the recent
visit by Remote Area Medical to Los Angeles should remind us all that health care reform is first and foremost a humanitarian issue that he needs to fight for.

So instead of President Obama offering another concession, he should have fought back by at least threatening to put single payer back on the table.

Of all the solutions to the health care crisis in this country, single payer is the simplest and most cost-effective because we will then no longer have the health insurance industry as a middleman to siphon off money for overhead and profits that could instead go towards actual medical care. We know that single payer works because it is used successfully in many countries around the world including here in the US as Medicare for those over 65.

It is important to point out that the objection by those Democrats who do not support single payer is usually based more on the belief that it is politically unfeasible rather than any belief that it is not a good idea. Then presidential candidate Barack Obama explained this in
an interview from last year.

A more recent example is Senator Max Baucus who as chairman of the Senate Finance Committee had the following exchange with NPR’s Julie Rovner.

JULIE ROVNER: The supporters of single payer health care point out that their plan is not on the table.

SEN. MAX BAUCUS: Well, just to be honest, it's not on the table - the only thing that's not - because it cannot pass. It just cannot pass. We can't squander this opportunity. We can't spend - we can't waste (political) capital on something that's just impossible.

Again, please note that Senator Baucus did not say anything negative about single payer itself except to say that it would be "impossible" to pass it.

The liberal Democrats in the House have now threatened to withdraw their support for any reform bill that does not include the public option. Along with them, I fear that any bill that is passed without a robust public option to provide competition for the private insurers will be worse than useless. The proposed public co-ops now being discussed may possibly work in theory but should we base our health care reform on something so untested?

Instead of accepting victory at any cost, perhaps it would be better to let this latest effort fail if we cannot at least get the public option included. If indeed the reform effort fails this time around, the stage will be set for the next round which will undoubtedly be about single payer. After all, if we have to start over, why not go with the best solution especially if it has been shown that all of the compromise solutions we have tried are no less “impossible”!

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