Healthcare Reform Debate: Shall We Include Single-Payer In The Debate?

Dear Friends and Colleagues:

Attached an editorial from yesterdays Seattle Times written by Dr. John Geyman is professor emeritus of Family Medicine at the Universityof Washington, past president of Physicians for a National Health Program, and a member of the Institute of Medicine.
He argues that legislators are "only considering options that build on the present system."He adds that "after months of work, legislative committees in Congress have brought forth drafts of proposals that the Congressional Budget Office (CBO) is starting to score in terms of cost and effectiveness. As expected, the costs of these incremental proposals are high BECAUSE they are based on the CURRENT dataset of health care costs and on data provided by insurance company actuaries. "He is correct that legislators refuse to even consider a single-payer option and that the CBO has yet to score such an option and how it would compare to the models proposed during the current debate.
He ends the editorial with the following challenge: " President Obama has brought forward the concept of audacity of hope. Is it too audacious now to hope that the legislators we elect to Congress can see beyond their campaign contributions and the lobbying efforts by corporate stakeholders to require that single-payer be scored?"

Yours
Bernd




The Seattle Times
July 6, 2009
A pay-go option for health-care reform
By John Geyman

As Congress recessed for the July Fourth holiday, the debate over
health-care reform was reaching a fever pitch. Now the top domestic issue
for the Obama administration, the biggest questions are how much a reform
bill will cost and how to pay for it, quite aside from how effective a
"reform package" will be.

Skyrocketing costs that are out of control are the hallmark of our present
system. Yet legislators have already acceded to pressures and dollars from
stakeholders in the present system (within which costs are revenue) and are
only considering options that "build on the present system."

After months of work, legislative committees in Congress have brought forth
drafts of proposals that the Congressional Budget Office (CBO) is starting
to score in terms of cost and effectiveness. As expected, the costs of these
incremental proposals are high. The first number of $1.6 trillion over 10
years (while still leaving 36 million Americans uninsured) sent these
committees back to the drawing board. At the moment, leading Senate
Democrats are hailing $1 trillion over 10 years as potentially doable.

After presiding over huge deficits during their eight years in power,
Republicans are now demanding "pay as you go" (pay-go) policies. Together
with Blue Dog Democrats, they are threatening to act as spoilers of any
health-care-reform bill on its price tag alone.

Given the dimensions of these difficult economic times including a $1.8
trillion deficit for 2009, $5 trillion in new federal debt over this year
and next, and rising unemployment, pay-go makes good sense. And the
president is making the case that his health-care plan must pay for itself.

Conventional "wisdom" (as generated by the mainstream corporate media) says
that any health-care reform will cost a lot, and that there is no pay-go
option. But there is.

Single-payer financing (public financing coupled with a private delivery
system, a reformed "Medicare for All"), as embodied in Rep. John Conyers'
bill (HR 676 in the House) with its 83 co-sponsors, will yield savings of
some $400 billion a year. That's enough to assure universal coverage for all
Americans while eliminating all co-pays and deductibles ? the ultimate
pay-go. Single-payer will give us far more efficient, affordable, effective
and reliable health care than our present multipayer system. Health insurers
have known for years that they can't compete on a level playing field with
single-payer, and have only been surviving by favorable tax policies and
other subsidies from the government.

This recent testimony before the U.S. Senate Committee on Commerce, Science
and Transportation by Wendell Potter, former head of corporate
communications at Cigna, says it all: "I know from personal experience that
members of Congress and the public have good reason to question the honesty
and trustworthiness of the insurance industry. Insurers make promises they
have no intention of keeping, they flout regulations designed to protect
consumers, and they make it nearly impossible to understand or even to
obtain information we need."

Many studies over the past two decades, including those by the CBO, the
Government Accountability Office (GAO) and the nonpartisan Economic Policy
Institute, have concluded that single-payer can assure universal coverage
and still save money. HR 676 needs to be brought out of the closet and put
on the table for CBO scoring against other options being considered in
Congress, all of which cost much more and fail to provide universal
coverage.

President Obama has brought forward the concept of audacity of hope. Is it
too audacious now to hope that the legislators we elect to Congress can see
beyond their campaign contributions and the lobbying efforts by corporate
stakeholders to require that single-payer be scored?

(Dr. John Geyman is professor emeritus of Family Medicine at the University
of Washington, past president of Physicians for a National Health Program,
and a member of the Institute of Medicine.)

http://seattletimes.nwsource.com/html/opinion/2009424809_guest07geyman.html