Physician: Is Single-Payer Un-American like Roads and Schools?

[FayeforCure]

NE Florida may never get any info on this option through our local media, so here is what was published elsewhere.

Disclaimer: I favor a public option alongside private insurance for the sake of choice. If people like what they have, they should keep it. The private option would insure the uninsured and underinsured. Private insurance doesn't want those with pre-existing conditions anyway.

Posted on May 20, 2009
Single-payer health care is smart solution for America


Hedda Haning
The Charleston Gazette
May 16, 2009

CHARLESTON, W.Va. â€" Everyone agrees that we should all have health care. Most agree the federal government can fund it because we’re desperate. Even the insurance companies agree. The one thing no one discusses is “single payer.”

In case you can’t tell, it’s a swear word; the phrase is always followed by “Socialized medicine. Boo!” You never hear the fact that all other civilized nations have some form of a single-payer system and provide better health care than we do at much lower cost. If that does leak out, the next thing you hear is that it is obviously “Un-American.”

So what is a single-payer health-care system? It is non-profit. It is Un-American like roads and schools and fire and police and Social Security. It is not socialized medicine. Everyone chooses his own private doctor and hospital. The difference is in the payment system. Patients submit a card to doctors and hospitals and payments are made from a single payer, a trust fund established by taxes collected in a fair way at the federal level.

There would be no co-pays, deductibles or balance billing. The tax bill for most people would be much less than they pay for medical insurance and uncovered care because there would be no profits, the administrative costs would be cut by approximately 80 percent, and care would no longer be fragmented and disorganized. Insurance companies would no longer make medical decisions, and no doctor or hospital would be out of network.

There would be negotiated fees and global budgets keeping costs predictable and controllable. The mechanisms would have to be transparent and open to comment and the administrators widely representative. Today, many doctors will not accept Medicare and Medicaid patients because the fees are set lower than their expenses. Everyone suffers. In the single-payer system, the responsible board in charge would have to negotiate regularly with those doctors for changes. Also, without paperwork for each visit by each patient, administrative costs in each office (now huge because of all of the pre-approving, denying and re-submitting) would be greatly reduced - cutting the doctor’s overhead substantially.

A single-payer system would cover everyone, including the CEO of GM, your senator and you. Do you think Congress would pay more attention if they had the same health care we do? The Gazette has recently commented that our Congressional folks want universal coverage. Watch out, because it is a glib trap. Their plan is to mandate that everyone get care through private for-profit insurance firms with public assistance as needed. Unsurprisingly, the insurance industry is strongly supportive. Their huge overhead will be built into the plan. Call it what it is: welfare for insurance corporations.

This approach has been tried in several states, most recently Massachusetts, and has failed everywhere to be affordable and provide necessary care.

In a single-payer national health program, it doesn’t matter if you are rich or poor, just lost your job, have diabetes and heart disease or are healthy. We will no longer have to humiliate people by having them prove they are poor enough to be eligible. The care is comprehensive, covering all medically necessary expenses including primary care, medications, procedures, hospitalizations, mental health, dental, nursing home and home health care.

In case you want to move to Arizona, you will have medical care there, too. Think of single-payer as a better Medicare covering everyone.

A single-payer system can better assess the application of new technology and quality of care outcomes. It can make better long-term decisions and investments, based on patient needs rather than profit. Since we would all be in the same boat, we would all have an incentive to fix the problems that come up. Other countries do this.

Most people don’t know that the federal government already pays for two-thirds of health-care costs through programs including Medicare, Medicaid, the military and tax breaks. The federal government alone already pays - right now - more per capita for health care than any other developed nation pays, but it does not control the system. It is run by insurance companies protecting their profits.

And here’s another little secret: our economy would be much more vibrant if every employer did not have to carry the burden of health care for every employee and if employees were not often stuck in dead-end jobs for fear of losing medical coverage.

Single-payer’s most serious problem is that it puts people before profits: the insurance and pharmaceutical companies hate it. Their lobbyists are already hard at work convincing your legislators that it isn’t feasible. No doubt the ads will be on TV any minute. There was just a conference at West Virginia State University. Single-payer was never mentioned.

It’s apparently not enough that most physicians (an overwhelming majority of primary care physicians) support such a program, as do nurses, many other medical professionals, unions and non-profit organizations.

And doctors in other capitalist countries are quite positive about their own single-payer systems. They are financially comfortable. They do research, develop and use new drugs, and often have access to more advanced technology than we do. They have less interference with their medical decisions than private insurance imposes on our doctors and patients. And study after study shows their health outcomes are better than ours, all while keeping their health-care costs half of ours.

Did I mention their patients aren’t bankrupt by medical costs? No other country rations care as we do by ability to pay.

The best kept secret is that polls show two-thirds of Americans supporting such a program, even if they have to pay more in taxes to get it, which would still cost less and be a more predictable expense than paying for private insurance. The fact is if what we’re after is medical care for all Americans at a price we can afford - hugely important to our stressed economy - then single-payer, not-for-profit health care is the ONLY feasible solution.

Haning, a Charleston doctor, is a member of Mountain State Physicians for a National Health Program.

http://www.wvgazette.com/Opinion/OpEdCommentaries/200905160309

Also published in The Charleston Gazette

[CrysG]

It’s time to stop kicking sand in the face of single-payer health care. It may be the strongest solution around to insure every American at a lower cost.

After decades of industry campaigns against this model -- dubbed by its critics as “socialized” medicine -- it’s important to stop whining and evaluate the many economic benefits. Health care is a fundamental human right.

http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_wasik&sid=ao58otXrmrPM

[FayeforCure]

It’s time to stop kicking sand in the face of single-payer health care. It may be the strongest solution around to insure every American at a lower cost.

After decades of industry campaigns against this model -- dubbed by its critics as “socialized” medicine -- it’s important to stop whining and evaluate the many economic benefits. Health care is a fundamental human right.

http://www.bloomberg.com/apps/news?pid=20601039&refer=columnist_wasik&sid=ao58otXrmrPM

I'm impressed: Bloomberg no less!!!

[BridgeTroll]

Health care is a fundamental human right.

If so... we need to do it right.

[JaxNole]

I think what is off-putting is 'socialism'.  That irrationally sparks fear by many, especially in this part of the country.

I suggest championing the use of 'single-payer'.  Too many un-/underinsured Americans (in the millions) result in higher premiums for all of us because insurance companies absorb the cost for their treatment and pass them on to us.  Preventive treatment and basic exams and treatment should almost be guaranteed; plasma TVs not so much.

I am fortunate my premiums amount to no more than 1% of my gross monthly salary.  Adding other benefits such as FSAs, greater insurance coverage, AFLAC, supplemental and group life insurance and investment vehicles (401(k), Roth IRA) increases my deduction rate to 20%.

Still, others are not as fortunate.

[JeffreyS]

I think what is off-putting is 'socialism'.  That irrationally sparks fear by many, especially in this part of the country.

I think that is because people have been mistakenly told this is a strict capitalist society when we have long been a mixed market economy. We will always have socialist aspects to our government and it is shocking how many people will argue we don't. Health care should be a socialist tax supported(not free) endeavor IMO.

[downtownparks]

The problem is, you show me a government run program, I will show you a badly run, over-cost program.

Schools and roads? Our schools are among the worst in the industrialized world, and the only roads in the nation that are worth driving on are the ones that were just put down. Take a drive down Silver or Laura st, and come back and tell me that the tax payers are getting thier moneys worth.

Healthcare for all is a lovely, feel good idea. Its also the path to power and money for our congressmen once we put it in their hands.

Find a way to remove lawmakers from the process, and you might find a way to stop getting sand kicked in the face of the concept.

[FayeforCure]

The problem is, you show me a government run program, I will show you a badly run, over-cost program.

Find a way to remove lawmakers from the process, and you might find a way to stop getting sand kicked in the face of the concept.

Well, ironically the healthcare industry is worried it won't be able to compete with a national healthcare option. And the reason for that is that Medicare overhead is just 3%, whereas industry overhead which includes all administrative costs is 31%.

Senator Ben Nelson calls a national option a deal breaker:

Nelson’s problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. “At the end of the day, the public plan wins the game,” Nelson said. Including a public option in a health plan, he said, was a “deal breaker.”

http://www.huffingtonpost.com/2009/05/01/ben-nelson-plans-to-oppos_n_194907.html

But yeah for the past three decades we've been told that government can't do anything right. Now we know that private industry without government oversight will go wild as we've seen from the deregulation of the banking industry.

What we need to do is remove industry lobbyists from the lawmakers, so the lawmakers can start listening to the people, and do what's right for the people instead of only havng corporate interests in mind.

[civil42806]

The problem is, you show me a government run program, I will show you a badly run, over-cost program.

Find a way to remove lawmakers from the process, and you might find a way to stop getting sand kicked in the face of the concept.

Well, ironically the healthcare industry is worried it won't be able to compete with a national healthcare option. And the reason for that is that Medicare overhead is just 3%, whereas industry overhead which includes all administrative costs is 31%.

Senator Ben Nelson calls a national option a deal breaker:

Nelson’s problem, he told CQ, is that the public plan would be too attractive and would hurt the private insurance plans. “At the end of the day, the public plan wins the game,” Nelson said. Including a public option in a health plan, he said, was a “deal breaker.”

http://www.huffingtonpost.com/2009/05/01/ben-nelson-plans-to-oppos_n_194907.html

But yeah for the past three decades we've been told that government can't do anything right. Now we know that private industry without government oversight will go wild as we've seen from the deregulation of the banking industry.

What we need to do is remove industry lobbyists from the lawmakers, so the lawmakers can start listening to the people, and do what's right for the people instead of only havng corporate interests in mind.

Medicare overhead is just 3%?  where is that from and how was it derived?  I've worked for the feds, no program I know of has 3% overhead.  That means just 3% of all funding goes to building support, maintenance,new construction,  salary for folks that process paperwork such as medicine acquisition, including secrataires, security personel, clean up crew.  Supply acquisition,  electricity and all utilities that the facilities use?

Direct cost should be defined as all employees who actually deliver medical care, their salaries and associated costs  patients, doctors, nurses, physical therapists, actual cost of medicine and supplies delivered.  The supplies would be charged as they are used.  3% is interesting, like to see how that was defined.

[FayeforCure]

3% is interesting, like to see how that was defined.

Here is more on that 3%, which often is cited at 2%:

numerous studies have shown that the administrative costs for Medicare â€" a government-run program â€" run at about 2%, as compared to 30% or more for private insurance. (Some have estimated that the total overhead and administrative costs for the U.S. health-care system is as high as 50%!)

A GAO study, already in the 1990's, found that the U.S. could save enough simply on administrative costs with a single-payer national health program to cover all uninsured Americans.

A 2003 study in the New England Journal of Medicine, comparing administrative costs of health care in the U.S. and Canada, found that in 1999, administrative costs per capita were $1,059 in the US, compared to $307 in Canada. By one measure, administration was 31% of health care expenditures in the US, compared to 16.7% for Canada's mixed public-private insurance system. Canada's national health insurance program had overhead of 1.3%; its private insurers had overhead of 13.2%.

The NEJM study found that it would save $209 billion annually, just to cut U.S. overhead costs to the level of Canada. That figure is about $400 billion today, according to testimony by Harvard's Dr. David Himmelstein, to a House subcommittee on 4/23/09. Himmelstein argued that only a publicly-financed, single-payer system can rein in costs while guaranteeing universal, comprehensive coverage.

Himmelstein attacked the half-measures being proposed by some Democrats, including that of a "public plan option," and he showed that costs have skyrocketed under the Massachusetts plan, which has a public plan co-existing with private insurance.

Medicare's costs have risen significantly under the HMO system which Congress grafted onto Medicare in 2003 at the behest of the insurance companies. The Center for Medicare Advocacy cites numerous studies showing that it costs 14% more, to provide services through the Medicare Advantage program (Part C â€" additional coverage through HMOs and PPOs), than through the traditional Medicare program administrative costs of 2%.

As for the prescription-drug component of Medicare (Part D), which is run through private insurance companies under the 2003 "reforms," a House subcommittee reported in 2007 that administrative costs, sales expenses, and profits account for 9.8% of the total costs of Part D, as compared what it gauged as the traditional Medicare administrative expenses of 1.7%.

http://www.larouchepac.com/node/10212

[civil42806]

3% is interesting, like to see how that was defined.

Here is more on that 3%, which often is cited at 2%:

numerous studies have shown that the administrative costs for Medicare â€" a government-run program â€" run at about 2%, as compared to 30% or more for private insurance. (Some have estimated that the total overhead and administrative costs for the U.S. health-care system is as high as 50%!)

A GAO study, already in the 1990's, found that the U.S. could save enough simply on administrative costs with a single-payer national health program to cover all uninsured Americans.

A 2003 study in the New England Journal of Medicine, comparing administrative costs of health care in the U.S. and Canada, found that in 1999, administrative costs per capita were $1,059 in the US, compared to $307 in Canada. By one measure, administration was 31% of health care expenditures in the US, compared to 16.7% for Canada's mixed public-private insurance system. Canada's national health insurance program had overhead of 1.3%; its private insurers had overhead of 13.2%.

The NEJM study found that it would save $209 billion annually, just to cut U.S. overhead costs to the level of Canada. That figure is about $400 billion today, according to testimony by Harvard's Dr. David Himmelstein, to a House subcommittee on 4/23/09. Himmelstein argued that only a publicly-financed, single-payer system can rein in costs while guaranteeing universal, comprehensive coverage.

Himmelstein attacked the half-measures being proposed by some Democrats, including that of a "public plan option," and he showed that costs have skyrocketed under the Massachusetts plan, which has a public plan co-existing with private insurance.

Medicare's costs have risen significantly under the HMO system which Congress grafted onto Medicare in 2003 at the behest of the insurance companies. The Center for Medicare Advocacy cites numerous studies showing that it costs 14% more, to provide services through the Medicare Advantage program (Part C â€" additional coverage through HMOs and PPOs), than through the traditional Medicare program administrative costs of 2%.

As for the prescription-drug component of Medicare (Part D), which is run through private insurance companies under the 2003 "reforms," a House subcommittee reported in 2007 that administrative costs, sales expenses, and profits account for 9.8% of the total costs of Part D, as compared what it gauged as the traditional Medicare administrative expenses of 1.7%.

http://www.larouchepac.com/node/10212

LYNDON LAROCHE!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Tell me is Queen Elizabeth still running the drug trade 

Do you know anything about this guy.  By the way you omitted his delightful lead in:

May 11, 2008 (LPAC)â€"As against President Obama's pet Nazi, Peter Orszag, who wants to cut life-saving medical treatments to balance budgets, Lyndon LaRouche has emphatically argued that it is the overhead costs of our corrupt, private insurance-dominated health-care system that are killing people, and that the only solution is to go back to the Hill-Burton system of providing adequate medical infrastructure, while dumping the HMOs.

[FayeforCure]

OK let's stick to what the CBO, the Congressional Budget Office says:

CBO’s comments on the overhead (administrative) cost issue are completely consistent with what we know about this issue. At the beginning of its comments on overhead costs, CBO noted that Medicare’s overhead costs are lower than those of private plans. I quote these remarks below. Note that in these remarks CBO says Medicare’s overhead is 1.5% of expenditures, not 3% or “less than 5%” nor any other number. You’ll see that CBO says “large employers’ plans” allocate about 7% of total expenditures to administration. That means that large employers who self-insure are paying out about 7%. The overhead of insurance companies is far higher, around 20%. Here is the quote:
“The share of costs in the fee-for-service Medicare program that are devoted to administration (about 1.5 percent) is lower than the share observed for large employers’ plans, whose administrative costs average about 7 percent of premiums…. To some extent, those differences reflect both the characteristics of the Medicare population and the unique features of the program. Differences in current administrative costs between Medicare and private insurers partly reflect differences in the tasks that each performs. Medicare has little need to advertise or seek out enrollees because eligible individuals are usually enrolled by default on the basis of Social Security records, which determine their eligibility. By contrast, private health plans need to establish and solidify their market presence and must compete with each other for enrollees and for employers as clients, generating costs for advertising, marketing, and sales. Further, Medicare does not employ many of the cost-management techniques used in the private sector, such as conducting utilization reviews or requiring prior administrative authorization for tests or procedures…. Another source of the difference in administrative costs between private insurers and Medicare is that private insurers retain profits.

http://www.mnhealthplan.org/img/medicarecompete.doc

You can find the entire Dec., 2008 CBO report here:

http://www.cbo.gov/doc.cfm?index=9925

[FayeforCure]

This where we can get the savings,.....cutting overhead:

The NEJM study found that it would save $209 billion annually, just to cut U.S. overhead costs to the level of Canada. That figure is about $400 billion today, according to testimony by Harvard's Dr. David Himmelstein, to a House subcommittee on 4/23/09.

[civil42806]

Okay I'll let you off for quoting a bizarre conspiracy laden, formerly right wing nut case, that has moved to the left wing nut case side.  Though quite frankly you need to explore the people that agree with  you more.  I"m still not sure what the percentages mean, after all medicare actually doesn't provide any medical care it just pays for it.  Was the CBO actually comparing say medicare against HMO's (though who uses HMO's any more almost everyone has gone to ppo's)  that sort of goes with the dates  of 2003.    Or does it include the brick and mortar hospitals which have huge built in overhead?

[JMac]

We pay into Medicare for 40 years before we're eligible to submit a claim and yet it's still on track to run out of money in eight years.  I can imagine how much red ink your single payer system will bleed.

Additionally, most employers will stop offering health insurance because the expense won't be deductible and/or employees will have to pay tax on the benefit, so we won't have much choice.

Faye - why don't you start a charity or non-profit insurance and healthcare company instead of trying to force gov't healthcare on everyone.