Myths About Single-Payer Health Care

Myths About Single-Payer Health Care

D. S. Mitchell

Honest health care policy experts know that the solution to fix the American health care system is staring us in the face, and it is single-payer, Medicare-for-All. The defeat of the Republican health care legislation put a nail in the coffin of the idea that Americans can’t be sold on Medicare-for-All.

The evidence is clear, Americans believe that every person has a right to health care, irrespective of ability to pay. We as a people, believe that we have an obligation to take care of each other. In fact, there is more momentum for single payer than at any time in our history.

Despite its enormous popularity and unparalleled record of success Republicans are deep in their war on Medicare. New proposals have emerged since the 2016 election that would slash benefits for the elderly and leave older Americans at the mercy of the “for profit” insurance industry.

Paul Ryan Republican Speaker of the House has been vocal in his attacks against both Medicaid and Medicare. He is calling for a voucher program that would transfer more costs on to seniors and leave them at the mercy of the private insurance industry. This action must be stopped.  It is not just about protecting our existing Medicare system, it is about ensuring that everyone receives health care as a right. It is a case of “everybody in, nobody out.”

One hundred Americans die everyday from the lack of health insurance. That is over 30,000 unnecessary deaths each year and that number is scheduled to grow steadily over the next decade. This is an American tragedy. With the Republican tax scam now signed into law we will see millions remain uncovered and millions more lose coverage due to increased cost for insurance coverage brought on by the elimination of the insurance mandate. The insurance mandate was a device used by the ACA plan to expand the pool to keep prices down.

Former editor in chief of the New England Journal of Medicine, Dr. Marcia Angell believes Medicare-for-All is the best health care reform, and it is the only health care reform that will cover everyone and control costs. That is why the majority of doctors, nurses and hospitals support a Medicare-for-All system.

What about CIGNA, Wellpoint, United and Humana? Their place in American health care would disappear.  They would be replaced with one insurance pool. The Medicare system that serves the elderly so well would be expanded to cover all Americans. “Everybody in. Nobody out.”

How would such changes save money? Upfront we as a country would save at least half a trillion dollars in administrative costs, waste and profits. That sizeable savings would be used to cover everyone.

At birth, everyone would get a health insurance card. This card would give you access to any doctor or hospital in the United States. Free, unfettered choice of doctor and hospital. This is unlike our current practice of allowing health insurance companies to tell us which doctors and hospitals we can see.

As it stands, if you don’t have health insurance–or if you have insurance with sizeable co-pays and deductibles–you’re likely to stay away from a doctor or hospital until the condition becomes  critical, and then most likely you will end up in your local ER.

Obvious positives: A Medicare-for-All system would cut drug prices by more than 40%. A Medicare-for-All system would  emphasize prevention. “An ounce of single-payer prevention is worth a pound of high-tech cure.” A Medicare-for-All system would be a powerful voice against alcohol, tobacco, junk food and sugary beverages. Furthermore, a single-payer system would store treatment results in a single database, doctors would have access to more complete research data, thereby making it easier to detect the dangers of certain drugs and environmental and workplace exposures.

Our inadequate health care system leaves millions out in the cold. Until every American is covered the body count will continue to rise. Remember at least 100 Americans die daily directly related to their inability to pay for health care. Tens of millions of people face crushing medical bills, even people with insurance are forced to choose between medicine and basic necessities like food and shelter. This is WRONG.  Medical bills are the number one cause of personal bankruptcies in the United States.

Health insurance costs are going to continue to spin wildly out of control. Insurance premiums are doubling every six years, and insurers are continually pushing for patient increases in the share of cost, most definitely through higher deductibles and co-payments they demand from their customers.

Bernie has it right. There can be no compromise with the health insurance industry.  Putting the sharks in charge of the goldfish makes no sense. If Paul Ryan has his way that will be the result, seniors will be at the mercy of insurance companies.  The ACA tried to keep the insurance companies in the game, however it has become clear to most of us who are following this issue closely that the insurance industry will give less at more cost. Ryan’s voucher program in place of Medicare-for-All would be a disaster.

Remember every day 100 Americans die from lack of health insurance. Every day hundreds go bankrupt from medical bills. Both a national tragedy and a national disgrace. We must support sensible policy and sensible policy is Medicare-for-All. There is an army of lobbyists representing health care and drug industry visiting legislators everyday their central mission is to block Medicare-for-All.

Public Citizen is a citizen action group working on many public policy issues, one of them being Medicare-for-All. In a recent mailer Public Citizen responded to 6 “Myths and Lies” about a single-payer system. I would like to share their responses to the most frequent arguments.

1.) Argument: Single-payer is government-run health care.

WRONG.

Government run health care is the Veterans Administration. Or the British system where the government pays for the doctors and hospitals.

Under Single-payer you get a health care card and you can go to any doctor or hospital in the U.S.

Doctors are not employees of the government. Hospitals stay in private hands. You get free choice of doctor and hospital.

2.) Argument: Single-payer will lead to rationing, like in Canada.

WRONG.

Right now in the United States, the private health insurance companies ration care.

If you don’t have health insurance, you don’t get health care. More than 30 million Americans now lack health insurance.

That’s why 100 Americans die every day from lack of health care.

There are some problems in the Canadian system, but most of what you hear about long lines is health insurance industry propaganda.

Zero, let me repeat that, zero people die every day in Canada due to lack of health insurance.

3.) Argument: Costs will skyrocket under single-payer.

WRONG.

Single-payer is the only health care reform that will save enough money to ensure everyone.

By eliminating the health insurance industry, the country will save $500 billion a year or more in administrative costs and profits.

That money is then used to insure those who lack insurance and fully cover those who are under-insured.

Yes, more people will be seeking health care because they will now have insurance. But they will be taking care of medical problems early, thus preventing more costly treatment later.

4.) Argument: Drugs will be more difficult to get under single-payer.

WRONG.

The drug industry would have you believe that there will be less research and development under a single-payer system.

In fact, much medical research is now funded by the National Institutes of Health.

Under single-payer, this would grow.

Also, drugs will be cheaper under single-payer.

When all patients are under one system, the payer wields a lot of clout.

For example, the VA gets a 40% discount on drugs because of its buying power.

This single-payer buying power is the main reason other countries’ drug prices are lower than those in this country. (*Now you know why the drug industry is so opposed to a potential single-payer system.)

5.) Argument: Single-payer will cover less than the insurance I have now.

WRONG.

For the majority of Americans, single-payer will be a vast improvement.

All medically necessary care would be funded through the single-payer, including doctor visits, hospital care, prescriptions, mental health services, nursing home care, rehab, home are, eye care and dental care.

An enlightened single-payer will also result in a sharp increase in public health funding to prevent disease.

No more bills. No more deductibles. No more co-pays.

6.) Argument: Single-payer will cost me more than I’m paying now for private health insurance.

WRONG.

The majority of Americans will pay about the same or less than they are paying now.

Instead of paying premiums to a private insurance company, most of us will pay a similar or smaller amount in taxes.

So, now, if you are paying $8,000 in premiums for a family of four with a $4,ooo deductible, your yearly liability is at least $12,000.

It is most likely that you will pay less than that in taxes to fund a universal single-payer.

There will be no deductibles or co-pays.

And, you can go to see any doctor or check into any hospital in the United States.

Thanks again Public Citizen for answering a lot of the common questions people have about single-payer. Public Citizen is fighting for single-payer every day.  Put them on your donation list.

Calamity Politics is an online news magazine presenting a progressive view of politics and policy. Join me for comment and opinion. Join the Resistance. We are Indivisible.

Dar

(**In my perfect world the health care insurance card would also a national voter ID. A guarantee to get access to voting nationwide. Just my idea to stop the calls of fraudulent voters and the ongoing suppression of the vote.**)

Three Goblins In The Health Care Closet

3 Goblins Facing Health Care

D. S. Mitchell

On The Front Line

Writing for www.CalamityPolitics.com allows me a grass root platform to discuss health care, and every other area of our political spectrum, for that matter. It does not give me the right to say anything I want about the issues. With that said, I have ground level experience in health care. Because of that experience and exposure to trench warfare in hospital health care I have strong opinions. Client care and results need to be discussed and evaluated for effectiveness. I have a passionate interest in health care, and in this area, I believe my street level experience gives me the right to discuss the issues. Bringing common sense thinking to health care should always be welcomed. I am an RN, and have worked for 38 years in hospitals in Oregon, Washington, California and Nevada.

The Sickest

My two primary areas of specialty are Crisis Psychiatry and Cardiac Intensive Care. Whether the issues are mental, behavioral, or cardiac emergency, many of the issues facing the caregiver, and the client are the same. Despite the obvious differences in the front line needs of the clients, both of these populations are often the sickest in the hospital. One thing I know, is that the health of the American citizen should not be decided by a politician in Washington, D.C. Sadly, that’s where this battle always shows its ugly underbelly.

Goblin 1: Big Pharma

Suitcases Of Medications

For the first twenty-five years of my career, when I admitted a patient that came to the unit with a suitcase of medications, I believed it was because they were incredibly ill. Like physicians I had been trained to believe in  pharmaceuticals.  As an old nurse, my thinking transformed into, the patient is sick because they are taking so many prescribed medications. I can hear the protests from the audience now. Don’t believe me, just read the labels. These are chemicals and they are toxic and poisonous.

Side Effects

Truthfully, every pill has the potential to cause side effects, some known and some unknown.   When a person complains to his doctor that he is uncomfortable due to the side effects of the medication he is taking, his doctor writes him another prescription to help deal with the side effects.  The patient has pain so his doctor writes him a prescription for an analgesic. When he complains of constipation, he is given a prescription.  You can see where this is headed, right?

Advertising Medications

In America, television is the best friend of the pharmaceutical industry.  Constant television marketing convinces viewers that there is a pill that will fix anything and everything. Unfortunately, many Americans now believe that there is a pill that will make everything in their life better.  Health care policy makers need to take this issue very seriously. I realize drug manufacturers want to make a profit, but I also believe constant repetition creates a need that previously did not exist.

Goblin 2: Poor Life Style Choices

It is important to recognize that there are both Non-Modifiable issues and Modifiable issues.

Non-Modifiable Conditions:  unchangeable circumstances, such as age, gender, race, genetics.

Modifiable:  changeable circumstances, such as life style choices that people can change.  Most particularly, cigarette smoking, poor diet, inactivity, alcohol abuse or overuse, and chronic stress. Most people understand the link between lifestyle choices and chronic illness are undeniable. Understanding that continuation of unhealthy behaviors leads to chronic disease more often than not. People need to make good choices.

Painful Truths

Predictors of chronic illness: smoking, processed foods, fast foods, starchy carbs, bread & pasta, sugar drinks, excess alcohol, overeating, excessive salt use, sugar, high fat diets, and lack of exercise.  These behaviors will lead to obesity.  Obesity increases risks, particularly of diabetes and cardiovascular disease. Lifestyle diseases kill more people than communicable diseases. The top five killers in America are:

1.) Diabetes
2.) Cardiovascular disease (High Blood Pressure, Heart Attack, High Cholesterol)
3.) Stroke
4.) Chronic Obstructive Pulmonary Disease (COPD)
5.) and some forms of cancer.

The Numbers Are Eye Opening

More than 70% of deaths in the United States are attributable to one of the above listed diseases.  Even more alarming is that 75% of the U.S. Health Care dollar is spent on the same listed diseases.  Furthermore, the numbers do not reflect the personal and economic burden of chronic illness, lost work days, low productivity, disability and poor quality of life. “I’m going to die from something,” is the most common response people make when confronted with their poor life style behaviors.  There seems to be no regard for the overall effects of that attitude on self, family, community or country.

Stop Smoking

Smoking is the leading preventable cause of chronic illness and death in the U.S. and is responsible for 1 in 5 deaths.  Statistics show that 10 times as many Americans have died prematurely from cigarette smoking than have died in all American wars.  Smoking hardens arteries and causes the heart to work harder.  Emphysema and COPD are caused by smoking.  Smoking causes 80% of all COPD deaths and 90% of lung cancer deaths.  Additionally, smoking is a major cause of throat, bladder cancer, voice box, liver, pancreas, stomach, kidney and colorectal cancers. So, America become your own best physician:

1.) Stop smoking
2.) Eat a plant-based diet
3.) Exercise at least 7 hours per week
4.) Reduce stress
5.) Practice good dental health
6.) Have fun

Goblin 3: The really big lie. A free market solution

Whistle-blower

Former CIGNA Senior VP turned whistle-blower, Wendall Potter called it “general gullibility and blind adherence to ideology.”  The American public has been bamboozled ” by the self-serving propaganda from health care insurance companies and pharmaceutical companies and every other part of the medical industrial complex,” he told Congress in 2011.

Around The World

Government leaders in other developed countries decided long ago, the following: 1.) health care is a right AND as such, is different than the typical free market arenas.  2.) Goblin Three: The really big lie is that health care can be viewed through a free market lens. In 2011, Jason Adkins commented in a Catholic Spirit piece, “slavish adherence to ideology in politics can and does inflict harm to the very people public officials claim to serve.”

Failure Of Competition

One basic element rarely discussed is failure of competition.  The hospital industry is highly concentrated in areas with higher populations while under serving the rural populations of the U.S. and often leaving rural hospitals subject to failure.  As as with hospitals, “health care services don’t really compete with one another as equal goods.” My doctor’s care is different from the care provided by my neighbor’s physician.  My medications are different from my neighbors.  Response to care is different for me than for him.  These variables show that no case is the same.  Thus, no “equal goods,” can apply.

Profits Vs Health

Mark Sokr 2/17/2011 said, “I think the health care market is functioning perfectly.  The problem is that the market is producing profits, NOT health.”  Hmmm.  Patients most likely would call this failure.  However, for all facets of the health care industry, profits are spectacularly high, so it can be claimed that the market is a success and doing what it is intended to do, make money, and to expect better health care results would be unrealistic. A very obvious dilemma exposes itself.  Two separate and divergent end desires.  The free market wants profit.  The citizenry wants good, inexpensive health care.  The ideology of profit and successful health care delivery do not coincide.  Since the primary goal of the free market is profit, “Any diversion from this goal is inefficient and against the interests of the holders of capital,” Mark Sokr concluded.

Conclusion

To slay the goblins in our health care closet it seems to me that we need to drop the ideology and look at the facts.

1.) Prevention must become the goal of this country.  We can cut the cost of health care by billions of dollars.
2.) Give up the idea that a pill will fix everything  and as part of that our doctor’s need to direct their patients to a healthy lifestyle and stop handing out a pill for every complaint.
3.) Personal responsibility and self advocacy must become the center of each individual’s health care and their greatest well-being.
4.) Accept the proven fact that “free market” systems are inappropriate for health care and continuously fail.
5.) A single payer system delivers the best and least expensive care.

“Yes, President Trump, “health care is complicated.”

Join the Resistance