Wednesday, June 3, 2009

Why Congress Will NOT Pass a Universal Single-Payer Health Care System

I've advocated for a universal single-payer health care system for years. It is the only system that can reign in health care costs because it eliminates profit from the equation. Therein lies the reason it will not pass. Even if the Democrats held well more than a 60-vote majority in the Senate, no such bill would pass.

Every Republican in the Senate has gone on record to oppose an expansion of the Medicare system to cover everyone, even a gradual expansion that would phase in different demographic groups over time. Many Democrats would join the Party of No on such a vote. But it will never come to a vote. Few Democrats really want to go on record against universal health care. It angers us liberals and progressives in the party. They won't bring it up for a vote.

The public option was not even brought up in hearings before the Senate Finance Committee.

Senate Finance Committee Chairman Max Baucus (D-Mont.) told leading advocates of a government-financed health care system that he made a mistake by not giving their proposals more consideration in the reform debate, according to participants in a meeting Wednesday.

...

“That was concrete movement. Unfortunately, there was not very much in the way of other concrete movement,” said Dr. David Himmelstein, co-founder of Physicians for a National Health Program and associate professor medicine at Harvard Medical School.

“While he did say it was probably a mistake not to have given a full hearing to single payer in the past, he announced no intention of opening up the hearings on single payer in the future and we will therefore need to continue to press him,” Himmelstein said. [politico.com]

Physicians for a National Health Program (PNHP) have this to say on their website:

The U.S. spends twice as much as other industrialized nations on health care, $7,129 per capita. Yet our system performs poorly in comparison and still leaves 45.7 million without health coverage and millions more inadequately covered.

This is because private insurance bureaucracy and paperwork consume one-third (31 percent) of every health care dollar. Streamlining payment through a single nonprofit payer would save more than $350 billion per year, enough to provide comprehensive, high-quality coverage for all Americans.

Let me give you an idea from a patient perspective. I had surgery less than two weeks ago. I have already received a form from a company called Anthem UM Services, Inc. (I have no idea what this company does.) that tells me:
We reviewed the submitted medical information regarding the...and determined that the information provided does not meet the medical necessity requirements for coverage as described in the member's benefit plan.

This determination is based on the following criteria and clinical rationale: Cannot Approve. This is a...year-old admitted...for laparoscopic cholecystectomy. The clinical information provided does not support the medical necessity for acute inpatient hospitalization since it appears that this procedure could have been done on an outpatient...basis....
Yada, yada, yada. This came on Saturday, so I called BC/BS of GA on Tuesday. They say the hospital has not sent the necessary paperwork. I was told that I shouldn't call BC/BS back unless I receive a bill from the hospital in the next two weeks.

Today, I got a statement from the hospital. I called the hospital today to inquire as to what they had sent me. They said it was just a statement, not a bill. (Since when is a statement NOT a bill?) They only filed for the insurance today, I was told. Don't worry about it. Yeah, right.

So I have two pieces of correspondence, both of which caused me to call either the insurance company or the hospital billing office. Each piece of correspondence has a cost and a price associated with it. Each phone call has a cost and a price also. All costs and prices are built into the $11,000 "statement" that I received from the hospital for a one-night stay and operation. No bills have yet come from any of the physicians, but we know they are coming.

My mother lived almost 20 years on Medicare. She rarely had any contact with the Medicare office. She only had one appeal, which she won. She was more often on the phone with BC/BS of Georgia, from which she had purchased a Medicare supplement policy. These are now replaced with Medicare Part D policies from private providers authorized by legislation, which was passed during Bush's term in office and without a method to pay for it. Purpose: Drive Medicare into the ground.

My point here was to show you some of the unnecessary costs of a private system and the greater efficency of a single-payer public system.

Back to why Congress will not vote for a public single-payer system: the answer is the profit. Insurance companies and pharma companies make hundreds of billions on a private system. They have thrown huge sums of money to elect candidates in both parties. Until we resolve to have publicly financed elections, we will go on having the best legislation that money can buy. You can take that to the bank, but you'll still have to stay on the phone with insurance companies. Have fun.