The Case for Single Payer Healthcare

Background
I covered a conference in April called "Transforming Healthcare," where healthcare experts, physicians, and local officials talked about the reform of our healthcare system. There were a whole lot of news angles to take when writing this story (every story needs a particular angle of focus, especially with something as complicated as the US healthcare system) so I focused on one of the biggest controversies- universal healthcare. In particular, a single payer system that would completely overhaul private health insurance as we know it.

For the pro side, I talked to physician and former Morehead Clinic President Dr. Ewell Scott. He believes not only should there be universal healthcare, but that we should get rid of private health insurance providers altogether. His case is that healthcare should be a basic human right, not a for-profit industry that capitalizes off of other people's illnesses and injuries. He says with one government-funded single payer health plan, we'd save hundreds of billions of dollars a year.

As for cons of universal healthcare, I spoke with Jim Frogue, the Executive Director of the Newt Gingrich Center for Healthcare Transformation. He says universal healthcare is too costly for taxpayers, and that existing single payer systems such as the one in Canada, and partially socialized medicine in France, are failed systems. He says government intervention isn't the answer for healthcare reform, but that there needs to be a movement to encourage preventative measures among individuals. Frogue argues if Americans ate healthier, exercised more, and stopped smoking, there would be collectively less hospital visits, meaning the cost of care would decrease.

Dr. Daniel Mongiardo is Kentucky's current Lieutenant Governor and also a licensed physician. He gave the keynote address during the dinner at the conference. His view of universal healthcare is somewhat pragmatic when compared to the ideas of Frogue, who says no, and Dr. Scott, who gives a definite yes to a single payer plan and for doing away with private health insurance firms.

Mongiardo wants universal healthcare, but isn't calling for a single payer plan. However, one should also take note that Mongiardo is running for US Senate in 2010. And he's got some pretty stiff competition with Jack Conway, Kentucky's current Attorney General (Conway's already been endorsed by Louisville Mayor Jerry Abramson, Congressman John Yarmuth, and State Auditor Crit Luallen). All that being said, Mongiardo knows he can't be too controversial with what he says, because he needs all the votes he can get. Guys like that, you've gotta take everything they say with a grain of salt. All of the advantages of a government-funded plan and money-saving measures would be rendered useless if you kept all the private insurance companies around, too. It's like when McCain said he supported a Cap and Trade system on companies for their carbon emissions, but with no mandatory caps (you need mandatory caps for the system to work). It just doesn't make sense pragmatically. You either do or you don't. My opinion after hearing both sides is that if you're gonna do it, go full out. Keeping around the private health insurance firms doesn't save any money and adds to the problem of too much bureaucracy.

All of us agreed that our system was broken and needed some serious change. During Frogue's presentation, he showed a pie graph with all the major concerns of the current healthcare system in the United States. The figures in the graph were gathered by the Newt Gingrich Center. Surprisingly, cost was the number two issue behind wait time. I'll address both of those issues in this blog, and I hope that by the end, if I haven't convinced you to support single payer universal healthcare, that I've at least made you think about it and maybe you'll do your own research on your own.

An American Single Payer Heathcare System: The Cost Perspective
Right now, healthcare is one of the most profitable industries in western society. There are approximately 1,500 different health insurance providers alone in the United States. Ewell Scott proposes that with a single payer plan, we would save hundreds of billions of dollars a year with the elimination of competition in the healthcare market as it becomes a public service; Frogue believes converting to an electronic system would save hundreds of billions per year in the elimination of bureaucracy and fraud. However, both of them disagree on the implementation of a single payer plan.

Right now, nobody can afford healthcare right now, especially the poor; a bad diagnosis can spell financial ruin for the average family in America. Say there's one person, working at McDonalds who makes $20,000-$25,000 per year, who has a spouse that makes relatively the same amount of money. With a $40,000-$50,000 income, it's absurd to think that these people can afford $15,000 per year for a healthcare premium.

Also, it's been shown that employers have been steadily reducing health benefits in the last ten years while keeping wages either stagnant or at a very slight increase. As of right now, the majority of employer-provided healthcare plans are inadequate for the workforce. There needs to be something besides underfunded medicare and medicaid policies and shoddy employer-provided health insurance. As the years have progressed and the economy has worsened, employers may have given very slight wage increases, but they have drastically cut benefits to save money on personnel costs. This means employer-provided health insurance is still too costly for a majority of families.

The paradox is that the more well-off you are, the healthier you are; you have money to buy and cook healthy food, the money for a gym membership, and thus have low health insurance premiums. The same applies for the poor, except vice-versa. The poorer you are, chances are, the worse off you'll be healthwise. The people who need care the most aren't getting it because they aren't insured, or they just don't have the money. In most cases, it's both.

Indeed, Jim Frogue believes that preventative measures taken by individuals would mean collectively less hospital visits, thus citing less demand, driving the price of healthcare down. Basic economics. However, this is under the assumption that everyone will quit smoking, and that Americans will suddenly become proactive in living a healthier lifestyle as they eat less fast food and cook more, and take the initiative to exercise at least 30 minutes a day. This is wishful thinking at best, considering our obesity rate is the second-highest in the world. (33% of our population is considered obese; Saudi Arabia is #1 at 35% of their population) Instead of crossing our proverbial fingers and hoping everyone will do the right thing, our government needs to be proactive and realize that everyone has the right to get taken care of when they're sick, rather than suffer. Moreover, private health insurance companies who pick and choose the areas they cater to and who would rather make the most money than get people the care they need contribute nothing to society.

Ewell Scott goes so far to say that healthcare is a basic constitutional right. As we have the right to life, liberty, and the pursuit of happiness, healthcare involves the issue of life. If you're sick or injured and lose your life because you couldn't afford adequate care, that serves as a testament against the entire privatization of the healthcare industry, as corporate profit gets between you and one of your basic constitutional rights under the bottom line of the private health insurance industry.

Some things are meant for industry, free market, and competition. Restaurants, stores, and manufacturers having some healthy competition with one another and avoiding monopoly is a huge help for the populace; it divides demand evenly and keeps prices low. But some things are more important than profit, and when the greed for profit keeps needy people from their essential rights to life, that's when the government needs to intervene. It just isn't right for someone to make money off of someone else's suffering; in essence, that's what happens when healthcare is made into a business instead of a public good. Take a look at one of the many free public goods we take for granted everyday; firefighters.

Did any of you know that firefighting used to be a privatized industry? You had to pay to have an emblem of a particular unit on your home. If your home was on fire, and a rival firefighting team saw that burning home with another emblem, they would just drive on by. That's a prime example of profit coming before the good of the people. Just like the private healthcare industry. Some things are just better socialized- as a public good, profit is not an issue, but rather the well-being of the people. Sometimes, people getting what they need is more important than making money.

Critics of the single payer system point to Canada; they say it takes months to wait for an operation, and that systems are so backed up with people making unnecessary hospital visits and abusing the free care system. Critics also say eliminating the private health insurance industry would leave a great deal of people out of a job. However, this all too often spouted opinion is based on information that is wrong, or nonexistent. I mean, how many people do you know go to the hospital for kicks? Certainly given the ratio of doctors to residents in rural areas (1 to 100 in Eastern Kentucky) the emergency room is the only option for most people. And considering a lot of people don't have the money for health insurance, and considering private health insurance companies often refuse to serve rural areas for the lack of money available, that leaves people further and further in the dark.

For example, Canada's healthcare system has half as much money as we put into ours. We can do a single payer system better, because we have the people, the money, and the technology necessary. Combining a single payer healthcare system with a completely digital health database would be the first system of its kind; a system without unnecessary bureaucracy and wait. In Canada, nobody has to wait for emergency care, and nobody has to wait for urgent care. The only wait time is for operational procedures like knee or hip replacements. While you may have to wait three or four months for that hip replacement, most of the time, that replacement was needed for a condition that had been exacerbated over a period of five years. If care is free, then what is a few more months time?

While eliminating the private health insurance companies would leave people jobless, it's simply a matter of priority. One has to ask a poignant question to oneself; is it more important to give Americans the care they need, or is it more important for to keep pointless jobs available that only serve to deprive people of care for purposes of profit?

Eliminating Healthcare Bureaucracy
In January, my right hand needed $13,000 worth of surgery to fix a hole from a mishap I had on New Years' Eve. This was for the anesthesia, the operation, the pre-op, and for the labor. I can honestly say that 90% of the time I spent in the hospital wasn't on my operation, x-ray, pre-op, or post-op. It was in the paperwork, in calling and confirming my being on my mom's health insurance plan, calling her to get her social security number and birthdate to verify it all, and other such nonsense that could be avoided very easily if done digitally.

Jim Frogue made a very good point in that after Hurricane Katrina, millions of paper records were lost with the damage from the storm. He used the Jiffy Lube example; if someone from New Orleans drove to Houston for an oil change, Jiffy Lube could pull up your last visit on their computer with just your name, see exactly what they did, how much it cost, and what procedures they used. However, if someone from New Orleans drove to Houston who had cancer, Houston hospitals wouldn't have the faintest who that person was. In this sense, Frogue is right on; this is exactly backwards from where we need to be, especially as we move into the next decade of the 21st century.

This isn't a cost-saving measure; the real cost-saving comes from doing away with private insurers. Indeed, this alone would save us $400 billion each year in taxpayer dollars. And as we saw with the computerization of records by banks, money wasn't saved, but financial procedures have now become much more streamlined and efficient. Most other practices have now computerized their records, making wait time for clients almost nonexistent. Considering healthcare is such a necessity, why haven't healthcare records been computerized? With a single payer system that makes healthcare a right and not a commodity available only to the rich, and a digital system that eliminates wait time and paper clutter, the quality of healthcare would improve drastically.

Imagine if doctors could spend their time being doctors instead of insurance couriers! If nurses could spend their time caring for patients instead of filling out unnecessary paperwork! If people could get the care they need for free without having to compensate for losing a valuable day of work or wasting time they don't have waiting or filling out paperwork! What's not to like about this system?

Why the Obama administration is wrong about healthcare reform
Private insurers follow a bottom line of making the most money and earning as much profit as they can, not getting people the care that they need. In businesses like manufacturing, food service, and retail, profiteering and private ownership is encouraged in our economy as it allows for competition, low prices, and everyone always striving to make the best quality products for as little a cost as possible, meaning the people reap the benefits. There's nothing wrong with capitalizing off of consumer goods.

However, capitalizing off of human illness and debilitation is inherently wrong. We all deserve quality care when we're sick and injured, and making money should never come between someone living and dying; any sensible person would find profiteering from the misfortune of others to be entirely immoral. However, this is the primary goal of the private health insurance industry. Private insurers have no qualms with denying the uninsured the care they need if it doesn't suit their corporate interests, or if they see no profit potential. Private health insurance companies contribute nothing worthwhile to society.

Barack Obama proposes a free, government-funded insurance plan to all those who want it, but he's doing nothing about existing private insurers, whose sole purpose is to make money, not provide for those who need it. All of the cost-saving measures that would take effect in a single payer system would be nonexistent if private insurers are allowed to stick around.

If we want affordable, quality healthcare for all citizens, and if we want to eliminate unnecessary bureaucracy and wait time, then a single payer healthcare system is the only true reform. Eliminating private insurers and computerizing healthcare records are the first steps to take. Obama needs to put his re-election hopes aside, man up, and challenge the private health insurance once and for all by allowing a single payer option on the table in his vision for universal healthcare reform.

What the media hasn't told you about the stimulus and GOP opposition

Introduction
At just the end of January, 150 workers at the Cintas uniform plant, formerly known as Bath Manufacturing, were laid off. Many of these people had been at BM since its opening around 20 years ago. Some of them had come from Carhartt's plant which was also closed a few years ago, due to outsourcing and automation. A good number of these people had only worked this job, and didn't have training in any other field. These people all have families to care for, children to feed and clothe, and bills to pay. Luckily, Cintas gave its employees a great severance package; this included an unemployment check for the next two years and free tuition toward vocational training at the Rowan MCTC campus for an associate's degree in a number of fields.

I'm currently working on an in-depth report for radio on these displaced workers, and have spoken with Sen. RJ Palmer and Bath County's Judge-Executive along with some of the workers at a recent MCTC open house. I plan to speak with Rep. Sannie Overly and Governor Beshear in the early part of the week and get their take on these workers and the state of Kentucky's economy as a whole. When I asked a woman who had been laid off what her question to her elected officials would be, this is what she said-

"I don't blame Cintas. They did right with me. They took care of us. I blame the government for letting the economy get this bad. I blame them for not doing enough."

We all know by now, if any of you watch the mainstream media, that jobs are on the decline to say the least, and that this recession is getting worse. And if you've been paying attention to the news in Kentucky(or to my feed in the left column), you'd know we're in the midst of a $450+ million dollar deficit and our government has cut programs across the board. Our president has the difficult task of finding a way to create around 3 million more jobs in one of the worst economic spells in our nation's history. After being president for about two weeks and change, he's brought forth an extensive bill that aims to put money into infrastructure, education, renewable American energy, and new ways of taxation. The full text of the bill can be found here. Or, if you don't want to slog through 300 pages, you can find summaries here, here, and here.

This bill also proposes detailed solutions for fixing healthcare, adapting our economy to the needs of the 21st century, helping displaced workers like those I spoke with last week, and saving jobs and services in the public sector. More crucially, this stimulus plan has allotted money to potentially help states in severe economic trouble, like Kentucky, create jobs of their own and help save vital programs like affordable public education. If you'll read the criticisms of this bill, they harangue Obama for sneaking in unnecessary earmarks for things like National Mall lawn restoration and new cars for federal government use. Social conservatives have a problem with the allocation of funds to give sex education that isn't focused on abstinence. Fiscal conservatives are at loggerheads with the president on the proposed funding of arts education in schools and with money set to go toward anti-smoking efforts. Big Oil and its political minions are against the potential $1 billion toward Amtrak and more funding toward renewable energy. While a few of these criticisms hold water, and while I by no means readily agree with every provision of this proposal, this stimulus is needed far too much to stall progress based simply on disagreements with minor, inconsequential components of the package.

Outrageously, House Republicans all voted a unanimous "NO" to the stimulus recently, and now the bill is being hashed out in the senate. Republican leaders have been mouthing off to the press about their drooling over a juicy opportunity to block the stimulus package's progress, ending it before it reaches Pres. Obama's desk.

After being trounced in November, the GOP has been gaining momentum after selecting a black RNC chairman, and now they have an opportunity for more political gain should they block the stimulus bill. Should this happen, Republican legislative leaders and potential challengers for the 2010 midterm elections will capitalize doubly from stopping progress and the potential creation of jobs and economic and environmental reform. Not only will they have struck a blow against the president, the liberals and the democrats, but they will energize their ideological base, and future efforts to stall the democrat's endeavors will gradually gain more grassroots support.

Essentially, House and Senate Republicans are presently more interested in political gain than they are in creating new jobs.

I've read plenty of conservative criticism to the president's plan, especially on the funding of contraception and safe sex education, but I have yet to hear any leaders from the GOP and conservative base propose innovative solutions of their own on how to fix the credit situation, the housing crisis, the job market, climate change, efficient use of energy, or education. In this post, I'll be defending some of the most important parts of the stimulus bill that don't see as much of the press coverage.

Energy Independence and Sustainability
The president has allotted a total of $54 billion to reduce our dependence on foreign oil sources and to develop ways to use energy wisely and sustainably; $32 billion for an energy grid that supplies power from green sources (wind, solar, biofuel, hydro, geothermal), $16 billion to retrofit homes to the new energy grid, and another $6 billion to help mid to low-income families weatherize their homes.

We cannot afford to invest in radical, oppressive Sunni regimes like Saudi Arabia and the UAE for oil- moreover, we cannot afford to ceaselessly burn fossil fuels and needlessly harm the environment with our methods of extraction and use. This money would be used to make sure we have steady footing in the green energy market, meaning we could potentially be in the vanguard of the green movement; a world leader in green technology and a shining example to rapidly industrializing countries like China and India. This could provide some obvious economic advantage over those countries as well, as we would start to produce our own clean energy sustainably and renewably for relatively little cost in the long-term.

Reforming our Economy for the 21st Century
In an earlier blog entry, I announced and explained my support of The Venus Project, a rough outline for a resource-based economy, rather than a money-based system. While Obama's plan differs a bit from Fresco's, they both agree we have the science and technology available to make significant economic progress. Obama has proposed $16 billion be used for nationwide wireless broadband internet access ($6 billion) and for more scientific research grants, facilities, and equipment ($10 billion). Should this plan go through, not only will we potentially unearth efficient new ways to do business, but American businesses will have unprecedented new advances in communication; this new system would better orchestrate delivery, inventory, manufacturing, and consumer demand. The possibilities would be veritably limitless.

Transforming Public Education to Meet Tomorrow's Needs
One of the more popular talking points for Reagan-ites and proponents of small government is that public education is a state responsibility, rather than a federal one. However, this is a dead idea- in today's global economy and fast-paced online society, our government can no longer ignore states that languish in key areas. Take Kentucky and education, for instance.

Obama has allotted a whopping $141.6 billion for public school reform- this includes $41 billion for school modernization and repair initiatives, the Education Technology program, Title I, and IDEA (Individuals with Disabilities Education Act). Proposals also include $79 billion for state relief so programs like KEES and others don't get cut. That money would also fund an incentive program aimed at rewarding states that bolster education, along with various other public services. Finally, this provision allots $15.6 billion for pell grants, helping college students like me and you get job training without sending us into tens of thousands of dollars into debt; another $6 billion would go toward modernizing public universities.

This is maybe the most important provision for states like Kentucky- we're damned if we do and damned if we don't when it comes to education. The more debt we run into, the more we cut education and other key programs. And the more we cut these programs, the less opportunity we have to get the education needed for quality jobs, leading to more people leaving the state for education and careers. On this path we're in now, Kentucky has virtually nothing to offer to potential employers looking to relocate; without an educated workforce or places to educate a potential workforce, we're in progressively worse shape each year. In the long term, this stimulus plan could potentially mean lots of help for Kentucky. Kentuckians, of all people, should be behind this endeavor.

A Computerized Healthcare System
In my most recent entry, two primary healthcare measures were observed- one was a government-offered plan to the uninsured, and one was a modernization of current healthcare records. The infrastructure has been proposed to cost $24.1 billion; $20 billion would be used to help prevent casual mistakes in the recording of information, organize records efficiently, and overall provide more effecive healthcare without all the bureaucratic mess we have now. $4.1 billion would be allotted for preventative healthcare measures (wouldn't anti-smoking programs sort of fall under this category, too?) and research for more effective methods of healthcare.

While I'd like to see an overhaul of publicly-owned pharmaceutical companies and the healthcare market be consolidated into a solely government-owned operation, this is a step in the right direction. Ideally, this would mean that walking into a doctor's office would only require you to give your name and an ID, and your plan, claim, and payment could be processed almost instantly. This means doctors can actually spend their time being doctors instead of insurance couriers.

More Help for Displaced Workers
Like the folks at Cintas, a high cost of living and the outsourcing of jobs has led to displacement for millions. $102 billion has been included in the stimulus package to increase unemployment benefits and provide more training for those needing 21st century job skills ($43 billion). This $102 billion includes $39 billion for the keeping of employer-provided health insurance, and more short-term medicaid options. Also included is $20 billion for food stamp benefits. Conservatives like to call that "pork barrel spending," and equate food stamp recipients with the cultural stereotype of the wifebeater-clad lottery ticket/big screen TV purchaser. In reality, food costs have risen while wages have remained stagnant. This is aimed at simply easing the burden for those who struggle with buying enough groceries to feed their families.

Much-Needed Relief for States
Presently, taxes would need to be raised even more on the middle class for states to continue hiring necessary public sector jobs like firefighters, police officers, teachers, garbage collectors, and the like. With a proposed $91 billion, $87 billion would fund a temporary increase in the matching rate for state medicaid programs, and $4 billion more would fund state and local law enforcement.

So, there you have it. I was, too, at first assaulted by right-wing commentators' protests on the cable news networks, complaining about the stimulus using misleading facts and associations of dectuple-figure (12-digit) numbers with controversial legislation regarding abortion, contraception, and things of that nature. Indeed, the more controversial parts of the stimulus package are inconsequential in comparison to the funds being spent on the programs that matter- the programs that would create jobs and reform our economy and energy system for the better.

I admire Barack Obama for sticking to his guns and being the agent of change that he built himself up to be in his campaign. And God willing, this necessary change we need won't be stopped by petty partisan politicking from the right. There's simply no place for it in such dire times.