The Social Medicine Portal

Who is afraid of single payer? Single payer advocates excluded from Thursday’s White House’s health reform forum.

by Claudia Chaufan

As far as we can tell, it is not primary care physicians who are afraid of single payer: poll after poll shows that they support social insurance – single payer type.

Or the American people, who support single payer every time they are asked the right questions and are given the chance to speak.

Could it be President Obama’s Secretary of Health and Human Services nominee, Kathleen Sebelius? Probably not. After all, her own state agency, the Kansas Health Policy Authority, recommended single payer as one of five health care financing options — by far the cheapest and most effective to eliminate financial barriers to health care for all Kansans — even if for some mysterious reason the single payer route so far has been rejected.

So why, then, have single payer advocates not been invited to the White House’s health care reform forum this coming Thursday, March 5, as the country gests ready for a major health care overhaul? Why Physicians for a National Health Program and Progressive Democrats of America, both supporters of single payer, are yet to receive that phone call? Why John Conyers, Chair of the House Judiciary Committee, and the very author of H.R. 676, the model bill for single payer advocates, among all others, is still waiting for an invitation?

And why are groups such as Families USA and Health Care for America Now among the guests, even when they are pushing for plans that include private insurers “yet hold them accountable”, and where the “bad customers” (the too old, too poor, or too sick”, need to rely on public subsidies? (And we do not need yet another task force to demonstrate how poorly these plans serve the interests of patients – the failure of over ten health care “overhauls” since at least 1988 provide ample evidence for it).

Could it be President Obama who is afraid of single payer? Not likely. After all, hasn’t he encouraged an open discussion on health care reform and promised a transparent debate that includes everybody?  Hasn’t he asserted that reform could not wait, eliminated unjustified subsidies granted to private plans or drug companies that operate at taxpayers’ expense, through Medicare and Medicaid, and use this money towards a “down payment” of over 630 billion dollars whose purpose is to revamp the health care system? And has he not invited all proposals, providing only general guidelines — that coverage would be universal, affordable, and portable — only warning that any proposal should include effective mechanisms to control escalating costs of health care?

And single payer, nothing more than a variety of social insurance, a public-private partnership combining the strength of public funding with private delivery of medical services (and real choices – of doctors and services) is the only policy option that can save money, not by excluding services or shifting costs to patients’ shoulders (“cost-sharing” in policy jargon), but by using the power of large pools — all Americans even — to slash prices and administrative waste. The power of single payer is evident in countless instances: for example, when comparing a ‘single payer sub-system’, such as the Veteran’s Administration, with the ‘regulated private competition” of Medicare Part D.

Well, my guess is that legislators, and White House party organizers, need to be reminded who they should be working for: the American people. Which is why doctors at Physicians for a National Health Program are encouraging Americans to call the White House to help it complete the guest list for such an important event.

My other guess is that the “s” word (single payer, social insurance) is still scary, not to Americans, but to American politicians.

So how about asking them to support “cooperative insurance” instead? Or forget about the labels and tell them that constituents would love to have a health care system that gives them access to comprehensive health care (outpatient, inpatient, dental, mental, visual, etc.), with free choice of doctors and hospitals, just by paying a predictable percentage of their income (around 5% with HR676) into a cooperative financing pool?

I bet this would draw many votes!