by Dr. Peter Mott
Why would many of us who worked hard to make Barack Obama president now work hard to oppose his health plan?
The explanation is quite simple: There are three possible directions to take with our complex, confusing, expensive, and failed health care non-system in the US – but only one of them is affordable. If our leaders choose one of the other routes they will vastly increase our deficit and we will find ourselves back in the old quagmire of rationing, with the same questions raised: Who will we exclude from receiving medical care? Which elderly citizens should not have major surgery – and at what age? Which should not have unlimited nursing home stays?
The three main options before us are:
- Continuing the current mix of hundreds of private insurance corporation plans and several public programs;
- A single payer system; and
- The Obama compromise – a public/private option.
The cost of the Obama plan, however, would be huge. Total health care costs in the US now are nearly twice that of any other industrialized nation per person per year; and our costs are rising at a rate faster than any other country each year. Imagine the total cost if, added to all this, we help pay for those same 90 million under- and un-insured people. What if we add long-term care insurance for nursing home or home care – which most Americans do not have now? On 7/17/09 Congressional Budget Director Elmendorf stated that the proposed Obama plan legislation “significantly expands…health care costs.”
The President’s hope is that a competing “public option,” on the model of expanded Medicare for All, would attract enough customers to force down overall costs. However, if the premiums for the private and public options are equal – and the insurance corporations will push for this – a majority of citizens probably will choose the private route. Then overall costs will go through the roof.
The “single payer” proposal is easiest to understand by looking at the bill now in Congress called HR 676 or “Medicare for All.” Everyone would be covered. We would have free choice of doctor and hospital. All needed services would be covered at no charge, including regular care, preventive care, emergency services and chronic, long-term care. Health care would be planned and organized by regions. The single plan would be paid for by a progressive income tax and an excise tax on corporations. Such single payer public plans have been shown in careful studies to save money over our current health care costs. After a transition period there would be expected savings of $350 billion per year. Administrative costs of the current Medicare program are only 2-3% - compared to those of private insurance corporations that are from 15-30%, largely because of advertising costs, shareholders’ profits, and high pay/benefits for executives.
Why does President Obama – who previously favored single payer – now push for a compromise? Because he wants to win Congressional votes – and the gigantic insurance corporations control many of those votes. Is this anti-democratic? Yes, indeed! But Congress won’t care about that unless there is a groundswell from the grassroots demanding what is best for America.
Seventy per-cent of the public have expressed support for national health insurance. Now that 70% must speak out. The stakes are high: public good vs. corporate profit. Battling the insurance corporations, their lobbyists, and the propaganda which is already spreading - will be tough. But when was democracy ever easy?