The majority of the American people want a single-payer health care system Medicare for all.
The majority of doctors want it.
A good chunk of hospital CEOs want it.
But what they want doesn’t appear to matter.
Because a single-payer health care plan would mean the death of the private health insurance industry and reduced profits for the pharmaceutical industry.
Presidential candidates John Edwards, Barack Obama, Hillary Clinton, and Mitt Romney and California Governor Arnold Schwarzenegger talk a lot about universal health care.
But not one of them advocates for single-payer because single-payer too directly confronts the big corporate interests profiting off the miserable health care system we are currently saddled with.
"Currently, we are spending almost a third of every health care dollar on administration and paperwork generated by the private health insurance industry," said Dr. Stephanie Woolhandler, an Associate Professor of Medicine at Harvard Medical School and co-founder of Physicians for a National Health Program. "Countries like Canada spend about half that much on the billing and paperwork side of medicine. If we go to a single-payer system and are able to cut the billing and paperwork costs of health care, that frees up about $300 billion per year. That’s the money we need to cover the uninsured and then improve the coverage for those who have private insurance but are under-insured."
"The idea behind single-payer is you don’t have to increase total health care spending," Woolhandler said in an interview with Corporate Crime Reporter. "You take the money we are now spending but cut the administrative fat and use that money to cover people."
None of the declared Presidential candidates with the exception of Congressman Dennis Kucinich (D-Ohio) is supporting single-payer.
Last year, Kucinich and Congressman John Conyers (D-Michigan), introduced a single-payer bill, HR 676, which garnered support of more than 75 members of the House.
Woolhandler expects that number to grow substantially this year.
And Woolhandler says grassroots activists have been mobilizing at the state level.
"State single-payer organizations have been very active," she said. "Early in the process, you can get a lot of politicians interested they want to show up at your rallies to show support for national health insurance. But as you get closer and closer to actual passage of a law, it is harder to keep the politicians on board."
"The legislature in California passed a single-payer bill last year, but everybody knew that Governor Arnold Schwarzenegger was going to veto it. So, it was very easy for the politicians to say yes, I’m going to support it. The insurance industry did not come in and throw their millions against it. But every time there is a real possibility of a bill coming through, the insurance industry has weighed in very heavily against."
Woolhandler called the universal health care law passed in Massachusetts by Governor Mitt Romney "a hoax."
"The core idea is the individual mandate forcing uninsured people to go out and buy insurance," Woolhandler said. "And if they don’t buy insurance, we are going to fine them. The first year it is an $80 fine. The second year, it’s half the value of the lowest priced policy we’re talking about a $2,000 fine. So, they are saying anyone who earns more than three times poverty has to bear the entire price of a private insurance policy."
"Romney’s bill was written by Blue Cross," Woolhandler said. "Romney was saying he was going to offer health insurance starting at $200 a month. And of course, that was a hoax. No insurance policy in Massachusetts comes in at $200 a month. When Blue Cross was asked to produce the policy, it turned out the policy was going to cost $380 a month for a policy that had a $2000 deductible. So, you are going to tell this poor bloke who is earning $29,400 a year that he has to go out and spend $4,000 a year on an insurance policy. And if he gets sick, he doesn’t even have any coverage until he has spent $2,000. And that’s not family coverage. That’s individual coverage."
Schwarzenegger would do the same fine individuals for not having insurance.
Former Senator John Edwards would have a Medicare-like system compete with private insurance.
"Edwards plan is not going to work," Woolhandler says flatly. "We know there is not going to be fair competition between Medicare and the private plans. You have to take on the private health insurance industry and tell them you are out of here. This is an entitlement program like traditional Medicare or Social Security. We are going to get the administrative efficiencies you get from running it as a single program and use that to expand coverage. That’s what you have to do."
Senator Hillary Clinton (D-New York) doesn’t want to get specific.
"She is nowhere on this issue," Woolhandler says.
Ditto Senator Barack Obama (D-Illinois).
But Woolhandler sees an opening.
"We are at the cusp of a new single-payer movement," she said. "Things have been quiet over the last eight years of so. Nobody was talking about health care. But now, everyone is talking about health care. And it’s obvious that politicians are realizing that health care can be a ticket to higher office. So, we are about to see a real blossoming of the health care debate and it will present an opening for us to get the single-payer idea out there."
[For a complete transcript of the question/answer format "Interview with Stephanie Woolhandler," see 21 Corporate Crime Reporter 9(12), February 26, 2007, print edition only.]