- CounterPunch.org - https://www.counterpunch.org -

Single-Payer and Medicare

Some critics have written, in response to my article calling for extension of the single-payer plan called Medicare to all Americans, that actually Medicare is a badly flawed program that leaves America’s elderly without coverage for many important health services, and which requires them to pay for supplemental insurance, or to go on Medicaid, too.

These critics are correct. Medicare is great as far as it goes. It is simple for people to use, allows them to go to the doctors of their choice, covers 80 percent of their care, and is liked by nearly all who use it. But it doesn’t pay for needed tests, only lets seniors buy mediocre versions of devices like hearing aids, and most importantly, it has been requiring more and more contributions by the elderly year after year. Today, Americans over 65 and the permanently disabled pay a greater percentage of their income for medical care than they did in 1964 before Medicare was established!

But having said that, I have to say that it has nothing to do with whether or not it makes sense to expand Medicare to all Americans as a way to solve our health care crisis–as Rep. John Conyers’ bill, HR 676, would do.

The reason Medicare is inadequate is because the Republicans and the conservative Democrats–the very “Blue Dog” vermin who, engorged on health insurance, hospital and pharmacy bribes and campaign donations, are undermining and destroying the already lousy health care “reform” plan of President Barack Obama–have been underfunding it, and performing a slow “privatization” of the program, chipping away at its benefits, adding increased self-pay requirements, and raising the Medicare tax on all workers.

They get away with this treachery because their actions only affect the minority of Americans served by Medicare.

If Medicare was expanded to include all Americans, suddenly this kind of political backsliding would be opposed by everyone who was in the program. It simply couldn’t happen. Rather, the public would, as one, demand better coverage, fewer self-pay requirements, and an end to supplemental insurance.   The right knows this, and the health care industry knows this, and that is why they are all bitterly opposing the expansion of Medicare–and yet it is so obvious that Medicare is the answer to America’s health crisis–and it’s staring us all in the face. It works, it’s cheap, and it could be implemented immediately.

We are being betrayed by President Obama and by the Democratic leadership in Congress, who will not talk about single-payer.

Not one of the committees working on the health reform bill in Congress allowed any discussion of Rep. Conyers’ HR 676. Under pressure from the public, and groups like Physicians for a National Health Program (PNHP.org) and Progressive Democrats of America (PDA), House Speaker Nancy Pelosi has agreed to allow a floor vote next month on Conyers’ bill, but that is a sop. Floor votes are heavily manipulated by the leadership and never go anywhere unless a committee has already held hearings and voted to approve a bill, which was not allowed to happen in the case of HR 676.

The so-called “reform” bill that is going to emerge from the current process is going to be the legislative equivalent of road kill, barely recognizeable either as health care or as a “reform.” It will be a Christmas present for the insurance industry, the hospital industry and the phramaceutical industry, all three of which struck secret deals behind closed doors with the White House.

It will set back health reform in America a generation, will require everyone to buy inadequate and overpriced insurance, overpriced drugs and to go to overpriced hospitals. And the cost of healthcare to individuals, businesses, and the nation as a whole (already the highest in the modern industrial world), will continue to soar.

This is not a case where the right thing to do is push for any bill, and then try to move on. This is a case where Obama and the Democrats have whored themselves out to the greedy industry that is causing all the problems, and are pushing a plan that is worse than nothing.

We should all be working to kill this whole thing and start over, with HR 676.

If Congress won’t do it, we need to start working for a new Congress in 2010 that will. No Democrat running for House or Senate in 2010 who isn’t solidly for expanding Medicare to all should get a single vote.

DAVE LINDORFF is a Philadelphia-based journalist and columnist. His latest book is “The Case for Impeachment” (St. Martin’s Press, 2006 and now available in paperback). He can be reached at dlindorff@mindspring.com