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Trashing Single-Payer

In an article in the Sunday New York Times, headlined “Medicare for All? ‘Crazy,’ ‘Socialized’ and Unlikely,”reporter Katherine Q. Seelye did her best to damn the idea of government insurance for all with faint praise.

To begin her article, Seelye quoted from a 2005 episode of the NBC drama “West Wing,” in which two presidential candidates, a Democrat played by Jimmy Smits and a Republican played by the always loveable Alan Alda, are discussing health care reform. The Smits character says his “ideal plan” would be Medicare for all. “That’s crazy” counters the Alda Republican. Then Seelye sequed to an opinion piece recently penned by real-life one-time Democratic presidential candidate George McGovern (a noble figure who nonetheless has long-since been type-cast as an out-of-touch extreme liberal loser), who favors expansion of Medicare into a national single-payer system.

Turning to the real world, Seelye then trotted out several economists, ostensibly to give a broad spectrum of arguments about the idea of single-payer, but in fact carefully avoiding including anyone who actually supports the idea of expanding Medicare.

As her representative liberal, she quoted Brandeis economist Stuart Altman, an Obama adviser during the presidential campaign, who said that while he is not “ideologically uncomfortable” with expanding Medicare, such a move would be “disruptive.” Going then to what she described as “the other end of the political spectrum,” Seeley quoted Robert E Moffit, of the right-wing Heritage Foundation, who claimed Medicare would mean too much government power over heatlh care.” Finally, seeking what she could call middle ground, Seelye turned to Dartmouth economist Jonathan Skinner, who claimed that expanding Medicare would be good because it would cover everyone, but bad because it would mean tripling the Medicare tax, currently 2.9% of paychecks.  If we were looking at a political yardstick here,  Seelye started at the 16” mark (Altman), then went to the 36” mark (Moffit), and finally went to the 24” mark (Skinner).

But where was an economist from the real left end of the political spectrum, over in the single digits of that yardstick? Altaman, representing the private insurance-based Obama approach, was hardly it!

Seelye might have gone to her colleague, columnist Paul Krugman, a Nobel Prize-winning economist at Princeton, who has on a number of occasions written and stated that a single-payer system such as Medicare for all would be “far cheaper” than any private insurance-based system.  Krugman, at least, would be over by the 10” or 12” line on a political yardstick.

Never has the Times really analyzed the true costs and benefits of the plan espoused in a bill, HR 676, authored by House Judiciary Chair John Conyers (D-MI), which would expand Medicare to cover every American.  Seelye mentions Rep. Conyers’ bill, but says innocently that it is “going nowhere” in the House. In fact, his bill, despite having been co-sponsored by 86 members of the House, has been blocked from getting a public hearing in committee by Nancy Pelosi and the House leadership, at the behest of the Obama White House, which is dead-set against a single-payer reform of health care.

The reason the Times and the insurance industry-besotted White House and Congressional leadership don’t want that analysis is that it would show clearly that a single-payer system would mean vast savings for all Americans.

Seelye quotes economist Skinner as claiming that Medicare expansion to cover every American would mean a tripling of the Medicare payroll tax—currently set at 2.9% of wages. But even if we accepted Skinner’s math, it is meaningless without looking at the savings side.

Sure expanding Medicare would mean higher Medicare taxes, but what about the following:

Medicaid, the program that pays for medical care for the poor, and is funded by federal and state taxes, would be eliminated, saving $400 billion a year.

Veterans’ care, currently running at $100 billion a year, would be eliminated.

Perhaps two-thirds of the $300 billion a year spent by federal, state and local governments to reimburse hospitals for so-called “charity care” for treatment of people who have no insurance but don’t qualify for Medicaid, would be eliminated.

Individuals and employers would no longer have to pay for private insurance.

Several hundred billion dollars currently spent on paperwork by private insurers would be eliminated.

Car insurance would be cheaper as there would no longer have to be coverage for medical bills.

Federal, state and local governments would no longer have to pay to insure public employees.

In short, if every person were on Medicare, the overall savings would overwhelm the small increase in the Medicare payroll tax of 5.8%.

The bottom line is that Canadians, who have Medicare for all, devote 10% of GDP to health care. Americans, who have private-insurance-based health care except for the elderly, devote 17% of GDP to health care.

Seelye and the Times have never mentioned any of this. Neither does President Obama or the Democratic Congress.

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

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Dave Lindorff is a founding member of ThisCantBeHappening!, an online newspaper collective, and is a contributor to Hopeless: Barack Obama and the Politics of Illusion (AK Press).

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