As the election looms, once more it is the extravagant and dysfunctional US health care system that shows how little the two main parties differ on the key issues facing working people. US doctors organized through Physicians for a National Health Program have been campaigning for the present system to be swept away and replaced by a single payer National Health Insurance scheme. Steffie Woolhandler and David Himmelstein are among the leading advocates for PNHP. By Steffie Woolhandler and David Himmelstein Like Capistrano's swallows, the Democrats always return to health reform. Unfortunately, this year they're showing little more brain power than the birds.
Don't get us wrong, were no fans of President George Bush's health agenda: Ship tens of billions of federal dollars to a panoply of healthcare firms, privatize Medicare, and dangle skimpy tax credits in front of the 44 million uninsured.
But Kerry seems intent on refilling a failed prescription for reform: by proposing to give hundreds of billions to private insurers in exchange for measly coverage for some of the uninsured.
Our healthcare system is so sick that even people with good insurance are feeling the fever. Premiums for employers and their workers are rising 12 percent, even 18 percent per year.
Insurance often proves illusory when it's most needed — payment denials, visit limits, loopholes and policy cancellations leave millions stuck with huge medical bills despite what they thought was good coverage. Most people's choice of doctors and hospitals is restricted. Seniors can't afford drugs, Medicaid recipients face draconian cuts and everyone's rushed out of the hospital.
Sadly, many Bush initiatives merely continued Clinton's policies. Kerry promises more of the same. He proposes to spend about $65 billion annually to expand coverage through two mechanisms: One, offer government subsidies for private insurance; two, expand Medicaid.
Kerry's massive new spending would leave at least 17 million uninsured by his own estimate) and tens of millions more with inadequate coverage, and stimulate the malignant A HMO fit for heroes? The bedrock of private health care provision in the US, the giant Health Maintenance Organisations (HMOs nearly doubled their profits in 2003, coining in a massive $10.2 billion.
The biggest increase has been at the Kaiser Foundation Health Plan, where changes in regulations assisted a dramatic transformation from a loss of $117 million to a profit of $995 million: but Blue Cross Blue Shield managed a modest but respectable 63 per cent increase in profits, which rose $2.1 billion to $5.4 billion.
One commentator pointed out that "The industry's soaring profits continue to irk both consumers and businesses who are shouldering skyrocketing healthcare costs without any perceived improvement in benefits." growth of healthcare costs.
In contrast, a single payer national health insurance (NHI) program could simultaneously cover all of the uninsured, upgrade coverage for most other Americans and save money. Under NHI, everyone would be covered for care at any hospital, doctor's office or clinic without copayments or deductibles. Patients would enjoy a free choice of provider, and doctors and nurses would be freed from the massive bureaucracy that encumbers care and wastes money.
For-profit ownership of hospitals and other clinical facilities would be proscribed, and private health insurers and most HMOs would be eliminated-saving billions now squandered on profits and executives' incomes, while upgrading quality.
Surprisingly, universal coverage under NHI would not increase health costs. At $6,200 per capita, Americans already spend nearly twice as much for care as do Canadians, Australians, Germans, Swedes and the Swiss-all of whom enjoy universal coverage and lower death rates than ours.
Much of the cost difference is due to our mammoth health bureaucracy, which wastes upward of $300 billion annually. NHI could slash bureaucracy by replacing the current wetter of private plans with a single public payer and simplifying payments. Even the Congressional Budget Office and the General Accounting Office concede that NHI could save enough on bureaucracy to cover all Americans for what we're now spending.
On the contrary, Kerry's plan would actually boost bureaucracy. He'd funnel hundreds of billions of additional public dollars through wasteful private plans. And he'd do nothing to cut the tens of billions that doctors and hospitals waste on insurance paperwork.
For the 85 percent of Americans who currently have insurance, Kerry offers virtually nothing. He'd just ask tax-payers facing skyrocketing premiums to chip in for the coverage of the uninsured. Much of what Kerry is proposing already was tried, and failed miserably.
NHI isn't just good policy, its good politics. According to a recent Washington Post/ABC News poll, 62 percent of Americans favor "a universal health insurance program, in which everyone is covered under a program like Medicare that's run by the government and financed by taxpayers."
Of course, NHI would be a death blow to the health insurance industry and it would threaten the super-profits of powerful drug and hospital firms. Presumably, that is why only Ralph Nader and Dennis Kucinich have been willing to buck the special interests, and say what Americans long to hear about health care: NHI can succeed. Healthcare is a right, not a commodity. • more details: www.pnhp.org