Is single payer healthcare reform too radical a step for America to take?

Tell MoveOn it is the right step.

“If you bend your back, people will ride your back.“- Taylor Rogers, retired Memphis Sanitation Department worker

There is a vigorous debate among those who agree that the US must move toward universal health insurance coverage, but disagree on how to get there. Health Care for America Now (HCAN) has pushed forward with a plan remarkably similar to that proposed by Barak Obama. It is based on the premise that the most politically feasible path forward requires giving Americans the choice between keeping their current insurance, or buying into a government sponsored plan based somehow on the Federal Employees Health Benefits Program, like members of Congress have.

Obama used to be a single payer advocate, and more than once has said that in the ideal world, single payer health insurance would be the best system possible, but given current political reality his plan is the best way to go. There are articulate voices arguing that the Obama-HCAN plan would be a strong step toward single payer. And there are others who argue that Obama and HCAN are simply afraid of the power of the insurance industry and their well-funded lobbyists.

If single payer is the ideal plan, then why compromise before we’ve even sat down at the negotiating table? I’m reminded of a piece NPR did on the 40th anniversary of Martin Luther King’s assassination. They interviewed two of the sanitation workers on whose behalf Dr King had gone to Memphis. Mr. Taylor Rogers was one of those men, and he recalled how bad the working conditions were, and how inspired they were by the words of Dr. King. He explained how thirteen hundred sanitation workers decided they werent going to take it any more. You know, if you bend your back, people will ride your back. But if you stand up straight, people can’t ride your back. So that’s what we did. We just stood up straight.

I went to medical school 35 years ago to learn how to take care of sick people, and that’s what I still do. I serve the sick and the suffering. I love my work, but I hate how I’m paid. The cost shifting, the complicated crazy undecipherable bills, the lives ruined by my unpaid bills turned over to collections, and on and on. The insurance industry, on the other hand, is here to serve its shareholders, not its customers. It takes money in the form of premiums from the healthy, and in order to make a profit, it must put all its ingenuity and guile into not paying for the care of the sick. That’s how they are profitable, take in money as premiums, but find ways to not pay it back out for health care. I am completely at odds with that. I want to take care of the sick, and they want to avoid taking care of them.

The sins of the insurance industry are well documented, and I don’t need to recount them here. Our entire system has become distorted, inefficient, and administratively bloated, and the reason is as simple as this: Americans want the sick to get taken care of, and the private insurance industry doesn’t want to take care of them. The insurance companies are the problem. They are not going to be a helpful part of the solution, but the HCAN plan protects them. And yet they are collapsing as our bloated system collapses. The for-profit insurance industry is like a dinosaur stumbling toward a tar pit. Let them go.

On the other hand, we have over forty years experience with a universal single payer system. It’s called Medicare, and although not perfect, it works very well. It already takes care of our sickest and most expensive patients, folks over age 65. Medicare is very popular. Medicare runs at about 3% overhead, compared with 15-30% overhead with private insurance. Expanding Medicare to cover everyone can hardly be called radical. It,s the most commonsense idea on the table.

As we seek our way forward, let’s hold our heads high and our backs straight. Who can foresee what compromises may have to be made to bring about true universal health care in America, but let’s start our with a clear voice: We want the best health care system in the world! We can have the best. If we walk into the room already compromised and bent over, they will climb on and ride. Stand tall, America. Medicare for All.


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