Healthcare... What's the real skinny?

The best plan is single payer,
where everyone is included, nobody is
excluded, and profiteers are out of the picture.

Paul Krugman
A new blog from The New York Times
tracks the health care debate as it unfolds.

More Health Care Overhaul News

The Conscience of a Liberal: The Public Option as a Signal

Here are extracts from Payl Krugmans ideas...

"Let’s talk about health care around the advanced world."

Every wealthy country other than the United States
guarantees essential care to all its citizens.

There wide variations in the specifics, with three main approaches.

First, In Britain, the government runs the hospitals and employs the doctors.
Like every system, the National Health Service has problems, but it
provides good care while spending only about 40 percent as much per person
as we do in America. The Veterans Health Administration, which is run
somewhat like the British health service, combines quality care with low costs.

The second route to universal coverage leaves the actual delivery of
health care in private hands, but the government pays most of the bills.
This is how Canada and, in a more complex fashion, France do it. This is a
system familiar to many Americans, since even those of us not yet on
Medicare have parents and relatives who are. French health care is excellent.
Canadians with chronic conditions are more satisfied with their system than their
U.S. counterparts. And Medicare is highly popular.

Finally, the third route to universal coverage relies on private insurance
companies, using a combination of regulation and subsidies to ensure that
everyone is covered. Switzerland offers the clearest example: everyone is
required to buy insurance, insurers can’t discriminate based on medical
history or pre-existing conditions, and lower-income citizens get government
help in paying for their policies. The Massachusetts health reform more or
less follows the Swiss model; costs are running higher than expected, but
the reform has reduced the number of uninsured.

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify
America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route.
True “socialized medicine” would undoubtedly cost less, and a straightforward
extension of Medicare-type coverage to all Americans would probably be cheaper
than a Swiss-style system. That’s why many believe a true public option competing
with private insurers is important: otherwise, rising costs could all too easily
undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on
what we have now. We already know that such systems can work.

We can do this. At this point, all that stands in the way of universal health care in
America are the greed of the medical-industrial complex, the lies of the right-wing
propaganda machine, and the gullibility of voters who believe those lies.


Krugman also has some critical commentary regarding "off the table" Single Payer

Why Americans hate single-payer insurance

Because they don’t know they have it.
A commenter points me to this:
At a recent town-hall meeting in suburban Simpsonville,
a man stood up and told Rep. Robert Inglis (R-S.C.) to “keep
your government hands off my Medicare.”
“I had to politely explain that, ‘Actually, sir, your health care
is being provided by the government,’ ” Inglis recalled. “But
he wasn’t having any of it.”

One of the truly amazing and depressing things about the health
reform debate is the persistence of fear-mongering over
“socialized medicine” even though we already have a system in
which the government pays substantially more medical bills
(47% of the total) than the private insurance industry (35%).

In a way, this is the flip side of the persistent belief that
the free market can cure healthcare, even though there a
re no places where it actually has; people also believe that
government-provided insurance can’t work, even though
there are many places where it does
— and one of those places is the United States of America.

Here is what Doctors have to say about Single-Payer:
Single-payer national health insurance is a system in which
a single public or quasi-public agency organizes health financing,
but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive,
yet inadequate. Despite spending more than twice as much as the
rest of the industrialized nations ($7,129 per capita), the United
States performs poorly in comparison on major health indicators
such as life expectancy, infant mortality and immunization rates.
Moreover, the other advanced nations provide comprehensive
coverage to their entire populations, while the U.S. leaves 45.7 plus
million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is
because we have a patchwork system of for-profit payers.
Private insurers necessarily waste health dollars on things that have
nothing to do with care: overhead, underwriting, billing, sales and
marketing departments as well as huge profits and exorbitant executive
pay. Doctors and hospitals must maintain costly administrative staffs
to deal with the bureaucracy. Combined, this needless administration
consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money.
The potential savings on paperwork, more than $350 billion per year,
are enough to provide comprehensive coverage to everyone without
paying any more than we already do.

Under a single-payer system, all Americans would be covered for all
medically necessary services, including: doctor, hospital, preventive,
long-term care, mental health, reproductive health care, dental, vision,
prescription drug and medical supply costs. Patients would regain free
choice of doctor and hospital, and doctors would regain autonomy over
patient care.

Physicians would be paid fee-for-service according to a negotiated formulary
or receive salary from a hospital or nonprofit HMO / group practice. Hospitals
would receive a global budget for operating expenses. Health facilities and
expensive equipment purchases would be managed by regional health planning boards.

A single-payer system would be financed by eliminating private insurers and
recapturing their administrative waste. Modest new taxes would replace premiums
and out-of-pocket payments currently paid by individuals and business. Costs would be
controlled through negotiated fees, global budgeting and bulk purchasing.
The links below will lead you to more specific information on the details of single-payer:

Single-Payer Overviews
The Physicians Proposal for National Health Insurance
“Proposal of the Physicians’’ Working Group for Single-Payer
National Health Insurance,” JAMA 290(6): Aug 30, 2003

Key Features of Single-Payer
A useful handout detailing the main features of single-payer.
Statement of Dr. Marcia Angell: U.S. National Health Insurance Act
A great overview of the need for and logic of a single-payer system.
Perfect as an introductory handout.

Liberal Benefits, Conservative Spending
Another great introductory handout.

The case for eliminating the private health insurance industry
By Don McCanne, MD and Leonard Rodberg, PhD

Public Citizen's Response to the Citizens' Health Care Working
Groups Interim Recommendations (En Español)
A great overview on the benefits of a single-payer system
by Public Citizen.Rep. Dennis Kucinich Tackles Health Care

Rep. Kucinich talks with Truthdig about the health care crisis
in America.Financing single-payer national health insurance:
Myths and factsDownload PNHP's Brochure

and Howard Dean, a physician and former
head of the Democratic Party weighs in...
he says co-ops and abandoning a public
option would do more harm than good.

with video

Dean: We will have a public option

Aug. 17: Former DNC Chairman Howard Dean explains why
he believes a public option is likely be included in the health
bill during the reconciliation process between the House and Senate.

Dean, a physician, argued that a public option is fair and said there
must be such a choice in any genuine shake up of the existing system.

"You can't really do health reform without it," he said.
Dean maintained that the health insurance industry has
"put enormous pressure on patients and doctors" in recent years.

He called a direct government role "the entirety of health care reform.
It isn't the entirety of insurance reform ... We shouldn't spend $60 billion
a year subsidizing the insurance industry."

His remarks were echoed by lawmakers as well as a top labor union
official, John Sweeney, who said the option was the only way to force
"real competition" on the insurance industry.

The United States is the only developed nation that does not have a
comprehensive national health care plan for all its citizens. About
47 million of America's 300 million population are without health
insurance.


And for the most up-to-date info.... on healthcare
reform,current trends, best options, and how to get there...

listen to this show:KBOO Labor Radio Fifth Monday:

The Truth About Healthcare in America:

90.7FM, KBOO Radio, August 31st at 6 pm

http://laborradiocollective.blogspot.com/

Call in and join the conversation:
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