Joining the Health Care Debate

My dear friend Susan lives in Canada and complained the other day about how her friend has had to wait three months for a follow-up mammography when a first one came back suspicious. She used that as the example of why a single-payer system creates a terrifyingly rationed health care system. I have recently had a health care crisis, and I, too, having exorbitantly expensive health care paid for by my employer, have had to wait. The myth of rationed health care is part of the propaganda campaign being waged by the insurance industry lobby. We already have to wait for procedures. The difference in America is that if you know the right person, you can move yourself up the list.

Another privilege that remains invisible to most mortals.

We subscribe to the Public Citizen Health Research Group Health Letter.

Its June 2009 issue takes on the silence in the current health care debate on the efficacy of a single-payer system. Essential to the debate is a comparison between a single-payer system and the universal coverage based on multiple payers, meaning that there would be competing insurance companies providing service. Here is an excellent issue-by-issue discussion of the benefits of a single-payer system.

You can keep current with legislative efforts to change our health care system by going here.

Most of the criticism about single-payer is paid criticism coming from the insurance companies that have a lot to lose. Like most American industry, rather than invest in the future, insurance companies during the last twenty years, wasted money buying each other up and paying off massive debt while laying off workers. Back when, doctors were paid, some say extravagantly, but I believe commensurate with their education, but now its insurance executives and the owners of for-profit health care facilities that make the money. My primary health care doctor, a lovely man who spends time with his patients, no longer has the income he once had. He's even moved from being a Republican to a Democrat in the Bush years. Every time I open the New York Times and see another supplement advertising health care services, I get angry. We shouldn't be marketing health care, but promoting good health. There is a difference.

The worst aspect of the multiple payers health care system involves risk pooling. Under a single-payer system, the entire population is part of a single risk pool. People with pre-existing conditions cannot be excluded. However, in the current system, insurance companies attempt to attract lower risk patients, and premiums vary according to risk. Insurance becomes unaffordable for many with health care conditions that then lead to becoming uninsured. The New York Times, this week, finally wrote about the bankruptcy of those with health insurance, because the small print excluded many expensive and needed procedures. Three-quarters of those pushed into bankruptcy over medical bills had insurance at the time of on-set of their disease or condition. It's the limited coverage problem that pervades the private insurance business, and will pervade any health care reform if we do anything less than single-payer.

We need to inform ourselves and fight back against one of the most powerful lobbies in the nation. President Obama is right to take on the issue, now let's make sure he really solves it, and just doesn't do a cosmetic job that doesn't do what it needs to do. With so many Americans aging out of the job market, as the Boomers grow up, and with childhood obesity at crisis levels, we had better prepare for providing health care fairly and equitably across the population.