Obama health care summit and the fight for the single payer plan

Obama, in his recent weekly address regarding his budget plan, spoke tough when it came to his domestic priorities such as health care reform and renewable energy:

"The system we have now might work for the powerful and well-connected interests that have run Washington for far too long," Obama said in his weekly radio and video address. "But I don't. I work for the American people."

" 'I know these steps won't sit well with the special interests and lobbyists who are invested in the old way of doing business, and I know they're gearing up for a fight," Obama said, using tough-guy language reminiscent of his predecessor, George W. Bush. 'My message to them is this: So am I.'

Though its great to hear a president talk tough about issues that haven't been done so in a long time, it seems a bit like faux populism, especially when it comes to health care reform. He said that when it comes to health care reform insurance companies won't like "to bid competitively to continue offering Medicare coverage, but that's how we'll help preserve and protect Medicare and lower health care costs." But the fact is the only true way to lower health care costs and ensure universal is the single payer plan which is exactly what health insurance companies don't want because it would end their for-profit industry.

Dr. Daniel P. Wirt, a member of Physicians for a National Health Care Plan (PNHP), lays out that argument in a recent article asserting that:

the data and evidence are clear: to a scientific certainty, only a single-payer “Medicare-for-All” system of health care financing will solve the serious cost and access problems and achieve good, affordable health care for all in the United States. As a scientist and physician, this is my conclusion after studying the data for years. The data are voluminous, stretching back to World War II, and come not only from the United States, but from all other industrialized countries. Except for the United States, all industrialized countries have some form of universal health care...

All of the incremental reform programs proposed --- tax subsidies, health savings accounts, individual or employer mandates, increased regulation of for-profit insurance companies --- keep these proverbial foxes in the henhouse and are doomed to fail to control costs and provide universal access. Competition among the foxes does not benefit the chickens, the patients, the doctors or the hospitals. The for-profit insurance companies fundamentally reduce choice --- your preferred doctor or hospital is “out-of-network”? Too bad, we won’t pay, says your insurance company.

The data are in. Incremental reforms, mostly mandate schemes which retain the for-profit insurance companies have been tried in seven states over the past two decades: Massachusetts, Tennessee, Washington, Oregon, Minnesota, Vermont, Maine. In all of these states the reforms have failed to contain costs. In all but Massachusetts, they have failed to reduce the number of uninsured. In Massachusetts, there has been a modest decrease in the number of uninsured, falling from 13% of adults in 2006 to 7.1% of adults in 2007, but at the cost of a substantial increase in public spending (spending for “Commonwealth Care” was $629.8 million in fiscal year 2007, $1089.2 million in fiscal year 2008 and $1317.7 million in fiscal year 2009). Most of the gain in Massachusetts has come from expanding Medicaid and subsidizing the purchase of private insurance; very few people have signed up for the unsubsidized but mandated private insurance. Not to mention that 7.1% uninsured is unacceptably high. Far from controlling costs, these mandate plans will add hundreds of billions of dollars to the nation’s health care costs...

Under a single-payer, “Medicare-for-All” system, delivery of health care remains private. The providers of health care remain private. Patients choose any doctor and any hospital. Parenthetically, replacing the wasteful for-profit insurance companies with a single-payer national health insurance program for financing health care in the United States would save enough money (more than $350 billion) to not only achieve universal coverage, but allow the coverage to expand and be more comprehensive, while not spending any more than we do now.

Moreover, a recent report published by the National Nurses Organizing Coalition (a prominent union supporter of the single payer plan) "the first known study to provide an econometric analysis of the economic benefits of healthcare[ through a single payer plan] to the overall economy" concluded that:

Expanding Medicare to include the uninsured, and these on Medicaid or employer-sponsored health plans, and expanding coverage for those with limited Medicare, would have the following immediate impacts:

• Create 2,613,495 million new permanent good-paying jobs (slightly exceeding the number of jobs lost in 2008)
• Boost the economy with $317 billion in increased business and public revenues
• Add $100 billion in employee compensation
• Infuse public budgets with $44 billion in new tax revenues

Unfortunately advocates like PNHP for a single payer plan are barely even getting a voice in Obama's grand scheme for health care reform and his summit. In the media, their perspective and voices are equally marginalized. Yet 62% of Americans support a single payer plan as well as 59% of physicians. Initially Obama didn't invite any single payer plan representatives to his health care summit. It was only after various single payer organizations mobilized its members and sent a barrage of calls, faxes and e-mails to the White House did his administration invite Congressman John Conyers, the primary sponsor of the single payer plan bill HR 676, as well as the PNHP president Dr. Oliver Fein. With only 2 representatives out of the 100 or so guests present, their views will, again, most likely be marginalized in this summit.

Obama as well as many other Democrats consider themselves pragmatic when it comes to health care reform and dismiss the single payer plan as not "politically viable." A single payer plan is not "politically viable" according to them not only because of likely Republican opposition but, more importantly, lobbyist opposition, the kind of people Obama has publicly challenged on health care reform.

But for grassroots organizations that want meaningful health care reform, its not an option to settle for what politicians in Washington DC consider "politically viable." It should be their goal to change the terms of the political debate by building up public support and pressure on Congress as well as the Obama administration to force them to adopt the single payer health care as the only possible option to counteract lobbyist opposition. The fight to overcome its marginal status will start from the bottom up and just to get your foot in the door in the Obama administration's health care summit is just the beginning.

Yet, on the left, their are divisions over how to achieve health care reform. The most prominent progressive groups and labor unions close to the Democratic Party have adopted a compromised "multi-payer" health care proposal. This proposal would maintain public and private insurance plans which fail to address the root causes of rising health care costs and ensure universal health care, mainly a private, fragmented health care industry. They formed a non-profit lobbying group called Health Care for America NOW (HCAN) almost a year ago to promote their version of universal health care. HCAN was formed after the organization Health Care Now which consists of groups such as PNHP and the National Nurses Organizing Committee pushing for a single payer health care plan. HCAN.

As a result, the single payer plan faces a serious uphill battle with many institutional barriers and opponents. Yet the benefits and far reaching positive impacts certainly make it a worthwhile fight.