Environment

National Health Insurance Now, Not Later

Health care costs continue to skyrocket, and 47 million people remain uninsured. Sooner, if not later, the system will crash. Must we wait for that to happen?
Who's afraid of the single payer health plan, otherwise known as National Health Insurance? Big Pharma and the medical establishment, that's who -- because "single payer" is the big bad wolf that's huffing and puffing and is about to blow their house down. And it's a big house, bloated by excess profits, government subsidies and sheer theft of the people's money.

To paraphrase our former President, Richard Nixon, "you're not going to have America's healthcare system to kick around forever."

Health Insurance has been a political football in this country for decades. It's been on every politician's laundry list, in one form or another, in every election. There have been employer plans; there have been government plans; city, state and federal plans. It's been brought up again and again in every State of the Union address, year after year. Despite all the talk and attention by both parties, census figures show that a record 46.6 million Americans, including 8.3 million children, have no health insurance at all, at a time when the cost of health care has gone through the roof. How can they afford to see a doctor or fill a prescription?

Are we going to go on talking the talk and getting ripped off by Big Insurance forever? Why can't we have what every other industrialized nation in the world enjoys -- some form of national health insurance?

That may be the first question some Democratic Congressman or Senator may ask now that they have a majority in both houses of Congress -- but I doubt it.

A look back at the endless squabble over health care in this country will reveal where this timidity comes from. It all began with the bug-a-boo of "Socialized Medicine" raised by the American Medical Association after World War II when they saw their "fee-for-service" system being threatened. The system was: You go to the doctor, you get a service and you pay a fee; and that's the way they wanted to keep it, by God!

But after the war, something new was blowin' in the wind. People like Henry Kaiser, the auto maker and ship builder, came up with a Health Maintenance Organization (HMO) for his employees. You pay a small monthly fee, you get your entire medical and hospital needs free of any other charges.

The city of New York jumped right in with HIP (Health Insurance Plan of Greater New York), a pre-paid health plan for city employees. "Socialized medicine!" screamed the AMA. Physicians and surgeons manned the battle stations. Many saw their seven figure incomes taking flight.

Other HMOs mushroomed around the country. And then, in 1965, President Lyndon Johnson made "medical care for the aged" part of his Great Society package. We know it today as Medicare. Then came Medicaid, medical care for the indigent. The flood gates were opened. For the first time, huge amounts of government money started pouring into the health care system.

The insurance industry knew a good thing when they saw it. Organized medicine, the AMA and its state and county medical societies, did not -- paralyzed by the fear of government intrusion.

Insurance companies relished the enormous cash flow of government money emanating from Medicare and Medicaid and other government programs like Champus, medical coverage for servicemen and their families.

Insurance companies set up their own private plans, yes, HMOs, to sop up all that loose cash. They turned pre-paid plans into their opposite -- not "socialized medicine" for the people but corporate welfare for the insurance companies. Through the years, they increased premiums and cut services, raking in billions in profits instead of providing not-for-profit medical services to their subscribers. The doctors allowed themselves to be co-opted and blind-sided. They allowed the pre-paid plans to get away from them. Their fear of "socialized medicine" dimmed their vision.

Instead of "socialized medicine" the doctors got privatized sweatshops where some doctors can't make medical decisions without the approval of an HMO bureaucrat. Managed care became mismanaged medicine.

The epitome of outrage was Hillary and Bill Clinton's opportunistic brainstorming of a National Health Plan in 1992. They devised a government health plan they knew would never work. They dangled it before the nation. They were too politically sophisticated not to know they were playing right into the hands of the insurance companies.

The Clintons set the national health care movement back a generation. Now, Hillary Clinton is running for president in 2008. What's her health care program? More of the same. Single payer? No way.

The current health insurance system violates the very essence of the insurance principle -- the widest coverage for the least cost. The larger the pool, the more efficient the system.

In the current US system, there are literally tens of thousands of different, and overlapping, health care organizations generating a blizzard of paperwork in an administrative wilderness creating enormous waste -- thousands, if not millions of people pushing paper around. They are driving doctors, trying to do a job, up the wall with the different forms needed to be completed in order to get paid, to say nothing of patients fighting their way through a jungle of obstacles trying to get the health care they need.

A single payer system would eliminate all that.

One administrator or "payer" -- yes, a government supervised agency, would collect all health care fees and pay out all health care costs. In a single payer system, all hospitals, doctors and other health care providers would bill one entity for their services. Every US citizen would be covered. It's been done successfully in most "civilized" countries. Why not here?

US health care is in crisis, today. The system just isn't working, for anybody, except, maybe the health insurance industry and their HMOs that are siphoning off whopping profits. But doctors aren't happy. Patients are burdened more and more with increasing co-payments. Health care costs continue to skyrocket. And 47 million people remain uninsured. Sooner, if not later, the system will crash. Must we wait for that to happen?
Stephen Fleischman, television writer-director-producer, spent thirty years in Network News at CBS and ABC, starting in 1953. In 1959, he participated in the formation of the renowned Murrow-Friendly "CBS Reports" series. In 1983, Fleischman won the prestigious Columbia University-Dupont Television Journalism Award. In 2004, he wrote his memoir. See: www.ARedintheHouse.com, E-mail: [email protected]
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