Why Single-Payer Health Care Can't Wait
A steady stream of reporters from corporate news media outlets warmed things up at a frigid Camp Hope in Chicago last week, when CNN and the local affiliates of ABC, NBC, FOX, and CBS all called at Drexel Park on day two of the 18-day vigil urging President-elect Obama to make good on his campaign pledges.
Universal, publicly funded health care was the theme, highlighted by a presentation from one of the nation’s top authorities on the subject, Dr. Quentin Young, MD.
For decades, Dr. Young has promoted the benefits of a Canadian-type, “single-payer” system like most of the world’s industrialized nations. Young’s office is in Hyde Park, the same venerable neighborhood where Camp Hope is pitched, a few short blocks from Barack Obama’s home. His partner in the practice has been Barack Obama’s personal physician since the Senator moved into the historic district a few years ago.
Young related that in Obama’s early years in politics, he used to say he was all for single-payer. Then in 2006, the Senator started to say he was still for it, but that it would never happen without a solid Democrat majority in Congress. Then during the presidential campaign, he said that because of America’s rich experience with employment-based insurance that option would be included in the mix of plans he supported.
The white-haired physician paused for a moment and added, “Well I can tell you as someone who has practiced medicine for decades, Americans may have experience with employment-related health benefits but it’s been far from a happy experience.”
Even though health insurance costs in the U.S. add $1200 or more to the price of a car produced here Young said, big employers like General Motors Corp., along with the Chambers of Commerce are opposed to single-payer insurance because “they’re trapped in ideological blinders and unable to see the issues clearly.” However, in Canada, he said, the Big Three automakers and the Canadian Auto Workers Union both say they like the system they have, even admitting when pressed that it gives Canadian industry an advantage.
“The power of corporations is incredibly strong. Take a look at the number of registered lobbyists
Big Pharma (the pharmaceutical industry) employs to sell its message to the U.S. House of Representatives: it has 675 registered lobbyists, plus staff, and there are 435 members of the House. ‘Hope and change.’ I like it,” Dr. Young said, “but I’d rather hear us talking about solidarity.”
Discussing some of the health care proposals under discussion, Dr. Young offered, “The ‘incremental’ plans put forth by some activists are idiotic. Every year companies try to off-load more of the cost of health benefits onto workers. I just hope that when Obama gets into office he quickly says ‘The situation is much worse than I thought. We need single-payer insurance now.’ What’s more likely, though,” Dr. Young observed, “is we will start hearing some baloney like, ‘Don’t worry, the public plan is so much better that it will eventually win out over the private one.’”
Referring to past proposals that maintained the central role of insurance companies, Dr. Young pointed to Hillary Clinton’s plan early in her husband’s first term and charged, “The only thing worse than the crushing defeat it got would have been if it was enacted.”
“You know, we hear so much about the wonders of the free market -- that invisible hand with the extended finger…” Young mused, and then took the next question.
Health care costs a total of $2.5 trillion dollars in the U.S., or 1/6 of the country’s entire Gross Domestic Product, Dr. Young said. He briefly described two of the reasons for the high cost: overspecialization and high administrative overhead.
Regarding the rate of doctors going into specialty practices, Dr. Young said the ratio of primary care doctors to specialists is recommended to be about 70-30. “That might be considered just a little high by some, but it should be at least 60-40. In the U.S. right now it’s 50-50 and the percentage of general practitioners is still dropping.”
He used his own Hyde Park office as a good example of high administrative costs, which nationally account for nearly a third of all health care outlays. “We have five doctors and the equivalent of 14 full time employees. Five of those employees do nothing but shuffle paper,” he added ruefully.
Nick Skala, a law school student and intern with Healthcare Illinois who accompanied Dr. Young to the presentation told the 50 attendees that, “People sometimes ask me ‘Can’t we have serious health care reform without taking on the private insurance companies? Obama says his plan will compete with private insurers.’ The thing is, it’s not just insurance companies that people will be competing with, but drug companies, right-wing think tanks, and a massive, ongoing public relations campaign.”
One way to judge the level of dissatisfaction with the current private, for profit system, Skala said, is that 12 to 14 states now have proposed either legislation or citizen initiatives to get a single payer program. “The California legislature twice voted in favor of a single payer plan, only to have it vetoed both times by Governor Schwarzenegger.”
Asked about Obama’s cabinet nominees, Dr. Young said, “One or two of them have souls, but most of them don’t.” He added that one of his partners recently told him what one of his patients said about the President-elect, “So far all he’s given us is hope.”
Camp Hope continues in Drexel Park until January 18.