Personal Health

We Already Have a Popular Single-Payer Health Care System -- It's for Active Military and Veterans

Oddly the states with the most people enrolled are down South -- where political leadership has been most opposed to single-payer.

In this year's health reform debate, congressional Democrats quickly took proposals for a single-payer system off the table, claiming it was "unrealistic."

But more than 9 million people in the U.S. have already signed on to a single-payer system that has proved both workable and popular: TRICARE, the Department of Defense's program for active-duty military and retirees.

Even more interesting: According to a Facing South analysis, nearly half of TRICARE beneficiaries live in the South -- states where congressional leadership has been most vocal in opposing public involvement in health care.

Last week, a top-rated diary at DailyKos by a person claiming to be "an active duty obstetrician/ gynecologist in a major medical facility on the East Coast" noted that:

9.2 million active-duty and retired uniformed service member and their families receive their health care from the federal government. My family and I receive free health care from the federal government ...  I am struck however that nobody has brought up the simple fact that the government already provides free health care in a single-payer model to over 9 million of its population.


I decided to look into where TRICARE beneficiaries were located. According to my analysis of TRICARE data, 47 percent of the 9.2 million using TRICARE live in 13 Southern states:

TRICARE South.jpg

Overall, 6 of the 10 states with highest number of TRICARE beneficiaries are in the South. This makes sense given the high number of military bases in Southern states, as well as the concentration of active-duty and retired military in states like Virginia.

The high Southern enrollment in government-run TRICARE, where the military pays private doctors in a single-payer system, seems at odds with the vocal opposition of Southern lawmakers to anything smacking of public involvement in health care.

South Carolina:

The Palmetto State has the eighth-highest TRICARE enrollment in the nation, nearly a quarter-million people. But South Carolina's overall population ranks only 24th nationally -- meaning that the share of South Carolinians using TRICARE's single-payer government option is one of the largest in the country.

Contrast TRICARE's popularity in South Carolina with these words last week from Sen. Jim DeMint, R-S.C., who has led the Republican Party's attempts to torpedo health proposals that involve the government: 

"[Democrats] think we're stupid," said DeMint. "They think that you don't know that government does not work well, that the same people who cleaned up after Hurricane Katrina are the ones who can really run our health care system with that personal touch that we all want ... They're talking about a government plan that can do things that no government plan has ever done."


The 233,725 people who chose to use TRICARE in DeMint's home state probably disagree.

Chris Kromm works with Southern Exposure magazine and the Institute for Southern Studies in Durham, N.C.
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