Wednesday, September 2, 2009

The Elusive Single Payer Plan


Mr. Obama, are you ready to rumble?

Mr. President, consensus is a good thing and compromise is often the basis for lasting agreement. But the stubborn refusal to accept the demands of the majority is a common response of a group that is scavenging off the welfare of the public. We see this response in mafias, in corrupt governments and with cartels and price fixing. This is the case of the insurance companies and the health care system in America.

In 2000 the World Health Organization ranked its 191 member’s health care systems using five criteria, they were:

1. Overall health of the population.
2. Even distribution of health (not big differences in health of wealthy and poor for example.)
3. Responsiveness of the health care system.
4. Even distribution of the responsiveness.
5. A fair distribution of the costs of health care.

Of the 191 countries the United States ranked 31st. Nonetheless, the US ranked first in per-capita health care costs in 2003, at $5,711 while France, who ranked number one in the WHO survey, had a cost of $3,048. So why is health care so expensive in the US?
It is important to consider health care as a portion of our GDP. Japan spent in 2003 right about 8% of GDP on health care, while Germany spent a little less than 11% of GDP compared the US which spent a little more than 15% of GDP on health care. We are losing competitiveness, especially in traditional manufacturing and we are short-changing the American people by selling them very expensive health care that does not deliver.

This is a simple business question. Most countries have a nationalized health care system, one set of system costs, granted, there might be large inefficiencies, but the system costs what it costs. Many countries have of a national public system with an alternative private system functioning parallel to it. The private system can remove some of the burden of the public system, or simply act as an upscale version of public system. Nonetheless, it is competing with a “free” option for the end user.

For the United States, no one contemplates creating a complete public option, with large state run hospitals. Our mix of private, state owned and non-for profit hospitals supplies a good quality health care to a large portion of the population. The problem is that it is too expensive and that it doesn’t reach all end users. Almost 45 million Americans don’t have health care, which is over 15% of the population. By eliminating one tier of margin (insurance companies), and aggregating all buying power in a single payer nationalized insurance, two things are accomplished. One, everyone in the United States is insured, and two, the overall cost of health care would drop significantly.

Everyone who works and reaches a certain threshold of income pays in. All employers who employ pay in (maybe have waivers for first few employees as to not create barriers of entry for small entrepreneurs). People who are independently wealthy or live off fixed or investment income would simply pay their portion in when they file their income taxes, always when income is above a certain threshold.

We let free enterprise battle for the Federal dollars, with the end user deciding where the money is spent. All people who live in the United States would be covered, and all those who work, have income or employ, pay in. By spreading the burden we make ourselves more competitive. In this plan no one is asking for anything for free. All will be paid for, the budget will balance every year. No one living in the United States will ever have to go to bed at night worried about what they will do if they get sick or how to pay for their own or loved ones health bills. People will not go into debt to pay for basic health care.

If the American people decide this is what they want, it is up to our politicians to implement it. If, on the other hand, a large portion of our politicians are in the pockets of insurance companies, we the people have a very simple and effective option. Remove the entire congress. Our founding fathers wisely gave us this option. Every two years we can replace the entire congress if need be. It is time that the people of this country demanded a single payer health care option. No compromises. If we the people demand this, it will be accomplished, maybe not the first time around, but certainly by the second. If we told the 111th congress, if we do not have a single payer plan approved by both houses of congress within your existing terms, we will replace the entire congress and all Senate seats that are open, and we said it loud enough, I think they would listen. Enough propaganda from greedy insurance companies and paid for pundits and politicians, enough with Blue Dogs and whatever other ridiculous excuses are found to do nothing. We the people want universal health care, and we want it now.

A movement must begin that demands action in congress. It is all or nothing. Political affiliation is irrelevant. All we ask is that you go to Washington, and pass the legislation that we want. We are talking about four or five major pieces of legislation per congress. If the movement gained enough momentum, it could play a big enough role where both parties would be scared into actually solving problems and creating viable legislation. Clear concise goals for each congress, with a completely transparent score card. This would be a grass roots movement, and authentic American rebellion against the ineptitude of our current political leadership.

Mr. Obama, you said you would bring about change. Have you ever heard of change without a battle? Take a leadership role on this. Bring it to the people. Present a single payer plan to the country. A simple plan, all receive health care, all who have income above a certain threshold pay in, all who employ a minimum number of workers pay in. Everyone has the same card. While diversity may be one of our most treasured qualities, when we are sick we are all the same. Mr. Obama, make this your fight. If this congress can’t do it, we will do it in the next congress. Lead the people in demanding what is rightfully theirs.


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