The need to push for a Single-Payer healthcare system

Writing in Labor Notes, Rose Ann DeMoro, Executive Director of the California Nurses Association/National Nurses Organizing Committee argues that the leadership of organized labor owes it to its members and the American people at large to champion the necessity of a government-financed, single payer healthcare system. The logic is simple enough for anyone to follow: She explains that under single-payer, workers don’t face the loss of health benefits if they are fired or are forced out on strike. “You don’t face employers constantly shifting costs onto your back,” you don’t have to worry about retiree health care if you are able to retire before age 65 and you are no longer at the mercy of the insurance industry predators who routinely deny care.”

It’s nice to see someone not only advocating for “universal” health care, but also making the critical distinction of noting the importance of single payer and the superiority of that system. Employer-mandated “pay or play” plans as well as requirement from California and Massachusetts legislatures that all state residents must buy health insurance are shown to be far less desireable outcomes to single payer, with their notable shortcoming exposed. She points out, however:

Most of the alternatives offered instead are based on expanding the role of the insurance industry. Among the ideas now being touted by, among others, liberal advocacy groups and a few Presidential candidates, are mandates that everyone be required to buy insurance, tax deductions to encourage people to buy insurance, taxes on employers to pay for more insurance, and expansions to existing federal or state programs to buy insurance for the low income.

For more in a similar vein, see this editorial by Al Hart, also in Labor Notes, this editorial from the Seattle Post-Intelligencer in 2005 in support of single payer and this book club discussion over at TPM Cafe on Jonathan Cohn’s book “Sick: The Untold Story of America’s Health Care Crisis—and the People Who Pay the Price.”

Wikipedia has a decent summary of the ins and outs of single payer here, and this helpful FAQ explains the difference between single payer and universal health care:

“Universal coverage” refers to a health care system where every individual has health coverage. According to the U.S. Census Bureau, there were 46.6 million Americans without health insurance coverage in 2005. In contrast, there are no uninsured Canadian citizens – their government-run system provides universal coverage.

A “single-payer system” is one in which there is one party – usually the government – responsible for paying health care claims. This contrasts with the current U.S. health care system, where thousands of private insurance companies are responsible for paying some claims, while federal and state governments are responsible for others.

In most cases, “universal coverage” and “single-payer system” go hand-in-hand, because a country’s federal government is the most likely candidate to administer and pay for a health care system covering millions of people.

It is hard to imagine a private entity having the resources – or even the inclination – to establish a nationwide health care coverage system.

However, it is possible to have universal coverage without having a single-payer system. For example, some experts have suggested that we incrementally reform the U.S. health care system to provide a government-funded safety net for the sick and poor, while requiring those more fortunate to purchase their own policies. Various political interests will likely prevent this from ever happening, but it is possible to construct such a system, which would provide universal coverage with multiple payers.

While it is theoretically possible to have a single-payer system without having universal coverage, it is extremely unlikely to ever occur because the single-payer would undoubtedly be the federal government. If our government adopts such a system, it would not be politically viable for them to exclude any citizen from coverage.

When you’re done digesting all of this information, check out the archives at dKos, where you can peruse 77 different diaries discussing the merits of instituting a single payer system, or this primer by Gar Lipow, writing over at MaxSpeak, fittingly enough entitled “SINGLE PAYER HEALTH – THE BASICS.” (h/t to this old post by Ezra Klein)

Also, David Sirota links to a good post by Kevin Drum, and underscores that single payer is quite popular with the American public (at least according to the opinion polls he cites).

Sirota concludes that: “[T]he entire idea that the public would oppose such a reform or see it as “out of the mainstream” – an idea pushed by the class of professional election losers in Washington – is just not backed up by the facts.”

Update: Check out Barbara Ehrenreich’s latest column in The Nation entitled “Healthcare vs. the Profit Principle.” She takes on greedy hosptal executives (whom she correctly refers to as “medical profiteers”) who argue that human beings should only get the amount of lifesaving healthcare they can afford.