Tempering Health-Care Goals

[question everything]

The Wall Street Journal

Tempering Health-Care Goals
Democrats' Proposals Build on Current System, Reject Single-Payer
By LAURA MECKLER
January 25, 2008; Page A5

WASHINGTON -- Democrats backing universal health care long favored a single-payer system, with government replacing insurance companies and covering everyone. More recently, most have advocated a more modest -- and politically feasible -- system that provides universal coverage by building on the employer-based system. But the ghost of single-payer past looms large. The idea remains popular with a large bloc of Democrats in the House, who are in a position to make life difficult for any new Democratic president. Single-payer legislation backed by Rep. Dennis Kucinich, (D., Ohio), who dropped out of the presidential race yesterday, has 89 co-sponsors -- more than a third of Democrats.

(snip)

Under a single-payer system, the federal government would use taxes to provide health insurance for all Americans, much as it does for senior citizens in Medicare. There are variations; a more extreme version would have the government own hospitals and employ doctors, like it does through the Veterans Administration. But, in general, the idea is that citizens would get their insurance from the government, not from an employer or private insurer.

The leading Democrats have tried to walk a careful line on the issue so far. Mrs. Clinton, Mr. Obama and former North Carolina Sen. John Edwards all have health plans that would build on the existing system of employer-based coverage. All call for a government-organized health-care pool in which people could buy private plans, with subsidies for those who can't afford the premiums. Yet all three also propose a government-run, Medicare-like alternative to compete with private plans, which would also be offered within the pool. Let people decide which they like best, they say. "Allow Americans to decide whether they want...government-run health care or whether they want to continue the private system that we have today," Mr. Edwards said in September at a forum organized by Families USA and the Federation of American Hospitals.

Any Democrat who won the White House and proposed such a plan would be in for a big fight. Liberals would back a government-run option as the closest thing they have to single payer. Insurance companies would fiercely oppose it. Supporters of single payer cite universal coverage, administrative efficiencies and equitable financing as the chief advantages. Detractors say government would have way too much power to set prices and benefits and would likely do a poor job. It also would be disruptive to the 160 million Americans who currently have employer-provided coverage. Forty years ago, single payer was Democratic orthodoxy, backed by then-powerful labor unions. Republican President Richard Nixon proposed a universal-coverage plan requiring employers to provide coverage -- not that far from what leading Democrats support now. But Democrats killed it, holding out for a single-payer plan.


Since then, the party's priorities moved rightward. During Ronald Reagan's presidency, Democrats focused on protecting existing government programs, not creating new ones. In the late 1980s, Sen. Ted Kennedy (D., Mass.), a leader of the single-payer movement, proposed an employer-mandate bill of his own. In 1993, President Clinton proposed a plan that also built on the existing employer system. Many Democrats concluded that single payer might be good in theory but impossible to achieve politically. "There are a lot of different ways of skinning this cat," said David Nexon, a longtime adviser to Mr. Kennedy and now senior executive vice president with AdvaMed, a lobby group representing medical-device manufacturers. "The key is to get one that can pass and provides decent-quality, affordable coverage to everyone, not the one that is the perfect system in the eye of whatever beholder it is."


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http://online.wsj.com/article/SB120123158058516047.html (subscription)

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1. Unfortanately, "politically feasable" usually doesn't mean universal coverage

Read this:
http://www.nytimes.com/2007/12/15/opinion/15woolhandler.html?_r=1&oref=slogin

Many states have tried this "policitally feasable" combination of public/private partnership to provide universal coverage, and all have one thing in common: they have NOT succeeded. In fact, the number of uninsured has continued to increase in many cases.

Anything other than single-payer, government-sponsored health care will do nothing but line the pockets of big insurance companies.

NONE of the major candidates are in favor of single-payer universal care. We should demand NOTHING LESS of them.

[question everything]

3. Congress will have to initiate it

The reality is that most people who do have insurance get it through their employers and like it... until they really need it.

[Cleita]

2. How many people have to die of treatable diseases and

who go untreated and unable to work for political feasibility? Anyone who bothers to learn about this knows that the middle-men, the for profit insurers and for profit HMOs, are at the crux of the problem and any effort to include them will only exacerbate an already deteriorating system and make it more costly than it already is.