(You are not going to like this) Why we MUST demand single payer.

denem

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Sun May-10-09 07:21 PM
Original message

(You are not going to like this) Why we MUST demand single payer.

Edited on Sun May-10-09 08:08 PM by denem

Answer: Because we won't get single payer this time, but its the best way to get the best public option. Second, maintaining the Health Insurance model, is not a concession, but the best foundation for the future of universal public insurance. Why?

!. Pure Politics - the Health Insurance Industry will not accept a universal public option without a stick - the credible threat to decimate their racket. Moving the 'debate' from 'health plan vs health with a public option' to 'public option vs single payer' is a game changer.

2. The health-economics arguments are the same: The bigger tent (a) the lower the costs per member (b) The more comprehensive the insurer, the more bargaining power they have with health care players: drug companies, big hospitals, private medicine in general.

3.(adding to two) Single Payer (and the public option) goes a long way towards fixing Medicare / Medicaid. The old and the disadvantaged are the most expensive of all of the population. Expanding medicare as an option lowers cost per person, "Medicare for all" provides the lowest cost per person.

4. The public option + mandates is problematic - politicians need to explain exactly how low income earners and the poor do not suffer in comparison to single payer. They either have to choice of expanding public coverage or putting together a truly fair hybrid.

So basically, the arguments for a public option and single payer point in the same direction. By demanding single payer now, with clear simple points, we both advance single payer and demand sideways,that the Health Insurers back down on accepting a real public option.

BTW - An earlier poster was dead on in framing this about Health Insurance. I ask those against a public plan - Why are you defending Private Insurance companies? , Have you been screwed by Insurance companies? You know Private Insurers are accountable to no one but their shareholders. We need public insurance that is accountable to the public.

'Medicare Plus' Medicare plus some additional services not covered now) is an easy sell. Medicare for all is KISS. I don't like the term 'single payer'. Universal Public Insurance is simple and saleable.

Finally - I believe it would be better to keep the plan as insurance, with a sliding scale for the lowest paid.. The whole 'Why should I pay for ... xyz' disappears in an insurance system. There are easy retorts: you mean you don't want to may for grandma, because she costs the health system so much etc.

From my experience in the UK and Australia, if health care does not follow and insurance model, but goes into general revenue, or even a revenue fund, its not long before Government poaches the money, and health care is starved.

How would private insurance fit in? in a universal system Easy. The first part of a private premiums goes directly to the public insurance agency. They can offer whatever a la carte they want. Again, it's the politics of the thing. It's not single payer, you can insure with anyone you want to (but...

In summary we need to demand 'universal public insurance, accountable to the public', drop the words 'single payer', talk about Medicare Plus for all, and be aware they we are advancing the public option, and will hold the final (compromise) plan up to real scrutiny.