William Brinker: Health care reform: Single-payer is the answer

To the Editor:

The Great Health Care Reform Debate has finally begun, this time in the context of a truly massive financial and economic failure brought on by the market-worshipping excesses of the GOP. You would think this a golden opportunity for the Democrats to champion practicality over ideology, and deliver affordable universal coverage that actually works, modeled on examples that do. The trouble is, either they have bought into Reaganism themselves, or they have been bought.

The Democratic party seems to be unaware of the fact that a majority of Americans now favor a universal health insurance program that is administered by the government and funded by taxation [ http://www.consumerwatchdog.org/resources/PollMemo.pdf ] . What most Americans want is something that works comparatively very well in most advanced countries, and yet it is off the table here in the USA solely because it is inconsistent with the very political philosophy that has just brought the global financial system to its knees.

Politics aside, it is ethically offensive that private health insurance companies (PHI’s) compete with one another on the basis of who can most successfully exclude from coverage those that are likely to become ill. It is also scandalous that customers must pay high premiums in part to cover the cost of PHI staff hired for the sole purpose of fighting or denying legitimate claims, a documented practice. The responsibility of the PHI’s for this state of affairs is heightened by the decisive role they have played over the decades in shaping their own market through their lobbying efforts on Capitol Hill. They are not hapless participants in a market naively and incompetently devised by the US Congress. They designed this very profitable failure, and are now using some of our premiums to defend it from the properly irate public.

There are proven, affordable alternatives to tolerating these abusive business practices.

Since the early 1990′s, numerous credible studies have found that Single Payer (SP) systems typically boast administrative costs in the 5% range, while PHI’s average over 20%. Others found that whereas only 18% of respondents using PHI’s were satisfied with their coverage, over 70% of those in SP systems were satisfied with theirs, overblown horror stories from Canada notwithstanding. Further, several federal government studies (GAO, CBO) have found that the administrative cost savings from implementing SP would more than offset the cost of providing coverage to all of those that are currently uninsured.

I see little hope of achieving significant health savings while indulging the scale of administrative costs exhibited by PHI’s, whereas the savings available from a shift to SP, judging from longstanding and numerous foreign examples, would be in the hundreds of billions of dollars annually. As in:
EVERY YEAR. Forever.

We need to face the fact that in certain markets private competition has failed us utterly, even unforgivably. When those markets are important ones, like health insurance, theory and ideology must give way to experience and practicality. As evidenced by the numbers of the uninsured, and of bankruptcies caused by medical expenses (1 every 70 seconds!), Americans plainly cannot afford the Reaganite ideological purity that the GOP, and sadly too many Democrats, continue to demand of them. Nor should they, as they contemplate the economic carnage around them, the bitter fruit of that failed and hopelessly simplistic ideology.

Single Payer is the answer. The data are irrefutable. Look it up. Tell your friends. Write your congressional representatives. The time is now.

William Brinker
Boulder