Spring Break
Laying the Foundations for a Single-Payer Solution
Simona Li '10, Health Care Columnist
Issue date: 3/10/08 Section: Opinion
An article from the December 15 New York Times by the co-founders of Physicians for a National Health Program blasted the Democratic presidential candidates for shying away from a single-payer healthcare solution. Instead, the authors claim, they are going back to the progress-stifling plans by Nixon and some individual states that have shown little concrete progress and even regression in some cases. The cowards.
Or are they? It is very likely that the candidates see the benefits of a single-payer healthcare system. First of all, let's make it clear that this would not mean government-run hospitals and socialized medicine, but rather socialized insurance. The government would pay the hospitals and doctors, who would still be privately run. This saves money by decreasing the ridiculous administrative costs we currently have (31 cents per dollar now, and only be 4 cents per dollar under a single-payer plan) by universalizing forms and documentation. Also, this would decrease prescription costs by allowing this 'single-payer' to buy medication in bulk quantities.
Sounds pretty good, right? So why haven't any mentioned this their campaign except Kucinich (and look where he ended up)? I am willing to say that most candidates realize the advantages of a single-payer system, but realize that there is just too much inertia in the US to hope that such a radical change can be implemented without mass protests and chaos. So what they have done instead is the next best thing - endorse a viable transition plan for the country leading to eventual drastic change. Like building a house, the first step is to level the ground to lay a foundation for future construction. Mandating that everyone be required to get insurance now will guarantee that in the future, new plans can focus on tackling the insurance companies and will not have to worry about both the companies and whether or not Americans will actually be affected by the change.
One of the primary critiques from the article's authors is that mandating healthcare is not an effective transition plan because of evidence from failed state plans. Massachusetts, Tennessee, and Vermont, for example, saw only minor decreases in the number of uninsured followed by increases a few years later after implementing healthcare mandates. The problem with this analysis is that its focus on figures may obscure actual decreases in the overall percentage of residents affected. It compares figures between years as far apart as 1988 and 2007, making it quite possible that the increase in uninsured only reflects a normal increase in the US population.
Or are they? It is very likely that the candidates see the benefits of a single-payer healthcare system. First of all, let's make it clear that this would not mean government-run hospitals and socialized medicine, but rather socialized insurance. The government would pay the hospitals and doctors, who would still be privately run. This saves money by decreasing the ridiculous administrative costs we currently have (31 cents per dollar now, and only be 4 cents per dollar under a single-payer plan) by universalizing forms and documentation. Also, this would decrease prescription costs by allowing this 'single-payer' to buy medication in bulk quantities.
Sounds pretty good, right? So why haven't any mentioned this their campaign except Kucinich (and look where he ended up)? I am willing to say that most candidates realize the advantages of a single-payer system, but realize that there is just too much inertia in the US to hope that such a radical change can be implemented without mass protests and chaos. So what they have done instead is the next best thing - endorse a viable transition plan for the country leading to eventual drastic change. Like building a house, the first step is to level the ground to lay a foundation for future construction. Mandating that everyone be required to get insurance now will guarantee that in the future, new plans can focus on tackling the insurance companies and will not have to worry about both the companies and whether or not Americans will actually be affected by the change.
One of the primary critiques from the article's authors is that mandating healthcare is not an effective transition plan because of evidence from failed state plans. Massachusetts, Tennessee, and Vermont, for example, saw only minor decreases in the number of uninsured followed by increases a few years later after implementing healthcare mandates. The problem with this analysis is that its focus on figures may obscure actual decreases in the overall percentage of residents affected. It compares figures between years as far apart as 1988 and 2007, making it quite possible that the increase in uninsured only reflects a normal increase in the US population.
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