Single-Payer and H.R. 676: Debunking the Myths

Here's some responses to the false, but commonly made, criticisms of single-payer health care plans. H. R. 676 is a Congressional bill co-authored by Dennis Kucinich, has now gained over 75 cosponsors and the endorsements of powerful unions and organizations, such as the AFL-CIO, California Nurses, PNHP and One Care California, as well as Michael Moore. It would set up a national, not-for-profit, health care system in the United States and provide fully comprehensive health care to ALL Americans, including all primary, emergency and long term care, office visits, medication costs, dental, vision and mental health, as well as drug and alchohol counseling. Further it, eliminates all co-pays, deductibles and medication costs. It is the simplest, most reasonable and dependable solution for the U.S. health care crisis.

1.) We already spend so much on healthcare, so we can’t afford a universal healthcare system that covers everyone:
This is false. In fact, H.R. 676 spends $56 billion less each year, while covering all Americans with fully comprehensive medical benefits. The reason is because, as a for-profit industry, the current private system wastes 31% of the $2.2 trillion spent each year on non-healthcare related costs such as, marketing/advertising, billing and paperwork, and corporate profit. H.R. 676 eliminates profit and is thus able to operate at a much more efficient 3% administration cost, saving over $4oo billion a year. Utilizing this money is what makes true universal healthcare for all Americans possible.

2.) I’ve read about other countries with healthcare systems similar to H.R. 676 that have experienced rationing. Wouldn’t H.R. 676 lead to rationing:
No. There are quite a few things to be said about rationing, but first and foremost, H.R. 676 is designed to eliminate rationing. Though other countries operating with a single payer healthcare system have sometimes experienced rationing, they devote only half as much money towards the system. And that is the critical point involved here. Under H.R. 676, the U.S. will spend almost twice as much as other countries and get the best care because of it. Under the current private system, the U.S. also spends twice as much as any other country, yet ranks consistently lower on vital indicators of health, such as infant mortality, average lifespan, and rates of terminal illness like heart disease and diabetes. As stated above, this is because the current system wastes more than 1/3 of all healthcare spending on non-healthcare related costs. To paraphrase Marcia Angell, former editor of the New England Journal of Medicine, for other countries the problem is money, for the U.S. it is the system.
Furthermore, it must be pointed out that the current private system is already effectively rationing access to healthcare. Same-day access to primary-care physicians in the U.S. is 33%, significantly lower than other single payers like the U.K. at 41%, Australia at 54%, and New Zealand at 60%. Poll after poll reports many Americans admitting to going without needed care because of out-of-pocket expenses like co-pays and deductibles. Moreover, 46 million Americans are uninsured and another 50 million are considered underinsured.

3.) H.R. 676 is socialized medicine:
This is false. H.R. 676 is not socialized medicine. It is a publicly financed, privately delivered healthcare system. This means that the government is the sole provider of insurance, paying the healthcare providers (physicians, nurses etc.) who remain private. So, under H.R. 676 you have free choice of healthcare provider. There is no out-of-network.

4.) I wouldn’t want my benefits to drop and also, I wouldn’t want to change physicians:
Under H.R. 676 the large majority of Americans’ benefits would dramatically increase. This is fully comprehensive coverage including office visits, hospitalization, long term care, all prescription medications, and even dental, vision, and mental health services.
You will not have to change physicians unless you choose to. You have free choice of provider. Further, when changing jobs or place of employment, under the current private system people often must change physicians or even go without coverage temporarily. However, under H.R. 676 coverage is not affected and patients can continue to see the same physician.

5.) Isn’t government control of our healthcare system going to lead to a much less efficient and more bureaucratic operation:
No. In fact, the current private system is much more bureaucratic and much less efficient. Not only does the current system waste 1/3 of all spending, but it interferes in the patient-physician relationship, making doctors justify every test and procedure-while attempting to influence these decisions through financial penalties and incentives. Physicians have to hire administrators just to keep up with the excess of claims and administration. Insurance companies also invest in drug companies, so when covering medications they have corporate duty to cover these medications even if others are cheaper and/or more effective. When further considering the confusing mass of bills, E.O.B.’s, deductibles, co-pays and the up, down and in the middle communication of physicians to insurance companies, insurance companies back to physicians and then the patient’s to both, the current private system is one impressively bureaucratic system, indeed.
H.R. 676 eliminates the administrative waste, patient billing, co-pays and deductibles, by funding the system directly through tax dollars. Further, H.R. 676 leaves the medical decisions to the physicians themselves, reviewing their performance regularly instead of directly interfering with the patient-physician relationship.

6.) Isn’t the market based competition of the current private based system the best way to control costs:
Obviously not, since the costs of premiums rose 86% between 2000 and 2006; three times faster than inflation. The rise of income in the same period rose only 15%. Medical bankruptcies are up 2200% since 1981 and profits for the largest pharmaceutical companies hit $62 billion back in 2004.
H.R. 676 addresses cost control immediately by cutting out the profit and wasteful administration of the private system. Further, by being the sole insurer, the government will have the necessary influence to negotiate fair drug prices. Finally, the promotion of preventative medicine, which is virtually non-existent in the private based system, will control costs in the long term by reducing chronic diseases that require expensive treatment, such as cancer, heart disease and diabetes.

7.) Isn’t the reason that healthcare costs keep rising is that we are unhealthy as a country:
Yes and no. First, through there are many factors to rising costs in healthcare, one important reason is poor health; with the consequent cost of treating chronic diseases. But, it is here again that the private system fails us. As a for-profit industry, there is no incentive to promote preventative medicine, the cost of such programs being immediate and the long-term financial dividends uncertain; uncertain because clients often switch coverage and companies. The fact is, not only do the private insurance companies rarely promote preventative medicine, they actually invest in industries that cause chronic illnesses. For instance, an insurer may invest in the tobacco industry.
However, the “no” is that there are other important factors in the rapid rise of healthcare costs, not the least of which are corporate profit, poor administration, and the outrageous cost of medication.

8.) I’ve read that trial lawyers and malpractice suits are driving up healthcare costs:
Yes and no. These do drive up costs, but only fractionally compared to the factors mentioned above, accounting for only 0.46% of our total healthcare spending. This is not the real problem.

9.) There seems to be a lot of factors involved in the high costs of healthcare. Can’t we just make reforms to the current system instead of changing over to another system:
This is the critical point: no matter what reforms take place, keeping the for-profit, private insurance healthcare system requires wasting billions of dollars on non-healthcare costs. This system exists first and foremost to make money, not provide care. In fact, as a business it is in their best interest not to pay on claims, to deny claims whenever possible. As for-profit companies, they must use money to market themselves to prospective clients, they must hire administrators and marketers to do the job, and this is factored in to every premium dollar. As for-profit companies they must profile clients and underwrite them, they must promote medications based upon money instead of efficacy. And they must generate billions in profit; billons which don’t go towards healthcare.
Consider further that as for-profit companies they have a vested interest in not insuring the elderly or the sick because they are too “expensive”, that they pass off the chronically ill to government programs in the long run anyway. And consider their inability to control pharmaceutical prices. With these considerations, as well as those of above, it becomes evident that reform is not really an option. For, it is the for-profit system that is the problem.