Single Payer Health Care

Health insurance companies and HMOs are now charging a percentage of the cost of prescription drugs rather than a fixed fee. This means that instead of paying only $10 to $30 they are spending 20 to 33 percent. This is a huge difference. Not only are uninsured people going to go without needed medicines, even those with insurance will no longer be able to afford their meds. These are people who will generally suffer the most from lack of medication as they are the people with the most debilitating illnesses.

The New York Times story describes a woman who is purchasing a multiple sclerosis drug with a co-pay of $20 using the insurance provided by Kaiser Permanente. She is now paying more than 15 times that amount. If you’ll recall, Kaiser Permanente is the HMO whose plans were discussed by Richard Nixon (there will be a few second whistle) and John Ehrlichman. Their whole business model is to make a profit by collecting insurance premiums paid by both employees and employers while not providing services. This is another example of that unethical behavior.

The insurance companies have justified their change of rates and the addition of what they are calling Tier 4 as a response to employers complaints about the high cost providing health care. Many companies leave the US because of the high cost providing health care. The reality is that HMOs are making profits in ever greater numbers in study after study. However, it has also been shown that HMOs give poorer care dollar for dollar nor do the insurers want you to know this fact.

In the new book Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves into Slick Marketing Machines and Hooked the Nation on Prescription Drug, author Melody Peterson states that the material expenses of producing most medications are approximately 10% of the total retail cost paid by the consumer.

It is bad enough that pharmaceutical companies charge exorbitant prices but now insurance will cover much less of the cost of prescriptions. So now we have both the HMOs and the pharmacuetical companies ripping off the consumer while we have no recourse but to bite the financial bullet or suffer from lack of medication.

Here is another reason to remove the profit motive from health care.

Yesterday Elizabeth Edwards endorsed the Hilary Clinton health plan. Although it isn’t an official endorsement of Clinton, it is the closest either she or Barack Obama have recieved from John Edward’s camp. They both could use his 115 delegates at the Democratic convention in Denver.

I’ll grant that in some ways the Clinton plan is better. It covers almost everybody and offers subsidies in an attempt to make it affordable for everybody. The way everyone is covered is through a mandate that all Americans are required to purchase health insurance. Obama, rightfully so, states that people are uninsured not because they don’t wish to buy insurance but because they cannot afford insurance. We are talking about the working poor and the unemployed. No amount of subsidy will help them. It is a choice of food or insurance. If they are forced to pay for insurance, they will not eat and therefore will need the health care services more. Economist and author Paul Krugman has said that Clinton’s plan will cover nearly all of the currently uninsured at half the cost of the Obama plan. Obama’s plan will cover half as many of the uninsured. http://www.nytimes.com/2008/02/04/opinion/04krugman.html

However, they both involve using privately owned insurance companies. Private insurance companies have to make a profit for their share holders. That is what private businesses do. In order to make a profit they will be required to limit care. That is the main reason there has to be government intervention in the first place and no amount of “voodoo health economics,” to quote Kruman in another article discussing John McCain’s non-plan, will cause the private sector to give every American adequate health care.

Even if the Clinton plan to digitize the medical records of all Americans actually does save 77 billion dollars, that still falls short of the more than $500 billion, (yes that half a trillion dollars), that Americans spend just on making sure the insurance companies get their paperwork from doctors and hospitals

Once they do get their hospital records, HMOs do everything in their power to find a reason not to pay. Some HMOs even resort to fraud and charge Medicare. So even with 45 million more Americans insured by private insurers with the Clinton plan, they will still not get respectable care and the taxpayer foots the bill.

This will not change with either the Clinton or Obama plans. I could say these plans are better than nothing but they are not much better than nothing. Imagine if your house was burning but the firemen wouldn’t put out the flames until you wrote them a check. This is what we see with our health care system and that will not change as long as HMO’s are involved. The profit motive must be removed form health care. Health care is a basic human right.

Today’s New York Times has Krugman again discussing the differences in health care between the rich and the poor. The poor suffer and die needlessly in what is nothing short of criminal behavior on the part of medical organizations who require payment before treatment. Once someone is in an emergency room and the Hill-Burton Act is in force, requiring hospitals to care for a patient, it is often too late. Once released, that patient will be indebted for most, if not all, of their life. Many will file bankruptcy. (The Bankruptcy Bill passed by the Republicans gives no one an easy way out but that is off topic.) The poor die more often from Cancer and the life expectancy gap between the rich and poor has grown wider in the last few years.

The Huffington Post has a multi-part posting by Miles Mogulescu describing the Democratic distancing from a single-payer system. Miles does a good job of describing the political environment. He states that any plan that involves private insurers is doomed to failure. He also points out that about 30% of current health care costs is administrative due to billing paperwork.

What wasn’t mentioned is that the insurance companies and HMOs are also corrupt. The folowing excerpt from a proposed platform plank in Washington State say it all.

The Washington Post reported on February 8th 2008 that Merck Pharmaceutical paid a $650 million fine for defrauding the Medicaid system. Carrie Johnson, Washington Post staff writer, states, “Prosecutors say the drug maker gave pills to hospitals at virtually no cost to hook poor patients on expensive medicine. When the patients left the hospital, they often continued taking the drugs, but with the government footing the higher bill.”
On January 16th 2007, Premera Blue Cross asked a judge to seal documents that disclosed it defrauded Medicare by using it to pay insurance claims. On August 26th 2006, the New York Times reported that the California State Attorney General filed charges against 39 drug companies suspected of defrauding the state by overcharging for medicines.
When former Republican President Richard M. Nixon first introduced HMOs to the American people in the 1970s, those who had developed the business structures knew they were taking client funds and profiting by not providing services. It is obvious that private insurers or Health Management Organizations cannot be involved in any successful health care system. The current United States health care system, using private insurers, is not only ineffectual and inefficient but it is corrupt, as well.

Links to Miles Mogulescu’s posts are below.

Part 1: http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-a_b_67836.html
Part 2: http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_70848.html
Part 3: http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_75070.html
Part 4: http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_84862.html

Part 5:

http://www.huffingtonpost.com/miles-mogulescu/why-not-single-payer-par_b_94239.html

I know I’m playing catch up here but I wanted to make sure this information was available. We know it is not a surprise that there is a coverage gap. Poor people cannot afford insurance. This is described in the first article. It follows that the wealthy who can afford insurance will have an earlier diagnosis of cancer and a lower death rate from the disease.

The links below will take you to the stories. Contact me if a link is broken. I have the articled saved.

http://query.nytimes.com/gst/fullpage.html?res=940DE4D9103BF930A15750C0A96E9C8B63&sec=&spon=&pagewanted=print

March 23, 2008

By ROBERT PEAR

New government research has found ”large and growing” disparities in life expectancy for richer and poorer Americans, paralleling the growth of income inequality in the last two decades….

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http://query.nytimes.com/gst/fullpage.html?res=9C05E1D9173EF93BA25751C0A96E9C8B63&sec=&spon=&pagewanted=print

By KEVIN SACK

February 18, 2008

A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival….

    Massachusetts has recently implemented a universal system that requires everyone to purchase health insurance. It is no surprise that there is a sudden influx of new patients and that the new system is being taxed to extreme. Whenever a new universal system is implemented we will likely see the same thing happen.

We can count on these statistics being used as proof that a universal system is flawed. Don’t fall for it.

Once there is an equilibrium reached in the number of new patients who have previously been left untreated and the number of patients who are receiving hitherto unaffordable preventative care, this will no longer be a problem. At some point, the number of new patients should start to decline to manageable levels.

As in Canada, the problem is a shortage of doctors and not a result of the payment structure. The cost of receiving a medical education is the problem which results in the subsequent shortage of medical personnel.

http://www.nytimes.com/2008/04/05/us/05doctors.html?_r=1&hp=&oref=slogin&pagewanted=print

….In pockets of the United States, rural and urban, a confluence of market and medical forces has been widening the gap between the supply of primary care physicians and the demand for their services. Modest pay, medical school debt, an aging population and the prevalence of chronic disease have each played a role. Now in Massachusetts, in an unintended consequence of universal coverage, the imbalance is being exacerbated by the state’s new law requiring residents to have health insurance….

In case you are curious as to why Medicare is “going broke”. We know it is because the surplus once in the Trust Fund was squandered but this is what happens to the rest.

http://www.nytimes.com/2008/04/01/business/01disabled.html?_r=1&oref=slogin&pagewanted=print

April 1, 2008

Insurers Faulted as Overloading Social Security

By MARY WILLIAMS WALSH

The Social Security system is choking on paperwork and spending millions of dollars a year screening dubious applications for disability benefits, according to lawsuits filed by whistle-blowers.

Insurance companies are the source of the problem, the lawsuits say. The insurers are forcing many people who file disability claims with them to also apply to Social Security — even people who clearly do not qualify for the government program….

Singlepayerhealth.org is dedicated to educating the American public about the benefits and wisdom of using a single payer health insurance system in the United States. The site is new and in development. As it progresses in name and stature, it will be the focal point for many activities inside and outside of cyberspace. At some point and organization will be formed with a non-profit status in order to raise money to further the end of educating the public. This site will stay active as long as the US health care system remains in the 19th century.