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Against single-payer health care? Then no AARP for me!

After receiving its latest invitation, I told AARP why I wouldn't join up: It doesn't support single-payer health care. AARP responded with its argument against single-payer (HR 676), and I responded to their points.  Here is a summary of the exchange:

AARP: HR 676 does not address the problem of increasing health care costs ...

Thomas Dickinson: HR 676 does not need to address increasing health care costs. We need care now for everyone, rich and poor — everyone in the same pool. That needs to be addressed first. No need to conflate all the parts of a complicated problem. Solve the most egregious inequities first.

AARP: HR 676 essentially eliminates Medicare, Medicaid, and the SCHIP programs that have served the American public well for many years. ...
 
TD: The only reason these three programs exist is to repair shortcomings ever since Frances Perkins had to give up on single-payer back in the '30s so that President Roosevelt could get other New Deal programs passed. She wasn't wrong then. In fact, history has proven the gross inadequacies of what we got instead or we wouldn't be having this discussion now. Saving these is only "if it ain't broke don't fix it" applied to a very flawed system cobbled together more than 70 years ago. 

 
AARP: HR 676 does not promote shared responsibility for health care coverage among employers, employees and the government — a basic principle of AARP policy. ... Taxes will need to be increased.  This means that the bill simply shifts the burden of the rising costs of health care onto the taxpayer alone, with no motivation built in its structure for cost-containment. 
 
TD: Why is health care tied to the workplace at all?  Only because "that's the way we've always done it." It became the responsibility of employers after the failure, noted above, to pass single-payer in the '30s. It was a novelty, a perk to attract employees by holding back income that presumably would've been spent on health insurance by the individual — and thereby possibly putting the employee in a lower tax bracket — and then spending a portion of what was held back on health insurance for them, allowing the employer to negotiate better rates so their employees cost them less. A complicated "win-win" for employee and employer, but all just fancy machinations covering the failure back then to enact single-payer.
 
Also, the taxpayer is not "alone."  We taxpayers are together helping each other and especially those too poor to pay taxes. One of my greatest roles as a citizen is "taxpayer."  Isn't it yours?  Why do you go along with the very mean-spirited spin that taxes are bad and raising taxes for something as altruistic and life-affirming as health care for all, by all — which is what a single-payer is — is somehow bad?
 
Government regulates, and cost-containment is clearly a function of regulation. Right now, cost-containment is for bigger profits, not better health. That will remain true as long as the profit motive remains in the system.
 
AARP: In addition HR 676 has not gathered bipartisan support, which is important to enacting and implementing any reform.
 
TD: And it won't as long as organizations like AARP aren't advocating for it. The health care lobbies are the most powerful, and AARP has thrown in with them. How is it that while the public, the doctors and the nurses all consistently prefer a single-payer solution, our "representatives" don't?  How is it that single-payer is "off the table" according to the politicians in charge of the discussion? No representation there.  (If it were "on the table" as a voter referendum, it would win, wouldn't it?) Who benefits when single-payer is not an option?   Certainly not the sick and the lame, the youngest and oldest, the poor, the public. No, the beneficiaries are the businesses built upon people's misery, and the politicians and others they reward for not representing the wishes of the public.
 
So, I'm curious what the relationships are between AARP and the health care lobbies.  I want to know all details — the previous employment of AARP officials, their Washington friends, the donations, the meetings, etc.  I want to understand why AARP would advocate against what its constituency wants.  
 
I don't care if businesses fail, not even a whole sector of the insurance world; the economy changes all the time. This is America, after all. I do care if a citizen dies because his neighbors —  you and me and the rest of our society — said, "Tough luck, fella, the business of health care is more important than you."
 
We can handle overhauls and upheavals; we're handling an economic one now. We can handle one in health care. 
 
AARP: "All Americans should have access to affordable health care ..."
 
TD: No.  All Americans should have health care. The society affords it, not the individual.  Do we put that "affordability" criterium on national defense?  Fire safety?  Police?  Education?  Of course not. All of us pay for those things together, yet you think health care should be paid for individually? 
 
AARP: "... these costs should not burden future generations." ... "Wellness and prevention efforts, including changes in personal behavior such as diet and exercise, should be top national priorities."
 
TD: You measure in dollars only?  There are far greater costs to future generations when citizens' lives are destroyed by disease and avoidable death ruining them economically, keeping them underemployed, undereducated, unable to contribute to civil society because all they can be concerned with is covering costs — let alone the pain and suffering from ill health that could have been avoided had our society accepted its responsibility.
 
The first change in personal and national behavior is for those who have to help those who don't. When did that notion depart the national psyche?  We are our neighbors' keepers. Helping others is not a burden, it is a responsibility according to all the major religions and our Constitution. We formed the government for exactly that, and the health of the citizenry is one of society's most basic collective needs.

Burden?  We haven't come close to accepting the "burden" bestowed upon us by our Founding Fathers. The only people who have the luxury of future money woes are the ones who've already got some. We are charged with caring for everyone now, especially those without. A society is only as good as the way it treats the least among it. We've got a long way to go, and AARP should direct its considerable clout at the real solutions, not the half measures designed to keep business in business.
 
Thomas Dickinson is a pianist and piano teacher in the Powderhorn neighborhood of Minneapolis.

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Comments (24)

AARP receives more annual revenue from licensing and sponsorships than from membeship dues.

The truth of this is evidenced by the fact that numerous studies have shown that the administrative costs for Medicare — a government-run program — run at about 2%, as compared to 30% or more for private insurance. (Some have estimated that the total overhead and administrative costs for the U.S. health-care system is as high as 50%!)

A GAO study, already in the 1990's, found that the U.S. could save enough simply on administrative costs with a single-payer national health program to cover all uninsured Americans.

A 2003 study in the New England Journal of Medicine, comparing administrative costs of health care in the U.S. and Canada, found that in 1999, administrative costs per capita were $1,059 in the US, compared to $307 in Canada. By one measure, administration was 31% of health care expenditures in the US, compared to 16.7% for Canada's mixed public-private insurance system. Canada's national health insurance program had overhead of 1.3%; its private insurers had overhead of 13.2%.

The NEJM study found that it would save $209 billion annually, just to cut U.S. overhead costs to the level of Canada. That figure is about $400 billion today, according to testimony by Harvard's Dr. David Himmelstein, to a House subcommittee on 4/23/09. Himmelstein argued that only a publicly-financed, single-payer system can rein in costs while guaranteeing universal, comprehensive coverage.

Himmelstein attacked the half-measures being proposed by some Democrats, including that of a "public plan option," and he showed that costs have skyrocketed under the Massachusetts plan, which has a public plan co-existing with private insurance.

A rational observation of the issue reveals that this is nothing less than the opening of a new socialist front against capitalism.

And, as with any aspect of socialism, this front fails completely when the supposed merits are examined.

That's because proponents of socialized medicine are forced to rely on false claims, obfuscation and outright lies to come up with anything that could possibly appeal to anyone. There are, in fact, no merits to socialized medicine.

Consider the weakness of this statement: "A GAO study, already in the 1990's, found that the U.S. could save enough simply on administrative costs with a single-payer national health program to cover all uninsured Americans."

Can you name one large scale social program under government management that "saves money"? Just one program? Anyone?

OK, forget the cost; let's go with the "higher good". Can you name one large scale social program under government management that is even marginally successful. Just one program? Anyone?

The public school system costs taxpayers uncounted (literally) billions of dollars each year, and returns hundreds of thousands of students to the streets each year without a diploma. And college entrance exams prove that a large percentage of those that do graduate are woefully uneducated.

Social Security is a ticking time bomb that people of my generation will have the honor of standing on while it explodes. For decades, the government has been carefully studying actuarial tables to keep the "brass ring" just short of life expectancies.

Have a day to spend with nothing pressing to do? Google “fare hike” “strike” “service cuts” along with the acronym for a transit system in any American city.

Welfare dependence has absolutely decimated generations of American families, especially in minority populations.

But with socialized medicine, we really needn't guess how it will end, take a look at the return on investment of any of the myriad of socialized medicine programs in operation today.

In England, one in five citizens have resorted to extracting their own teeth.

In Canada, the system has reached the point where Claude Castonguay, the man who almost singly handedly created it now admits it is a failure.

In Germany (and in Canada), a two tier system has evolved in which the wealthy pay for private insurance to receive satisfactory service, while (in Germany) the middle class and poor have recently found themselves having to fork out ever increasing "co-payments" to subsidize their treatment. So much for "free" health care, eh, Siegfried? Contributing to the failure is a widespread shortage of medical professionals and modern equipment.

Oh, yeah. Sign me up for that.

We have a cost containment problem in American health care. But putting all of our eggs into government’s basket will add poor quality and rationing to the mix, and will not contain costs.

Hey, I know. If socialization is such a good idea, why not let’s start with the legal system? Sure, let’s put the practice of law under the auspices of the “US Department of Public Defense” and see how well that works out.

HA! Case closed.

Having belonged to AARP for over a dozen years, I have seen it morph from a useful lobbying organization for older folks into essentially a quasi-insurance company. I just got their newsletter and magazine -- both filled with ads pimping their various insurance products. It is an organization that has "lost its way".

I tore up my ARRP card several years ago. This organization has become a personal money fountain for a few of its owners. It hasn't represented its claimed constituency for years.

Another classic American fraud.

With traitors like this, who needs friends?

Bravo, Mr. Dickinson.

I'd like to see a good investigative journalist investigate the reasons the administration and Congress have for declaring single-payer off the table and, according to a FAIR.org study, out of the mainstream media except when coverage is uncomplimentary. To please the industry instead of serving US?

Some former supporters (FamiliesUSA, SEIU and other groups) as well as many former supporters in the Congress are now going along with the plan to foist a Massachusetts-like clone upon all 50 states. The Mass-Plan is hundreds of millions of dollars over budget, has yet to achieve universality, and monetarily punishes those poor folks who do not purchase insurance.

A Physicians for a National Health Plan study reveals that the savings from single-payer would be $400 billion per year ($4 trillion in 10 years). Contrast that to the $2 trillion in "voluntary" savings the for-profit health industry is saying they will achieve in 10 years. Why is there any doubt as to which plan to adopt?

About 65 percent of Americans favor a single-payer system. We are being robbed of representation by the refusal to discuss single-payer seriously instead of dismissing it with the falsehood that "America is not ready" or, "It's not an American solution."

Thomas: Single-payer is NOT socialized medicine. That would require making all health care providers employees of the government and for the government to buy all hospitals and other facilities.

Single-payer is publicly financed but privately delivered. Unlike for-profit insurers, no one would tell you to stay "in network" or pay for care yourself, for instance.

Government systems that are extremely efficient are those we have socialized: police and fire protection, military forces (except for out-of-control weapons spending) and those, like the interstate highway system, that government standardizes nationwide and purchases on our behalf.

Thomas, you're funny.

"A rational observation of the issue reveals that this is nothing less than the opening of a new socialist front against capitalism."

Wow. In the same sentence, after declaring your observation to be rational, you then jump into the pejorative of "socialism", and the hyperbole of a warlike reference to describe the opposition. A "front"? Do you think single-payer advocates are out digging trenches in front of insurance companies?

Then you ask a bunch of questions, provide your own wrong answer, and declare the case closed. "Rational", right.

Dilbert: If we lease a machine from you, how can we be sure you'll stay in business to service it?

Egbert: How can we be sure you'll have enough money to buy the lease?

Dilbert: You could check our financials.

Egbert: I'm pretty sure your financials are as fraudulent as ours.

Dilbert: Good Point. Maybe we could ask trusted third parties to vouch for us.Do you trust any third parties.

Egbert: Not since my financial advisor put my retirement savings in a ponzi scheme and had an affair with my wife.

Thus, all the Lilliputians agreed, ended Capitalism.

socialism  /ˈsoʊʃəˌlɪzəm/ [soh-shuh-liz-uhm]

–noun 1. a theory or system of social organization that advocates the vesting of the ownership and control of the means of production and distribution, of capital, land, etc., in the community as a whole.

Democrats propose governmental taxation of the community as a whole and handing the control of the distribution of payments and of services rendered to an agency of the government.

That is socialism by any definition.

They need not necessarily "own" the buildings if they control the people in the buildings (at least not at first)...you're jumping ahead of the plan, comrade!

Bernice does bring up an interesting point, though. We do have the best military, very good fire and police protection and at least servicable roads.

I wonder if anyone can guess what these things have in common?

Here's a clue: It's a thing that inherently sets them apart from the socialist campaign the Democrat party has championed since Johnson.

For Eric:
http://www.thefreedictionary.com/front

front (frnt)
n.

10. A field of activity: the economic front.

I'm going to have to start getting a stipend from Minnpost for all of the English language lessons I've been providing the public school graduates around here!

AARP has been corrupted by its relationship to United Health where it sponsors supplemental insurance for Medicare patients. This is how they get a substantial part of their revenue. They are an insurance company pretending to be an advocacy organization!

Thomas, putting your "public school" insult aside (and you wonder why you never convince anyone of anything), your definition of front is still the war definition, just applied to economics. It entered common usage during World War I, when "front" was applied not merely to the trenches from which everyone learned the word, but then to other struggles. Thanks for language lesson, and I hope you don't mind being taught some etymology.

By the way, want to provide a source for your crazy-sounding claim that a fifth of people in Britain pull their own teeth because the medical system is so bad? I consume a fair bit if British media and oddly, I've never heard that.

Glenn:
It was very thoughtful how you used fact, data points and statistics in your comment.
It made for a convincing case.

I have always found that the use of demagoguery as we see in some of the "comments" really only adds nothing but melodrama to an issue

Demagogic statements like: "socialized medicine" "rationing" and "welfare dependence" and my personal favorite "socialism". These touchstones if you will are rather typical of the opposition to just about anything these days. I almost expected "Harry and Louise" to jump out at me.

The United States spends at least 40% more per capita on health care than any other industrialized country with universal health care

Single Single payer health care is not socialized medicine, any more than the public funding of education is socialized education, or the public funding of the defense industry is socialized defense.

Private for profit corporation are the least efficient deliverer of health care. They spend between 20 and 30% of premiums on administration and profits. The public sector is the most efficient. Medicare spends 3% on administration.

Federal studies by the Congressional Budget Office and the General Accounting office show that single payer universal health care would save 150 to 200 Billion dollars per year despite covering all the uninsured and increasing health care benefits.

Health care costs are simply unsustainable both to government and to business. The external costs just to us as a society are staggering.

However this health care issue shakes out. The private for profit health care industry needs to reduce their overhead. Up to this point they have had no incentive to do so. Perhaps single payer (or a variation of) is the impetus that has them re accessing their business model.

It's been years since I heard it but it applies more now then ever especially to this ongoing discussion about health care or rellay the lack there of it. Check out FDR's 10/31/36 speech at Madison Square Garden. Found conveniently at MinnPost.org at http://www.minnpost.com/steveperry/2009/05/11/8692/fdr_at_madison_square...

OMG no wonder he was elected 4 times. His logic is impeccable. His delivery is smooth and he is honest.

Bring it on. Let's get it done. And in the process build a monument to Francis Perkins.

Eric, how about that well known tool of the GOP, the London Mail & Guardian:
http://www.mg.co.za/article/2007-10-15-english-pull-own-teeth-as-dental-...

"Falling numbers of state dentists in England have led to some people taking extreme measures, including extracting their own teeth, according to a new study released on Monday."

"Overall, 6% of patients had resorted to self-treatment, according to the survey of 5 000 patients in England, which found that one in five had decided against dental work because of the cost [of private Dentists]."

Thomas: Huh?

One in five equals 20% ... your source says 6%.

You're either bad at math or like to, um, stretch the truth.

Your source also says that the 6% resort to self treatment, which *can* include teeth pulling.

Your post says 20% pull their own teeth. You're bad at parsing English sentences and a total failure at making logical deductions.

Do you ever base your opinions on facts, or is that something they only teach in public schools?

Tim, as a careful reader might deduce, I obviously remembered the 1 in 5 statement out of context.

The story says "one in five had decided against dental work", I remembered it as tooth pullers...probably had something to do with the indelible visual I got stuck in my head.

Of course I saw the discrepancy as soon as I posted the actual story, but have no worries since my point stands undamaged.

If 1% of the population of the UK has resorted to pulling their own teeth, is that going to be acceptable to you? How about .5%? .2%?

Love to hear that one.

When I can show that *anyone* is *pulling their own teeth* rather than dealing with a failed system of socialized medicine, I've got nothing to hide, or make up.

So, now that my mendacity is fully exposed, please take the opportunity to make your argument in favor of socialized medicine against the cold, hard, undiluted facts.

Take your time, we'll wait.

Nice backtracking, TS.

What percentage of Americans pull their own teeth?

What percentage of Americans delay or never get routine dental or medical care that then multiplies into serious illnesses that cost tons of taxpayer dollars when they go to the ER at the county hospital?

When this happens, isn't this the "socialized" medicine you hate, only it's through the backdoor, so to speak? How do we fix THAT situation?

These are the figures we need to compare, whether it's 1% pulling their teeth, or 6%.

That there may be people in the US that resort to self dentistry, or show up in the ER for free treatment is a problem, not an advertisement for more of the same.

There are a couple of things that come to mind that might alleviate the pressure on hospitals.

First, insurance costs for practitioners, medical facilities and the manufacturers of drugs and medical equipment has skyrocketed; these costs are always passed on to the consumer.

It's way past time we overhauled the tort laws in this country. Since everyone seems to love European heath care, how about adopting "loser pays"?

Secondly, perhaps it is time to create bare bones regional clinics that can provide non-invasive care and triage for the indigent.

I have refused to rejoin AARP for that very reason. I saw an article in it last year talking about "health care reform," but oddly, single payer wasn't mentioned.
TS: What the hell is wrong with socialism, except that the corporations and businesspeople of this country, since World War I, done a highly successful job of making socialist economic theory sound like an obscenity. Most people who get excited about the concept of socialism have very little idea of what it's about. A dictionary definition won't do. I recommend some sound basic books on the economy. You could start with Paul Krugman and Joseph Stiglitz, both Nobel prize winning economists.
Look things up; become informed; get educated. Nothing is stopping you in this country.

Thomas, it would be nice to know how many Americans have to resort to self-treatment because they can't afford proper medicine but of course, when you do it yourself, you're not in any records. We know about 40 million Americans have no insurance. The number in Britain: zero. Their fix is a fraction as tough as ours. One flaw, even several flaws, doesn't show it's as crappy a system as ours.

Have sent Thomas Dickinson column:
Against single-payer health care? Then no AARP for me!, to all my friends over 50 with the following note:

Contact AARP and tell them no AARP for you until they support single-payer health care.
Please don't join AARP or cancel your membership to AARP. Make sure you tell them why....

Call 1-888-OUR-AARP (1-888-687-2277)
Monday - Friday
7am - 11 pm ET

to send an e-mail to AARP go to: http://www.aarp.org/about_aarp/contact/a2003-01-22-membershipfaq.html

Thomas Swift, you're using The Daily Mail as an authoritative source on life in Britain? That's just a shade better than using the National Enquirer as an authoritative source on life in the United States.

If you're going to quote a conservative British newspaper, at least quote a respectable one like the Times or even the Telegraph.