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Single payer: the logical choice, not the radical choice

mnpACT! Progressive Political Blog

When it comes to health care, single payer advocates (like myself) are considered to be on the fringe — the "far" left. Too often, the second you say single payer, the word "socialist" enters the conversation or the obligatory eye roll shuts down rational talk.

Sen. John Marty

Yesterday I motored on down to Mankato to listen to a pitch for the Minnesota Health Plan, which is Senator John Marty's pride and joy as well as a number of progressive legislators in both the House and Senate.

This Mankato seminar was dubbed "MNsure and Beyond: The Minnesota Health Plan." It is an appropriate title because the MNsure exchange would not be one of the few state exchanges that actually works if it hadn't been for health care single payer activists that wanted to make sure it worked right.

In fact, you can point to farm advocates for shepherding this project along because farmers, more than any other profession, have to deal with the individual insurance market. Paul Sobocinski and Megan Buckingham (Land Stewardship Project) presented an overview of MNsure and the complications of making a market work that still depends on the old insurance system.

The health care debate in the legislature also made some very important changes to MinnesotaCare that tried to make a smoother transition to incorporation into the ACA. First, they removed a $10,000 coverage cap (which, prior to that, had made MNCare little more than a stop gap insurance measure). Secondly, they removed the asset restrictions. This was important to farmers in getting affordable insurance.

Now, with MinnesotaCare as a viable insurance alternative for low to moderate taxable income residents, the next phase in health care is possible.

This brings us to the Minnesota Health Plan which is a viable health care coverage plan that utilizes a single payer base. This isn't pie in the sky socialism, it simply solves a lot of basic health care problems.

For instance:

1. Health Care Choice. With single payer, you don't have to worry about in-network or out of network providers. Everybody is in.

2. Eliminates bureaucracy. It might be strange to think that a government program would actually reduce bureaucracy, but it will. Insurance and health provider networks have become an intolerable maze of coverage snafus. From network plans to tiered prescription plans to "experimental" treatment to pre-authorizations to step therapy programs, it is just plain nuts. Single payer will be one payment — one set of coverages — and one place to ask questions or to appeal.

3. Bulk purchasing. Companies that employ a lot of people can get the power of special bulk pricing. Companies that provide services will compete to get that business. That has left individual policy holders holding the bag. But not with single payer. The state is the ultimate in bulk purchasing power and everyone gets the same advantages.

4. Businesses Can Focus on Business. Too often, health care becomes a dominant part of business costs, business time, and business competitiveness. So much money and effort is wasted trying to find reasonably priced health care that the focus of really doing business can get lost. Single payer frees up business from having health care be a secondary business. Think about that as an economic benefit.

We just have to think about this in a realistic manner. We can't continue to have 2/3rds of all bankruptcies caused by medical debt. We can't continue with 45,000 people dying because they lack health care access. And most certainly, we cannot continue to hve 1/3 of every health care dollar wasted on administration.

Single payer isn't a radical choice — it is the logical choice.

This post was written David Mindeman and originally published on mnpACT! Progressive Political Blog. Follow Dave on Twitter: @newtbuster.

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Comments (17)

Single Payer: Access to Healthcare

Thanks for this post. Obamacare (ACA) is a step in the right direction, but we will need to urgently advance the single-payer healthcare (Medicare for ALL) system. It IS the logical future. The rest of the modern world knows this. US is kept in the cruel, unconscionable dark by huge healthcare corporations (BIG pharma, hospital and insurance corps). Americans-wake up!

Obamacare is NOT affordable

The problem with single payer and Obamacare is that Obama dictates what is required to be covered and no insurance company can afford or offer a plan that covers everything AND is affordable, that is why millions of people are losing their coverage. I happen to live in NY and the options I have for my family are a few plans--the middle of the road plan will cost $7200 a year in premiums alone. Deductibles are $3000 per individual and coverage is only at 50% of cost up to the out of pocket limit of $6700 for each.
So the AFFORDABLE care plan could potentially cost my family of 2 $25,000 a year. That's because the plans have to cover everything Obama feels they should cover like maternity care, free preventive services, no lifetime limits, etc. Insurance companies can no longer carve out plans to fit an individual's needs due to the mandates. So, what you are going to see is a bunch of middle class people without health insurance and a bunch of poor people all hopping on coverage because hopefully the others will pay for it. So much for fixing the problem Obama, this is a complete disaster. And employers are responding and dropping families from employer provider coverage and only insuring the employee or letting go full timers to avoid having to pay for their plans. Great job Mr. President.

Universal Health Care

Joan, you just made a good case for universal health care. With that in place everyone has skin in the game, which brings the price of insurance down for all Americans. Get everyone on board and it creates a bigger insurance pool and everyone shares in the costs and the benefits.

Single Payer

Might I suggest going here: http://hcamn.org/donate and making a donation to an organization doing the leg work to make this a reality in Minnesota.

It's not the role of government

to provide the people with health insurance any more than it's the role of government to provide the people with auto or life insurance. John Roberts re-wrote the law out of whole cloth to make it legal. I have no doubt it will be overturned when it's challenged after January 1st. (You can't challenge a law until it actually goes into effect).

When the government dictates what your product will be, leaving virtually no choice for your customers (who's choices were deemed illegal), then you no longer even have a "marketplace." You have a government take-over of an industry.

Obama's repeated lie of "If you like your policy you can keep it. Period" will go down as the most bald-faced lie by an American politician in history.

The elections of next year will be interesting. The ineptness with which this rollout has been handled, will make even more people believe that government is indeed the problem, and not the solution, pushing back the collectivists' dreams for "single-payer" yet another generation.

We don't have to guess.

The developed world has single payer, and it works better at less cost than anything we have done.
Medicare is single payer, and try find a senior who would give it up.

Unfortunately

The country will have to give at least some of it up as it is completely unsustainable.

Affordability

All we have to do is give up a few aircraft carriers or nuclear attack subs and health care will be covered.

I seem to recall

that Mr. Tester had "no doubt" about the outcome of the voter ID amendment, the marriage amendment, the ACA SCOTUS ruling, that the republicans would retain the majority in the state legislature, would reclaim the senate and that Romney would win the presidency in a landslide. With that track record, I won't hold my breath that the ACA will be overturned anytime soon, And yes, the elections will be interesting, but not for the reasons he's hoping for.

Tom Anderson: One reason that Medicare is unsustainable

is that it serves only the oldest, least healthy segment of the population.

The occasionally heard Republican suggestion to raise the age of eligibility to 68 or 70 would only make its problems worth, because then the percentage of frail elderly in its patient base would increase, further throwing the budget out of balance.

Furthermore, President Bush's Medicare Part D program, in which Medicare is expressly forbidden to negotiate drug prices, is another drain on the coffers.

Why, you'd almost think that Republicans were trying to destroy Medicare with these ideas!

Maybe some of them don't know the reason that Medicare was instituted in the first place. It was because private insurance companies were refusing to insure seniors or agreeing to insure them only at prices that were out of reach of the average person. So much for giving seniors vouchers to buy insurance in the private sector.

Adding younger, healthier people to the mix, people who would pay the same premiums as the seniors but for the most part use the system less, would go a long way toward balancing Medicare's finances.

Thanks for singling me out

Part of Medicare's problem is that it doesn't pay what the care costs, reducing the number of places that will accept it.

Another problem is that it will provide the best of everything (and who wouldn't take the best if it doesn't cost you anything) thus raising costs.

I'm no fan of Part D but this administration has had every opportunity to get rid of it and hasn't. Besides, now it is being promoted by the ACA as an example of a great program with a rocky start.

FORCING younger healthier... might help, but we don't need Medicare anymore since we have the ACA. Why have two government programs doing the same thing? (OK, silly question, it's the government)

Two Programs

We have dual programs because this was the market driven compromise Obama put forth to make conservatives happy. The program was dreamed up by Republicans, implemented with great fanfare by a Republican governor, and then promptly rejected because a Democratic president said "OK, let's give it a try."

But hey, you just made a good case for universal single payer health care. Then we'll just have one program instead of two!

Yes, that's exactly what I meant

Medicare was implemented because seniors couldn't find or afford insurance coverage. That is now a problem for the majority of the population. (Even if you're employed, I bet your coverage is not as generous as it was twenty years ago.)

It's time to fold both Medicare and Medicaid into a single public plan open to everyone.

Better yet

Eliminate both Medicare and Medicaid since the ACA covers everyone, or at least requires everyone to participate. The savings might almost pay for the ACA and we could all move on.

The ACA was a Republican venture?

Why didn't any of them vote for it and why do they all keep trying to repeal it? Certainly the Republicans had some similar ideas, but this monstrosity is not owned by them.

Ventures

They didn't vote for it because it was proposed by a Democrat president and the Republicans had avowed to make him a one term president. The idea was proposed by a conservative think tank Heritage Foundation and implemented by a Republican governor Mitt Romney. They liked Romney's approach so much that they even made him their presidential candidate.

Obamacare was the conservative's market-driven approach to solving the healthcare problems. President Obama adopted it in the hopes that the Republicans would get on board with their own idea and it would sail through the legislature. Instead the Republicans decided it was suddenly horrible and had to go. In other words, they were for it until they were against it.

Single Payer

I would add just a few items to Dave Mindeman's excellent article above.

Single payer is not only good for businesses as it takes a major expense and headache off their hands, but it's good for employees too. Many people are reluctant to switch jobs because the new employer's health plan isn't as good as the one they have now. And if it's a smaller employer, the company may not have a health plan at all. This frees up our work force to be more mobile and go where the jobs are as well as to smaller companies that desperately need their talent.

Along the same lines, it also frees up people to start new companies. Many people have new and innovative ideas they would like to bring to market, but they can't afford to strike out on their own and leave their families without health insurance while they build their client base. A universal single payer healthcare option frees the up the market potential for new entrepreneurs to do what they do best: innovate.

To be clear here, a single payer universal system is not the only step we need to take to fix healthcare. We also need to change the compensation system from procedural-based to outcome-based. Doctors need to be paid not by how many tests they run on your body, but rather on how healthy you are.

Couple single payer with outcome-based medicine and we'll have a solution that's a hit for everyone.