Single-Payer Deserves a Hearing in the Senate
Published June 06, 2009 @ 01:03PM PT

Today is the day when Organizing for America, the heirs of the Obama campaign, are calling on people to organize around health care in their communities and brainstorm on what they can do to help move the ball forward. I’d like to take them up on the offer, though probably not in the way they intended.
We’ve heard repeatedly from the president, Sen. Max Baucus and other Congressional leaders in the fight for health care reform that “everything has to be on the table.” We’ve heard that we need to have a frank, open and honest debate on how to achieve the three goals of “(1) reduce costs, (2) guarantee choice, and (3) ensure all Americans have quality, affordable health care.” But what we've heard just hasn’t been true. Single-payer advocates, who represent a large constituency in this national debate, have been entirely shut out so far.
Look, you don’t have to be a proponent of single-payer to realize that what we’ve seen so far is ludicrous. As Sen. Bernie Sanders said in an interview with Ezra Klein:
I think we will try to get a hearing in the HELP Committee. I think the importance of the hearing is not that it will change minds but that the American people -- and Congress -- should hear the facts about the enormous waste and bureaucracy and profiteering associated with private health insurance. Not to deal with that is mind-blowing.
I wrote in the past about the Senate Finance Committees’ guest lists. Although they eventually got better after the first one featured a list where a full third of the speakers had ties to the insurance industry, the only time single-payer was mentioned during the proceedings was when several nurses attending stood up in protest and were dragged out of the chamber. That means the Senate Finance Committees heard from economists, doctors, nurses, hospitals, private insurance, not-for-profit insurance, pharma and medical device manufacturers, unions and patient advocates. That’s healthy – they heard quite a few dissenting views. But it makes it beyond incomprehensible to exclude one and only one perspective.
We’re not talking about a fringe group. As Matt Holt (who doesn’t even support single-payer) writes on The Health Care Blog, “Now imagine that there’s a policy that polls show at least 35% and (depending who you believe) perhaps up to 60% of all Americans want, and that the same polls show that a vast majority of Democrats want it… So by the numbers, in not even considering the single payer option (not even Kennedy’s plan comes close), the Democrats are proving themselves to be pussies.” But even beyond partisan politics, we’re talking about simple fairness. Many countries around the world enjoy the benefits of reduced costs, choice of provider, and equitable, quality care. That doesn’t even warrant a hearing? Moreover, Baucus, Kennedy, Obama and the House leadership are themselves championing public coverage based on Medicare in the public health insurance option – the main fault line between progressives and conservatives in Congress. It would only be to their benefit for a frank discussion of an even more aggressive approach to public coverage – namely, Medicare for All.
In that same interview with Klein, Sen. Sanders, dishes some dirt on a cordial meeting with Sen. Baucus and single-payer advocates:
Baucus began by talking about a trip to Canada and saying he left impressed by what he'd seen. People in Canada seemed to be doing a very good job. He also indicated that he regretted having said that single payer is off the table. But he felt that at this point the process was so advanced and the timetable so tight that he didn't think he could schedule anything.
So much for the Finance Committee. The Health, Education, Labor and Pensions Committee, chaired by Ted Kennedy, is a different story, as their hearings and deliberations are to begin this month. For the sake of having a true, honest debate on all options that can meet the president’s three principles, single-payer deserves an honest hearing.
(Photo credit: Jenae on Flickr.com)
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Comments (13)
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Tim has been an online organizer and blogger on health care policy for the Obama for America campaign (during the primaries) and currently for the Committee of Interns and Residents/SEIU Healthcare, a labor union for intern and resident doctors. Views expressed here are Tim's, and don't represent the positions of CIR or SEIU.

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This is not for this time. It is for next time.
Bohdan A. Oryshkevich, MD, MPH
Posted by Bohdan Oryshkevich on 06/06/2009 @ 02:25PM PT
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today i met with some OFA folks and others who were interested in reform. over half the group supported single payer. i was told by the moderator that OFA does not endorse single payer. i politely told them they should not obstruct debate.
we all left on friendly terms and have even planned an event in new haven at the international festival of art and ideas or something like that. kind of an outreach thing to see how informed the public is about reform an an attempt to encourage them to get involved in contacting their legislators. in all honesty, i think the administration is trying to micromanage the grassroots effort directed at health care reform. i think they are beginning to see that some of the "followers" actually have minds of their own.
i am still wondering why the obama camp is not affirming the merits of CONSIDERING single payer. they have to realize that this looks bad from a democratic point of view.
i had heard that dodd was considering a hearing on single payer in the HELP. i know he is getting an earful from single payer advocates within our state. i think it is important to hand hold these guys now and let them know we are happy but we expect them to do what is in the public's best interests. dodd is fighting for his political future and i believe he is ready to do something bold. if SP advocates in CT go to battle for him in 2010, he stands a better chance of winning the election. also, there are rumblings he may want to run for governor. either way, his departure from corporate politics will only serve to help his prospects. dodd is asking people to you tube him about health reform. maybe he really wants to do something.
democrats pussies????
Posted by Lauren Serven on 06/06/2009 @ 07:33PM PT
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Tim, would not a constitutional amendment be needed to usurp state and individual freedom in this way?
Posted by Charlie Reed on 06/06/2009 @ 08:13PM PT
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To have a hearing?
Posted by Timothy Foley on 06/07/2009 @ 11:04AM PT
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i guess if the government wants to provide national health insurance for the citizens they can. to avoid any constitutional upset, let the private insurers stay in biz, but take away their federal employee customers and their advantage programs.
this is what the private insurers are really afraid of, the loss of a taxpayer based supply of customers. and if you start to tax the private insurer employer based benefits you will have successfully extracted the tax payer's money from the private insurance industry. without those taxpayer dollars, they will have to be competitive. gee, imagine that, a business having to operate with a business model that is actually competitive. well, those CEOs must be real smart because you know they make very nice salaries. i'm sure they will be able to figure out a way to swindle, er provide an attractive product for the consumer.
i don't know about you, but i am sick of paying taxes to fund this industry. our health care system can be less expensive, cover more people, and be transformed into a model that will fit 21st century medicine by adopting a single payer system of administration.
i don't care about my constitutional right to purchase private health insurance...hell, i can't even afford private health insurance. i am more concerned about my human right to health care access and protection. private insurance companies don't seem to be guaranteeing too many folks with that.
Posted by Lauren Serven on 06/07/2009 @ 05:56AM PT
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Lauren, What i am asking is, do they have the comsitutional right to take away a states' right to manage these affairs, or an individuals rights in this case.
Posted by Charlie Reed on 06/07/2009 @ 06:07AM PT
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I am convinced it is the only way to start refining the process of putting the usa on parity with france, uk, canada etc.
Current day physicians just do not have a clue how bad things are. Self delusion and out of touch.
The so-called "dillema of healthcare polls" is really simple. While 80% urge major reform, 70% cling to their present care. The explination is simple, desperation and fear cause people to cling to a familiar devil, a devil that is unsustainable.
They have their heads in the sand with the prosperouus medical establishment. It must be changed NOW!
Posted by grant simmons on 06/21/2009 @ 10:22PM PT
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I'll admit, Charlie, I'm going to sound more combative than I'd like to here, but where are the rights being taken away? Any Single Payer system that would be implemented in the United States would take care to make sure the patient is able to choose his doctor and his hospital; it's even feasible that single payer could improve choices in personal care by being able to do away with things such as required referral and other constraints put on most affordable private insurances plans and focus on reforming payments to control costs (I personally prefer the Mayo system).
Doctors and Hospitals may have less flexibility in negotiating payments, but that's not even necessarily a bad thing. Patients shouldn't be treated as contracts, with providers fighting to get the most profit out of each one them. So long as providers meet the prescribed standards, they would still be allowed and be able to benefit from experimentation and innovation. Nobody is really losing a choice or a right with a single payer system.
As for states, they don't necessarily need to lose power over their health care laws. Accreditation could still be handled by States, as could Malpractice and certain coverage (in cases like Euthanasia, Medicare could be required to only cover it if the state allows it). The only significant thing states would lose is management over Medicaid, which would be made redundant with universal Medicare. In the case of Medicaid, most regulation already comes from the federal level (DRA 2005 and such) and still requires states pay into it, I think that state legislatures would be relieved to have that funding responsibility lifted from their shoulders so they could focus on the parts of health care they actually manage.
This all depends on the way it end up implemented of course, but a Universal Medicare program can easily and effectively meet all its goals without reducing either a patients or states power in health care. Given that Medicare, Social Security and Medicaid have been deemed totally constitutional, they constitutional right of the federal government to provide voluntary and compulsory insurance. Now,
I'm sure you're a legitimately concerned person, Charlie, and I'll say again this sounds more combative than I'd like it, but I always found the constitutional argument to be more of an mask for opposition than a standalone concern.
As Teddy said, "The Constitution was made to serve the people, not the other way around"
Posted by Jacob Levine on 06/07/2009 @ 01:01PM PT
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Jacob, I was not commenting on how good the plan might be, just as to the legality of canceling states rights. Federal government and even state government were granted by the people with certain limited powers. I am wondering by what twisting of those powers the state of mass. can be forced to give up its' own system and adopt a federal one. Taxing me to support the less fortunate I understand. My liberty, I am prepared to fight within the system for. (yes that is combative)
Posted by Charlie Reed on 06/07/2009 @ 04:47PM PT
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Yet how are states rights being canceled? The federal government would not be recieving additional duties but simply additional scope, so if the exsisiting program are legal, one covering more people should be as well.
All I say now is among those powers granted to the Federal was to promote the general welfare (Article I, Section 8) and Health Care is entirely within that remit. Every precdent states that yes, the Federal Government may manage health care. Now, what rights would states be losing under a Single Payer system and how, may I ask, does it attack your liberty? I see the concern, but I don't see the real substance behind it.
Posted by Jacob Levine on 06/07/2009 @ 05:55PM PT
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"Obama wrote in a letter to Democrats this week that he "strongly" backs creating a public insurance option to compete with private carriers, and also signaled that he is open to the idea of requiring coverage for all Americans."
http://tinyurl.com/l3l4rg
Now, how is mandating that every American purchase health insurance (and then subsidizing the tens of millions who cannot afford it) any more or less "radical" than Single Payer?
Such a system is less radical in that it leaves most of the current methods of financing health care in place. It is more radical, however, in its added complexity.
The Radical Is The Rational.
Might that be a motto for Single Payer advocates?
Posted by Martin Bring on 06/07/2009 @ 07:06PM PT
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"The Radical Is The Rational.
Might that be a motto for Single Payer advocates?"</blockquote>
That should be the motto to stand up to all the Orwellian vampire cabals that are bleeding our society into Ruin.
Health Care Insurance is neither the biggest or the worst, but if we cannot stand up and put a stop to them, where can we start?
Posted by Bob Danforth on 06/22/2009 @ 09:45AM PT
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Has HELP already convened? And if not, can you repost/bump this blog entry along with the contact info for the HELP committee so we can ensure single-payer will be a part of this?
Thanks!
Posted by Evan Shulman on 06/30/2009 @ 12:05PM PT
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