Single-Payer Universal Healthcare for all

Background: The Crisis in Health Care

Our country’s deplorable health care crisis continues to worsen, as the numbers of people who are underinsured or completely lacking health coverage steadily increase. Only a complete overhaul of our health care system will cure its grave illness. We must deeply question and reject the model of health care as a commodity, and eliminate the profit motive from all levels of our health care system. Corporate business concerns must cease dictating medical treatment access and choices.

More Americans are losing their health care insurance as they lose their jobs in times of economic crisis and corporations look for cheaper ways of doing business. 86.7 million people under the age of 65 – one out of three non-elderly Americans – went without health insurance for all or part of 2007-2008. Add to that 50 million who are currently underinsured, and another 30-50 million who have substandard care, and it is apparent that the magnitude of the health care crisis is staggering.

More than 22,000 people in the U.S. die prematurely each year because they have no health insurance. Lack of health coverage is the sixth leading cause of death in the United States.

This is a crisis and a national disgrace of major proportion.

(A healthcare perspective from the 2008 Presidential election.
Presentation by Rep. Dennis Kucinich at an SEIU forum on March 24, 2007.)

The results of relying on our for-profit health insurance system are increasingly devastating for ordinary Americans. Many people stay in jobs they hate because they are terrified of losing their health benefits. Families can lose their life savings and homes paying their medical bills. The percentage of Americans’ income spent on health care rose 200 per cent in the last quarter-century. More than half of personal bankruptcies declared each year in the United States stem from medical bills. Seventy-five per cent of those declaring bankruptcy due to medical bills have health insurance.

Nearly two-thirds of adults in this country – an estimated 116 million people – struggle to pay medical bills or go without needed care because of cost. Medical bills or accumulated medical debt have caused an estimated 28 million adults to use up all their savings, 21 million to accumulate large credit card debt, and another 21 million to be unable to pay for basic necessities. Particularly troubling is the fact that 61 per cent of those struggling to pay huge sums for out-of-pocket medical expenses have health insurance. These economic hardships cause stress, which in turn contributes to health problems.

Americans are primarily dependent on their employers for group health insurance. Ninety per cent of private insurance policies are taken out by employers, and that coverage is getting more expensive. Businesses now pay 10–17 percent of payroll for health care benefits. Health insurance premiums paid by Canadian employers, on the other hand, amount to only one percent of gross pay.

Private health insurance is very hard to obtain for individuals who do not have a perfect health history. People who move or change jobs find their chronic illnesses are no longer covered. Those who have recovered from a serious illness, such as cancer, often find that they can not obtain health insurance because of their medical history. Costs are rising for premiums, co-payments and deductibles, yet coverage has diminished or is eliminated for the specific problems people need care for. Most people who have health insurance do not have comprehensive coverage, such as long-term care or hospice.

Private health insurance premiums are rising at an unsustainable average of 13 percent per year – and are as high as 25 percent in some areas of the country. Anthem Blue Cross, the largest for-profit health insurance company in Maine, recently notified policyholders of a plan to increase premium rates as much as 38%.

Escalating premiums make coverage unaffordable for many and prompt many others to reduce their coverage by switching to less expensive catastrophic policies and/or policies with reduced benefits. As of 2006, approximately 72 per cent of policies in Maine’s individual insurance policy market had deductibles of $5,000 or higher and the average deductible was approximately $7,000. This means that Mainers are paying much more, and getting less coverage, or they are being forced to drop health insurance coverage altogether.

Between 2000 and 2007, family premiums for job-based health insurance increased by 78.3 per cent, while median worker earnings rose by only 14.5 per cent. Since 2006, Anthem has declared over $152 million in dividends, reflecting profits from all of their business in Maine in individual, small group, and large group markets. The only explanation for the demand for higher premiums is corporate greed.

The irony of the U.S. health care system is that, despite extraordinary measures to cut costs, our country spends more per person on health care than any other nation in the world. In spite of this outpouring of funds, people have fewer choices, and hospitals, clinics, emergency rooms and trauma centers are closing. In Maine, assisted living centers and nursing homes are closing as well, due to inadequate financial support.

The World Health Organization ranks the U.S. 37th in the world in quality of health care, and 55th in fairness. The United States ranks 25th in the world in terms of life expectancy. The American infant mortality rate is 7 per thousand live births, ranking a shameful 34th in the world. Maternal mortality stands at 14 per 100,000, which is twice that of Canada. Life expectancy and mortality figures for African-Americans and Native Americans are much worse.

Several studies have shown that for-profit hospitals have higher death rates than not-for-profits. Hospitals are dangerously understaffed, with fewer trained health professionals caring for larger numbers of more acutely ill patients. Supervisors in medical bureaucracies who make critical decisions increasingly are business people with no medical background. For-profit insurance companies and health maintenance organizations (HMO’s) make more money when they deny authorization for treatments and procedures, regardless of whether they are medically necessary.

For health care workers, conditions have steadily deteriorated under the combined effects of understaffing, overwork, poor pay, cuts in benefits, stress, disrespect and disillusionment with a system that does not allow them to provide adequate care to patients. Registered nurses and other professional health practitioners have been replaced by unqualified personnel; a dangerous yet common practice. Nurses are leaving the profession in large numbers because they are not valued or paid adequately, and because they risk losing their license when patients are harmed as a result of the conditions imposed by the profit-driven health system.

Public Support for a Solution

The United States is the only industrialized nation in the world without a national health care system. The current system’s high costs and widely recognized failures demand that bold, not incremental steps be taken. The Green Party supports a universal, comprehensive, national single-payer health program as the only solution to the current disastrous for-profit insurance system.

Public support for a universal health insurance program “in which everyone is covered under a program like Medicare that’s run by the government and financed by taxpayers” is high and rising rapidly. The public favors national health insurance to “the current health insurance system, in which most people get their health insurance from private employers, but some people have no insurance”. 64 percent of those polled support covering all the uninsured, even if it means paying higher taxes. According to 72 per cent of the public, “The time has come for universal healthcare in America.”

As far back as 2001 a majority of Portland voters passed a referendum supporting the concept of universal health care.

A majority of physicians nationwide (60 per cent) support establishing National Health Care Plan. A recent poll of physicians in the Maine Medical Association found that 52.3 per cent of those polled expressed a preference for a single -payer system such as “Medicare for All” over the current public/private system. The Maine Nurse Practitioner Association supports universal single payer health care.

People in the middle class, who never imagined they would be without health insurance, are finding themselves uninsured. Many companies that have gone out of business have laid off millions of workers and eliminated health benefits for millions of retirees. Premiums for COBRA insurance coverage offered after a worker is laid off of work are so expensive that they cost 83 per cent of unemployment income. The new groundswell of public support for single-payer is due to the unprecedented numbers of people who find themselves locked out of affordable health coverage.

On April 8, 2009 Maine State lawmakers made history by passing a resolution calling on President Obama and the Congress to establish a single payer health system that covers everyone.

SINGLE PAYER: The solution to the health care crisis

The Maine Green Independent Party has always advocated that health care must be a human right for all, and not a privilege for those who can pay, or a source of profit-making. We further believe that health is both a personal and a community responsibility.

Under a universal national single-payer health care system, we would pay less and receive more. The administrative waste of private insurance corporations (37 per cent of health dollars) would be redirected to patient care. The General Accounting Office of Congress has concluded that: “If the US were to shift to a system of universal coverage and a single payer plan … the savings in administrative costs would be more than enough to offset the cost.” According to Harvard researchers, the United States would save more than $200 billion dollars a year if we converted to a national universal single payer health care system. A single-payer system would allow the reorganization of existing health care expenditures toward substantial savings and broader coverage.

Businesses currently providing employment-based benefits would see their costs reduced. State and local governments would pay less because they would receive reimbursement for services provided to the previously uninsured, and because public programs would cease to be the dumping ground for high-risk patients and those rejected by HMO’s when they become disabled and unemployed.

Most importantly, the people of America will gain the peace of mind of knowing that needed health care will always be available to them. No longer will people have to worry about facing financial disaster if they get seriously ill, get laid off their job, or are injured in an accident. No longer will anyone have to put off addressing serious health problems for lack of coverage. We will all receive the same benefits that people in all the other developed countries have enjoyed for a long time: better quality health care, more preventive services, less cost, predictable coverage, and hopefully improved health statistics.

A universal, comprehensive, national single-payer health plan will provide, with no increase in cost:

  • Lifetime benefits for everyone
  • No one will lose coverage for any reason
  • No co-pays
  • No deductibles
  • No bill for service
  • Freedom to choose whatever type of health provider you wish, providing a wide range of health care services in private offices and public institutions
  • A publicly funded and administered health care program
  • Health decision-making back in the hands of health providers and their patients, where it belongs
  • Comprehensive benefits, as good or better than existing plans, including dental, vision, mental health care, audiology, hospice, long-term care, substance abuse treatment and prescription medication coverage.
  • Emphasis on preventative health care to promote healthy behaviors and practices
  • All licensed and/or certified health providers may participate, subject to standards of practice in their profession
  • Health plan benefits are portable; they go wherever you go
  • Primary and preventive care are priorities in the plan
  • Greatly reduced paperwork for both patients and providers
  • Providers receive fair and full reimbursement for their services in a timely manner
  • Preservation of all health care services currently available
  • Cost controls via streamlined administration, global health care budgets, national fee schedules, bulk purchases of drugs and medical equipment, and coordination of capital expenditures. Hospitals can afford safe staffing levels for registered nurses.

The single payer program would establish national, state, and local Health Policy Boards consisting of members representing health consumers and providers to oversee and evaluate the performance of the system, expand access to care, and determine research priorities. All meetings of the boards shall be open to the public.

It would establish a National Health Trust Fund and channel all current Federal payments for health care programs directly into the Fund, in addition to employers’ and employees’ health premium payments.

And it would provide funding for two years of salary benefits and retraining to people whose jobs are eliminated due to implementation of the new system.

Recognizing that human health is also affected by the health of our environment, the Maine Green Independent Party supports policies that would promote both human health and the health of our ecosystems:

· Eliminate the emission of toxics that pollute the environment and harm our health

· Improve identification and regulation of agricultural and industrial pollutants

· Eliminate the use of herbicides

· Mandate the labeling of all ‘foods’ that have been genetically engineered, irradiated, or to which chemical pesticides have been applied

· Fund research into the cause, prevention, and treatment of disease, including the ways in which toxic chemicals cause disease

Implementation of a national single payer health care system would create 2.6 million jobs in the national economy; this is a net figure that takes into account jobs that would be lost. Indeed, establishing a single payer health care system could pull the economy out of its quagmire by creating new jobs doing meaningful work, thus solving two crises at once.