Universal Healthcare

Cover of Sicko (Special Edition)

I just finished watching Michael Moore's Sicko. It was a truly amazing film. One of the segments that I found most enlightening was with Tony Benn, former member of Parliament. I transcribed an entire section because I found it to be the most coherent explanation of how we find ourselves in our current situation.

If you have power, you use it to meet the needs of your community. This idea of choice, choice depends on the freedom to choose. If you’re shackled to debt, you don’t have the freedom to choose. People in debt become hopeless and hopeless people don’t vote. If the poor in Britain or the US turned out and voted for people who represented their interests it would be a real democratic revolution.

I think there are two ways people are controlled. First of all, frighten them and secondly demoralize them. An educated, healthy and confident nation is harder to govern and I think there’s an element in the thinking of some people- we don’t want people to be educated, healthy and confident because they would get out of control.

Remember this. I'll be referring to it in a bit.

President Obama's health care plan calls for a public option to be added to our current system. The idea is to provide choice, thus driving down the costs of healthcare because insurance companies will have to do so in order to compete, never mind that every place this has been tried it hasn't worked. Seven states have tried this mixture of public and private plan and not one of them is a success. The choice they provide is illusory. As long as the private for profit health care system remains in place, costs will remain high. And as long as debt, or the fear of debt, exists, the poor have no choice. They, like Benn said, become hopeless.

So what if you think Michael Moore is loony tunes and not to be trusted? How about listening to a doctor? Dr Sidney Wolfe testified before the Subcommittee on Health last month. You can get the transcript here.

He believes, and the Congressional Budget Office and the Government Accountability Office agree, that our current level of spending, if switched over to a national plan, would be sufficient to cover everybody in the US with no co-pays and no deductibles.

Think about that for a moment. Every person in the US with health insurance. Where would that money come from? Your taxes. The amount that you're currently paying for health insurance would leave your paycheck and, instead of lining the pockets of Blue Cross or Humana, would go to the government. They would pay the doctors and the hospitals just like they now pay the firefighters and the teachers. And these doctors and hospitals wouldn't be government employees. The financing would be provided by the government but the system would remain private. We do it already with Medicare.

Who would this benefit? Only the 45 million US citizens without health insurance. Who would this hurt? The health care industry, of course, and by that I mean the insurance companies since they would cease to exist. Some how that doesn't bother me.

We don't trust the insurance companies. With good reason. They've been claiming they would cut costs for decades. Just a month ago, they promised to cut 2 trillion dollars in costs over the next 10 years. Wolfe says "the amount that can be saved over the next ten years by just eliminating the health insurance industry and the $400 billion of excessive administrative costs it causes each year is $4 trillion, in one fell swoop. "

Medicare has problems, certainly, but those mostly stem from the health care industry trying to make sure they keep getting paid. Like Bush's 2003 Medicare prescription plan that was supposed to save seniors all this money but actually ended up costing them more. The plan was pushed by Big Pharma. In fact the congressman who championed the plan left Congress to work for PhRMA, the drug industry's largest lobbying group. At a salary of several million dollars a year.

It's not just health care costs that are skyrocketing. The cost of higher education is growing more and more out of reach every year, placing a college degree out of reach for millions of Americans. In our increasingly technology dependent economy, this means these people will have fewer opportunities.

It's not just the poor that have concerns about the cost of health care, either. Medical bankruptcies accounted for 62.1% of all bankruptcies in 2007; 92% of these medical debtors had medical debts over $5000, or 10% of pretax family income, according to study published in the American Journal of Medicine. 75% of these people had health insurance.

This all adds up to fear and demoralization. Remember how Benn said you control people with fear and demoralization? A person unable to afford to attend college faces severe difficulties in today's job market. I'd personally find that pretty damn demoralizing. Knowing that you were one hospitalization away from bankruptcy makes for a lot of fear. So does not feeling able to change jobs because the one you have gives you insurance and with rising costs you might not be able to find another that did. Those 45 million Americans without health insurance at all live in fear every day. What happens if they get sick or injured? According to Institute of Medicine of the National Academy of Sciences, 50 people a day die because they lack health insurance and wait too long to seek medical care. That's 18,000 a year.

And that my friends, is the source of all our problems. Some say that to change to a single payer plan would be disruptive. President Obama says so. It would certainly be disruptive to the health insurance industry. Think it can't be done? That no one has ever done so? Think again.

Taiwan did it. In 1995, Taiwan moved to a single payer plan. Before, 40% of their population had no health coverage. Today 90-95% are covered. It just took the political will to do the right thing.

Obama wants to find and build consensus. He believes that despite the fact that 60% of Americans feel we need a national health program, he has to work with the health care industry and Republicans to create a compromise. Despite the track record of the health care industry over the last 40 years that proves in no uncertain terms their only interest is in increasing profits, he thinks he must work with them. Meanwhile, single-payer proponents have to beg to be heard. Any industry that considers paying a medical claim as they contracted to do is a loss, has no interest in being an advocate for reform. It won't happen. It's simply not in their best interest.

And so I remind you, Mr President, you were elected on the idea of hope. Hope for true change in health care cannot be found by working with the insurance companies or Big Pharma or the AMA. You and Congress must do the right thing. Not the expedient thing. Not the thing that brings in the most money for your campaign coffers, but the right thing.

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