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[David Minton <dminton AT mindspring.com>]

On 11/12/03 6:34 PM, "Sil Greene" <Sil_greene AT unc.edu> wrote:

> .:I am not sure what the best solution is for the country as a whole. It 
> would
> .:be great to have a national healthcare system, but I am not sure if
> .:American's are willing to foot the bill for an effective one, or put up 
> with
> .:rationed healthcare in the case of a less expensive one.
> 
> This is a very good point.  We're obviously not willing to foot the bill
> for effective public education, after all, and public health care would
> likely turn into a similar debacle.
> 
> I don't believe for a second that effective equals expensive.  Not in
> education, not in health care.  Maybe one day we'll realize that it's more
> important to have working, effective, useful public services than to make
> one, or two, or a handful of private entities rich.

I listened to Dennis Kucinich speak on universal health care, among other
topics, on WUNC today (not sure which program). His idea is to eliminate
for-profit health insurance companies in the US. Not sure if an entire
industry would be willing to roll-over and play dead on command. I would
image they have a very powerful lobby that would have something to say.

Seems interesting though:

http://www.kucinich.us/issues/issue_universalhealth.htm

The Kucinich plan is enhanced 'Medicare for All' -- a universal,
single-payer system of national health insurance, carefully
phased in over 10 years. It addresses everyone's needs, including
the 40 million Americans without coverage and those paying
exorbitant rates for health insurance. This approach to healthcare
emphasizes patient choice, and puts doctors and patients in
control of the system, not insurance companies. Coverage will
be more complete than private insurance plans, encourage prevention
and include prescription drugs.

Health care is currently dominated by insurance firms and
HMOS, institutions that are more bureaucratic and costly than
Medicare. People are waiting longer for appointments. Fewer
people are getting a doctor of their choice. Physicians are
given monetary incentives to deny care. Pre-existing illnesses
are being used to deny coverage.

Over time, the Kucinich plan will remove private insurance
companies from the system -- along with their waste, paperwork,
profits, excessive executive salaries, advertising, sales
commissions, etc -- and redirect resources to actual treatment.
Insurance companies do not heal or treat anyone, physicians
and health practitioners do ...and thousands of physicians
support a single-payer system because it reduces bureaucracy
and shelters the doctor-patient relationship from HMO and
insurance company encroachment.

Non-profit national health insurance will decrease total healthcare spending
while providing more treatment and services -- through reductions in
bureaucracy  and cost-cutting measures such as bulk purchasing of
prescriptions drugs. Funding  will come primarily from existing government
healthcare spending (more than $1  trillion) and a phased-in tax on
employers of 7.7% (almost $1 trillion). The employers'  tax is less than the
8.5% of payroll now paid on average by companies that provide  private
insurance. 

This type of system -- privately-delivered health care,
publicly financed -- has worked well in other countries, none
of whom spend as much per capita on healthcare as the United
States. "We're already paying for national healthcare;
we're just not getting it," says Kucinich. The cost-effectiveness
of a single-payer system has been affirmed in many studies,
including those conducted by the Congressional Budget Office
and the General Accounting Office. The GAO has written:
"If the US were to shift to a system of universal coverage
and a single payer, as in Canada, the savings in administrative
costs (10% to private insurers) would be more than enough
to offset the expense of universal coverage."

Over the years, groups and individuals as diverse as Consumers
Union, labor unions, the CEO of General Motors, the editorial
boards of the Atlanta Journal-Constitution and St. Louis Post
Dispatch, and Physicians for a National Health Program have
endorsed a single-payer approach. It is sound economics --
what actuaries call 'Spreading the Risk' -- to extend Medicare
to younger and healthier sectors of our population, thereby
putting everyone in one insurance pool. It permanently saves
and improves Medicare, while eliminating duplicative private
and government bureaucracies.

While enhanced Medicare for All makes economic sense, it has not made
political  sense to some, due to the power of the private insurance lobby.
The streamlined  Kucinich plan is very different than the 1993 Clinton
HMO-based plan, a complex  proposal that left big insurance firms in a
central role. After Clinton's 'Managed  Competition' plan failed without
coming up for a vote, talk-radio host Jim Hightower  asked President Clinton
why he hadn't put forward a "simple, straightforward"  single-payer plan
"instead of all this bureaucracy." Clinton replied,  "I thought it would be
easier to pass" a bill that left the insurance  industry in place. "I guess
I was wrong about that."


I don't think it could happen, but it is a nice idea.

David

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