Single Payer, State and National

Single payer is the only solution that will work.

The Citizens Federation and its statewide group, Greater MN Health Care Coalition, hold a clear belief that in order to make health care affordable for everyone, as well as paid for and delivered in a fair way, the key is to eliminate the role of the insurance company middlemen. They cause huge waste of 20% to 30% of all health care dollars, including imposing huge administrative costs onto hospitals and clinics. The insurance industry — including the supposedly benign non-profit HMOs have also poisoned the entire system, with a cold bottom-line, corporate mentality lacking compassion or decency. They have an upside-down business model: Making the most profit by denying people services. They put the very concept of insurance on its head: Instead of maximizing the pool to spread risk, they only want you if you don’t need much health care, and they absolutely don’t want you if you really need insurance to take care of significant medical needs. They don’t add any value, and are parasites, bankrupting more families and businesses every year. We spend twice what other countries spend on health care, and get worse results and widespread suffering.

A better alternative:

In contrast, look at the Medicare and Veterans Administration (VA) systems in our country. Medicare, in its original, traditional form, is a universal, single-payer public insurance program for everyone 65 and older, plus some disabled people. Its administrative overhead is a mere 2%. All providers in a region get paid the same amount for the same procedure. All enrollees get the same benefits, and pay a fairly low premium to the government. The VA goes a step further, with a “socialized” system in that the government owns the VA hospitals and clinics, and the staff are government employees. It has a very efficient, well coordinated hospital system. It uses its bargaining power to get much lower prices on prescription drugs — about 60% of what the rest of us pay.

The Citizens Federation and GMHCC support what is called a “single-payer system.” What does that mean? It means a system like traditional Medicare (but improved). The government takes the place of the insurance companies, and creates standard, comprehensive coverage that EVERYONE gets just by virtue of being a resident. It doesn’t matter what job you have, or whether you have one at all. Premiums are based on true ability to pay, according to household income. Out-of-pocket co-pays and other expenses are minimal or non-existent.

The Minnesota Health Plan

Our top priority is the Minnesota Health Plan, which is a serious effort in the Minnesota legislature to enact a public-administered single-payer program. It has one-third of all state legislators as co-sponsors, and it has already been approved by two Senate Committees. GMHCC helped write the bill, helped launch it, and has organized many events to publicize and support it, including a large rally at the State Capitol, turnout and testimony at hearings, and pressing candidates to support for it.

All state residents would get full coverage, including dental and long term care; no co-pays or deductibles; and pay an affordable premium based on household income — that is, ability to pay. Your age, gender, or pre-existing conditions will not matter at all. Some large self-insured employers might choose not to participate, but most likely would because they would end up paying less than they do now. Businesses’ contributions would be based on their profit level, which is much fairer than the current system. Overall costs would be reduced by slashing the wasteful, costly administrative overhead of the insurance companies and HMOs; reducing high specialty fees and drug prices; eliminating excess facilities and equipment; shift the focus of care to more primary care and reduce the need for expensive acute care

The Minnesota Health Plan’s bill numbers are SF (Senate File) 118 and HF (House File) 135. The chief authors are Sen. John Marty and Rep. David Bly. For complete information on the bill, there is a website devoted to it, including a summary and full text of the bill, list of co-sponsors, FAQs, and more. Click here to visit it: www.mnhealthplan.org.

What about single payer at the national level?
Ultimately, this is what we need. However, Congress is so heavily influenced by the money and lobbying of the insurance and drug companies, that national single-payer will be “the last domino to fall,” after it has been enacted and proven in a number of states. After all, the Canadian national single-payer system started with just one province. Others eventually copied it, and then finally a national system was consolidated. An alternative to single-payer could be a national system of very heavily regulated non-profit insurance companies, as is done in several countries. But like single-payer, this method would overturn the US insurance companies’ anti-consumer, wasteful and economy-wrecking business model. A national single-payer system would be more financially efficient than a regulated insurance model, and it would also be more efficient and simpler than a patchwork of state single-payer systems. Some day it is likely to come about, from sheer economic necessity. As Winston Churchill said while he was waiting for the US to enter World War II: “Americans can be counted on to do the right thing, after they’ve tried everything else.”