Health Care Here: Q & A on Single Payer Plan

May 5, 2009

Dear friends, relations, neighbors, acquaintances:

If I had the energy, I would write a letter to each of you separately. But I am old and tired; I can’t manage that.

Those of you who know me well know that I have for a long time paid attention to what is going on in the world. Not much of it has made me happy.

But recently I learned of something--a bill in Congress--that is the best news I have heard since the days of FDR. It is HR676, Expanded and Improved Medicare for All. It is a single-payer health care bill, the National Health Insurance Act, sponsored by John Conyers and co-sponsored by 75 others. It will cover every resident of the U.S.

It emphasizes preventive care, includes in-patient and out-patient , emergency, long-term and palliative care . It provides dental care, mental health services, vision care, chiropractic service, podiatric care, substance abuse treatment and prescription drug coverage.

In these days, when health care is the business of investors--of HMOs and PPOs whose single pursuit is profit--we need a different system. Now is the moment to reach for it.

I want to tell you about HR 676. I ask that you read on, and that you act. You may want to skim, choose what to read and what to skip. But you will get the idea. When you have understood what is at issue, please write your members of Congress. And please tell everyone you know about this, as I am telling you

You will ask:What does single-payer mean? Will it be another big bureaucracy?How will HR 676 work? Can we afford it? Who will pay for it? How?Why include everyone? Can we combine it with for-profit plans?Does HR 676 have a chance of passage in Congress? What about similar bills (HR1200, S703) and not so similar proposals?

The answers to these questions, and more, will be found at the web site of Physician for a National Health Program. The text of the bill can be found on google.

Type in HR 676.

To save you time, I offer some short answers :

What does single payer mean?It means that the government sets aside the taxes it collects for this purpose and pays the bills. The taxes, in this case are a 2% income tax and a 7% payroll tax.
Will it be another big bureaucracy?No. The big one is the one we have now, with multiple duplicating and fragmented entities--investors and their HMOs/PPOs.

How will HR676 work?We get an identification card, show it to our doctors, hospitals, etc. We are not billed, have no co-pays or deductibles.

Can we afford it? Who will pay for it?It will cost less, and we will pay less, than what we pay now. We all--except the poor-- pay:2% of income, 7% of payroll.

Is it “socialized medicine” ?No. That term means that the government owns the hospitals and employs the doctors. Here the doctors and hospitals are independent.
Why include everyone?Because that is the most efficient, lowest-cost way. And morally right. 22,000 of us die each year for want of health care.

Can we combine a single payer plan with for-profit plans?No. When we put everyone in one group, the costs are as low as they can be. When we have for-profit investors alongside, they will--as they have done--siphon off the low-cost young and healthy.
Does this bill have a chance of passage in Congress? It now has 75 co-sponsors in the House. It has wide public support: physicians, nurses, unions, the NAACP, the League of Women Voters, others.

What about the other proposals before Congress?In the Senate, Bernie Sanders has introduced a single-payer bill that stresses rural health centers and family doctor training (S703). In the House, Jim McDermott has introduced a bill similar to it (HR1200). Max Baucus and Ted Kennedy are meeting with people to put together a bill; but the people they are talking to are for-profits. S703 and HR 1200 also need our support.

MORE QUESTIONS? Please write to me, since I have done some reading. Or see the bill and PNHP.You may want to know what will happen to Medicare and Medicaid, VA hospitals, US employees’plans; what will happen to investors in HMOs, to their facilities and employees; how the US subsidizes health care today; how we got so stuck in the present system.