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Robert Weissman
YES! Magazine / Op-Ed
Published: Saturday 30 June 2012
There is a single solution to the challenges of providing coverage to the 50 million who are uninsured that would curb out-of-control health care costs and provide a humane standard of care to all who enter the medical system.

Medicare for All: A Single Solution to the Health Care Fracas

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It will take some time to digest the Supreme Court's decision yesterday, but it appears to have averted some terrible jurisprudence that might have very seriously restricted the government's overall ability to regulate the economy and protect citizens.

In upholding most of the Affordable Care Act, the Supreme Court lets stand legislation that offers some important benefits, but only to a portion of those who are uninsured, and will predictably fail to solve our nation's health care crisis.

However the health reform law ultimately plays out, we know two things for certain: Tens of millions of Americans will remain uncovered as will tens of millions of under-insured who will remain at risk of financial ruin if a major illness strikes; and it will leave the private health insurance and pharmaceutical industries in charge of prices and life-and-death treatment decisions.

There is a single solution to the challenges of providing coverage to the 50 million who are uninsured that would curb out-of-control health care costs and provide a humane standard of care to all who enter the medical system. That solution is an improved Medicare-for-All, single-payer system.

The improved Medicare-for-All approach starts with the premise that health care is a critically needed right that must be afforded to all, irrespective of any individual's ability to pay for care. It solves the problems of 50 million uninsured Americans simply and directly by establishing that everyone is covered by the improved Medicare-for-All system. Everybody in, nobody out.

Improved Medicare-for-All would prevent the deaths of the 45,000 Americans who die every year from lack of health insurance. It would eliminate the hundreds of thousands of medical bankruptcies—affecting millions of Americans every year—that occur because people can't pay their medical bills. These deaths and economic tragedies are entirely preventable; a system that permits them to continue is morally repugnant and must be replaced.

The improved Medicare-for-All approach would eliminate the greatest waste in the health care system: the needless costs imposed by private health insurers. These firms impose hundreds of billions of dollars of excess cost on us via excessive profit-taking and executive compensation, marketing expenses, vast bureaucracies devoted to denying care, and imposition of massive paper-pushing obligations on actual health care providers.

It is not for lack of policy justification or moral force that Americans continue to suffer from a malfunctioning health care system. Our failure to have adopted an improved Medicare-for-All system is due in large part to the political power of the health insurance industry.

That political power can be overcome, however, by a grassroots movement that musters enough of its own power. The country cannot continue to survive the continued reign of the private health insurance industry, and it will not.

Winning a single-payer system will not be easy. In the near term, the single-payer movement will need to devote substantial energy to holding off efforts to further privatize and weaken existing Medicare

The early steps forward in winning expanded and improved Medicare-for-All will likely come from state initiatives, where success will depend on local movements plus assurances that states pursuing improved Medicare-for-All can obtain needed waivers from federal laws and rules.

But there should be no doubt about what must ultimately be achieved. We can no longer tolerate a system that pointlessly kills 45,000 fellow Americans a year. For those who doubt the political potency of this moral imperative, consider that economic facts counsel just as strongly for an improved Medicare-for-All system.

We can be our brother's (and sister's) keeper and be cost-effective at the same time. Indeed, it turns out that being cost effective requires that we take care of each other.

Robert Weissman is president of Public Citizen, a national, nonprofit consumer advocacy organization based in Washington, D.C. Public Citizen has supported a single-payer system since its founding more than four decades ago. For more information on its advocacy for a single-payer system, please visit

ABOUT Robert Weissman

Robert Weissman is the president of Public Citizen. He is an expert on economic, health care, trade and globalization, intellectual property and regulatory policy, and issues related to financial accountability and corporate responsibility.

Universal health care is the

Universal health care is the only workable option until someone can think of one that is better. That is doubtful. Taxes may not go up that much more but may be spent more wisely therefore a better deal with little increase. Regardless, as is said in these comments (the sensible ones anyway) care for our fellow man is bottom line the only way. Get rid of the greed and lies to steal more than deserved. Other civilized countries are proof.

For the past thirty years

For the past thirty years medical costs have been rising faster than wages and inflation. During that time most people were covered by their employers, which offered no deterrent to stop rising medical costs. As prices went higher, employers covered the costs. With the baby boomers coming in for retirement and their pensions coming due, there was a shortfall of funds to cover this. Why? Because instead of putting that money away businesses were using it for their own reasons. It was invested in new machinery, and stocks etc. The stock market was good for that, in most cases turning a sizeable profit of as high as 8 to 10 per cent for years. But when it crashed, there went that money. Huge losses wiped out billions in gains. On top of that remortgaging or buying property as an investment was a bubble that burst not long after the technology bubble did, and even before that you had the Savings and Loans crash (Newt was in on that one). Anyway, with so many losses and bailouts the wealthy turned to the buying of futures in oil, sugar, wood, and metals in the commodity market as a safe investment. All that speculating artificially drove up the cost of oil etc.. Even our biggest supplier Saudi Arabia told Bush Jr when he went looking for relief, that they could do nothing as they (OPEC) were not responsible for the spikes. It was the world's richest 1% betting on future prices going up or down that caused the spike in fuel prices. Whenever fuel went up, the economy pulled back. The price of oil and the crash of the stock market caused recession after recession, and as a result, companies, unable to back pensions and healthcare costs either closed or passed more of the burden unto it's workers, who's wages had already lost buying power and this made it worse. The survivors like Blue Cross and Blue Shield split into separate entities to save costs, HMO's popped up to try to compete, and the idea was to make a quick dollar while decreasing quality care, eliminating previous conditions and all kinds of tough new regulations, but the system itself could no longer be supported as before. The less people could afford insurance, the higher costs went. The higher costs went the less quality was available. Less quality equals more lawsuits. More lawsuits meant higher costs for medical malpractice insurance. Then doctor fees went up. One thing beside that went up, CEO wages and company profits went higher than ever, because they refused to handle previous existing conditions, in many cases denying benefits to terminally ill subscribers. Medical caps were put on the amount an insurance company would cover. In the end, we all suffered but the companies themselves. People lost their jobs due to outsourcing, with no savings to pay for COBRA (a disaster type backup but costly). If they had a medical illness like my friend who needed a gall bladder operation, he had to be covered for two years before they would pay for the operation, or he had to pay out of pocket. (I moved before I found out how that went for him). Another thing, if you had coverage and your coverage didn't pay the full amount, under Blue Shield you didn't have to pay the difference in most cases. If you had NO coverage you had to pay the full amount that Blue Shield didn't even have to pay because they were a BULK provider. Individual subscribers were at an economic disadvantage. People found out that a hospital could not legally turn you away from an emergency room (a good thing for the poor without coverage, a bad thing for the hospital who made up the loss by charging higher costs to those who had insurance). Plus if you were in a different state you could pay more or less for the same MRI, etc. There was NO interstate competition pricewise.

The cycle HAD to be broken. Like car insurance becoming a necessity, it only made sense that healthcare NEEDED regulation. Everyone had to be covered not only because it was the Christian thing to do, but so that something could be started to stop doing the same ol' self-destructive practices over and over. If the government, under Medicare could set a ceiling on costs like Blue Shield for everyone, than maybe the spiral could be broken. If insurance companies are forced to compete against a government run plan, then those high CEO wages and costs will have to come down and they will have to work for every customer's dollar instead of robbing them for profit. I am convinced that single-payer Medicare for everyone is the way to fix the system, and eliminate greed and suffering completely. I doubt if I will live to see it, but consider this, if you took the cap off the number of doctors that can be trained that the American Medical Association has set (so many schooled per year), and flooded the market with doctors, and if you had government contracts for the largest pill manufacturers that had to be bidded on, and if you stopped Goldman Sachs, Chase, GE, and others from bidding up the futures market, and if the government voided all those free trade agreements that favor imports over exports, yeah... that's all you'd have to do... but profits would fall for the greedy, and there ain't no way that will happen when elected officials need campaign money. Unless you designate that 3 dollars or more from your tax refund towards a campaign fund, but that will never happen. But if we did all that I guarantee you that things would shape up to be a lot better for every working American, plus there would be a lot more of them working to be able to pay for health insurance, especially under a cheaper government controlled plan. Of course that wouldn't be Capitalism would it? It all comes back to capital... it's not about making a buck anymore, it's about making a ton of them. And to hell with the poor homeless man choking up blood in the street. It's the American way... even if that man was a Vet.

"All I have in this world is my balls and my word,
and I don't break them for no one."
Al Pacino- Scarface

education and healthcare

education and healthcare should be every citizens right.

instead of letting a person

instead of letting a person decide how much health care they want have gov decide by using dr berwick method of cost + effectivness+ who you are

Those in favor of Universal

Those in favor of Universal Healthcare don't seem to realize that countries which already have it in some form like Socialized Medicine, pay 50-60% in taxes (once you add together Income Tax, National Insurance Tax, and the 20% Value Added Tax levied on all merchandise sold in stores, in order to pay for it. Is that what you all want?

Perhaps those who never worked and never will, would like it; why not? They don't have to pay for it. But those who work are the ones who keep getting clobbered for all of these "free programs". Nothing is free. SOMEONE has to pay for it.

After you figure in all of

After you figure in all of the taxes I pay, it's around 50%. Yes, I would like to have healthcare for 50%. They also have other benefits too, such as free university education and when there aren't jobs for those to work, a guaranteed place to live with food and basic clothing allowances too.

Sure, I'll trade a few dollars for that sort of security for my family and me. You bet.

What people who don't want national healthcare don't realize is that other countries that do have these benefits standard of living is just as high as the USA's. Travel to New Zealand or Norway, for instance, and ask people, see how they live, and see for yourself the benefits they receive--their taxes are offset by free human necessities--such as education, healthcare, and a very effective safety net.

See how they have a notion of care for others in their own country, for the benefit of all. See how they interact with one another. Check the crime rates in Norway. Educate yourself.

The Koch Brothers could

The Koch Brothers could afford to pay for it all by themselves!!!

ALTAGIR, The Koch Bros are

ALTAGIR, The Koch Bros are proof our tax code has let some have too much.

@BOBINBPT--have you added up

@BOBINBPT--have you added up all the hidden taxes and fees WE pay? Even before I get to spend a dime, almost 30% of my check goes to all sorts of interesting things that I don't benefit from. Then, once I go to pay bills, there are fees and surcharges and taxes that add another 10-15% to the final amount. Taxes are added to the gas for your car, your phone service, your electricity and other utilities... At least in those countries that pay the same amount of taxes as we actually do, people get something useful for what they pay in.

BTW, most countries' average citizens pay about 40% in taxes including all of what you list. The nice thing is that the wealthy don't get a pass on things like medical (Medicare) and pension plans (Social Security) like they do here. It really is a bad thing when a person can earn millions a year and only contribute on the first $108K. Everything above that is exempt. :(

Enemies of Universal Health

Enemies of Universal Health Care should revisit what Winston Churchill said about Democracy (having changed Government for Democracy and Health Care for Universal Health Care): Many forms of health care have been tried and will be tried in this world of sin and woe. No one pretends that Universal Health Care is perfect or all-wise. Indeed, it has been said that Universal Health Care is the worst form of health care except all those other forms that have been tried from time to time. GOP, the contrarians, are against anything proposed by a Democratic WH even if it sinks the nation. In the 80’s, Clinton was for an employer mandate on Health Care, GOP was against it and for an Individual Mandate instead. Now Obama's for an individual mandate, Repubs are screeching against it. Go buy a used car from the GOP.

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