The basic debate about single payer and whether we want it is over, and the only voices telling us that we do not want it belong to entrenched special interest groups. Reformers need to pull together, coordinate efforts and combine strengths, and the sooner the better. Special interests have been well organized for a long time. Now it's our turn to unite or lose.
Why can't we get health care reform accomplished? What do we do now?
Facts: special interests are owning us - Hillary Clinton's universal health care reform was quashed within months with such authority that for over a decade real health care reform has really become "The third rail in political life." Citizens did not quash this effort, special interests did.
- US citizens are prevented from buying drugs from Canadian pharmacies at sometimes half price. Our regulators said they were saving us from risky purchases and unsafe drugs. Not only was this offensive to Canada but simply untrue. Citizens did not quash this effort, special interests did.
- Medicare Part D prevents Medicare from negotiating prices with the drug industry. Do you believe citizens don't understand this affront to their intelligence? Citizens did not prevent shopping for the best price--special interests did.
- Most recently the Bush Administration used stance on the "morning after pill" as a litmus test for who gets to run the FDA. Ordinary citizens did not do this but a very large block of special interest did.
The special interests, which are well funded beyond anyone's wildest imagination, were able to work through our legal lobbying system and accomplish their goals to preserve their position in our economic life, albeit after spending 50 million dollars in the last several years. So, we know why they dominate the field, but what do we do about it? The rules for influencing our congressional representatives are not going to change. Assume for all practicality this is an axiom.
There is plenty we can do, but not in our current disarray.
More facts: we're unorganized
- We have had no attempt at real health reform for over a decade, with the health care crisis worsening almost on a daily basis.
- Health care reform remains in the citizens' court, but with no common leadership to accomplish the task.
- The Massachusetts plan is being implemented despite its predicted disastrous results.
- The Conyers plan advanced by the Coalition of Physicians for a National Health Program remains in committee and offers every possible health care need. I judge it to be totally unaffordable as written now, but certainly a goal to be reached--after very basic cost-control health reforms are enacted first.
- Senator Feingold's "State Based Health Reform Act" is in committee but urges studying the issue another five years. We can't wait that long.
In summary, there can be no "Band-Aid" approach to reforming this massively errant health care system. Tweaking deductibles and co-pays, adding health savings accounts, expanding Medicaid or Medicare, or simply adding bulk purchasing from the same wasteful system are not enough. Leadership from individual candidates is not enough; we need to pull together.
A new approach
Reformers need to pull together, coordinate efforts and combine strengths, and the sooner the better. I am recommending a meeting of all the health care coalitions working for single payer, universal health care plans come to one spot and meet. Some have great ideas and others have access to money. I would urge that manufacturers, unions, and other large employers be invited to attend in addition to representatives from groups already committed to a single payer, universal health care plan. At this meeting, a national single payer universal health care plan will be discussed and a set of common criteria will be established. I expect the criteria might approach 5-7 non-negotiable items. Following the acceptance of these criteria, I suggest citizen groups unite under a "super group" umbrella, put together grant requests, and approach manufacturers, unions and individuals of means who might consider working with us and contributing their money toward universal health coverage and use the money in the following way.
We would start by educating and supporting sympathetic candidates for open seats of Congress as well as state legislators (I think that if we can get universal single payer health care in a state first, fine, but the final goal is a national plan). After all, drug companies have raised upwards of 50 million dollars over the past several years and spent it in states as well as nationwide to influence legislation--and of course bump up their profits and bottom line. We can do it, too, but in a different way. It is a way of influence that is not very easy for drug companies to do. We will be able to get away with spending far less money; several million dollars will go a long way.
As an example, I recently encountered a man in his mid-twenties trying to wrest a seat from a member of the opposing party who had not supported single payer universal health care. This young man would support us--why shouldn't we support him? The last two months of the election process we would make a sizeable contribution to the candidate. Much of this money would likely go toward hiring people the last two months of the campaign to help this candidate win as well as working with him on his media spending. This might amount to $20,000 for a state candidate--perhaps more--but once he or she is elected, we have a person thinking our way. In Wisconsin, where I live, it might take two election cycles or more, but each time we would be changing the votes in our favor.
I am not concerned who enters the bill or even about his or her party affiliation, but it will have to be a bill that spells out all of our non-negotiable criteria with the included checks and balances. This bill will have to give ordinary citizens autonomy in administering any health program, totally free of the administration in power at the time.
The basic debate on single payer universal health insurance reform should be brought to an end and now all efforts should be spent implementing this reform.
www.healthsecurityamerica.com
fredb@healthsecurityamerica.com
fredb's diaries on Daily Kos
Thank you,
Fred Bannister, M.D.
Director
The Coalition for a Health-Secure America
Author Health Security America: Fixing the health care crisis