What Would Single Payer Look Like in The US, Dr. David Himmelstein

[mother earth]

Why strengthen the private insurance industry?

Dr. David Himmelstein: The goal would be to expand Medicare to all, considering private insurance costs seven times as much to administer compared to Medicare

An excerpt, for full transcript: http://therealnews.com/t2/index.php?option=com_content&task=view&id=31&Itemid=74&jumival=11152

DESVARIEUX: So let's just start off. Off the bat, can you just explain how the U.S. has the most costly health care system, and yet we don't cover everyone? How is this even possible?

HIMMELSTEIN: Well, we have an enormous number of people making profits and middlemen in the system. So our insurance companies, for every $1 we pay in, we get about $0.86 worth of care out. Fourteen cents of every dollar stays with the insurance firms, doesn't buy any health care. And we have enormous numbers of for-profit hospitals, dialysis companies, nursing homes, a lot of money being made in the health care system, not to delivering the care that people need, but actually supporting corporate profits and interests.

DESVARIEUX: So let's talk about that this system that we have now and what we're hoping to implement, which is Obamacare. Do you think that this addresses the root problems at all of what's happening?

HIMMELSTEIN: Well, Obamacare is really a compromise with the insurance industry and the drug industry, the people who've been running the health care system into the ground. So it would dump $1 trillion into the private insurance industry over the next ten years trying to get them to behave better. And it may get some people additional coverage, and expanding Medicaid, part of the Obamacare program, is probably a good thing. But it doesn't fundamentally address the problems in our health care system. And, in fact, the $1 trillion we'll give to private insurance companies in a way puts them in a stronger position.

DESVARIEUX: But, Dr. Himmelstein, there are people that are saying that we know Obamacare is not perfect. However, it is a path to eventually getting single-payer. What's your response to that?

HIMMELSTEIN: Well, we'll have to see whether that's true. I'm concerned that strengthening the private insurance industry may not be the right way to move towards eliminating the private health insurance industry, which is what we need to do to have a decent health care system. I mean, in Canada, insurance takes about 1 percent of running the system; in our system, as I said, about $0.14 of every dollar for insurance. And these new exchanges which are being set up, which are really just a sales force to sell private insurance, they're taking another 3 percent, another $0.03 of every $1, to run them. So we're spending an enormous amount of money pumping more administration, more bureaucracy into the system, and strengthening the private insurance industry. I worry that that doesn't lead us in the direction we need to go.

DESVARIEUX: Okay. Let's turn the corner here and talk about how we can actually implement a single-payer system in the United States, 'cause there are some people who are skeptical saying, you know, it works in Canada, it works in Denmark, but it's not going to work in the United States. Can you just lay out a framework of how single-payer could work in the U.S.?

HIMMELSTEIN: Yeah. Well, you could expand Medicare to cover everybody in this country, upgrade Medicare coverage. Medicare at present takes only about $0.02 to administer versus that $0.14 in the private insurance industry. And if you expanded Medicare to everybody, you would have that $0.12 on the dollar left over to actually improve the coverage. And you could give first-dollar coverage to everybody in the United States if you did a Medicare program for everybody and cut out some of the bureaucracy that the insurers now make hospitals and doctors put up with.

So if you go to a hospital in Canada, there's no billing office in most hospitals, because every Canadian has the same coverage and a hospital gets paid the way a fire department gets paid in our country. They get one check a month to run the entire operation. There's no need to figure out who got each Band-Aid and aspirin tablet. You go to a typical American hospital, there are 150 people doing nothing but billing. And we ought to put those people to work doing useful things, help taking care of people, and put those resources to actually making health care work in our country rather than shuffling papers and enforcing inequality, enforcing that some people have the right to good health care and many others don't.

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While they look for 50 billion to improve VA care, why not go full swing and implement a single payer system for ALL? The time has come to do away with the GOP endless whittling away at the ACA, and just DO what needs doing. Isn't it time?

[Thinkingabout]

1. A friend experienced the French healthcare last year after breaking her ankle.

Within three hours of going to the medical facility she had a cast, saw a primary care and orthopedic specialist, given crutches and the cost was $36. If she was a French citizen the cost would have been $8. When she returned to the US the copay was $35 for an orthopedic specialist

[mother earth]

3. People need to wake up to single payer, it's the only solution to bring costs down and improve upon

care. It's a solid return on money well spent, not what we have here, a constant political tug of war with all of us as losers. We have a health care crisis on our hands, and band-aids are not holding up.

[Enthusiast]

2. This is why it was necessary for the powers of darkness to co-opt the American media.

If the true health care story was told it would compromise the profits of hundreds of US corporations.

So, as a result of the threat to American corporate profit, the media has become so compromised that it has become a threat to democracy itself.

But Americans won't hear about this threat to democracy because the threat to corporate profit is more important than the threat to the lives of actual people.

See what we are up against here?

An honest and objective media is not only a threat to health care and insurance profits. An honest and objective media is also a threat to many non-health care related corporations that seek to profit by keeping consumers and citizens in the dark.

[mother earth]

4. Honesty and objectivity have been sidelined...it's time to reel it all in and demand better. I'm

with you, Enthusiast. Our "democracy" is a POW, SCOTUS granted corporate rule, and this is why everything is about profits now.

[Enthusiast]

5. These errant supreme court decisions have changed the fundamental nature of the country.

What ever happened to the good corporate citizen? Standard operating procedure is now the bad corporate actor.

This is a crisis.

I do not take any Democratic candidate seriously if they do not address this crisis in a meaningful way. That means you, Debbie Wasserman Schultz.

I have had it with these corporate lackeys.

Aligned with Third Way? Dead to me.

Say it again.

Aligned with Third Way? Dead to me.