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Health Care for All: Why We Need a New Prescription

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Posted on Oct 1, 2013
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By Scott Tucker

(Page 4)

The competition and consumer choice that Obama touts merely keeps the premiums from skyrocketing, but such market forces are undesirable when it does that by creating crummy insurance products that do not provide adequate financial security. Instead of relying on the dysfunctional marketplace, we should have the government administering the program. Medicare has been far more effective in controlling health care prices than have the private insurers, but, furthermore, Medicare does it at an administrative cost of less than 2 percent, whereas private insurers will be using 15 to 20 percent of premium dollars for their own administrative costs and profits. If Obama really wants us to have greater value in health care he should have supported Medicare for All instead of accommodating the private insurance industry.

The Office of the Actuary of the Centers for Medicare and Medicaid Services recently released a report that shows in the next decade administrative costs for government health programs such as Medicare, Medicaid, VA, Children’s Health Program, Indian Health Service and others will be about $79 billion. Contrast that with the administrative costs of private insurers. They will be spending $313 billion on administration and profits—far more than the government spends on administration of its extensive public programs. The government gives us a far better deal than the private insurers. Yet Obama insisted that we should keep this lousy system in place.

ST: Health care for all is a basic social democratic reform that was won by class conscious movements in every industrial Western democracy other than the United States. Once the reform was gained, even the conservative parties of those countries soon adjusted to the new reality and made it part of the practical consensus in government. In some of those countries, that consensus is once again being eroded by parties and groups committed to a greater “free market” in health care.

The right wing in this country has tried to demonize Obama and the Democratic Party by calling them “socialists,” which turns reality upside down. Sen. Ted Cruz, a Texas Republican, launched a 21 hour speech against Obamacare in the Senate, and he compared anyone who fails to join his crusade to those who appeased the Nazis. Cruz was promptly upbraided by a Republican colleague, Sen. McCain of Arizona, who has always opposed the ACA and who reminded Cruz that “elections have consequences.”

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The ACA was not designed to be truly comprehensive, and it turns out to be a bargain for private insurance companies. The right wing treats any kind of health care reform as though it is a foreign import from scarlet Scandinavia, but we have a closer example of social democratic health care in Canada.

Don, in your Quote of the Day for September 25, you refer to a column by Matt Miller, “Canadians don’t understand Ted Cruz’s health care battle,” published in The Washington Post on the same day. Miller, who defines himself as a political centrist, wrote, “The moral of the story? Don’t let the rants of cynical demagogues like Cruz confuse you—it is entirely possible to be a freedom loving capitalist and also believe in a strong government role in health care.”

You commented on Miller’s column by writing, “That single payer is appropriately a centrist concept is demonstrated by the fact that it fulfills the fundamental business principles of being efficient (lower costs per person), effective (everyone is included), and of high quality (better health outcomes.)”

Matt Miller, however, failed to mention Tommy Douglas, who was named “The Greatest Canadian” in 2004 by a CBC Television program, after counting the votes on a viewer-supported survey. Douglas was a Baptist minister, a Scottish-born social democratic politician and a founder of Canada’s universal health care program. He was by no means a political “centrist,” and when he was premier of Saskatchewan from 1944 to 1961, he led the first democratic socialist government in North America.

The pioneering Saskatchewan Medical Care Insurance Act of 1961 became the prototype for other provinces, and by 1971 a single payer, universal health care plan was established throughout Canada. Tommy Douglas was a freedom loving socialist who fought for a health care program that lowered costs per person, that included everyone, and that maintained high quality and health outcomes. Most of the doctors in Saskatchewan had other ideas of fundamental business principles when they went on strike on July 1, 1961, the first day that Saskatchewan’s new health care program came into effect. Doctors from other provinces gave their own aid and services to the new program, and the public turned against the striking doctors. The social democratic reform of health care gained ground and momentum.

Obama did not even make the business oriented “centrist” argument for universal health care that Matt Miller has made. Indeed, Obama and the Democrats in Congress shut down an open debate on health care, and treated health care reform as though it was one more backroom deal between career politicians. The doctors who are members of PNHP no doubt include some Republicans, but I’d venture to guess most of them are Democrats. Some of them would even be partisan social democrats, if only this country had greater democracy in big elections. Since a corporate “centrist” such as Obama is red-baited by the right wing, anyone who proposes real social democracy in health care can expect the same treatment, though with more political justice.

So my questions concern the present political culture within Physicians for a National Health Program (PNHP), against the wider background of partisan corporate politics in this country. The social democratic reform of health care in other countries was won only with the support of strong labor movements and indeed of strong social democratic parties. Less than 12 percent of this country’s labor force is now unionized, and no one would mistake the party of Obama for a party of social democratic hope and change. Our situation seems dire, yet we have a world to win. Do the doctors of PNHP have the political will to form a strategic alliance with labor unions and with democratic socialists? Have such strategic political issues already been raised within PNHP? And how would PNHP envision a historical breakthrough for universal health care in this country, of the kind that occurred in Saskatchewan in 1961?


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