Single Payer and Poster Children

In the past week or so Senator Mitch McConnel has been telling the story of a Canadian woman who ended up getting treatment (at her own cost) at a facility here in the United States because she would have had to wait months to see the needed specialists in Canada under their Single Payer system
Senator McConnel is using this woman's story as a cautionary tale about the failures of Single Payer and why we cannot possibly adopt anything close to that here.
I won't pretend to understand what happened in this woman's case that caused the delays.
What I do know is that this failure in the Canadian system is relatively rare.
A good friend of mine is Canadian. Her mother was ill with a serious disease and a shortage of the appropriate specialist resulted in her recieving treatment in the US - paid for by the Canadian Single Payer system.
The Canadian Single Payer model is not perfect.
But Senator Mitch McConnell has a good Poster Child for his case.
I have 47 million.
What ever the weaknesses in the Canadian system, the Canadian system covers EVERYONE IN CANADA. No one in Canada has to rely solely on the Emergency Room for their only medical care, and then only when they are really sick. No one in Canada has to go into Bankruptcy because of their medical bills.
Senator McConnell and the Republicans point out that the Canadian system is not perfect.
DUHHHH!!!!
What a newsflash. The Canadians don't have a perfect system.
But for far less money per person than we spend, the Canadians have longer life spans, lower rates of infant mortality, and universal coverage.
He has his poster child
I have 47 million uninsured poster children.

Healthcare

There is a huge debate underway in the halls of Congress over the future of the American Health care system.
And despite large majorities in both Houses of Congress, the Democrats are loosing.
Sometimes I despair for my party.
Though it is clear to me that some form of Single Payer is far and away the best answer for this nation, that is an option that is not even being considered.
Sigh
The battle in Congress is largely over two issues. Including a public option and how to pay the $100 - $160B/year that this program will cost us.
Despite several polls showing very widespread public acceptance for a Public Option and a strong majority who are willing to pay more taxes in order to finance this system, some Democrats (including the the Blue Dogs) are blocking a public option. Listening to the debate I hear Republicans (and some Democrats) mouthing the same old tired attacks on a public option.
They ask if Americans want a bureaucrat standing between them and their doctors. The sad fact is that for most Americans there already is a bureaucrat standing between them and their doctors. The current bureaucrat works for an Insurance Company and that bureaucrats job is to protect the profits of the Insurance Company. I some how do not see that as any better than a bureaucrat who works for the US Government in the same role. In fact, since the Federal bureaucrat isn't focused on protecting any Insurance Company's profits, they might be more responsive to the needs of the patient and the decisions of the doctors.
For years Republicans have stated as if it were a fact that private industry can always do things better than a government entity. Yet now they are publicly worried that many people might leave private insurance for the government run insurance program. Why would they do that if the private insurers could do a better job?? Just look at how well Medicare is managed and what its administrative overhead costs are compared to the inefficiencies and bloated salaries and administrative overhead costs of private insurers. There are some things governments can do well and this looks like it might be one of them.
One of the elements of President Obama's proposal is a structure that studies medical methods and outcomes and costs and looks for ways to maximize positive outcomes while reducing costs. Though no one has proposed imposing the results of these studies on anybody, Republicans have twisted this into a government plan to ration care in some way. Its a lie but Republicans do seem to like their lies.
One thing that is lost in the current rhetoric is that the current system is financially unsustainable. Its not just that Medicare will grow to consume the entire federal budget, its that private citizens and employers will no longer be able to afford to provide quality care. There is tremendous waste and duplication and conflict of interest in the current system. Administrative overhead consumes about 30% of every health care dollar. (as an aside, overhead in Medicare is far far lower at about 5%). We have well over 1000 insurance companies along with hundreds of thousands of providers of medical services. Yet with all that supposed competition duplication and waste and inefficiency and costs continue to rise far faster than inflation. Without at least a public option, it may not be possible to get control of costs and without getting control of costs the question of who pays the bills is almost meaningless.
The current health care system in this country is a national disgrace. We have the best, most advanced, most successful health care in the world, if you can afford it. But we pay way too much for what we get. We pay 20%/person more than the second most expensive country and 50% more than the 3rd most expensive country and yet we have a shorter life expectancy that most industrialized nations, we have higher rates of infant mortality that any other industrialized nation, and we still have 50 million people in this country that do not have any health insurance at all. 62% of all Bankruptcies are partially or completely the result of medical bills and 2/3rds of those medical related bankruptcies involve people WHO HAVE health insurance. No other industrialized nation on earth would tolerate such an outrage.
And Republicans (with some Democrats) don't seem to really want to change anything.
We are facing a crisis.
And it doesn't look like we are going in the right direction.

Universal Health Care

Preview of Coming Attractions in Washington DC.The debate over health care.The President has pointed out (correctly) that the most important step that his administration can take to reign in long term government spending is to control the cost of health care. Far more than Social Security (which may or may not have liquidity problems long term depending on who you ask), Medicare, with health care costs in general, is growing at a pace that is clearly unsustainable.There are two Frontline articles that I recommend to everyone.Sick in America (http://www.pbs.org/wgbh/pages/frontline/sickaroundamerica/) examines the weaknesses and inefficiencies in our current system of paying for health care that rely in large part of for profit insurance companies. Sick Around the World (http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/)examines how 5 different capitalist countries addressed the issue of universal care. Of note, none of those systems allow for profit health insurance companies in their basic care programs.
Somewhat lost in the debate about how to achieve universal health care is the issue of cost. If we cannot find a way to reign in the growth in health care costs, who pays for health care will really be a moot issue, no one will be able to afford it.To his credit, President Obama has recognized that critical fact and is trying to make it a central part of the move towards universal care.
It is a national embarrassment that the Richest and Most Powerful nation in the world has 50 million people without health insurance (I am currently one of them).
Finding ways to control costs and ensure that everyone has access to the full range of health care (not just the emergency room) is perhaps the most important thing we can do for our future financial success.
Let the debating begin.