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Massachusetts has the most expensive model of paying for health care that the world has to offer. It’s a model that preys on our genuine need for health care insurance to insure the short term profits of large corporations.

If the current House or Senate bills were to pass they would move from covering 84% to 96% of us, while other industrialized countries cover 100%. We spend 17% of our GDP, or 2.5 trillion dollars a year, on health care, while they spend on average 8 to 9% of GDP; this is an excess of about a trillion dollars a year for us; the excess is more than our military budget. We rank behind most industrialized countries in terms of health outcomes. All this is true, in spite of our having some of the best health care in the world. Our current system of paying for health care does not work; the proposed reforms have improvements, but do not go to the root of the problem.

No country with universal coverage relies on private, for profit insurance to finance health care. They all have a variety of single, not-for-profit systems. One version is a single payer system where taxes are funneled through a single governmental agency to pay either private or public providers of health care. Other versions are networks of not-for-profit companies that administer the payments to providers so that all play by the same rules; they are more like claims processing entities than insurance companies as we know them in this country. In this way, they cover everyone and need much less bureaucracy. Citizens spend much less on health care, have the security of no bankruptcies due to medical expenses, and have better health outcomes. It’s a partnership of government and providers that works.

For years we’ve had the ironic situation in which, while the majority of us are covered by private insurance policies, the majority of health care is financially supported by government. Tax deductions, Medicare, Medicaid, SCHIP, the VA, the NIH, Federal Employee Health Benefit Plans and other programs pick up where private insurance is unwilling or unable. Subsidies and mandates will only compound the inefficient role that government has in financing health care through a system that tries to rely on for profit insurance.

Besides spending too much, we pay dearly in other ways because of our system of paying for health care:

— Yearly, we have 45,000 of our fellow citizens dying due not to being able to afford health care.

— Hundreds of thousand of us file bankruptcy every year due to medical expenses. This just doesn’t happen in countries with a single, not-for-profit system. 75% of those filing bankruptcy due to medical expenses had insurance when they got ill.

— We don’t support good preventive and primary care.

— Providers spend far too much time and overhead fighting with insurance companies and thus less with their patients.

— We don’t have the cradle to grave coverage that gives the long term incentive to do what maximizes health.

— We do have for-profit companies competing to avoid paying for health care; they’re for profit and collecting premiums and not paying for health care is how to maximize profit.

Our electoral process leaves legislators beholden to the dollars of big corporations to finance their elections. We’ve seen energy policies, financial deregulations, and health care financing reforms that are designed for the short term profit of a few individuals and corporations. Profits have been privatized, risks socialized. This is not the partnership that works.

We have the tradition of public education, public police and fire protection, roads, public libraries, national parks and many other communitarian endeavors that have wide-spread support and benefit. Yet for several decades we have been driven by the mantra, “government is the problem, not the solution”. There is truth to the statement, when government is beholden to the short term interests of private corporations.

We now have a country in which our soldiers are four times more likely to die after getting back home due to lack of affordable health care than they were in Iraq or Afghanistan. Can we move to a government that represents the wellbeing of the many, more than the short term interests of a privileged few?

The health care reform debate of the past year is a case in point. Single payer advocates, with proven plans to spend less and cover everyone, wanted to be part of the discussion; they were excluded. A robust public option has had majority support and would contain costs; it was whittled down and now is gone. For a few weeks, the ability of those 55 and older to buy into Medicare was floated; it’s gone.

Some say the health care reform was too ambitious. By relying on a system that is way too expensive and inefficient, it was too timid. Our legislators now will face the threat of health insurance companies free to spend as much on attack ads as they please.

We can be a country that looks out for each other in terms of health care. In the process, we can have secure coverage for us all and spend half as much on health care as we do now. To do so, we need to trust that our government be of, by and for us. We must insist on it.

1. Frank Povah says:

   January 30, 2010 at 6:34 am

   Well argued, Bill. The Australian model isn’t perfect, but it’s sure better than the one I now live under. However, Australia is now burdened with the threat of a split system thanks largely (though not entirely) to John Howard’s mob and their mates in the largely foreign-owned private “health-care” (their words, not mine) sector. Howard’s government agreed with that lot that it was difficult for private health care to operate under “competition” from a “subsidized socialist health-care system”, so the government (i.e. taxpayers) pay them a subsidy to help their bottom line. Of course young people didn’t want to join – they don’t get sick do they – so the private funds offered gym memberships, rebates on jogging shoes, yoga classes, all that stuff, subsidized by the taxpayer. Very commendable, preventive care and all that, old chap. But why then shouldn’t the government scheme offer the same? After all, Australian women receive free breast screening and pap smears, there’s a free school dental service for remote areas and free immunization for kids and all that sort of thing. Well, the argument goes, if government offered things like gym shoes and Tai Chi classes, they’d be unfairly competing with the private sector because Medicare is subsidized. Yeh, fellers, and you aren’t? Anyway, who pays for your bloody subsidy AND Medicare? Shouldn’t we have a say in it? Oh yes, does that also mean that you’re only interested in the bits of health care that make a profit and making people well is only incidental to your business – a sort of sideline? Was it in “Geraniums red and delphiniums blue” that the poet said of the doctor (read health insurance) “If they live, they pay me well;/If they die, their heirs pay double”?

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2. Gita says:

   January 31, 2010 at 12:00 pm

   Bill, I have preached about the wonderful single payer system in Canada for years to deaf ears. I grew up there; my parents grew old there with cancer and heart problems that needed expensive treatment, yet did not bankrupt our family. Americans, including some close friends, respond with “horror stories” they’ve heard about someone’s cousin who supposedly had to wait years for a life-saving surgery. I explain that my mother, at age 81, was at her doctor for a regular checkup when her heart condition was assessed. Forty-eight hours later she was in surgery for a quadruple bypass. Following her recovery she spent two weeks in a state-of-the-art rehab facility to regain strength and lung capacity — all at no cost. She lived to age 92. What is important here is that at age 81 she was considered a human being worth saving by a medical community that values life — whereas insurance companies in the USA likely would have said “she is too old to undergo that type of surgery.”

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3. Frank Povah says:

   January 31, 2010 at 1:10 pm

   Gita’s right. There ARE waiting lists for SOME procedures in SOME parts of Australia but as in Canada, all else is treated as necessity demands. You need it, you get it regardless of age or income.

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4. Terri Evans says:

   February 1, 2010 at 10:09 am

   I’d go either place if they’d take me!

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5. Frank Povah says:

   February 1, 2010 at 11:05 am

   Ask Australia to swap me for you, Terri. The standard levy for Australia’s Medicare is 1.5 per cent of income up to $70,000 pa, rising by up to 2.5 percent for people earning over that amount who don’t have some form of private insurance. The 1.5 per cent reduces for low incomes and there are tax exemptions for children and so on. If you are retired and don’t have above a certain income from superannuation, investments, etc. – which is the majority – you pay nothing. “Treatment in a public hospital as a public patient is fully subsidised by Medicare. Regardless of means, every Australian is entitled to attend a public hospital and receive medical treatment free of charge.” Medicare sets a “scheduled fee” for doctors and if you choose a doctor who charges over this, you pay the difference. There is also a pharmaceutical benefits scheme whereby the cost of essential medicines are subsidized.

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6. Brenden says:

   February 3, 2010 at 11:09 am

   Canadian healthcare is so great the governor of one its provinces is coming to the U.S. for surgery. Why would that be, I wonder?

   http://www.cbc.ca/canada/newfoundland-labrador/story/2010/02/01/nl-williams-heart-201.html

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7. Frank Povah says:

   February 3, 2010 at 11:26 am

   He’s rich? He doesn’t want to be seen with the people who elected him? He’s a surgery snob? Canadian doctors have said they won’t treat him? Is he helping lobbyists plug a two-tier health system for Canada?Could we perhaps find out a little more before we start waving the old “what I believe is socialism is a failure” banners? Oh, and by the by, he’s not governor, Brenden, he’s the Premier, there’s a vast difference.

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8. Brenden says:

   February 3, 2010 at 1:16 pm

   I can convert to metric gov’t systems very well. So your saying someone even HIGHER on the political totem pole abandons Canada for the U.S. for healthcare? Hmm. If their own politicians don’t believe in their politically-rationed healthcare, well then…

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9. Frank Povah says:

   February 3, 2010 at 5:33 pm

   I quote you “the governor of one its provinces”. The metric system is another creeping socialist plot?

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10. Brenden says:

    February 4, 2010 at 10:24 am

    You know, I also find it amusing that I post a verifable fact about a high-level Canadian politician choosing to leave the country to escape its medical system — and you say, “Could we perhaps find out a little more before we start waving the old “what I believe is socialism is a failure” banners?”

    When before you cheered the socialist mantra, “You need it, you get it regardless of age or income” as random poster weaves a tale about parental medical treatment at some indeterminite point in the past — completely unverifiable.

    This high-level Canadian politican obviously needed surgery and could not get it in Canada.

    I will say the metric system and socialism are highly correlated, but that does not necessarily imply causality.

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11. George says:

    February 24, 2010 at 9:38 am

    According to every source that I could find there was no reason for Danny boy to fly to sunny Florida to have his surgery and recoup on the beach. There is still speculation as to who exactly is going to pay for the whole thing. I would love to get an itemized list of charges for the entire trip and find out who pays. Im sure the cost would be mind boggling I am going to guess that Danny is another spoiled wealthy conservative politician who found a way to have the taxpayers foot the bill for treatment and a vacation at the beach for something that according to everything I have read was available in at least 4 Canadian cities AT ZERO COST. And of course Mr. Williams doesn’t want to talk about his treatment or who is paying for because it’s personal and private. Brenden I hope you are one of the very wealthy and not just another guy that thinks you have something in common with people like Danny Williams just because your white. If you have a better idea that you could prove would cost less than what I have today and provide the same level of treatment I would love to see it.

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12. Brenden says:

    February 25, 2010 at 8:26 pm

    George, do you deny that wealthy power elite from all nations around the world come to this country to get their healthcare? It’s not some conservative capitalist conspiracy — it’s just that these people don’t want to die and they want the best healthcare in the world that they can afford. I will defer to Danny as to why he came here. Even if he did it for political pique, I don’t think anyone gets major heart surgery to score a political point. But conservatives are so very evil, they just might! I bet Cheney is faking all those heart attacks!

    And I love this:

    “Brenden I hope you are one of the very wealthy and not just another guy that thinks you have something in common with people like Danny Williams just because your white.”

    George, do you know how stupid this bullshit makes you sound? I guess I’m glad that the usual suspects no longer post on this forum these irrelevant racial cannards designed to feign concern for the little guy. Idiots.

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13. Johanne Sorola says:

    February 27, 2010 at 3:33 pm

    je suis fan aussi

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