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Feel free to reproduce any of these essays without prior permission as long as they are unedited and posted or printed with attribution and a link to the website.

Wednesday, November 25, 2009


Written by: Rick Staggenborg, MD on May 10, 2009 6:10 AM PDT

Congress is reportedly considering a variety of universal health plan options that involve using multiple payer sources including a Medicare-like plan and traditional insurance offered by for-profit corporations. These plans are all supposed to offer similar benefits, but there is a huge debate as to whether the public option will have to be handicapped by regulations to decrease its efficiency to match the poor performance of private plans. 

We do not know the details of the negotiations because Max Baucus, chairman of the Senate Finance Committee, has closed the hearings after supporters of a single payer, Medicare for All plan tried to speak from the audience in the opening committee hearing.  Instead of being invited to join the negotiations, 13  patriots including doctors, nurses and lawyers were arrested and charged with trespassing for refusing to be silent in the face of this betrayal of the American taxpayer, including most of the millions of workers who were denied access to health care.

The Baucus 13 were forced to speak out  when Baucus refused to invite any single payer supporter to the hearing, which was dominated by representatives of the for-profit health care, insurance and pharmacy industries. 

The ostensible purpose of  the hearings is to come up with a plan that will provide health care to the millions of low and middle income wage earners whose taxes would disproportionately fund the resulting plan. Instead, experts in the economics of  single payer health care were excluded from the process of coming up with a plan. Predictably, this  will ultimately prove to be a bailout of the medical insurance industry that has caused the crisis. Perhaps it is not coincidental that these same industries gave a combined total of over 1.6 million dollars to Baucus during the previous Congress.

The public option will not work because Baucus and these lobbyists are not about to endorse a plan that will let the Medicare option outperform the private plans, as it would if it were operated as efficiently as possible. How could Medicare, with its three percent overhead not outcompete private insurance, which consumes 30 per cent of its revenue in administration, advertising, marketing and profits? 

The only reasons Medicare is so expensive is that 1) It covers the at-risk elderly and the much sicker patients who cannot get private insurance and 2) Since the passage of the Medicare Modernization Act, it has been burdened by partial privatization and the unsustainably expensive Part D medication plan that specifically bars the government from negotiating for favorable drug prices using its huge purchasing power. These problems can be corrected by incorporating what amounts to repeal of this law in the reform legislation. 

As an Oregonian, I cannot fail to note that our own Senator Wyden cast the final and deciding vote for this bill, despite strong Democratic opposition to this blatant gift to the private medical insurance and pharmaceutical industries.

The Medicare Modernization Act is a perfect example of what a Senate brought to us by corporate sponsors will produce when it is not watched closely by citizens. This is the reason we must educate ourselves about the options being considered by Congress and more importantly, the one that is being explicitly not considered, the single payer system. 

Polls show that this is the option favored by over 60% of the American public and 60% of physicians. These numbers are growing rapidly as universal insurance approaches reality and people are educating themselves about the costs and benefits of various proposals. The percentage of doctors favoring a single payer plan has increased by ten percentage points in just five years.

The public option plans are estimated to sacrifice over 80% of the savings achievable through a single payer plan in order to satisfy the corporate medical care industries that dictate policy to many of our Senators. Single payer achieves its efficiencies through a variety of means. 

It streamlines paperwork and would dramatically cut administrative costs to providers that currently consume 10 % of the health care dollar. It eliminates excessive insurance industry profits and all of their advertising and marketing expenses. It would lower administrative costs because government employees do not demand excessive salaries to serve the public. A single payer plan can monitor abuses of fee-for-service providers and administrators will have the mission of ensuring prompt payment to providers, rather than to repeatedly review claims to find loopholes to deny payment.

Most people do not realize that government is only expensive because we keep re-electing pork-loving politicians who reward their corporate masters with lavish contracts paid for by the taxpayer. If we paid more attention to what our Congressional representatives were doing and routinely got rid of those not serving the public interest, corporate money would be less influential. In other words, most of the blame for the exorbitant cost of government is ours.

We are not powerless. President Obama has told us that we must “be the change.” If we let our Congress know that we want single payer now through letters to newspapers, magazines and especially calls, emails and faxes to members of Congress, we can change minds by empowering more responsible members of Congress to resist lobbyist pressure. 

As for those who put corporate interests over those of citizens, we can send them an even stronger message in 2010 and 2012, when 2/3 of the senate will stand for re-election. While there are compelling reasons to oppose single-issue voting, the establishment of a single payer system is the defining civil rights issue that will tell us which members of Congress understand and believe in democracy and which do not.

Please learn more about the advantages of a single payer system of universal health care at the website of Physicians for a National Health Program.

Rick Staggenborg, MD

Physicians for a National Health Care Plan

Coos Bay, OR


  1. This first essay was written on the Democracy for America website in response to a challenge to win a scholarship to their NetRoots Nation conference in Pittsburgh. It is essentially a protest of their having told the public that their purported million members supported the public option bait-and-switch presented by the Democratic leadership under the guise of reform.

    Ultimately, my blog became popular enough to win a partial scholarship to the convention, though only the winners got public recognition. At the convention, I confirmed my suspicion that all of the members I met would support single payer if asked, even if they signed on to promote the "reform" proposed by the Democratic leadership that was withdrawn as I predicted in response to the expected chorus of howls from the medical insurance industry who also claimed to want "reform."

    I have great respect for DFA founder and chief political consultant Howard Dean, but I would have even more respect if he would tell the story of how the public option strategy was developed. It was clearly a strategy designed to mollify the corporations comprising the medical-industrial complex. According to knowledgeable sources, Rahm Emanuel shut Dean out of the plannning despite his great work for the Party in getting Obama elected, then gave him his marching orders after the plot was hatched.

    You know the players in the medical industrial complex. They are the ones who paid so handsomely for such stalwarts of reform in the Senate as Schumer, Baucus, Kerry and the "Gang of Six" with whom Senator Wyden stood when he called to "slow down" the process of "reform." Meanwhile, he worked behind the scenes to block the toothless public option and get his own bailout scheme on the table.

    Did you hear about his Healthy Americans Act, Wyden's mandate plan to be paid for on the backs of the American worker? When unions complained, he used some of that corporate moneyy to demonize them in a Portland radio campaign. So much for Party loyalty among the Demicans. You can't tell them from Republicrats without a scorecard.

  2. Replies
    1. I am glad you agree, Deb. Thanks for reading and commenting, I wish more people had paid attention at the time!


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