Crash of Trumpcare Opens Door to Single Payer or Full Medicare for All by Ralph Nader

You can thank House Speaker Ryan and President Trump for pushing their cruel health insurance boondoggle. This debacle has created a big opening to put Single Payer or full Medicare for all prominently front and center. Single Payer means everybody in, nobody out, with free choice of physician and hospital.

The Single Payer system that has been in place in Canada for decades comes in at half the cost per capita, compared to what the U.S. spends now. All Canadians are covered at a cost of about $4500 per capita while in the U.S. the cost is over $9000 per capita, with nearly 30 million people without coverage and many millions more under-insured.

Seventy-three members of the House of Representatives have co-signed Congressman Conyers’s bill, HR 676, which is similar to the Canadian system. These lawmakers like HR 676 because it has no co-pays, nasty deductibles or massive inscrutable computerized billing fraud, while giving people free choice and far lower administrative costs.

Often Canadians never even see a bill for major operations or procedures. Dr. Stephanie Wohlander, who has taught at Harvard Medical School, estimated recently that a Single Payer system in the U.S. would potentially save as much as $500 billion, just in administrative costs, out of the nearly $3.5 trillion in health care expenditures this year.

Already federal, state and local governments pay for about half of this gigantic sum through Medicare, Medicaid, the Pentagon, VA, and insuring their public employees. But the system is complexly corrupted by the greed, oft-documented waste, and over-selling of the immensely-profitable, bureaucratic insurance and drug industry.

To those self-described conservatives out there, consider that major conservative philosophers such as Friedrich Hayek, a leader of the Austrian School of Economics, so revered by Ron Paul, supported “a comprehensive system of social insurance” to protect the people from “the common hazards of life,” including illness. He wanted a publicly-funded system for everyone, not just Medicare and Medicaid patients, with a private delivery of medical/health services. 

That is what HR 676 would establish (ask your member of Congress for a copy or find the full text, click "here." (Conservatives may wish to read for greater elaboration of this conservative basis, my book, Unstoppable: The Emerging Left-Right Alliance to Dismantle the Corporate State.)

Maybe some of this conservative tradition is beginning to seep into the minds of the corporatist editorial writers of the Wall Street Journal. Seeing the writing on the wall, so to speak, a recent editorial, before the Ryan/Trump crash, concluded with these remarkable words:

“The Healthcare Market is at a crossroads. Either it heads in a more market-based direction step by step or it moves toward single payer step by step. If Republicans blow this chance and default to Democrats, they might as well endorse single-payer because that is where the politics will end up.” Hooray! 

Maybe such commentary, repeated by another of the Journal’s columnists, will prod more Democrats to come out of the closet and openly push for a Single Payer system. At a recent lively town meeting in San Francisco, Minority Leader Nancy Pelosi blurted at her younger protesters: “I’ve been for single-payer before you were born.”

Presumably retired President Barack Obama and Hillary Clinton will do the same, since they too were for “Full Medicare for All” before they became politically subservient to corporate politics. 

Even without any media, and any major party calling for it, a Pew poll had 59% of the public for Full Medicare for All, including 30% of Republicans, 60% of independents and 80% of Democrats. Ever since President Harry S. Truman proposed to Congress universal health insurance legislation in the nineteen forties, public opinion, left and right, has been supportive.

We’ve compiled twenty-one ways in which life is better in Canada than in the U.S. because of the Single Payer health insurance system. Canadians, for example, don’t have to worry about pay or die prices, don’t take or decline jobs based on health insurance considerations, nor are they driven into bankruptcy or deep debt, they experience no anxiety over being denied payment or struck with reams of confusing, trap-door computerized bills and fine print.

People in Canada do not die (estimated at 35,000 fatalities a year in the U.S.) because they cannot go for diagnoses or treatment in time. Canadians can choose their doctors and hospitals without being trapped, like many in the U.S., into small, narrow service networks. In Canada the administration of the system is simple. You get a health care card when you are born. You swipe it when you visit a physician or hospital.

All universal health insurance systems in all western countries have their problems; but Americans are extraordinarily jammed with worry, anxiety and fear over how or if their care is going to be covered or paid, not to mention all the perverse incentives for waste, gouging and profiteering.

Time to call your Senators and Representatives. There are only 535 of them and you count in the tens of millions!

21 Ways the Canadian Health Care System is Better:

 

Number 21:
In Canada, everyone is covered automatically at birth – everybody in, nobody out. In the United States, under Obamacare, 31 million Americans will still be uninsured by 2023 and millions more will remain under-insured.

Number 20:
In Canada, the health system is designed to put people, not profits, first. In the United States, Obamacare will do little to curb insurance industry profits and will actually enhance insurance industry profits.

Number 19:
In Canada, coverage is not tied to a job or dependent on your income – rich and poor are in the same system, the best guaranty of quality. In the United States, under Obamacare, much still depends on your job or income. Lose your job or lose your income, and you might lose your existing health insurance or have to settle for lesser coverage. 

 

Number 18:
In Canada, health care coverage stays with you for your entire life. In the United States, under Obamacare, for tens of millions of Americans, health care coverage stays with you for as long as you can afford your share.

Number 17:
In Canada, you can freely choose your doctors and hospitals and keep them. There are no lists of “in-network” vendors and no extra hidden charges for going “out of network.” In the United States, under Obamacare, the in-network list of places where you can get treated is shrinking – thus restricting freedom of choice – and if you want to go out of network, you pay for it.

 

Number 16:
In Canada, the health care system is funded by income, sales and corporate taxes that, combined, are much lower than what Americans pay in premiums. In the United States, under Obamacare, for thousands of Americans, it’s pay or die – if you can’t pay, you die. That’s why many thousands will still die every year under Obamacare from lack of health insurance to get diagnosed and treated in time.

 

Number 15:
In Canada, there are no complex hospital or doctor bills. In fact, usually you don’t even see a bill. In the United States, under Obamacare, hospital and doctor bills will still be terribly complex, making it impossible to discover the many costly overcharges. 

 

Number 14:
In Canada, costs are controlled. Canada pays 10 percent of its GDP for its health care system, covering everyone. In the United States, under Obamacare, costs continue to skyrocket. The U.S. currently pays 18 percent of its GDP and still doesn’t cover tens of millions of people.

 

Number 13:
In Canada, it is unheard of for anyone to go bankrupt due to health care costs. In the United States, under Obamacare, health care driven bankruptcy will continue to plague Americans.

 

Number 12:
In Canada, simplicity leads to major savings in administrative costs and overhead. In the United States, under Obamacare, complexity will lead to ratcheting up administrative costs and overhead. 

 

Number 11:
In Canada, when you go to a doctor or hospital the first thing they ask you is: “What’s wrong?” In the United States, the first thing they ask you is: “What kind of insurance do you have?”

 

Number 10:
In Canada, the government negotiates drug prices so they are more affordable. In the United States, under Obamacare, Congress made it specifically illegal for the government to negotiate drug prices for volume purchases, so they remain unaffordable.

 

Number 9:
In Canada, the government health care funds are not profitably diverted to the top one percent. In the United States, under Obamacare, health care funds will continue to flow to the top. In 2012, CEOs at six of the largest insurance companies in the U.S. received a total of $83.3 million in pay, plus benefits. 

 

Number 8:
In Canada, there are no necessary co-pays or deductibles. In the United States, under Obamacare, the deductibles and co-pays will continue to be unaffordable for many millions of Americans. 

 

Number 7:
In Canada, the health care system contributes to social solidarity and national pride. In the United States, Obamacare is divisive, with rich and poor in different systems and tens of millions left out or with sorely limited benefits.

 

Number 6:
In Canada, delays in health care are not due to the cost of insurance. In the United States, under Obamacare, patients without health insurance or who are under-insured will continue to delay or forgo care and put their lives at risk.

 

Number 5:
In Canada, nobody dies due to lack of health insurance. In the United States, under Obamacare, many thousands will continue to die every year due to lack of health insurance.

 

Number 4:
In Canada, an increasing majority supports their health care system, which costs half as much, per person, as in the United States. And in Canada, everyone is covered. In the United States, a majority – many for different reasons – oppose Obamacare.

 

Number 3:
In Canada, the tax payments to fund the health care system are progressive – the lowest 20 percent pays 6 percent of income into the system while the highest 20 percent pays 8 percent. In the United States, under Obamacare, the poor pay a larger share of their income for health care than the affluent.

 

Number 2:
In Canada, the administration of the system is simple. You get a health care card when you are born. And you swipe it when you go to a doctor or hospital. End of story. In the United States, Obamacare’s 2,500 pages plus regulations (the Canadian Medicare Bill was 13 pages) is so complex that then Speaker of the House Nancy Pelosi said before passage “we have to pass the bill so that you can find out what is in it.” 

 

Number 1:
In Canada, the majority of citizens love their health care system. In the United States, the majority of citizens, physicians, and nurses prefer the Canadian type system – single-payer, free choice of doctor and hospital, everybody in, nobody out. 

For more information see "Single Payer Action."

For more information on health care in the U.S., what’s being done to combat vicious commercial assaults on our country’s most vulnerable people, and to find out how you can help fight back, visit http://www.singlepayeraction.org/.

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