Coastal Post Online


November, 2003

A Single Payer Plan That Will Improve Health And Lower Costs
By Stephen Simac

Over ten thousand doctors nationwide have signed on to The Physicians for a National Health Program proposal. Their plan calls for federally funded medical insurance for all Americans. These doctors want to improve American's health by insuring everyone but they face an uphill battle against powerful enemies. They have enlisted few allies for their plan yet will need many for their plan to succeed. They estimate their proposal would cost about $1.8 trillion a year, roughly four times the current federal military budget. The physicians propose to pay for their plan by a payroll tax of 7% for employers, 2% for employees and a repeal of Bush's tax cuts. It would cover all "medically necessary services" such as doctor's visits, hospital costs, substance abuse treatments, pharmaceutical prescriptions and medical supplies.

Their plan could theoretically save money overall from the enormous costs of the American Medical System. Some expenses for doctors would be shaved by increasing efficiency of billing practices.

Many workers who have various insurance plans now and some companies that already provide insurance would save some money and insurance hassles with this plan. The problem with funding by payroll taxes is that workers and businesses will simply see it as another tax on working, which actually promotes better health. More businesses and employees would get behind the physician's plan if the funding were from other sources.

The Devil's In The Detains

The most obvious funding sources are "sin taxes" on products, companies and activities that directly cause death, disease or injury. These are the reasons for medical necessity, why should they get a free ride? Motor vehicles have caused more American fatalities and disabling injuries than all our foreign wars and industrial accidents combined. The corporations that profit off the carnage and mayhem on American highways need to pay their share of medical costs from traffic accidents and the air, water and soil pollution they cause.

The processed food industry has been using trans-fatty acids or hydrogenated oils for fifty years. For decades this man made fat was touted by food companies and medical doctors as a healthy alternative to saturated fats. It has been proven to cause heart disease and cancers, the top two killers of Americans. A direct tax on this type of food additive and others proven to harm health would raise billions and discourage use and consumption of them.

Companies that profit off destroying public health eventually are going to pay huge legal costs just like the tobacco, asbestos and drug industries. The psunamis of class action suits will start crashing against their corporate practices.

An excess profit tax on jury awards going to class action lawyers would help fund the medical fallout from those practices instead of paying for these lawyer's Lear Jets and lavish lifestyles.

Changing from a prohibition model of banning substances, lifestyle practices and dangerous products and instead taxing them to pay for their costs would save billions on law enforcement and the "justice" system. Those savings could help fund medical costs and reduce government expenditures. Along with the taxes generated from sins, you're starting to talk real money.

Give Us Our Meds

The efficiencies of size and collective bargaining power of Canada's government run health care system reduces the cost of their pharmaceuticals 20-80% from the states. Instead of importing drugs from the north, their lower prices could be negotiated here except for industry opposition.

The pharmindustry in America is extremely powerful and controls the FDA. Naturally they oppose lowering prices but favor having insurance pay for prescriptions. Giving in to the pharmindustry will destroy medicare, social security and anything attached to those. Even military funding eventually will collapse to pay for the aging ill's daily meds. A truly revolutionary plan would negotiate lower prices, limit the FDA to its original purpose of ensuring purity of food and drugs, and heavily fine the pharmindustry for decades of profiteering off Americans, tracking down their illgotten gains wherever they have hidden them.

Ultimate Wellness

It's unlikely that Americans' health would significantly improve with the Physician's Single Payer Plan, just because more people have medical insurance. Their proposal is mainly reactive not preventive. Most illness and injuries are not inevitable. The majority of physicians are well aware that disease prevention is possible and more economical than medical treatment.

This is possible if "national health care" included funding to improve public health like safer sidewalks and bike paths to schools, places of worship, employment and shopping, hiking paths through more parks, subsidizing fruits, vegetables and whole grains. If it reduced or eliminated known environmental health hazards such as ionizing radiation, mercury, lead, diesel and coal soot, decibel levels and many more dangers, the doctors could start to gain critical mass for their plan with a broader coalition of allies.

If their plan funded Dental Care it would save money on medical complications from teeth and gum problems. Funding mental health therapies, stress reduction methods and covering costs of needed psych meds would broaden their alliance while splitting the pharmindustry opposition.

Conventional physicians only grudgingly consider complementary and alternative treatments to be medically necessary even when they've been proven effective. Research to "prove" the effectiveness of CAM treatments is barely funded, but millions of Americans now prefer them and pay billions of dollars out of pocket for complementary and alternative health care. For these patients it works, or at least works better for them than conventional treatments. Benefits are often achieved for far less expense than conventional care.

If single payer health care coverage funded these consumers' preferred choice of treatments the plan would have the support of millions of patients and providers.

If a national health care plan paid for the Recommended Daily Allowance of vitamin and mineral supplements and for other supplements proven effective, millions more citizens and companies would push for national health care.

As it is the physicians for national medical insurance are only rearranging deck chairs on the Titanic of American's poor health while their opponents want to keep the deck chairs chained to the sinking deck. The American Medical Association rejects their proposal outright claiming they want to "build on the strengths of our current system."

The physicians who oppose their plan are as physician centric as those who support it. Their arguments have used the same cliches for decades. One of these is that "Americans have the best health care in the world." By objective measurements of life span, child mortality, and rates of illness the United States compares poorly with other industrialized nations and even some third world economy nations. Canada, Germany, Japan and many other countries including Cuba spend far less on medical care than the United States with better outcomes for their citizens' health.

Opponents claim that "health care" will be rationed under a single payer plan. It already is "rationed" in the current system though in a less than "rational" fashion. What they mean is that single payer plan patients will have longer waiting periods for elective surgery and expensive operations like heart surgery. There is a huge profit margin built into these treatments but wealthy patients will still pay for elective surgery on demand just as they do now.

However preventive health care could greatly reduce the need for "heroic" interventions while avoiding patients' suffering- the root cause of the enormous costs of "medical necessity."

Half of Americans claim they suffer from chronic pain for which current medical care has strictly rationed treatments or even banned them under pressure from the DEA. Law enforcement is already determining health care policies in "rationing" pain management without even a medical degree. If that's not quack medicine, what is?

Both physician centric proponents and opponents of federally funded medical treatment agree that new technology and medical research will improve Americans health. Supporters claim that "a government run system would focus investment and research to reduce the spiraling costs of medical machinery," while opponents say "the spiraling costs of new technology and medical advances would force substantial tax increases to pay for them."

Yet low tech and less expensive public health measures will reduce the need for costly technological medical treatment. Encouraging more sharing of these technological resources will further reduce expenses. Focusing on improving wellness would lower costs and add value to the economy and society rather than merely patching up debilitating diseases and injuries at ever increasing expense.


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