April 21, 2018
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Mainers must stand up for single-payer health care

By Rufus Wanning, Special to the BDN

Jerry Call of South Thomaston is out of jail.

Jerry was arrested for protesting at a Senate Finance Committee hearing on health care reform. He was shackled and put in leg irons and held for 30 hours. All this because the committee, chaired by Montana Democrat Max Baucus, refuses to hear from advocates for single-payer health care, also known as Medicare for All. Single-payer means a health care system that covers everyone, where doctors and hospitals are independent, but paid by a single government board.

Before Jerry was hauled out of the hearing room, he said, “60 percent! Why not 60 percent of the people in front of you representing single-payer?” I understand Jerry’s frustration, and so do about the same number of doctors, while nurses favor single-payer even more strongly. Maine is crawling with single-payer advocates. A Medicare for All bill is in Congress, H.R. 676, and Chellie Pingree is a co-sponsor.

The Baucus committee is discussing a deal with insurance companies known as “individual mandates.” Everyone would be required to get insurance, and in return, the insurance companies would agree to take everyone, and charge the same amount to everyone of the same age. You will have to look hard to find advocates of mandated insurance, in Maine or anywhere outside of Washington. Single-payer is cheaper and produces better outcomes than any system the Baucus committee is discussing.

Our health care system is insanely expensive, costing $2.4 trillion per year, and growing rapidly. Of course, that means lots of people make a bundle off the rest of us. What with the hundreds of millions they spend on lobbying, and on campaign contributions, they have more power in Washington than we do. The Max Baucus idea is to bring together these special interests, and produce a plan that they will all support. Naturally, it won’t cut spending.

After a recent White House conference, President Obama announced that health care industries had agreed to a 1.5 percent cut in the rate of growth of health care expenses. That would mean a cut from 6.2 percent per year in growth to 4.7 percent. That is well over the general rate of inflation, and still ruinous, but would not ruin us so quickly. Later, health care representatives said they never agreed to that; they only agreed to work toward that cut.

By contrast, single-payer could lead to substantial savings immediately. One reason our system is so expensive is because of high administrative costs for providers and insurance companies. Those costs eat up 31 percent of health care dollars. Taiwan, with electronic billing — smart cards for everyone — pays less than 2 percent on administrative costs.

Another problem with our system is that the incentives are all wrong. Doctors and hospitals aim for health, but they are compensated for tests and procedures. The more procedures performed, the more profit. Under single-payer, we could pay for health. Doctors could be paid so much a month for each patient on their list, and hospitals could be given a budget for their entire year’s operation. No more billing for each aspirin or Band-Aid. Would this result in doctors skimping on necessary care? Not in England, which has better health care outcomes than we do, while paying far less.

Finally, single-payer would cover nearly everyone, just as Medicare covers nearly all seniors. Individual mandates won’t do the job. Congress could pass a law that everyone must get health insurance, but not everyone will be able to, even with subsidies. Massachusetts passed such a law three years ago, and half the people uninsured before the law remain uninsured.

The process of producing a health care reform that will please the insurance and drug industries is well under way in Washington. The only thing that could turn it around, and turn Washington toward single-payer, would be a huge uprising of the people. This is what Jerry Call was working on before he went to Washington to protest and get arrested. There will be a big demonstration in Augusta on Saturday, May 30. The rally will be at the Capitol from 12 p.m. to 2 p.m. This will be part of a National Day of Action, with demonstrations all across the country.

Henry David Thoreau went to jail rather than pay taxes toward the Mexican-American War, which he and his friends believed aimed to extend slavery to the Southwest. Ralph Waldo Emerson visited him in jail and asked him, “Henry, what are you doing in there?” Thoreau famously replied, “What are you doing out there?” This story haunts me; I think of Jerry Call as Thoreau. I urge everyone out of jail to turn out for the Augusta rally.

Rufus Wanning of Orland is a master arborist.

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