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Single Payer Silence

What is Single Payer?

As the Health Care debate rages on, why have we heard so much about “Public Options” and fictitious “Death Panels” but little about Single Payer?

Many health care professionals, like the group: Physicians for a National Health Program, (PNHP) support Single Payer.

The group bills itself as a single issue organization advocating a universal, comprehensive single-payer national health program. It says it has more than 17 thousand members and chapters across America.

So when I wanted to understand what Single-payer was, I turned to their website and found this:

Single Payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity, a government-run organization, would collect all health care fees, and pay out all health care costs.

In the current US system, there are literally tens of thousands of different health care organizations—HMOs, billing agencies, etc. By having so many different payers of health care fees, there is an enormous amount of administrative waste generated in the system.

(Just imagine how complex billing must be in a doctor’s office, when each insurance company requires a different form to be completed, has a different billing system, different billing contacts and phone numbers—it’s very confusing.)

In a single-payer system, all hospitals, doctors, and other health care providers would bill one entity for their services. This alone reduces administrative waste greatly, and saves money, which can be used to provide care and insurance to those who currently don’t have it.

Access and Benefits
All Americans would receive comprehensive medical benefits under single payer.

Coverage would include all medically necessary services, including rehabilitative, long-term, and home care; mental health care, prescription drugs, and medical supplies; and preventive and public health measures.

Care would be based on need, not on ability to pay.

Payment
Hospital billing would be virtually eliminated. Instead, hospitals would receive an annual lump-sum payment from the government to cover operating expenses—a “global budget.” A separate budget would cover such expenses as hospital expansion, the purchase of technology, marketing, etc.

Doctors would have three options for payment: fee-for-service, salaried positions in hospitals, and salaried positions within group practices or HMOs.

Fees would be negotiated between a representative of the fee-for-service practitioners (such as the state medical society) and a state payment board. In most cases, government would serve as administrator, not employer.

Financing
The program would be federally financed and administered by a single public insurer at the state or regional level. Premiums, copayments, and deductibles would be eliminated.

Employers would pay a 7-percent payroll tax…employees would pay 2-percent. 90 to 95 percent of people would pay less overall for health care. Financing includes a cigarette tax of 2-dollars per pack.

Single Payer was discussed on PBS show – Bill Moyers Journal (May 22, 2009). (http://www.pbs.org/moyers/journal/index-flash.html or just pbs.org).

Moyers calls Single Payer one of the most controversial but popular options relating to health care reform.

And many health care professionals (who may have a much better handle than most of us on health care and insurance as it relates to the patient and health care delivery) seem to be throwing their weight behind it.

But they were not being invited to the table, so they took their protest to the Capitol…where some were arrested for it.

As Dr. Margaret Flowers told Moyers: Health care professionals like her want to take care of patients…not have insurance companies and administrators who know nothing about medicine tell then what they can and can’t do!

Another protester, Dr. Pat Salomon: There were all these arbitrary decisions, which were not about people’s health care. They were about profits. How can I get away with the least amount of care offered to this person, so that their premium is going to give me the most profit? That’s not the way health care decisions should be made.

Donna Smith, a community organizer appeared on the Bill Moyers Journal. She’s the legislative advocate for the California Nurses Association, whose 85 thousand members across the country were early champions for a single-payer program.

She told Moyers: Congress is not listening to advocates of a single-payer system. They seem to be bent on one direction and one direction only…expanding the broken system that we have now.

She says there are so many insurance companies involved in making health care decisions in this country, and so many Americans suffering at the hands of those insurance companies, whether it’s through higher premiums and higher co-pays and deductibles…

According to Smith, The California Nurses Association asked Congress and the Obama administration to allow them to contribute to the Health Care Reform debate. She says doctors and nurses were invited to attend the White House forums on health care reform (but didn’t speak) only after protesting and getting quite active.

Smith thinks it’s because lawmakers have already made a choice…to stay with the moneyed interest, the people who fund the campaigns and the people who fuel the government system…

She points to democrat Max Baucus, Chairman of the Senate Finance Committee which was holding hearings on health care reform.

Smith says Baucus, is the third highest recipient of donations from the health insurance and health care industry in general. He’s the highest Democratic recipient. She thinks he should have to disclose that at the beginning of every single hearing that he chairs.

Smith argues that doctors have had to spend several hours per day on the phone hassling with insurance companies, trying to negotiate to get a patient a treatment.

In terms of cost, she says the argument about socializing things and making things government-run seems a little bit yesterday to her…because in three days, we were able to come up with three quarters of a trillion dollars to throw into Wall Street.

Check the PNHP website (pnhp.org). It says Single Payer activists have set up a memorial on the National Mall for the more than 44-thousand Americans who die every year from lack of health insurance.

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