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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.

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.

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). ( or just

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 ( 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.

Freed Journalists Lead to Embrace!

I didn’t watch the triumphant homecoming of Laura Ling and Euna Lee…the two journalists who were jailed in North Korea, since March.

The TV was playing in the background so I know they arrived.

I’m sure their relatives, friends, employers are happy to see them and I would too, in their place.

What I care about right now is bringing home military personnel captured in Iraq and Afghanistan.

I’m all for evacuating nationals when there’s a disaster, a coup, a plague etc. And I don’t like it, either, when fellow journalists get captured on the job. We expect these journalists to take risks, to get up close and dodge bullets so those of us at home can know what’s happening in these remote locations.

My struggle is: (1) How indebted should your country be to you when you break another country’s rules, enter forbidden territory and knowingly take risks? We lose out when journalists are not there, taking those risks, but how far should they go – how far do we want/expect them to go? Are they working for the country – or their network? Don’t they often get more money and greater prestige the more risks they take? It’s nice when the government steps in…but should it always?

(2) Whom do we treat as “real” journalists? New York Times reporters? What if it’s a blogger, who may or may not be a journalist…like me?

In listening to the commentary about the freed journalists, some people say this just gives countries like North Korea the leverage to act badly and get rewarded with a high profile visit from a powerhouse like former president Bill Clinton. They claim it will embolden the Irans of the world to try similar stunts.

To me, all this attention, diplomacy, time and money spent negotiating these releases (plane was paid for privately) should now be focussed on military personnel who are missing in Iraq and Afghanistan.

23-year-old Bowe Bergdahl, disappeared from his base in Afghanistan (July 2009), and was later seen in a Taliban video posted online. Bergdahl was serving with an infantry regiment at Fort Richardson in Anchorage. Where is he?

Dianne Feinstein, of course (the Senator from California) speaking as a politician, says: American citizens are in trouble overseas – we must rescue American citizens in trouble overseas? Really? If Americans go to China and take part in anti-government protests that the Chinese say is illegal, and officials sweep them up, we must rescue them, too? Where does it stop?

If religious people rush to Iraq to impose their version of God on the Muslims, and are arrested, should we go free them? I think Jesus will come and free them, since they’re doing his work, not the state’s…and if he doesn’t free them, like he did for Paul, (and Silas, Acts 16:25-28) then he either (a) just doesn’t support what they’re doing and couldn’t care less or (b) it’s his will that they sit in that prison and convert the prisoners.

On the other hand:

Why don’t we just say it’s a game we’re playing with whichever country happens to be holding the hostages, and that even if it was Ronald McDonald, we’d want him back!?

If we manage, through our offensives – charm or military – to free hostages, then it looks like we’ve won! AND, if it brings North Korea to the negotiating table, then send strategic “hostages” to every troublesome corner of the globe! I’ll support that!

One U.S. official says President Clinton talked to North Koreans about the “positive things that could flow” from freeing the two women”. Some analysts apparently think now that North Korean leader Kim Jong-il has gotten his high-profile visit from a former president (he didn’t want a former VICE-president, and turned Al Gore down) that could open the way to direct nuclear disarmament talks.

Plus, it was worth it to see Gore embrace Clinton.

Guess he’s not mad about his lost election anymore!

A tale of Two Women

TWO WOMEN made national news this week.

Secretary of State Hilary Clinton and ex-Alaska republican governor Sarah Palin.

Let’s compare what they said, where they were and what they’ve been up to since the last election…in their own words!

HILARY CLINTON: Travels around the globe pushing President Obama’s foreign policy goals. Just returned from: Asia, where she attended a meeting of leaders from ASEAN, the Association of Southeast Asian Nations. Appeared on: NBC’s Meet The Press Sunday. Talked about a range of issues.

Kicked North Korea’s butt. “their behavior is not going to be rewarded. In the past they believe that they have acted out, done things which really went against the norms of the international community and somehow then were rewarded. Those days are over”.

Working to release American journalists Laura Ling and Euna Lee, being held in N. Korea: America is “certainly pursuing every lead we have. The messages that we’ve received from the young women both through our protecting power, the Swedish ambassador, and through the messages and phone calls they’ve had with their families are that they’re being treated well, that they have been given the supplies that they need“.

On a Nuclear Umbrella in Middle East: “if the United States extends a defense umbrella over the region, if we do even more to support the military capacity of those in the Gulf, it’s unlikely that Iran will be any stronger or safer, because they won’t be able to intimidate and dominate as they apparently believe they can once they have a nuclear weapon…We believe as a matter of policy it is unacceptable for Iran to have nuclear weapons.”

Championed Healthcare: “the chances that businesses will continue to pay for insurance over the next five, 10, 15 years are diminishing. I think, if I remember correctly, in ’93 and ’94, 61 percent of small businesses provided some kind of health insurance for their employees. It’s down to 38 percent.”

Running for president: “It is daunting. And it is, you know, probably a path that doesn’t appeal to a lot of women even in elective office, because it is so difficult. But I am convinced–and I don’t know if she’s in elective office right now or if she’s preparing to run for office–but there is a woman who I am hoping will be able to achieve that”.


SARAH PALIN: Has visited some states to Speak and Campaign for Republicans. Just returned from: Wasilla. Appeared in: Fairbanks, Alaska. Talked about a range of issues.

Kicked media butt. “some in the media because another right protected for all of us is freedom of the press, and you all have such important jobs reporting facts and informing the electorate, and exerting power to influence. You represent what could and should be a respected honest profession that could and should be the cornerstone of our democracy. Democracy depends on you, and that is why, that’s why our troops are willing to die for you. So, how ’bout in honor of the American soldier, ya quit makin’ things up”.

Working to ensure Holywood doesn’t hijack Alaskan way of life: “got to stiffen your spine to do what’s right for Alaska when the pressure mounts, because you’re going to see anti-hunting, anti-second amendment circuses from Hollywood…they use these delicate, tiny, very talented celebrity starlets, they use Alaska as a fundraising tool for their anti-second amendment causes. Stand strong…and by the way, Hollywood needs to know, we eat, therefore we hunt.”

 Touted accomplishments in office, including Ethics Reform: “We promised it, and now it is the law. Ironically, it needs additional reform to stop blatant abuse from partisan operatives, and I hope the lawmakers will continue that reform“.

And Alaskan ruggedness: “remember we sported the old bumper sticker that said, “Alaska. We Don’t Give a Darn How They Do It Outside?” Do you remember that? I remember that, and remember it was because we would be different”. Why she’s leaving Office? For Alaska! “It is because I love Alaska this much…that I feel it is my duty to avoid the unproductive, typical, politics as usual, lame duck session in one’s last year in office. How does that benefit you? No, with this decision now, I will be able to fight even harder for you, for what is right, for truth. And I have never felt like you need a title to do that“.

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