OP-ED

Single Payer Health: It’s Only Fair

The United States is the only major nation in the industrialized world that does not guarantee health care as a right to its people. Meanwhile, we spend about twice as much per capita on health care and, in a wide number of instances, our outcomes are not as good as others that spend far less.

It is time that we bring about a fundamental transformation of the American health-care system. It is time for us to end private, for-profit participation in delivering basic coverage. It is time for the United States to provide a Medicare-for-all, single payer health coverage program.

Under our dysfunctional system, 45,000 Americans a year die because they delay seeking care they cannot afford. We spent 17.6% of our GDP on health care in 2009, which is projected to go up to 20% by 2020, yet we still rank 26th among major, developed nations on life expectancy, and 31st on infant mortality. We must demand a better model of health coverage that emphasizes preventive and primary care for every single person without regard for their ability to pay.

It is certainly a step forward that the new health reform law is projected to cover 32 million additional Americans, out of the more than 50 million uninsured today. Yet projections suggest that roughly 23 million will still be without insurance in 2019, while health-care costs will continue to skyrocket.

Twenty-three million Americans still without health insurance after health reform is implemented? This is unacceptable. And that is why, this week, Representative Jim McDermott and I are announcing the re-introduction of the American Health Security Act, recognizing health care as a human right and providing every US citizen and permanent resident with health-care coverage and services through a state-administered, single payer program.

Let’s face it: until we put patients over profits, our system will not work for ordinary Americans.

It is incomprehensible that drug companies still get away with charging Americans twice as much, or more, than citizens of Canada or Europe for the exact same drugs manufactured by the exact same companies. It is an outrage that insurers still often hike premiums 20%, 40% and 60% a year on individual policy holders; and some insurers still spend 40 cents of every premium dollar on administration and profits while lavishing multimillion-dollar payouts on their CEOs.

It boggles the mind that approximately 30% of every health-care dollar spent in the United States goes to administrative costs, rather than to delivering care. We must do better. Taiwan, for example, spends only a little over 6% of GDP on health care, while achieving better health outcomes on some key indicators than we do; yet they spend a relative pittance on administrative costs.

I am very proud that my home state of Vermont is now taking big steps to lead the nation in health care by moving forward on a plan to establish a single payer health-care system that puts the interests of patients over chasing profits. The American Health Security Act would make sure every state does the same — taking profits out of the equation by implementing a single-payer system, but letting each state administer its own program, according to strict standards, in a way best suited to its needs.

The goal of real health-care reform must be high-quality, universal coverage in a cost-effective way. We must ensure, to as great a degree as possible, that the money we put into health coverage goes to the delivery of health care, not to paper-pushing, astronomical profits and lining CEOs’ pockets.

Bernie Sanders is the U.S. Senator (I) from Vermont, and the longest serving independent member of Congress in American history. He is a member of the Senate’s Budget, Veterans, Environment, Energy, and H.E.L.P. (Health, Education, Labor, and Pensions) committees.

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William Palmer MDKatieAuslandsversicherungVeronicaWendell Murray Recent comment authors
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William Palmer MD
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William Palmer MD

I would like to see a system that makes serious health care a true public good. …Ie there would be no way to charge for it. By serious I mean conditions that could result in death or disability, or could result in bankruptcy. “Could” means in the near term or in the far term .This means roughly that society would take care of folks without billing or charging who had in-patient types of problems, not ambulatory conditions. … With plenty of exceptions. It would be a county or hospital district or US Representative-sized operation to avoid the dangers of big… Read more »

Katie
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Katie

Many other countries use insurance mandates. Switzerland, Japan, Austria, Germany uses premiums or tax directed to health funds, France could be better described as private-public rather than single-paye, as most French carry some additional private health insurance to complement the program. All these systems are admired by reformers and none of them properly qualifies as a true sngle payer. .I would ratrherr have us form any of the above systems than radical single-payer. I say this as a former resident of a nation that refused to treat or even diagnose me,or help me find a private pay alternative in their… Read more »

Auslandsversicherung
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My deepest admiration, and wishes for success, Senator Sanders. We need a CHANGE and our hope is in you success.

Veronica
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Veronica

It is disheartening to read comments from educated and thoughtful individuals who constantly use the term ‘liberal’ as a slur toward programs or policies they do not agree with (and with glee if the program proves to be unsucessful.) Only when we are willing to set aside our egos and this ridiculous obsession with being ‘right’ rather than setting policy that makes social AND fiscal sense will we as a country become whole again. As much as we want to resist, removing the profit motive from health care is change that is long-overdue. Let’s stop wasting time squabbling over what… Read more »

Nate Ogden
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Nate Ogden

“Let’s stop wasting time squabbling over what ‘liberal’ or ‘conservative’ policy is better or worse and instead abandon those terms in favor of policy that actually works.”

Get rid of the failed liberal policies and we will be there.

Nate Ogden
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Nate Ogden

Whats amazing is even after these over the top claims not one of these people paid any price for being wrong? TANF was unquestionable success, these people could not have been more wrong yet they suffered no accountability, Liberals never do get held accountable. “So it seems a good time to remember the drama—make that melodrama—that the bill unleashed in 1996. Cries from Democrats of “anti-family,” “anti-child,” “mean-spirited,” echoed through the Capitol, as did warnings of impending Third World–style poverty: “children begging for money, children begging for food, eight- and nine-year-old prostitutes,” as New Jersey senator Frank Lautenberg put it.… Read more »

Nate Ogden
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Nate Ogden

http://www.city-journal.org/html/16_2_welfare_reform.html “How should progressives respond to what we know so far about welfare reform and children?” he asked. “By progressives, I mean leftist/liberal and feminist scholars and observers, who, based on past experience, probably constitute 80 to 90 percent of this audience.” His answer suggests some serious soul-searching. “[T]here may be something to the idea that long-term dependency on public assistance is detrimental,” he conceded, though he had always “rejected this idea out of hand prior to 1996.” That sums up the problem with liberals. They reject logical answers out of hand becuase it doesn’t fit their dogma. Despite Wendells… Read more »

Nate Ogden
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Nate Ogden

To top it off you can find thousands of stories in the media how welfare reform was going to lead to dead bodies in the street then when it turned out not to be true a fraction of the stories with the true outcome.

The media has no problem carrying water for liberal dogma and doing everything they can to burry the truth. Some point the america public will wake up to what they are doing and tear them both down once and for all. The wizard can’t hide behind the curtain forever.

Barry Carol
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Barry Carol

“Failure has never detered progressivism” Nate – This has always bugged me as well. I’ve never heard of a government program that failed when liberals / progressives said something like this: We believed in this program, we fought for it; we got it passed into law and implemented. We thought it would work but it didn’t. Let’s kill it and try something else. Instead, they are likely to say if we just put some more money into it, maybe then it will work. That’s their basic approach to primary and secondary education in the inner cities where failure has long… Read more »

Barry Carol
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Barry Carol

Nate – People who work in VT but live in a neighboring state will likely be covered under VT’s insurance if it’s financed by a payroll tax which is probably the most likely approach. By the way, if VT chooses the payroll tax option, it will likely take a tax rate of at least 15% of wages or about the same as current FICA taxes. This is Germany’s rate though it only applies to wages up to €43,000 or about $62K at current exchange rates. Depending on the reimbursement rates, I wonder if providers in other states, like Dartmouth-Hitchcock Medical… Read more »

Nate Ogden
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Nate Ogden

If the ERISA exemption is for residents of VT would someone not living in VT but covered by VT still have ERISA protection? What about residents that live in VT but work over the border outside VT? We have clients that avoid hiring people that live in NY because of their terrible legislation, VT might find its self in the same boat. Not that it all can’t be accomplished it will just be a blast watching politicians that don’t know anything about insurance try to do it. If they try to fund it all with payroll taxes that would create… Read more »

Wendell Murray
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I disagree regarding the premise that employees at companies such as IBM oppose single-payer. It may be true. It may not be. Opposition is largely based on false assumptions in any case. Single-payer is a superior system to the current system in the USA for all people. Nothing is lost, much is gained to all. Otherwise I agree on the other points. I also agree that Vermont, given its size and the willingness of the population to experiment with alternative means of achieving social benefits, is a good place to institute some version of single payer, although as I note… Read more »

Nate Ogden
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Nate Ogden

“Opposition is largely based on false assumptions in any case.”

Wow does this sound like your typical liberal. Any opposition to their idelogy means your ilinformed, they are never wrong the public just doesn’t know what is right.

Barry Carol
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Barry Carol

Wendell – I mentioned IBM as an example of a large FOR PROFIT employer. Employees of such companies are probably more likely than others to oppose a single payer healthcare system. By contrast, hospital systems, colleges and universities, state and local government entities, and the like may be more inclined to favor the approach. The small business sector and individuals who cannot afford to buy insurance under the current system are also more likely to support single payer if the requisite taxes don’t put them out of business first. With Vermont’s economy based mainly on agriculture, tourism, state and local… Read more »

Nate Ogden
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Nate Ogden

This will have some interesting ramifications. Going to make VT very unattractive for some employers. VT will need an ERISA exemption like HI has. This will allow them to have single payor for their residents. What about someone that lives in another state on the border and works for someone in VT? If a company has only 1-2 employees that live out of state how do they get insurance now? Or will the VT plan be open to residents of other states that work for VT companies? What happens when they have some multi million dollar claims from non VT… Read more »

Nate Ogden
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Nate Ogden

There needs to be a way to report people like Wendell and have their right to vote taken away. If your this detatched from reality and facts you shouldn’t be allowed to elect leaders. This is almost as bad as the women that said voting for Obama he will pay her mortgage and gas bill. Why are these people allowed to participate in democracy?

Good ole Peggy Joseph

Walter Valliere
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Walter Valliere

Wendell, 1. You can’t find a successful single payer system anywhere 2. For single payer to survive, rationing access is a requirement 3. Vermont lack the funds to keep a single payer system going without a strict diet of healthcare rationing and tax increases 4. If Vermont wants to do what has succeeded nowhere else, it’s fine with me. I don’t live there anymore. You can just continue with the great lie. 5. Regarding commentators on this blog, please understand that you are the one who started issuing the insults. While I don’t know anyone writing here, it is clear… Read more »

Wendell Murray
Guest

As the saying goes, Mr. Valliere, I have forgotten more about the USA healthcare system than you will even learn. I have zero desire to communicate with you privately.

If you need a fellow traveler in your knowledgeless commentary, please ask Nate or Mr. Turpin for their e-mail addresses.

Wendell Murray
Guest

Nate: Please keep your idiotic comments to yourself. And stop insulting me. You clearly have shown through this weblog no ability to do the most basic research on any relevant topic. The lack of facts and research is matched by the profusion of commentary that is both insulting and nonsensical. I have extensive done research. None of what I have learned reflects any political viewpoint whatsoever. Only political extreme rightists such as yourself or Mr. Turpin constantly make factless assertions, then claim that anyone who points out the lack of facts must be some sort of “leftist”, whatever that term… Read more »

Nate Ogden
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Nate Ogden

” You clearly have shown through this weblog no ability to do the most basic research on any relevant topic. The lack of facts and research” so all the facts about how many employers self fund and how many people have insurance through these plans and the factual fraud rate of Medicare and how that relates to the cost of private insurance are not facts because? I have posted numerous facts, all you have posted is opinion supported by nothing. Let me make it really simple for you. How will your single payor proposal resolve the 10%+ fraud rate inherant… Read more »

Wendell Murray
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Whether the 25% figure you cite represents any reality or not, such as figure is meaningless in regard to anything. The average USA resident or citizen has so fully been propagandized against the idea of single payer that any reference to aggregate public opinion only reflects the pervasive propaganda. It reflects next to zero understanding of the choices that individuals might make intelligently of how the USA healthcare system should be structured. I do not know how large an employer IBM currently is, but it is not even listed among the top 50 employers in the State, so why mention… Read more »

Nate Ogden
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Nate Ogden

“To be anywhere near effective, a single payer system must be universal for the largest relative national entity, i.e. the entire USA.”

So NHS is no where effective? Can you name any effective single payor system in the world?