The Top 10 Enemies of Single-Payer

The Profiteers of Suffering

By Russel Mokhiber-Editor of Corporate Crime Reporting and Founder of

Most people, when they arrive in Washington, D.C., see it for what it is – a cesspool of corruption. Two reasonable reactions to the cesspool.

One, run away screaming in fear.

Two, stay and fight back and bring to justice those who have corrupted our democracy.

Unfortunately, many choose a third way – stay and be transformed. Instead of seeing a cesspool, they begin seeing a hot tub.

The result – profits and wealth for the corporate elite – death, disease and destruction for the American people.

Nowhere does this corrupt, calculating transformation do more damage than in the area of health care.

Outside the beltway cesspool/hot tub, the majority of doctors, nurses, small businesses, health economists, and the majority of the American people – according to recent polls – want a Canadian-style, single payer, everybody in, nobody out, free choice of doctor and hospital, national health insurance system.

Inside the beltway cesspool/hot tub, the corrupt elite will have none of it. They won’t even put single payer on the table for discussion.

Why not?

Because it will bring a harsh justice – the death penalty – to their buddies in the multi-billion dollar private health insurance industry.

The will of the American people is being held up by a handful of organizations and individuals who profit off the suffering of the masses.

And the will of the American people will not be done until this criminal elite is confronted and defeated.

(Remember, virtually the entire industrialized world – save for us, the U.S. – makes it a crime to allow for-profit health insurance corporations to make money selling basic health insurance.)

Before we confront and defeat the inside the beltway cesspool/hot tub crowd, we must first know who they are.

To wit, we present the Top Ten Enemies of Single Payer (listed here in alphabetical order):

American Association of Retired Persons (AARP).

AARP, one of DC’s most powerful lobbying groups, has worked inside the beltway for years to defeat single payer. Why? AARP makes about a quarter of its money selling insurance through its affiliate, United Healthcare Group, the nation’s largest for-profit insurance company. AARP must defeat single payer – which if enacted, would wipe out that revenue stream.

American Health Insurance Plans (AHIP).

The private health insurance industry. Public enemy number one. The health insurance corporations must die so that the American people can live. Of course, facing the death penalty, AHIP is the most aggressive opponent to single payer. No compromise with AHIP.

American Medical Association.

With a shrinking base of doctors (only 25 percent of doctors nationwide belong) – the AMA is the most conservative of the doctors’ organizations. I just returned from a health care policy forum at the Center for American Progress. As usual, not one of the panelists mentioned single payer. Only during the question period did a self-identified patient/citizen ask the single payer question. And a pit bull-like Nancy Nielsen, president of the AMA, ripped into the questioner. “Sounds more like a statement than a question,” Nielsen said. “And clearly you have a point of view about that. And I don’t happen to share that point of view.” Clearly she doesn’t. But just as clearly, the majority of doctors, probably even a majority of doctors who belong to the AMA, support single payer. Nielsen is in denial and must be defeated.

Barack Obama.

He was for it when he was a state Senator in Illinois. Now, ensconced in the corporate prison that is the White House, he says single payer is off the table. To get off the list, Obama needs to put single payer back on the table.

Business Roundtable.

Dr. David Himmelstein, co-founder of Physicians for a National Health Program (PNHP), was at a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience – made up primarily of representatives of big business – to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: “In private, they support single payer, but they’re also thinking – if you can take away someone else’s business – the insurance companies’ business – you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it’s also a cultural thing – we don’t do that kind of thing in this country.”

Families USA.

A major inside the beltway liberal foundation and long-time foe of single payer. It’s chief executive, Ron Pollack, was once an advocate for single payer. But no more. In November 1991, Pollack was at a Washington hotel debating Yale University professor Ted Marmor in front of then Arkansas Governor Bill Clinton. Marmor was making the argument for single payer. Pollack against. A November 1994 article in the Washington Monthly, co-authored by Marmor, reported the result this way: “After the two advocates finished, Clinton looked thoughtful, pointed to Marmor and said, ‘Ted, you win the argument.’ But gesturing to Pollack, Marmor recalls, the governor quickly added, ‘But we’re going to do what he says.’ Even considering the Canadian system, everyone in the room agreed, would prompt GOP cries of ‘socialized medicine’ – cries that the press would faithfully report.”

Health Care for American Now.

The largest coalition of liberal groups promoting a choice between a public plan and private insurance companies. “They are saying – we can’t do single payer because Americans don’t want it,” said Kip Sullivan of the Minnesota chapter of PNHP. “That’s based on junk research conducted by Celinda Lake for the Herndon Alliance. It is bad enough to say we can’t do single payer because the insurance industry is too powerful to beat. But it is just plain insidious to say we can’t do single payer because the American people don’t want it. In fact, polling data indicates that two-thirds of Americans support a single payer system. And that level of support exists despite the fact that there is little public discussion about it.”

Kaiser Family Foundation.

One of the most prestigious liberal inside the beltway think tanks on health reform policy. Saul Friedman is a reporter for Newsday. In February, Friedman wrote an article for Newsday arguing that single payer is suffering from a conspiracy of silence. And he says Kaiser is the most culpable of the co-conpsirators. Kaiser, funded initially by insurance industry money, regularly keeps single payer off the table, Friedman says. When single payer advocates released a study in January asserting that Congressman John Conyers’ single payer bill (HR 676) could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers, “the Kaiser Family Foundation’s daily online report on health care developments at didn’t mention it,” Friedman reported. “Nor has Kaiser, the most comprehensive online source of health care information, made any mention of single-payer or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls.” After a number of insistent inquiries, Kaiser told Friedman that they would publish charts in March comparing the Stark and Conyers bills. They never did.

The Lewin Group.

The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option, showed that the insurance industry would lose 32 million policy holders if a public plan is enacted. Lewin’s health reform policy guru, John Sheils, told the Associated Press: “The private insurance industry might just fizzle out altogether.” What the mainstream press didn’t report was that The Lewin Group is a wholly owned subsidiary of Ingenix, which is in turn owned by UnitedHealth Group, the nation’s largest health insurance corporation. Lewin Group has conducted studies on single payer at the state level – and their studies consistently show that single payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676 – which would create a single payer for the entire country and drive The Lewin Group’s parent – UnitedHealth Group– out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said – “the President didn’t propose single payer, did he?” No, he didn’t. That’s why he too is on this list. (Sheils says The Lewin Group has studied national single payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill – including one by Congressman Pete Stark (D-California). Stark’s bill would give every American the option of opting into Medicare. But that’s not single payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. “The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.” Sheils says that of all the plans studied, the Stark bill saves the most money.)

Pharmaceutical Research and Manufacturers Association of America (PHRMA).

PHRMA chief executive Billy Tauzin says that under single payer, the government would become a “price fixer.” By which he means, the government, as a single payer, will have the power to negotiate drug prices downward, thus costing the drug corporations millions in excess profits. In recent years, PHRMA has infiltrated liberal sounding groups like America’s Agenda – Health Care for All. PHRMA’s Vice President for Government Affairs and Law, Jan Faiks, now sits on the board of America’s Agenda and PHRMA contributes money to the group – which has worked in recent years to undermine single payer at the state level. (America’s Agenda Mark Blum won’t say how much money PHRMA gives to his group.)

We have met the enemy.

And they ain’t us.


2 Responses to “The Top 10 Enemies of Single-Payer”

  1. Single-payer SOUNDS attractive but if that payer is the Government the concept of efficiency, cost saving, etc. just disappears. Do we really want a huge bureaucratic system that rations healthcare? Do we want a system that stifles innovation because the profit element has been removed from “big pharma” or even bio-tech entrepreneurs? You paint a rosy picture but if “the public” is presented with the downsides of single-payer (e.g.- huge waiting lists for essential but unavailable services because doctors won’t accept government-dictated, absurdly low reimbursement rates) the public will have a far different opinion.

    No doubt our current system needs fixing- portability being just one issue of concern. But the US still has one of the best healthcare systems in the world as evidenced by the many foreigners who come here for treatment. Let’s fix the problems without throwing out the baby with the bath! And there is nothing wrong with making a profit- its the whole basis of our capitalist system that has served us well for centuries.

  2. You have obviously concluded that virtually everybody involved in the process of healthcare financing is against a single payer system. Although on some points you are dead on, it seems that some major facets of the situation have eluded your notice. This is likely because many of the facts have been distorted and drowned out in the sea of political rhetoric.
    First, Congress as a whole actually DOES want single payer socialized medicine. Our neighbors to the north pay an average of 24% of their ALL their income for their single payer system. Canadian providers of medical care are paid about 10% of what their counterparts make in the U.S. Now consider, the average annual family income in the U.S. is $50,355.00 and pays $8,000 per year for healthcare, or about 16% of their income. Most Canadian make on par about the same as we do here in the States. So translation is that Canadians families pay an average $12,085.00 per year for healthcare. Congress is constantly harping that we “have the most expensive medical system in the world” quickly pointing out that U.S. medical providers are paid ten times more than under the single payer systems.
    However, Congress is playing a ‘smoke and mirrors’ game. They are trying to distract the citizenry from comparing ‘premiums’ and asking the obvious question. “If this is the case, then how is Parliament spending the rest of the money they collect?” Answer, they ration healthcare, pay their providers a pittance, and pocket the extra money for their own ‘pork’ and special interests projects. Congress has been deliberately sabotaging any effort to improve the free market system and has done all in their power to make it unbearable. Their goal is to frustrate the citizenry to the point where most people will beg for “change”.
    This government was originally established with the purpose of protecting the rights of the citizenry. So we might ask, why are so many insurance companies ‘legally’ allowed to dupe the public to buying health insurance contracts which provide so little coverage that they are tantamount to little more than ‘legal’ embezzlement. Why has the government continued to fail to establish STANDARDS (as they have with Medigap policies) that the public can count on when they purchase health insurance. Why does legislation restrict medical providers, especially physicians, from publicly posting their fees? Again, STANDARDS need to set. Depending on the insurance carrier and locale, 15% to 20% of our premium payments go to (mostly mega-hospital conglomerate owned networks) for network pricing access to assure that we are not ‘overcharged’. Again, this is nothing more than legalized extortion. Setting standards would eliminate this layer of fees.
    Moreover, admit it or not, insurance IS a social mechanism. It only works if there are enough participants to redistribute the expenses of losses among. So again, why is it that there are no mandates requiring that everyone carry health insurance.
    I can rattle on for hours on this facet alone.
    Your assumption that the majority of physicians would widely embrace a single payer system is totally fallacious. Independent physicians are now struggling under the weight of their practice overhead which includes extra staffing to deal with insurance companies, higher office expenses, and escalating liability insurance coverage (this is a whole issue unto itself). Most people are totally unaware that independent physician income has fallen significantly over the last 25 years while their expenses continue to increase. The public is also unaware that it is illegal for independent physicians to group together for the purpose of standardizing their fees.
    However, you are correct that the American Medical Association (AMA) is against a single payer system. Also, that the AMA has a shrinking base of physician members. Years ago the AMA established itself as an organization to set ‘standards’ for accepted medical care. Their premise was this, constrict the number of ‘authorized’ medical practitioners (physicians) so as to assure that demand substantially exceeded supply. This way the compensation of physicians was raised substantially. They were very effective in this pursuit. Indeed, at one time virtually no one could get certified as a physician unless they were a member of the AMA.
    As laws changed, so did the AMA, about 40 years ago they became an ally and minion of the mega-hospital conglomerates (their new constituents). The current goal of the AMA is to force independent physicians to become employees of large medical groups and, ultimately, the mega-hospital conglomerates. As salaried employees, physicians relinquish control over their practice and their income. This way the majority of profits are redirected to the heads of the mega-hospital conglomerates.
    In addition to Congress, the major enemies of healthcare reform in general are:
    The Pharmaceutical Industry; which is totally unchecked and is deeper into our pockets than anyone (roughly 40% of all healthcare expenses are paid to pharmaceuticals).
    The FDA which is merely a minion of big PHRMA.
    The AMA which stand to become obsolete.
    United Healthcare, which is striving to become not only an insurance monopoly; but to integrate itself into the medical services provider sector through ownership and alliances with the mega-hospital conglomerates.
    Although there are some facets of a single payer system that do work; the most terrifying aspect of this mechanism is that it would give cause for bureaucrats to delve freely into our pockets. Moreover, single payer systems have proven time and again that their interests is not in providing better quality medical care; but simply to assure that the masses of the population are sufficiently appeased so as to not rebel or riot.

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