Single payer needed now more than ever

Published 5:10 pm Friday, August 7, 2020

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Jack Bernard

Single payer was a major issue in the Democratic primary race. Democrats staked out positions, with the moderates against single payer. Bernie was the same guy he has been for 30 years, a Medicare for All advocate. He won a number of states, such as California, before dropping out.

The conservative/moderate plan advocated by Biden is increasingly unacceptable to progressives. Since my time as Director of Health Planning for Georgia, the percent of GNP consumed by healthcare expenditures has doubled to 18%. We have no money for infrastructure, education and other priorities. And it will only get worse. Our care is uncoordinated and poorly managed in crisis, like now.

As someone with a heavy health policy background who has researched and written about the topic extensively in newspapers around the nation, I know Sanders is correct regarding healthcare. Medicare for All is not only a moral imperative, it is completely feasible and the only way to control our runaway health expenditures. The public option Joe Biden advocates may be more acceptable politically, but due to “adverse selection,” i.e. cherry picking, it is not financially feasible, as any actuary will tell you. And bringing the Medicare age down to 60 from 65, as he advocates, won’t solve the underlying problem.

I’ve been a VP or SVP for several large for-profit healthcare firms. I’m a capitalist. Generally, private enterprise is more efficient than government. It’s easy to see why those advocating Obamacare, like Biden, would assume private insurance to be more effective. However, the exception to the rule is healthcare financing. Medicare’s overhead is 2% versus 12% for for-profit insurance companies. Organization for Economic Co-operation and Development analyses illustrate we pay more per capita than any other affluent democracy. For example, France is considered to have the best healthcare system in the world while we are 37th by the World Health Organization. Yet, France’s 2017 per capita expenditures were $4,902. Our per capita health expenditures were $10,209.

It’s not just France; all developed nations have greater government involvement in healthcare financing; all cover 100% of citizens at a lower per capita cost. Here are per capita costs for other democracies: Israel: $2,833; New Zealand: $3,682; Australia: $4,543; Canada: $4,826; Denmark: $5,182.

Clearly, single payer is the solution, but is opposed by the massive and influential healthcare industrial complex for self-interested reasons. They spread their money around in both parties, influencing policy for their benefit.

Lobbyists for the drug, insurance and provider groups have invested heavily in buying off key “moderate” politicians. Some supposed “reformers” are right in line for the handouts. Beto O’Rourke of Texas (who withdrew from the primaries and endorsed Biden) is a good example, having received nearly $3 million from these special interests.

And, an eye opener, the next four top recipients of drug/insurance/provider groups a few years ago were all moderate Democratic Senators: McCaskill, Casey, Heitkamp and Nelson. No wonder each of them opposed single payer. When will our nation be ready to overcome the inertia caused by the self-interested medical-industrial complex? The answer is when each of us, regardless of party, makes real change a priority in our voting and vote for those politicians advocating single payer.

Bernard is a retired corporate executive