End insurance bailout with single-payer system

The Register Guard

End insurance bailout with single-payer system

By Rick Staggenborg

Difficulties with the rollout of the misleadingly titled Affordable Care Act have renewed catcalls from opponents of health care reform who don’t yet realize that some type of reform is inevitable. The previous system was economically unsustainable. Unfortunately, defenders of Obamacare seem unwilling to admit that the ACA isn’t sustainable either. Even Senate Majority Leader Harry Reid admitted as much last Aug. 9, when he said: “What we’ve done with Obamacare is have a step in the right direction, but we’re far from having something that’s going to work forever.” He added that the country has to “work our way past” insurance-based health care. The question is, when do we start? If in defending Obamacare its supporters continue to overlook its serious deficiencies, it could spell disaster for Democrats. When medical costs continue to rise due to the inherentinefficiencies of a for-profit health care system, those who have believed or feared that we cannot afford universal health care will conclude that Republican detractors were right. Having lost credibility, how will Democrats then make the case for a single-payer system? The effect may be seen as early as this year and will certainly be felt by 2016 if Democrats do not start heeding Reid and laying the groundwork for a single-payer system. More importantly, failing to acknowledge the weaknesses of Obamacare would set back the stated goal of the Democratic Party and many of the local Democratic central committees, including those in Rep. Peter DeFazio’s district, of establishing a singlepayer system. From the outset of the debate on health care reform, singlepayer advocates were dismissed with the claim that the “public option” — a government-run plan that would be an alternative to private insurance — was the only thing that was politically possible. Only it wasn’tpossible, for the same reason that those who controlled the debate carefully kept any mention of a single-payer system out of the discussion: The entire process of devising and approving the ACA was controlled by the medical insurance industry. Even if a public option had been achieved despite opposition, it wouldn’t have moved us much closer to single-payer. Sen. Chuck Schumer, D-N.Y., declared early on that any public option would not compete with private insurance. What would be the point, then? It seems clear that the ACA’s main priority was providing a bailout for an insurance industry that was pricing its product out of the market. That is not just speculation, it is simple math. As costs rise, fewer can afford insurance. To maintain profits, the remaining insured have to pay more, leading to fewer being able to afford it. This is the death spiral familiar to anyone who has looked at the economics of our insurance- based health care system. I repeat: 

Obamacare is a bailout for the insurance industry. The reluctance of Democratic leadership to seriously challenge the interests of the medical industrial complex made that inevitable. The subsidies in Obamacare have the effect of temporarily delaying the ultimate demise of the medical insurance industry at a tremendous cost to taxpayers, who were not told an option exists that costs about half as much per person and would cover everyone. Until Obamacare is replaced with a single-payer system, costs will mount and anger will grow among those who were told that it would save money. The glowing Congressional Budget Office report touted by the Obama administration concluded that even under the rosy assumptions it was forced to make, savings would amount to only 0.5 percent of gross domestic product — while total health care costs are more than 17 percent of GDP. Bending the cost curve, as is claimed to be a result of the ACA, just means slowing therate of growth in health care expenditures. The total is still going up. Only a single-payer system will bend the cost curve sharply downward. We are already seeing conservative commentators picking up on the fact that Obamacare is a bailout. In an interview with Fox news in late December, analyst Byron York made that very argument. Less than two weeks later, ultra-right-wing columnist Charles Krauthammer made the same point. Democrats will dismiss them at their own peril, because they are telling the truth. Opponents won’t get the ACA repealed, but they will generate a lot of anger toward Democrats, and the chance to have a real debate about health care reform may be lost for a generation.

Rick Staggenborg, M.D., of North Bend is a member of Physicians for a National Health Program, but the opinions expressed here do not necessarily reflect the opinion of the organization.