Single-payer plan is best way to assure true reform in care

By Geri Jenkins
LA Daily News
March 7, 2009

President Obama’s call for achieving “comprehensive” health-care reform this year, and the criteria laid out by the White House for what the plan should include, reflect a large vision and laudable commitment.

Clearly, the moment for transformative change has arrived, starting with the bully pulpit in the Oval Office. What a stark difference from the dismal health-care policies of the past eight years.

Unfortunately, the majority of proposals floating around Congress would default on the ambitious aims and principles set by the administration – and almost certainly fail to contain the rising costs that put so many families in peril or to assure coverage for all.

To achieve the lasting and cost-effective reform the president seeks, we must confront the source of the present crisis – an insurance industry that has been steadily pricing people out of access to care, or bankrupting them if they attempt to use it. It’s those same insurance companies which all too routinely deny needed medical treatment, even when recommended by a physician. Not because they are malevolent, but because their principle obligation is to their shareholders, not to patients.

As if we needed any more reminders, they came in two reports in late February. The Institute of Medicine noted that family insurance premiums shot up 119 percent the past eight years, nearly four times faster than incomes. A Kaiser Family Foundation report found that 53 percent of Americans say they or a family member skipped needed care the past year because of cost.

Insurance company practices drive those skyrocketing costs, a problem that won’t be solved by more technology, electronic medical records, or any other stopgap measures some propose.

With one important exception – single-payer reform, or expanding and updating Medicare to cover everyone. That’s also the best way to achieve the admirable principles for reform laid out by the White House.

A health-care plan, they’ve said, should be universal, covering everyone; portable, not tied to your job; protect families financial health; make coverage affordable; guarantee choice of physician and health plan; promote prevention and wellness; improve patient safety and quality care; and maintain long-term fiscal sustainability.

To the administration’s credit, these should be benchmarks for any real reform. And they’re also on the right track in proposing progressive tax reform as a major financing mechanism.

However, the private insurers remain an implacable impediment to every one of these goals.

Private insurance plans aren’t universal because they exclude people based on pre-existing conditions or age or anyone else they think will be expensive to cover. They don’t guarantee choice of physician or hospital, but limit you to their network of providers.

The insurers won’t assure affordability because they are constantly raising premiums, deductibles, co-pays, and other fees to generate high revenues and profits. They can’t guarantee safety and quality because they actively discourage the delivery of care or deny treatments, diagnoses, or referrals they don’t want to pay for.

And, they will never be fiscally responsible because there is no independent oversight, decisions are made in secret in closed board rooms or CEO offices, and, their priority is profits, not care.

Single payer, however, does succeed in all eight areas. It’s not government-run care, government just pays the bills with no incentive for price gouging, and it takes control of our health away from the insurance companies, and puts it where it belongs, in the hands of patients, families, and their doctors and nurses.

Single payer also promotes national recovery, by creating 2.6 million new jobs, infusing $317 billion in new business and public revenues, and injecting $100 billion more in wages into the U.S. economy, according to a recent study by the California Nurses Association.

HR 676, the U.S. National Health Care Act by Rep. John Conyers, is the plan that best meets the grand vision painted by our president. It’s the reform with the broadest, national grass-roots constituency led by nurses, doctors, patients, and health care activists, and the surest path to achieving the yearning desire of our nation for a more humane health-care system.

Geri Jenkins is co-president of the California Nurses Association. The economic recovery study may be viewed at


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