Differing Dissent: Physicians for a Single Payer System

Monday began a historical session for the Supreme Court. Called into the question was the legality of the Affordable Care Act, or as others call it, Obamacare. What is at the forefront of this discussion is the idea of mandated coverage by the federal government. The media has been fascinated with the hearings but has exclusively focused on the battle between Democrats and Republicans.

On one side are the Republicans. This short term memory disease ridden party cannot seem to recall, or don’t care, it was themselves that pushed for individual mandates in the 1990s as an alternative to the Clinton plan. The Heritage Foundation expressly fought for it as well as every Republican figure at the time, and kept that platform until the election of Obama. In fact, Blue Cross Blue Shield Foundation wrote the original framework for Massachusetts. Unfortunately for suckers such as Romney, he was unable to realize that the political platform continuously shifts to the right, therefore to pass any landmark legislation in your state would be completely foolish if you have plans to run for president in the GOP. Luckily for him he has billions of dollars, raised by passing deals such as Romneycare, to remedy that situation so maybe it wasn’t a mistake after all.

The opponents of the GOP are the zero principled Democrats. They are willing to adopt any position President Obama expresses support for even if they spent the previous 8 out of 10 years pretending to fight against it when Bush was in office. Unfortunately their followers seem to struggle to grasp this concept and are apparently willing to shift 80 percent of their platform every decade or so. In some cases every 8 months such as when every Democratic supporter forgot that President Obama promised to include a public option in the legislation, to only secretly lobby against it at the behest of big pharma and others. Or the fact that the Senate framework of the bill was crafted by Elizabeth Fowler, whose previous job had been vice president of WellPoint, the nation’s largest private insurance company.

Essentially it is a battle between the super right, or the right wing that tried to shut down the government in the 1990s who are now Democrats; while supporters of both parties root for team R versus team D blindly and excitedly.

What is not reported however is that there is a 3rd opponent in the ring. This shockingly principled group of people not only disapprove of the public mandate, but state the Obama’s plan did not go far enough, and in fact may hurt us in the long run. These radical rag tag job hating pinko hippies are known as Physicians for a National Health Program. Citing this bill still leaves 27 million uninsured Americans, translating to 27,000 deaths per year, these physicians are attempting to pull down Obama’s mission accomplished banner.

While this bill contains beneficial areas such as Medicaid expansion, big pharma and health insurance companies essentially got all that they asked for. Hundreds of billions of dollars will now be allocated to private insurance companies. Can you imagine your small business given a stimulus so big? A mandate that every person in the country has to buy from you! Of course these CEOs will then claim to be financial geniuses and thus deserve hundreds of millions of dollars in bonuses that otherwise would go to coverage for sick people.

The bill contained no cost controls, no alternative to private insurance, no meta-analysis on hospitals and physicians being paid by the procedure instead of being paid by the health of the patient. The Medicaid expansion itself is easily reversible. Every year a budget is made that can allocate funds to this or that, as we will see in the so called grand bargain budget coming up, however a mandate to insurance companies is damn near impossible to revoke. With both sides of the aisle grid locked into the pockets of the lobbyists, to expect otherwise is a pipe dream at best.

Democrats counter with arguments such as, “It’s a first step!” and “This will be like Social Security you’ll see!” The only problem with that argument is that this is not a step in the right direction at all. In fact it is a step backwards. This strategy is equivalent to beginning Social Security by giving all our money to private pension funds. Now the insurance companies have more money, more power, and can blame the government for all wrong doing. As prices of deductibles and copays continue to rise conservatives will then proclaim that Socialism has failed us again! Instead of any type of fight back by supporters of the Democrats they will instead say well golly gee willkers, guess we’ll need to give more to the private insurance companies and big pharma who could have seen this coming!

Outside of the nonsensical political theater of Washington, physicians overwhelming supported the public option. A poll conducted by Dr. Salomeh Keyhani , a researcher at Mount Sinai School of Medicine found that nearly three quarters of physicians support a public option. Polls conducted by Physicians for a National Health Program found that 42% supported a single-payer national health insurance program. Never mind the fact a poll by SurveyUSA found 77% of American’s support a choice of a public option and a New York Times/CBS News poll found “59% [of Americans] say the government should provide national health insurance, including 49% who say such insurance should cover all medical problems.” Only 32% thought that insurance should be left to private enterprise.

With these numbers in mind, physicians, along with the National Nurses United, who have openly endorsed a single payer system, demonstrated in front of the White House and were continuously arrested interrupting Senate hearings for insurance reform. Nurses and physicians were forced to these measures because the media refuses to cover any opinion not 1 percent approved, aka Democratic vs. Republican approved political discourse.

Like financial reform, the so called ending of the Iraq war, and the minuscule stimulus package passed, the insurance reform has prescribed aspirin for cancer. Health insurance coverage does not mean medical coverage. Cofounder of Physicians for a National Health Program Steffie Woolhandler states:

“If you go on the exchange website in Massachusetts and try to buy health insurance for someone my age, you’re going to be taking $5,600 out of your pocket to pay the premiums. Then, if you got sick, you would have a $2,000 deductible. So you’re $7,600 out of pocket before the insurance pays a penny. And you’re mandated to buy that coverage; you don’t have a choice”

It is critical to remember that President Obama immediately proclaimed that single payer wasn’t even on the table as a possibility in this bill. He also secretly killed the public option and then claimed he never campaigned on the subject, thank Horus for YouTube! He could have easily fought for either or just for minor reforms such as a Medicare buy in, an ending to preexisting condition exclusion, and expansions to community rating, which means that everybody pays the same insurance premium, but no, he chose to actively work behind the scenes with big pharma and the insurance companies for the mandate in order to secure campaign donations and favor.

Ultimately it is forgotten the Democrats used reconciliation to pass the legislation, only 50 senators were needed to pass the bill. No Republicans were needed and no grand compromise was needed. They could have rammed a single payer system through with no problem, remember how the Republicans did this with the Bush tax cuts? When it came down to choose between the people and industry they chose to purposely push a water downed hand away of billions of dollars to special interests while their supporters cheered them on every step of the way.

For current students of science such as me and doctors in Physicians for a National Health Program, this national debate is largely irrelevant. In the end thousands of people will still die for no reason due a lack of health care coverage, our debt will continue to rise, and special interest will still privatize the profits and socialize the risk. To me, the only place Obama should hang the mission accomplished banner is at his future lobbying desk at Wellpoint. Luckily, or unlucky, for myself and those who share my views, this system will undoubtedly fail, and another debate will be forced to occur. Hopefully by that time we will have the strength to not be co-opted and instead fight for a future that places justice for all as the basis for systemic alterations.

-Daniel Fisher