Business Coalition for Single Payer Healthcare
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Frequently Asked Questions

Isn't Medicare plagued by too much fraud and overuse?

Yes, it is. Any is too much, and that must be corrected.

But it is small compared to the private sector because the state laws and enforcement are not as strict. Overuse and abuse is said to account for 30% of our overall healthcare costs. Add the 31% of bureaucratic waste and easily half is not useful expenditures. Health care is a very lucrative industry.

Roughly 10% of overuse occurs when physicians order tests for defensive purposes, that is, to avoid a malpractice lawsuit. Another 10% is due to patient pressure. The remaining 80% is due because the tests are profitable. A recent McKenzie study demonstrated that when physicians have an ownership in the lab or equipment, they order up to eight times more tests than do physicians without such ownership.

Worse are the excessive ordering of tests in nursing homes, where patients have been sat in front of a TV set and Medicare billed for a therapy session. Or sat in a coffee klatch and billed for a group therapy session. (Don't laugh; these are real happenings.) 

Whether we achieve single-payer or not, a law must be established that requires all healthcare providers to educate their employees on the whistleblower laws and rewards. With the employees providing oversight these violations will disappear quickly.

As well, physician ownership in equipment and labs must be eliminated, and hospitals must be prevented from employing physicians that refer patients to them. And this, whether we have a public or private system.

But isn't government management more expensive than the private market?

Certainly not in the field of health care. For example, Medicare has both a public and private component. Instead of signing up to traditional Medicare, seniors may opt for a private HMO that has been approved as an alternate source. Nineteen percent have done so. Unfortunately for the taxpayers, these plans cost about 15% more than the government version, which serves 81% of Medicare patients. The best thing about the Medicare Advantage plans is that they put to rest the claims that privatized "free market" health care is cheaper than the government. For more on this go HERE:

Isn't health care cheaper when the free-market creates competition?

There is no such thing as competition in the health care industry. Never has been and never will be. What "bidding" that does go on is to increase the insurance company profit margins, not to lower costs to patients. As well, if there ever was "competition," few patients would seek out the lowest bidder. Just the opposite would occur as people mistake high prices for better care.

Aren't high Malpractice awards our biggest problem?

The malpractice system indeed needs to be reformed, but it isn't the monster driving the system. Malpractice awards have increased by the same 87% since 2000 that health care costs have risen, but they have remained essentially steady at 1/2 of 1% of total costs. But it's not as simple as that. The 87% increase is due to an increase in administrative waste, and though malpractice costs are not levied against waste, "premiums" rose with it. Even when medical mistakes are not on the rise, the insurance premiums often go up because the insurers need to make up losses in other categories, like hurricanes and forest fires.

And, frankly, doctors and hospitals are an easy target and do not dare go without insurance, so they become a captive market.

To mitigate these issues we should establish medical courts with a three-judge panel of retired physicians and nurses. Doctors should be judged by their peers -- other doctors -- not by 12 jurors without medical knowledge. And the medical societies should establish a co-op malpractice provider that pools all physicians and hospitals and insures them at cost, just as they do in Canada. (Wait a minute. We don't like to do things the way Canada does!)

How do doctors feel about a single-payer system?

Recent polls show that over 64% of physicians prefer a single-payer system to the one we have now. Not only would it cut office billing personnel, it would eliminate bad debt caused by patients that cannot afford care. Study the single payer popularity at Physicians for a National Health Plan

Importantly, physicians and patients alike should be concerned about where medicine is going to end up if we do not implement a Medicare-for-all system. Think free-market, CEOs, shareholders and profits. Add them together and you have a managed-care-for-all system. Businesses will not sit still for the uncontrolled rise in health care costs.

Why don't we leave it to the free market?

Because what is a free market to the health care industry is unaffordable health care to everybody else. It is the so-called free market system that has gotten us to where we are today, with costs rising by 87% since 2000 alone. Frankly, there are some things that are better left to the government; funding roads and health care are good public-private ventures, as are funding police and fire protection being totally government. Can you imagine a privatized highway patrol getting paid on the basis of how many tickets they wrote?

Leaving health care to the whims of CEOs and shareholders should not be our goal in health care.

If the system is so broken, why don't the politicians fix it?

Follow the money. Over $200 million dollars per year in campaign contributions pass hands from the for-profit interests that want to keep the system broken, inefficient and profitable -- to the 535 members of congress willing to oblige them as they pocket the funds. Many congressmen also have their private investments in industries like health care and pharmaceuticals, so they become very conflicted. It's not a pretty sight.

Get the private money out of the electoral system and we'll fix health care virtually overnight. As well, require that all congressmen put their personal finances in a blind trust that grows with the economy and you'll see changes in both attitude and action.

If you think health care is expensive now, wait until it is "free."

That's one of the most contrived statements ever. It is geared to instill fear, as are the words "rationing" and "wait times." But Medicare has neither wait times or rationing, so they speculate for the worst (as if it could get worse).

Indeed, we will never make health care free. But we can take the waste out of it and make it affordable if we spread the risks to a single pool of 300 million people and get rid of the current, bloated insurance bureaucracy. Every other industrialized country has a single-payer of one sort or another, and in most cases they've achieved better medical outcomes than ours at half the costs.

Our great American experiment -- Medicare --  has been going on for half a century, and seniors love it. It's an investment they paid into all of their working lives, and it's now working for them.

We don't need any more experiments; we need to expand Medicare to everyone.

And think about it. The insurance industry is shining today, but that won't last. Corporate leaders will not stand still while their profits are eaten by the system. They are already switching to managed care systems, which will be run by the CEOs and shareholders. A "managed-care-for-all" system will not be good for anybody --  not the employees, physicians or hospitals, or even the insurers that lose out to the CEOs. Nor do the corporations gain because they still pay the bill, albeit a smaller one.

Why are we jumping through these hoops for a system nobody will like? Because it delays the inevitable, a Medicare-for-all system. Businesses must demand an immediate conversion.

How is a single payer system to be paid for?

Businesses would pay an additional 3.3% healthcare tax on payroll, but this would be more than offset by the 10-15% of wages they'd no longer have to pay for health benefits. Workers would also be taxed an additional 3.3%, but this would be offset by the elimination of co-pays, deductibles, and the costs for prescription drugs, mental health, long-term care, vision and dental. And it would be portable, so employees changing jobs would no longer suffer delays, pre-existing denials, and costs for COBRA (which often is picked up by the new employer).

What about Health Savings Accounts?

They aren't what they appear. They benefit those looking for a tax free investment vehicle, but not those seeking health care. See a complete article HERE.

Who would oppose such great savings to the public?

Clearly, those who make their money on the current system weaknesses. Private insurance companies, banking and credit card companies that want to expand health savings accounts, even bankruptcy attorneys who represent one side or the other when health care debt has driven patients into default (which includes over half of all bankruptcies).

Strangely, many business associations like the Chambers of Commerce and other business associations oppose single payer because an estimated 10-20% of their members are either in the insurance, banking, credit card or other industry that would lose money on an efficient health care system. Some also have a conflict of interest in that they profit by selling insurance plans to members.

That the other 80-90% are corporations that are eaten alive by those 10-20% seems not to interfere with this inherent conflict of interest. Associations would be wise to sit this issue out, but not all business leaders are wise.

We also have many state and federal politicians who receive substantial campaign contributions from the industry, adding yet another conflict we must deal with. How do they represent both factions? Being able to justify it makes them what they are: politicians.

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339 Lafayette St, New York, NY 10012-2725
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