Because we continue to insist that private insurance remains a mainstay of financing health care, we perpetuate the confusion between the health insurance product itself and the actual health care that people need. A well functioning health care financing system should remove financial barriers to health care that people need.

Louisiana Attorney General Buddy Caldwell, a Republican, who has joined the lawsuit against the Affordable Care Act, certainly understands the greatest flaw in the legislation. “The worst thing you can do is give it to an insurance company.” Leading to his conclusion, “If the government wants to put forth a policy where they will pay for everything and you won’t have to go through an insurance policy, that’d be a whole lot better.”

This is merely a sampling of the plethora of new articles that suggest that single payer may be the answer to the constitutionally-challenged Affordable Care Act. They represent the views of enthusiastic liberals, reluctant conservatives, and everyone in between. If you read only one entry, I would suggest the very last one, which is my response to today’s New York Times Economix blog by Uwe Reinhardt. Although at times it seems like we single payer activists are hollering in the wind, the profusion of responses demonstrates that single payer is now widely recognized as a model that would work for all of us. Keep hollering!

Pay for performance (P4P) is one of the measures in the Affordable Care Act (Sec. 3001) that supposedly is designed to improve quality and reduce costs. The recommendation was based on data such as this Medicare Hospital Quality Incentive Demonstration (HQID) which had shown that providing financial bonuses and penalties improves processes of care. But does it improve outcomes?

What is the basis for this conversation about starting over if the Affordable Care Act (ACA) is struck down by the Supreme Court? Implicit is the concept that the Affordable Care Act actually accomplished the reform that we need. Of course, it didn’t. So, regardless of the decision, we wouldn’t be starting over since no iteration of ACA would hardly even begin to complete the process of reform.

NHS reforms finally become law By Andrew Woodcock, Tim Schulthorpe The Independent, March 27, 2012 The Government’s controversial reforms to the NHS became law today after a tortuous 14-month passage through Parliament, when the Queen granted Royal Assent to the Health and Social Care Bill. The new rules mean the Government can create GP commissioning [...]

The attention to the Supreme Court deliberations on the Affordable Care Act is an unfortunate distraction since, regardless of the outcome, intolerable levels of uninsurance, undersinsurance, and unaffordability will still be with us. We need to replace the Affordable Care Act with single-payer national health insurance, an expanded and improved Medicare for all.

Now that the Affordable Care Act (ACA) is law, we can be assured the the private insurers will be team players in helping to craft regulated insurance markets that will serve the interests of patients first. Right? Wrong! Just read this article about how they are dumping much of the risk onto employers through these phony “self-insured” plans, while using ERISA to escape some of the regulatory provisions of ACA.

The title of today’s message, “Controlling costs through HHS rate reviews,” is deliberately deceptive to make a point. Supposedly, the Affordable Care Act (ACA) was designed to help control spending in health care, and the insurance premium Rate Review process was a component of cost containment. In fact, not only does the process have no impact on health care spending, it doesn’t even have any federal control over increases in health insurance premiums.

Since the political barriers to enacting a national single payer program seem to be insurmountable, at least for the near future, many single payer activists are pursuing state level single payer models of reform. To be truly single payer, federal legislation would be required to free up funds from federal programs. The Health Care Compact should give us pause as to whether or not we want to give states that much control over our federal tax funds.