Although we have seen many employer surveys in the past, this one is especially important because it represents the views of employers’ human resources professionals who face the reality that the Patient Protection and Affordable Care Act (PPACA) is now law. Since PPACA was designed to perpetuate the role of employer-sponsored health plans, we need to look at the likely responses of employers.

The President and Congress believe that competition between private health plans will contain costs when decades of experience with the private insurance industry has proven that this is a false belief. Competing private plans have failed miserably in controlling costs.

You would think that now that the Patient Protection and Affordable Care Act (PPACA) is law, UnitedHealthcare, the nation’s largest insurer in terms of revenues, would shape up its act by offering expansions of coverage compliant with the alleged intent of the law to provide adequate health insurance for everyone. That’s what you might think, but you’d be wrong.

We could have had a health care financing system that automatically included everyone. Instead we enacted a complex, fragmented system with so many eligibility and payment variables for a large variety of plans and programs that it is impossible to fit everyone into a slot. Not only is this the most expensive way to pay for health care, it also ends up being inequitable since individuals with similar circumstances can end up having quite different financial obligations, or even end up with one covered and the other not.

Non-profit Detroit Medical Center (DMC) is the city’s primary safety net, providing more uncompensated care than any other health system in Michigan. In spite of difficult economic conditions, DMC has been profitable for the past six years. Even Vanguard’s chairman states that the DMC management “has an outstanding record of delivering care and managing financial challenges.” So why is DMC selling to an out-of-state, for-profit hospital chain?

“… a sex tape that lives in perpetuity in cyberspace…” Certainly very few if any readers of these comments have personal sex tapes that could live in perpetuity once released in cyberspace, but we all have personal medical data that we would just as soon not share with the world, even if we are revealed as living a perhaps boring life of relative purity. Even that is no one else’s business.

When you look at different models of health care delivery and its financing, the logic of single payer prevails. President Obama has stated such, and even many conservatives agree, though ideologically opposed. So it has been difficult for those of us who support health care justice to understand why there has not been an adequate national grassroots uprising demanding the enactment of an improved Medicare for all. Dr. Slosar’s book provides some insight as to why.

Although we don’t agree with Newt Gingrich’s solution for our health system’s problems (computerize and privatize the entire system), we do agree with him and the multitude of other conservatives who state that the intolerable costs of health care eventually will drive the nation to demand a nationalized health care system. It’s just too bad that so much more suffering will take place before we arrive there.

Who could understand better the British National Health Service than the physicians of the British Medical Association? Their experience has led them to take a strong stand against for-profit commercialization of health care. Are physicians in the United States fundamentally that much different from those in Great Britain? Don’t think so.

Right-wing ideologues, such as former premier Ralph Klein of Alberta, have continued to push for more privatization of Canada’s health care system. They claim that the private sector provides greater access and higher quality at a lower cost. As if they didn’t have enough contrary evidence from the United States, they have continued with their experiments in privatization.