Single-payer Advocates Make Case in Health Reform

NewsHour with Jim Lehrer
June 26, 2009

JUDY WOODRUFF: The business of passing health care legislation also remained front and center in Washington this week. Health correspondent Betty Ann Bowser has our update. The Health Unit is a partnership with the Robert Wood Johnson Foundation.

BETTY ANN BOWSER, NewsHour Correspondent: Health care reform moved on two fronts this week in Washington: on Capitol Hill and at the White House, where President Obama was once again in campaign mode, this time pushing for elements he wants in health care reform legislation.

Yesterday, Democratic Senator Max Baucus announced his Finance Committee had found a way to cut the projected 10-year cost of its health care reform draft, saying, “We have options that would enable us to write a $1 trillion bill fully paid for.” But the senator did not spell out where the money would come from.

The bill reportedly would tax workers on their insurance benefits and cut the number of low-income people who would qualify for government subsidies to buy insurance.

The other Senate committee working on a bill, the Health Committee, spent the week marking up its draft. But by week’s end, lawmakers were still behind in their original timeline for completion and still worried about how much it was going to cost.

SEN. TOM COBURN ®, Oklahoma: Why is it that we’re writing a bill that increases the cost for health care when, in fact, 50 percent — the cost of health care in this country is 50 percent higher than anywhere else in the world?

Differing views on reform

BETTY ANN BOWSER: The lawmakers also talked about ways to make Americans healthier.

SEN. TOM HARKIN (D), Iowa: We have to change not just the way we do medicine, but the medicine we do, not just the way we pay our bills, but, really, the medicine we do. And the medicine we do ought to be more preventative, and more upfront, and more wellness types of programs, and interventions.

But it has to be comprehensive. You can’t just do a little bit here and say, “Well, we’ve taken care of it in the workplace or we have clinical and we take care of it in the clinical.” It has to broad. It has to be pervasive in our society that we gear ourselves towards a wellness structure.

BETTY ANN BOWSER: On Thursday, several hundred people rallied in the shadow of the Capitol Dome, making it clear they were growing impatient for legislation.

PROTESTORS: We want, we want health care.

BETTY ANN BOWSER: Included in the group health care providers.

EDIE FALCO, Actress: Hi. I’m a nurse.

BETTY ANN BOWSER: Actress Edie Falco.

EDIE FALCO: We can no longer wait for a health care system that every individual, business, family in this country can afford.

BETTY ANN BOWSER: And union workers from across the country.

UNION WORKER: I’m here to support health care for everyone.

UNION WORKER: I’m worried about them taxing my health care.

BETTY ANN BOWSER: Most Republicans and moderate Democrats also oppose taxing employer-sponsored benefits. And the House Republican leadership has consistently hammered away at the House’s so called tri-committee bill drafted by Democrats.

Minority Leader John Boehner.

REP. JOHN BOEHNER (R-OH), House Minority Leader: When it comes to the issue of health care, the Congress shouldn’t rush through health care like we did with the stimulus plan several months ago. A Washington takeover of health care I think will limit the flexibility of our states and hurt working families around our country.

Single-payer system

BETTY ANN BOWSER: This spring, a group of people who support the concept of a single-payer plan were ejected from a hearing and arrested. But this week, they got a chance to be heard in a House committee.

Harvard Professor Dr. Steffie Woolhandler spoke on behalf of the organization Physicians for a National Health Plan.

DR. STEFFIE WOOLHANDLER, Physicians for a National Health Program: Our 16,000 physician members support nonprofit, single-payer national health insurance because of overwhelming evidence that lesser reforms, even with a robust public plan option, lesser reforms will fail. Private insurance is a defective product.

BETTY ANN BOWSER: A single-payer plan would make the federal government the sole payer for all health care services using revenue from taxes. Dr. Woolhander says that would fix the broken U.S. health care system.

DR. STEFFIE WOOLHANDLER: A single-payer lets you have administrative simplification that saves you about $400 billion a year. And then you take that $400 billion and use it to cover the uninsured and plug the gaps in coverage for people who now have private coverage so you can improve coverage for everyone without increasing total health care spending by a single penny.

Single-payer system debate

BETTY ANN BOWSER: But a hearing is all single-payer advocates got. No committee writing health care reform legislation is considering including it.

LEN NICHOLS, New America Foundation: They’re just not willing to spend time debating it since they know it cannot pass.

BETTY ANN BOWSER: Len Nichols directs health policy at the New America Foundation.

LEN NICHOLS: If you actually did single-payer, you would be outlawing private insurance, you would be outlawing any form of nonprofit health insurance, you would be ending health insurance as we know it all across the country, so, A, there would be a lot of capital that would have to be disposed of that would at some level become worthless overnight. Second, an awful lot of people would lose their jobs.

BETTY ANN BOWSER: Nichols says there might be initial cost reductions, but…

LEN NICHOLS: You would take a big chunk out of our current costs, probably 15 percent, maybe 20 percent, but that’s a one-year, one-time kind of thing.

The president’s argument

BETTY ANN BOWSER: At the White House, President Obama ramped up his public profile on health care reform, devoting almost an entire day to national television coverage on ABC, including a live town hall meeting where he once again pressed his argument for a public insurance plan.

BARACK OBAMA, President of the United States: Unfortunately, government, whether you like it or not, is going to already be involved. You know, we pay for Medicare and we pay for Medicaid. There are a whole host of rules both at the state and federal level governing how health care is administered.

And so the key is for us to try to figure out, how do we take that involvement, not to completely replace what we have, but to build on what works and stop doing what doesn’t work? And I think that we can do that through a serious health care reform initiative.

BETTY ANN BOWSER: Lawmakers will resume their work on health care reform after they return from next week’s July 4th recess.