By Ahmed Kutty
Kearney Hub
11/03/2008
With an economic meltdown under way and a new president and a new Congress about to be in charge of our country, time is now for Americans to demand a publicly funded health care financing system of universal, comprehensive and equitable coverage against illness.
The U.S. Constitution confers the responsibility “to form a more perfect union … , promote the general welfare and secure the blessings of liberty,” on our elected government.
Our current system of financing health care costs has been very inefficient, terribly expensive and often unresponsive to the needs of the people when stricken by illness, primarily because it is a for-profit, investor-owned and a fragmented-patchwork system, but with the singular exception of Medicare, which is run as a non-profit service-oriented organization for Americans over age 65.
It’s overhead is in the single digits, while in the private system approximately 35 cents out of each health care dollar is spent on the company expenses, including exorbitant CEO salaries, and only 65 cents per premium dollar is available for direct patient care expenses.
The SCHIP program for children was a success until its recent demise by defunding. For working-age Americans, keeping health care insurance as an employer responsibility has been a failure, both for the employees and the employers, including big corporations and small-business owners, with skyrocketing costs making them non-competitive in a globalizing world, especially the industrialized world where some version of a publicly funded health care system is available to all their citizens.
The United States is the lone outlier in this context.
Medicare is not for free, as the free-market fundamentalists would have us believe, nor is it government run. Just as for the private insurance plans, everyone pays a premium via the federal withholding tax and after age 65, the premium is billed directly to the beneficiaries of the program.
Choice of doctors and hospitals has never been fettered, ever since President Lyndon Johnson signed the law in the fall of 1965. Over the past 40-plus years with modifications and regulations put in place, the program is enormously popular with senior Americans, and is a success story.
This was a part fulfillment of President Harry Truman’s effort to introduce a national health care system in the late 1940s and represented a belated big step toward what FDR called “a minimum of the promise that we can offer to the American people” in his address to Congress as it adjourned in December 1933.
Now fast forward to the early Bill Clinton presidency and we find an attempt to introduce a national health care insurance system, under Hillary Clinton’s leadership, fail for lack of political will.
This fall the California Legislature passed a bill, SB840, piloted by state Sen. Sheila Kuehl, providing for an expanded Medicare for all-style single-payer health insurance plan, only to be vetoed by Gov. Arnold Schwarznegger.
This time, we the people should settle for nothing less than a comprehensive national single-payer system, which means Medicare for all. We must work to create a constituency to get the necessary legislation passed by the next Congress and signed by the new president, regardless of party affiliation.
This year’s momentous election will have a long-lasting positive effect on the crisis of health care financing, a major concern of the electorate, if the next Congress takes up the proposal/bill that Sen. Ted Kennedy, from his sick bed is working on, behind closed doors in the Dirksen Senate Office building, a measure Kennedy called, “the cause of my life.”
We shall have them not resuscitate the current failed system, and we will forge the political will necessary for our elected leaders to do the right thing, by raising the voice of an aroused public conscience, that shall be heard loud and clear in the corridors of power.
As true patriots, we will have them treat health care as a right, not a privilege, and not as a commodity but as part of our social compact. Surely a bulwark of “the American Dream” must include a measure of security against vagaries of illness, collectively provided, with risk spread over three hundred million Americans, in this great nation of ours, the most affluent on the earth.
Ahmed Kutty, MD, FACC, of Kearney is a member of the American College of Physicians, which supports the single payer plan.