By David Himmelstein and Steffie Woolhandler
The New York Times, Room for Debate, June 17, 2012
Occupy Wall Street wasn’t born in time for the 2009 health care debate. But that debate was a quintessential display of the power and privilege of the 1 percent.
Drug and insurance firms dictated the terms of reform: “do it our way or do nothing at all.” The result was a lopsided bargain: the American people were allowed to expand Medicaid, ship a few scraps to community health centers and impose feeble insurance regulations. Insurers got hundreds of billions of taxpayer dollars and a mandate ordering the middle class to buy their defective products.
The plan’s demise would offer peril and possibility. The corporate-backed “do nothing at all” option would perpetuate disaster: about 50,000 annual deaths from the lack of insurance; about 800,000 medical bankruptcies each year, mostly among families with coverage; a continuing spiral of rising costs and shrinking coverage; and continuing assaults on Medicare. But we need not meekly acquiesce to the dictates of the 1 percent.
A single-payer reform — a public, national health insurance plan that pays virtually all medical bills — would fix the health care mess; and, like Medicare, it’s clearly constitutional. Single-payer would save $400 billion wasted each year on insurers’ overhead and the paperwork burden they impose on doctors and hospitals. It could redirect this money to cover the uninsured and upgrade coverage for the rest of the 99 percent. As nations with single-payer systems have found, cutting out the insurance middlemen and driving a hard bargain with drug firms makes universal coverage affordable and lowers death rates. And single-payer would restore Americans’ right to choose any doctor and any hospital.
Of course, the impetus for such measures can’t come from inside boardrooms or the Beltway. The overturning of the Obama reform could add fuel to the Occupy impulse, stoking the broad social movement that’s essential for achieving real health care reform, and for rebuilding American democracy. Certainly, many doctors and nurses will be prepared to join our patients in the streets.
David Himmelstein, M.D., and Steffie Woolhandler, M.D., M.P.H., are internists and professors of public health at the City University of New York. They are co-founders of Physicians for a National Health Program.