Editor’s Note: An extraordinary argument against a public health insurance option is that more than one-third of the U.S. population would want to sign up, or as Sen. Charles Grassley, R-Iowa, put it: “As many as 119 million Americans would shift from private coverage to the government plan.”

That, Grassley argued, would devastate the private insurance industry and “put America on the path” to a government-funded single-payer system. So, instead of allowing 119 million Americans to have a public option to pick from, industry defenders – like Grassley and Senate Finance Committee chairman Max Baucus – have excluded single-payer advocates from the debate and sought to defeat or undermine the creation of a public option.

David Swanson of AfterDowningStreet.org describes the latest developments in the dispute:

According to one report, Baucus suggested that he'd been mistaken to exclude single-payer but asserted that the process of creating healthcare reform legislation was too far along now to correct that omission.

Sanders said after the meeting that if healthcare reform did not create a single-payer system it shouldn't be done at all, and that within three or four years we would realize we'd solved nothing. He said that it would be better to increase funding for community health centers and take steps to make it easier for medical students to go into primary care, than to enact major reforms that didn't go to the root of the problem.

Sanders has a bill (S 486) that makes some of the changes he advocates, as well as a bill (S 703) to facilitate the creation by states of single-payer healthcare systems. Rep. Tammy Baldwin, D-Wisconsin, has introduced resolutions on the same topic in the House. 

Dr. Margaret Flowers, co-chair of the Maryland chapter of Physicians for a National Health Program (PNHP), attended a press conference following the meeting on Wednesday and filled me in. She said that while states are pursuing single-payer legislation, it would be much easier for them to succeed if they had waivers allowing federal healthcare dollars to go to the states, and if needed changes were made to the Employee Retirement Income Security Act.

Advocates of single-payer emerged from the meeting with Baucus declaring their determination to push ahead with what they see as a fundamental struggle for human rights.

Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee and national vice president of the AFL-CIO, said the fight for single-payer is a civil rights movement, and that people "have to turn up the heat." 

When someone questions the political viability of single-payer, she said, we should question "allowing people to die and suffer for lack of political will."

The press conference, in which Baucus did not participate, was attended by the New York Times, Politico, the Associated Press, Pacifica Radio, Congressional Quarterly, and a camera that Flowers believed belonged to CNN. 

Sanders opened the press conference with a statement on the domination of the private for-profit health insurance companies wasting $350 billion per year in billing, profiteering, and complexity.  If we were serious about healthcare reform, he said, we would be having a serious discussion of single-payer.

Dr. Marcia Angell, former editor-in-chief of the New England Journal of Medicine and senior lecturer at Harvard, said that in her diagnosis the disease was market-driven healthcare in which access is based on the ability to pay.

Dr. David Himmelstein, co-founder of PNHP and associate professor medicine at Harvard Medical School, reported that Baucus had said he might be willing to drop charges of unlawful conduct and disruption of Congress against 13 people but had no intention of opening up any hearings to include single-payer.

Himmelstein also announced the release of two new studies. The first reportedly finds that some of the largest investors in tobacco stock are private health insurance companies. The second reportedly shows that not only are personal bankruptcies increasing, but 62 percent of them are now due to medical debt.

Geri Jenkins, RN, co-president of the California Nurses Association/National Nurses Organizing Committee and a practicing registered nurse, reported that Baucus had implied he'd made a mistake in not including single-payer but that it was too late now.

And, finally, Dr. Oliver Fein, president of PNHP and associate dean at Weill Medical College of Cornell University, said that he and his colleagues had asked Baucus for a full hearing on the merits of single-payer and asked for the Congressional Budget Office to create a comparison of single-payer with whatever plan Congress produces that is not single-payer.

Sen. Sanders said that he would continue to push Baucus to hold a hearing.

Dr. Flowers said that in her analysis the single-payer movement is largely inclined to go in the direction that Sanders stated: support for a single-payer bill or nothing.

I asked her whether she believed that those pushing for single-payer would ever support a public option as doing more good than harm and whether she thought those pushing for a public option would ever advocate allowing states to enact single-payer.

Flowers acknowledged that there are many (perhaps even most) people in the public option movement who prefer single-payer. In fact, it is difficult to find a supporter of the public option who does not claim to "personally" want single-payer but to find it "politically unfeasible."

But Flowers said that PNHP does not support a public option and backs only single-payer. And she said she was unaware of any advocates of a public option also advocating for allowing states to create single-payer.

David Swanson is the author of the upcoming book "Daybreak: Undoing the Imperial Presidency and Forming a More Perfect Union" by Seven Stories Press.  You can pre-order it for a discount price at http://tinyurl.com/daybreakbook

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