Dr. Steffie Woolhandler rejects House healthcare plan and calls for Medicare for all in Mt. Holyoke speech
mp3 audio of Dr. Woolhandler's Nov. 18th speech (44 MB download)
In a fact- and chart-packed speech at Mt. Holyoke College in South Hadley, MA, November 18th, Dr. Steffie Woolhandler, a founder of Physicians for a National Health Program, delivered a compelling rationale for adopting a "Medicare for all" approach to American healthcare, often called a "single-payer" system. Under such a system, the 1500 private for-profit U.S. health insurance plans and companies would be replaced by a single, nonprofit, public or quasi-public healthcare financing agency. Healthcare would continue to be delivered, as now, through private doctors, clinics and hospitals, chosen by each patient. A single-payer system is used in Canada and many other developed countries, and typically costs much less than the American private health insurance system, with its high administrative costs, CEO salaries and profits.
A professor of medicine at Harvard Medical School, and co-author of Bleeding the Patient:The Consequences of Corporate Health Care, Dr. Woolhandler is one of the foremost advocates for a single-payer healthcare system in the U.S. To hear Dr. Woolhandler's November 18th Mt. Holyoke speech, click here (44 MB download).
Woolhandler started her talk with a lot of numbers and facts because, she said, "when you do look at the numbers and facts, it's quite clear that what's needed is a Medicare for all approach for the United States, and not what's [currently being offered] up there in Washington." She observed that our current healthcare system now left 46 million Americans uninsured, a number of uninsured that has more than doubled during the years she has been practicing medicine. The uninsured now also include twelve percent of non-elderly veterans in the U.S., as many veterans do not qualify for VA coverage, reported Woolhandler.
Sixty-two percent of American bankruptcies are now due to illness or medical bills, noted Woolhandler, and the majority of these bankrupted families started out with health insurance. But co-pays, insurance limits and insurance coverage gaps under private policies left many families bankrupt due to medical costs despite their health insurance.
The U.S. now has the most expensive healthcare system in the world, asserted Woolhandler -- at roughly twice the cost per capita of many other developed countries' healthcare systems. The number of U.S. health administrators, for example, has grown three thousand percent over the past several decades, she noted, with private health insurance companies now taking up to 20% of every healthcare dollar for adminstrative and overhead costs. This compares to about 3.5% in administrative costs for the current government-run Medicare system.
Huge CEO salaries also consume millions of dollars under the private healthcare insurance system. Woolhandler gave the example of one of her Harvard colleagues who became the head of Aetna healthcare insurance and made half a billion dollars during his 5-year tenure at Aetna, about $220,000 in salary each day, seven days a week, according to Woolhandler's calculations.
Yet this huge cost has not meant a higher quality of care and better health outcomes for Americans, said Woolhandler. >>>More
Under the impact of the recession, consumer prices have generally fallen, with the consumer price index actually dropping 1.3% over the past year. But one industry kept increasing prices, and at an astounding rate -- the pharmaceutical industry. The NY Times reported November 16th that drug makers have raised the wholesale prices of brand-name prescription drugs about 9% over the past year, adding "more than $10 billion to the nation's drug bill . . . ." (See Duff Wilson, "Drug Makers Raise Prices in Face of Health Care Reform," NY Times online version dated 11/15/09.)
The drug companies have actively opposed cost-cutting provisions of Congressional legislation, and had earlier promised to reduce drug prices by $8 billion a year for ten years as part of a deal with the Obama administration and the Senate Finance Committee chairman, noted the Times. "But this year's price increases would effectively cancel out the savings from at least the first year of the Senate Finance Agreement. And some critics say the surge in drug prices could change the dynamics of the entire 10-year deal. 'It makes it much easier for the drug companies to pony up the $80 billion because they'll be making more money,' said Steven D. Findlay, senior health care analyst with the advocacy group Consumers Union", reported the Times.
The House of Representatives narrowly passed the "Affordable Healthcare for America Act" (HR 3962) on Saturday, Nov. 7th, by a vote of 220 to 215. Differences between the House bill and the Senate Finance committee's healthcare bill have yet to be resolved, so the healthcare debate is not yet over for this session of Congress.
Both the House and Senate bills leave in place the for-profit private health insurance system in the U.S., and would make it mandatory for all Americans to buy health insurance or obtain it through their employers, or through a so-called "health insurance exchange" or government plan. The House bill would place a tax penalty of 2.5% of income on individuals who do not obtain health insurance. The Senate version would exempt some individuals on economic hardship grounds. The House version would require employers with over $500,000 in payroll to offer health insurance plans to their employees. (See "House, Senate bills diverge on details," Boston Globe, 11/9/09.)
On November 6th, New York Democratic Congressman Anthony Weiner withdrew his single-payer amendment to H.R. 3962, the House health care reform bill. Weiner issued a statement that said, in part: "Given how fluid the negotiations are on the final push to get comprehensive health care reform that covers millions of Americans and contains costs through a public option, I became concerned that my amendment might undermine that important goal."
Democratic Speaker of the House Nancy Pelosi issued her own statement on Weiner's decision, acknowledging that single payer healthcare was a popular healthcare reform proposal, but making clear that single payer would not be included in the health care reform measure she was helping shepherd through the House of Representatives. Pelosi said:
"Within the next few days, the House will vote on the most comprehensive health care legislation in our history. Our bill will provide affordability to the middle class, security to our seniors, and responsibility to our children by not adding a dime to the deficit. While our bill contains unprecedented reforms, including an end to discrimination for pre-existing conditions and a prohibition on raising rates or dropping coverage if you become ill, our bill cannot include provisions some strongly advocated. The single payer alternative is one of those provisions that could not be included in H.R. 3962, but which has generated support within the Congress and throughout the country."
For those advocating the continuation of a private for-profit health insurance system in the U.S., the successes of the Swiss model are sometimes cited. (See, for example, Regina Herzlinger, The Atlantic, "Why Republicans Should Back Universal Healthcare".) But important details of the Swiss system are sometimes left out of the discussion, such as the not-for-profit nature of the basic, legislatively mandated social health insurance plan, and the negotiated price ceilings on medical care.
In Switzerland, health insurance is mandatory for every resident, but the costs for low-income people are subsidized. Healthcare insurance is provided by private health insurance companies, and residents may select their own plan provided the insurer meets the conditions to offer the basic plan, the so-called “social health insurance.” The insurance companies are, by law, however, not allowed to make a profit on the basic healthcare plan. They are allowed to profit on sales of supplemental health insurance coverage -- to cover alternative medicines and therapies, for example. (See Swiss Federal Office of Public Health, “Health insurance,” and “FAQ – Requirement to take out insurance.” See also NPR, “In Switzerland, A Health Care Model For America?”, 7/31/08.)
Page last modified: 11/21/09