Healthcare

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Speaker of the House Nancy Pelosi will reportedly allow a Congressional up or down vote on a single-payer healthcare bill as early as September. (See NY Daily News 7/31/09 report; The Hill, "Liberals will get single-payer vote on House floor," 7/31/09; and Healthcare Now, "Single-Payer Gets A Vote In House" 8/2/09.) Simply getting to vote on the issue is a step forward -- won by Congressman Anthony Weiner of New York and others -- as single-payer proposals have largely been frozen out of the Congressional debate.

A single-payer system would function essentially like the popular Medicare program for seniors, but would be extended to cover all Americans. The actual medical care would still be provided by private doctors, hospitals and clinics, but payment would be through a single governmental agency, rather than through hundreds of private health insurance companies, each with their own rules of coverage, differing plans, and different forms.

For the C-Span 2 / YouTube video of the exchange between Congressman Weiner and Congressman Henry Waxman, chair of the House Energy & Commerce Commitee, in which Waxman relays Pelosi's commitment for a Congressional floor debate and vote on single-payer, go to www.commondreams.org/video/2009/08/01. If you have an opinion about whether the country should adopt a single-payer healthcare system, now is a good time to call your Congressional Representative and let them know it.

In July the Education and Labor Committee in the House of Representatives passed an Amendment to proposed healthcare reform legislation that would allow states to adopt single-payer healthcare plans. (See "A Real Win for Single-Payer Advocates", 7/17/09 and "House Panel Votes to Let States Adopt Single-Payer Health Coverage".) The Amendment, proposed by Ohio Congressman candidate Dennis Kucinich, passed in Committee by a vote of 25 to 19. To become law, the Amendment would have to be passed in the House version of any final healthcare reform bill, and then survive negotiations in the joint House-Senate conference committee that would iron out differences between House and Senate versions of healthcare reform legislation. Kucinich's proposal, if enacted, would at least allow some states to experiment with the single-payer healthcare approach used for seniors in the U.S. under Medicare, and used for everyone in Canada and much of Europe.

Nonprofit healthcare cooperatives might offer another model for improving healthcare coverage and lowering costs.  USA Today ran an interesting feature (8/21/09) on Group Health Cooperative, a 566,000 member nonprofit healthcare cooperative network in Washington State originally founded by farmers and loggers in 1947.  Group Health now operates 26 medical centers and contracts with 41 community hospitals, and directly employs about 9,000 healthcare workers.  Consumer Reports ranked this cooperative first in the nation among HMO-type healthcare plans, says USA Today.
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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.)

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Page last modified: 8/29/09