Sustainable reform needed

Guy Saperstein writes Medicare for All: The Only Sound Solution to Our Healthcare Crisis at Alternet. It's a feature-length piece, with all the persuasive arguments necessary for rational listeners.

He writes that "'Universal healthcare' that does nothing more than bring more people into the most expensive and inefficient private insurance-based healthcare system on the planet would accelerate the total collapse of the system for everyone."

Saperstein uses a great quote from Joe Garamendi, California's former insurance commissioner and now lieutenant governor: "Are you aware that for 40 years, the United States has had a universal single-payer healthcare system that allows every participant to choose their own doctor, its administrative cost is one-tenth the cost of private insurance and people do everything possible to get into the system (i.e., live to 65). It is Medicare, and no one calls it socialized medicine."

He alerts us that The Center for American Progress' plan would fund insurance through the existing system of private insurers via a regressive sales tax. That's a big, bad, wasteful idea. Only genuine reform is sustainable.

Other points:

• 41 percent of Americans with incomes of $20,000 to $40,000 did not have health insurance for at least part of 2005, up from 28 percent in 2001

• average health insurance premiums for a family of four are $10,880: annual gross income for a full-time, minimum-wage worker is $10,712

• people without health insurance have 25 percent higher mortality rates

Regarding quality of care:

• the top quintile of the U.S. population has infant mortality rates higher than Canadians in the lowest quintile of wealth

• In terms of continuity of care (i.e., five-plus years with the same doctor), the United States is the worst of all developed nations

About the cost of care:

• Administrative costs, marketing and profits account for 22 to 31 percent of the U.S. healthcare dollar

• Since 1970, the number of medical doctors in the United States has increased 40 percent; the number of medical administrators has increased almost 3,000 percent

About pharmaceuticals:

• Americans pay 30 percent to 80 percent more for prescription drugs than citizens of any other country

• Only 13 percent of pharma cost goes to research and development (mostly of copy-cat drugs, for instance more erectile dysfunction pills)

• 51 percent goes to marketing, administration and profits.

About reform that's not really reform:

• No credible economist thinks America can sustain healthcare costs exceeding 20 percent of GNP

• adding 47 million more people to the current decrepit system would bring the United States to the 20 percent threshold

Single-payer solutions

• Howard Dean endorsed single-payer at a Democracy Alliance conference in Miami

• Progressives have to participate in this debate

• Democrats say that if they push single-payer they'll be attacked for promoting socialized medicine

• Medicare is a single-payer system; Medicare isn't socialized medicine; Single-payer isn't, therefore, socialized medicine

• The real reason Ds won't embrace single-payer is because they're scared of the insurance industry

• Reform could be done by incrementally expanding Medicare

There are a couple dozen good comments at Alternet.

Take time to read the entire article.