What the hell is single-payer?

On Saturday I was cold-calling in person at a conference, approaching people and asking them if they were for single-payer universal health care. It's a bruising thing to do, because you're not insulated from people who are annoyed by your invading their space and people who disagree with your message.

But it's also instructive.

One guy was impatient. "What's single-payer?" he asked. "What is that?"

I began to explain and he cut me off after less than 10 words, saying his life was too short. "You mean socialized medicine," he informed me. "Why don't you just say 'socialized medicine'?"

He went on to say that to him, single-payer is what we already have. He's the single-payer for his health care.

He was so arrogant, dismissive and nasty that I was left reeling -- and wondering what he was doing at a "Faith in Action" conference. I suppose this is why the "heartland" feels the way it does towards academics, because that's all I could imagine that he was. But trying to put it into perspective, his observation was a good one. It's not something that we didn't already know, but it's a confirmation, once again, that the term "single-payer" is a head scratcher.

Guaranteed health care might be better. How would we describe the police or fire departments? Guaranteed police or fire? Universal police protection... with single-payer financing? State police protection? Municipal fire protection? Government-sponsored health insurance?

George Lakoff likes "doctor- and patient-run health care" -- like citizen- and police -run policing?

Or, back full circle, universal health care with single-payer financing?

I'm reminded of the Family Research Council employee who got a month sabbatical to go work for Huckabee. He said that among the things he learned were that the mainstream media were far more fair and balanced than the right-wing media, and that whenever people asked for real information, not just a soundbite, their attention would be gone after 30 seconds. And those were people who wanted to pay attention.

People want things to be easy. We want someone else to have to make the changes, to do things differently, in order to better the system. Mandates are just the ticket for that in many politicians' eyes. Since the majority of Americans do already have Medicare or employer-sponsored insurance, it's a siren call for them to hear that if we just force the uninsured to buy insurance out out-of-control costs will be solved.

They won't be.

Cost-shifting (providers charging insurance companies more to make up from losses elsewhere) is only part of the problem, and only a small percentage of cost-shifting is due to the uninsured. The rest is from Medicare and Medicaid. But even if it were mostly from the uninsured, who really thinks that companies and families would reap the benefits of forcing everyone to buy insurance -- who really thinks the insurance companies would turn around and lower their costs? This is one of the most profitable industries in the world -- has that led them to step back and reconsider their profit margins?

But from what I heard Saturday, a number of people, especially elderly women, are enthusiastic about forcing poor single moms to buy insurance. These seniors were also outraged about their personal out-of-pocket costs.

Why single-payer is coming

My friend Bob Pfohman, a Vietnam vet and all around brilliant guy, now and then says that someone has "shit in their own mess kit."

Meaning they'd fouled their own livelihood, their own good deal, or even their own survival. Kinda gross imagery, but vivid...

As in the health insurance industry becoming so grasping and greedy that they've now got a majority of Americans seeing clearly that health insurers have more in common with the Mafia than any kind of institution we'd want to subsidize.

Utah is the most Republican state in the union. It's not really the place to go to for liberal commentary. But here's the Utah Statesman's film reviewer going over the top 10 movies of 2007:

9. "Sicko": No, I didn't pick this documentary by Michael Moore to be on my top 10 list because I'm some "bleeding heart liberal." As a matter of fact, I detest politics and politicians (on both sides of the aisle) more every day. So, if you're like me and want to see what politicians have done to our healthcare system, this is the movie for you. Moore is a master of editing and making people feel what he wants them to feel, I know that. But you can't argue with the fact that the way our healthcare system is set up is ridiculous. Maybe, just maybe, socialized medicine would work here. That's right, I said it. Now I'm going to run and hide so I don't get stoned.

That from a writer so immersed in right-wing culture that he calls guaranteed healthcare "socialized medicine."

Does he also call the police and fire departments socialized protection, I wonder?

Hillary says it right

For all those who hate Hillary, take a look at this. In "Hillary Lashes Out at Health Care Critic," she answers someone accusing her of being for "socialized" medicine, like they have in Canada.

"Do you think Medicare is socialized medicine? Clinton asked, turning the tables on her inquisitor, who did not identify himself.

"To a degree," he responded.

"Well, then you are in a small minority in America," Clinton said to applause, before explaining that Medicare allows patients to choose their doctors even though the federal government foots the bill with money deducted from workers' paychecks.

Clinton then asserted that "on balance" countries with uniform national systems of health care, including Japan, Australia and Canada, offer their citizens better health care than the U.S. The answer left her questioner shaking his head in disagreement.

"I can give you the statistics and you can shake your head," Clinton said sharply. "You come and introduce yourself to the staff. And we'll try to give you some information if you're interested in being educated instead of being rhetorical."

Christianized medicine

Donna Smith, who appears in Michael Moore's new film Sicko and who is very much a Christian, sent along these quotes from the end of a story in the Detroit News.

"This film comes from a spiritual place," Moore says, "so I wanted to go to the headquarters of the sisters who taught me in my early years. They had a profound impact on me."

The idea that it's about "the we, not the me," came from the nuns. "Instead of calling it 'socialized medicine,' it should be called 'Christianized medicine.'"

"This was one of the ground rules that was laid down by Jesus. He said, 'I'm going to ask you a bunch of questions when you get to the pearly gates. When I was hungry did you feed me? When I was homeless, did you give me shelter? When I was sick, did you take care of me? And if you didn't do these things, and you didn't do these for the least of my people, then I'm going to have to say that you can't come in the big house.'"

Michael, according to Maryknoll Father Charlie Dittmeier, is probably a Matthew 25 Christian — a verrry different species than a Matthew 28 Christian.

Here's the difference:

In Matthew 25:31-46, Jesus told his disciples that those who fed the hungry and gave water to the thirsty, those who clothed the naked and visited the sick or in prison will go to heaven. “I tell you the truth, whatever you did to one of the least of these brothers of mine, you did to me,” said Jesus.

Those who don't will go to hell: “Depart from me, you who are cursed,” he begins. “… I was a stranger, and you did not invite me in, I needed clothes, and you did not clothe me, I was sick and in prison and you did not look after me.”

Now Matthew 28: “Go, therefore, and make disciples of all nations, baptizing them in the name of the Father, and of the Son, and of the Holy Spirit, teaching them to observe all that I have commanded you.”

















I wrote last year in the Catholic Sentinel about what a difference that makes in real life:

PHNOM PENH, Cambodia — The middle-aged woman waiting for a connecting flight is an Evangelical Christian, proud of what her church is doing in Cambodia. There is an orphanage for 30 children and a school for more than 200. But most important, they were building churches so fast that she couldn’t keep track of them: A dozen just this year.

The Catholic Church, she said, doesn’t have much of a presence in Cambodia.

How about Catholic Relief Services, Caritas, the Jesuits, the Maryknollers, the PIME fathers and all the other Catholic NGOs and orders?

She shook her head. “All they do is help people,” she said. “They’re not really spreading the Good News.”

Bless that woman for giving me such a great lead.

That great photo, by the way, is from Rick D'Elia, who has recently emailed from Rwanda.