29 September 2015

Single Payer or Die?

A forceful begging letter came in from Public Citizen today. They're waging a petition campaign, hoping to get legislators to support some form of single-payer health insurance as an alternative to Obamacare. The letter makes many good points and includes a useful list of myths (or lies) about single-payer systems and Public Citizen's somewhat speculative corrections. The alternative to single-payer, the letter says starkly, is a "pay or die" society. Despite Obamacare, the U.S. remains such a society, along with "most poor countries in the world." Public Citizen claims that 45,000 Americans, or 120 a day, die because they lack health insurance. Author Robert Weissman wants legislative action as soon as possible because premiums continue to increase. Obamacare can't do anything about this, he argues, because Obama "sought a compromise with the health insurance industry" when "there can be no compromise with the health insurance industry. If you keep them in the game, they will devour you." He proposes nothing less than legislating the big insurers out of existence. But the audacity of his proposal isn't matched by Public Citizen's strategy. The petition is, of course, attached to a donation coupon, with "Do Not Detach" instructions. You can give as little as $20 and you get Public Citizen's bimonthly magazine. The arguments for single-payer are compelling enough to make this appeal for money tempting, but what will Public Citizen really do with it? "We need to strengthen our presence on Capitol Hill and to make the case in the states," Weissman writes. Put that way, I agree, but what sort of "presence" does Weissman mean? I'm afraid he means a lobbying presence because Public Citizen, however well intentioned it is, is still a lobby. Given the urgency of the situation, as Weissman portrays it, this seems like a distractingly indirect approach. Rather than spend money to lobby elected officials, shouldn't they spend it to elect officials who'd be sure to vote as they want? Instead, it looks like Public Citizen is less audacious in the field of electoral politics than it claims to be in the realm of health insurance. Weissman believes that Aetna, Humana, etc. need to go, but has he considered that the Democratic party may need to go before his legislative agenda can be realized? Public Citizen wants money so they can counter the influence of corporate lobbyists. It boasts that it takes no corporate money itself. Shouldn't it make sense to elect people who will not listen to corporate lobbyists, people like themselves, rather than compete with those lobbyists for the attention of legislators? Is it any more impossible to overthrow the Democratic party than to revolutionize the health insurance industry as completely as Public Citizen proposes? Both may be more possible if the problems are tackled in tandem. When Public Citizen is ready to consider that possibility they'll be closer to getting my dollar.

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