Editorial 11.6, June 2009, by Deirdre Helfferich Sick and Getting Worse This morning (June 16), I heard Health and Human Services Secretary Kathleen Sebellus on NPR’s Morning Edition confirm firmly and blandly that single-payer health care was not going to be even considered as an option in any reform proposal that the adminsitration would back and that any plan the adminstration would draft would quite deliberately prevent single-payer from even being a future possiblility. In fact, she expressed a bit of chagrin that Republicans are concerned that the Obama plan is a back-door way to single-payer, and hastened to reassure such listeners by suggesting they “talk to the single-payer proponents who are furious that the single-payer idea is not part of the discussion.” Damn right, they’re furious. Of course they are. And so am I. When it is made so blatantly clear that reform can only go so far, when ideas are banned from consideration and honest, full discussion on the matter is to be squelched at the outset, when options considered perfectly viable by numerous countries that have better and cheaper health care than we do (as rated by the World Health Organization) are simply ignored, then it is pretty obvious that what the administration—and a large proportion of Congress—is seeking is not the best solution to our national health care problem (which may or may not be a single-payer system), but the answer it has already selected and in which it has a vested interest. The “discussion” is a sham. It is an undemocratic, calculating jerrymander, not a sober attempt to address the problems with our current system: outrageous costs, lack of access to health care, and the resultant poor health of our citizenry. Whether a plan is passed by Congress will make no difference: the resulting system will fail to function properly. It has been hamstrung before it even gets to the starting gate. One tellling factor in the national discussion on the reform measures being considered in Congress: there is practically zero mention of shareholder profit as a cost that could be saved by instituting a nonprofit or government-administered system. The simple fact that health insurance companies make a profit by denying coverage—and thus actual health care—is rarely explored, nor is the reality of a byzantine, time-consuming, stress-inducing, paperwork-generating, and expense-producing insurance bureaucracy that restricts which doctors you can see (“preferred provider plans”), rations health care (deductibles and outright lack of dental or other coverage), and prevents preventative or early care (expensive co-pays). This bothers me intensely, because the profit motive is such an obvious piece of the problem. Congress and the Obama administration have an obligation to pay attention to the need of the nation for genuine reform, and must not dismiss out of hand any option, whether it is “politically feasible” or no. People can change their minds about which options are the best if they have a chance to discuss them. We must explore all our options, because the nation’s body politic is facing catastrophic illness. But I forget: we’re not insured for that.
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