Friday, May 15, 2009

update on the marginalization of Single Payer

Of course, to much fanfare, I posted this on Shared Sacrifice yesterday.
Obama is betraying his most intelligent, hardworking
and serious supporters in the worst way possible: To be excluded from the deliberative process is dehumanizing, instrumentalizing, and marginalizing. He's not even bringing it to the table to explain what's wrong with it. This is important for process-oriented reasons. Obama is kicking it off the table rather than explaining why it's "infeasible" because its infeasibility is not one of "policy logistics" or even cost. Its infeasibility is an effect of elite opposition, opposition by parties who will win because they have resources, not arguments. And that's exactly the distinction progressives need to be making
on this, as on so many other issues.

Obama prefers to appeal to tradition. Fallacy, and lots of bad traditions, but yeah...
Obama was asked why a "single payer" plan — where the government makes payments directly to medical care providers — isn't on the table.
He said the nation has a tradition of employer-based health care using private insurance companies, and that a lot of people are satisfied with it.
Congressional leaders have said a single-payer plan is politically impractical.

David U. Himmelstein's testimony before the Health, Employment, Labor, and Pensions Subcommittee is right on.
...doctors in the U.S. waste about $95 billion each year fighting with insurance companies and filling out useless paperwork.
Unfortunately, these massive potential savings on bureaucracy can only be achieved through a single payer reform. A health reform plan that includes a public plan option might realize some savings on insurance overhead. However, as long as multiple private plans coexist with the public plan, hospitals and doctors would have to maintain their costly billing and internal cost tracking apparatus. Indeed, my colleagues and I estimate that even if half of all privately insured Americans switched to a public plan with overhead at Medicare's level, the administrative savings would amount to only 9% of the savings under single payer.

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