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Dr David Himmelstein on Diane Rehm today; Very strong single payer arguments --$400B v. $100B per year savings

Diane Rehm devoted the first hour today to a very good single payer healthcare discussion, actually giving Dr. Himmelstein, cofounder of PNHP (Physicians for a National Health Program), time to present the rationale and benefits of single payer. The program apparently is a response to listeners' complaints that single payer did not get much time in last week's discussion.

Way to go, listeners!

Save $400 Billion a year, cover everyone. How do we get Congress on board?

From the web sites program description:

Proponents of a single-payer plan argue it is the best solution for the nation’s health-care system. But chances of such a program making it into law appear remote. How a single-payer plan might work and why it faces an uphill battle in Congress.

Roger Hickey, Co-director of the Campaign for America's Future

Dr. David Himmelstein, primary care doctor; co-founder, Physicians for a National Health Program; associate professor of medicine at Harvard University

Bernie Sanders, was elected to the U.S. Senate in 2006 after serving 16 years in the House of Representatives. He is the longest serving independent member of Congress in American history.

Susan Dentzer, Editor-in-Chief of Health Affairs, and an on-air analyst on health issues with The NewsHour with Jim Lehrer on the Public Broadcasting Service (PBS)

Dr. H said single payer would save $400 Billion per year and offer comprehensive care for everyone. Single payer would add all the uninsured, covering everyone, and would upgrade all those currently insured to provide first dollar coverage.

If only....

I'm hoping PNHP will have a transcript, but the audio is available--about 51 minutes, including musical interludes.

Diane Rehm asked Dr. H to describe single payer: Everybody gets same coverage under a single plan nationwide, which offers attractive payments to doctors and hospitals; paying for care would no longer be a problem; no copays or deductions or bills. All that without increasing national healthcare spending.

Rehm said it sounded "magical," then asked Susan Dentzer why we have the situation we're in. She went through the WWII wage caps, businesses offering healthcare benefits in lieu of higher wages, said private insurance "developed" and became a "very, very effective interest group." Of course, millions have no insurance.

Roger Hickey said he would be for single payer "in the best of all possible worlds." [Which I took as condescension, that he was using it in Voltaire's satirical way of criticizing Dr. Pangloss -- as Obama might say, "the little single payer advocates are here" while telling people his plan is so much more "pragmatic."] I did wonder why he thought the US was in a different world from all the other industrialized countries which have single payer or single-standard/controlled rates but use private insurers....

Hickey said a public plan would save $1 Trillion over 10 years since the competition between the public plan and the for-profit insurers would cause them to lower rates (and coverage, Roger???? Or reimbursements???) Also, how does this figure fit with the $2 Trillion Obama gave in his Pronouncement last Monday? Anyone feeling bamboozled yet?

I've been noticing the single payer advocates usually speak in terms of savings per year while Obama et al use this 10 year savings amount. It may be because the early years save very little, with larger savings coming later. Or it may be that they think the huge number* is mind numbing and people won't understand it's only $100 Billion per year.

Let's see: We as a nation can save $400B each year or $100B each year...and the $400B povides health care for all, with no deductibles, no copays, no billing.... Gee, why're they going for the worst plan? Oh, yeah. They're owned by BHIP....

Dr. H said paperwork imposed on all areas of healthcare won't go away under the public plan, that there is no evidence of savings from DMR (Digitized Medical Records) or evidence of savings through disease management programs. Studies show the public options savings 9% of what single payer would save. Vaporware and wishful thinking is how Dr. H described it. When private insurance remains in the middle, increases cost for everyone.

Bernie Sanders came on briefly, spoke glowingly of the benefits of his first choice which is single player, then said said it didn't have a chance. He will work for a public option where people 48-50 can join Medicare. Uh, what about people younger than that?

He also says he would like single payer administered at the state level, which set off alarm bells for me. We do see widely disparate standards for care when states can set their own standards. Shudder. And how does it work when people travel? Or companies have people in many different states? Or get sick while on business trips?

Sanders used the 50 million uninsured number, emphasizing that 50 die every day in the country due to no insurance. He said healthcare should not be an area of high profits and huge executive compensation packages.

He said single payer offers health security (hey, that's a cool name for single payer, plays off Social Security!), eliminates large deductibles, copays, meaning people can go to doctors when they get sick and not have to wait until it becomes a true emergency and is life threatening. He saw savings as $400 Billion per year, as well, perhaps more if the government can bargain on prescription costs.

Dr. H says massive public outpouring of support is necessary to move Congress. Bernie Sanders says the debate is not about healthcare, but about economics, politics, and the power of the BHIP (Big Health Industry Playahs--my phrase).

Listening to this program was both exhilarating and depressing. Dr. Himmelstein is persuasive and logical, but the political reality seems to be that Congress is controlled by BHIP. Dammit, dammit, dammit.

Audio archives are available from 1999; this calendar grid shows this years programs. Last Monday also had a discussion of healthcare reform, the one listeners said didn't give single payer enough attention; guests were:

Russell Mokhiber, Founder of "Single Payer Action" and owner/editor of the weekly newsletter "Corporate Crime Reporter."

Len Nichols, director of the health policy program at the New America Foundation

Julie Rovner, health policy correspondent for National Public Radio, author of "Health Care Policy and Politics A-Z," and contributing editor for National Journal's CongressDaily.

Stuart Butler, Vice President, Domestic and Economic Policy Studies, The Heritage Foundation

*See lambert's post on graphic representation of 1 trillion compared to 1 billion

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Comments

Submitted by hipparchia on

and thanks for your excellent writeup here.

i don't like bernie sanders' putting so much power in the hands of the states for his version of single payer. i can see some upsides, but people like me, who live in states controlled by thieves and liars, will be in trouble.

i feel like i should listen to the other broadcast too, but i know it's going to make me frothing-at-the-mouth mad.

Submitted by hipparchia on

[if you don't, why not?]

you can reply to diane rehm here. her question:

What are your thoughts on single payer health care? Can in happen here? Should it?

and here:

anyone out there want to share their single-payer story?