September 29, 2003
Guest Viewpoint: Single-payer health care viable solution
By Marc Shapiro
Common rhetoric in presidential campaigns asks, "Are you better off than you were four years ago?" That question comes to mind as we close in on the first anniversary of the Measure 23 initiative campaign to enact universal single-payer health care in Oregon.
The answer falls out pretty easily from Tim Christie's Sept. 10 article, which reported that health insurance premiums have gone up an average of 14 percent - the worst in five years, and more than double the 1999 increase of 5.3 percent. This at a time when the Federal Reserve expresses concern about deflation in the rest of the economy. Rapid premium inflation is expected to continue into the foreseeable future, doubling health insurance premiums every five years.
As a primary speaker for the Measure 23 campaign, I became aware of most of the questions about a single-payer health plan. In the aftermath of the campaign, there is irony to be found in looking at where all of the opposing forces find themselves nearly a year later.
• Employees with employer-provided family coverage are paying 12.9 percent more for premiums, with less coverage.
• Employers are paying 14 percent more in premiums.
• Some members of the Oregon Health Plan wouldn't support Measure 23 because they believed they were secure, with health care provided to them without cost. Now many of them have no coverage, and many more have coverage that no longer meets their needs.
• Employees whose jobs and benefits disappeared in the economic downturn now find that because of the high cost of providing benefits, employers are not rehiring.
• Employers who would not support the plan because they were afraid they could not afford it find they are paying far more, or are having to reduce or terminate their coverage.
• Insurance companies and agents who believed they could remain fat and happy skimming the cream from insurance premiums are now seeing that fewer people can afford insurance, so their customer base is shrinking. (Of course, their role in health care would be eliminated by a single-payer system, so they remain happy if not quite as fat.)
• Doctors find that more and more of their patients are without insurance. Eight thousand of them have signed onto a proposal for a universal single-payer plan put forth by Physicians for National Health Care.
• The AFL-CIO leadership adamantly opposed our campaign and now finds, as we predicted, that an increasing number of union workers are without either jobs or benefits.
• Those on Medicare find that prescription drug coverage, promised in the last presidential campaign, remains elusive. The need for such coverage is serving as a means for the current administration to privatize Medicare so that its resources will provide profits for the insurance industry instead of health care for seniors.
• Finally, as predicted, hospitals, which universally opposed the plan, find the very viability of their emergency rooms threatened by an inundation of uninsured patients. The cost of this expensive care is then passed on to those who do pay for care. This is a major factor in the increased cost of medical care and insurance for those who do pay.
Few can say that their position with respect to health care is better than it was a year ago - overall, the picture is pretty bleak. If the deteriorating situation causes you to ask "what can we do now (beside kick ourselves)?" the answer is not simple.
We will unlikely be able to deal with this crisis through the initiative process. The same organizations that poured unlimited funds into the campaign to defeat Measure 23 would do it again, and the AFL-CIO-sponsored initiative to prohibit paying petitioners by the signature effectively would prevent grass-roots movements from being able afford to put initiatives on the ballot.
That leaves only the possibility of a political solution. Unfortunately, the insurance industry directs so much money toward the Legislature that it may respond only to the complete collapse of the system (which may not be far away).
On the national front, while Rep. Dennis Kucinich has consistently supported universal single-payer health care, those who control the media have decided to ignore his presidential campaign. However, he stands as our best chance for reform on a federal level.
In the wake of the demise of Measure 23, the basic parameters remain the same. Virtually all studies show that only a universal single-payer health plan has any hope of reversing the disintegration of the American health care delivery system. It is time for the U.S. to catch up with the rest of the industrialized world. It is time for people to let their representatives know that the health care crisis requires their attention and that a universal single-payer system appears to be the viable solution.
Marc Shapiro of Eugene was the Lane County chairman for the campaign to enact Measure 23.