On the status of health reform

by Andrew Coates MD

At the end of August the Republican Party took the position of “hands off Medicare.” While this would leave in place “Medicare Advantage” (which pays private insurance companies 12 to 17% more than it pays for the costs of care of traditional Medicare), and Medicare Part D (another huge giveaway to the drug and insurance industry), it was striking to see the Republican Party tie itself in knots after decades of calling for the abolition of Medicare.

Also in the name of "keeping the government out of health care" the Republican Party came out in defense of the Veterans Administration, a socialized health care system directly owned and operated by the federal government. In August the Congressional Budget Office released a study that underscored once again evidence of superior quality of care at the VA: better than Medicare, better than private practice and better than managed care.

If we were to engage a truly evidence-based debate over how to pay for health care using a “uniquely American” model, it would be a debate between single payer, the Medicare model, and socialized medicine, like the VA.

From "off the table" to "on the floor"

Single-payer national health insurance, after more than 20 years of accumulating evidence, now accumulates unprecedented popular support. Although polls have shown for decades that a majority, including physicians, favor national health insurance, the depth and passion of grassroots activism for the proposal is something new. For the first time this fall single payer may be voted on on the floor of the House of Representatives.

At the end of July, as the Energy & Commerce committee completed deliberations on HR 3200, Representative Anthony Weiner of New York, with 6 others, put forward an amendment to replace the text of HR 3200 with the text of HR 676. Committee Chair Waxman interrupted to say that House Speaker Nancy Pelosi offered to allow single payer to be voted on by the entire House of Representatives if the amendment were withdrawn from Committee. Weiner accepted.

Perhaps the prospect of defeating single payer on the floor of the House of Representatives seems, to the Democratic Party leadership, a way to at last get single payer off the table.

Single payer activists have welcomed this turn of events, for it was the direct fruit of grassroots mobilization. The proposals before Congress, with the exception of HR 676 and S 703, will simply not work. Whatever happens in Congress this fall, the system will grow more dysfunctional. And with expectations for fundamental reform now raised even higher, excellent prospects to build a movement for single-payer national health insurance will persist.

Read it all at PNHP's blog.

Dr. Coates practices medicine in Albany, NY, where he is assistant professor in the departments of medicine and psychiatry at Albany Medical College, secretary of the Capital District chapter of Physicians for a National Health Program and co-chair of Single Payer New York.

Does the government actually run the BEST healthcare?

The main thrust of the anti-reform argument is that government is bad at running things, and would be terrible at running a healthcare program. Better to entrust running healthcare to the very same private insurers who have gotten rich creating the very problem we have now: skyrocketing premium costs, coverage reductions or limitations, denials due to pre-existing conditions, etc.

But is there really a good argument to be made against government run healthcare plans in general? Certainly, the healthcare enjoyed by members of congress is government-run, as is that offered to our armed servicemen and women. How do they measure up to privately run medical programs?

A team of researchers recently set out to compare the quality of VHA care with that of care in a national sample by using a comprehensive quality-of-care measure.

From the study, the research team concludes that patients receiving socialized, government-run medicine from the VHA received higher-quality care according to a broad measure. Differences were greatest in areas where the VHA has established performance measures and actively monitors performance.

What this study really says is that the more accurately we measure, the more we begin to see that socialized, government-run medical programs like the VA provide extremely high quality medical care

Read it all here.

Lincoln Mitchell: Fearing Government Involvement in Health Care

Medicare, Medicaid and veterans' benefits have become an indispensible part of our health care system providing valuable services and benefits to people, many of whom would have very few health care options were it not for these government programs. This is something which should be kept in mind when scare tactics about government takeover of health care are used. These programs also demonstrate the inaccuracy, or perhaps nuttiness, of some of the more outlandish claims about Obama's proposed programs. For example, if the government were really going to ration health care or set up "death panels" as part of government health care programs, wouldn't the government have started by doing these things to the poor, the elderly or disabled veterans-precisely the people who rely on the government for health care today.

Read it all.