Having watched the entirety of President Obama's televised health summit Thursday, I was struck by several things.
The president's Republican opponents once again revealed their deep-seated, single-minded commitment to enhancing the profit margins of the insurance and drug monopolies. There were no surprises -- and next to no useful additions to the debate -- from the GOP's stalwarts, only a repetition of their shopworn proposals for tort reform, the ability to sell health insurance across state lines (read as: eliminating state consumer protections) and the like.
The president's proposal, an 11-page document released last Monday, along with the summit itself, was clearly aimed at creating a reform posture that would grease the wheels for getting the 51 Senate votes he needs to pass his party's deeply flawed bill through the reconciliation process.
President Obama sought to create an impression of willingness to deal with his Republican opponents from a straight-up gamesmanship point of view. In this regard he prevailed, in my opinion. His skills of debate are quite formidable, as even his most bitter opponents have to admit.
But the really important question is this: What are the American people being offered in the way of real health reform by the Democrats?
A good starting point is to look at what they are not being offered. They are not being offered a universal plan. They are not being offered comprehensive coverage. They are not being offered affordable care.
In some ways, what they are not being offered is the saddest part of all, because the president, who was elected by a large majority with high expectations -- along with solid Democratic majorities in both houses of Congress -- has not fulfilled his mandate. Having struck a series of deals with the for-profit health industry, he has been unable to move any genuine health reform legislation forward.
The American people obviously are hurting. The health care crisis has done nothing but worsen in the months succeeding his election. The adverse economic events make certain that there will only be huge increases in the number of uninsured. The last official figure was over 46 million, and it's hard to believe there will be less than 50 million who lack insurance when this year's tally takes place.
The meeting took place with dark economic clouds hanging over it. And the horror stories related at the summit -- of people being dropped by the insurers when they got sick, of people being unable to bear the burden of monstrous costs when illness struck -- were a recurring and sobering theme.
During the summit I was struck by Sen. Harry Reid's citation of two recent studies from Harvard University - one showing that 45,000 deaths annually can be linked to lack of health insurance (15 times the number of people who perished in the 9/11 tragedy), another showing that 62 percent of personal bankruptcies are linked to medical debt - to make the case for acting quickly to implement a reform of our broken system.
The irony is that those two studies, which played an outsized role in the health reform debate, just happen to have been conducted by research teams led mainly by Dr. Steffie Woolhandler and Dr. David Himmelstein, two of our nation's most prominent advocates for single-payer Medicare for All and co-founders of Physicians for a National Health Program.
The stubborn fact remains that the only way that you can achieve truly universal coverage -- that is, give access to health care for every person in our nation -- is through a single-payer system. That's also the only way to attain real cost control.
Our present arrangements, dominated as they are by the for-profit insurers, result in about $400 billion annually being wasted on useless paperwork and bureaucracy. Those excess administrative costs are weighing down on the medical profession, the public and the economy. By replacing the private insurers with a streamlined, nonprofit single-payer financing mechanism, we would reap sufficient savings to cover all the uninsured. The same savings would allow us to end co-pays, deductibles and caps, thereby upgrading everyone's coverage. And patients could go to the doctor and hospital of their choice.
We could also reap savings from bulk purchasing, negotiated fees and rational capital improvement planning. From the standpoint of health economics, it's a no brainer.
The tragedy is that President Obama, as recently as when he was an Illinois state senator, acknowledged that single-payer financing of health care was the logical and the best way to go. But now that he's made fatal concessions to the insurers and Big Pharma, crystallized as they are in the odious Senate bill, his stated goal of fundamental reform has unfortunately been foiled.
What does this mean for the single-payer movement? It's worth noting that although that we are obviously not in a decisive, victorious mode, the single-payer position has never been stronger. Whatever the outcome of this round of congressional maneuvering, the need for real reform will remain.
That was the message of the "Sidewalk Summit for Medicare for All" that took place outside the official proceedings at Blair House (and in several cities around the nation) on Thursday. Dr. Margaret Flowers, PNHP's congressional fellow, was joined by other physicians, health professionals, unionists and other health care advocates, in bearing witness to our eminently rational and humane solution. And they are just the tip of the iceberg.
The single-payer issue should loom large in the 2010 elections and single-payer supporters, whose ranks are steadily increasing, are in this battle for the long haul.