What About the Single Payer Plan?

by Bret Kincaid

Now that Arlen Specter has switched to the Democratic Party (http://www.nytimes.com/2009/04/29/us/politics/29specter.html), and Al Franken is likely to be seated in the US Senate this summer, the Democratic Party in the Senate is better poised to defeat Republican filibusters of President Obama's policy reform of healthcare.  Unfortunately for President Obama, this past weekend Specter told Meet the Press that he would oppose public health insurance, the topic I explored in my April 22nd issue of the ePistle.

It is reasonable to assume, then, that if Specter would oppose Obama's public health insurance proposal, he would certainly oppose what is probably the most radical healthcare reform proposal—the single payer plan (SPP), or what is being strategically dubbed "Medicare for All."(http://www.medicareforall.org/pages/Home)  Specter's opposition to a SPP is just the tip of the opposition iceberg, and the iceberg includes hefty industries like insurance and an array of other healthcare-related interest groups with gobs of dollars to throw into paid advertisements to scare us with the specter (no pun intended) of long lines, low quality, and rampant inefficiencies (as if none of these serious problems exists now).

It is troubling that Obama reluctantly allowed only two proponents of SPP into his White House Forum on Healthcare (http://www.truthdig.com/report/item/20090310_put_single_payer_on_the_table/)  two months ago attended by about 120 stakeholders. This is strangely contrary to his typical disposition to reach out to draw Americans into the political process. Opinion polls are mixed on this issue, and public opinion is quite malleable depending on what respondents are asked and what language is used in surveys.  A public opinion poll done last year by Kaiser doesn't bode well for SPP: When asked to choose among seven healthcare reform options, the SPP came in last place.  Still, when asked in another Kaiser poll whether the respondent would support "a public health insurance option similar to Medicare to compete with private insurance plans," 67% of respondents said they would.(http://www.politico.com/news/stories/0409/21763.html)

The support inside Congress seems much clearer, if dimmer for a SPP.  If congressional opinion of last Congress is any indication, SPP proponents have a very steep mountain to climb.  According to a rough survey done by Medicareforall.org, (http://www.medicareforall.org/pages/Monitor_Political_Support) only 3% of Senators and 20% of Representatives supported a SPP.  Perhaps even more deadly is the fact that Senate Finance Committee Chair Max Baucus, a key player in the legislative process around healthcare reform, recently said, "I don't think a single-payer system makes sense in this country."(http://www.npr.org/templates/story/story.php?storyId=98374633)

I believe a SPP makes a lot of sense as a remedy for achieving universal healthcare coverage.  It is made appealing by a growing number of interest groups advocating a SPP, probably the most prominent one being Physicians for a National Health Program (http://www.pnhp.org/facts/what_is_single_payer.php).  And our Canadian and European counterparts, who enjoy a right to healthcare, are perplexed and appalled at the fact that some 47 million Americans are without health insurance.  But there are potential flaws (http://www.nationalcenter.org/NPA561.html) in a SPP, just as there are in every proposal floating around out there.  And reforming healthcare —a $2 trillion industry—will immediately create many winners and losers in the healthcare industry, unsettling millions of people who earn a living directly or indirectly from it.

We should move cautiously, but we should move nonetheless.  The issue is too important to leave policy reform strictly to the insiders.  Let's get up to speed on the key details of Medicare for All and competing proposals (including Obama's), prayerfully decide which most conforms to biblical justice, and then join the legislative process informed and committed to loving our neighbor.

Bret Kincaid is associate professor of political science at Eastern University in St. Davids, PA.

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