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Saturday, July 20

Gapers Block

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If you want the rich to get richer, like I do, and you also want the middle class to expand, then you want single-payer universal health care coverage in the United States. The problem with a lot of the dialogue about universal health coverage -- besides the fact that conservatives consistently lie about it -- is that it is couched in the wrong terminology. It is not about what is "fair" or what is "right"; it is not even about "safety nets", although all of those things apply. It is about that thing economists value more than any other, with the possible exception of pocket protectors -- efficiency. Study after study has shown that not only would a single-payer system save the American family money despite the slight increase in taxes, it would also save corporations money both in overhead costs and in lost productivity -- not to mention it would also give small businesses a competitive advantage in the labor market.

This has become such a glaring reality that even the CEO of fledgling underdog General Motors has said it's time to unburden the business community and establish a single-payer universal system.

But wait, you may be saying, isn't it un-American to have the federal government stepping in and taking over our hospitals, and telling us where to get treated, and making our best and brightest take enormous pay cuts when they become employees of the federal government?

Calm down, there, Rush. Take it easy. You're suffering from confusions and delusions that afflict millions of Americans subjected to nearly 60 years of campaigning by insurance interests. These things that concern you are all indisputably myths and misconceptions that first began when Harry S. Truman tried to pass Universal Health Coverage in 1946.

Before I go on to lay out the myriad ways universal health coverage will make all Americans better off, allow me to put the above myths to rest:

MYTH 1: "You pinkos want the federal government to own our hospitals, and employ our doctors, and limit our physician choices!"

The Truth: The federal government wouldn't own hospitals or make health workers into federal employees. It would simply expand the Medicare model and put all Americans into the same risk pool, thus cutting costs and taking away the inhumane practice of denying coverage to the chronically ill. And choice? Please. How much choice does the average American get from their HMO? According to studies by the American Medical Students Association, individuals would have more choice under a single-payer system.

MYTH 2: "Here you big-government Democrats go again, trying to create another huge bureaucracy to come and solve our problems."

Actual World: Funny how conservatives loath democratically controlled government bureaucracies but are so enamored with plutocratic, monopolistic business bureaucracies that are inefficient. It wouldn't do that anyway. Currently, about 2.5 percent of Medicare costs are administrative; in managed care, it's usually about 10 percent to 15 percent. Boom.

MYTH 3: "Why are you effeminate bleeding-hearts always trying to tax our problems away?"

Planet Earth: The increase in taxes in every case -- on businesses and individuals -- would be lower than the current mean expenses for healthcare costs. Not to mention nearly eradicating exorbitant deductibles and co-pays.

MYTH 4: "I get it, you're trying to protect your precious trial lawyer friends! Medical malpractice is the real reason 48 million Americans lack health coverage!"

Reality Town: This may be the biggest fraud perpetrated by big business in the last 30 years. No no no no no. Nope. You know why premiums are going up? Because insurance companies lost umpteen billions of dollars between the stock market bubble burst and September 11th. This is how they raise capital. Study after study has shown that the medical malpractice argument is a complete falsehood. A definitive study by the Justice Department was released in 2000, and practically every editorial board from the Atlanta Journal-Constitution to the DesMoines Register has issued opinions supporting studies released by their own papers. "Tort reform" is just a bogeyman fabricated by the US Chamber of Commerce and the insurance lobby to punish consumers and justify their own negligence and greed.

MYTH 5: "If universal healthcare is so good, why are Canadians coming to America in droves for healthcare?"

New South Truthville: Limbaugh loves this one, probably because it is a lie. The May/June 2002 issue of Health Affairs finally and definitively put an end to this persistent myth. Simply untrue. A study revealed that 0.11 percent (i.e., one tenth of one percent) of Canadians have ever sought medical care in the United States. For the record, that's less than 3,000 people. How many Americans have gone up to Canada for prescription drugs? A lot more than 3,000 people.

MYTH 6: "Always with the socialism. Rationing medicine, long Soviet-style lines to see a doctors. Why do you liberals hate America?"

You're An Idiot: HMOs already "ration" medicine, according to who's less likely to get sick; in Canada and Switzerland, for example, priority is given to the most ill. Also, Canadians see their doctors three times more often than Americans do, and that is with a doctor shortage.

MYTH 6: "Pfft. Doctors'll never go for it!"

Boring But True Fact: Fifty-eight percent of physicians surveyed by the American Medical Association said they would support a single-payer system.

Whew! Glad that's out of the way. So why is a single-payer, universal healthcare system so purely capitalist?

First, because it improves efficiency. Because of burdensome deductibles and co-pays -- or a complete lack of coverage -- employees will often put off geting checked out by a doctor until they are ill, often seriously ill, increasing the costs to the employer and insurer and costing the employer valuable productive manhours lost because of sick time as well as inefficiency caused by the employee working while ill.

Second, it helps entrepreneurs. Small business employees account for one of the largest groups of uninsured. If employees can count on single-payer health coverage, it allows small businesses to be more competitive in the labor market. It also frees up valuable capital for expansion, and therefore job creation.

Successful entrepreneurs and even big business CEOs would stand to benefit from the deletion of healthcare expenditures from their budgets. With healthcare costs stabilized, consumer spending would go up as disposable income is returned to the "spending class" -- families new to the middle class. As aggregate demand increases, the job market would expand while simultaneously improving individual productivity due to a healthier populace.

The US already spends more per capita on healthcare costs than any other nation -- that's per capita, not aggregate -- meaning we are in effect already paying for universal health coverage, we simply aren't getting it.

And how about national security? Bet you thought I wouldn't be able to tie that in. When Harry S Truman introduced legislation providing for universal health coverage in 1946, he did so using the rationale that America's health as a whole was reaching critical levels, and therefore weakening us. Nearly 18 million men had been found unable to serve in the armed forces during World War II due to otherwise preventable health issues. Also, infant mortality cost us a competitive advantage in a demographic growth. The same issues apply now: our nation's young aren't getting proper health supervision, which will lead to millions becoming unproductive adults and thus a burden to the rest of us. This curbs our own productivity.

How would we pay for it, you say? To which I would say, of course, that we already are paying for it. But here's an idea: how about forcing enormous corporations to actually pay their taxes?

In 1998, 24 of the nation's wealthiest corporations -- including such sweethearts as GM, J.P. Morgan, Pfizer, Pepsico, Chevron, and Enron -- paid $-1.3b in taxes. That dash means "negative." That's right; on $12b in profits, they paid a -10.6 percent tax rate. So if you were working in 1998, you paid more in taxes than, say, MCI Worldcom. Even if you only paid $300 in taxes that year, that is still $19,000,300 more than Colgate-Palmolive paid.

So it isn't socialized medicine. It would be better for business. And we can easily fund it. The only people who oppose it are partisan hacks in the pockets of the insurance lobby.

So what are we waiting for? Email this article to your Congressional Representative. Or better yet, call him or her up and yell at them for a while.

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About the Author(s)

Ramsin Canon covers and works in politics in Chicago. If you have a tip, a borderline illegal leak, or a story that needs to be told, contact him at .

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