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The solution to our failing health care system is simple. The
complexity arises from special interest groups who benefit from the
status quo. These special interest groups will go to great
lengths to mislead the American people in the pursuit of maximum
profits. "The bottom line" for patient care is that money spent
on administration, overhead, marketing, inflated CEO salaries, and
corporate profits is money that cannot be spent on patient care.
The following MYTHS will illustrate how "maximum profit" market driven health care has misled the American people.
The Myth The myth that single payer is impossible in America has been propagated by special interests in order to cut off any discussion of single payer as an option. Our recent experiments with a series of incremental proposals have only seemed to buy time for the special interests, time during which the plight of the American people, and their access to health care, has only gotten worse. The most current proposals du jour are now tax credits and "defined contributions." And soon we will be hearing about "personal health accounts." All of these incremental efforts have zero potential for changing a system that is broken. In fact, they fragment the system even more by making it even more complicated and administratively wasteful. As for the managed-care approaches, such as Medicare+Choice, Medicare Advantage, they have often only served to increase overall cost-the opposite of their intended goal. Moreover, they have led to an accentuation of the problem for risk avoidance or "cherry picking," a problem which only a "single risk pool," or national health insurance, can solve. In comparison to the attention given to costs for government and industry, almost no attention has been devoted to the cost of health care borne by the patient or consumer. Instead, the patient has been increasingly squeezed with a spiral of higher deductibles and co-pays. And people who have been sick are penalized even more, especially, if they have an awful "pre-existing condition," with astronomical prices for health insurance, if it's even available. The "incremental" approaches have done nothing to improve this situation. Nor do such approaches have the potential to deal with these kinds of problems. When considering low-income patients, the various piecemeal proposals medical savings accounts, tax credits, and small group arrangements to buy bare-bones coverage seem like pipe dreams as opposed to single-payer. To the American people (all of us who are patients/consumers, and especially those of us who are squeezed by health care costs or simply unable to afford health care at all), single payer national health insurance is probably the only solution that will work. Other solutions, the incremental type, not only will continue to perpetuate an increasingly complex and wasteful system, but also will create new cracks in our already profusely leaking series of safety nets. If the American public really understood what the trade-offs were, they instead of corporate America, could apply pressure to our politicians that would make national health insurance a political reality instead of a political pariah (despised and rejected). Increasing the eligibility for Medicaid CHIP, as many states have already done and as some national schemes propose (including ACPASIM proposal for universal coverage), thus increasing the enrollment of low-income people in these plans are unpopular with state politicians trying to cut costs, and access is low to providers because of low reimbursements. Getting some value for what we spend depends very much on having a cohesive financing system that can share the risk, set priorities, use scientific and information-based health care modalities (including prevention), and have some vision of what America needs. Our fragmented system does virtually none of the above. Incremental changes do not give a proper place to prevention. It will take a critical mass of hurting Americans-and a better public understanding of a complex issue-to create the grassroots groundswell that will make national health insurance politically acceptable. This is where the Tompkins County Health Care Task Force of Ithaca N.Y. will focus its effort. Keeping America Clueless Americans have been conned into believing that "we have the best health system in the world," along with a host of other myths. The spreading and maintenance of the myths has been bankrolled by the vested interests. The millions spent by the AMA in the early 90's to discredit Canada's system, the many more millions spent in 2000 by the pharmaceutical industry on "the bus from Canada," and the millions spent on "Harry and Louise" by the insurance industry and small businesses to kill the Clinton plan (as bad as it was) are but a few examples of the concerted and directed effort to kill or delay meaningful health care reform. These efforts to keep America clueless have been amazingly successful-to the point of having created inner (almost) dogmas that inhibit rational thought. This programmed mythology has implanted certain catchwords in our collective American psyche. In seemingly rational discussions about health care, throwing in phrases like "socialized medicine", "the federal government", "rationing", "taxes", "Great Britain" or "Canada" brings discussion to a screeching halt. The issue of health care in America has become so complex that a few million media dollars to plant doubt can block significant change. The spreading of the"myth that co-pays and deductibles are a part of personal responsibility is just a ploy to shift the cost to employees and individuals. It will take a stronger sense of "community responsibility" to assure everyone in America access to health care. Unless someone is ill or injured, there is little interaction with the system or appreciation for how it doesn't work. They often have little sense of what it means to lose your dignity in a dysfunctional health care system. Only after they've been sick and had the misfortune to experience the crazy side of American health care, do they wake up and realize something has gone wrong. The conflict of globalization can be described as one between the multinational corporations and the working people of the world. Of course, that's too simple a definition. But it does come down to a battle between the "haves" and the "have-nots," with the "haves" telling the "have-nots" they should have faith in free markets, capitalism, privatization, free trade, etc. Around the world, the efforts of the International Monetary Fund-notably their "structural readjustment" or privatization plans-have disastrous results for working people. Health care cannot really be viewed in a vacuum. It interrelates with other social and economic issues, such as poverty, hunger, racism, a living wage, adequate housing, and education. In a larger contest, our current dilemmas with health care raises the whole issue of whether, as a community, we have some responsibility to care for each other-as opposed to "personal responsibility." Unless there is some reversal of direction soon, America's health care seems to be headed increasingly towards greater discrepancies between rich and poor, as we progressively become a "culture of extreme inequality. " Needed for Affordable and Effective Health Care Reform in America: A Paradigm Shift for Prevention Affordability is a critical part of the solution to making "Health Care for All" possible. Prevention-real prevention-has a key role (along with administrative savings) in making "Health Care for All" affordable. Immunizations and prenatal care have been clearly demonstrated to save money for our society as a whole. For example, it is generally agreed that for every dollar we spend on prenatal care, we save $7 in the long run. We as a
society have failed so far to come to grips with how we should deal
with a host of chronic diseases--e.g. heart disease, strokes, obesity,
arthritis, and diabetes. There is evidence that chronic diseases affect
the uninsured, much more adversely than people with coverage. A study
by the Center for Studying Health System Change found that the
uninsured with chronic illnesses are three times more likely not to get
the medical care they need. Going without good health care
coverage is the sixth leading cost of deaths. Real prevention could go a long way to making America a much more humane society:
We relate better to each other if we're not depressed, not sick, not limping with a worn-out knee joint, and more able to do our daily activities for others and ourselves. Our physical and mental wellbeing is directly related to physical activity. It would be a key measure going to improve the health of Americans. It would make us a healthier and kinder society, and it would help make "Health Care for All" an affordable reality, not just a dream. The long-term financial consequences of failing to deal with preventive measures will severely affect our ability to create an affordable health care system.
The Medical-Industrial Complex The Merchants of Misinformation and Myth 2. Everyone should have a "Choice of plans." Fact -
everybody should have a choice of doctors and hospitals, which
"Medicare-for-all" (a single-payer system) would provide.
. Our present for-profit system has 1500 insurance companies and
300 HMOs. We don't need more choice of plans, we need choice of
physicians and hospitals.
9. "People don't want "Government run health care" Medicare for all, Single Payer or National Health Insurance is only government run non-profit insurance (like Medicare). It does not tell Doctors how to practice medicine. 10. Why should I pay-for Congressman's expensive obesity operation or the lung surgery of someone who chose to smoke? Because they will pay for a kidney operation of yours or a mastectomy for your wife. When everybody pays for everybody, we all get protected at the lowest cost for each of us. 11. "Give everyone a deal like federal employees" This is the biggest myth of all that won't die, that FEHP is a cure for our failing system. In the real world, it means dealing with HMOs, which are subsidized by taxpayer money. FEHP averages 72% of premiums subsidized by government. 12. "There is more than one path to universal coverage." Unless the fiscally sound rule of insurance is evoked any plan will fail. I repeat: "The more people in one insurance pool, the lower the cost for all", which insurance actuaries call "Spread the risk." 13. Do you want a Washington bureaucrat controlling your health care? The wording implies politicians will make medical decisions (no way). What we propose is a government non-profit insurance pool that would pay all medical bills; while patients choose their own doctor. Doctors make the medical decisions. And the patient never sees the bill, as the non-profit insurance pool pays the doctor and hospital. The equivalent of a "Medicare for All". You Save Money with a Single-payer Everyone has a sensible system, you save money. You do not Spend More! We save $500 Billion, cover everyone, restore free choice of doctor and get the hated HMOs off our backs. The real truth; In 2003 the government paid 60% of the cost of health care. Medicare, Medicaid, the VA, Active Military, Subsidies to Employers to provide health care to their employees, etc. On top of that we have workers compensation, and others that further separate our health care system. In 2007 the government now covers two-thirds of the health care costs. Myths What we think as truth but in reality is not verifiable Americans Don’t Want "Rationing" of Health Care—every Country has some rationing in their health care system. The question is; who has excessive rationing. The United States has rationing and "waiting lines", and the way we do it is with money. The definition of U.S. style rationing is: If you can afford it you can get it. If you can’t afford it, you either can’t or won’t get it unless it’s a dire emergency and you’re lucky enough to catch the problem in time to survive We Don’t Want Socialized Medicine Like in Canada—There is no such thing as socialized medicine unless you want to include America’s private system where private insurance companies tell physicians what tests they can and cannot do. No country educates their doctors and then tells them how to practice medicine, which would be absurd. Canada has a social insurance system like our Medicare. Universal Coverage Will Overburden Our System—The assumption is that if we were to open the "floodgates", the system would be overwhelmed by the demands for health care or the abuse of the system. This has never materialized in countries with a National Public Health Plan. People don’t want to get sick; they don’t want to be put in the hospital. We have an undersupply of primary doctors and an over supply of specialists; a NHI will correct this situation. We have a sufficient number of health care providers—even nurses, if we count all the nurses who now do administrative duties or who have left nursing out of frustration over adverse working conditions. A national health care plan could provide free education for our "want-to-be" doctors and nurses and give them an incentive to practice quality medicine instead of being highly in debt when they graduate, and money being their primary concern. We Can get to Universal Coverage Through Incremental Changes—Refundable tax credits, federal subsidies, medical savings accounts, vouchers, employer defined contributions, supplemental insurance policies to cover drugs or items that primary insurance doesn’t cover, and buying cooperatives, among other things—are simply too complex and costly for the average near-poor family without health insurance. We spend way too much on health care in this country ($1.8 trillion annually, 2007 $2.2 trillion now) and incremental changes have only led to higher cost, and still they exclude many. Incremental changes only fuel the present system and keep us from reforming health care. Americans Won’t Accept Single-payer Universal Coverage—the American people, who have been exposed only to the rhetoric of the vested interest, have not had the opportunity to form any thoughtful consensus on the single-payer approach. The merchants of misinformation and myth have been successful at hawking a line of philosophic incompatibility to discredit the single-payer approach. The American people want universal coverage and they are sympathetic to those without coverage. Everybody Has Access to Care Through the Emergency Room— This is very costly health care. A visit to a primary doctor may cost $80, a trip to the emergency room probably $500. The ER physician doesn’t know the patient record which results in more cost and more tests. The patient is often given a few sample pills and a prescription to take to a pharmacy only to find they can’t afford to buy the medicine. "The consequences of being underinsured leads to a 10-15 percent higher mortality rate". Care Without Coverage: Too Little, Too Late May, 2002 Institute of Medicine the second of a series of six reports on the consequences of un-insurance. A study reports, that 18,000 die yearly because of being uninsured. We Can’t Afford Universal Coverage— We surely can afford Universal Coverage for all, all we have to do is limit private health care to those medical needs not deemed extremely necessary. With a National Health Care Plan (NHI) or "Medicare for All" we can save money and easily cover the uninsured. The saving could be as high as $700 billion; the amount to cover the uninsured would be around $50-$100 billion annually. Some of the savings could go to educating health care providers and re-training or better education for all. Private is Always Better than Public— Take a look at the administrative costs in health care; the comparison between the public and private sectors is not even close. Medicare’s 3 percent to private’s 20-30 percent (which does not include cost for lawyers, consultants, evaluators, and such). The private-sector has excelled at manipulating regulations to maximize profits. Medicare is going Broke— At the present time Medicare has a surplus of $30 billion. What we can learn from Medicare is the need to reform our health care system to "Medicare for All". If Medicare is going broke it’s because our whole health care system is going broke because of rising prices. We cannot afford to spend one-third of our health care dollars on things unrelated to health care. In 2005 Medicare premiums will increase another 12 percent.
Myths and Health Care Reform 1. We don't have a problem with access to care in America since anyone can get needed health care by going to an emergency room. 2. The system's not broken, so it doesn't need to be fixed. 3. "The market" can solve the problems with our health care system. 4. Private solutions are always better than public solutions. 5. Medicare is going broke. 6. America can't afford universal coverage. 7. Americans will not accept health care "rationing" like they have in other countries. 8. Canada's health care system is terrible and failing. 9. The insured are subsidizing the care of the uninsured. 10.We don't have the resources to handle the increased demand for services that would result from universal coverage. 11. Drug prices are higher in the U.S. because our pharmaceutical industry spends billions of dollars on research and development. 12. We can get to universal coverage through incremental or piecemeal change. 13. Americans will never accept a "Single-Payer" system. Believe any of these, call me; I will sell you the Brooklyn Bridge, and maybe throw in the White House. Debunking Myths about Universal Health Care Under a Single-Payer Plan Single-Payer Costs Too Much. (false) The first argument against single- payer system is that it will cost too much. This is not true. One way single-payer can save money is by reducing administrative overhead, (spending from the current level of 30% down to 3%, the rate which Medicare runs on). The savings could surpass $250 billion in yearly savings. If We're Switching Plans We'll Have to Switch Physicians. (false) For many, changing the entire health care system in the U. S. seems too much like a daunting task which will disrupt our entire way of life. But the fact is, single-payer is the least disruptive system. Single-payer systems would only change the financing system of the health industry. This means that hospitals and doctors' offices would continue to run normally, and people would get care just as they always have. Single-Payer is Government Run Health Care. (false) One misconception about universal health care is that it is run by the government. This is not necessarily true. Most single-payer systems keep the management and delivery of medical care, which includes doctors and hospitals, in the private sector. Administration of hospitals can remain the same as it is now. Doctors will still get paid the same for services. Calling a single-payer system government-run is often a result of popular stereotypes and not knowledge of the subject. The Government Can't Do Anything Right. (false) Under a single-payer system the financing system would change, making the government the single-payer of all health care bills. Many would argue that such a system would never work because the government can't possibly do a good job. This couldn't be further - from the truth. First, the government is already successfully running a version of single payer health care-Medicare. Many older Americans are very satisfied with the care and service they receive through this program. Second, the government can coordinate the financing of health care with a lower administrative overhead than private insurance companies can. Administrative costs account for only 3% of Medicare's budget, while in the private sector they can cost anywhere from 20 to 30%. Financing quality health care is clearly something the government can do well, while saving money. Taxes Will Skyrocket. (false) Just because a singlepayer system is financed by the government does not mean that it will come with a giant tax hike. Many single-payer systems get their funding from taxes of some sort, but the average individual will pay no more for health care, and will even pay less. A single-payer system basically transfers existing private multi-payer payments toward a new single-payer system. Single-Payer is Socialized Medicine. (false) This argument is an attempt to cover the real facts on single-payer in the shadow of socialism, a philosophy which is not welcomed in the U.S. Such a label is nothing more than an attempt to avoid the real issues of health care, and it is not accurate. For most single-payer systems, including ones proposed in the U.S, delivery of medical services remains in the private sector. The government will not take over the hospitals, and doctors will not become federal employees; medicine in the private sector is actually preserved under single-payer systems. **Debunking Myths about Universal Health Care was put together by students and staff of Ithaca College.
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