Dollars & Sense: Crisis = Opportunity for Single-Payer

Crisis = Opportunity for Single-Payer
Fiscal crises may force Obama to save costs via a single-payer plan.

By Roger Bybee


President Obama seems ready to proceed full-throttle toward a health care reform plan, but one that will keep private insurers at the center of the system. The plan, termed “guaranteed affordable choice,” would allow workers to “keep the insurance they like,” find a rival private insurer, or opt into a Medicare-style public plan.

To date, Obama has sensibly insisted that quick action on health care is imperative. “It’s not something that we can put off because of the emergency,” Obama declared in December. “This is part of the emergency.” Questioned about the wisdom of launching a $100 billion health care program at a time of mounting government deficits, “I ask a different question,” Obama countered. “How can we afford not to?”

He’s right: economic meltdown is making health care reform more urgent by the day. Hospitals are hurting; while “the number of paying patients and profitable elective procedures is down . . . ,” the LA Times reported recently, “the number of uninsured patients whom hospitals treat is rising.” At the same time, escalating health care costs are squeezing private employers and governments alike. “The new Congressional Budget Office report shows that rising health care costs are the largest driver of the nation’s long-term budget problems,” budget watchdog Robert Greenstein of the Center on Budget and Policy Priorities told Congress last fall.

But Obama’s hybrid, public-private plan is likely to hit a fiscal wall as federal spending balloons, and along with it the deficit. In the end, both popular sentiment and fiscal barriers may force him to follow a different course.

The administration’s plan subsidizes lower-income Americans to enable them to buy private health insurance. Contrary to Obama’s statements during the campaign, his plan will “need to require” all individuals to have health insurance, concludes the respected Commonwealth Fund. Such a mandate would be crucial to securing industry concessions necessary to move toward universal coverage, particularly a ban on excluding people with pre-existing conditions from coverage. .........(more)

The complete piece is at: http://www.dollarsandsense.org/archives/2009/0309bybee.html