PHA-Exchange> Health insurance USA

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Dear Friends:

I was one of eight people recently selected to participate in POLICY AND
IDEAS: A THINK TANK FOR SOCIAL CHANGE. We deliberated over many things;  the
following was one contribution to the Think Tank's output.


A CALL FOR A NATIONAL SYSTEM OF SINGLE-PAYER HEALTH INSURANCE

Currently, the United States is the only industrialized country in the
world without a system of universal health coverage. Such systems were in
place in1941 in Australia and New Zealand; 1944 in Canada; 1948 in Britain;
1961 in Denmark; 1964 in Finland; 1966 in Norway; 1978 in France; and 1984
in Spain. We believe that the United States, the leading country in the
world in terms of technology and finance, should rise to first place, as
well, in its system of healthcare delivery. And we think this can only be
accomplished when every person, regardless of ability to pay, can receive
compassionate and informed healthcare.

Currently, more than 41 million Americans are without any form of health
insurance. That number is growing by approximately one million people each
year. And yet, these are not people who have dropped out of the system:
astonishingly, over 56% of those uninsured Americans are working full time.


And although United States medical facilities have numerous advanced
technologies which make our country the prime destination for wealthy
individuals seeking expensive treatment, the vast majority of medical care
needed throughout the world is delivered at far more mundane levels. And
it is here that we are in the most shameful position: access to basic
health services such as check-ups, immunizations, and pre-natal care is
poor. For example, all of the countries with a national system of
healthcare have lower rates of infant mortality than does the United
States. And all industrialized countries but Denmark have longer life
expectancies than our citizens do. The World Health Organization currently
ranks the United States as 37th in healthcare delivery.

Meanwhile, our current system is the most expensive in the world. In 1999
the average spending on healthcare was roughly $4,600 per person. Citizens
in most industrialized countries pay less than half that amount. One
problem arises due to the structure of the businesses which control the
delivery of health care in the United States. These companies spend 14% of
every dollar which Americans put into the system on administration alone.
This money does not go to doctors; it does not go to nurses; it does not
even make it into the budgets of hospitals, which are closing in the United
States in record numbers. Meanwhile, healthcare systems managed publicly,
run at a far lower overhead, leaving more money available for the people
who actually provide healthcare, and more money in the hands of the people
who actually end up having to pay the bills. Canadians run their
healthcare system with an overhead of only 1 percent. And right here - in
the US - Medicare covers the health of our own elders with an incredibly
lean 2% overhead!

In consequence of all the foregoing:

1) We believe that NOW is the time for the President of the United States
to create a Presidential Commission on a single-payer universal coverage
healthcare system. This Commission, with legislative representatives, as
well as representatives of relevant federal agencies, healthcare
associations, and public and private healthcare organizations should be
mandated to recommend ways of moving the United States toward a
single-payer universal coverage healthcare system.

2) We believe that NOW is the time for the development of a broad program
of public education about the true cost and the true extent of a
single-payer universal coverage healthcare system. This program should be
organized under the auspices of the US Surgeon General's office and should
be taken up by every federally funded Public Health office in the United
States.

3) We believe that NOW is the time for all relevant advocacy groups to
identify the single-payer universal coverage healthcare as an idea whose
time has come, and for their constituencies to publicize and support the
need for such a plan.

4) We believe that NOW is the time for the American Association of Medical
Colleges and the corresponding organizations serving other health
professionals to make available to their constituencies series of grand
rounds presentations and public seminars and symposia for the meaningful
discussion of the effects a single-payer universal coverage healthcare
system will have on their constituencies.

5) We believe that NOW is the time for those organizations responsible for
licensing dentists, nurses, physical therapists, psychologists, and
physicians (including board examining agencies in every medical specialty)
to require of their examinees detailed knowledge of the mechanisms of a
system of single-payer universal coverage healthcare system for those
licensed in their professions.

6) We believe that NOW is the time for the Joint Commission on Accreditation
of
Healthcare Organizations to require of hospitals seeking accreditation the
making available to all patients, family members, and caregivers detailed
information about the scope and meaning of a single-payer universal
coverage healthcare system in the United States.

7) We believe that NOW is the time for every state legislature to discuss,
debate, and ultimately pass for their constituents a plan for single-payer
universal coverage healthcare.

8) We believe that NOW is the time for the creation of a national databank
of statistics on the incidence and relative cost - including medications -
of treatment of every medical condition in the United States today, and
comparisons with the expense of treating those same conditions - including
medications - in other industrialized countries. This databank should also
include information about the economic consequences of the lack of
single-payer universal coverage healthcare, such as those released recently
by the National Academy of Sciences (poor health and premature deaths of
people without health insurance costs the nation between $65 billion and
$130 billion annually). All of this information is readily available from
the Veterans Administration, health insurance providers, pharmaceutical and
medical device manufacturers, managed healthcare organizations and major
employers, both corporate and public.

9) We believe that NOW is the time for every member of Congress and every
official of government at the state and local level to bring to meaningful
debate the question as to why every American cannot carry in his or her
wallet a simple card - as does every Canadian citizen - which can be given
to any doctor or any hospital or any pharmacy to receive the check-up or
care or medication that he or she needs, wherever it is needed, whenever it
is needed - with no questions asked.

10) We believe that NOW is the time for every healthcare policy holder in
America to ask his or her HMO or insurance representative EXACTLY what
things are covered and what things are not covered in each person's
respective plan, and EXACTLY how long she or he might have to wait in an
emergency situation for the clearance for some needed procedure, and
EXACTLY what she or he will have to do if there is any disagreement over
treatment, and EXACTLY what the statistics are related to such
disagreements.

11) We believe that NOW is the time for Americans everywhere to enter into
discussion of this important issue. We invite churches, educators, unions,
trade associations, and civic, social and democratic groups of every stripe
and denomination to enter into this needed and pressing conversation.

12) We urge all of our friends and colleagues to work with us in refining
this Call, then adopting it and broadcasting it as widely as possible.

Joseph Janeti
Think Tank for Social Change
Humanities Institute
University of Minnesota
July 4, 2003