By: Meg Brook, VT for Single Payer, Supporter
As I listen gather information on health care options from letters to the editor, opinion pieces, debates, testimony and more there seems to be a lot of emotion around the ideas of a Single Payer system or a Public Option. With so much information out there I decided to try and figure out what the difference between these two proposals could be.
Nationally a Single Payer system was taken off the table but many Representatives wouldn’t vote for Obama’s bill unless it contained a Public Option. Why? They say it will be a way to show insurance coverage can be affordable and will create competition to drive the prices of larger insurance carriers down.
If I understand correctly the Public Option would be a non-profit health insurance program that is administered by the public, or a group they appoint. The idea is it would be no-frills, low administrative costs, and more affordable so even those currently without health insurance could afford it. My fear is this won’t address our current situation because:
- All insurance companies have at least part of their business as non-profit and that doesn’t ensure affordability since they still spend lots on lobbying, paying retiring CEO’s, advertising, and more.
- It will be only one of many insurance carriers so administrative paperwork and waste won’t be reduced, a major cost in the current system.
- People who currently have insurance will probably keep the coverage they have leaving those who are in higher risk groups as the majority of the policy holders. The only way to keep costs down is to have lots of people on the same plan so there are healthy and sicker people each drawing from the system when they need.
Single Payer, as I understand it, means there would be one insurance carrier that everyone would use (hence the name single payer because all medical expenses would be paid by the same carrier.) I think this would improve the coverage of many because:
- Everyone would be in the same system creating a very large pool of people with a wide variety of health needs.
- Significant administrative waste would be reduced since all claims would be processed with the same carrier.
- There would be opportunity to oversee costs and frequency of procedures.
- If everyone has health insurance from birth until death they are much more likely to visit a doctor for preventative care before illness becomes life threatening or the cost sky-rockets.
So why do I think Single Payer has more of a chance in Vermont than nationally? Because insurance giants are not going to let go of a billion dollar business very easily. In Vermont we have a history of making decisions that are right for our citizens and we have a legislature that responds to citizen pressure. We also have a well educated public who can see the current system is a disaster with costs to Vermont, Vermonters, and business owners going up exponentially at the same time that the rate of uninsured is increasing.
So what do you think? Can we pass Single Payer in Vermont? Can we ensure health care for all Vermonters? Will this save us money? Is there another option?
Thank you for your thoughtful article.
I think that single-payer and the public option need to be considered as one and the same thing! And I think that single payer has more of a chance in Vermont because we are such a small state. Then we can let our new system be a model for the U.S.
I lived in France for over 15 years, and so I’ve experienced a wonderful and humane and affordable system. EVERYONE has the gov’t sponsored basic health coverage. EVERYONE sends in the same one-page form! It’s fast and easy because ALL doctors fill out this same form. You go to the doctor, pay your 30 euros or so, and you get a form that every French citizen recognizes! This is sent to the local gov’t insurance office, depending on where you live. They process it according to how the gov’t reimburses–there are strict guidelines! Most expenses are reimbursed, except for some things: eyecare, for example, or expensive dental care. Now this is where the insurance companies come in! IF you need eyecare and dental (and most people do), you can 1) choose any insurance company (a “mutuelle” in France) and 2) choose plan A, B or C. The cost is very reasonable compared to ours, say, 90, 120, 150 euros a month for those plans. Plan C would be the “royal” plan–you are really covered well, especially if you know you’ll go to the hospital (because let’s face it, some people enjoy going to the doctor and hospital, or see it as a part of their lives! And they are willingly “heavy users” of industrial medicine.). You’d get reimbursement of practically all expenses.
In France with a “mutuelle” you can get at least one new pair of eyeglasses a year. Now if you are someone who wants a new pair every few months, you’ll have to cough up the extra yourself. So most people will go ahead and get a new pair of glasses a year, because they’re paying for it with their premiums! But others won’t bother. And what’s great about the French system, is that you RECEIVE SOMETHING BACK FOR YOUR PREMIUMS, vs, the American system which is like PAYING INTO A BLACK HOLE. My husband and I don’t even believe in the current industrial disease-management system and yet, we pay into this huge black hole. We are tempted to drop insurance altogether. It is absurd that we don’t have in place a minimum “catastrophic” plan for people like us who eat well and take care of ourselves. A “catastrophic” plan would pay for the very unlikely emergency room visit. I admire the French system; the gov’t requires people to use cheaper generics; in fact, prescription drugs in France as a rule are super-cheap! We as Americans have not stood up to the drug companies, who need to be scaled back dramatically; we can start by banning drug company advertisements everywhere.
Reimbursements in France are generally quick and simple; there obviously is fraud, such as doctors giving unnecessary tests out of greed, and this needs to be dealt with of course. But the magic of other countries’ health systems is that there is, at the base, a single payer mechanism. If the current insurance companies want to stay in business, then they can offer “added benefits” mutual policies at a reasonable rate. Cost-containment is the real issue that needs to be addressed, and it has hardly been addressed at all during this mostly absurd health care reform debate that we have all been subjected to for months. There should be NO 30K a month “treatment”. There should be NO million-dollar “treatment”. Sorry profit-seekers in healthcare, but our health system has to be a non-profit system! How it got to be profit-driven, is hard to fathom.
I think anyone who’s given this any true thought KNOWS that we need to rebuild a system from scratch and that single-payer is the only logical option. It is indeed possible! And it can only do good. Even the current Vermont healthcare premiums, which are supposed to be cheaper and better, are horrifically overpriced, as is Catamount! Why on earth should Catamount cost a couple almost 800 dollars a month? It boggles the mind! That should be no more than 300 dollars a month to be fair. In fact, healthcare should never cost more than 10% of people’s income. It’s no wonder the French call our whole healthcare debate “surreal”–because it is! It’s time we have the courage to completely overhaul the system, and not be afraid of change. This can only save money in the long term, and importantly, we need to have a true health care system that embraces prevention, good eating habits, natural medicine, etc. We should not be FORCED as citizens to prescribe to an industrial medical complex that we would never choose to use! There has to be more choice, and true health care reform in Vermont needs to address the sizable percentage of citizens who are already taking responsibility for their health care by eating in a healthy manner.
Thanks to you and to all in Vermont who are working on making true health care reform a reality–it can’t come soon enough!
i see a huge difference between single payer and the public option. the public option separates the haves and the have nots. single payer puts everyone in the same boat. the public option still includes the for profit insurance companies. single payer does not. the public option would be similar to catamount – there is still a large percentage of people that this plan leaves out. single payer covers everyone.
Health reform will injure our system.
Single Payer is the Single Option to rid ourselves of private profiteering insurance corporations:
Single Payer ensures everyone has health care coverage, paid for by the same taxes we all currently pay for Medicare (for example, Soc Sec routinely deducts $$ for our Medicare coverage)whether we are retired or not: no age limit: Birth to Death.
Single Payer savings through the currently necessary & immensely expensive administrative costs levied by private insurance & paid for by your premium $$, all of which would be completely eliminated once the private insurance corporations are eliminated from our “health care system”. Think of the savings (less expensive)to health care providers (and thus to patients) who will no longer have to staff their offices with health insurance “managers”.
Public Option is the exemplar of a compromise position, allowing private insurance corporations to continue to exist, prospering all the while, competing with the public option provisions,leaving the public still having to manage the overwhelmingly complicated language of insurance forms/language/policies, etc. As long as the concept of “insurance” survives, we’ll continue to be at the mercy of profiteering,influence-peddling (i.e. campaign donations)corporations on the human rights issue of health care.
As currently written, you & I will be mandated to continue purchasing our “insurance” policy, or be fined substantially. That translates to a windfall market of at least 30 thousand customers who will have no choice. Consumers will actually be insuring the corporations by our continued hostage-like position: no choice but to contribute to their stranglehold on our health care.