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'Everybody wins with single-payer'

Berry Craig
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EDITOR'S NOTE: More than 600 labor organizations, including the Kentucky State AFL-CIO, have endorsed HR 676. 


AFT Local 1360

Kay Tillow answers naysayer to single-payer health care by pointing to polls and citing history.

Several public opinion surveys show growing support for a single payer system, according to Tillow, who heads Kentuckians for Single Payer Healthcare.

A June Kaiser Health Tracking Poll revealed 53 percent of Americans favor a single government plan that would provide health care for everybody.

History, Tillow added, proves that more than a few people doubted the success of other significant reform movements.  

“They said we couldn’t end slavery or win the vote for women or pass the Civil Rights Act,” said Tillow, who lives in Louisville. “But those were things that happened when grassroots movements took hold within the nation and made them ideas whose time had come.

“We believe that it can and must happen on the issue of health care.”

Skeptics might argue that single-payer is an easier sale in “liberal Louisville” than in most other parts of the Red State Bluegrass State.

The Falls City is the seat of Jefferson County, one of only two Kentucky counties that Democrat Hillary Clinton managed to carry in last November’s presidential election. (The other one was Fayette; Lexington is its seat.)

Undaunted, Tillow, who is also a veteran union and civil rights activist, barnstorms Kentucky—and the country—preaching single-payer with almost missionary ardor.

She and fellow KFSPH volunteers Charlie Casper and Mark McKinley recently teamed up to tout single-payer in the Jackson Purchase, deepest western Kentucky.

The region is arguably the most conservative corner of the state. President Donald Trump handily carried the region, topping his statewide victory margin of 64.6 percent in all seven Purchase counties.

Even so, Tillow and Louisvillians Casper and McKinley found a receptive audience at a monthly meeting of the local Kentuckians for the Commonwealth chapter.

 “We believe that single-payer is the solution for the nation and we believe that if we do enough work at the grassroots it will become obvious that single-payer is what we have to do,” Tillow told a group of about 30 KFTC members and others who gathered in a Murray State University classroom.  

“Single-payer solves not only the problem of covering everybody. It also brings the insane cost of health care under control.”

Tillow said Americans spend more on health care – about $9,225 per person, or 17.4 percent of GDP, in 2013, according to the Centers for Disease Control and Prevention. The U.S. is the only industrialized country without some form of government-run or regulated universal health care.  

Yet the U.S. trails the European Union and 55 other countries, including Canada, in infant mortality, according to the CIA Factbook online. The U.S. ranks 42nd in life expectancy.

Longevity and infant death rates are standard measures of health care quality, Tillow said.

“We are paying much more for health care than the rest of the world pays. If  you put that fact together with the outcomes [infant mortality and life expectancy], we pay double and we get less.

“That calls for more than just putting more money into a few tweaks. We need to go to single-payer. Single-payer is sound policy based on research, science and the experience of other industrialized countries.”

KFSPH, which is allied with Physicians for a National Health Care Program, a national organization, supports HR 676, the Expanded and Improved Medicare For All Act. The measure is sponsored by Rep. John Conyers, D-Mich. 

“It has 116 co-sponsors,” Tillow said. All are Democrats, including Rep. John Yarmuth of Louisville, Kentucky’s only Democrat in Congress.

“We’re at a solid majority of Democrats and feel very good about the prospect of building a movement to put this forward.”

She conceded that winning over Trump and the GOP-majority House and Senate is a tough row to hoe. Republicans all but deify private health as a pillar of “free enterprise.”

Tillow is philosophical. “Nothing worthwhile ever was easy.”

She is not a fan of the Affordable Care Act, which survives despite GOP efforts to scuttle President Barack Obama’s most important domestic policy success.

The ACA extended care to millions more Americans. But Tillow said the nonpartisan Congressional Budget Office reported that about 27 million will still be uninsured by 2025.

At the KFTC gathering, she passed out a flier that says:

— About 42,000 deaths annually were linked to a lack of health insurance in 2013. (American Journal of Public Health)

— Sixty-two percent of personal bankruptcies stem from medical bills or illnesses; 75 percent of bankrupted people had insurance when they got sick. (American Journal of Medicine)

— Insurance companies annually siphon off 12 to 25 percent of premiums—billions of dollars—on overhead expenses, including advertising, underwriting costs, and hefty payouts to executives and stockholders. (New England Journal of Medicine). Medicare’s overhead was around 1.6 percent in 2013. (Medicare Board of Trustees report)

— CEOs at the country’s half dozen largest insurance companies enjoyed $157.9 million in total compensation in 2014. (SEC 14A Schedules)

The flier also says that HR 676:

— contains a simple enrollment mechanism

— provides comprehensive coverage for all medically necessary care and drugs

— allows free choice of doctors and hospitals (no more private insurance-mandated networks)

— gets rid of all co-pays and deductibles

— creates a non-profit public agency to pay the bills and oversee the single-payer program, thus simplifying administration, paperwork and bureaucracy and saving money to boot.

— finances the program through progressive taxation. (Individuals will pay less than what they pony up now for premiums and out-of-pocket expenses, according to Tillow.)

— would stimulate the economy and job growth by eliminating the cost of employee health care for businesses

— would extend to everyone quality health care without spending any more than is being spent now thanks to administrative savings (estimated at $400 billion yearly)

— would provide strong cost control tools such as bulk purchasing and global budgeting

Tillow said HR 676 is not “socialized medicine” because many doctors and other health care providers would remain in private practice.

“Just the financing would change. Nor would HR 676 mean the government would ‘ration’ health care—as opposed to rationing we now based on our ability to pay.”

Tillow said a “Medicare for all” system would restore the vital doctor-patient relationship by removing insurance company bureaucrats from the picture. 

“Everybody wins with single-payer,” Tillow said. “Everyone is covered.  States and municipalities win win.

“Doctors and hospitals win. There’s a lot of physician burnout now and a great part of it is because insurance companies interfere with their practice.

“It is frustrating for a physician to have to spend half of the day on the phone trying to get an insurance company to approve a certain procedure he or she thinks is appropriate for a patient. It’s happening more and more.”

She argued that switching to a single-payer system is not mission impossible. “We can do it. We have good doctors, good nurses and good hospitals. We just need to reallocate the money so it can go to care and not to administrative waste.”