Idaho Health Care for All

Dear colleagues,

We share your commitment to unite physicians in support of the most
affordable, high quality health plan. We write to suggest joining forces
at this historic moment to rapidly advance progressive health reform.

In his inaugural speech, President Barack Obama said, “The question we
ask today is not whether our government is too big or too small, but
whether it works. … Where the answer is yes, we intend to move forward.”

When it comes to health insurance, government works better than the
private sector. Medicare provides much higher value for cost than
private health insurance, and patients like it better.

As you may know, Physicians for a National Health Program has advocated
for single-payer national health insurance – an improved “Medicare for
all” – for more than two decades. We base our position on the extensive
evidence, both at home and abroad, that such systems are effective,
equitable and economically sustainable, unlike our present arrangement.

Single payer is also the only reform that can simultaneously guarantee
truly universal, comprehensive care and, thanks to savings from reduced
administrative costs and from other economies, require no new money to
fund it.

Many PNHP members were active in the Obama campaign (including through
Doctors for Obama), despite their awareness that his campaign platform
fell short of endorsing single payer. Among other considerations, we
were mindful that in the recent past he has more than once spoken of
single payer as the best answer to our nation’s health care crisis.

We write to you now because of our concern that the incremental health
reforms now outlined on the White House web site, along with recent
proposals by HHS Secretary-designate Tom Daschle and Senator Max Baucus,
will, if implemented, almost certainly fail. Needless to say, we do not
want to see the President – or fundamental health reform – fail.

Our concern is based on the experience of seven states over the past 20
years (including Massachusetts in 1988 and today) that have employed
mandates, “public plan options,” “insurance exchanges,” and the like –
i.e. elements of the Obama-Biden plan as it currently stands – as part
of their reform. In each case, the private health insurance industry
remained in a commanding position of influence, and in each case, the
reform failed to insure everyone or to contain costs. (See “State Health
Reform Flatlines” at http://tinyurl.com/bau5s4).

In Massachusetts, for example, the 2006 reform has left tens of
thousands uninsured even as safety net programs have been cut to the
bone in a bid to subsidize the purchase of health insurance policies.
The result has been a drop in the number of uninsured, but with little
improvement in access to care due to rising premiums for increasingly
skimpy coverage, a decline in health care for the indigent and massive
layoffs and cutbacks in safety net hospitals. Costs continue to rise
uncontrollably, and the viability of the reform is in grave doubt.

Approaching this issue from a different angle, we worry that President
Obama and his advisers are setting their sights too low on what can be
achieved at this critical moment in our nation’s history, perhaps
wanting to avoid a confrontation with the private health insurance
industry. Yes, fundamental reform will require standing up to the
private insurers and the other vested interests who oppose it. But
failure to stand up to these interests will jeopardize not only health
reform but also the Obama administration’s entire domestic reform strategy.

Surveys taken last year indicated that single payer had majority support
from the public and physicians even before the recent economic downturn
and “bailout.” This support can only have grown since that time. Support
for Rep. John Conyers’ single-payer bill, H.R. 676, includes 92 other
members of the House, over 450 labor organizations (including 39 state
AFL-CIOs), several major religious denominations, and dozens of city
governments.

Our membership’s participation in the recent “health care community
discussions” called for by HHS Secretary-designate Daschle revealed a
groundswell of support for single payer. A similar wave of support was
manifest on change.gov in the “Open for Questions” feature, with
single-payer questions being among the most often asked and highly rated.

We hope you will join with us in conveying to President Obama and his
advisers the critical importance of swiftly enacting single-payer health
reform, and how success on this front can play a crucial role in
ensuring the success of his overall domestic program. We believe
progressive physicians have a civic responsibility to convince him of
this, and that it is in the interest of our profession and the public to
do so.

We would welcome an opportunity to meet with your leadership to discuss
these and related matters. You can reach me at info@pnhp.org, at (312)
782-6006, or at PNHP, 29 E. Madison St., #602, Chicago IL 60602.

Sincerely,

Quentin D. Young, MD, MACP
National Coordinator
Physicians for a National Health Program
www.pnhp.org