October 2, 2005
New York Times

In the aftermath of Hurricane Katrina, we have an opportunity to construct something far more important than higher levees - a national health care system that looks less like a tightrope and more like a safety net.
A dozen years after Bill Clinton's health reform efforts were destroyed by the insurance industry's duplicity, it's worth trying again. The health care system is steadily becoming more gummed up in ways that are impossible to hide.


One of the bumper stickers attacking the Clinton plan read: "If You Like the Post Office, You'll Love National Health Insurance." That wouldn't work today: the Postal Service runs a system that is manifestly more rational and efficient than our health care system. For starters, imagine a postal system that refused to deliver letters to or from 45 million Americans - except on rare occasions, by ambulance.


"This is one of those fleeting opportunities where a catastrophe creates an opportunity to rebuild something better than before," says Dr. Irwin Redlener, president of the Children's Health Fund and associate dean of the Mailman School of Public Health at Columbia University.


In a sign of the growing disenchantment with our health system, 13,000 doctors have joined Physicians for a National Health Program, which lobbies for a single-payer government-financed health program.


There are four main problems with the existing system. First, it leaves out 45 million uninsured Americans, and their number is rising. Second, it is by far the most expensive in the world, costing 15 percent of our national income, yet our outcomes are awful - U.S. life expectancy is worse than Costa Rica's. Third, our business competitiveness is undermined when, for example, medical expenses add $1,500 to the sticker of each General Motors car. Fourth, our system is catastrophically inefficient: according to a study in The New England Journal of Medicine, health administrative costs are $1,059 per capita in the U.S., and just $307 in Canada.


A single-payer system would be most efficient but probably is not politically feasible at the moment. The smart new book "The Health Care Mess" suggests a variety of more gradual approaches that would face less opposition.


Whatever the mechanism, all children should be covered. It's a disgrace that we use public funds to save the lives of nonagenarians but not those of 9-year-olds. And kids are a bargain: per capita medical spending is $1,525 for children less than 5, and $9,000 per person aged 65 to 74.


A second principle is that we should put less emphasis on curative medicine and more on public health and prevention - everything from preparing for avian flu to encouraging exercise. Sure, we can buy more "left ventricular assist devices," which cost $210,000 per patient installed, or buy Erbitux for colon cancer, at $17,000 per month of treatment. But as a wise new book, "Prescription for a Healthy Nation," argues, you get more bang for the buck when you promote healthier lifestyles - fighting obesity, cigarette smoking and the like.


Raising cigarette taxes saved far more American lives, for example, than an army of neurologists ever could. In the same spirit, I'd like to see a French-fry tax. And imagine the health gains if we banned potato chips and soda from schools.


Reforming the health system won't be easy. In the real world, poor kids don't see doctors not only because they're uninsured, but also because Mom doesn't have a car, can't easily get time off from work, or doesn't speak English. Those are hard nuts to crack - but one reason to think that we can do better is that much of the world does better.


I've been thinking of health care partly because of something that happened when I was on vacation in August. My kids and I were stacking firewood for my parents on the Yamhill, Ore., farm where I grew up, when suddenly the seven-foot stack collapsed - on top of my youngest. She was knocked down and pinned, her face bleeding, under a pile of logs.


I had insurance, and a car to get to the emergency room - and in the end the logs (stained with blood) turned out to be in worse shape than my daughter. She's just fine. But that instant was heart-stopping in its terror - and the system routinely does fail such children in need. Isn't it worth fighting one more time for reforms, so that we Americans can get health care every bit as good as Canada's?

Bullet Points for Legislators

  • Single Payer saves money.  For the past 20 years, states have commissioned studies on different types of health care systems.   In EVERY case, single payer was shown to be the only way to cover everyone and the only system that saved money and controlled costs.

  • Publicly financed does not mean government run health care.  YOU have publicly finance health coverage, but the government does not make decisions regarding your health care.

  • Cost conscious patients often don't get the care they need.   Most decisions are made by the doctor in concert with the patient, but the patient relies on the doctor's knowledge to make a decision.  Expensive tests and treatments cannot be ordered by the patient, only the doctor.

  • Lifestyle choices are not what is fueling high costs in health care.   The United States ranks low in general health indicators, but high in good health habits.  We smoke less, drink less and consume less animal fat that many other countries with better health indicators and much lower health care costs.

  • Businesses can accurately determine their health care costs and are not subject to unanticipated large premium increases.

  • It will reduce labor costs due to a more efficient way of financing health care, eliminating much wasteful administration.

  • Workers' Compensation costs will be reduced, likely by half, due to the fact that everyone has health coverage and there is no need for the medical portion.

  • It reduces the need for part time employees and provides easier recruiting.  There are no pre-existing conditions or Cobra issues.

  • Eliminates the oversight of health benefits and bargaining health coverage with employees.

  • It creates healthier personnel and more stable employees, reduces absenteeism and eliminates employer health coverage complaints.

  • It reduces employee health related debt and personal bankruptcies.

  • It frees up family income that can be spent on other goods and services, thus stimulating the economy.

Tips for Writing Letters to Editor

Follow guidelines for your local paper (word count, submission instructions, etc.)

Frame your letter in relation to a recent news item Use state specific data whenever possible (let us know if you need help finding some!)

Address counter arguments

Be aware of your audience and emphasize how Medicare for All is good for ALL residents of the state

Criticize other positions, not people Include your credentials (especially if you work in the healthcare field)

Avoid jargon and abbreviations

Don’t overload on statistics and minor details

Cover only one or two points in a single letter

Avoid rambling and vagueness


Donations to SPAN Ohio help cover operating and lobbying expenses and are NOT tax deductible. To donate, click the DONATE button below. On the page that appears, type in the amount of your donation. If you want your donation to be recurring, check the box where it says "Make this a monthly donation." If this is a one-time donation, leave that box blank.Then click either "Donate with PayPal" (if you have an account) or."Donate with a Debit or Credit Card." Complete the transaction on the page that follows.

Donations to HCFAO go to our education fund and ARE tax deductible. To donate, click the Donate button below. On the page that appears, type in the amount of your donation. If you want your donation to be recurring, check the box where it says "Make this a monthly donation." If this is a one-time donation, leave that box blank.Then click either "Donate with PayPal" (if you have an account) or."Donate with a Debit or Credit Card." Complete the transaction on the page that follows.


  • Region 1 SPAN MeetingMon. 19 Nov, 2018 (5:00 pm - 6:30 pm)North Shore AFL-CIO Office.    3250 Euclid Ave, 2nd floor, Cleveland - Note:  enter parking lot from...
  • SPAN STATE COUNCIL MEETINGSat. 1 Dec, 2018 (10:00 am - 1:00 pm)First Unitarian Universalist Church of Columbus - 93 W Weisheimer Rd – Columbus OH
  • SPAN Ohio Sixteenth Annual State...Sat. 27 Apr, 2019 (9:30 am - 4:00 pm)Quest Conference Center - 8405 Pulsar Place - Columbus OH
Add New EventShow Full Calendar