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Michele Swenson

Walker Stapleton is Wrong - Single Payer is NOT "government takeover of healthcare"

Walker Stapleton is Wrong - Single Payer is NOT "government takeover of healthcare"

July 9, 2018
Michele Swenson

Colorado gubernatorial candidate Walker Stapleton is among Republicans who characterize single payer health insurance as a "government takeover of healthcare” or "socialized medicine." Social insurance is "socialized" by definition - each insurance provides coverage for a group of individuals who pay premiums to belong to the same "risk pool" – the larger the risk pool, the more economically sustainable and the lower the premiums.

Health insurance is not to be confused with health care delivery, which is not socialized in the U.S. (except the VA model). Generally, care, including original Medicare, is obtained from any private or public provider. Only the original Medicare single-payer model offers full choice of public and private providers. Whereas, the U.S. model of multiple private insurers continually shrink their provider networks in order to cut costs, thereby, limiting provider choices.

Faux "Health Reform" shifts cost and risk to the insured

Republicans' vaunted plan to "repeal and replace" the ACA has gone nowhere, because there is "no there there" – no proposal for sustainable policy; only a disjointed set of proposals such as state block grants, to decrease benefits and shift ever more risk and cost to the insured, while prioritizing greater profits for corporate insurers.

Health care does not even merit mention on Stapleton's website. He has stated a preference for taking his young children when sick to a "Community Health Clinic"in a supermarket, where the cost is a "$10-$15 copay" rather than a "six or seven times" higher cost billed by an insurance company. Clinics have a place, but not as access to comprehensive health care. Acknowledging that too many Coloradans pay "more for health insurance than for their mortgages," Stapleton does not propose a means to access health care for the many who are left hanging out to dry.

Multiple Commercial Insurances vs. Actuarially-Sound Single-Risk-Pool Health Insurance

Republicans promote "free-market" health care in the form of multiple commercial insurances, including "high-risk" and reinsurance pools - all small risk pools that drive up premium costs. A "public option" or "Medicare buy-in" proposed by some Democrats also represent additional small risk pools operating in a sea of multi-payer private insurances.

Note: A state-proposed single-payer plan also equates to a relatively small risk pool insurance. Only a single large risk pool at the federal level can leverage the economy of scale to provide comprehensive universal health insurance, negotiate bulk medicine rates, and utilize global budgets.

Ultimately, multiple-payer insurances represent an inefficient, fragmented, dysfunctional model that minimizes coverage, while maximizing premiums, deductibles, co-pays and corporate profits. Commercial insurance middlemen practicing "denial management" delay and deny health care to benefit their bottom line. Not uncommonly, commercial insurances have slashed membership numbers in order to increase profits, as Aetna did in 2009, forcing 600,000-plus members from its rolls to boost profits, placing shareholders' interests above the insured.

Advocating that health insurance be relegated to states in the form of limited Medicaid block grants, reduction of uncompensated care has stabilized rural economies especially, contributing to job growth and permitting hospitals and clinics to remain open.

Stapleton calls for "catastrophic" health insurance for the young, who are ostensibly healthy. Rather than providing single risk pool coverage according to need, covered by progressive payment, the gamble is that the young won't require health care, meriting only catastrophic insurance that too often includes prohibitive copays and deductibles that lead to medical bankruptcy.

Single Risk Pool Insurance: Heatlh care as a right, not a commodity

Based on actuarially sound insurance principles, a single large risk pool public national health insurance based on improved Medicare for all, is the most fiscally sound, sustainable health insurance model, providing the ultimate diversification of risk, while lowering premiums and overall costs and covering everyone for all necessary health care.

Original Medicare's overhead costs amount to 1 to 2 percent, contrasted with average 20 percent overhead of U.S. private insurances, which siphon 31 percent of each health care dollar for administrative costs. Dozens of studies over decades have demonstrated savings over $400 billion annually; with single payer health insurance, enough to cover the uninsured and supplement the underinsured.

Reminder to Mr. Stapleton: Of the five health reform plans evaluated by the Colorado 208 Commission report in 2008, only one plan was found to save costs and cover everyone - the Single Payer Plan was evaluated to save the state almost $1.4 billion annually, with savings shared across all segments of the economy.

When addressing health insurance reform, too many state and congressional leaders remain in thrall to their corporate funders, even as they supersede the good of the people. Rather than moving toward improved, expanded Medicare for all, many in Washington have moved to privatized Medicare Advantage plans that are heavily subsidized by taxpayers and intended to increase private insurance profits.