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The Top Ten Enemies of Single-Payer

By Russell Mokhiber

Most people, when they arrive in Washington, D.C., see it for what it is—a cesspool of corruption.

Two reasonable reactions to the cesspool.

One, run away screaming in fear.

Two, stay and fight back and bring to justice those who have corrupted our democracy.

Unfortunately, many choose a third way—stay and be transformed.

Instead of seeing a cesspool, they begin seeing a hot tub.

The result—profits and wealth for the corporate elite—death, disease and destruction for the American people.

Nowhere does this corrupt, calculating transformation do more damage than in the area of healthcare.

Outside the beltway cesspool/hot tub, the majority of doctors, nurses, small businesses, health economists, and the majority of the American people—according to recent polls—want a Canadian-style, single-payer, everybody in, nobody out, free choice of doctor and hospital, national health insurance system.

Inside the beltway cesspool/hot tub, the corrupt elite will have none of it.

They won’t even put single-payer on the table for discussion.

Why not?

Because it will bring a harsh justice—the death penalty—to their buddies in the multi-billion dollar private health insurance industry.

The will of the American people is being held up by a handful of organizations and individuals who profit off the suffering of the masses.

And the will of the American people will not be done until this criminal elite is confronted and defeated.

(Remember, virtually the entire industrialized world—save for us, the U.S.—makes it a crime to allow for-profit health insurance corporations to make money selling basic health insurance.)

Before we confront and defeat the inside the beltway cesspool/hot tub crowd, we must first know who they are.

To wit, we present the Top Ten Enemies of Single Payer (listed here in alphabetical order):

American Association of Retired Persons (AARP): AARP, one of DC’s most powerful lobbying groups, has worked inside the beltway for years to defeat single-payer. Why? AARP makes about a quarter of its money selling insurance through its affiliate, United Healthcare Group, the nation’s largest for-profit insurance company. AARP must defeat single-payer—which if enacted, would wipe out that revenue stream.

American Health Insurance Plans (AHIP): The private health insurance industry. Public enemy number one. The health insurance corporations must die so that the American people can live. Of course, facing the death penalty, AHIP is the most aggressive opponent to single-payer. No compromise with AHIP.

American Medical Association: With a shrinking base of doctors (only 25 percent of doctors nationwide belong)—the AMA is the most conservative of the doctors’ organizations. I just returned from a healthcare policy forum at the Center for American Progress. As usual, not one of the panelists mentioned single-payer. Only during the question period did a self-identified patient/citizen ask the single-payer question. And a pit bull-like Nancy Nielsen, president of the AMA, ripped into the questioner. “Sounds more like a statement than a question,” Nielsen said. “And clearly you have a point of view about that. And I don’t happen to share that point of view.” Clearly she doesn’t. But just as clearly, the majority of doctors, probably even a majority of doctors who belong to the AMA, support single-payer. Nielsen is in denial and must be defeated.

Barack Obama: He was for it when he was a state Senator in Illinois. Now, ensconced in the corporate prison that is the White House, he says single-payer is off the table. To get off the list, Obama needs to put single-payer back on the table.

Business Roundtable: Dr. David Himmelstein, co-founder of Physicians for a National Health Program (PNHP), was at a healthcare forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience—made up primarily of representatives of big business—to indicate their preference of healthcare reforms. And the majority came out in favor of single-payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: “In private, they support single-payer, but they’re also thinking—if you can take away someone else’s business—the insurance companies’ business—you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it’s also a cultural thing—we don’t do that kind of thing in this country.”

Families USA: A major inside the beltway liberal foundation and long-time foe of single-payer. It’s chief executive, Ron Pollack, was once an advocate for single-payer. But no more. In November 1991, Pollack was at a Washington hotel debating Yale University professor Ted Marmor in front of then Arkansas Governor Bill Clinton. Marmor was making the argument for single-payer. Pollack against. A November 1994 article in the Washington Monthly, co-authored by Marmor, reported the result this way:

“After the two advocates finished, Clinton looked thoughtful, pointed to Marmor and said, ‘Ted, you win the argument.’ But gesturing to Pollack, Marmor recalls, the governor quickly added, ‘But we’re going to do what he says.’ Even considering the Canadian system, everyone in the room agreed, would prompt GOP cries of ‘socialized medicine’—cries that the press would faithfully report.”

Health Care for American Now: The largest coalition of liberal groups promoting a choice between a public plan and private insurance companies. “They are saying—we can’t do single-payer because Americans don’t want it,” said Kip Sullivan of the Minnesota chapter of PNHP (Physicians for a National Health Program). “That’s based on junk research conducted by Celinda Lake for the Herndon Alliance. It is bad enough to say we can’t do single-payer because the insurance industry is too powerful to beat. But it is just plain insidious to say we can’t do single-payer because the American people don’t want it. In fact, polling data indicates that two-thirds of Americans support a single-payer system. And that level of support exists despite the fact that there is little public discussion about it.”

Kaiser Family Foundation: One of the most prestigious liberal, inside the beltway think-tanks on health reform policy, Saul Friedman is a reporter for Newsday. In February, Friedman wrote an article for Newsday arguing that single-payer is suffering from a conspiracy of silence. And he says Kaiser is the most culpable of the co-conspirators. Kaiser, funded initially by insurance industry money, regularly keeps single-payer off the table, Friedman says. When single-payer advocates released a study in January asserting that Congressman John Conyers’ single-payer bill (HR 676) could create 2.6 million new jobs and would cost far less than the private insurance currently paid for by individuals and employers, “the Kaiser Family Foundation’s daily online report on healthcare developments at kff.org didn’t mention it,” Friedman reported. “Nor has Kaiser, the most comprehensive online source of healthcare information, made any mention of single-payer or the Conyers bill since it was introduced in 2003, despite widespread support for such a plan according to Kaiser’s own polls.” After a number of insistent inquiries, Kaiser told Friedman that they would publish charts in March comparing the Stark and Conyers bills. They never did.

The Lewin Group: The go-to consulting firm for health reform studies. The most recent study, released last week and widely quoted in the press, of the public plan option, showed that the insurance industry would lose 32 million policyholders if a public plan is enacted. Lewin’s health reform policy guru, John Sheils, told the Associated Press: “The private insurance industry might just fizzle out altogether.” What the mainstream press didn’t report was that The Lewin Group is a wholly owned subsidiary of Ingenix, which is in turn owned by UnitedHealth Group, the nation’s largest health insurance corporation. Lewin Group has conducted studies on single-payer at the state level—and their studies consistently show that single-payer is the most efficient cost saving system. But Lewin Group has never done a study on HR 676—which would create a single-payer for the entire country and drive The Lewin Group’s parent—UnitedHealth Group—out of business. When asked why Lewin Group never has done a study on HR 676, Sheils said—“the President didn’t propose single-payer, did he?” No, he didn’t. That’s why he too is on this list. (Sheils says The Lewin Group has studied national single-payer. He points to a recent comparison of the different health reform proposals floating on Capitol Hill—including one by Congressman Pete Stark (D-California). Stark’s bill would give every American the option of opting into Medicare. But that’s not single-payer, because it keeps the private insurance industry in the game. Sheils counters that he modeled the Stark bill as single-payer. “The employer coverage option under the Stark bill is made so unfavorable that no employer would do it. We have everyone in Medicare, with the resulting savings.” Sheils says that of all the plans studied, the Stark bill saves the most money.

Pharmaceutical Research and Manufacturers Association of America (PHRMA): PHRMA chief executive Billy Tauzin says that under single-payer, the government would become a “price fixer.” By which he means, the government, as a single-payer, will have the power to negotiate drug prices downward, thus costing the drug corporations millions in excess profits. In recent years, PHRMA has infiltrated liberal sounding groups like America’s Agenda—Health Care for All. PHRMA’s Vice President for Government Affairs and Law, Jan Faiks, now sits on the board of America’s Agenda and PHRMA contributes money to the group—which has worked in recent years to undermine single-payer at the state level. (America’s Agenda Mark Blum won’t say how much money PHRMA gives to his group.)

We have met the enemy.

And they ain’t us.

Russell Mokhiber is editor of Corporate Crime Reporter and founder of singlepayeraction.org

CommonDreams.org, April 16, 2009