Single-payer Health Care Works Best for Singles...and Everyone Else

Today, Singletude was going to feature a review of Internet Dating Is Not Like Ordering a Pizza by Cherie Burbach, part of the gift basket giveaway contest ongoing till Sept. 28, 2009. However, with Congress in recess and the fate of the American health care system still up in the air, I feel compelled to address how our current options will affect the single population.

Unless you've been living in a cave and eating grubs with Geico actors, you know that President Obama has introduced health care legislation that would allow the private insurance industry to coexist alongside a so-called public option, which may amount to nothing more than a private co-op that could claim non-profit status but still behave like a for-profit company. (Don't believe me? Kaiser Permanente and a number of Blue Cross Blue Shield franchises are registered not-for-profits.) The proposal might accomplish a number of admirable things. It might make preexisting condition exclusions a thing of the past, forbid companies from dropping policyholders, cap rate hikes and out-of-pocket payments, eliminate gender-based discrimination, and insure single young adults for longer. It might provide a more affordable plan that would be subsidized for those earning up to 400% above the poverty line. But for all the good it promises, this "reform" is just as likely to make a bad situation worse. Especially for singles and, in particular, single women.

Singles are more likely to be uninsured than married couples are, and 49% of single women have no insurance. It's not a coincidence that single adults are also, on average, worse off financially than their married counterparts. Many if not most of these singles simply can't afford health coverage. Yet a main component of the health care reform under discussion would be an individual mandate to obtain insurance.

Although the aforementioned subsidies would help, they would phase out for singles making a little over $40,000 a year. In some areas of the country, a salary of $40k is just scraping by. Certainly in New York, an individual wouldn't even qualify for a studio on that income. What makes the government think that people in that position can afford to pay several thousand dollars a year toward health care? Some may argue that no one needs to live in a metropolitan region, but that's where the jobs are.

Switching gears to the lower end of the income spectrum, unless the government subsidy represents the full cost of the premium, how will people who already can't pay their bills bear the burden of yet another monthly charge? Some low-income adults, especially young, healthy singles, forgo insurance because it's a financial burden that doesn't pay off for them. They can save more money by paying out-of-pocket the few times a year that they need care. An individual mandate would force them to pay full price for a product they underuse. But, as we'll see, the suggested mandate is the least of our possible woes under this new system.

The reason universal health care works in other industrialized nations is because they have single-payer systems. That means there aren't any competing, profit-driven insurance companies, just one organization that covers health care expenses in each country. The people of these nations pay a tax for this, but they don't have to pay premiums, deductibles, or co-pays. Ever. There is no annual maximum on their benefits, after which they'd have to go into debt to pay out-of-pocket. They never have to get pre-approvals, authorizations, or referrals before they can receive the care they need. They don't have to worry that the best physician in town might be out of network. They're not kicked out of their hospital beds the day after surgery or told they can only have 10 treatment sessions, so they'd better hurry up and get well. Perhaps best of all, their health care decisions are made by their doctors, not some overpaid bureaucrats in an office far away. Good single-payer systems put the decision-making power in the doctors' hands because they're public services and, as such, are beholden to taxpayers, not Wall Street investors. To keep costs down, they reward doctors for improving preventive care rather than rewarding faceless managers for denying it. Sounds like utopia, doesn't it?

Single-payer health care works because it creates one enormous risk pool. The bigger the risk pool, the less any individual has to pay. It also works because it eliminates the tremendous expenses incurred by for-profit insurance providers and the medical personnel who have to deal with them, both of whom pass on these expenses to consumers. In other Western countries, the pharmaceutical industry is regulated, too, which prevents price gouging. That's why Americans can get such good deals on drugs from international pharmacies.

Unfortunately, Obama's health plan will do none of these things. It will just add another insurance option to the mix. He's betting that this lower-cost option will force private companies to reduce their premiums. A more likely and frightening outcome is that anyone who can't afford private insurance because they're high-risk (the poor, the unemployed, the unhealthy, and the elderly) will flock to the public option, which will go bankrupt before you can say "bailout." Meanwhile, the insurance industry and big pharma will keep on keepin' on, finding ways to circumvent the law and deny consumers coverage because these are businesses. They run on a business model. That means they can't make a profit unless they take in more consumer dollars than they pay out. That's why 77.9% of bankruptcies due to medical expenses are filed by insured Americans. For-profit insurance is an illusion of protection at best.

In 2000, the last year that the World Health Organization ranked the world's health care, the U.S. health system placed 37th, scoring behind countries like Andorra, Oman, Iceland, Colombia, and Morocco. Isn't that embarrassing? Meanwhile, the rest of Western Europe outlives us and loses fewer infants at birth. It's not because they drink wine with dinner, either. It's because they have access to free health care for everyone. Contrary to what fear mongers would have you believe, single-payer health care wouldn't mean extending the clunky Medicare program to everyone. It would mean totally revamping what we now call Medicare and remodeling it based on proven programs in other progressive countries. Yes, the government would have a hand in it. Just like it does education, law enforcement, the postal service, public transportation, and other services which--fancy that--work pretty well.

At this sensitive moment in time, we singles, both insured and uninsured, have a precious chance to speak up for health care for ourselves and everyone else. That's a big part of what we elected Obama for. Let's not sit by and watch a few greedy, self-centered politicians ruin it for the rest of us! When the House reconvenes, our representatives will finally be voting on H.R. 676, the United States National Health Insurance Act, which would create a single-payer health care system for all Americans. A health care system that doesn't discriminate based on marital status! No longer would any of us have to feel pressured to get married or stay married for access to medical care. No longer would our salaries subsidize the health benefits of married employees. What a monumental breakthrough a single-payer system would be, not even just for health care but as a precedent for dismantling legalized discrimination against singles!

Here's what you can do to spread the word about H.R. 676:
--Call and/or write to your representative.
--Write to President Obama.
--Write a letter to the editor of your local paper.
--Distribute flyers at a busy place in your town.
--Canvas door to door or on the phone.
--Write about it on your blog or web site.
--Leave comments about it on political web sites and blogs.
--Talk to your friends and family about it.
--Sign petitions.

To find out more about H.R. 676, including what you can do to help raise awareness about single-payer health care, check out these links:

Change.org: Free Single Payer Health Care
Dennis Kucinich: Universal Health Care
HR676.org
HR676.org Blog
Healthcare-NOW!
John Conyers, Jr.: Healthcare
SiCKO: What can I do?
PNHP (Physicians for a National Health Program)
Unions for Single Payer Health Care


What kind of health care system would you like to see the U.S. adopt? Why? How do you think the system you prefer would benefit singles?


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Do you have a question for Clever Elsie about some aspect of the single life? Have a rant or rave about singlehood? Write in, and you just might see your question in a Singletude Q&A or your rant or rave in a Singletude Sound-off!