In his book Critical: What We Can Do About the Health-Care Crisis, former Senator Tom Daschle argues the federal government should shrink away or rather, shirk the power vested in it and delegate the administration of the nation’s healthcare insurance to private interests. He would, if he gets his way, place in charge the very same private interests that are currently responsible for the dysfunctional tripartite between the patient, healthcare provider, and the insurer.
The system he touts would, in form, resemble the current Federal Reserve System that arose out of the great compromise of 1913. He proposes “a Federal Health Board, modeled loosely on the Federal Reserve System . . . It would create a public framework for a largely private healthcare delivery system. Its main job would be to develop standards and structures for a health system that ensures accessible, affordable, and high quality care.” He argues that “like the Federal Reserve, the Federal Health Board would be composed of independent experts insulated from politics.” He envisions either extending the current Federal Healthcare Benefits Program to all Americans or creating a group purchasing pool akin to it.
Sound good: Not so fast! This is not Single Payer. This Federal Health Board would offer a menu of “private” healthcare plans from the current gaggle of healthcare providers. You know, the same folks whose for-profit business models do well by providing us less care.
In a pure single-payer environment, the government is the insurance company. It would be an extension of our current Medicare system with one big difference: the government would have free reign to collectively bargain with pharmaceuticals and healthcare providers. There are some things the government does well and, given its track record with Medicare and Social Security, I would say it should be able to effectively and efficiently deliver health insurance. The streamlining of administration alone could generate as much as a 20% reduction in overall healthcare costs. Single-Payer would remove the counter productive influences of the private insurers all together.
The to question to ask is why is Tom Daschle so gung ho on a system modeled on the Federal Reserve? I believe there are two reasons.
First and foremost, he finds the “a pure single-payer system to be politically problematic in the United States, at least right now.” He states that even though Americans have a highly favorable opinion of Medicare, they fear the “S” word – SOCIALISM. I would argue that any American who has been in for surgery in the past 10 years and inevitably wrestled with their coverage is probably ready for a little bit of socialism. The second reason is he seems to be suffering from the delusion that the Federal Reserve System was and is some kind of panacea for the nation’s monetary woes.
If I may digress, what many Americans fail to understand is that the whole idea of a “Federal Reserve” was not conceived of by economists, bankers, treasury officials, or scholars. Rather, it was conceived in the late 1800s by barefoot farmers suffering under the practices of Eastern bankers such as J.P. Morgan and an inelastic monetary system that when combined deflated the prices of their crops. What these early Populists had devised — according to William Grieder in his book, Secrets of the Temple: How the Federal Reserve Runs the Country — was a new monetary system for the nation that would create “money” in the name of the whole people. This system would ensure ample credit for productive enterprises and free producers from the control of commercial bankers. The plan was a radical one, perhaps too radical for the times. But many years later, John Maynard Keynes postulated it would have probably worked.
So what happened? Well, again, according to William Grieder, “the money system that was adopted in 1913, instead, preserved the banking system as the intermediary that controlled the distribution of new money and credit. When the Fed expanded the money supply, commercial bankers decided who would get to use it and also how much it would cost.”
In much the same way that the Federal Reserve Act of 1913 neatly rolled the banks that were guilty of being part of the highly exploitative “Money Trust” into the new monetary system, so will Daschle’s Federal Health Board allow the current group of insurance companies that we fight with over our coverage today to continue to profit from us.
This is a real boon for the private insurers. Under the auspices of the federal government, these companies will be able to greatly expand the pool they cover while being only nominally answerable to the people.
After all, it probably makes a lot of sense in their eyes. The insurance companies by now have figured out the average American is only going to get poorer, so what could be better than getting the government to compel all its citizens to pay them their premiums albeit, smaller premiums per capita? Ah, the best government money can buy!
Perhaps I am being a little conceited here, but if I am going to pay an insurance premium to the government, I do not want those monies finding their way into the pocket of a private for-profit firm whose first (as should be expected) priority is to its shareholders. No sir! I believe this country not only needs but is ready for a single-payer system. Daschle argues that his Federal Health Board will ensure that Americans will not be underinsured, denied the care they need or be “forced to run up huge medical bills.” But so will single-payer, and single-payer will do it more effectively and efficiently than some quasi public/private system.
Next week, the Senate will move to confirm Daschle as Secretary for Health and Human Services. There is going to be a lot of talk about the Critical issues affecting healthcare delivery. We are going to hear the term affordable healthcare bantered around a lot. But lets be very clear on one thing V “affordable” does not equate to single-payer. If a single-payer system is what you want, then let your voice be heard in the Senate chambers!