The healthcare legislation under consideration in Congress would prevent states from improving on what Congress creates. An amendment is under consideration right now in a House committee that would change that, leaving the federal initiative as is but permitting states to do better. This battle pits states’ rights against the much less spoken of insurance company rights. And it calls the bluff of every individual or group who opposes single-payer healthcare at the federal level on the grounds that it is not “viable.” That argument would seem to provide no basis at all for denying states the right to create single-payer healthcare or any other solution they see fit.
In fact, the amendment now under consideration provides an opportunity for advocates of single-payer and proponents of a public-option compromise to join forces and work together in good faith against the forces of the insurance lobby. The amendment being considered in the House Subcommittee on Health, Employment, Labor, and Pensions, is offered by Congressman Dennis Kucinich (D., Ohio). The amendment gives states the right to pass and implement state-based single-payer plans and would ensure the federal rules waivers required to allow that innovation. If a public option at the federal level can move the nation over time to a single-payer solution (a big if), the example of states getting there first should offer no hindrance. In Canada, it was the example of provinces that moved the nation to the single-payer solution now in place.
Of course, there are those who argue against single-payer on the merits, rather than simply resigning themselves to its alleged lack of “viability.” But none of those arguing against single-payer as expensive, inefficient, or heavy-handed have an obvious argument for denying states the right to choose it. They would argue against the wisdom of any state choosing it, but that is different from denying states the right to choose it by imposing a federal ban. In addition, of course, most arguments against single-payer (or a public option) on the merits are based on false information, which the American public does not accept. Americans consistently tell pollsters that they want public health coverage. Hence the need felt by the insurance companies to ban states from providing health coverage: the residents of many, if not all, states want it.
Other nations that have public health coverage (government spending on private or public healthcare) provide their people with better care. The U.S. system is ranked 37th by the World Health Organization. The United States is 24th in life expectancy and 29th in reducing infant mortality. Infants who do not survive the US system do not get a chance to experience the joys for-profit healthcare.
A single-payer system would cover everyone at all times with no exceptions, allow completely free choice of doctors, invest in preventive care, and allow patients and doctors to make their own decisions free of insurance company restrictions. If enacted at the federal level, a single-payer system would eliminate huge inefficiencies. It would reduce the 30 percent waste in the current system to the 3 percent overhead in Medicare, and create a net gain of 2.6 million jobs, $317 billion in business revenue, and $100 billion in wages, according to a study by the California Nurses Association. Enacting single-payer at the state level would not boost the state’s economy to the same extent, but to a lesser and still significant degree it would be a stimulus, one that other states would take note of.
House Resolution 676, backed by 86 congress members, would create single-payer at the federal level. Congressman Anthony Weiner (D, N.Y.) is proposing an amendment in the House Energy and Commerce Committee that would substitute H.R. 676, for the proposed Tri-Committee legislation. Of course, this amendment deserves our support. But if it fails, there will be no excuse for not passing Congressman Kucinich’s amendment permitting states to do what most other wealthy nations have found the decency to do at the national level. If Kucinich’s amendment fails, the fault will not be the media’s or political calculations or party discipline. The fault will be the extreme degree to which the health insurance companies own our federal government. And only those who supported this amendment should henceforth be permitted to speak of states’ rights.
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