Healthcare: Senate legislation much weaker than single-payer, but has merit

 In the midst of this horrendous lack of coverage, the U.S. spends far more per capita on healthcare than any other nation. The average American spends about $7,900 per year, almost twice as much per person as any other major country — all of which have national healthcare programs guaranteeing coverage to all of their people.

Despite all that we spend, our healthcare outcomes lag behind many other countries in infant mortality, life expectancy and preventable deaths. That is because much of the money isn’t really going for healthcare. With 1,300 private insurance companies and thousands of different health benefit programs designed to maximize profits, our country spends an incredible 30 percent of each healthcare dollar on administration and billing, exorbitant CEO compensation packages, advertising, lobbying and campaign contributions. Public programs like Medicare, Medicaid and the VA are administered for much less.

Not surprisingly, while healthcare costs are soaring, so are the profits of private health insurance companies. From 2003 to 2007, the combined profits of the nation’s major health insurance companies increased by 170 percent. Executives receive lavish compensation packages — averaging $14.2 million for the top seven companies.

In my view, the United States must join the rest of the industrialized world and guarantee healthcare to every man, woman and child in a cost-effective way. The evidence is overwhelming that we must end the for-profit private insurance company domination of healthcare in our country and move toward a publicly funded, single-payer Medicare for All system.

A publicly funded, single-payer Medicare for All program would provide freedom of choice in terms of doctors, hospitals and other medical providers. Most importantly, it would save $400 billion a year in administrative waste by eliminating the private insurers’ efforts to fight claims, issue denials and make sure that the people they cover are profit generators.

Sadly, the single-payer legislation that I introduced in the Senate and others have offered in the House of Representatives will not likely be passed into law this year. The reason: the enormous power of the insurance and drug companies that over the last decade spent hundreds of millions on lobbying and campaign contributions.

While legislation now winding its way through the Senate health committee is nowhere near as effective as single-payer, it does have some positive attributes. They are:

• An effort to provide at least a minimal level of coverage for all Americans by increasing Medicaid eligibility and providing insurance subsidies for low- and moderate-income people.

• A radical improvement in primary healthcare by providing a medical home for every American. This would be accomplished by substantially increasing the number of Federally Qualified Community Health Centers and the number of primary care doctors, nurses and dentists.

• A major increase in funding to significantly improve our efforts at disease prevention and lowering the numbers of Americans who fall ill to chronic diseases.

• An increased focus on quality control and trying to assess why some medical facilities provide better care at far lower costs than others.

• Efforts to expand independent living and help keep the elderly and disabled out of nursing homes if they prefer to live at home.

The most contentious issue being debated is whether all Americans should be entitled to the choice of a public option — a federally run, premium-based, Medicare-type plan — which would compete with private insurance companies. This is an approach I support, as do most Democrats. It is vigorously opposed by the insurance companies and drug companies — and all Senate Republicans.

The fight for real healthcare reform is slow and complicated, but the stakes are enormous. With the healthcare industry spending tens of millions on lobbying and campaign contributions, it is imperative that all Americans stand up and fight for a healthcare system that is worthy of our great nation.

Sanders is a member of the Senate Health, Education, Labor and Pensions (HELP) Committee.

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