HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Tuesday, August 7, 2007

Support for Single Payer

Ezra Klein points out a recent article on the American Prospect website concerning an interview by Roger Bybee, writer and progressive activist, who formerly edited the official labor weekly Racine Labor, with Dr. Steffie Woolhandler, one of the founders of Physicians for a National Health Program, on single-payer health care.   Here is a brief portion of the interview:

How do you envision closing the gap between big firms like Wal-Mart making vague commitments to universal healthcare and actual recognition that only a single-payer system can hold down costs, reach all citizens, and provide free choice of doctors?

If companies want to hold down costs, they need to support universal healthcare. Otherwise, it won't solve the problem of healthcare for low-wage workers. The good news is that no one would miss the administrative burden that accounts for such high costs in the


However, we would have to provide retraining and income support to displaced health insurance workers. 

Polls of doctors in


(Feb., 2007) and


(2004) both show a remarkable 64 percent favoring a single-payer plan. What accounts for this historic shift in the sentiment of doctors, when you think back to how the American Medical Association successfully mobilized doctors in every community to block Harry Truman's health reform effort? This new polling seems extraordinary; both because doctors' support for single-payer is just slightly below the general public's and because doctors are presumably much more knowledgeable about health systems than the average citizen. How do you see things developing among doctors and the health industry?

The opposition in Truman's era was the medical profession, and the AMA still is opposed even though a high percentage of doctors support a single-payer plan.

But now there are two other powerful forces: the health insurance industry [that emerged since the Truman plan] and the pharmaceutical companies. Under a single-payer plan, the government steps into the pharmaceutical pricing picture with a lot of bargaining power, so both of these forces feel threatened. 

It's ironic that hospitals aren't more supportive. The health insurance industry would be put out of business, so it's life or death for them. But hospitals would still be there. Some for-profit hospitals oppose national health insurance, and our plan calls for reconversion to non-profit status. With the non-profit hospitals, I think opposition to single-payer is mostly fear of change. I think that they can live with a single-payer national health insurance plan, so I don't see them as our biggest enemy.

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