Corporate downsizing and runways to low wage no benefit areas have diminished the amount of dollars available--that's where Steve Perry's comment on Lee Iacocco comes in--fewer employers paying more dollars to maintain a shrinking health insurance pool. And Lee Iacocco isn't the only one to realize this! National single payer health insurance makes good business sense. And as I have pointed out before no matter what the economic system people are still going to do business.
Tom Lehman
Wojtek Sokolowski wrote:
> At 04:31 PM 8/25/99 -0500, Steve Perry wrote:
> >
> >Out here in Minnesota--whose gift to the world was the HMO system--
> >there have been quite a few interesting folks involved with the single-
> >payer question. Early in his first term, Paul Wellstone was seriously
> >interested in pushing single-payer initiatives--not that he thought it
> >was practical to attempt it nationally at that point; his notion was to
> >pursue measures that would make it easier for states to do single-payer
> >experiments and thus try for a groundswell that way. But he was
> >seduced by Hillary Clinton during her '93 March to the Sea, and
> >he's never made a noise about it since, to my knowledge. (By the way--
> >why does everyone persist in claiming that the Clinton plan failed,
> >just because it wasn't passed into law? It's quite obvious that the
> >administration's move in the direction of HMOs touched off a merger
> >mania that made her plan--minus some of its rube goldberg
> >convolutions--into reality.)
>
> -- snip
>
> Two points. First, Christopeher Hitchens argues that Hillary's "reform"
> was, in fact, a move designed by big insurance firms and received a
> relatively mild oppsotion from smaller guys in the insurance biz. So it was
> hardly a propaganda blitz that "killed" that initiative. Au contraire, the
> whole "initiative" was a scham never intented to be implemented as advertised.
>
> Second, health reform involves two conceptually different issues - the
> cost-effectiveness and the universal coverage. "Single payer" or more
> generally - public insurance schemes are designes primarily to address the
> cost-effectiveness issue by reducing transaction costs that are significant
> in this business. It does not automatically lead to universal coverage -
> in fact the acclaimed public health care systems under state socialism were
> NOT truly universal - for example, self-employed were not covered.
> Moreover, not every procedure was covered - only those available in public
> health care facilities.
>
> Universal coverage does not require a single payer solution - it is
> possible to attain by means-tested public subsidies of insurance premiums.
> That is, you buy your insurance from a market vendor, and if you cannot
> afford one - government subsidies will make up the difference between what
> it costs and what you can afford.
>
> So it makes a lot of sense, from the Left's point of view, to make that
> conceptual distinction clear. As katha p. & others pointed out, changing
> the status in the insurance biz will be extremely difficult politically,
> and the left should focus their energies on issues that really matter to
> its constituents, i.e. working class.
>
> I do not think that cost-efficiency should be of primary concern to the
> Left for a number of good reasons, chief among them being that insurance
> companies can take of that. Moreover, "government health care" has become
> one of the buzz-words that provoke a knee jerk reaction on the right - so
> fighting for a single payer system is not the best strategy for the left,
> except perhaps for scoring symbolic points in a kulturkampf.
>
> A much better strategy is to focus on universal coverage - which as I have
> argued - can be achieved by institutional arrangements that are not limited
> to a single payer public insurance scheme.
>
> wojtek