Grand Illusion
by Ralph Nader

In 2003, Barack Obama said he was for single payer.

What would it take to get single payer enacted?

“First, we have to take back the White House, the Senate and the House,” Obama said at the time.

Fast forward six years.

The Democrats have taken the White House.

The Senate and the House.

And now what’s Obama’s position?

In a speech this week in Chicago before the American Medical Association, Obama made clear he was now opposed to single payer.

And his lieutenants suggested that Obama would support legislation to make sure that single payer does not become a reality in America.

There’s only one explanation for Obama’s flip-flop on single payer.

The health insurance and drug corporations have a hammerlock on Washington.

And Obama is going along to get along.

What’s the net result?

Sixty Americans are dying every day due to lack of health insurance. (Institute of Medicine report.)

Instead of getting behind single payer, Obama and the Democrats are engaged in the what Dr. Marcia Angell, former editor-in-chief at the highly regarded New England Journal of Medicine calls “the futility of piecemeal tinkering.”

Earlier this week, the Congressional Budget Office (CBO) estimated that the most liberal of the Democrats’ tinkering plans would cost $1 trillion over ten years and still leave 37 million Americans uninsured.

Single payer on the other hand would cost less than we are overpaying now — and cover everyone.

Zero uninsured.

As Dr. Angell puts it — single payer is not only the best option.

It’s the only option that will both control costs and cover everyone.

Replace 1,300 insurance industry payers with one payer.

Save $400 billion a year in bloated corporate administrative and executive compensation costs.

Free choice of doctor and hospital.

Use that money to insure everyone.

No bills, no co-pays, no deductibles.

No exclusions for pre-existing conditions — because under single payer, you are insured from the day you are born.

No bankruptcies due to medical bills.

No deaths due to lack of health insurance.

Cheaper. Simpler. More affordable.

Everybody in. Nobody out.

According to recent polls, the majority of Americans, the majority of doctors, the majority of nurses, even the majority of health economists want single payer.

That’s why almost every health care town hall event I hear about is dominated by citizens speaking out for single payer.

Last month, we asked that you help fund a new non-profit organization – Single Payer Action – to focus this citizen energy, break through the corporate logjam in Washington and make single payer a reality.

You came through with flying colors — and blew past our initial fundraising goal.

The foundation was set for action.

Out of the blocks, Single Payer Action led a stand up protest before Senator Max Baucus’ Senate Finance Committee.

Thirteen doctors, nurses, lawyers and other single payer advocates were summarily arrested and charged with “disruption of Congress.”

(Baucus later told single payer advocates that he regretted not inviting them to testify before his committee.)

The arrests of the Baucus 13, their upcoming trial, and other similar single payer actions around the country have galvanized a nationwide movement.

Single Payer Action now wants to supercharge the grassroots movement for single payer.

Confront members of Congress back home all around the country.

And lay the groundwork for a national citizen’s organization that will refuse to compromise with corporate power — inside the beltway and out.

Many progressives are now confused.

They took Obama at his word.

They thought once Obama was elected President, he would do the right thing.

My colleague, Theresa Amato, is not confused.

She saw clearly through the Democratic Party’s duplicity and shenanigans — and has written a new book, titled Grand Illusion: The Myth of Voter Choice in a Two Party Tyranny (New Press, June 2009)

The book documents how the corporate two-party system thwarts citizen activism and blocks challenging candidates in the electoral system and beyond.

Phil Donahue said this about Grand Illusion: “Theresa Amato takes the biggest swing — not a jab, but a roundhouse punch — at America’s corrupt electoral system.”

Single Payer Action needs to raise $50,000 over the next month to fund its actions around the country this summer.

Yes, I’m aware that people in general, don’t vote based on a single issue. Why don’t you list your top 5 priorities/issues as a voter and then compare Obama’s stance to those of the Green Party and Nader’s stance on those issues that you care for, and see who comes out in front? That would be the rational and logical way to choose whom to vote for.

The elections are not about issues, though we like to pretend that they are – most people vote along straight party lines and simply rationalize their decision.

There are more issues to deal with than just health care. You voted for the person who most represented your stand on them and so did the rest of us.

The reality is that there are too many power players to go directly to single payer, much as I would prefer it. I find it odd that people say offering a ‘public’ option will drive the private insurers out of business. Isn’t that what the capitalistic system they espouse SUPPOSED to do? Let the buyer choose and if some entity can’t “compete” they go out of business? Won’t it be “funny” if there is a “choose what you have now or choose the public option” and all of a sudden, the private insurance companies find a way to cut costs and be competitive.

The cost of interim systems will be higher than going directly to single payer but as we live in a democracy, there is no dictator at the top that will decide what is best for us all.

I guess those voters, who support single-payer health-care but voted for Obama/McCain when neither of them supported single-payer health-care as part of his election campaign, need to do some soul-searching regarding their stance and whom they supported/voted for and why, and how to bridge that disconnect.

I also can’t begin to tell you the grief I got from my Democrat apologists friends for supporting Nader – but I had done my research while they were living in 2000 (and had swallowed the media demonization of Nader hook-line-and-sinker without their own independent analysis), so I was confident in my choice. I sleep with a clear conscience because I believed in my ideals and voted for someone based on those ideals, instead of compromising.

And we need to question the media (including On Point/WBUR) as to why didn’t they highlight Nader and Green Party’s stance on single-payer health care when they were covering the elections in the Fall of 2008 and why do they narrow down the choices given to readers/listeners to just Democrats/Republicans when both of those parties are corrupt. And why was single-payer health-care not important enough to discuss in Sept 2008 before the elections. Let’s talk about democracy and freedom here in the US first instead of (or in addition to) being concerned about what’s happening in Iran – there’s plenty to correct right here in our country when it comes to free press, media and democracy.

Of course, I’m glad that the Democrats are thinking about single-payer health-care now, but it remains to be seen whether they will implement it. Let’s give credit to Nader/Green Party who championed it long before the Democrats. And of course, please consider supporting the Green Party in the next elections instead of maintaining the status quo of the corrupt duopoly.

And so long as they can talk about “health care reform” without being stopped in their tracks, they will control the message.

Change the message to universal single payer health care all the time and every time and that message control is defeated.

Message control was used by political speech writers like Frank Luntz to brand the estate tax as “the death tax”. Health Care Reform is the same sort of spin.

NPR print media and Democrats and Republicans have allowed this trope to be used against the American people in defense of insurance companies. Insurance companies provide NO health care.

Get it?

and as myself and others have to pay additional money for a health care account on top on what i pay for my health insurances. (get this) i need that account to pay for anything that could happen to me. (since my insurance doesnt cover zip) and nickle and dime me with co-pays luckly im in good shape and rarly get sick, but for some of my friends its killing them and others prefer to pay the fine(that goes up the more the make) since both ways u really dont get any coverage.

Mass with the work of those econ democrats and former Gov Romeny(toolbag) design a system that requires the state to be beholding to the private insurance companies and CEO’s making millions who contribute zip to our health.

if obama took the mass way of health care will not vote for him and work to get others not too since hes not big enough leader to stand up to the lobbist.

Because of mass. and the massive amount of money being made for the private insurances they agreed to help obama only if the public option doesnt make them lower cost, increase care, but have everyone be in the servitude to them.

I agree with the other guest who avocates for single-payers( which medical/health care should be a right not a luxury )i would hope those care about unborn babies also care about the born ones and vote out those republicans,and dems as well whose all beholded to these blood sucking insurance co.

Base coverage (I’m sure there would be a HUGE fight over what is covered) for ALL legal residents, cooperative coverage with other countries for visitors, supplemental private insurance for those who want and can afford it.

There is no way we can pay for a partly private (through employers), and a partly public (for those not insured by employers and not able to pay the rate private insurance companies charge) and Medicare/medicaid.

1) FREE medical school (base MD, not specialization) for those with the aptitude and desire to get into medical school. No 6 figure loans, no need to repay them. No need for ‘extra’ income to cover the loans.
2) No more ‘in network/out of network’ with separate deductibles and pay ratio bull. Since all medical services are payed from a single source, EVERY medical provider is ‘in network’.
3) No more ‘can we get some other insurance company to pay this charge’ questionnaires when you make a claim.
4) No more lack of insurance for ‘pre-existing conditions’.
5) No more loss of insurance when you get laid off.
6) Computerized records so ANY doctor can see the history of any ailment you might come in with. No repeated tests simply because the data is not available. And no getting multiple prescriptions for controlled drugs from many doctors. PLENTY of pluses.

How do you pay for it? The same way every other single payer system pays for it. Everyone pays in some fashion. Business tax, Value Added (sales) tax, income tax. A mix of the 3 I’m sure. It would cost LESS than we pay now.

When it comes to health care reform, Obama is a huge disappointment, having years ago forthrightly stated that single-payer was the way to go. His supposed reform effort is merely the latest in a long line of lukewarm attempts to prop up a failing system, amounting to a minuscule band-aid stretched across a gaping wound. We shouldn’t be surprised, given his similarly timid approach to the Wall Street financial crisis, that Obama has abandoned his previous commitment to a rational single-payer system. What is galling is his explanation, in which he invokes our country’s “tradition” of private, employer-based insurance, a system inimical to providing full care for all at lower costs. He essentially is saying we can’t rock this leaky old boat. The man who strode to victory intoning the mantra of “Change” has had a golden opportunity to strike for real change, but apparently because of his own notions about political expediency, he refuses to do so.

We are left with a debate about health care “reform” that turns on such straw-man issues as whether Obama’s plan is a “Trojan horse” for “socialized medicine,” that irksomely tiresome refrain regularly trotted out by right-wing apologists for rampant greed, which they prefer to call “free enterprise.” For over seventy years, reactionary forces in the government and corporate media have prevented a national, single-payer health plan from being created. If you want to know why, simply “follow the money,” to use an old phrase from the Watergate era. When one senator from the sparsely-populated state of Montana, Max Baucus, can set the legislative agenda and dictate to the rest of the country what we can and can’t tolerate in the name of real reform, then one has to ask why and how he wields such power. One only has to look at the extent of his campaign contributions from the insurance industry to begin to understand how the government in our vaunted democracy actually works, and for whom.

Do we really expect those Chinese who work fourteen hour days for four and half dollars per day to not only support our welfare system, but while they being forced to abort a second fetus, to loan us monies to take care of the likes of Nadya Suleman and the Tennessee guy with the twenty one kids.

And expect the people of the Indian and the African slums to pay us to keep our air conditioners going and have free health care?

Or the Arabs to give us oil for cheap while they buy billion dollar aircraft and pay for our high dollar prostitutes.

Or may be the Japanese and the Koreans who send their kids to ten hour school days followed by four hour home work to support our video game addicts and slackers?

MEDICARE should only pay for birth control or an abortion. You will see the savings.

To Dr. Martin Bur – As a patient and not a medical professional, I’ve experienced most doctors as very skilled, and also very caring and motivated largely by very high ethics, just as you describe. But I’ve also seen a grandparent and also a friend (two separate cases) subjected to what I believe was at best very lackadaisical care, which verged in each of those cases on negligence if not malpractice. It’s important for doctors to begin to regulate their admittedly rare, less competent and careful “bad apples” effectively, so that patients are realistically protected against isolated incompetent physicians, instead of just characterizing all malpractice suits as frivolous or vindictive and requiring arbitrary limits on patients’ ability to sue. My own experience is that even most families who lose a member due to medical incompetence do not bother to sue, because of the time and effort and additional pain it would involve, on top of the bereavement. My family did not sue, and neither did my friend’s family.