Conversion of our prohibitive, low-ranking health care system to an equitable single-payer, not-for-profit health care system, which will be the envy of the world, financed by a national pool and administered in a way which minimizes government and empowers physicians.  Put another way, I will fight to, in essence, expand Medicare to include every U.S. citizen   The grip of corporations on congress and the executive and judicial branches is not limited to the defense industry.  Campaign contributions to democrats and republicans sustain a two-party tyranny which enables the corporate state to thwart and subvert democratic institutions.  Unless we wrest congress out of corporate hands by voting against the two parties corporations control, unless we develop equitable, publicly financed elections in which all candidates receive equal funding, unless we establish term limits, our national and state problems will only worsen rather than be solved.   The grip of corporations on democrats and republicans is not limited to the defense industry, but controls every aspect of the economy and American society, including health care and American health in general.  Consequently, President Obama and the democrat-controlled congress cut deals with pharmaceutical and medical insurance industries in exchange for support of ill-advised and inconsequential legislation, legislation that would not address the systemic failures of a health care establishment driven by profit rather than affordability and accessibility for all Americans.  In exchange for their support and advertisements, pharmaceutical companies were promised continued restriction of foreign drug imports, which, if available, would have reduced the cost of medicines for all Americans, including the elderly.  The Obama administration and democrats in congress promised still greater profits for medical insurers by proposing a largely unenforceable mandate (perhaps also unconstitutional), which would have required large percentages of heretofore uninsured Americans to pay premiums the insurance industry had yet to reap.  More importantly to the insurance industry, that subset of the population would have provided rolls of healthier Americans from which to cherry pick as the chronically ill were denied medical treatment or priced out of medical insurance by escalated premiums and co-pays.  These machinations point to the failures of a health care system in which corporate profits are put ahead of human welfare profit. Only a systemic change can stem the tide of increasing costs of American health care, that systemic change is a not-for-profit, single-payer health care system.  Some health care advisers tout the benefits of having coops and pools of patients organized to negotiate down the price of health care.   What better solution than everyone in the pool?   

In addition to the potentially unconstitutional mandate forcing Americans without coverage to buy private insurance, I support single-payer health care and oppose the Senate health care bill on many other grounds.  The Senate bill has insufficient cost controls on skyrocketing premiums and ancillary insurance costs.  It fails to challenge insurance company monopolies, especially in the top 94 metropolitan areas where one or two companies dominate choice.  Congress and the Obama administration expect a family of four with an annual income of $54,000 to pay 17% of that income ($9,000) on healthcare without exposing the family to grave financial risk.  The excise tax on comprehensive insurance plans will encourage employers to reduce benefits, shift costs to employees, proliferate high-deductible plans, increase self-rationing of care and medical bankruptcies and lead to layoffs.   Loopholes abound, including provisions permitting insurers to double charges to employees who fail “wellness” programs because of diabetes, high blood pressure, high cholesterol and other conditions.  Insurers are permitted to cross state lines and thereby circumvent patient protection laws passed in other states and encouraging insurers to race to the bottom by moving to lesser regulated states.  Insurers can charge 4 times more based on age and other conditions which enable cherry picking of healthier, less costly enrollees.  Insurers may easily rescind policies on the basis of misrepresentation, the main pretext for medical insurance companies to cancel coverage.  The bill will leave hundreds of millions of Americans with inadequate insurance, an actuarial value as low as 60% of actual health costs. 

Predictably, more families will face prohibitively soaring co-pays and deductibles.  There will be minimal oversight of insurance denials, inadequate limits on drug pricing, and public hospitals and clinics will be dumping grounds for patients the private medical insurance system does not want.  The bill would drain an estimated $43 billion from Medicare payments to such safety-net hospitals, representing perhaps 80-85% of the costs and threatening the 23 million Americans, who would still remain uninsured by the bill.  The bills anti-abortion provision restricts reproductive choice and compromises the health of women and adolescent girls, who could fall victim to septic abortions.  There is no single standard of care, much less one established by physicians as would happen with a single-payer, national health care system administered by medical professionals.  Health care would still remain a privilege in America instead of a right.  The 40% tax on high-cost health plans, deceptively called a “Cadillac tax,” would impact many middle income families.  Because group insurance costs are determined by a calculus of demographics of the covered group and regional health care prices, businesses employing more women and older and sicker employees will be adversely affected, particularly in New York, Maine and other high cost states.  A single-payer health care system will not compromise health care of Americans as described above.  The current system, including minor incremental changes proposed by congress, has been rigged by the insurance companies to generate profits not health care.

It can be argued that the “free market” may have reduced the cost of Lasik eye surgery in recent years because corrective vision procedures, such as eyeglasses and Lasik surgery, are not covered by medical insurers.   Patients, therefore, choosing Lasik surgery over eyeglasses can shop around for the best prices and procedures.  Such is not the case with more serious, non-elective medical treatments.  Someone facing the prospects of chemotherapy or heart surgery is not likely to shop around for better prices for their insurance company, even if they are faced with mounting costs from deductibles, co-pays and flat out rejection of some coverage by the insurer. 

The free market works well with the purchasing of VCRs, cell phone and refrigerators to potentially bring down prices via Adam Smith supply-and-demand economics.  Refrigerators of the same price provide about the same value and dependability, regardless of manufacturer.  But human bodies differ.  A procedure that works well for one may not work well for the other.  As a “consumer” of a medical treatment critical to survival, the patient is very vulnerable and open to suggestions by medical providers and physicians.  The patient cannot sample or test drive a surgery beforehand, and the medical treatment or “product” may do more harm than good.  Even if useless to cure an illness or downright harmful, the patient still has to pay for it.  In the medical “marketplace” caveat emptor does not apply.  The private market has lost the ability to control costs of health care.  The free market not only fails to work in health care as in other sectors of the economy but actually works in reverse to exacerbate the problem.  Insurance companies have lost the ability to control health care costs and simply increase deductibles and co-pays to accommodate those rising costs and thereby maintain or multiply their corporate profits.  Doctors, motivated by defensive medicine and economic incentives, often over treat well-insured patients.     

Another reason I will fight incessantly in congress for a single-payer health care system is to enable the medical profession in America to transform from a system which is costly and too reliant on desperate measures to prolong life to a system which emphasizes front end, preventive care to avert the desperate measure scenario.  In recent academic polls, over 70% of American physicians are in favor of a national health care system, one that could be administered by people in the medical profession, so neither insurance companies nor government officials get between patients and doctors.   I suspect that many physicians embrace a national health care system because it empowers them, can be more easily directed at preventive care, unifies recordkeeping and reduces administrative costs.

Attempts by the democrat-controlled congress to create a health care system that conciliates the very insurance and pharmaceutical companies profiting from millions of sick Americans is the essence of stupidity and doomed to fail.  Health care in America is neither accessible nor affordable, except to the wealthy, because of systemic failures.  We cannot build on or successfully amend the present system because it is a system in which profits take primacy over human health.  That problem is inherent to private insurance and pharmaceutical industries, which, by corporate by-laws, must put the interests of their shareholders above their enrollees and patients.  This produces fragmented risk pools, cherry-picking the healthier part of the population and leaving the chronically ill uninsured or underinsured and driven to financial insolvency by jacked-up premiums and co-pays.  The current system can never be more efficient than a publicly financed system similar to those successfully operated in every other industrialized nation on earth but the United States.  A study by Harvard Medical School suggests that national health insurance would save the country over $350 billion per year.  Why?  In part, the answer is because Medicare and the U.S. Veterans Administration health system are both examples of single-payer, publicly financed health care.  Single-payer, national health care is essentially Medicare for everyone.  Furthermore, the conversion to national health care is not a Herculean overhaul. Including national health care for federal employees, veterans and recipients of Medicare close to 60% of the insured U.S. population has single-payer health care presently.  Most importantly, those programs operate with 3% administrative costs whereas overhead and administrative costs of private health insurers range from 15% to 31%.   Much of that discrepancy accounts for higher premiums.  A family of four now pays over $12,000 a year in premiums, which have increased by nearly 90 percent in recent years, in part because insurers are not covered under anti-trust laws (a legal quirk I will fight to correct by repealing the McCarran-Ferguson Act while in congress, a lousy piece of 1945 bipartisan legislation exempting insurance companies from most antitrust laws).  A report in the journal Health Affairs concludes that if we retain any variation of the current for-profit health care system, 20% of every dollar spent by U.S. citizens in 2017 will go to health insurance.  Such increases are unsustainable and account for the growing numbers of uninsured or underinsured Americans.  An estimated 18,000 Americans (some estimates are as high as 45,000 Americans) die every year from lack of health care and because 47 million fellow citizens in this country lack basic health care coverage.  At least 25 million more Americans, who do have medical insurance, lack adequate coverage to cover their medical needs. Tens of thousands of Americans, most of whom are insured, go bankrupt every year because they cannot afford their medical bills and because we spend on medical care twice per capita what others nations spend with much lesser results.  In fact, well over half of all bankruptcies in America occur because families are unable to pay medical bills.

Despite false advertising to manipulate public opinion otherwise, American health care is not the “best in the world” as we are led to believe.  The cost of American health care is twice per capita the cost of comparable health care in countries with national health care systems.  Despite the much greater cost, the World Health Organization’s international comparison of health care systems ranks the United State 37th among nations, just above Cuba and just below Costa Rica.  The U.S. also ranks low in a number of key categories, such as infant and maternal mortality (27th) and life expectancy (22nd male/23rd female).  Many countries with national health care systems have significantly shorter waiting periods for medical services; and France, often touted as having the best health care system on the planet, requires doctors to be part of emergency medical response teams to administer many life saving treatments which EMTs cannot.  Diabetes, hypertension and obesity are epidemic in America, while sustained, programmatic dietary and preventative care is almost nonexistent.  Meanwhile, democrats and republicans in Congress subsidize food industries which exacerbate these problems.   Consequently, the United States is very good at drastic measures to prolong life of patients with the aforementioned conditions.  Other countries take a different approach; they provide extensive counseling, preventive programs and treatment of problems, such as diabetes, before they progress to life threatening stages requiring extensive and complicated surgery to keep the patient alive.

Rather than one integrated data base to synthesize medical research data, choose best courses of treatment and facilitate care of patients, America has over 1,200 databases (roughly one for each insurance company), not containing pertinent medical research, but containing cost/actuarial information with which insurers may deny treatment or jack-up co-pays and deductibles.  Pharmaceutical companies have likewise stacked the deck against a single-payer health system with their contributions to democrats and republicans because a national health program could negotiate lower drug prices.  Canadians pay 40 percent less for the same drugs prescribed to U.S. patients, just as the U.S. Department of Defense and our Veterans Administration negotiates pharmaceutical prices 40 percent lower.  A national health care system would also take the burden of health care from small businesses and reduce for everyone the crippling cost of many high end products, such as automobiles.  In the United States, absorbing the costs of employee health care in the automotive industry, cars are sold at prices roughly $1,700 higher than the same vehicle manufactured in Canada, a country whose auto assembly line workers are covered under national health care.

When LBJ’s administration passed Medicare in 1964, President Johnson concluded that Medicare was the first step in improving American health care.  He concluded that other presidents and other congresses would make further improvements.  Forty-six years later, that has not happened.  Alone among all advanced nations, America continues to have health care for a profit, distributing health care as a private commodity to make money for corporate shareholders rather than to provide health care.  We recognize that health insurance companies are the problem, but a democrat-controlled congress and President Obama are mandating that everyone buy their products.  What may now pass in congress is too little and too late and ultimately pours gasoline on the leaping flames of health care costs, making accessibility and affordability more tenuous.  President Obama and democrats and republicans “caved in” to pharmaceutical and insurance companies very early in the process and now have a bill that should not pass.  I strongly oppose it.  Medical insurers make profits by denying rather than by providing health care (e.g., $12 billion in cumulative profits among the 5 largest medical insurers in 2009).  The Obama plan secures that systemic problem.  The individual mandate, requiring everyone has to buy a commercial insurance product, will further increase rising costs, and it will do so sooner rather than later.   

Furthermore, Medicare, so urgently sought and passed in 1964, will be raided to subsidize private health insurance companies should current legislation pass.  Insurance companies can charge 3 times more premiums for older U.S. citizens than citizens in their 30s.  Like an excise tax on those who are least healthy, least able to afford high premiums and most desperate to buy medical coverage, older, less healthy Americans will be priced out of health and potentially fined for failing to meet the mandate.  As that older subset of the population falls by the wayside, a younger, healthier clientele will swell insurance rosters and maximize profits.  The system will unravel so quickly that we will become a third world nation in terms of our health care.  Some democrats suggest that congress should hold its nose and pass the bill anyways as a small step in the right direction to be revisited later.  Such visitations will not happen soon if the bill is passed.  As the system unravels and health care costs continue to mount, opponents to universal health care will point to the legislative failure as a resounding argument against measures to make health care accessible to everyone.  The current bill should die because it is a bad bill, designed with the intent of getting President Obama and the democratic majority in congress reelected, not to provide affordable health care for Americans.  The people now in congress, democrats and republicans alike, do what the insurance and pharmaceutical companies want them to do.  To borrow a recent metaphor, the medical insurance industry is a shark in the waters, rapacious and undetected until it bites.  Unless proponents of single-payer, not-for-profit health care are elected to congress in November, the waters are destined to turn red.

Single-payer health care is not a bridge too far. The time is now for a progressive voice in congress to fight for not-for-profit national health care, a system empowering our medical professionals so neither insurance companies nor bureaucrats will get between us and our doctors.  As your congressman, I will join Dennis Kucinich and Conyers in their fight for such a system.  We cannot improve the system by expanding government oversight or by tinkering with for-profit health care by requiring doctors and hospitals to prove the quality of their services.  That would exacerbate overhead and paperwork costs which a single-payer system will alleviate.  Converting paper record-keeping to electronic will not significantly decelerate rising costs, nor will forcing insurance companies to use more income from premiums for patient care, nor will mandating that everyone get medical insurance whether they can afford to do so or not.  There is no affordable mechanism to enforce such a mandate.   Just as with auto insurance mandates and environmental mandates with which I have had 27 years experience, there will always be a large percentage of the population (usually 15% or more) which will be in violation, and the cost of ramping up enforcement mechanisms merely adds to the cost of health care.  Such proposals are the insurance and pharmaceutical companies talking through the democrat and republican mouthpieces they have bought with campaign donations.  Tragically, and at the cost of our health, Congress and the White House have once again ceded control of the medical establishment to the insurance and pharmaceutical companies so that their continuing and unprecedented profits will translate into campaign contributions and retention of power by democrats and republicans alike.  (Having sold us out, so-called “representatives” in the House are preparing to vote for the onerous Senate bill by imbedding their votes in a scheme called auto-execution, thereby preventing their districts from tracking their vote.)  More than ever, the time for a necessary and inevitable overhaul of our medical system to a universally affordable, single-payer system is NOW!  Dr. Marcia Angell, former editor of the New England Journal of Medicine, recently stated that not-for-profit, single-payer national health care is “the only health care system that will both control costs and cover everyone.”  Countries with a strong third party and third party candidates elected to government have single-payer, not-for-profit health care. Only a congressman, who for many years has championed single-payer, national health care (consistent with the Green Party’s 10 Key Values and the Green Party’s national platform), will make it a reality in America.  I am that candidate in the 2nd CT congressional district.