To Editor of Seattle Times

Your editorial of June 22^nd identifies the importance of a public-health insurance option, and that “consumers” need an “affordable” choice. I rather doubt that most people, who are provided their god-given medical coverage by Microsoft or Boeing, view themselves as making profound consumer decisions for coverage whose monthly premiums range from zero to a relatively nominal sum relative to the amount that they charge their former employees in a COBRA. And certainly when we show up at an emergency room, and especially those that have no coverage, are they not facing just a Hobbesian choice? At this time, like when we choose an employer-based provider, we don’t typically go shopping for coverage for a heart attack or pancreatic cancer—unless we have a pre-existing condition. Then, as Paul Harvey used to say, we “know the rest of the story.” And after a few months when the federal subsidies for the employer-based COBRA are exhausted, what makes out-of-pocket expenses of $500 per unemployed person so affordable about this approach? Unlike transportation or education, this year with 10,000 employees involuntarily leaving Boeing and another 5,000 jettisoned from Microsoft, the stone-silence of these companies relative to the public option—let alone any option—is noteworthy relative to these unemployed people or their own “golden handcuffs” for the remaining employees.

Similarly the silence of Group Health, being promoted by Senator Cantwell as a model, is also striking. As the Northwest Federation of Community Organizations noted in January of 2008 in its article “Insuring Health or Ensuring Profit?: A Look at the Financial Gains of Washington State’s Health Insurers,” Group Health had the highest per-member-per-month profitability of the three dominant health insurers in Washington state. Now whether this organization or model should be the paradigm for our Senator and our country is questionable and certainly debatable. What cannot be debated is that in its IRS Form 990 for 2007, Group Health spent a total of $1.4 million out of $1.9 billion for “healthy communities programs . . .that promote the overall health and well-being of all members of the community.” In 2006, it spent $800 thousand for “Healthy Communities Programs” out of $1.8 billion. I can say that this is one taxation model and one approach to medical insurance and provisioning that I prefer to forego.

Without question the current Medicare and Medicaid programs as projected by the Congressional Budget Office will double in expense by 2017, raising their current approximate twenty percent of the federal budget to something closer to 35 – 40 percent. We need change here in just the way we are financing it alone, or we need drastic reduction in benefits. I have difficulty thinking that as the baby boomers retire they will support those who give us less. Likewise I have even greater difficulty imagining that the Group Health model that Senator Cantwell supports will make our society any more accountable for contributing to a compassionate, civilized society. Hence, do we really have any choice in the long-term but to begin the transition to the single-payer insurance approach?

Newton Simmons

Seattle

When I am asked to give a presentation on single-payer, I usually bring my projector and my laptop and am able to expound on the benefits of having one public financing system, which, by the way, is the purest definition of a single-payer system.

Single-payer routes 97% of its funding stream to a fair and regulated budget dedicated strictly for providing medical care and services to its benefactors, in other words, to us, the taxpayers. Getting care would be a handsome return on our investment. Not only would the question “Do you have insurance?” be rendered obsolete, it would finally put to rest this ethical conflict of interest: medicine is a calling, not a business! But, what most people don’t realize is that the interest of health will no longer compete against other government priorities for funding, e.g., for education, public transportation, housing, road construction or bridge repairs.

Here’s something else that single-payer would do just by the very nature of it being a public program. The sanctity of the doctor-patient relationship would be restored by putting you and your doctor in control of your medical decisions. It’s about you and your doctor working cooperatively, as partners, rather than as adversarial buyers and sellers. Your doctor would enjoy the professional sovereignty and freedom to diagnose and prescribe treatment while you as a patient have the choice of physician, a right as important as voting and free speech. Should you ever get sick or hurt in an accident, you want to know that your medical interests come first and that you get the same treatment as everyone else. But let me remind you, the United States is the only industrialized nation in the world where a financial middleman determines who gets care and who doesn’t.

In the end, I inform my listeners that it is not up to President Obama or your congressional representative to change our broken health care system. We, the everyday working stiff, have got to defend and protect good health - the most precious gift we have in life. The strength and resolve of all of us in this great country depends on our moral convictions with respect to care for the health of our sons and daughters, mom and dad, our sisters and brothers. I know that you may have read this before, but if we don’t stand up for ourselves, who is going to stand up for us?

Larry Kalb

President

Having worked on operating and capital budgets for more than a dozen years for public agencies, I know that the cost of health care benefits is a critical factor in determining which programs are funded or cut entirely. Rather than talk about how these costs affect our economy in general, I am going to focus on education because, frankly, the quality of our society’s human resource is vital to the social and economic development of future generations to come.

Let me help you connect the financial dots to better grasp what is going on here. Your local School Board announces to the public that that there is a budget shortfall due to the escalation in health care inflation. In order to balance the budget, the Board decides to eliminate some full-time positions for teachers, teacher training programs, classroom aides, crossing guards, and even school nurses. But the Board doesn’t stop there. It also cuts classroom supplies, textbooks, and technology as well as discontinuing band and swimming programs and deferring building maintenance. To bolster the flow of a revenue stream for operations, the Board wants you, the voters, to approve a new tax levy. Once approved, your property taxes go up. The lingering question is: “When is this vicious cycle going to stop robbing our kids’ future of a decent education and draining education of the funding that it so desperately needs?”

Here’s the deal, folks. As long as we keep marching down the historical road of incremental health care reform as one happy family, I will guarantee you that even more cuts are on the way, but they will be deeper than ever and they will really hurt for a long time. Ironically, some people in our community are so afraid of reforming our health care system that, unbeknownst to them, they are directly burdening themselves with higher property taxes to keep the local school operating until there is another call for another tax levy because of health care inflation. Thus the practice of incrementalism in health care reform is leading us down the path of defunding public education.

Just look at Massachusetts as a case in point. To borrow the words of Maggie Mahar, author of the book Money-Driven Medicine, Massachusetts’ reformers didn’t set out to contain costs: their primary goal was to cover everyone, and on that score, they came very close to succeeding. But having insurance doesn’t mean much if you cannot afford to use it. The March 16, 2009 issue of the New York Times reports that Massachusetts expects to spend $595 million more on its health insurance programs this year than in 2006, a 42 percent increase. But if costs continue to spiral, the state will not be able to continue funding its universal health care plan controlled by Massachusetts’ private sector insurers, a fatal flaw in its design. A financial drain that gets 42 percent larger siphons off funding for education at a faster rate. Think about higher property taxes along with ever more out-of-pocket medical expenses and you come up empty handed.

Robbing Peter to pay Paul or as I see it, robbing our kids’ education to pay the bank robber, the insurance companies, is an incremental failure of major proportions. Washington State needs single-payer legislation that will finally stop the deadly financial bleeding of critical funding for education, a systemic change for the common good. Single-payer contains costs by implementing a highly regulated budget program from which it pays hospitals, doctors and pharmaceutical companies while at the same time guaranteeing high quality care for everyone.

As the saying goes, things won’t change until the pain of staying the same is greater than the pain of change. Have we now learned enough by cutting funding for education just to make the insurance companies happy?

Here’s what you can do. Join Health Care for All – Washington and be part of that change to reinvest in our kids’ educational future. Who is going to do it for you, if you don’t?

Larry Kalb

President

Health Care for All - Washington