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Single Payer Health Care

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A veteran of the past health care battle, former Mont. Rep. Pat Williams says even if single-payer won't pass, it deserves a hearing.

After 60 years of suffering the enormous, costly inequities in private health insurance, the Congress finally recognizes that only a common effort, led by the national government, can reform what is an obsolete, broken health insurance model. For the first time in many decades, Americans are experiencing reform impulses and once again have a healthy skepticism about the corporate-controlled market place. For the first time in 30 years the Congress has the winds of reform, change, at its back.

Nonetheless, both the U.S. Senate and House are choosing to accomplish reform not through an efficient, simple process such as single-payer but rather by layering onto the current private system. Although most Americans want something far more direct and less costly,
the insurance industry does not. Guess which group, thus far at least, has Congress's ear.

Members of Congress believe, correctly, that single-payer does not have the votes to pass. That does not, however, absolve them from considering single-payer and conducting hearings dedicated to it or, at the very least, inviting experts of that system to testify at the general
hearings on the issue.

I refer to this with some experience. When Pres. Clinton offered his plan for universal healthcare coverage in the fall of 1993, I was chairman of the House Committee on Labor Management-one of the three subcommittees in the U.S. House with jurisdiction over the issue. As chair, I knew full well that single-payer was unlikely to pass the House and would surely die in the Senate which, frankly, was cowed by reform opponents. Nonetheless, my committee and I decided to have hearings on both the President's complex proposal and single-payer, both of which I sponsored. The dual process was very beneficial; each proposal informed the other. Our committee came to understand that there were benefits and liabilities in both plans and considering them together allowed us to improve each.

I managed to round up the votes to pass the two bills through both my committee and the full committee of Education and Labor. Unfortunately that was the end of the reform road. Suspecting that the Senate would not act, we held my bills. The Senate eventually refused to
even consider reform.

Can single-payer pass this time? No. However, the champion of healthcare reform, Sen. Ted Kennedy, has the best idea about making something out of the current flawed efforts. He has proposed a version of single-payer as an integral piece of the current reform proposals. He
has proposed to include within the overall legislation a separate, truly public healthcare option. No doubt because of Kennedy and out of respect for him and "the cause of his lifetime," Pres. Obama recently wrote to both Sen. Kennedy, who chairs the Committee on Education and Labor, and to Sen. Max Baucus, chair of the Senate Finance Committee, "I strongly believe that Americans should have the choice of a public health insurance option operating alongside private plans. This will give them a better range of choices, make the healthcare market more competitive and keep insurance companies honest."

A recent nationwide poll shows that 72% of Americans support the public option. Will we get one? Yes, but it is likely to be a watered down version that will be far more acceptable to the insurance companies than it will be to Sen. Kennedy. As New York's Sen. Chuck Schumer recently said, "It's pretty certain that Sen. Kennedy could not support the Baucus plan and Sen. Baucus could not support the Kennedy plan." With the gravely ill Ted Kennedy unable to put his full energy into passing his proposal, it will apparently be up to the House and the
President to act as the public's backstop in passing a bill that contains a good, competitive public healthcare option. That is, in fact, the sad predicament because the Senate Finance Committee is more interested in "consensus" and "bipartisanship" (i.e., agreeing with the
insurance companies) than it is in fighting for full appropriate healthcare reform and wrangling the majority necessary to pass it-even if by only one vote.

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