Rep. Dennis Kucinich

Posted July 3, 2003 at 5:04pm

The Kucinich plan is enhanced “Medicare for All” — a universal, single-payer system of national health insurance, carefully phased in over 10 years. It addresses everyone’s needs, including the 40 million Americans without coverage and those paying exorbitant rates for health insurance. This approach to health care emphasizes patient choice and puts doctors and patients in control of the system, not insurance companies. Coverage will be more complete than private insurance plans, encourage prevention and include prescription drugs.

Health care is currently dominated by insurance firms and health maintenance organizations — institutions that are more bureaucratic and costly than Medicare. People are waiting longer for appointments. Fewer people are getting a doctor of their choice. Physicians are given monetary incentives to deny care. Pre-existing illnesses are being used to deny coverage.

Over time, my plan will remove private insurance companies from the system — along with their waste, paperwork, profits, excessive executive salaries, advertising, sales commissions, etc. — and redirect resources to actual treatment. Insurance companies do not heal or treat anyone, physicians and health practitioners do … and thousands of physicians support a single-payer system because it reduces bureaucracy and shelters the doctor-patient relationship from HMO and insurance company encroachment.

Nonprofit national health insurance will decrease total health care spending while providing more treatment and services — through reductions in bureaucracy and cost-cutting measures such as bulk purchasing of prescriptions drugs. Funding will come primarily from existing government health care spending (more than $1 trillion) and a phased-in tax on employers of 7.7 percent (almost $1 trillion). The employers’ tax is less than the 8.5 percent of payroll now paid on average by companies that provide private insurance.

This type of system — privately delivered health care, publicly financed — has worked well in other countries, none of whom spend as much per capita on health care as the United States. We’re already paying for national health care; we’re just not getting it. The cost-effectiveness of a single-payer system has been affirmed in many studies, including those conducted by the Congressional Budget Office and the General Accounting Office. The GAO has written:

“If the United States were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs (10 percent to private insurers) would be more than enough to offset the expense of universal coverage.”

Over the years, groups and individuals as diverse as Consumers Union, labor unions, the CEO of General Motors, the editorial boards of the Atlanta Journal-Constitution and St. Louis Post-Dispatch, and Physicians for a National Health Program have endorsed a single-payer approach. It is sound economics — what actuaries call “spreading the risk” — to extend Medicare to younger and healthier sectors of our population, thereby putting everyone in one insurance pool. It permanently saves and improves Medicare, while eliminating duplicative private and government bureaucracies.

Although enhanced “Medicare for All” makes economic sense, it has not made political sense to some, due to the power of the private insurance lobby. The streamlined Kucinich plan is very different than the 1993 Clinton HMO-based plan, a complex proposal that left big insurance firms in a central role. After Clinton’s “Managed Competition” plan failed without coming up for a vote, talk-radio host Jim Hightower asked President Bill Clinton why he hadn’t put forward a “simple, straightforward” single-payer plan “instead of all this bureaucracy.” Clinton replied, “I thought it would be easier to pass” a bill that left the insurance industry in place. “I guess I was wrong about that.”

Rep. Dennis Kucinich (Ohio) is a candidate for the Democratic presidential nomination.