Advocates of single-payer health care are working to persuade the nation that nothing less than a major change to a single-payer system can solve our health care problems. They propose to cut out the insurance companies and HMOs with their high administrative costs and profits and to redirect those funds to coverage for all.

Ida Hellander, MD, executive director of Physicians for a National Health Program (PNHP), told the World, “Single payer would cover more people for less. Once people learn about single payer, they never forget. Vague talk of universal coverage is inadequate. We need to speak specifically as to why single payer will bring higher quality, is more humane, and is much less expensive. We are spending more than we need to. We are spending more money on healthcare than other countries – and getting less care.”

The U.S. spends over 14 percent of its national income on health care yet more that 40 million people are without coverage. Another 40 million have inadequate coverage. Insurance and prescriptions costs have escalated geometrically, and unions find it harder to negotiate health benefits. Shutdowns and layoffs threaten millions of workers, including tens of thousands of steelworkers, with loss of their health plans. HMOs often deny care as evidenced by the photos taped to glass jars in convenience stores as families and friends try to raise the money for care.

Single payer advocates are raising healthcare to code red on the nation’s priorities. Dr. Hellander projected that a single payer bill will be introduced into Congress sometime this spring. PNHP has two dozen chapters working on both the national and the state efforts. “The state and national activities are synergistic – each helps to advance the other,” said Dr. Hellander.

In 2000, Maine lawmakers created the Health Security board to generate a proposal for universal single-payer health care. The report and plan are due in March 2002. Last November the Maine People’s Alliance and Consumers for Affordable Health Care beat the wealthy insurance industry 52 percent to 48 percent when voters expressed public approval in a referendum for universal health care in Portland, Maine. The opponents outspent them by 25 to one. Still universal healthcare won. Maine’s single payer bill (LD-1277) passed the state’s House but not its Senate.

Oregon activists have collected over 40,000 of the 67,000 signatures necessary to place their single payer initiative on the ballot for Nov. 5. Health Care for All Oregon plans to collect 80,000 signatures by July. On March 10, the group was successful in winning adoption of a “single-payer health care delivery plan for all of Oregon” as the top priority plank in the state Democratic Party platform.

The Massachusetts Campaign for Single Payer Health Care has won referenda questions in at least six senatorial districts and seven representative districts. The campaign achieved city council, select board or town meeting endorsements in Brookline, Cambridge, Northampton, Amherst, Leverett, Hawley, Greenfield, Adams, Hancock, Windsor and Lee. The Campaign, a coalition of over 75 organizations, is working to build the grassroots clout to pass the Massachusetts Health Trust Bill.

In Vermont, single payer advocates are preparing for a statewide conference on May 11 to plan their campaign. Last November Vermonters welcomed a study by the Lewin Group that found that the state could save $118 million a year while extending care to everyone under a single payer system.

At a meeting in Bellow Falls to report on the study, Rockingham physician Matthew Peake asked why anyone would oppose universal healthcare with such dramatic cuts in costs. Dr. Deborah Richter, a Cambridge Physician and member of Physicians for a National Health Program, responded: “Did you miss the part of the plan that gets rid of the insurance companies.” She stated that two thirds of the people in the country agree with universal single payer healthcare while the insurance and pharmaceutical companies have a lot of money to work against it. Still she predicted that Vermont would win universal single payer health care within five years.

In Rhode Island, the coalition for Consumer Justice won a legislative grant for an economic feasibility study of Rhode Island’s health care system in mid-2001. The School of Public Health of Boston University will be conducting the study.

Single payer advocates have achieved introduction of the legislation in Missouri, Vermont, California, Massachusetts, and the list is growing. The Des Moines Register, the largest daily newspaper in Iowa, endorsed single-payer national health insurance last January.

“This issue is the same as abolition of slavery and the women’s right to vote. It is not minor,” said Dr. Hellander. “It means a total revamping of the way we look at health care. Corporations see health care as a commodity – a way to make money. People see it as a right.”

The author can be reached at pww@pww.org

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