Friday, January 19, 2007

Single Payer is Necessary Now

While I was busy blogging about California's and Pennsylvania's Health Care Proposals just put forth last and this week respectively Guy Saperstein, one of the "100 Most Influential Lawyers in America" (according to the National Law Journal) posted a compelling case for a single payer health care system on AlterNet on Tuesday.

Saperstein correctly points out that by every objective documented measure the US has a second rate health care system which, too boot, is economically unsustainable. Also he states we are paying for a massive,inefficient bureaucracy - namely the private insurance based health care system destined collapse our system.

The reason,he says, however that the Dems are not generally endorsing a single payer system,like Medicare,which already exists for 40 years and does generally work, is that a single payer system will be viewed as "socialized medicine" and therefore is not politically viable. Fear among politicians of the Insurance industry and Big PhRMA/BIO lobbies are very real.

I began asking the question on this blog beginning in a Feb 06, as the Nov 06 elections loomed in Nov "where are the Dems on Health Care?- Where was Democratic leader Dr. Howard Dean?" Hearing silence I turned to writing about creative solutions from Governors and a few ex-governors.(Richard Lamm and John Kitzhaber)

Well apparently Dr. Dean has recently appeared (re-appeared?) on this issue endorsing single-payer at a Democratic Alliance conference in Miami correctly saying that "healthcare is emerging as a top-tier political issue?" Really? I thought every credible poll has been telling us that for at least two years?

Well it's still not to late and I say we rally around Dr.Dean and The Democratic Alliance- A group of Progressive Philanthropists and the American public who is fed up to get this job done now.

My one regret about the Saperstein piece on AlterNet on Tuesday is that it failed to reference even one word about prevention and health promotion- clearly our only way out of the economic meltdown of our high-tech, high cost "disease" care system.

So I again include my own 8 point health care plan from 1995 called "Grow Up America" below which undoubtedly is even less politically viable than a single payer system


- Stop prolonging death. It's both expensive and dehumanizing at best, greedy and cruel at worst.

- Empower US citizens to assume increased individual responsibility for health and convince medical consumers that it is in their best interests not to assume the role of helpless, dependent victims/patients.

- Yet also recognize that we have medicalized America’s social problems. So we must provide healthy and safe jobs for all able citizens thereby reducing poverty and all its subsequent health impacts (possibly 1/3rd of Health Care Costs)

- Provide healthy environments including healthy air, water, soil and food.

- Rebuild America's public health infrastructure to ensure we provide appropriate macro and individual interventions to especially low income citizens such as childhood and adult immunizations and response to man-made and natural catastrophes.(added 2006)

- Face the reality that a very large percentage of illnesses, injuries and hospitalizations are entirely preventable. Subsequently, the elimination of tobacco, alcohol, drug and medication abuse alone could immediately reduce medical costs by a factor of at least fifty percent.

- Incent and train physicians to maintain the health of patients and populations. Radical changes in provider re-imbursement and medical education strategies are necessary

- Recognize that early childhood preventive medical education can profoundly affect lifelong health behaviors.

I would posit that my plan would cut health care costs anywhere from 1/3rd to 1/2 of our current 2 Billion dollars =16% of our GNP national health expenditures

But, alas, I am a realist? Who wants to grow up? Some patients that I see do but probably not enough to vote for a preventive based health care system?

Anyway Saperstein characterizes the current US health care system as "fast approaching a perfect storm". He is correct and we need to read his article and turn it into federal legislation quickly.

I'll wait for another decade for Prevention! I am a patient but persistant man.

Be Well all,

Dr. Rick Lippin

PS- Hey Michael Moore - Where is your movie on the US Health Care crisis allegedly entitled SICKO?


Blogger Cervantes said...

I appreciate your strong emphasis on public health in the context of discussing the organization of health care. As I have confessed on Stayin' Alive, it's too easy to spend most of our time and energy focusing on the medical institution when we know that it is not the primary determinant of health.

It's also very sad that in our political culture, it is possible to destroy any hope for a rational policy just by yelling words like "socialism."

6:25 AM  
Blogger Blake said...

Coudn't agree more Cervantes- And thanks.

Howard Dean seems to be coming out of the woodwork on single payer?

Do you think Dean can influence his colleagues to go along with him?

Dr.Rick Lippin

9:55 AM  
Anonymous Shams Kairys said...

Great post Rick.

I originally read your subject line as "Single Prayer is Necessary Now"!

Still have one LARGE quibble with your otherwise excellent 8 point plan:

-Face the reality that a very large percentage of illnesses, injuries and hospitalizations are entirely preventable. Subsequently, the elimination of tobacco, alcohol, drug and medication AND DIETARY abuse alone could immediately reduce medical costs by a factor of at least fifty percent.

The Standard American Diet is SAD indeed.

See the Surgeon General's Report on Nutrition and Health, the first comprehensive review by the Public Health Service of scientific evidence on the link between diet and chronic disease:

Shams Kairys

11:34 AM  
Blogger Blake said...


This is an excellent addition to the language of my plan

I will add the word "DIETARY" to my plan.

The human sufferring and costs associated with a poor diet are absolutely unacceptable, getting worse, and need to be addressed in any U.S. Health Care Reform Plan

I am in your debt for pointing out this oversight on my part.

Rick Lippin

11:40 AM  

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