Single-payer health care gains steam as Dems rally around it

a Friday, May 6, 2016 photo, LSU medical student Felicia Venable,
left, briefs fellow students and medical residents on a patient
they are visiting during daily rounds with a group of medical
residents and medical students at Our Lady of the Lake Regional
Medical Center in Baton Rouge, La.

Gerald Herbert/AP Images

Once confined to the fringes of debate, the idea of single-payer
healthcare is making a comeback with support from some unlikely

Single-payer healthcare is a system used in Canada, France,
the UK, Australia, and other countries. In theory, it provides
near-universal coverage through the government rather than
private insurance companies (some countries use a hybrid
public/private structure).

While progressive groups have long pushed for a single-payer
system in the US, Democratic Party leaders are starting to
suggest they are open to advocating for such a system.

“We’re going to look at broader things” for the nation’s
healthcare system, Senate Minority Leader Chuck Schumer said on
ABC. “Single-payer is one of them.”

Some of the richest and most powerful Americans — many of them
Republicans — have recently brought up the possibility of
shifting to the single-payer system. It comes as the
Republican-controlled government has spent months attempting to
revamp the US healthcare system with legislation that would move
the system further away from single-payer.

Perhaps the most striking was the recent admission by Aetna CEO
Mark Bertolini, at a private conference, that the US should start
considering the idea.

According to Vox’s Sarah Kliff
, Bertolini told Aetna
employees at a town-hall-style meeting in May that regarding
single-payer, “I think we should have that debate as a nation.”

Kliff said, according to a person who was in attendance and
provided the comments, that Bertolini did not support a
total government-run single-payer system, but could be open to a
private-public system that is used in some nations.

“So the industry has always been the back room for
government,” Bertolini said. “If the government wants to pay all
the bills, and employers want to stop offering coverage, and we
can be there in a public private partnership to do the work we do
today with Medicare, and with Medicaid at every state level, we
run the Medicaid programs for them, then let’s have that

The idea for Bertolini is that the government would finance
insurers to provide the care, similar to a Medicare-for-all. The
Aetna CEO, however, didn’t think total government run healthcare
was the solution, which makes sense considering it would put him
out of business.

“But if we want to turn it all over to the government to
run, is the government really the right place to run all this
stuff?” Bertolini said. “And that’s the debate that needs to be
had. They could finance it, and if there is one financier, and
you could call that single-payer.”

The shift is understandable for Aetna, since for the
first-time most of its business is coming from government
programs like Medicare and Medicaid. Additionally, as Bertolini
repeatedly likes to point out in interviews, the insurer was the
first Medicare provider in 1965.

In addition to the CEO of one of the five largest public
insurers in the US, the single-payer idea has also received
recent calls of support from business titans Warren Buffett and
Charlie Munger.

charlie munger and warren buffettEric Francis/Getty Images

Munger, who is a Republican, railed against the current US
healthcare system at Berkshire’s annual meeting on May 6, and in
subsequent interviews said the country should shift to

“The whole system is cockamamie,” Munger said in an
interview with CNBC’s Becky Quick on Monday. “It’s almost
ridiculous in its complexity and it’s steadily increasing cost
and Warren is absolutely right. It gives our companies a big
disadvantage in competing with other manufacturers. They’ve got
single-payer medicine and we’re paying it out of the

Buffett, when asked by Quick if he supported single-payer,
said, “I personally do.”

Buffett also bemoaned the fact that the US pays roughly 17%
of GDP to healthcare costs (according
to the Centers for Medicare and Medicaid Services
, it was
17.8% of GDP in 2015), much higher than any other developed
nation. The Berkshire CEO noted that these increased costs for
businesses are holding back American competitiveness, rather than
the corporate tax rate.

Even President Donald Trump, who has supported
Republican-led efforts to overhaul the healthcare system, has
praised Australia’s public-private system (the government pays
roughly 70% of all healthcare costs). He did so in a meeting with
Prime Minister Malcolm Turnbull and in subsequent tweets.

“I shouldn’t say this to our great gentlemen and my friend
from Australia … cause you have better healthcare than we do,”

Trump said in his meeting with Turnbull on May 5.

After critics noted that Australia has a universal
healthcare system in which the government pays roughly 70% of all
costs, Trump took to Twitter to defend the comment the next

“Of course the Australians have better healthcare than we
do — everybody does,”
Trump tweeted.

With Republican control of the presidency and Congress,
much of the talk about single-payer will amount to just talk on
the national level. 

There is some action being
taken on the state level, though. Both
 have recently discussed legislation that
would provide single-payer in those states. Other states have
also discussed the issue in the past.


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