Live-blogging: Single-payer health

I generally find discussions about health care to be endless and unenlightening. So why am I live-blogging today’s Midmorning discussion about the future of a single-payer health plan proposals? Because today the game changes for health care when thousands of Minnesotans are thrown under the bus through Gov. Pawlenty’s unallotment plan for balancing the state budget. And thousands more will lose their health care as they continue to lose their jobs. Health care in tough times is a different beast than health care when times are good.

You can listen to today’s show here. I hope you’ll share your stories.

Guests: David Himmelstein, primary care doctor and co-founder of Physicians for a National Health Program. He’s also associate professor of medicine at Harvard University.

Thomas Miller, resident fellow at the American Enterprise Institute. He was former senior health economist for Congress’ Joint Economic Committee.

9:09 a.m. – Kerri just promoted a July 9 event in the UBS Forum on health care. However her instructions won’t work. It’s not listed on the MPR page. I’ll try to get that fixed.

9:11 a.m. – Hillmelstein says the Canadian system has only a few people in a hospital for sending out bills. Back in Boston, a local hospital had 350 people doing the same task. “Each doctors office has to have the clinical staff to fight with the insurance companies,” he said. He says $400 billion could be saved with single-payer.

9:13 a.m. – Miller says “going down a different trail doesn’t deliver all those things that are promised.” He says it’ll just create a different bureaucracy. “Most of the problem is in how health care is delivered…. choices we make.” We hear the choice thing all the time. What does that mean? Getting you to understand the cost more. If you had chest pains and the ambulance costs $900, would you be less likely to pay attention to the chest pains?

9:16 a.m. – Thirty-one cents of every health care dollar goes to bureaucracy, Himmelstein claims. Miller disagrees and cites this data. There, by the way, you’ll find a list of how fast health care costs are growing (thru 2004). In Minnesota — 7.6%.

“He’s absolutely lying” Himmelstein counters. Oh dear. This has potential to be YouTube comments section.

9:21 a.m. — Caller: Sheila in St. Croix Falls. Would there be an option so that insurance are run as non-profits?

Miller: There’ve been different ways to propose that. Sen. Conrad of North Dakota reflected uneasiness among moderate Democrats who want to have a cooperative insurance plan through the government w/o heavy hands. Howard Dean rejected this idea.

Miller says we’re not going to take profit out of the health-care system in this country. Himmelstein says the idea would help, but not that much.

9:25 a.m. – “Why is single payer a non-starter on Capitol Hill,” Kerri Miller asks.

“Most doctors aren’t going to be activists,” Himmelstein says. “The majority of doctors are with us, but I think the reason it’s not on the agenda in Washington is clear. There’s an industry here that does nothing useful and is taking money from the American people — the health insurance industry.” The industry is a big campaign contributor, he says.

9:27 a.m. – Health Insurers Owe Policyholders, But Pay Congress Instead

9:29 a.m. – Obama referred to a ‘public plan option’ yesterday. Is that single-payer? “Same railroad track, different speeds, reflecting political realities,” Miller says. “We’ve already overloaded the government with massive amounts of debt; You just can’t absorb that much.”

9:30 a.m. – Caller Tim from Duluth says Canadians come to the U.S. for their health care needs. “The Canadian insurance industry wants to portray that as true,” Himmelstein says, “but it’s not true.” He says surveys of hospitals along the border — including the Mayo Clinic — and they found a few Canadians come across the border for care, but not many. The Mayo Clinic, by the way, actively recruits Canadian patients.

9:33 a.m. — Here are the details of the July 9 event in the UBS Forum on health care. (h/t: Michael Wells)

9:35 a.m. – Recommended reading during the news break:

Kathleen Sibelius “This is not a trick”

Red State Single Women: Support Single Payer Healthcare, or Stay Virgins

9:38 a.m. – Caller John from Minneapolis. “The paperwork has gotten out of hand. We do less paperwork than the nursing staff but it increases all the time. I’ve yet to take care of a disgruntled Canadian patient.” (He works for HealthEast)

Tom Miller says “I don’t want to make up numbers.” He gives his email address: and says he’ll email information comparing the two systems. “There’s not a gigantic pile of money (through cutting waste) that’s going to solve all of our problems.”

9:41 a.m. – An online commenter says he/she worries that a single-payer plan would operate “like the DMV,” slow and inefficient with poor service. “That’s what we have now,” Himmelstein counters.

9:42 a.m. – Doctors weigh in on health care plan as outlined by President Obama.

9:47 a.m. Caller Henry in Owatonna: “I lived and practiced in Canada and I now practice in the U.S. When it (Canadian system) first started, I thought I’d gone to heaven. 100% were insured and it made no difference to how I related to patients. After about 15 years, the government found the plan was too expensive for them and the government started budgeting hospitals the way you do school districts… They would give a hospital administrator $100 million to run the hospital for a year. To get the cost down, the administrator finds things that don’t cost much — my mother had a stroke and spent 9 months in the hospital. Here in Owatonna, they’d have spent a week.”

9:48 a.m. – “We spend $8,000 per person, they spend $4,000 per person and they deliver better care,” Himmelstein says. He says for whatever money is spent, a Canadian-style plan gets you better care.

Based on what you heard, do you favor a single-payer health plan in the United States?(polling)

9:52 a.m. – Would it make sense to try it on a state level? No, says Miller. There are three barriers: “Politics, economics, compulsion,” he says.

Himmelstein says there should be an option to buy supplemental coverage over a state or federal single-payer plan. “You can’t make the system run with private insurers in the middle of it,” he says.

9:55 a.m. – Online comment from Eagan:

I keep excellent health and pay $600 a month premium and my employer pays atleast that much towards my health care. Literally I dread the occassions to visit a doctor. As much as I can, I keep fit by good eating habits and exercise routine.

I feel sorry for those people who donot have health insurance and my heart goes out to those who file for bankruptcy because of health care costs.

Medicine in USA is treated as money making machine for business and not as keeping healthy citizens and treating deceases. Now the entities who fear loss of their profits are fighting tooth and nail to protect, all the in the name of free choice. Only people waking upto this reality and actively participating in the debate will make a difference.

9:56 a.m. – Miller and Himmelstein debate whether one of them is lying. Welcome to TV cable talk show.

9:58 a.m. – I’m not sure anything much has been accomplished. This remains a hot-button issue, of course. BTW, here’s an interesting blog post on NPR Check on how the issue was covered recently.

// end of live blog

==> An additional blog post with more information can be found here.