Physicians for a National Health Program:

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 47 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do

Bruce Dixon:

No presidential administration keeps its promises without relentless pressure from below. It's never happened before, and there's no reason to expect any different. The popular demand for jobs, peace and justice are the concrete “change” Democratic voters believe in, and what swept Obama and his party to power. The self-made crisis of the US auto industry is the perfect opportunity to make good on two of those promises. It's not just the first test of whether an Obama administration intends to serve its voters or its wealthy corporate campaign contributors. It's the first test of whether Obama's popular base can or will hold the new president and his party accountable for producing the “change” they promised.

The US auto industry is in deep trouble. There's no room for doubt about that. But there are plenty of reasons to disbelieve the explanations of and doubt the possible solutions to the crisis put forth by our bipartisan political elite, their mouthpieces in the corporate media and public office.

The media and politicians have exhibited amazing discipline in that few of the analyses and none of the solutions advanced in the mainstream media take into account the competitive advantage of universal free health care enjoyed by auto makers in Canada, Japan and Western Europe. The biggest difference between US and foreign auto production is that only US automakers are saddled with the burden of paying the health care costs of current workers and retirees.

To make matters worse, beginning in the Reagan administration, federal laws allowed automakers to spend their employee pension funds on executive bonuses and bad investments and not repay them. After three decades of executive raids on the money that should pay for pensions and medical care, there is nothing left. GM alone has at least $5 billion in unpayable pension and medical liabilities, money it deducted from worker paychecks for decades and promised to prudently invest and safeguard but instead spent.

What well-disciplined mainstream pundits never mention is that more than any other single factor over the last thirty-five years, the drive to avoid paying medical benefits for its current and retired workers has shaped the US auto industry's decisions about which plants to open and close and where to locate its new operations. When foreign automakers began locating plants in the US in the 1980s they enjoyed a competitive edge over US production lines located in Michigan, Ohio, Indiana, Wisconsin and Illinois for a generation because their younger workforces had fewer medical bills and they had no retired workers to pay pensions and medical benefits for. GM, Ford and Chrysler learned that lesson quickly and well. They abandoned nearly every assembly plant open thirty years or longer, not because machinery and production methods couldn't be modernized, but to cut the number of workers in their forties and fifties, who use their medical coverage significantly more than workers in their twenties, and to stop new retirees coming online for whose pensions and medical bills they would be liable.

Of course the US auto industry could have produced greener cars in greener plants. They should have invested more in hybrid, electric vehicle and fuel cell technologies. They might have used their marketing muscle to create demand for smaller cars instead of SUVs. But why should they? Foreign automakers haven't done much better at any of these things either, especially in the US market. And apart from health care expenses, many foreign and Canadian auto workers are paid as much or more than their US counterparts. So none of these serve to explain why foreign automakers have out-competed the US for a generation.

The big difference that establishment politicians turn a blind eye to, and media pundits refuse to mention in print or on the air has always been government-paid universal health care as a human right in Europe and Japan compared to a health care system in the hands of private for-profit insurers in the US. Universal free health care is the secret competitive weapon of the Japanese, Canadian and European auto industries.

This is not the time to lay back, to wait and see what the new administration does or wants to do. Every day we wait before organizing to inform each other and publicly pressure the new president and his party to keep their promises is a day that the parasitic private health insurers enjoy unrestricted and unfettered access to the new administration behind the scenes. Elite pressure occurs behind the scenes. Pressure in the public interest is-- well-- public.

This won't be easy. Nearly every Democratic president since Harry Truman has aimed at some kind of solution to the health care mess. Producing an aroused public makes it easier for the new administration and its party to do the right thing. But if we don't get loud about the link between saving jobs and delivering health care early in an Obama administration, a precious opportunity will be lost that we may never see again.

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