Sick of it

“I’m mad as hell.” Diane Krieg, a petite, athletic 40-something blonde, was in no mood to mince words. “I’m paying 250 bucks a month not to be covered.” Her health insurance, which has a monthly premium of $250, also has a $5,000 deductible. “If I get sick enough to go through the deductible, I’ll be too sick to work and make the payments. I might as well have no insurance at all.”

This dilemma brought Krieg to the Hart Senior Center last Saturday morning for an event billed as “Sicko 101.” Described as a “teach-in” on Senate Bill 840 and single-payer health care, the event drew a standing-room-only crowd of more than 100 locals. Some, like Krieg, were hoping to find out about alternatives to their health-insurance dilemmas. Others simply wanted more information about the bill, sponsored by state Senator Sheila Kuehl, D-Los Angeles, which has just been moved out of the Assembly’s health-care committee.

Sponsored by Health Care for All, a grassroots group lobbying for a single-payer health-care system in California, the meeting took its name—with filmmaker Michael Moore’s permission—from the documentary Sicko, currently in theaters. Most attendees apparently had seen the film, and references to it were almost as frequent as bad imitations of Governor Arnold Schwarzenegger.

A panel made up of Carolyn Negretti and Joe Dion from HCA and Dr. Robert Vizzard of the California Physicians Alliance presented a thumbnail sketch that defined single-payer health care—a health-care system in which health care is managed and paid for entirely by one source, usually a government agency—and showed how SB 840, should it become law, might work for Californians.

The point—made by each speaker—was that the single-payer system devised in SB 840 is universal, unlike more limited alternatives offered by Schwarzenegger and state Assembly Speaker Fabián Núñez, D-Los Angeles.

“I think we all agree that everyone should have health care,” said Negretti. Unlike Schwarzenegger’s plan, which would mandate that individuals purchase health insurance (and provide subsidies for people with lower incomes), and Núñez’s plan, which would mandate that employers provide coverage (and also provide some subsidies—as well as exceptions for small businesses and the self-employed), Senator Kuehl’s bill covers every Californian.

“No matter what, the answer is: You’re covered,” said Vizzard. An emergency physician, Vizzard has no health insurance. “I was two days late with a COBRA payment,” he told the audience. “I’m one heart attack away from disaster.

Dion pointed out that single-payer insurance “is absolutely not ‘socialized medicine.’” People will be able to choose their doctors and hospitals still will be privately owned. “It’s just that the state pays the bills,” he said. And, he noted, California already has some smaller-scale single-payer programs: CalPERS and CalSTRS, for example.

“Everybody says you can’t trust government, but we know you can’t trust the insurance companies,” said Negretti. The speakers—often referring to Moore’s film—pointed out how much of the insurance companies’ profits depend on denying care and avoiding insuring people who need medical care.

“Insurance companies are in business to make a profit,” Vizzard said, “and their profits come from insuring people who don’t need insurance.”

Health insurance can be obtained in group policies—usually offered by employers—or individual policies, which are often quite expensive. In either case, some exclusions might apply and certain treatments or pre-existing conditions might not be covered. In the case of individual policies, health exams often are required to qualify for coverage.

But the cost of paying for health care falls squarely on the individual; each consumer must either pay their medical bills or pay their insurance company to pay the bills.

So how will SB 840 save money?

“This gets a little wonk-ish,” Vizzard warned as he began explaining where the savings comes from. Ultimately, he claimed, the state—and by extension the taxpayers—would save billions simply by eliminating the multiple levels of administration that currently plague the health-care system. Eliminating that overhead would save, he said, “$9 billion the first year, and $253 billion over 10 years.”

The single-payer system in SB 840 will be financed by payroll taxes: 8 percent from employers and 4.5 percent from employees. Since both will be relieved of the obligation to contribute toward health insurance, Dion claimed this will result in savings for both parties.

“Single-payer is based on the same principle as police departments or fire departments,” Vizzard said. Rather than having for-profit companies provide services such as these, the public—taxpayers—fund them. While individual taxpayers may never need the most advanced services, the police and fire departments stand ready as needed. “Health care is a shared need, so we share the burden of paying for it,” Vizzard said, “and it’s there when we need it.”

As Dion pointed out, the real problem with health care is not the uninsured, who often can gain access to care through programs for indigents. “The insured are in trouble, too. Do you know what’s in your policy?” Dion asked. “All you have to do is get sick and you’ll find out.”