This is the personal blog of Rick Staggenborg, MD. The opinions expressed here do not necessarily reflect the official positions of Take Back America for the People, an educational 501.c3 nonprofit established by Dr Staggenborg.

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Monday, January 7, 2013


Medical insurers around the country are announcing a new round of double-digit premium increases, belying the promise that Obamacare would reduce costs of health care. Although the “Affordable” Health Care Act is not yet fully implemented, it is reasonable to assume that the further expansion of benefits will dwarf the promised savings as detailed in the error-filled CBO report Democrats use to justify the claim. The fact is that the ACA was never meant to be real health care reform, which can only be achieved through truly universal health care in the form of a single payer, Medicare-for-All model or something similar. What it amounts to is a taxpayer bailout of a failing medical insurance industry.

People who wonder how the tremendously profitable insurance industry can be failing need only consider the basic fact that as medical insurance costs rise, fewer people can afford it and profits drop, forcing further premium increases to maintain profit margins. This is the “death spiral” that single payer proponents have talked about from the beginning of the health care “reform” debate but which was ignored by the corporate media and both major Parties. It is time that taxpayers demand an honest discussion about the one option for addressing the crisis in health care access and affordability. Congress will continue to avoid this debate if we do not force them to. We need to make them fear us more than the anger of their political patrons in the medical-industrial complex of the insurance, pharmaceutical and corporate health care delivery industries.

Democratic politicians used a very clever strategy to avoid talking about true universal health care. At the outset of the debate, they took single payer off the table, arguing the self-fulfilling prophecy that it was “not politically possible.” Knowing that many of their own members were as dependent on campaign contributions from these industries as are the Republicans, they deliberately undermined support for Medicare-for-All by presenting a classic bait-and-switch in the form of a public option that had no chance of leading to single payer. The cat was out of the bag when Democratic Senator Chuck Schumer assured the medical insurance industry that they had no intention of creating a public option that could compete with for-profit insurance. 

It should have been obvious from the beginning, when Senate Finance committee chair Max Baucus was put in charge of the debate. He was the recipient of $6 million from corporations in the medical-insurance complex in the election cycle preceding the debacle. It is no surprise that he had 13 doctors, nurses and lawyers arrested during the first two days of hearings for “disrupting” the discussions with the representatives of industry by calling from the gallery for consideration of a single payer option.

To assure that there would not be mass dissention in the Democratic rank and file, Rahm Emanuel cleverly convinced Democracy for America and MoveOn to make the spurious claim that there millions of members supported the public option, without questioning those members or having any sort of open debate that would have demonstrated the overwhelming support for single payer that was evident at NetRoots Nation in Pittsburgh in 2009. In the end, Democrats gave up even the pretense of universal health care in accepting what was essentially Ron Wyden’s Healthy Americans Act. The insurance exchange, the mandate and other features of Obamacare came straight from that plan, which was put on the back burner while the phony debate about the public option was going on. Democratic leaders declared victory and told their supporters to go home and tell everyone what a good job they did against the big, bad Republicans and the insurance industry that got millions of new customers at the taxpayer’s expense. 

Health care costs are approaching 20% of GDP, with no prospects of improvement in sight. If Democrats and Republicans do not unite to demand their politicians have an honest debate on the merits of single payer they will continue to see personal and taxpayer costs escalate, adding to personal and federal debt in a time when Congress claims the latter is a crisis. What most Thanks to the fact that corporate interests control the terms of political debate, most Americans don’t realize that they are already paying more than the full costs of a universal health care system through taxes, subsidies and personal health care expenditures. 

Taxes for Medicare, Medicaid and the uninsured alone are nearly enough to fit the bill for a system of universal health care that already exists in other countries and costs about half what we pay in the American system that still leaves nearly 50 million uninsured, mostly working Americans and their families. Despite increased coverage of young adults, about 9 million children remain uninsured. This total exceeds the estimated 45 million uninsured before the medical insurance "reform" debate in 2009. Other unaddressed costs include medical bankruptcies, loss of competitiveness by employers who pay the brunt of the cost of insurance, lost productivity by the uninsured, failed businesses for entrepreneurs who lose their businesses when they are sick or injured and on and on. 

Peter DeFazio (D-OR) has a well-deserved reputation as a fighter for the average American, but he gave in far too readily to the fallacy that we cannot afford to give Medicare to everyone because “it has (financial) problems of its own.” Belatedly, he has acknowledged that the worst of these problems is the Wyden-supported Medicare Modernization Act of 2003 that gave us an unfunded Medicare prescription benefit plan under which pharmaceutical manufacturers can name their own price and the government is not allowed to negotiate. Even now, he refuses to discuss single payer with members of Physicians for a National Health Program. I know this because I have repeatedly asked him myself. This explains why he is still ignorant of the fact that the reason universal Medicare coverage will save Medicare is that it covers both the healthy and the sick, creating a universal risk pool so that everyone pays and everyone has access when they need medical care.

A universal health care system is inevitable unless Americans choose to give up their own access to health care. Even Republicans can’t make that seem like a good thing. If Democrats don’t join third parties and independents in calling for an honest debate on single payer health care, they will follow Republicans in the ashcan of history when Americans wake up to their collective power and vote for candidates who will put their interests over corporate profit.

To hear a discussion about health care and democracy, listen to this podcast from SFPI Radio, the voice of Soldiers For Peace International on the worldwide web every Saturday.


  1. We're coming up on the 7th anniversary of this excellent post. It's even more relevant today, December 2019, as 2020 presidential candidates ranging from Joe "Nothing Would Fundamentally Change" Biden to Pete "President McKinsey" Buttigieg beat the drum for a Medicare-for-those-who-want-it public option, cheered on by corporate media.

    The author mentions a public-option death spiral. See also:

    What do we really want? Why should ordinary folks be mobbing their members of Congress to demand single-payer universal healthcare, Medicare for All?

    1. Rick Staggenborg, MDDecember 12, 2019 at 6:02 PM

      Thanks for your supportive comments, Ira. I shared this old post recently because I have trouble writing repeatedly about things that should have been plain years ago. I appreciate your reminding me that I should emulate other bloggers who revisit old themes so that people who weren't interested or aware of these issues in the past might consider them, and others consider them anew.