Executive Summary: O'Connor Contest on Health Care Reform

The health care system that Americans want requires guaranteed access, freedom of choice, high quality affordable care, trust and respect, and some control over the system. They get almost exactly the opposite. The public is rapidly losing respect for the medical profession that seems to have joined hands with the greedy for-profit sector by helping HMOs and the health insurance industry to abolish free choice while compromising quality. The greed that has been manifest in corporate America has severely infected physicians as well.

With 30,000,000 patients uninsured and double that number underinsured, the American "health care non-system" is sick. Few policy makers seem to have noticed. The quality of care delivered by the for-profit HMO's is below that of the not-for-profit sector in almost every category including mortality rates. A recent study by Rand Corporation revealed that about 50% of patient visits to doctors resulted in sub-standard care. Another study by the Harvard School of Public Health indicated that as many as 100,000 lives were lost annually to medication errors. The sorry performance of the for-profit HMOs is therefore worse than one might think, since it is judged against a poor performance by the "health care non-system" as a whole. Because of this lack of concern for the health of unfortunate citizens, the U.S. is likely to be judged harshly by posterity.

This paper maintains that we get too little for too much. The U.S. spends twice as much as almost every Western nation for health care and is ranked a disgraceful 37th by the World Health Organization for quality of health care. America also rates poorly in infant mortality. We can do better. Americans must seize the moment and insist that public officials take up the adoption of a single payer system.

The single payer health care system can be financed with a value-added tax such as that used in Europe. If this route is chosen the current tax on corporate income could be abolished to pacify corporate America. The business community would welcome abolishing this tax. Financing can also be done with an increase and extension of Social Security taxes to cover all income rather than just salaries with a variable cap currently at about $80,000. Extending Social Security to cover all income including capital gains and all other passive income will make the tax less regressive by increasing contributions of higher income earners while reducing the relative load on the low wage earners. It will finally rid the Social Security System of the illusion of being an insurance program rather than what it actually is—a system financed by a regressive tax. Alternatively, some combination of the two taxes could be used.

A single payer health care system with this approach would diminish the financial load on corporations by canceling the need for health care insurance. Likewise, employees would pay less than they currently pay in health insurance premiums. Although both employer and employee would lose tax deductions, the savings realized from an efficient single-payer health care system would more than make up for the loss. This proposal would give the nation a much more effective health care system for less money than we are currently spending.

Back to top