Single-Payer to the Rescue: Why a National Healthcare System Will Save Our Cities — by Jeff Muckensturm

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The U.S. and its cities are in the midst of a healthcare crisis caused by a broken system that values profit over quality, affordable care.

Cities faced with rapidly increasing employee health insurance premiums, including Baltimore, are cutting back on much needed services to balance their budgets.

City residents aren't better off. Increasingly, people are going without insurance, while they put off care or rely on extremely expensive emergency rooms for preventable issues.

National, single-payer healthcare is needed now, more than ever, to free cities and families from the private health insurance industry that has profited from devastating levels of inequality in care and quality of life. It would reduce healthcare costs by removing profit and reducing wasteful spending on insurance paperwork that take up 30 percent of current costs ($230 billion nationally).

A single-payer system would make the federal government the sole insurer (the “single-payer” to doctors and hospitals) of all Americans. That's full, universal coverage.

It would remove all for-profit insurers from the system, and require that all hospitals, which would remain private, convert to non-profit entities. Insurance industry greed, along with profiting from death and illness, would end under HR 676.

Profit Over Care

In 2007, the US spent $2.4 trillion on healthcare (4.3 times what we spend on national defense), while 46 million Americans went uninsured, including 8.1 million children.

According to the SEIU, between 2003 and 2007, the nation’s largest insurers “raised premiums, increased co-pays and deductibles; refusing coverage or charging exorbitant rates to people with pre-existing conditions; and even retroactively denied coverage to people with insurance.” Profits rose 170.2 percent, to $12.6 billion.

According to the National Coalition on Health Care, “Since 1999, employment-based health insurance premiums have increased 120 percent, compared to cumulative inflation of 44 percent, and cumulative wage growth of 29 percent during the same period.”

As premiums rise, employers expect employees to contribute more. Employee spending on health insurance has increased 120 percent between 2000 and 2006. Studies show that increased premiums directly correlate with families dropping coverage contributing to about 18,000 deaths every year

Cities, like families, are affected by increasing health insurance costs. Baltimore's recently announced $65 million budget shortfall, partially due to rising health insurance costs for municipal employees, may force Mayor Dixon to cut police and fire budgets by 6 percent. According to Local 734 Fire Union President Bob Sledgeski, "This could have an immediate impact on citizens, resulting in less protection and longer response times."

Maryland's Governor, Martin O'Malley, plans to cut Baltimore's school budget by $23 million as he deals with a $2 billion budget shortfall, partially due to rising health insurance costs. According to the National Conference of State Legislatures, more than 30 states face deficits totaling a projected $40 billion this year.
Increasing Insurance Costs Lead to Increasing Inequality

As health insurance becomes more of a commodity only available to the rich, income becomes the most important determinant to life expectancy. A 20-year life gap separates the city's poorest from its wealthiest. The average life expectancy in Hollins Market, Baltimore's poorest neighborhood, is 63, while in Roland Park, Baltimore's wealthiest neighborhood, it's 83.

A full life, it seems, is only available to those who can afford it.

Why We Need National, Single-Payer Healthcare

Single-payer healthcare (H.R. 676) will save families money. A median income family in Baltimore (making $37,000) would pay about $1,700 a year for healthcare under H.R. 676. Now, if they have insurance through their employer, they're paying, on average, $3,300. That's a savings of $1,600 a year.

It will save cities money. Baltimore spends 11.2 percent of its budget on healthcare for retired municipal employees (over $120 million). In fact, Baltimore City officials estimate they will need $2.9 billion to cover employee retirement health benefits for the foreseeable future. The City would not be liable for retiree health benefits under H.R. 676, since it covers all U.S. residents. The City would also save on the millions it now spends on current employee health benefits. Studies show H.R. 676 saves cities between 30 to 50 percent in health insurance costs.

45 municipalities across the country (including Baltimore), and the US Conference of Mayors, representing over 1,000 cities with populations over 30,000, have passed resolutions endorsing HR 676 because they realize that national single-payer healthcare will save them money while covering all of their residents.

A December 2007 Associated Press/Yahoo! poll found: “Sixty-five percent of those polled said the United States should adopt universal health insurance that covers everyone under a program such as Medicare that is run by the government and financed by taxpayers.”

Single-payer healthcare can save our cities by providing affordable, comprehensive, and universal coverage for every U.S. resident.

Jeff Muckensturm is an organizer and web developer for Healthcare-NOW!, an organization that's organizing for national, single-payer healthcare. He can be reached through www.CityInvincible.org. Find out more about H.R. 676 at www.Healthcare-Now.org.

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