"UNIVERSAL HEALTH CARE" VS "SINGLE PAYER"
THEY'RE NOT THE SAME THING!

The term "universal health care" is often used by single payer advocates when they are talking about a "single payer" system but aren't comfortable with the name. The same phrase is used by the health care industry with a far different meaning. It's important that health care activists understand that these terms are not interchangeable and what the differences are.

"Universal health care" simply means that everyone (probably excluding some residents depending on immigration status) would have health coverage, thus addressing the issue of the uninsured. However, most proposals for "universal health care" do not address any of the problems with our existing health care system beyond lack of insurance. And we have learned too well that having health insurance does not guarantee good or even adequate medical care.

Much of the failure of our current system stems from the very structure of the health insurance system, including: profit-driven corporations; a wide range of coverage plans; the inefficiencies and unnecessary expenses of administrative overhead and paperwork; executives paid in the millions and; profiteering that steers health care dollars away from direct health care services. On average, 20-30% of every health care dollar goes to feeding this inefficient and greedy industry.

Under universal health care proposals, skyrocketing premium costs and prescription drug prices are not addressed. The level and access to services will still vary from plan to plan, often falling far short of people's real needs and excluding some important services. The illogical link between coverage and employment would not be severed, which brings multiple headaches in itself. Yet another tier of bureaucracy would direct uninsured folks to private insurance companies, who would profit from increased enrollment. In short, no real structural changes would occur. While most people would have access to care, unless these problems are addressed with systemic change, many of the woes of our health care system would remain to plague us.

In a "single payer" system all health plans (both public and private) are replaced with one comprehensive plan for everyone, eliminating the complex and confusing differences in policies and ensuring equitable coverage and care for all. Because there is one purchaser of medicines and supplies, cost savings are realized from the system's clout in negotiating prices. By having one payer, paperwork and administrative needs are greatly reduced. (Medicare, for example, operates on 2% overhead.) One form is sent to the central "pot" for payment of services, once again greatly reducing overhead costs and allowing providers to focus on healthcare.

So, don't be fooled by the rhetoric of those who tout universal health care but would never consider a single payer system. Perhaps we need a better name than single payer, but we have to educate ourselves and the public about the difference between universal coverage and single payer. Senator Sheila Kuehl's health care bill, now in the California Legislature, is a genuine single payer bill and deserves our support, regardless of what we call it.

Local Healthcare Updates:

The State Deficit and Our Local Safety Net: The Alameda County Medical Center Board of Trustees will announce their proposal for program cuts at the monthly Board meeting on February 24th, 5 pm, the conference room of the Eastmont Wellness Center at Eastmont Mall. Vote Health worries that the brief period of relative security for Fairmont Hospital's Skilled Nursing Facility (SNF) might end soon (as well as threats to other important programs). The state announced a 15% reduction in Medi-Cal reimbursement for 2003-4, which will have a direct impact on the SNF beds. Come find out how healthcare for the poor will be affected.

The Robert Wood Johnson Foundation is sponsoring "Covering the Uninsured" week (www.CoveringTheUnin- sured.org) from March 10th-16th in 27 major media centers across the country. This would be good news, if true solutions to our health care dilemmas were being discussed. However, given that it has taken dogged determination on the part of Health Care for All--SF activists to have single payer represented on two of the panels, we're not hopeful that the dialogues will further progress the struggle to make health care a right in this country.

On Monday March 10th, from 10 am-12, there will be a Town Hall Meeting and media event at the Herbst Theatre in the Veterans Building on 401 Van Ness, across from the San Francisco City Hall. Activists are urging all who can to arrive at 9:30 am, in order to get good seats and be seen by the press. It is particularly important to bring signs so that single payer supporters can be identified as such. Speakers will include advocates for single payer, the AFL-CIO employer tax-based legislation, and Blue Shield's thinly veiled attempt to boost business by requiring insurance for all!

Smallpox vaccinations: Jim Mittelberger, M.D., staff at Highland Hospital, announced to the Board of Trustees that the medical staff takes seriously the government's concerns about bioterrorism, but is not willing to quickly embrace President Bush's zealous attempt to have all health personnel inoculated with the smallpox vaccine at this time. Organized labor throughout the country has insisted that if the vaccination is mandatory, sick leave must be covered for those who have symptoms and need time off. The Medical Center will announce a formal position by March.

Vote Health Executive Committee Elections: At our January membership meeting, eleven people were niminated for he committee seats along with one alternate. All dues-paying members can vote at our February meeting.

Newsletter committee:
Nancy M. Friedman, Sue Bergman, Kay Eisenhower.
Our thanks to CA Nurses Association for their help in producing this newsletter