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4. Administration costs are not the only costs to be concerned about. It may be that the patients and others would "game" the system, if it was single-payer.

This one may be more of a concern than the other six myths. In fact, there are several areas that may well need to be dealt with previous to establishment of a single-payer system in the United States. The system is rife with unnecessary and, in some cases, mistaken and even harmful treatments. According to a Rand Study, published in the New England Journal of Medicine, patients in acute care having insurance are even less likely to receive "the proper care" than uninsured patients., This is because of the unnecessary, often costly, and even harmful treatments that the insured patients receive. (9)

In an article in Washington Monthly for May, 2007, Gene Longmans describes the world of well-financed hospitals, the "best" hospitals, with "dying patients hooked up on ventilators, dialysis machines, and feeding tubes as an endless procession of speicalists come and go, profiting from those patients' prolonged and sometimes againizing deaths." (10) Essentially, while the treatments there are obviously unnecessary, the situation described is just an extreme condition that permeates large portions of American medicine, difficult to explain unless one remembers that most of the medical system in the US is a business dedicated to the expansion of demand, by, for example, expanding and sometimes creating the very definition of disease itself. Doubters of that proposition might want to try the volume called Selling Sickness (11)

Then, of course, a mere look up-stream anchors the point. The reference is to the world so ably described in Fast Food Nation, of what is still in large part a nutritional dystopia. It's not just about fast food, but also of most of the selections of chain supermarkets, to say nothing of the mom and pop corner stores and "party stores" in the poorer areas of the nation's cities. The result is well enough known, a national diet consisting of large amounts of fat and sugar, which when combined with a basically sedentary existence leads to hugely common obesity among all age groups. There is probably a slow switch to healthier diets in that organics and farmers' markets are a slowly growing sector. But this process, as well as price control of and increased use of alternative therapies, would almost have to accelerate if single-payer were to be instituted in the US. Of course, adoption of the pre-cautionary principle and control of toxic chemicals would appear to be also necessary.

There does not seem to be either more motivation or more opportunity to "game" the system with single-payer than there is with the present system. In fact, it seems that there might even be less, if some of the protit-making opportunities were removed by enacting single-payer. By far, the greatest proportion of people gaming the system now are not patients, they're phony businesses supposedly offering medical equipment and medical providers submitting requests for reimbursement for services either not rendered or rendered at an entirely different level. That type of fraud is the danger and investigation or faulty prevention of it is basically all that could drive costs up under single payer.

5. While there are some problems and some dissatisfaction, most Americans are happy with their health care.
"In an extensive ABCNEWS/Washington Post poll, Americans by a 2-1 margin, 62-32 percent, prefer a universal health insurance program over the current employer-based system. That support, however, is conditional: It falls to fewer than four in 10 if it means a limited choice of doctors, or waiting lists for non-emergency treatments." The poll also found that 78% of respondents were either dissatisfied or very dissatisfied with the present system. (12)

In a Harris Interactive Poll, taken July 2, 2008, examining satisfaction with health care in ten "first world" countries, The Netherlands scored first, and the US last. "Fully 33 percent of Americans believe that the American system ''has so much wrong with it that we need to completely rebuild it', and a further 50 percent think that "fundamental changes are needed to make it work better. ... In the other nine countries, those who believe they need to completely rebuild their systems vary from only nine percent in The Netherlands and 12 percent in Spain to 15 percent in France, 17 percent in New Zealand, 18 percent in Australia and 20 percent in Italy; all well below the 33 percent [in the US]." (13)

The Commonwealth Foundation found similar results, when they asked patients and physicians in Australia, Britain, Canada, Germany, New Zealand and the United States about their satisfaction with health care. In the study, called "Mirror, Mirror on the Wall: An International Update on the Comparative Performance of American Health Care," the US came in last in most areas, "including access to health care, patient safety, timeliness of care, efficiency and equity." (14)

On performance indicators, the US ranks well below what can easily be described as having "some problems." This includes a ranking of 29th in the world on infant mortality. In fact, although there has been some improvement most places in recent decades in infant mortality, that has been slower in the US than many other places, so it was "27th in 2000, 23rd in 1990 and 12th in 1960." (15) That's slightly behind Cuba. The US also ranks 46th in life expectancy. (16)

6. In countries that have single payer, like Canada, people are tired of the long waiting periods and would like to change their healt care into something that works.

According to the "Sweeny Report": "In a new, bi-national opinion poll done by Canada’s CTV television network and the national newspaper Globe & Mail, 91 percent of Canadians said they prefered their national health care system over America’s pseudo-private system." The poll was done by The Strategic Counsel and surveyed 1,000 Canadians and 1,000 people in the United States. Actually, in the US sample, the Canadian system won out by 45 to 42%. This was reported on CTV.ca (17)

Generally, surveys of satisfaction with the Canadian system appear to have run in the vicinity of 85% approval, with concerns sometimes voiced over the direction the system is going and complaints of long waiting times for some procedures, either that the respondent has heard about or sometimes has actually experienced. However, in a Business Week debate over whether the US should adopt the Canadian system, the person representing the con (!) side had this to say:
"The biggest complaint, and often the myth, of nationalized systems is that everyone has inordinate waiting times for surgeries and treatments. In some countries, this has held true. At one point in Canada, residents of Saskatchewan waited two years for an MRI. But in Japan, there is virtually no waiting. In Germany, wait times for surgeries can be a few weeks, just like in the U.S. In Britain today, hip and knee replacements happen within three months of the asking. That’s faster than I was able to get one in the U.S." (18)

It's also the case that some of the reasons for delays for treatment in Canada would not be the case in the US under a single payer system. There is no shortage of surgeons in the US, and actually a surplus of advanced medical equipment. Shortages of both are involved in Canada with regard to wait times. There are long wait times in the US as well, due to non-coverage or undercoverage of the treatment. These presumably would be washed out with institution of a new system.

7. Myth: Single payer would not be acceptable to American business.

The Council on Foreign Relations, after lamenting at some length the high cost of American health care, has said: "These costs prompt fears that an increasing number of U.S. businesses will outsource jobs overseas or offshore business operations completely. U.S. economic woes have heightened the burden of healthcare costs both on individuals and businesses." (19) Of course, CFR goes on to express the hope that the Obama administration will be able to reform US health care sufficiently to be able solve this problem.

But, then, suppose the way the Obama administration insists on framing the problem precludes a solution to the problem. The Obama White House has insisted that single-payer is off the table, and that the only legitmate approach to the problem is to include not only private insurance, but to continue linking it to employment. This is expressed as the proviso that if an individual currently has an employer paid health plan that he or she will not be required to change to the government plan when one is instituted.

But, what is happening in the meantime is that many companies are shifting more and more of the costs of their particular employment based plan to the individual worker. Also, we've seen, as above in myth 2 that the administrative costs are generally higher than what they would be under a single-payer plan, making the total costs generally higher, often much higher. And, of course, if the companies off-shore production, not only is the cost of health care just one factor, it just might be that they would do so, in any case. Businesses that actually might really want to stay in the US, and also want to do something about the rising costs of health care might want to consider signing on to support HR 676, the Conyers and Kucinich universal health care bill. See http://www.hr676.org/4.html.

Of course, on the same page are links to how other groups can help, if they really want to bring about universal health care.

(9) Cited in Philip Longman, "Misdiagnosed," Washington Monthly 39(5), May, 2007
(10) ibid
(11) Ray Moynihan and Alan Cassels, Selling Sickness: How the World's Biggest Pharmaceutical Companies Are Turning Us All Into Patients (2006)
(12) http://abcnews.go.com/sections/living/US/healthcare031020
_poll.html
(13) http://www.harrisinteractive.com/harris_poll/index.asp?PID=927
(14) http://www.commondreams.org/archive/2007/05/15/1198
(15) http://health.usnews.com/articles/health/healthday/2008/10/15/
us-ranks-29th-in-infant-mortality.html
(16) https://www.cia.gov/library/publications/the-world-factbook/
rankorder/2102rank.html
(17) http://blogs.e-rockford.com/sweenyreport/category/canada-poll/
(18) http://www.businessweek.com/debateroom/archives/2008/06/
health_care_go.html
(19) http://www.cfr.org/publication/13325/