National Nurses United

Dr. Quentin Young Explains Why National Health Insurance is Good Medicine t's not just nurses who recognize that the healthcare industry is out of control and that our country needs a system of guaranteed health insurance. Many doctors do, too. As the national coordinator for Physicians for a National Health Program, a 14,000-member group that advocates for a single-payer health insurance system, Dr. Quentin Young has long been one of those enlightened doctors. Now 84, Young has lobbied for national health insurance since the days of Franklin D. Roosevelt, and spoken tirelessly for kicking private insurance companies out of healthcare. Born and raised on Chicago's south side, Young is an internist by training and for many years chaired the Department of Internal Medicine for Cook County, Ill. He has also served as president of the American Public Health Association, and is Clinical Professor of Preventive Medicine and Community Health at the University of Illinois College of Medicine. Now that debate over national healthcare reform has taken center stage, Young stopped by in February to share his thoughts on why guaranteed, national healthcare is a no-brainer. we're not one, we're not 10, weren't not 20, we're 37. We're bumping into third-world countries in some of these categories. It's a national disgrace. I Why don't we have national health insurance like every other industrialized country in the world? We have in this country a history of employment-based insurance. It was, in a sense, a fluke of history. In World War II, when the labor movement was growing very rapidly, the war economy made wage price freezes necessary. However, the national government allowed certain things to be allowed as perks to attract workers. And one of the perks was health insurance, so that the unions vigorously negotiated and sought health benefits, and that's how the whole employment-based system was discovered and exploited. Well, it worked for a number APRIL 2007 of years. Not great, but pretty good. But that's all history. Why do you believe a single-payer system is best? I always supported single-payer health insurance. It seemed quite natural to make sure there were no economic impediments to getting healthcare since it was obvious then as it is today the inverse relationship between illness and the ability to pay. And if you have a civilized society, by that I define a society that feels that at least healthcare is a social responsibility, you have single-payer. Every nation in the world with an advanced industrial economy and a democratic system of government has adopted a variation of single-payer national health insurance as government policy. And all of these countries deliver their service for a fraction of what we do. And more important, their health status is superior to ours. Longer life expectancy. Less infant and maternal mortality. More success in vaccinating against preventable diseases. You name the health criterion, and W W W. C A L N U R S E S . O R G Why do you think the United States has not been successful in establishing a single-payer system? In my mind it's pretty straightforward. It's the awesome power of the present profiteers in the system. The power groups in the medical world today are the big business ones, notably the health insurance companies, the for-profit hospitals, for-profit HMOs, and Big Pharma. This takeover of the health system by corporate America is relatively modern in the last 20-something years. They have inconceivably large resources. They have huge lobby establishments. Corporations are by law organized to develop a product, market it, charge for it, and make a profit. The object is to maximize profits. You can't have a corporate model for a health system where the need is not related to the ability to pay. And that's exactly the dilemma we're in today. Getting rid of private insurance is a pretty big proposition. Instead, many current proposals suggest expanding coverage for kids, requiring people to buy insurance but giving subsidies, and forcing employers to provide insurance or pay into a state pool. What's wrong with those ideas? Rather than dissect all the different games played, if you look what the common denominator is, it's that they insist patients go through private insurance with the 30 percent waste factor. The other thing is they don't mandate anything for the insurance company at the end of the day. It's all to preserve the private delivery of insurance. Over the years there have been scores of incremental remedies. Very typically they'll be to allow coverage for children who live in poverty. Or proposals to take care of certain diseases. Everything I've mentioned sounds good, right? Yes, but that's always a substitute for a comprehensive program. And if we REGISTERED NURSE 5

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