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NewsBriefs 2/14/07 4:07 PM Page 4 NewsBriefs The Simple Solution of a Single-Payer System L ike many typical middle-class Americans, Robert Marth grew up not trusting or believing in any kind of national healthcare system. "I wasn't too hip on this kind of stuff," remembers Marth, an ICU RN at Kaiser Permanente in Fremont, Calif. Access to healthcare was never a problem for Marth's family. His father, who held a doctorate in electrical engineering, worked for the Stanford Research Institute, one of the world's largest contract research organizations. The family lived in the fairly affluent San Francisco Bay Area city of Palo Alto. Marth, his parents, and his five brothers and sisters always had health insurance. He bought heavily into the American dream, that if you worked hard, you'd be successful and be able to buy the things you needed— including healthcare. "That's the American way," said Marth. Marth felt this way for many years, all through his years in the military and as he became a registered nurse in his 20s. But as he approached his 40s, events unfolded that prompted him to reconsider his attitudes. He started hearing about troubling developments in the families he'd grown up with. Couples he knew from the neighborhood who had good, decent-paying jobs, diligently saved, and otherwise meticulously followed the blueprint for the American dream were losing their life savings and moving out of their homes—usually because of medical bills. "They'd age to a certain point, and maybe the missus has a stroke and the husband has to stop working to take care of her, then she gets worse and has to go to a convalescent home, which ends up sucking up all their money in five years, and then they sell their house to keep paying for healthcare—I kept hearing these kinds of stories," said Marth. Then there was the matter of his own children. Marth and his wife have four kids, now 4 REGISTERED NURSE ages 20, 15, 12, and 9. One of them had a $60,000 cranial surgery just three months after birth to repair a malformed skull, and another has severe asthma attacks. In all, Marth estimates that his employer, Kaiser Permanente, has probably spent more than $1 million in medical care on his kids. Without health insurance, those kinds of costs would have quickly bankrupted them, much as they have already financially ruined hundreds of thousands of typical American families. "My kids have preexisting conditions so that if I didn't have insurance through my work, they wouldn't be able to have any healthcare," said Marth. "It's not their fault. It's not people's fault. That really hit home with me. Maybe you're born with a genetic disorder or whatever, or just have certain problems." Now that his children have the dreaded "preexisting condition" label, Marth worries all the time about what will happen to them after they are no longer eligible for insurance through his employer plan. "When they're 26 and don't have it anymore, are there companies out there willing to take care of a heart defect or a chronic asthma problem?" asked Marth. Living these experiences pushed Marth to think about what kind of health insurance plan would be fair to everybody. Through talking to patients and learning more through CNA/NNOC about healthcare systems around the world, his thinking evolved. His conclusion? A universal health insurance fund that everybody—individuals, businesses, government, states—pays into and is then used by the government to reimburse all providers for healthcare—what many proponents call "single-payer" because one entity collects and distributes all the funds. The U.S. actually already has such a single-payer plan; it's called Medicare. Proponents just want to expand W W W. C A L N U R S E S . O R G Medicare to cover everybody and improve it. Under such a system, everybody would automatically have health insurance and the high costs of administrating our current patchwork system—all the billing, claiming, and collecting that insurers, hospitals, and doctor offices do—would be eliminated. Studies show that about one-fourth, and even up to one-third, of each dollar spent on healthcare actually goes into administration. "To me, I don't care if you call it singlepayer, universal healthcare, or whatever you call it," said Marth. "It doesn't matter what you call it as long as you get the healthcare you need. If you have a sick child that needs treatment, you just want your kid taken care of with the best care available. It's just a more human way to go." From Marth's view, the myriad plans that are currently being floated by President Bush, Gov. Arnold Schwarzenegger, California legislators Don Perata and Fabian Nunez, and various other states all propose more of the same reliance on insurance companies when the industry has already proven it cannot be trusted to "do the right thing." "The insurance companies cherry pick healthy people, they change premiums, they deny claims, they revoke policies," said Marth. "Meanwhile, they're making record corporate profits, and their CEO compensation is through the roof. There's something very wrong with this kind of system." Marth knows that while many of his RN colleagues support a universal, single-payer health insurance system, many of them also don't. After all, he used to be one of them. He encourages them to suspend their disbelief for a moment and think about the people they've known who would benefit from the security and protection of a national plan, whether it's family, friends, or patients. "People don't usually change their minds until they experience one of their friends, one of their loved ones, or somebody close to their friends being in a compromised position that's not their fault," said Marth. "And when they hear about it, it'll make them sick to their stomachs. Hopefully, they'll be mad enough to do something." —staff report JA N UA RY/ F E B RUA RY 2 0 0 7