Health-care organizer Ajamu Sankofa

Some 50 million people in the U.S. have no health care insurance and 25 million more are underinsured. Existing programs such as Medicare, Medicaid and Children’s Insurance, each state administered, are under attack. In California, where budget cuts have drastically reduced access, 8,000 people lined up when a volunteer health group recently offered free service.

Ajamu Sankofa WW photo: Gavrielle Gemma

On Aug. 13, WW reporter Gavrielle Gemma interviewed Ajamu Sankofa, a Harlem attorney who is also former national organizer for Healthcare-NOW! and co-founder of the Private Health Insurance Must Go Coalition. WW asked him to explain his group’s Single Payer plan.

Single Payer is based on the principle that health care is a human right and would provide coverage for everybody in the country. It is modeled after Medicare. You would never be asked, “Can you pay?” If you already have insurance, love your doctor and your hospital, your choice remains the same. There would be no premiums, deductibles, co-pays, nor discrimination in service. Health care would be publicly delivered, privately provided.

Now, even if you have employer-based insurance or buy your own, you have no health care security. Each year employers change plans, usually covering less. Many employers now require workers to pay part or all of the premiums, and co-pays and deductibles are going up. Your choice is greater with Single Payer legislation—HR 676—in the House of Representatives, sponsored by Rep. John Conyers.

Virtually all the industrialized countries have some national health plan. The U.S. has the best health technology in the world, but it is wasted in the interest of profit and not accessible to everyone.

The attitude of medical professionals has evolved to predominant support for Single Payer. During the Franklin Roosevelt administration the American Medical Association (AMA) destroyed the move to Single Payer as an obstacle to doctors making huge amounts of money. Now the leading voices for Single Payer are organized nurses throughout the U.S. and the majority of doctors.

This spring the “Baucus 13” challenged this. Sen. Baucus (R-Montana) chairs the Finance Committee, which has jurisdiction over health care. They had a hearing on reform and denied single-payer advocates the right to be heard. Thirteen members of Healthcare-NOW!, including doctors and nurses, were arrested, as well as members of Labor for Single Payer.

A couple of weeks ago in Iowa nine protesters walked into the boardroom of an insurance company. They were young and old, doctors and nurses. They disrupted the board meeting because the company was denying people coverage for previous medical conditions and undiagnosed symptoms.

One-third of premiums paid to insurance companies go to the corporate departments that deny you care and provide a rationale for it. The more I know, the angrier I get.

A 2002 study showed that 18,000 people die each year because they do not have health insurance. With the current economic crisis, layoffs will make this skyrocket exponentially.

The U.S. pays more than twice as much per person as any other industrialized country for health insurance, yet it is 37th in the world in health outcomes, mortality, morbidity and chronic disease, according to the World Health

Organization.

Working people and unions are being forced to bargain away salary increases to maintain health benefits.

The proportion of the deduction workers pay for employer-based coverage is continuing to rise. The premiums are rising and co-pays are going up too. In most plans, if a worker has a chronic condition, there is a lifetime benefit and it will run out. Even if they’ve been paying for 30 years, they’re left with no coverage at all.

The financing in HR 676 would come from a payroll tax that the employer pays and a progressive income tax, a tax on stock transactions and an increase in the rate of taxes on the upper 5 percent—the richest will have to pay more. Some 95 percent of the people will experience a net saving on health care. So taxes are really a nonissue.

The corporate-controlled Republican and Democratic parties are not permitting the Single Payer plan to be discussed in Congress. A significant irony is that a Single Payer national health care plan saves between $300-$400 billion a year just because the 30 percent administrative cost is gone. It stimulates the economy because people will spend less on medical care and more on other goods—and have the health to enjoy them.

The ‘Obama plan’

Obama’s plan is modeled on Massachusetts. It keeps the private health insurance industry in existence. The plan’s “Public Option” is a government-subsidized insurance plan. It is a giveaway to the insurance industry and perpetuates their profits. Massachusetts mandated everyone must buy this insurance. While the cost may be lower, it’s still high and many can’t afford it. Massachusetts then tried to penalize those who can’t buy the insurance by having them pay higher taxes. It’s insane.

Companies still have the incentive to market their plans to the healthiest people and the richest people. This plan is an apartheidlike system and the health care crisis remains. It creates a huge windfall for the insurance companies, which will be free to continue to accelerate costs and the plan will go under.

The right-wing disruptions of the hearings on HR 3200—the “Obama” plan—are financed by the pharmaceutical and insurance companies. Now the right wing enters calling Obama’s plan socialism. The right-wing attacks are all bogus—they want to destroy any public health care.

The challenge of the left is building independent political institutions that are of, by and for working people. If we don’t get busy, we will be living with the right wing everywhere.

Single Payer has the capacity to win. It would take a campaign of a similar intensity to what was needed to dismantle Jim Crow. We are talking about one-sixth of the U.S. economy.

It is not an accident that Brown and Black people have the greatest health disparities in the U.S. There is one level of service for people of color and another for those of European descent and wealth.

For more information: HealthcareNow.org, PHIMG.org.