Scheiner believes that Obama’s approach to reform “has no cost control.... The [Congressional Budget Office] said it's going be incredibly expensive … and the thing that I really am worried about is, if it is the failure that I think it would be, then health reform will be set back a long, long time.” Part of what is bothering Scheiner is that the president is not pushing for a single-payer system. “His pragmatism is what is overwhelming him,” Scheiner said. “I think he's afraid that he can't get anything through if he doesn't go through this incredibly compromised program.”
The doctor has chosen to speak out as part of an effort by the group Physicians for a National Health Program. The group wants Congress to establish a single-payer healthcare system instead of implementing the reform proposals currently on the table. They have even embedded at their website a YouTube video of President Obama speaking in favor of single-payer at an AFL-CIO event in 2003. The complete transcript of what Obama said is posted below the video, but here are the most relevant parts:
I happen to be a proponent of a single-payer, universal healthcare program.... And that’s what I’d like to see. But as all of you know, we may not get there immediately. Because first we have to take back the White House, we have to take back the Senate, and we have to take back the House.
Dr. Scheiner agrees with Obama about the desirability of single-payer, but he has a very low opinion of Obama’s public insurance option. “First of all, they haven't really gone into great detail about the public option,” Scheiner said. "How much is it going to cost, are they going to really undercut private health insurance by a considerable amount?” When asked if it would be better to have less-than-ideal reform become law or to take the chance that we would be left with the status quo if a single-payer proposal got shot down in Congress, Scheiner said, “It's a good question. Is something better than nothing?... That is a difficult one, because, in the end, I think [Obama's] program is going to fail.”
In fact, if Dr. Scheiner’s bleak prognosis were to help defeat current reform efforts, it would be for the best. Why? Because the doctor has not factored into his diagnosis that Obama’s “incredibly compromised program” is actually the best way to achieve a single-payer system. As Obama said of single-payer in 2003, “we may not get there immediately.”
Being a shrewd politician, the president knows that once a Medicare-like program is available for some Americans who aren’t seniors, all that is needed is to slowly drive its competitors out of business. Government can do this by gradually expanding who can qualify for the public plan while also lowering the premiums below what private insurance companies can afford to compete with.
The Lewin Group has estimated that if the public plan pays healthcare providers at the lower Medicare rate, public premiums could be kept at least 20 percent cheaper than what private plans charge. All the government would have to do then is eliminate the restrictions on who can qualify for the public plan. According to the Lewin Group, 70 percent of those who are now privately insured would probably move over to the public plan. With healthcare providers charging private insurers more in order to make up for the public plan’s lower pay rate, and with fewer people left in private plans, private carriers would have to raise premiums to stay in business. These hikes would only drive more people into the public plan, starting a vicious cycle that would eventually drive almost all private insurance companies out of business.
At this point, the public option would become the only viable option, and both Obama and Scheiner would get their wish for single-payer, socialized medicine. Dr. Scheiner, of all people, should be able to appreciate the surgical precision with which President Obama would patiently accomplish this delicate operation. Unfortunately for the American people who are the unwitting subjects of this operation, they would be left with a healthcare system 100-percent controlled by the government, with the long waiting lines and healthcare rationing that would inevitably follow.