Note:  The following is a reprint of an article written by Monterey Park resident Terry De Wolfe for the NAMI (National Alliance on Mental Illness) . NAMI-SGV is a long time supporter of “Medicare for All” and parity for mental illnesses in all insurance programs.

In the political health care battle that resulted in the recent narrow (5 votes) passage of “something” by the House of Representatives, single payer health insurance –  “Medicare for All” (HR-676) - was exempted from the process. And while other plans were priced and analyzed by the Congressional Budget Office, Medicare for All was denied CBO review. This Cinderella was not invited to the ball.

Keep in mind that health care insurance reform became a legislative priority not because of any great burst of sympathy for the uninsured (Newsweek: “ Polls show that 87% of  those with health insurance aren’t much interested in giving any new rights or entitlements to ‘them’ – the uninsured”). Health care got on the Congressional agenda because health care costs are busting the national budget. So does it figure that what is passed is a health care plan that adds $1.05 trillion to national health care costs over10 years?

But while the CBO has been kept away from costing out Medicare for All in the current battle, it did do some single payer analysis back in 1991 and 1993. It’s findings from that era give pause as to why a 2009 update analysis has not been requested.

1991: “If the nation adopted a single payer system that paid providers at Medicare’s rates, the population that is currently uninsured could be covered without dramatically increasing national spending on health.

In fact, all U.S. residents might be covered by health insurance by roughly the current level of spending or even somewhat less, because of savings in administrative costs and lower payment       rates for services used by the privately insured. The prospects for controlling health care expenditures in future years would also be improved.”

1993:  “The net cost of achieving universal insurance coverage under this single payer system would be negative.”

In the intervening years, many states have commissioned studies showing single payer as enabling universal (truly everyone) health insurance coverage for less that is currently spent. Chief among these was a 2005 analysis of California’s single payer Senate Bill 840 by the Lewin Group which determined that 840 could save the state $343.6 billion over 10 years.

The irony is that Lewin is owned by one of the nation’s largest health insurance companies, United Health Care, which  would  have been pretty much sidelined by 840’s passage.

For a variety of reasons, not the least among them institutionalized political graft, national single payer will remain the elephant in the room for the foreseeable future and national health care costs will continue to escalate.  In the meantime, the single payer movement will focus on the states where chances of single payer enactment are more realistic.