Daniel Marsula, Post-Gazette Click Illustration for larger image. Related article: Forum: Rendell's remedy / Andrea R. Fox and Jessica Seabury

Gov. Ed Rendell has now unveiled his "Prescription for Pennsylvania" health-care proposal, which includes a call to "Cover all Pennsylvanians." The official press release describes the Rendell plan as a means to "provide access to affordable, quality health care for all Pennsylvanians."

I'm glad the governor acknowledges the need to cover all of the state's uninsured, but let's get a couple of things straight.

First of all, according to U.S. Census figures compiled by the Kaiser Family Foundation, there were 1,064,060 uninsured adults in Pennsylvania in 2004-2005 -- a far cry from the 767,000 figure the governor cites. Either way, there are far too many.

Second and most important, his proposal fails to provide affordable, quality health care for all.

There can be universal coverage with the private insurance industry and universal coverage without it. Gov. Rendell's plan attempts the former, promising some vague degree of government oversight. His plan offers all those without insurance the opportunity to purchase it from insurance companies, with government subsidies to help pay the premiums of those who earn less than 300 percent of the federal poverty level. Although voluntary at first, insurance coverage for all Pennsylvanians eventually would be mandated.

		Sandra Fox is chair of the Western PA Coalition for Single-Payer Healthcare.

While the governor indicates a desire to reduce health-care costs, he befriends the biggest culprit of all in keeping costs high -- private insurers. As you may recall, Highmark's surplus last year was $2.8 billion, tax-free. UPMC, another "nonprofit" insurer, reported record earnings, including "$321 million ... from patient, insurance and other operations ..." (Pittsburgh Post-Gazette, Aug. 18, 2006). The CEO of Highmark makes $2.5 million a year.

The health-insurance industry is phenomenally wealthy and has every reason to protect its interests. The question is: Are the insurance industry's interests also our own?

An estimated 15 to 30 percent of premiums paid to health insurers goes to administrative costs. Add to this their profits and costs for CEO salaries, marketing, lobbying and political campaign contributions.

The high cost of private insurance is the primary reason that health-care premiums and out-of-pocket expenses for consumers are skyrocketing, forcing many working families to ignore their health or file bankruptcy. Businesses that provide health insurance suffer, too, and are forced to reduce their work force and/or the quality of their benefit packages to stay alive. Government and union employees fear the loss of their jobs or a reduction in their health-care benefits, now and in retirement.

The insurance industry is getting richer while breaking the back of this country, maintaining a fragmented system of care that provides for unequal treatment based on the quality of one's coverage and ability to pay. While the description of the type of coverage available to the uninsured under Gov. Rendell's plan is left vague, I am certain we're not talking about the kind of coverage he enjoys. Shouldn't all of us have the best coverage available?

So, let's talk about universal health-care coverage without the insurance industry, also known as single-payer. Single-payer refers to having the government pay for health care, not multiple insurance companies and consumers. Health-care providers would remain private, and we could freely choose our own doctors or other professionals. No more co-pays, deductibles or premiums. Office visits, hospitalizations, emergency care, prescription drugs, durable medical equipment, long-term care, mental-health services, drug and alcohol treatment, dental, vision and chiropractic care could all be covered.

We're talking the best coverage imaginable. And here's the clincher: Everyone in this country could have this, and it would cost less than what we have now.

How is this possible?

It's possible because we can take out of the equation the profits, salaries and marketing costs of the insurance industry, while lowering administrative costs to the Medicare level of 3 percent, using the purchasing power of government to negotiate lower drug prices with the pharmaceutical companies and replacing premiums with a 3.3 percent payroll tax on employers and employees. This tax would be added to the 1.45 percent payroll tax already levied for Medicare.

Supplemental revenue would include an additional tax on the wealthiest 5 percent of taxpayers and a small tax (one quarter of one percent) on stock and bond transactions. According to Dean Baker of the Center for Economic Research and Policy, the U.S. National Health Insurance Act -- H.R. 676, which soon will be reintroduced in the U.S. House of Representatives -- would save $56 billion in health-care spending and significantly reduce costs for most consumers and employers.

Gov. Rendell had a choice. He could have supported a single-payer plan for all Pennsylvanians. He chose instead to support the insurance industry.

At an Oct. 26 public forum of the Pittsburgh Interfaith Impact Network, the governor said he would sign a state single-payer bill if it came to his desk. He also said he favored a national single-payer plan.

I and members of the Western PA Coalition for Single-Payer Healthcare implore him to put his words into action by introducing a resolution at the next national conference of governors in support of the U.S. National Health Insurance Act. Meanwhile, I encourage readers to join us in our efforts to secure single-payer universal health-care legislation.