John Conyer, Democartic congressman from Michigan, is proposing in HR 676 that congress approve a universal single payer health care plan.

Conyers says 47 million Americans have no health insurance and that health care should be considered a human right, not a market commodity.

Here are Frequently Asked Questions about HR676 that Conyer answers on his web-site:

H.R. 676, also called the United States National Health Insurance Act, is a bill to create a single-payer, publicly-financed, privately-delivered universal health care program that would cover all Americans without charging co-pays or deductibles. It guarantees access to the highest quality and most affordable health care services regardless of employment, ability to pay or pre-existing health conditions.

What is “single-payer”?

The term single-payer describes the kind of financing system that H.R. 676 uses. It means that one entity–in this case, established by the government–handles all billing and payment for health care services. Right now, there are thousands upon thousands of “payers”– HMOs, PPOs, bill collection agencies, etc. The sheer volume of paperwork required by our current system means that administrative waste accounts for roughly 31% of the money spent on health care. The single-payer system would eliminate the wasteful paperwork and administrative costs, redirecting more of our health care dollars to providing care.

Medicare is perhaps the best known single-payer system. Essentially, H.R. 676 would improve Medicare and expand it, so that it covers all Americans, regardless of their income.

Who will be eligible for health care coverage under H.R. 676?

All Americans will be eligible for health care coverage. Every person who enrolls in the program and receive a United States National Health Insurance Card and individual ID number, and that is all anyone will need to receive care.

What health care services are covered?

The program established by H.R. 676 will cover all medically-necessary services without charging co-pays or deductibles. The services covered will include: primary care; inpatient, outpatient and emergency hospital care; prescription drugs; durable medical equipment; hearing, dental and vision care; chiropratic treatment; mental health services; and long-term care.

What about “catastrophic” care? Will I ever reach a limit for coverage?

No. There are no limits on coverage. Just as you will never pay a co-pay or a deductible under the universal national health care program, you will never reach a ceiling on your coverage.

Will I be able to choose my doctor?

Yes. Patients will have their choice of physicians, providers, hospitals and clinics. The financing will be public, but the providers will all remain private.

No co-pays or deductibles– what’s the catch? Will I actually pay less for health care?

There is no catch. Both families and employers will pay significantly less for health care.

Currently, the average family of four covered by an employer-provided health care plan spends roughly $4,225 on health care each year, including premiums, services, prescription drugs and supplies. This figure does not include the annual Medicare payroll tax, currently at 1.45%. Under the plan created by H.R. 676, a family of four making the median income of $56,200 would pay about $2,700 in payroll tax for all health care costs. No deductibles, no co-pays, no worrying about catastrophic coverage.

Employers who provide health insurance currently pay, on average, 74% of employee health premiums. For a family of four, the average employer share is $8,510 per year. Under H.R. 676, the employer pays a 4.75% payroll tax, not a premium to health insurance companies. For an employee making the median family income of $56,200 annually, the employer would pay roughly $2,700.
Estimates taken from: Employer Health Benefits 2006 Annual Survey, Kaiser Family Foundation and Health Research and Educational Trust; Consumer Expenditure Survey, U.S. Department of Labor, Bureau of Labor Statistics; and Study by the Center for Economic Research and Policy.

How will the transition to the new system work?

The full conversion to a non-profit, single-payer universal health care program will not take place overnight once the bill is passed. The total transition time will be roughly a 15-year period. Important elements of the transition will include:

• Private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national health care program. The private companies will, however, still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures.
• Private insurance company workers who are displaced as a result of the transition will be the first to be hired and retained by the new single-payer entity. Any of the displaced workers who are not rehired will receive two years of unemployment benefits.

How will the universal program be paid for?

First, switching to a single-payer system will lead to billions of dollars saved in reduced administrative costs. Those savings will be passed on through the system and allow coverage for all Americans. Additional savings in the overall cost of health care will come from annual reimbursement rate negotiations with physicians and negotiated prices for prescription drugs, medical supplies and equipment.

Second, a “Medicare For All Trust Fund” will be created to ensure a dedicated source of funding in addition to annual appropriations. Sources of funding will include:

• Maintain current federal and state funding for existing health care programs
• Closing corporate tax loopholes
• Repealing the Bush tax cuts for the highest income earners
• Establish employer/employee payroll tax of 4.75% (includes present 1.45% Medicare tax)
• Establish a 5% health tax on the top 5% of income earners; a 10% tax on top 1% of wage earners
• One quarter of one percent stock transaction tax

The National Intelligence Council (NIC) this month released a report, “Global Trends 2025: A Transformed World.”   This report looks at the next 17 years, and sees a potentially very dangerous world, “more fragmented and conflicted,” with huge population increases and dwindling resources.

The 120 page report (download pdf here)  concludes by saying, “Leadership Will Be Key:  As we indicated at the beginning of the study, human actions are likely to be the crucial determinant of the outcomes.  Historically, as we have pointed out, leaders and their ideas— positive and negative — were among the biggest game-changers during the last century.”

The NIC releases such a report every four years between Election Day and Inauguration Day.  Some of the Reports assessments are:

• The whole international syste — as constructed following WWI — will be revolutionized. Not only will new players — Brazil, Russia, India and China — have a seat at the international high table, they will bring new stakes and rules of the game.
• The unprecedented transfer of wealth roughly from West to East now under way will continue for the foreseeable future.
• Unprecedented economic growth, coupled with 1.5 billion more people, will put pressure on resources — particularly energy, food, and water — raising the specter of scarcities emerging as demand outstrips supply.
• The potential for conflict will increase owing partly to political turbulence in parts of the greater Middle East.

This report is 120 pages, and I’ve just started to read it.  Some highlights:

• For the most part, China, India, and Russia are not following the Western liberal model for self- development but instead are using a different model, “state capitalism.”  State capitalism is a loose term used to describe a system of economic management that gives a prominent role to the state.  Other rising powers—South Korea, Taiwan, and Singapore—also used state capitalism to develop their economies.  However, the impact of Russia, and particularly China, following this path is potentially much greater owing to their size and approach to “democratization.”
• Asia, Africa, and Latin America will account for virtually all population growth over the next 20 years; less than 3 percent of the growth will occur in the West.  Europe and Japan will continue to far outdistance the emerging powers of China and India in per capita wealth, but they will struggle to maintain robust growth rates because the size of their working-age populations will decrease.  The US will be a partial exception to the aging of populations in the developed world because it will experience higher birth rates and more immigration.
• The World Bank estimates that demand for food will rise by 50 percent by 2030, as a result of growing world population, rising affluence, and the shift to Western dietary preferences by a larger middle class.  Lack of access to stable supplies of water is reaching critical proportions, particularly for agricultural purposes, and the problem will worsen because of rapid urbanization worldwide and the roughly 1.2 billion persons to be added over the next 20 years.  Today,
• Experts consider 21 countries, with a combined population of about 600 million, to be either cropland or freshwater scarce.  Owing to continuing population growth, 36 countries, with about 1.4 billion people, are projected to fall into this category by 2025.
• In the absence of employment opportunities and legal means for political expression, conditions will be ripe for disaffection, growing radicalism, and possible recruitment of youths into terrorist groups.  Terrorist groups in 2025 will likely be a combination of descendants of long- established groups—that inherit organizational structures, command and control processes, and training procedures necessary to conduct sophisticated attacks—and newly emergent collections of the angry and disenfranchised that become self-radicalized.