A small business owner’s take on why it’s time for a single payer system


Imagine a world without co-pays, deductibles, premiums, explanations of benefits, pre-existing conditions, tiers, in-network and out-of-network providers.

 I talked to two capitalists the other day. One in favor of Medicare for all. One on the fence.

I initially wanted to talk to small businesses in Philadelphia about Medicare For All and their challenges with our current healthcare system. But some business owners ran off screaming. And others apologetically replied that they didn’t know enough about it or flat out ignored my request.

Clearly, it’s a delicate matter, fraught with stress and fear.

But it’s one we must pay attention to. Especially thinking back on how COVID-19 restrictions swiftly reshaped our world last year, leaving many unemployed.

When millions of Americans lost their jobs in 2020, they also lost their health insurance. The unemployed could choose among several bad options: go into hock to buy a plan, buy a crappy mini-med-type plan that’s pretty useless if you have a significant medical problem, or go without.

Throughout the pandemic, I’ve paid special attention to how countries with national healthcare systems have responded. Israel and New Zealand imposed swift, strict measures to contain the spread of the virus. Their leaders masked up and respected the admonition to socially distance. Their healthcare infrastructures, though strained, were better equipped to handle the flood of COVID-19 victims. Their people didn’t worry that their healthcare system, driven by profit and plagued by inefficiencies, would bankrupt them.

photo of doctor using cell phone
Photo by National Cancer Institute on Unsplash.

Both Israel and New Zealand have public health systems with an option to supplement with private insurance. Their citizens do not lose their marbles   —or their lives—if they lose their jobs.

I’ve decided it is time for the U.S. to get educated about Medicare For All, also known as single payer (the single payer is the government).

Over the past two months, I’ve studied it, done a TV show about it, interviewed labor people, insurance brokers and small business owners to get a pulse on how people feel about a single payer system for our country.

“We can’t go on the way we are now,” says Susan Thomas, a retired Fortune 500 HR director, who lives in Philadelphia and currently consults. “We’re in a mess right now. It’s a disgrace the way things operate in this country.”

Thomas questions why the entire U.S. healthcare system can’t run more like Medicare.

“I’m a business person. I’m very much a Capitalist. I’m not a Socialist, but healthcare is a basic human need. Why shouldn’t we, as a nation, provide it less expensively?” she says.

When HR experts like Thomas speak, people like me listen.

The other Capitalist, my friend Doug, is very uneasy about Medicare For All, even though, he admits, his experience with Medicare as a senior is great.

“What I wouldn’t want to see,” he says “is removing private insurance companies from the mix. I don’t believe that the government and bureaucrats run things efficiently. Healthcare is better controlled with competition in the private sector.”

Furthermore, says Doug, the countries that have a single payer system, have had years of experience implementing it. “It will take decades for us to figure out how to do it. This country doesn’t know how. We will screw it up!”

I don’t buy Doug’s argument, simply because we already have a single payer system in the U.S. that’s working just fine. People over 65, including Doug, love Medicare. Just because it takes time to implement it, doesn’t mean we shouldn’t do it.

My husband and I both run our own businesses. We pay $1,500/month for our policy. We wonder, painfully, resentfully, what we could do with $18,000/year. I rarely use my health insurance. When I do need medical attention, I go the alternative medicine route. Herbs, exercise, chiropractors and acupuncture usually do the trick. But, of course, those are not covered.

Businesses, especially small businesses, would get huge benefits from a single payer system.

As Thomas explains: “Small businesses who cannot afford to, and aren’t required to, provide health coverage, wouldn’t have to worry about it. It’s not only that health insurance is very expensive, often 35% of a company’s budget, it’s also the fact that you need time to administer it…clerical support. It’s a lot of work.”

I ask Thomas to address the strong resistance from the Medical-Industrial Complex (Big Pharma, hospital chains and private insurers), who send battalions of lobbyists to Washington to fight single payer.

“Big Pharma could still do well because as a society you still need the same number of drugs,” she says. “You just don’t have as many intermediaries. The big insurance companies would be contracted by the government because they have the expertise in claims administration.”

Ultimately, our taxes would go up, but our overall costs would go down. I’d opt for a model like the one in Canada or Spain. In both of these countries, citizens get a basic plan, provided by the government, and people can buy additional coverage if they want additional kinds of care.

I don’t want to move to Canada or Spain, though I’ve been tempted. I simply want a healthcare system that works.

1 Comment

  1. Just turned 65 and glad I’m eligible for Medicare, because I have had no insurance at all as a gig construction worker, but in looking at the whole set up there the commercials you see but try to get everyone to sign up for the supplementals the plan c I guess it’s all very confusing so in retirement I’m going to contact the author of this article as well as our local Wendell Potter and join the campaign to bring us Universal Health Care it’s a life and death issue I’m going to use fire to fight fire the corporations tricks lobbyist tricks and the right wing smear campaign people that attacked Hillary when she tried it preempt there and nastiness and use the same tactics against the naysayers as well use the same propaganda that stirred people up to attack their own country or to not deny rights to others to fight for an actual benefit for themselves instead of being the mouthpiece for the corporations.

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