At a town hall meeting on health care reform Wednesday, August 19, at Wayne State University School of Medicine in Detroit, Conyers and a panel of five experts made the case for approving a single-payer health insurance program.

“This [Bush] administration has prevented us from getting things done, and now we have almost 50 million people uninsured, small businesses dropping health insurance for their workers and we need change now,” said Conyers, chair of the House Judiciary Committee.

Conyers is sponsoring H.R. 676, the United States National Health Insurance Act. He first introduced the bill in 2003. It would create a government-funded, single-payer system that would cover everyone. The program also would eliminate the private health insurance system.

Some 90 congressmen are co-sponsoring the bill, and none are Republicans or senators, he said.

Universal health insurance would eliminate the commercial health insurers that take 30 percent of every health care dollar in administration, profits and advertising, Conyers said. In comparison, Medicare spends about 7 percent of every dollar on administrative costs, he said.

In 1993 and 1994, the national health insurance lobby, America’s Health Insurance Plans, ran a series of television ads to mock the health care reform plan promoted by President Clinton and then-first lady Hillary Clinton. Harry and Louise were two characters who discussed the Clintons’ reform plan around a kitchen table and how it amounted to socialized medicine.

“The health insurance industry created fear when they ran the Harry and Louise commercials,” said Dr. John Flack, chair of internal medicine at Wayne State and one of the panelists.

Last week, Washington-based AHIP convened a roundtable panel of its own in Detroit to present its health care reform plan. Its panel contained average people who said they have little or no health insurance coverage.

AHIP’s five-person panel agreed that a universal health care program is the only way to address rising costs that have priced millions of people out of the health insurance market.

Conyers, who said representatives from the insurance industry were invited but declined to participate on his panel, said a Medicare-for-all program requires acknowledgement from commercial health insurers that the system is broken.

While Karen Ignani, AHIP’s president, is not advocating for a universal health care program, she acknowledged that the health care system is broken.

But AHIP is not calling for immediate sacrifices from its member health insurance organizations that would address complaints about premiums rising at more than three times the national inflation rate, policy denials for pre-existing conditions and policy rescissions based on high medical costs.

Instead, AHIP’s five-point reform plan calls for widespread adoption of electronic medical records, public dissemination of information on the effectiveness and costs of treatment, replacing the medical malpractice court system with dispute resolution, adoption of a value-based—or pay-for-performance—reimbursement system, and more programs that emphasize disease prevention.

Ignani said health insurance organizations will not unilaterally reduce health care premiums because they are partially based on rising costs. To contain premiums, she called on hospitals and doctors to reduce their costs and provide higher-quality medicine.

“We need additional resources from the federal government, and we need to repair our safety net,” Ignani said.

In a statement after AHIP’s meeting, Detroit-based Health Alliance Plan said reform requires stakeholders from all sides and opinions to work together toward a solution.

“Divisive approaches from the past won’t work,” said a HAP statement to Crain’s Detroit Business, a sister publication of Workforce Management. “Real reform requires bringing people together as policymakers to decide the future of health care. HAP will support thoughtful, workable solutions that reduce the number of uninsured, make health care coverage less costly and more accessible, and promote competition in the market.”

Flack said his department, which staffs various hospitals within the Detroit Medical Center, sees health care reform neither as a black-or-white issue nor as a Republican-versus-Democrat issue—it is a national problem.

“Our department struggles to provide care to the emergency room and hospital. We don’t have the dollars to get people into the clinics for prevention,” he said.

Under a universal health insurance program, Conyers said, the nation’s nearly 50 million uninsured could be covered for about the same amount of money that is projected for 2010 in total health care costs—about $2.8 trillion.

Universal health care, he said, would be paid for by a combination of $387 billion in savings, which includes a reduction of $278 billion in administrative costs, and about $1.3 billion in new revenue.

Conyers said new revenue would come from a new 3.3 percent payroll tax on employers and employees, reversing the 2001 and 2002 federal tax cuts and an additional 5 percent surcharge on the richest 5 percent of taxpayers and a 10 percent surcharge on the richest 1 percent of taxpayers.

“For 10 years I opposed universal health insurance; now I support it. It is the only way to go,” said David Ivers, secretary treasurer of the Detroit AFL/CIO.

But Dr. Herbert Smitherman, assistant dean of community and urban health at Wayne State, said a universal health care system that finances care for everyone won’t work if there aren’t enough doctors and nurses to provide primary care and other medical and dental services.

“We have got to have a system that shores up primary care to provide basic access,” he said. “We don’t have that now.”

Filed by Jay Greene of Crain’s Detroit Business, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

Workforce Management's online news feed is now available via Twitter.