Day after day, I become more certain that we need to scrap our entire health-insurance system, and go to a single-payer national plan. It would cover everyone in a simple and straightforward manner that wouldn’t require a Ph.D. in filling out forms to navigate, it would put enough healthy (for the moment) people into the system to make it affordable for those who need care at a given moment, and would give us a gigantic bargaining bloc (forbidden in Medicare Part D, thanks to Big Pharma) for containing drug costs. In other words, it would make sense.

And here’s the really, truly amazing thing about it. Nobody, but nobody, in the political mainstream will stand up and suggest it. In fact, political candidates go to great lengths, through all kinds of gyrations, to avoid it. This is so even though I have only heard three credible reasons why not to at least suggest it, to get a conversation started:

• The medical insurance industry doesn’t want it, because it does away with it’s reason to be.
• Big Pharma doesn’t want it, because if we banded together, it would no longer be able to overcharge for the drugs it pays billions to advertise.
• The idea of us banding together to act in our common interest offends some people’s ideology.

Yeah, I hear other objections — waits for procedures, reduction of choices — but those will be the features of ANY approach that works in lowering costs. The insurance companies have been telling what treatments we can and can’t have, and which doctors we can see, and which pharmacies and hospitals we can go to, for decades now.

Anyway, this little post isn’t about going into the details; this post is simply about the fact that we’re not even having a national conversation about whether to do this. With the exception of Dennis Kucinich, who doesn’t count because he doesn’t have a prayer of being elected, nobody is out there touting this idea, so that we can at least debate it. And rest assured, we won’t be doing anything bold in this area unless someone is elected with a mandate to do so.

There are people laboring in the field out there trying to drum up support for HR676, which would create a single-payer system, but you don’t usually hear about them. The one advocate of the approach best known to people on this blog is our regular contributor Paul DeMarco, a Marion physician, is a founding member of a group called South Carolinians for Universal Health Care that is pushing for it (I believe, and Paul will correct me if I’m wrong, that the group is affiliated with Physicians for a National Health Program. Some of his fellow single-payer advocates came to see the editorial board yesterday. The video above shows Sabra Smith, a practicing nurse and PhD student at USC School of Nursing, talking about why she got involved with Dr. DeMarco’s group.