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Scott McLarty: Fire Departments and Health Care

by Scott McLarty, media coordinator, Green Party US

Imagine for a moment that our public fire departments were privatized.

Imagine that you needed a special insurance policy before calling the fire department in an emergency, or you’d have to pay thousands of dollars out-of-pocket for the firefighters to put out the fire.

Instead of calling 911 for the nearest neighborhood fire department, you’d call whichever fire department is in your insurance plan, even if it’s across town or miles away. You might have to call your ‘Fire Protection Insurance Company’ or ‘Fire Protection Management Organization’ for approval.

Depending on your fire protection insurance plan, the fire department might tell you they can put out the fire in your living room and bedroom, but not the kitchen or the garage… unless you pay an additional out-of-pocket fee.

An insurance company agent might tell you that they won’t pay for a fire department to put out a fire, because your house has a ‘prior condition’ or is too old or in a high-risk area.

If you don’t have coverage and don’t want to pay an expensive out-of-pocket fee, you might try to put out the blaze yourself, or just let your house burn. The fire might spread to other houses in your neighborhood. An uninsured neighbor’s housefire might spread to your own house.

Imagine that you complained to your US Senators and Representatives that the system doesn’t work, that over 45 million Americans can’t afford ‘fire department coverage’ and millions more have inadequate plans, that thousands are losing their homes every year, and maybe your own home has been damaged. And your Senators and Representatives replied that we can’t have fire departments that are publicly owned and paid for with our tax dollars because that would be socialism. Even though public fire departments would be far cheaper and save lives and property, moving to a public plan would cause insurance companies to lose lots of money, and we can’t have that.

Insurance companies would spend millions of dollars in political contributions to make sure that fire departments remain under their control. They’d hire PR firms and place ads on TV and in newspapers to convince you of the wonderful job they’re doing, telling you how public fire protection is a radical idea, un-American, too expensive, inferior in the services they’d provide, etc.

The whole scenario is absurd, you might say. (In fact, it’s close to what many Americans experienced before public fire departments were established in the mid 1800s, when homeowners without insurance often watched their houses burn while negotiating fees with fire companies.) Why have a bureaucracy of insurance company middlemen, demanding high fees as gatekeepers for fire protection without actually providing the service itself, when we can have a far less expensive public system that guarantees firefighters will show up in an emergency regardless of who you are, where you live, or what’s in your bank account? Any reasonably intelligent human would recognize privatized fire departments as a disaster, a menace to public safety and utterly irrational.

So why do we tolerate a health care system that’s run the same way?

Private health insurance companies and HMOs don’t provide medical treatment. Instead, they act as gatekeeping bureaucracies that make an enormous profit based on the likelihood that at some time in your life you’ll suffer illness or injury and will need medical treatment. They provide cost but no value. With all this being said, as your health should be your top priority, looking to Enroll for Private Health Insurance could be very beneficial. As we can never predict what will happen, it is best to be safe than sorry.

Physicians for a National Health Program notes that “[o]ver 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc.” The overhead for Medicare, based on administrative costs but without the demand for profit, is about 3%. Why not convert to a public system, expanding Medicare to cover all Americans, perhaps saving us a third of the cost by eliminating the insurance and HMO middlemen — a system comparable to our public fire departments?

That’s what a Single-Payer national health care system would do. It would guarantee health care and medical prescriptions for everyone regardless of ability to pay, employment, age, or prior medical condition (criteria currently used by private insurance firms and HMOs to limit or deny coverage). Single-Payer would allow everyone to choose their health care provider — you could visit the physician or hospital of your choice, rather than select from a limited list of those approved by an insurance company or HMO.

We’d pay for Single-Payer with a progressive tax plan. Tax sounds like a bad word, until one realizes that the amount most middle- and low-income working Americans would pay would be far less than we currently shell out for private insurance and HMO plans, and any additional fees when you go to the hospital or clinic or doctor’s office would be zero or minimal. That’s because HMO-insurance company profits, big CEO salaries and bonuses, and administrative waste would be eliminated. Just as public fire departments have created an incentive for public education and measures to prevent fires, Single-Payer would create an incentive for encouragement of good habits, like a healthy diet, exercise, and quitting cigarettes.

Obstacles to Real Universal Health Care

Why can’t we get a Single-Payer/Medicare For All system? Because the profit-making health insurance and HMO industry holds svengali power over most Republicans and Democrats in Congress and the White House, thanks to campaign contributions. According to the Center for Responsive Politics, the amount of such contributions was over $46 million in 2008. Sen. Max Baucus, chair of the Senate Finance Committee, thus declares that Single-Payer is “off the table.” Barack Obama once supported Single-Payer, before he launched his bid for president. Now he favors a plan that would leave the insurance industry in charge.

There’s a small number of Senators and Representatives who support Single-Payer. Rep. John Conyers (D-Mich.) and Sen. Bernie Sanders (Ind.-Vt.) have introduced Single-Payer bills in the House and Senate (HR 676 and S 703). Most are Democrats. Presidential candidates Cynthia McKinney (Green) and Ralph Nader (Independent) promoted it during their campaigns in 2008, as did Dennis Kucinich before he was eliminated in the Democratic primaries. But the White House and most members of Congress have followed Sen. Baucus’s lead and don’t want it discussed. They don’t want its merits compared with the health care reform plans that capitulate to insurance and HMO demands. The health of insurance industry profits takes precedent over the health of the American people.

On March 5, a White House policy summit on health care initially excluded Single-Payer advocates until complaints led to last-minute invitations for Dr. Oliver Fein, president of Physicians for a National Health Program and Rep. Conyers. On May 5, a health care hearing sponsored by the Senate Finance Committee featured private insurance industry representatives, the Chamber of Commerce, the right wing Heritage Foundation, the Business Roundtable, and Blue Cross Blue Shield, but no Single-Payer supporters.

The hearing was interrupted by eight protesters who demanded public discussion of Single-Payer. The eight were arrested. Among them were Russell Mokhiber of Single-Payer Action and Kevin Zeese, former Maryland Green candidate for the US Senate and currently Executive Director of the Campaign for Fresh Air and Clean Politics. (Read Mr. Zeese’s account of the protest)

Such actions might be the only way to focus public attention on Single-Payer. In past generations, it took strikes, massive and sustained street demonstrations, and political campaigns outside the Democratic and Republican parties to win the eight-hour day and 40-hour week, an end to child labor, civil rights for African Americans, and other reforms. As more and more Americans learn about Single-Payer, how they’re getting cheated under the status quo, and how the alternative proposals from Democrats are designed to sustain insurance company profits through mandates and subsidies, the demand for Single-Payer will reach critical mass.

Polls have already demonstrated widespread popular support for a national health care program that guarantees universal coverage. In 2008, the US Conference of Mayors endorsed Single-Payer as have thousands of physicians.

The recent economic crisis has made Single-Payer even more urgent. Its enactment would provide relief for businesses large and small, since it cancels the high expense and administrative burden of employer-based health care benefits. It would relieve municipalities and school boards from having to bear the cost of providing health insurance to employees, reducing budgets and lowering local property taxes.

Many business leaders understand that Single-Payer is the best proposal economically, but they’re reluctant to support it. Why?

Dr. David Himmelstein of Physicians for a National Health Program has an answer. Dr. Himmelstein attended “a health care forum a couple of years ago sponsored by the Business Roundtable. And the moderator asked the audience — made up primarily of representatives of big business — to indicate their preference of health care reforms. And the majority came out in favor of single payer. Why then is the Business Roundtable opposed? Himmelstein put it this way: ‘In private, they support single payer, but they’re also thinking — if you can take away someone else’s business — the insurance companies’ business — you can take away mine. Also, if workers go on strike, I want them to lose their health insurance. And it’s also a cultural thing — we don’t do that kind of thing in this country'” (“Top Ten Enemies of Single Payer,” by Russell Mokhiber, Common Dreams, April 16, 2009). In short, business leaders don’t want to lose leverage over their employees and they fear creeping socialism.

Cheerleaders for Obama or Serious Advocates for Health Care Reform?

Why won’t some major unions, like Service Employees International Union (SEIU) and liberal advocacy groups like Families USA, support Single-Payer? (SEIU president Andy Stern and Families USA executive director Ron Pollack participated in the Senate Finance Committee hearing described above.) It could be their long alliance with Democratic Party leaders. The behavior of such groups during the Clinton Administration illustrates my point. Bill Clinton campaigned in 1992 on a promise of universal health care, but after taking office he introduced a reform plan that would have herded Americans into coverage under the top five or six insurance firms. The latter were well represented at the Jackson Hole summit hosted by Hillary Clinton and Ira Magaziner in early 1993, while consumer advocates weren’t invited.

The Clinton ‘managed care’ plan that emerged from the summit was a bureaucratic monstrosity filling over a thousand pages, a gift on a silver platter to those very insurance companies. Medium and small size insurance companies, which were behind those Harry and Louise ads critical of the Clinton plan, would not have been able to compete. President Clinton eventually acknowledged that the plan didn’t even cover all Americans.

Instead of supporting Single-Payer plans offered by Paul Wellstone (D-Minn.) and Jim McDermott (D-Wash.) in 1993, many unions and liberal organizations that had previously favored national health care endorsed the Clinton proposal. They wanted to show support for a new Democratic administration that had replaced twelve years of Republican rule. They didn’t want to jeopardize their newly won access to the White House, so they ready to set aside their own agenda.

Rather than winning influence when they invested their support in the Democratic ticket, these unions and liberal groups had purchased their own acquiescence to a president more responsive to major corporate lobbies. (Such acquiescence, combined with an expert public relations strategy, also explains why Hillary Clinton still wins praise as a champion of health care reform, and why the Clinton plan still gets labeled, erroneously, ‘universal health care.’) Under Bill Clinton, the Democratic pledge of national health insurance, a plank in the party’s national platform since 1948, was canceled.

Current enthusiasm for the Obama Administration and the new Democratic majority in Congress poses a similar danger. The Democratic goal is to make health care affordable — within the context of the market. If publicly financed health care is to be considered at all, it must only be an option in competition with other, private heatlh insurance options, inevitably balanced with public subsidies to ensure continuing profits for the private insurance providers. Thus on April 28, several congressional caucuses (Progressive, Black, Hispanic, and Asian and Pacific American) declared their support for the “public health insurance option” that would be “part of comprehensive health care reform legislation”, but shied away from endorsing the Conyers-Sanders Single-Payer bill. MoveOn has created a video ad promoting the Obama plan and critical of insurance lobbies, ignoring the participation of insurance companies in the crafting of the plan.

The goal of Single-Payer is to make high-quality health care a right for all Americans, replacing for-profit health coverage and rendering the market as irrelevant as it is to fire departments.

For those of us who understand that health care access, like fire department service, must never be based on corporate profit margins, there are lessons to be learned. We can’t rely on the Democratic Party. We can’t trust major liberal organizations or unions that have been compromised by politics allegiances. Groups like AMA and AARP that rely on insurance company contributions and ads in their publications will always oppose Single-Payer.

We can’t trust most of the media, either, since commercial and public broadcasters like NPR accept insurance and HMO money in the form of advertising contracts and underwriting. The result has been a near blackout of accurate information, sometimes any information at all, on Single-Payer in news about health care reform.

Leadership for real universal health care is coming from groups like Physicians for a National Health Program, the Healthcare-Now Coalition, and Single-Payer Action. Politically, the leaders are independents, the Green Party and other noncorporate alternative parties, and Democrats (perhaps a few Republicans, too) frustrated with their own party’s retreat on health care and other big issues.

As businesses lay off employees and cancel health benefits, this is the best time for a mass education effort on Single-Payer. It’s our best opportunity to persuade Americans that for-profit health insurance and HMO coverage are a lunacy of the same rank as privatizing fire departments, and that legislation to sustain for-profit health insurance firms and HMOs is as nefarious as multi-billion-dollar taxpayer-funded bailouts for financial corporations and their CEOs. No other industrial democracy in the world tolerates the rule of private health insurance bureaucracies. Why should Americans?


originally published at


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  1. Michael Seebeck Michael Seebeck August 9, 2009

    Hey William, no, you don’t.

    Ask Los Angeles how well their rail system works, because it doesn’t. Mass transit west of the Mississippi just doesn’t work, and the eastern systems are falling apart.

    Ridden any national rail passenger lines not named Amtrak lately? No? They don’t exist.

    Ask how many regulations interfere with cost-efficient development of polymer-based PV cells. Ask NREL or any aerospace firm, they know.

    Ask how much a national water pipeline infrastructure would cost, and why it hasn’t been done. We have the technology.

    Ask how many regulations interfere with toxic cleanups and more efficient recycling. Not to mention the subsidies.

    And yet you watermelons call for more of the same regulations and restictions?

    Makes a lot of sense, William.

  2. William Smith William Smith August 5, 2009

    Greens understand the market very well.

    Green is the new gold. Solar, Wind, Geo-thermal power, and building nationwide High Speed Rail are all the big money making industry of today and tomorrow.

    Greens also understand the market has long been fixed. Nearly $1 Trillion taxdollars wasted every year on defense spending waste.

  3. Eric M. Armstrong Eric M. Armstrong August 5, 2009

    It still amazes me that the average Republican has no idea that he is a pawn for Big Insurance and the pharmaceuticals. They look truth directly in the eye and deny it.

  4. jt jt August 2, 2009

    One difference between publicly and privately run enterprises is that public ones are publicly accountable. They not only have to account for costs, but also account for the way they’re serving their function in the community. It’s not always as simple as calculating shareholder equity. That seems to be what is at the heart of the injustices in the current insurance system. It’s also the reason people support fire departments as a public enterprise. Even the volunteer ones are supported by the community, in order that they be accountable to the people they serve. It would seem the enterprises protecting the health of people might benefit from the same oversight we give enterprises that protect the buildings they live in.

  5. Michael Seebeck Michael Seebeck July 27, 2009

    Too bad he never thought of the obvious on this.

    1. A system where there is a central fire/EMT authority we have now, but it’s paid for by insurance (home, car, medical, depending on the case) instead of property taxes.

    2. Multiple fire agencies, privately run by insurance, creates market competition and that drives down prices while driving up service quality.

    Funny thing is, that’s the system we have for medical care now.

    America doesn’t have a health care problem–America has a health care cost problem, and that’s not fixed by more regulations or single-payer–ask the CBO.

    But Greens don’t understand the free market very well. If they did they’d be screaming for less government regulation to open up the cleanup market to go greener, instead of screaming for more regulations that don’t work and cost jobs.

  6. Linda Lovelace Linda Lovelace July 27, 2009

    Hey Scott,

    This was really too short for a blog.

    Write more next time.

  7. Linda Lovelace Linda Lovelace July 27, 2009

    Scott McLarty – the Green Party Press Secretary for Life.

    Scott McLarty who calls two National Green Party press conferences a year. And NO press comes.

    Scott McLarty refuses to let anyone else be Green Party press secretary.

    I’ve known Scott McLarty for 15 years, and find him to be painfully dishonest.

    Nope Mr. McLarty has no crediblity.

  8. Catholic Trotskyist Catholic Trotskyist July 27, 2009

    Robert, the problem is that greens and libertarians are by definition people who won’t compromise so easily. If greens can’t get a completely nationalized healthcare and other socialist promises, they might as well just compromise with Democrats. That is the position of my Catholic Trotskyist Party; I disagree with little of the Green platform (actually it’s more radical because I support a one-world government, and although I am more right-wing on some social issues), but I disagree with the tactic of running only third-party candidates that will only spoil elections for Republicans, thus resulting in none of their goals being reached. And in my opinion, Roosevelt TR would have been more likely to support an alliance strategy of the Green and Constitution Parties, although he would rather support the Alan Keyes section because he was pro-war. But he was a theocrat, definitely.

  9. Bryan Bryan July 26, 2009


    I had been looking at this, and frankly, it just didn’t seem right….

    But you pointed out the difference…anyone can get emergency health care… all you gotta do is show up at the ER.

    “Right”, “Wrong”, I don’t know, but everyone gets service at an ER with an emergency.

    And I too live in a community where most of the firefighters are volunteer…they don’t get anything like the credit they deserve, but they do it for the town…

  10. Mik Robertson Mik Robertson July 26, 2009

    Isn’t there a federal law that says emergency medical care at hospitals cannot be withheld because of lack of insurance or ability to pay? There goes the whole premise of the piece.

    If your house does burn down, THAT is why you have insurance, not to prevent it from burning down. You have car insurance in case you have an accident, not for changing your oil. In some cases you can get an extended warranty in case something breaks, so that is a form of insurance.

    The ambulance services in our area are all private, and the fire company is a volunteer organization, funded with contributions. Just because you don’t have insurance does not mean you cannot get ambulance service or response from the fire company.

    Just because you don’t have insurance does not mean you cannot get health care. This is trying to make a problem where one does not exist. The problem is there is essentially no free market in health care.

    Why can’t we get a single-payer system for all? Because it is a bad idea that not only does not address the problem, but creates a new set of problems that are worse.

  11. HSR0601 HSR0601 July 26, 2009

    Let’s score this SECRET, KEY and GAME CHANGER first, CBO !

    The House leaders reached a deal on Medicare payments: A “Pay for Value” reimbursement system that rewards doctors and hospitals that achieve the best outcomes at the lowest cost.

    As a result, The House gained a lot of votes, a lot of people who were withholding support.

    The federal Medicare program insures some 44 million elderly and disabled Americans at an annual cost of $450 billion, almost one-fifth of total U.S. health care spending.

    Supporters of the agreement say it could save the Medicare System more than $100 billion a year and improve care, that means $1trillian over a decade. (Please visit for detailed infos)
    The Times in a July 7 editorial argued “As much as 30 percent of all health-care spending in the U.S. -some $700 billion a year- may be wasted on tests and treatments that do not improve the health of the recipients,” Thus the remaining $239 billions over a decade do not matter.

    No one can disagree with this best outcome / evidence-based system, and private insurance, too, will be greatly influenced by this change with the focus on value over volume. !

    Dr. Armadio at Mayo clinic says, “If we got rid of that stuff, we save a third of all that we spend and that is 2.5 trillion dollars on health care. A third of that and that is 700 billion dollars a year. That covers a lot of uninsured people.”


  12. Robert Milnes Robert Milnes July 26, 2009

    How about some sort of compromise? e.g. emergency services could be “socialistic” or “governmental”. With some sort of post emergency users fee maybe. & Private/HMO for personal physicians, elective treatments etc.

  13. Robert Milnes Robert Milnes July 26, 2009

    Sure American businesses & the American people are afraid of creeping socialism. I myself would be very apprehensive if leftists took over health care, let alone the government. That is why The Strategy went with progressivism. Teddy Roosevelt & the Progressives were the first to talk about national/universal/single payer type health plans. Roosevelt split off from the REPUBLICAN party. Listen to the libs. Get their support. & their 13% potential vote. They are part of the inheritors of the progressive legacy, not the liberal (Obama) or Blue Dog (Clinton) democrats. I have found that they don’t even realize that. They don’t trust YOU-socialistic Greens!

  14. Donald Raymond Lake Donald Raymond Lake July 26, 2009

    Mister Wilson may wish to investigate further. The establishment in San Diego County is constantly on the prowl to enlargen it’s power base. These Democrats in GOP clothing are, like corrupt bribery king and federal felon Puke Cunningham are virtually elected for life.

    Lots of back woods fire fighting is done by volunteers. After ‘blowing it’ on the various billion dollar lethal wild fires in recent Octobers, the government ‘professionals’ are using the more efficient and effective volunteers as scape goats and trying to drum up new funding to get rid of these guys.

    More details this week [July 22] in

  15. Robert Milnes Robert Milnes July 26, 2009

    Scott McLarty, well, since you don’t reply to my emails, get this. You have a lot of balls whining about how few U.S. Senators & presidential candidates support single payer. No mention of The Progressive Libertarian Alliance Strategy which could simultaneously vote out the dems & reps & vote in greens & libs. Then you would have a Congress & President in 2012 who will at least listen to your ideas. Listen to me whine about how green & lib party officials & candidates are not endorsing the Strategy for a change. & Thanks for not inviting me & Richard Winger to your Convention.

  16. Michael H. Wilson Michael H. Wilson July 26, 2009

    Without reading thru this entire thing may I point out that the emergency/ambulance service in our city is run by a private company AMR.


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