President Obama has said that if we were starting from scratch, a single payer health care plan would undoubtedly make sense. Yet this assessment is offered, unfortunately, as a roundabout way of explaining why a single payer plan will not even be considered among all options now being discussed.

It has been rather surprising just how persistent the American public has been in insisting that some form of public health care plan be considered, despite vigorous opposition to any government administered program from the health insurance and medical/pharma industries. So strong has the push been for a public option that it now seems likely that some form of government administered program will be included to compete with other private health care providers. The American people themselves are seemingly resigned to the fact that single payer is off the table, but there is an intransigence building that says any health care reform without the inclusion of some form of public option is a non-starter.

Why is this push for a public option gaining such wide support at the grassroots level? And how is it sustained in opposition to so many monied forces that are aligned against it? The health care and insurance industries are spending over $1.4 million PER DAY in lobbying efforts, mainly focused upon excluding such government involvement. How is it, then, that a "public option" still remains as a top priority for many of the consumers who seek genuine reform of their health care system.

Having first identified health care reform as a critical issue confronting the U.S., American health care consumers have looked around at other industrialized nations and see single payer systems that are serving all their constituents at less cost per person than our present system. Without even getting into the specific details of how these other programs work, the American health care consumer is able to determine intuitively that there are a number of ways in which a single payer plan can introduce efficiencies that result in real savings over present costs.

To begin with, there is an intuitive sense that a single administration overseeing a universal plan is surely far more efficient than a multitude of private corporations establishing their own bureaucracies to manage their own little corner of the comprehensive system that is required. Duplication of services is understood to be extensive and extremely wasteful, as is the number of people needed to simply keep up with the myriad of different bookkeeping and other paper trails that are created, generally as one whole system of paperwork and policies, etc., per provider.

These same consumers understand that it will take one CEO - a government Administrator, probably at the level of a Cabinet Secretary - to oversee a singular bureaucracy in charge of providing universal health care to all. This CEO will be expected to earn in the neighborhood of $197,000 (Highest rate now paid to any Cabinet Secretary) and will replace an untold number of private executives, each making multiples of this salary. Multiples of $197k? Well, yes. It was recently reported, for example, that Bill McGuire, former CEO of UnitedHealth Group, accumulated total compensation of $1.6 billion during 2005. Quickly doing the math, the consumer reasons that simply removing this one executive from the equation for one year provides enough financial resources to provide lifetime health care coverage for themselves and their extended family, almost without regard for how large that family might be. Eliminating all such highly paid executives could be expected to result in enormous savings without compromising so much as the availability of a single visit to a Doctor.

According to a recent article in The Economist, "The American health-care system, which gobbles up about 16% of the country's economic output, is by far the most expensive in the world." The article goes on to show that the US already spends more PER PERSON for health care than any other industrialized country, and even twice as much as is spent per person in Sweden, Japan, Britain and Italy. Most of these countries have universal health care. Even the casual observer among the health care consumers in this country look at this and see that we are already spending much more than is required for universal health care, yet we somehow fall short in providing coverage for over 42 million Americans. It is not unreasonable for these same consumers to deduce that this present system of insurance providers and Big Pharma and the private health care industry are consuming far more "non-direct health care related" resources than is required.

And herein lies the reason that a "single payer" health care solution had to remain off the table if we were to proceed with any kind of health care reform in this country. After all, if such a proposed solution were to be given serious discussion, much of what the consumer has already determined intuitively would be fleshed out in facts and figures. A full litany of efficiencies to be gained and resources to be reallocated from private industry profits and logistical support to the actual provision of health care would be enumerated, showing the way in which we could achieve universal health care without actually spending more money than is already dedicated to health insurance and health care. And that would be a good thing, right?

Well, yes it would, unless you were one of the insurance companies or Big Pharma or the health care industry that has bled our health care system dry. Alas, the prime thing the consumer realizes intuitively is that the majority of waste and the inefficiencies under which our health care system suffers is related to the parasitical tagalong that is the insurance/health care/Big Pharma industries. And the possibility of the consumers acting upon that realization has the executives in these industries losing sleep.

It is an unfortunate political reality that it is these parasites who own so much of Congress in these days of pay-to-play politics. And so any potential that the door would be open to arrive at a "throw the bums out" solution to health care reform by honestly considering single payer would never have been allowed to gain traction at all as Obama embarked on this process.

On the other hand, successfully eliminating single payer as an option to be considered allowed the monied interests to reason it was safe - nay, potentially highly profitable - to proceed with Obama's "health insurance reform." These health insurance industry providers calculated that they could improve their take from the health care system if they smartly played the reform game. Senator Max Baucus of Montana, Chair of the Finance Committee and one of the biggest benefactors of health care industry campaign contributions, seemed to carry their water quite well for so long as he was able. Stating strong opposition to any public option, Baucus' was instead inclined toward a solution wherein we would eventually subsidize consumers as necessary until we achieved universal health insurance coverage. Executives at the major insurance providers were nearly besides themselves in planning the next Congressional fundraisers, undoubtedly certain that they could double, triple, nay quadruple their budget for campaign contributions at a mere fraction of the profit to be made from the 42 million new customers they stood to realize out of this proposed "reform" package.

But it seems neither Baucus nor the bosses reasoned just how persistent the grass roots would be about gaining some measure of serious reform of our health care system. Baucus has encountered significant pressure from Montana voters who insist that a public option at least be included in any reform proposal. Liberal Democrats are growing more insistent that any proposal must have a public option to gain their support for the measure. And the health insurance/health care/Big Pharma industry lobbyists are discovering that no amount of arm twisting, glad-handing, or promise of campaign contributions is going to allow the public option to be taken off the table. The voters are being heard in large numbers, and the pols are rightly calculating that no amount of campaign cash is going to mollify these constituents; that the voters are drawing a line in the sand that insists some degree of genuine health care reform be enacted with no quarter offered to politics as usual this time around on this issue.

And so we have stumbled upon an inefficient solution to the reform of our health care system, one that preserves much of the inefficiencies we now suffer in relying upon the health insurance/health care/Big Pharma industries. But against great odds, a persistent grassroots effort has made it all but certain that any reform package will include some genuine reform in introducing a public option that establishes the groundwork for moving toward a more sanely efficient single payer system.

Is it perfect? Absolutely not, but then progress in politics is rarely accomplished in one large step. I would certainly have preferred that we simply get it done right all at once and shove the parasites aside in one big move toward a single payer system.

But I understand the political realities that made such a course of action impossible to achieve. And so I will celebrate the little victory gained by the grassroots in achieving a public option, and watch in satisfaction as the parasitic insurance and private health care industries are forced to compete with a more sane and efficient system that will eventually cause them all to give up this game of promising to provide health care while bleeding us all dry instead.

May they rest in pieces. And may the rest of us at last know justice in health care being provided as a right granted to all in this great nation.