Speakout: Single-payer health care is way to go

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By Drs. David Iverson and Elinor Christiansen
Rocky Mountain News
September 4, 2006f

The new uninsured statistics released Tuesday by the U.S. Census Bureau provide a sobering reminder of the failures of the U.S. health-care system. Here in Colorado the number of uninsured has risen to 788,000: nearly 1 of every 5 residents lacks coverage. Even for those lucky enough to be insured, ever-skimpier private policies helped push an estimated 14,000 Colorado families into medical bankruptcy in 2001. As physicians who face our state’s health-care crisis day in and day out, we support a single-payer “Medicare for All” system for Colorado and for the nation.

Misinformation abounds about countries with government-financed systems, which is why we were troubled to see Deroy Murdock’s column of Aug. 26, “Health-care horror,” featuring misleading, unsourced data pushed by an extremist think-tank. Despite the best efforts of such groups, real science - reviewed by scientists and published in academic journals - does exist. Its conclusion is clear: Even though they spend far less, countries with public health systems provide better quality health care, offer vastly better access, and ration care less than the United States.

Some of the most authoritative studies are worth reciting here:

• Americans are less healthy than the British. We have higher rates of cancer, lung disease and stroke. Americans have a 50 percent higher rate of heart disease and double the prevalence of diabetes. (The New England Journal of Medicine, May 3, 2006)

• Americans are less healthy than Canadians, with higher rates of nearly every chronic disease. This is in large part because Canadians have far superior access to health care: They were 33 percent more likely to have a regular doctor and 27 percent less likely to have an unmet health need. Americans were seven times more likely to report going without care due to cost. (American Journal of Public Health, July 2006)

• American care quality compares poorly against other countries. Of 21 international quality indicators studied by a team of distinguished researchers, the U.S. was superior on only two. Despite spending twice as much on health care, the U.S. performed at or below average on the rest. (Health Affairs, May/June 2004)

How can the U.S. spend so much more and get so much less? Anyone who has ever had to deal with the nightmarish paperwork of giant insurance companies already knows the answer: it’s our reliance on private insurers.

Insurance companies’ natural market behavior is to compete to cover healthy, profitable patients and shun those who are really sick. To do this, they erect a giant, expensive bureaucracy whose only purpose is to fight claims, issue denials and screen out the sick. They consume care dollars, but their main output is unnecessary paperwork headaches. It affects everybody: doctors and hospitals must maintain costly staffs just to deal with insurance hassles, and businesses are saddled with the burden of administering their own health benefits. In total, this administrative waste consumes nearly one-third of our health spending.

Research has shown that streamlining payment though a single public payer could save the U.S. more than $350 billion per year. Such a system could have saved Colorado $3.8 billion in 2003. That’s more than $5,500 per uninsured resident, enough to provide high-quality coverage to everyone. Everybody would be covered for all medically necessary services, including doctor, hospital, long-term, mental health, dental and vision care. All prescription drugs would also be covered. Costs are effectively controlled (as they are in other countries) by bulk purchasing of services.

Single-payer systems are often called “socialized medicine,” but don’t be fooled. In a “socialized” system (like the U.S. Veterans Affairs or Defense Department systems) the government employs the doctors and owns the hospitals.

In a single-payer system they stay private.

Much hysteria has been printed about alleged “rationing” of care in other nations. The truth is that the U.S. rations care more harshly than any other country. According to the Institute of Medicine’s most conservative data, 18,000 Americans die every year due to a lack of insurance. Millions more go without needed care because of cost. Now that’s rationing!

Single-payer offers the only solution for our state and for our nation. Let’s get there - it’s time.