Single-minded on healthcare
By ELIZABETH COONEY
Boston Globe
June 22, 2009
The debate in Washington about how to overhaul the nation’s healthcare system has included little from advocates for a single-payer plan. Dr. Steffie Woolhandler, a Cambridge Health Alliance internist and Harvard Medical School professor who cofounded Physicians for a National Health Care Program, has been raising her voice for a national plan for more than two decades, contending that the current system based on private insurance - including the Massachusetts model mandating near-universal coverage - does not serve people well, whether they are rich or poor, insured or uninsured. Here is an edited version of an interview last week.
ELIZABETH COONEY
Q. What do you think of current efforts in Washington to improve healthcare?
A. What’s currently on the table, what [President] Obama and [Senator Edward M.] Kennedy are talking about, will not fix healthcare. They don’t have any way to pay for it. We can’t just keep pumping money into the system. We actually have to fix the system.
Q. Why aren’t single-payer advocates at the table?
A. I think that was due to the tremendous influence of the private health insurance industry. We’ve pushed some and the process has moved some. At first Senator [Max] Baucus had 13 people, mostly doctors and nurses, arrested outside the hearing he was leading. We did get a hearing on single payer for the first time in history in the House Education and Labor Committee.
Q. How would a single-payer system pay for itself?
A. A single-payer system contains its own funding. It would fix the system by dramatically reducing administrative costs. Just the complexity of having competing insurance firms and the system overhead make costs go way up. In the United States, administration costs us 31 cents of every healthcare dollar. In Canada, it’s about 16.5 cents for every healthcare dollar. If we could have the administrative efficiency they have in Canada, we could move $400 billion in annual costs.
Q. What about waiting lists for care?
A. Canada spends half of what we do per capita on healthcare and they do have some waiting lists, but they’re really not as bad as the right wing portrays them. The waiting lists are a result of their level of spending. Our problem in the US is we spend a lot of money but we have a bad system. In Canada they have a good system but they just don’t spend enough money on it. We have great hospitals and great nurses and well-trained doctors and lots of fancy technology. We have what we need, and yet we still can’t take care of patients because the financing system doesn’t work.