Single-payer health care is smart solution for America
Hedda Haning
The Charleston Gazette
May 16, 2009
CHARLESTON, W.Va. — Everyone agrees that we should all have health care. Most agree the federal government can fund it because we’re desperate. Even the insurance companies agree. The one thing no one discusses is “single payer.”
In case you can’t tell, it’s a swear word; the phrase is always followed by “Socialized medicine. Boo!” You never hear the fact that all other civilized nations have some form of a single-payer system and provide better health care than we do at much lower cost. If that does leak out, the next thing you hear is that it is obviously “Un-American.”
So what is a single-payer health-care system? It is non-profit. It is Un-American like roads and schools and fire and police and Social Security. It is not socialized medicine. Everyone chooses his own private doctor and hospital. The difference is in the payment system. Patients submit a card to doctors and hospitals and payments are made from a single payer, a trust fund established by taxes collected in a fair way at the federal level.
There would be no co-pays, deductibles or balance billing. The tax bill for most people would be much less than they pay for medical insurance and uncovered care because there would be no profits, the administrative costs would be cut by approximately 80 percent, and care would no longer be fragmented and disorganized. Insurance companies would no longer make medical decisions, and no doctor or hospital would be out of network.
There would be negotiated fees and global budgets keeping costs predictable and controllable. The mechanisms would have to be transparent and open to comment and the administrators widely representative. Today, many doctors will not accept Medicare and Medicaid patients because the fees are set lower than their expenses. Everyone suffers. In the single-payer system, the responsible board in charge would have to negotiate regularly with those doctors for changes. Also, without paperwork for each visit by each patient, administrative costs in each office (now huge because of all of the pre-approving, denying and re-submitting) would be greatly reduced - cutting the doctor’s overhead substantially.
A single-payer system would cover everyone, including the CEO of GM, your senator and you. Do you think Congress would pay more attention if they had the same health care we do? The Gazette has recently commented that our Congressional folks want universal coverage. Watch out, because it is a glib trap. Their plan is to mandate that everyone get care through private for-profit insurance firms with public assistance as needed. Unsurprisingly, the insurance industry is strongly supportive. Their huge overhead will be built into the plan. Call it what it is: welfare for insurance corporations.
This approach has been tried in several states, most recently Massachusetts, and has failed everywhere to be affordable and provide necessary care.
In a single-payer national health program, it doesn’t matter if you are rich or poor, just lost your job, have diabetes and heart disease or are healthy. We will no longer have to humiliate people by having them prove they are poor enough to be eligible. The care is comprehensive, covering all medically necessary expenses including primary care, medications, procedures, hospitalizations, mental health, dental, nursing home and home health care.
In case you want to move to Arizona, you will have medical care there, too. Think of single-payer as a better Medicare covering everyone.
A single-payer system can better assess the application of new technology and quality of care outcomes. It can make better long-term decisions and investments, based on patient needs rather than profit. Since we would all be in the same boat, we would all have an incentive to fix the problems that come up. Other countries do this.
Most people don’t know that the federal government already pays for two-thirds of health-care costs through programs including Medicare, Medicaid, the military and tax breaks. The federal government alone already pays - right now - more per capita for health care than any other developed nation pays, but it does not control the system. It is run by insurance companies protecting their profits.
And here’s another little secret: our economy would be much more vibrant if every employer did not have to carry the burden of health care for every employee and if employees were not often stuck in dead-end jobs for fear of losing medical coverage.
Single-payer’s most serious problem is that it puts people before profits: the insurance and pharmaceutical companies hate it. Their lobbyists are already hard at work convincing your legislators that it isn’t feasible. No doubt the ads will be on TV any minute. There was just a conference at West Virginia State University. Single-payer was never mentioned.
It’s apparently not enough that most physicians (an overwhelming majority of primary care physicians) support such a program, as do nurses, many other medical professionals, unions and non-profit organizations.
And doctors in other capitalist countries are quite positive about their own single-payer systems. They are financially comfortable. They do research, develop and use new drugs, and often have access to more advanced technology than we do. They have less interference with their medical decisions than private insurance imposes on our doctors and patients. And study after study shows their health outcomes are better than ours, all while keeping their health-care costs half of ours. Did I mention their patients aren’t bankrupt by medical costs? No other country rations care as we do by ability to pay.
The best kept secret is that polls show two-thirds of Americans supporting such a program, even if they have to pay more in taxes to get it, which would still cost less and be a more predictable expense than paying for private insurance. The fact is if what we’re after is medical care for all Americans at a price we can afford - hugely important to our stressed economy - then single-payer, not-for-profit health care is the ONLY feasible solution.
Haning, a Charleston doctor, is a member of Mountain State Physicians for a National Health Program.