Cast a vote for single-payer

By Susanne King, MD
The Berkshire Eagle, 10/27/2010

On Nov. 2, you will be able to vote for "single-payer" health care if you live in the 2nd or 4th districts of Berkshire County. This referendum is non-binding, but will send a strong message to our legislators and governor.

A single-payer health care program would be an expanded and improved Medicare system for everyone, not just senior citizens. The government would be the only administrator of the health care funds (the "single payer"), rather than the hundreds of for-profit health insurance companies which currently administer our health care dollars.

The insurance companies add to the enormous cost of health care by keeping 20-30 percent of our health care dollars for their administration, profits and exorbitant CEO salaries. In contrast, Medicare uses less than 1.5 percent of our health care funds for administration. "Single payer" refers only to the administration of health care dollars, not to the delivery of care, which would remain in the hands of health care providers.

Who will benefit from a single-payer system?

First, patients will experience cost-savings and better access to care. Rather than paying insurance premiums that increase in price each year for policies that provide less coverage with higher deductibles and co-payments, everyone will pay a modest income tax that will cost less than current premiums for health care insurance. Plus, patients will be able to choose their own doctors.

Second, doctors and hospitals will benefit, because they will no longer have to hire legions of office workers for administrative tasks. Doctors will be relieved of the onerous paperwork demands from multiple insurance companies, freeing them to spend more time with their patients.

A majority of doctors support single-payer health care. The annual study by the Massachusetts Medical Society found doctor shortages throughout our state, especially in the Berkshires, and especially in primary care. Doctors were asked about their preferences for a health care system: they picked single-payer health reform over a public option, over high-deductible plans, and over the Massachusetts health reform -- in short, over every other option presented. The current Massachusetts health reform was least favored.

Third, business will benefit, especially small business owners who view rising health insurance costs for their employees as their greatest concern. If everyone were covered by a single-payer program, payment for health care would no longer be tied to employment, and business owners would be freed from an expensive, complicated responsibility.

Fourth, towns and cities will benefit because they will not need to provide health insurance for their active and retired employees; instead, that money can be used to improve other services such as education.

Fifth, our state will benefit. The recent health care legislation that extended health insurance to 97% of our state population has required enormous infusions of cash to provide subsidies for those unable to afford health insurance policies. As a result, we have filled the coffers of the private health insurance industry, while seriously straining the state budget.

Sixth, even though the Massachusetts referendum is not a national vote, the United States would benefit from a single-payer national health program by saving $400 billion per year in administrative costs alone; a serious consideration for a financially-strapped country. The legislation just passed by President Obama and Congress, the Patient Protection and Affordable Care Act (PPACA), makes only minor improvements to an unsustainable for-profit health insurance system. Similar to the Massachusetts legislation in its laudable attempt to provide universal coverage, this legislation is not cost-effective.

Our government will subsidize private insurance premiums for the "near poor," channeling $447 billion of taxpayer dollars to private insurers over the next decade. As Drs. Steffi Woolhandler and David Himmelstein (founders of Physicians for a National Health Program) have written, "Morphine has been dispensed for the treatment of cancer -- the reform (PPACA) may offer a bit of temporary relief, but it is certainly no cure."

Another physician, Dr. Edward Ehlinger, wrote, "Insurance is a strange model for health care . (Insurance) is meant for life's uncertainties, but illness is a pretty sure thing " That's why we don't use the insurance model for fire and police protection or for education. Health care should also be in the category of essential services we will all need someday.

The only loser after single-payer health care is enacted will be the health insurance industry, the middlemen who provide no medical care and siphon our hard earned premiums into their own exorbitant profits.

If you are in favor of a single-payer health care system for Massachusetts, I urge you to vote "Yes" on Question 4 on Tuesday, Nov. 2.

Susanne L. King, M.D. is a Lenox-based practitioner.