By J. David Gaines, M.D.
The Wall Street Journal, Letters, July 9, 2012
Regarding Daniel Henninger’s “The President That Time Forgot” (Wonder Land, June 28): Although the Supreme Court has upheld the Affordable Care Act, the unfortunate reality is that the law, despite its modest benefits, is not a remedy for our health-care crisis. It will not achieve universal coverage, as it leaves at least 26 million individuals uninsured. It will not make health care affordable to Americans with insurance because of high co-pays and gaps in coverage that leave patients vulnerable to financial ruin in the event of serious illness, and it will not control costs.
The reason for this is that the ACA perpetuates a dominant role for the private-insurance industry. Each year, that industry siphons off hundreds of billions of health-care dollars for overhead, profit and the paperwork it demands from doctors and hospitals. It denies care in order to increase insurers’ bottom line, and it obstructs any serious effort to control costs.
In contrast, a single-payer, improved Medicare-for-all system would provide truly universal, comprehensive coverage, health security for our patients and their families, and cost control. It would do so by replacing private insurers with a single, nonprofit agency like Medicare that pays all medical bills, streamlines administration and reins in costs for medications and other supplies through its bargaining clout.
The government need not run the program, only finance it. In the state of Connecticut, where I practiced general medicine for over 35 years, Medicare was administered by a private insurance company at an overhead of only 3%, compared to HMOs’ 20%. Unlike with HMOs, I was paid promptly and rarely questioned about my selection of diagnostic tests or treatments. My patients were satisfied with this type of care, and they never needed a referral to whatever specialist I thought was best to treat their conditions.
J. David Gaines, M.D., resides in New Haven, Conn.