Plan ignores 'free market' failure of health care costs

By Christopher Stack, M.D.
Indianapolis Star, Letters, July 23, 2013

Abdul-Hakim Shabazz (“We Need a Single Payer — You,” July 10) says he wants an adult discussion about U.S. health care and then presents a simplistic position on the issue: Get the government out. He proposes we return to our nation's pre-World War II state when people bought individual insurance policies. He facetiously calls this a “single-payer plan” when in fact it is the diametrical opposite of a publicly financed, nonprofit plan that assures everyone high-quality care.

Shabazz’ proposal is no surprise, given he is a self-proclaimed “free-market conservative, social-libertarian political pundit.” But it shows a remarkable lack of understanding of the economics of health care and the private sector's miserable failure to control costs over the last 60 years.

The basic principles of the free market (transparency, price competition, open access, informed consumers, etc.) do not and cannot exist in health care. Every other industrialized nation has already figured that out. Shabazz ignores the fact that Big Insurance is not about to give up its near-monopoly power, which it uses to keep out competitors and increase its bottom line. His proposal is completely unrealistic.

The way to solve our dilemma is to expand Medicare to cover everyone. Delivery of care would remain largely private; but instead of having private insurance middlemen maximizing profits at our expense, we’d have a lean, nonprofit single-payer program that emphasizes preventive care, no co-pays or deductibles, full choice of doctor and hospital, and cost controls through the program’s purchasing power.

Medicare, whose 48th birthday is July 30, works. It is time to make it truly universal.

Dr. Christopher Stack resides in Indianapolis.