Switch to single-payer system for equity, solidarity and cost control

By Edgar Lopez, M.D., F.A.C.S.
Louisville (Ky.) Medicine, Letters, October 2013

I wanted to address some of the statements made by Dr. Gordon Tobin in “A Trillion Here, A Trillion There ...” (Louisville Medicine, June 2013).

1. You fail to create a distinction between the original Medicare and the one administered by the profiteers of the private health insurance industry: the so-called Advantage Plans. The advantage plans (I would call them “disadvantage plans”) suck the money from the taxpayers in the form of excessive administrative expenses, decrease reimbursement to physicians and providers and the collateral damage is suffered by the Medicare system that is administered directly by the government. Sounds like a “conspiracy” or rather is working like such. If we would ever have (not with the bipartisan corrupted political system that we have) Expanded and Improved Original Medicare for All without the participation of the private health industry, all the physicians and providers would be reimbursed faster, better and equitably, meaning: taking in consideration high-tech specialties like yours and the primary care specialties that have a heavy dose of uncompensated cognitive work that goes unaccounted.

2. By the way, it is time that the specialty societies and the specialists that occupy prominent positions in the many medical societies start working in creating a bridge of solidarity with the primary care specialties which after all are the referring heath care providers to the specialty fields. There is a continental divide between the primary care providers and the multiple surgical specialties that needs to be erased with mutual generosity and cohesive solidarity to defend the medical profession against pseudo-medical organizations that claim magic cures for illness and all sort of medical problems. There is no room for arrogance among medical colleagues. (I got off track a little but this needs to be said.)

3. Agree with you that all type of physicians in all fields of primary care and specialties and subspecialties must be part of the cost control process and that includes the total elimination of conflict of interests when a physician is providing and advising medical care whether as treating physician or as a consultant.

4. The premium benefit imbalance that you so well explain in your note of the Doctors’ Lounge article would be immediately solved by switching to a single-payer system based on H.R. 676: The Expanded and Improved Medicare for All Act, devoid of the participation of the private health insurance profiteers. There is plenty of money in the Social Security and Medicare system unless we continue compromising with the insurance companies and continue the AMA self-destroying concept of incremental heath care reform that only gives us inadequate health care reform like the already failing Patient Protection and Affordable Care Act and gives chance to the corrupted political system to perpetuate our dysfunctional health care delivery and health care financing system. I almost say “cruel medical care system.”

5. There is only one viable solution: Comprehensive health care reform under the guidelines of H.R. 676. But to get to that we have to deal as a solid group of professionals with our corrupted bipartisan political system and that is another conversation.

Note: Dr. Lopez is a retired plastic surgeon. He is a member of Physicians for a National Health Program.