Single-payer health care system saves money, time

By Jamie Tobias Neely
The Spokesman-Review (Spokane, Wash.), Sept. 1, 2013

Contrast the following emergency room visits:

One evening a couple of years ago, my husband and I were attending the movie “The Social Network” in downtown Spokane when suddenly I looked over to see my husband’s eye bulging out of its socket.

He couldn’t blink, and he seemed so disoriented that I thought he might be having a stroke. We left the theater before Mark Zuckerberg could make his first million, zipped to a nearby hospital and handed over his insurance card.

After a quick evaluation, the ER doc ruled out anything serious. The diagnosis: sudden onset conjunctivitis or pinkeye, a common childhood malady. He put a few drops in the eye and the muscle relaxed. The bill: $662.24.

When Jill Williams’ husband was snorkeling in New Zealand recently, he dislocated his shoulder. She helped drag him to shore. They traveled to a hospital two hours away. There the hospital staff focused solely on his recovery. The cost to the patient: not a penny.

Williams, who has helped organize a Spokane advocacy group for single-payer insurance, was already convinced other Western countries have better health care systems than ours. The New Zealand experience simply reinforced her conviction.

Today, as rancor continues over the Affordable Care Act, or Obamacare, a number of quiet but determined Washington citizens are pushing for stronger reforms. Like Williams, they’re convinced that Washington should request a waiver from the Affordable Care Act and create the country’s first innovative single-payer system in our state.

It would be similar to Medicare, in which government finances the system but private doctors provide the care. Advocates calculate that by cutting paperwork costs (now estimated to be 31 percent of total health care spending in the U.S.) and forming a huge pool for negotiating drug prices, this new approach could save enough money to cover all of the state’s uninsured residents.

Williams’ book club read “The Healing of America” by journalist T.R. Reid and was inspired by his descriptions of health care systems around the world that are fairer, more effective and considerably more affordable than ours. They helped bring Reid to Spokane for two large community discussions, and they’ve continued to sponsor presentations here. They’ve met with state legislators, partnered with retired physicians and connected with a statewide advocacy group, Health Care for All – Washington.

They’re undaunted by the opposition to Obamacare. One of them worries about her daughter, a single mother who lacks health insurance. “My husband and I are always waiting for the other shoe to drop,” she says.

Another feels frustrated by her insurance company’s “deny first, pay later,” strategy. A third grew up in Canada, where her extended family still can’t believe U.S. residents actually make one another go into bankruptcy when they get sick. That’s 700,000 of us annually, according to a joint study by Harvard Law School and Harvard Medical School.

The women quote Reid’s book. “Those Americans who die or go broke because they happened to get sick represent a fundamental moral decision our country has made,” Reid writes.

How can we not, like citizens in other developed countries, believe it’s only right to take care of one another? “I just don’t get it,” Williams says.

Economically, middle- and upper-class Americans already pay the costs of treating the poor. We and our insurance companies wind up paying $662.24 for a simple eye infection – primarily because hospitals need to charge us exorbitant rates to offset the cost of treating the uninsured.

Williams’ group is forming a speaker’s bureau, and they can be contacted at spokanehealthcare They want Spokane residents to become well informed on the topic, to contact their legislators and to support smart, strong candidates for public office.

They know it could be a long fight. But these midlife women have watched many impossible battles. At one time, civil rights, laws against sex discrimination and gay rights were all unthinkable in this country. Hopelessly divisive. Polarizing.

And, in the end, all of them came to pass.

So, too, should a single-payer system for the state of Washington.

Jamie Tobias Neely, a former member of The Spokesman-Review’s editorial board, is an associate professor of journalism at Eastern Washington University. Her e-mail address is jamietobiasneely