Single payer would change the game

By Chinh Le, M.D.
Corvallis (Ore.) Gazette Times, Letters, July 23, 2015

"Readers will react quite differently to the headline: “Medicaid costs: Oregon faces soaring price tag” (Gazette-Times, July 20), depending on their ideological inclination.

“Can’t trust those irresponsible bureaucrats! Obamacare is a fraud, I told you so," would say my fiscally conservative friend.

“Well, spending 10 percent of our state budget (as projected by 2010) to care for our medically indigents is actually not an irresponsible figure," my socialist counterpart would say. “Aren’t we our brothers’ keepers?"

The headline, unfortunately, is somewhat misleading: predicting medical costs based only on body counts and insurance rates is like forecasting the economy on a very limited set of data and assumptions. Our health costs are driven by a multitude of factors that are in a state of constant changes and interactive adjustments, such as delivery of care, providers’ payments, medical innovations, consumer behavior, access to preventive care and mental health, just to name a few.

Non-Medicaid insured patients should also brace themselves for increases in premiums and out-of-pocket expenses, justified by the “free-market” side of medical economics, says one person, or to assure greedy profits for the medical-industrial complex, says another.

Balancing medical costs, funding, and benefits is like a game of bouncing hot potatoes. Another term is “cost-shifting." One way or another, we will all pay for them.

Tired of the way the game is played? Then think “single payer system;" universal health care, privately delivered, and publicly funded by an equitable progressive taxation policy. An improved form of Medicare-for-All. Affordable, dependable, and socially responsible.

Dr. Chinh Le resides in Corvallis.

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