Dr. Patricia Salber: Economically, a Single-Payer System Makes Sense

By the editors, AJMC TV, July 16, 2016

The United States is closer than it has ever been to considering a single-payer health system. Patricia Salber, MD, MBA, of "The Doctor Weighs In," discusses how a single-payer system economically makes sense.

Transcript (slightly modified):

The idea of a single-payer health system in the US has been discussed more in the past year. Do you think the US is ready for a single-payer health system?

I think we're more ready than we've ever been. Whether that means we're ready and it will actually happen this year or next year or 10 years from now, I don't know the answer to that question, because a lot of it has to do with politics. I think depending on the results of this upcoming election we may see us going back to the old battle of preserving the Affordable Care Act as opposed to repealing it as opposed to moving on.

I do think it's interesting that Colorado has an initiative on the ballot to have a statewide single payer. And although people I've talked to say it's unlikely to pass, I think it's very interesting to see something in a state as big as Colorado being put forward at this time.

Is single payer an actual possibility in the US or would the country not be amenable to such a health system?

Well, you know what Churchill said: we'll do everything wrong until we finally do it the right way. Even myself, I've not been a big single-payer advocate, but I feel like we've tried so many different things and the rest of the developed world has variations on a single-payer model, whether they're private delivery systems underneath the single payer. What they've done is simplified the process by having the management of the claims payment — you know, that payer part — managed by a single entity.

And it makes sense. Economically, it makes sense. There's a new video that's out that was produced by an employer called "Fix It" — I think the subtitle is "healthcare at the tipping point" — where they take you through how much money we're paying to continue to have the inefficient, complex, confusing, multi-payer system that we have now.

Sometimes I think we forget to say [when asking] "Is this thing we want to do going forward good or bad?" well we forget to say "What is it that we have right now?" Right now it isn't working for a lot of people.