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Docs want single-payer and so should you

By Phil Arvia
Daily Southtown, April 17, 2017

Obamacare, Trumpcare, I don't care.

There is no fixing U.S. health care as it now teeters, a festering bureaucracy that spends more money on patients than any other country in the world yet lets them die faster than many nations supposedly our lesser siblings.

I can give you the facts of our failings: Health care spending in the U.S. as a percentage of GDP is 1.5 times that of any country you've heard of. In the 34-nation Organization for Economic Co-operation and Development, the average is 3.1 physicians and 3.4 hospital beds for every 1,000 people, while those figures in the U.S. are 2.4 and 2.6. In 2010, the average life span in OECD countries was 79.8 years; in the U.S., 78.7. Medical expenses, according to a Harvard University study of bankruptcy court statistics, account for roughly 62 percent of all personal bankruptcies in the U.S. — and 72 percent of that group had health insurance.

So go ahead, repeal and replace Obamacare — President Donald Trump was maneuvering in that direction again last week — with something else that keeps the public sick and insurers rich. Or do something that an allegedly great and Christian nation should demand: A single-payer system — Medicare for all — that ensures everyone has all the medical care they will ever need.

It's the only thing that makes sense. Ask a doctor. Judging by the surveys, there's a 60 percent chance that doc is a single-payer proponent.

"That is correct," said Dr. Susan Rogers, an attending physician at Cook County Hospital and a board member of Physicians for a National Health Program. "Over the last 30 or 40 years, when managed care came along, the administration of health care became super complicated and labor-intensive. We're spending more time on administration and documentation than actual health care.

"Physicians are very, very frustrated."

Were the single-payer plan currently espoused by Bernie Sanders in place, frustration would fall away.

"People would be healthier," Rogers said. "The workforce would be stronger, families would be stronger. When everyone is healthier, everything works better.

"Most older people are satisfied with traditional Medicare. And if you look at other countries with single-payer systems and how people feel about their care, it is not a source of stress."

Stress is our current system's chief product — for patients and providers alike.

"Right now, there's an economic incentive for insurance companies not to pay doctors," said Dr. Peter Orris, the chief of occupational and environmental medicine at University of Illinois Health. "That's the origin of the huge administrative overhead that's inflating costs in this country."

Roughly 28 percent of health care spending in the U.S. is on administrative costs. Medicare shuffles its papers much more efficiently, as do virtually all other Western nations.

"Single-payer is the only system that addresses cost," Rogers said. "Single-payer eliminates the market forces and administrative costs that drive the cost of health care up."

It also eliminates the ridiculous premise that health care can be pursued in our capitalist, free-market society like a new car or a flat-screen. Because, sure, doc, you say I need an appendectomy, but let me shop around for a better deal on the anesthesiology, or at least for a hospital that will thrown in the sponge bath for free.

(By the way, according to the International Federation of Health Plans, in 2014 the average appendectomy in the U.S. ran about $16,000, and in Australia about $3,800.)

"Free markets are based on full knowledge on the part of the buyers and the sellers — and that's impossible here," Orris said. "The only thing single-payer takes out of the equation is private insurance agencies, which add nothing to the process except cost and complication."

The 2013 Commonwealth Fund International Health Policy Survey suggested that if the U.S. had Canada's health care system, 57 million fewer adults would go without health care because of cost; $1.3 trillion fewer dollars would be spent; 5,400 fewer infant deaths would occur; and 56,000 fewer preventable deaths would occur.

And the patients aren't the only ones who'd fare better.

"Doctors would make more money because they'd have more time to see patients and that whole administrative issue would be resolved," Rogers said. "Doctors could be doctors again."

But what about research? Would the next wonder drug be stymied if the pharmaceutical companies couldn't sell cancer drugs here at nine times the price they fetch in the United Kingdom?

"If you look at who is funding research, the government is already funding the bulk of it through grants," Rogers said. "And statistics show single-payer countries are producing more journal articles that the U.S."

Here in the greatest country on earth, our medical system seems simply to produce opioid addicts and opinion pieces.

We should demand more.

http://www.chicagotribune.com...