Single-payer is simpler and fairer

By Susan Miller, M.D.
Richmond (Va.) Times-Dispatch, July 30, 2017

Regarding the Commentary column, “Single-payer ‘dream’ would be a nightmare for Americans,” by Chris Renkar: On the contrary, the Improved Medicare for All Act, HR676, would be a godsend for Americans. The only loser in the fight to expand Medicare is the insurance industry. Under HR676 all Americans are automatically enrolled. All medically necessary care, drugs, equipment, hospitalizations, hospice, dental and eye care are included.

What the promoters of the insurance market fail to admit is that the market for health care is unlike the market for other consumer goods. The ability to make an informed choice about health care services is highly constrained by unequal information between the patient and the physician and the need for services right now.

The ACA exchanges are narrowing and prices are rising because of the failure of the for-profit insurance markets. The reasons for increasing delays in the U.K. are due to the Conservative government trying to privatize the National Health System. In most universal systems, the government collects money to pay the independent physicians, pharmacists, and hospitals for the care of citizens. There will always be a decision about whether taxes go to education, roads or the military versus health care. In the U.S. we ration based on one’s ability to pay. We pay more than twice the per-capita cost of the universal systems and have worse health statistics in nearly all important metrics.

Two things stand in the way of a simpler, less expensive and more fair health care system: political will and the health insurance industry.

This fight is essentially a moral one. Do we believe health care is a commodity or a human right; a social good like education that benefits our entire society by ensuring a competitive workforce and a level playing field for businesses, or just another way to make money from the illnesses of others?