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IN YOUR PRIME
Single Payer
These are the voices of concerned readers, reacting to mention here of “single-payer” health care insurance: a subject that represents a mystery among a majority of Americans:
“I wish you would elaborate a little more on the explanation of single-payer health care. Administrative expenses of 25 percent blows my mind.
--Bob Schott (via email)
“I have been in practice 35 years and the current system of health care delivery surely is the most inefficient and frustrating one a medical doctor could experience. I’ve concluded that a single-payer system would be the best…I don’t think our economy will support our current mess much longer…”
--Raymond F. Graap, MD, Tucson
“Having lived in Europe nearly two years, I was eyewitness to how an efficient system can work, and serve all citizens with hardly any paper work and/or unnecessary costs. Continue to write of this important matter.”
--J. Barrecchia, Summerfield, FL.
“It’s nice to have people spreading the word on single-payer. The current system (of health care delivery) is a patchwork, confusing mess, and single-payer would definitely be a different system and in my opinion, better!
Incidentally, I am a first year medical student and health policy hobbyist.
--Graham Walker, Stanford University School of Medicine
“Great article on single-payer. I never thought I’d see the day when a syndicated column would speak so highly of single pay. You have performed a public service.”
--Mitchell J. Freedman, attorney at law; Poway, CA
At the outset, let’s agree on a fundamental point: is health care a
right or, rather, is it a privilege to be purchased? Sadly, in our esteemed, and evolving democracy, health care today is viewed a privilege?
Who says? Well, for starters those 40 million luckless citizens who remain without health insurance and must postpone care, sit for hours in hospital ER’s, and even share medicines.
Next, take the question to the intransigent members of the American Medical Assn. board of directors. “No,” is almost an involuntary response among these well-fed authoritarians.
“Unlike all the other developed countries,” writes the late Dr. Robert H. LeBow in “Healthcare Meltdown” (Alan C. Hood; 2002), “America has not embraced the principle that health care should be a basic human right…”
Fairness, not to mention logic, demand the American people reform the present dysfunctional delivery system. Again, quoting Dr. LeBow, a patients’ advocate more than 30 years, “There is no planning, no vision, as our non-system seems to be imploding…Waste abounds as money for patient care is diverted to pay for higher administrative costs…(Indeed) all costs are soaring…medical errors happen much too frequently…(we’re) failing and in imminent danger of collapse, or meltdown.”
In pursuit of accord, and amity, let’s agree that: 1) health care should be a God-given or birthright, and that: 2) we in the United States could do with systemic reform. What then needs to be done?
Item 1: adopt a ‘one risk pool’, which is an insurance term identifying a body, or group, all sharing the same coverage and risk. Thus, no one person can become impoverished (wiped out!) by a catastrophic illness and, significantly, no one is left without care. (Aside: Medicare is a single risk pool.)
Item 2: we’re ready to reintroduce, and explain, the ‘single-payer’ concept. The label refers to a payout mechanism, where one power—usually a government—has sole responsibility for paying bills and claims. Remember: Medicare spends three percent (or less) on administration (read: paperwork); managed care corporations spend upwards of 25 percent on billing, bureaucracy and product promotion.
We are obliged here to identify the entrenched opponents to any democratic, common sense approach or philosophy. According to Dr. LeBow, the insurance industry, the pharmaceutical companies and “some elements of the medical care establishment” will oppose any reformation.
Activist Bob LeBow says he wrote his book because Americans “are clueless” about health care delivery, and that he grew tired of “seeing my patients continuing to wander in the health care wilderness.” He concludes that in this richest of all countries “what we lack is the political will, and the courage to stand up to the vested interests.”
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Outrageous Associations
