Health reform, single payer and our fair city

One well-established group of health reformers is feeling shut out of the current debate – single-payer advocates. That Canadian-style approach would set up a “public or quasi public” national health insurance program.  

Here’s a Newsday column complaining about it.  Public Citizen’s Health Research Group also comments here. For a local perspective see Mass Care.

Two major advocates of the approach are based here in Cambridge: doctors David Himmelstein and Steffie Woolhandler, aka the Himmelhandlers. (They’re a couple.) The Harvard doctors helped found Physicians for a National Health Plan.

Here’s the group’s description of their approach — which does not have a lot of support in Washington but is worth considering. Also, a PubMed search on either of the above names will bring up their ample research into the approach.  

Single-payer national health insurance is a system in which a single public or quasi-public agency organizes health financing, but delivery of care remains largely private.

Currently, the U.S. health care system is outrageously expensive, yet inadequate. Despite spending more than twice as much as the rest of the industrialized nations ($7,129 per capita), the United States performs poorly in comparison on major health indicators such as life expectancy, infant mortality and immunization rates. Moreover, the other advanced nations provide comprehensive coverage to their entire populations, while the U.S. leaves 47 million completely uninsured and millions more inadequately covered.

The reason we spend more and get less than the rest of the world is because we have a patchwork system of for-profit payers. Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.

Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do.

 Fairness and Accuracy in the Media says the lack of news stories on single-payer amounts to a “blackout.”  I might not word it so strongly. It just isn’t on the table, so no one is writing about it.


2 thoughts on “Health reform, single payer and our fair city

  1. Thanks for posting this. There seems to be a fear that single-payer or “Medicare for all” is an idea that’s too dangerous to even mention — even though it’s proven to be efficient, effective and popular in the countries that use it, and even though numerous surveys have indicated that many Americans either support it or are quite open to it.

    It’s true. There is a danger. A debate over single-payer would reveal that the fundamental problem with health care financing in the US is private insurance in all its forms; it provides zero heath card and diverts vast quantities of money away from health care and into advertising, claims denial, bureaucracy and profits.

    An honest and open debate on this problem is exactly what the doctor ordered.

    Fairness & Accuracy In Reporting has a study of the media blackout, here:

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