Single-Payer Health Care Reform: Removing the Foxes From the Henhouse

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Single-Payer Health Care Reform: Removing the Foxes From the Henhouse

March 3, 2009

Removing the Foxes From the Henhouse
Single-Payer Health Care Reform
By DANIEL P. WIRT, MD
Daniel P. Wirt, M.D. is a Pathologist, Houston, Texas and member of Health Care for All Texas and member of Physicians for a National Health Program.

The data and evidence are clear: to a scientific certainty, only a single-payer �Medicare-for-All� system of health care financing will solve the serious cost and access problems and achieve good, affordable health care for all in the United States. As a scientist and physician, this is my conclusion after studying the data for years. The data are voluminous, stretching back to World War II, and come not only from the United States, but from all other industrialized countries. Except for the United States, all industrialized countries have some form of universal health care.

A majority of physicians (59%) and an even higher proportion of Americans (at least 62%) support single payer national health insurance or �Medicare-for-All�. In spite of this, virtually all we are hearing about today are mandate plans that would require everyone to buy the same private for-profit insurance that is already failing us. The for-profit insurance companies and their plethora of plans make for a terribly complex, fragmented, costly and inefficient system. Administrative overhead consumes about 31% of health care dollars in the United States, and the for-profit insurance companies are responsible for half of this, or 15% of $2.4 trillion. This money, more than $350 billion per year, provides no health care: it is consumed by enormous administrative costs, profits for investors and shareholders, and large salaries for managers of these for-profit insurance companies.

All of the incremental reform programs proposed --- tax subsidies, health savings accounts, individual or employer mandates, increased regulation of for-profit insurance companies --- keep these proverbial foxes in the henhouse and are doomed to fail to control costs and provide universal access. Competition among the foxes does not benefit the chickens, the patients, the doctors or the hospitals. The for-profit insurance companies fundamentally reduce choice --- your preferred doctor or hospital is �out-of-network�? Too bad, we won�t pay, says your insurance company.

A single-payer �Medicare-for-All� system --- improved and expanded Medicare --- is embodied in a bill currently in the U.S. House of Representatives, H.R. 676, sponsored by Rep. John Conyers, D-Mich., and cosponsored by 93 other members of Congress in the last congressional session. Its features are: automatic enrollment for everyone; comprehensive services covering all medically necessary care and drugs; free choice of doctor and hospital, who remain independent and negotiate their fees and budgets with a public or nonprofit agency; processing and payment of bills by a public or nonprofit agency; promotion of job growth and the entire U.S. economy by removing the excessive burden of health care costs from businesses; coverage for everyone without spending any more than we are now.

The growth in health care costs must be addressed if any proposal is to succeed. Single-payer offers real tools to contain costs: budgeting, especially for hospitals, planning of capital investments (to avoid wasteful duplication and concentration of expensive technology), and an emphasis on primary care and coordination of care. Mandate plans offer only false hopes: competition among for-profit insurance companies, computerization and chronic disease management. Competition among the shrinking number of for-profit insurance companies has already failed to contain costs and, in the absence of single-payer and reformed primary care (so that everyone has a primary care home), computerization and chronic disease management will raise costs, not lower them.

Please read the complete article at:

http://www.counterpunch.org/wirt03032009.html