Health care reform means a single-payer system

Where is the change President Obama spoke of in his campaign? It certainly is not in the form of the health care reform bills going through congress right now. I still have hope that the bill that finally gets signed into law is real health care reform but things are moving in the wrong direction right now. The problem is that insurance companies are still at the core of the various bills being developed right now.

As long as for-profit insurance companies are part of the equation, health care will not see reform. Marcia Angell, a physician and Senior Lecturer in the Department of Social Medicine at Harvard University Medical School and the first woman Editor-in-Chief of the New England Journal of Medicine, put it well when she said:

We are the only advanced country in the world that has chosen to leave health care to the tender mercies of a panoply of for-profit businesses, whose purpose is to maximize income and not to provide health. And that’s exactly what they do.

Dr. Angell was referring to Obama’s position that Americans who do not get health insurance from their employers be mandated to purchase it under the health care reform plan. She says that by so doing, “We’re going to deliver the private insurance companies a captive market…And they love that.”

In fact what we need to do is eliminate the market—at least from the insurance companies—by creating a single-payer plan. Insurance companies deliver no value to patients or recipients of health care whatsoever in the current health care system. All they do is generate costs—almost one-third of what Americans are currently paying for health care goes to administration by health insurance companies.

Opponents of a single-payer system say that patients would get no choice in their health care. It would be completed dictated by the government. But the evidence contradicts this assertion. Dr. Angell goes on to point out about this claim:

It’s phony, in the sense that Medicare is a single-payer system, embedded within our larger market-based system. You have totally free choice of a physician in Medicare. You don’t in most employer-sponsored private plans. Canada, totally free choice of doctors. So, this is simply not true.

Opponents also claim that a single-payer system would lead to rationing. But the fact is that it’s our current “free market” system that rations health care by providing it to the insured and denying it to the poor and uninsured. In fact, even middle class families are falling victim to the status quo: sixty percent of bankruptcies are caused by health problems. Dr. Angell says:

If we continue to spend what we do, right now, on health care, but had a system that distributed it according to medical need, there would be no rationing. And if we held it at that cost, there would never be any rationing. So, it’s simply not right. The problem is not the money, it’s the system.

The system America needs right now is a single-payer system. Just a year ago, President Obama said, “If I were designing a system from scratch, I would probably go ahead with a single-payer system.” Even though congress is not designing a system from scratch, a single-payer system is still the only real way to reform health care if we want a sustainable and affordable system.

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