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The many advantages of a single-payer health care system

By Judy Garland • Updated Sep 28, 2016 at 9:24 AM

No Canadian, Brit, German, Swede, Dane, Swiss, French, Spanish, Dutch, Norwegian, Icelandic, Portuguese, Italian, Belgian, Cuban, Austrian, Greek, Japanese, South Korean citizen or citizen of other industrialized nations walks up to their physician’s office, clinic or hospital to find a notice that the physician or facility no longer accepts their health insurance.

Nor do they get letters informing them that their health insurance company finds it “necessary” to discontinue the policy or that premiums will increase 10 percent, 30 percent or more in the next coverage period. Nor do they pay co-pays or deductibles. Nor are their eyes and teeth excluded or included only at additional cost.

That only happens to us because we allow a for-profit corporate entity to manipulate our health care system. We are the only nation with so many payers whose complicated multiple policies require a hoard of billing clerks which doctors, clinics and hospitals have to hire to successfully or unsuccessfully elicit payment for services rendered, substantially raising medical costs.

It’s sometimes ridiculous to the point that Duke University Hospital once reported having as many billing clerks as beds. Another reported that their billing clerks had to deal with over seven hundred different policies.

It’s no wonder we can’t get a handle on rising health care costs or provide the public with a reasonable expectation of secure access to affordable medical care. The only Americans that have security are those on Medicare and even that’s precarious sometimes because some doctors and facilities refuse Medicare patients.

Even with its limitations, Medicare is an uncomplicated single-payer system like those in most industrialized countries and enjoys, like theirs, a very high approval rating by members.

Medicare, by the way, operates with a lean 2 to 4 percent overhead cost which should speak to its effectiveness, even to conservatives who foolishly think we should put it back into the hands of the for-profit insurers.

We might argue that the financial burden and uneasiness the health insurers impose is worth it if medical treatment were less expensive and provided better outcomes than in single-payer systems. That‘s not the case. Health care in the United States averages twice the cost of single-payer systems.

Drug costs are fully covered in countries with universal coverage and cost increases are controlled. Surely then, health outcomes are substantially better. But no, again. Countries with universal coverage have significantly better outcomes than we do.

However, cancer treatment outcomes are better in America. That shouldn’t be surprising, though, as cancers develop most frequently in older people and in America with the best treatment available older people have single-payer universal coverage.

In 19 states legislation has been passed or proposed or official studies are in progress for instituting a single-payer healthcare system, like Medicare, to replace the role of private insurers. Colorado will vote on its initiative in November. What more decent thing to do than to bring to the public forum a way to rescue the state’s private citizens and their businesses from the burden imposed by the for-profit health insurers who mandate, not negotiate.

The for-profits have no function but to channel our health care dollars. We supposed freedom lovers pay them to take our money, lift off a hefty profit for exorbitant salaries, lobbying, and advertising, and then pay our bills. Nothing more. Then they take our freedom to choose our doctor or medical facility and enjoy any sense of security. To complicate it even more they, for instance, may approve the hospital but not the hospital’s anesthesiologist.

How stupid can we be to have allowed such a ridiculous tangle to grow unchecked. A main advantage of a single-payer system is that it’s inner workings are comprehensible and problems can be readily identified and addressed.

Politicians in countries with universal coverage know better than to challenge the concept if they want to keep their jobs. With Medicare’s approval ratings as evidence, you’d better believe Americans of all ages would quickly warm up to the concept and protect it if given the opportunity to try it — which is the reason we’re denied it.

Given what the health insurance industry has put us through, particularly before the ACA stopped its most egregious practices, and their current price squeeze, it calls our good sense into question. Maybe it’s time to start listening to Democrats who’ve long been saying we, the public, can pay our own medical bills and far more efficiently.

It’s Republicans who say we have to backtrack and wipe out expansion of coverage to 20 million and restore to big insurers the egregious practices they’ve been forced to abandon. Medicare was resisted by conservatives, too, and with the same argument.

It will cost us our freedom, they say, and then trot out every phony scare tactic they can conjure. I challenge them to name anything more liberating for our older population and their families than single-payer, government-run Medicare.

I can’t emphasize more that the ones blocking universal coverage are the lucky beneficiaries for life of taxpayer-provided health insurance — the very best. That seems hypocritical to me.

Judy Garland of Johnson City is a health care activist.



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