kblair7

Single payer is not so simple or smart
Posted: April 13, 2001
1:00 am Eastern

© 2008 WorldNetDaily.com



Let's start with three facts. First, patients are unhappy and growing unhappier with the nation's medical care system. People want changes. Second, there are plenty of proposals out there. Third, this plenitude, indeed plethora of proposals demonstrates that none have the single right answer.

In medical practice, multiple treatment approaches usually show that there is no single best treatment. But just because there may be no best treatment, some treatments can still be worse, or altogether wrong. And so it is with health-care policy.

The search for a best solution has become so frustrating for the searchers that many large medical organizations are calling for a single-payer system. It seems simpler. It sounds simple. What could be wrong with that?

We remember the "Call to Action" in the Journal of the American Medical Association several years ago. More recently, the American Academy of Family Physicians and other responsible political organizations have started advocating the single-payer solution. One of the best reasons for a single-payer system, they say, is to free the patients, medical personnel and physicians from the burden of more than 400 different insurance forms. True. But the benefits end there. One form of thousands, government clerks still have this insatiable desire that every blank be filled. This means patients and their physicians will have to divulge a lot more information than necessary, wasting everybody's time and money, and giving up what little privacy they've managed to preserve.

Some thoughtful physicians have the attitude that a single-payer system wouldn't be bad because the government so far has left them alone or that dependence on government would somehow be better than dependence on their current employer. We know a talented physician who spent several years in prison because he was falsely accused by the government and convicted -- on the basis of perjured testimony -- of incorrectly billing insurance companies. Another stopped practicing because of similar accusations based on an unintended $37 billing error by a secretary. The single-payer system cannot work if the lessons of history are any indication.

We should be able to learn valuable lessons from one of the most prominent single-payer systems in the world. This system was developed over many years, with the advice of some of the greatest experts in the world, with minimal political bickering and with solid backing of the entire country. This nation even included the right to health care in its Constitution.

Yet this nation, the former Soviet Union, was renowned for the gross inequity and inadequacy of its medical system. For example, the doctors practicing in Moscow were essentially evenly divided into two medical systems. One system provided reasonable quality medical care for the nomenklatura, or party elite, who numbered about 5 percent of the population. The other 95 percent of the population was treated in very low quality hospitals and facilities by the other half of the physicians.

Remember managed care? In the December 21, 1995 issue of the New England Journal of Medicine, Cambridge, Mass., physicians Steffie Woolhandler and David Himmelstein complained about their professional limitations under corporate managed care at the same time that they pushed for a single-payer system. In a footnote, Himmelstein noted that he was being terminated by his corporate employer. He did not understand that a single-payer system is also essentially a single-employer system. If a single-payer government fired him, he would be permanently out of a medical job, unless he left the country.

Do we really want to make everyone's personal medical care the subject of a political experiment? Any single-payer system ultimately depends on government's monopoly on the lawful use of force. And who controls the government? The politicians and bureaucrats working for them.

This points to another problem with the single-payer "solution." When there's a change in the political winds, it can be like the calm in the eye of a hurricane -- a short period of transition from violent winds from one direction into equally violent winds blowing in the opposite direction.

Political control of payment ultimately means that decisions about health care will be political, especially when the government decides it doesn't want to spend as much money as patients require or hospitals and physicians need to do their jobs.

A single-payer solution would also foster even more of an entitlement attitude in the recipients. In practice, physicians note that some recipients of Medicare and Medicaid are demanding and non-appreciative. On the other hand, people who paid their own bills or were given charity care by individual physicians are usually more appreciative and interested in learning about their own ailments and how to manage them.

We therefore suggest that, if the government wants to stay involved in citizens' medical care, that it focus on people who actually need assistance rather than trying to control everyone. Attempts to try to control everyone remind us of America's failed past experiment with alcohol Prohibition. By using focus instead of force, government might be able to recover some respect from those resisting current attempts at central control.

The single-payer system is not so simple or smart especially when given Americans' abhorrence of the long-term results of single-payer medical solutions. Americans should have the inalienable right to choose how they want to meet their medical needs. This founding principle alone should be enough to cancel the idea of a one-size-fits-all monopoly.

When freedom of choice is so important to Americans in every other aspect of their lives, why are we so eager to give it up in matters of life and death?



Michael Arnold Glueck, M.D., is a multiple award-winning writer who comments on medical-legal issues. Robert J. Cihak, M.D., is a former president of the Association of American Physicians and Surgeons. Both doctors are Harvard-trained diagnostic radiologists.

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I can't help but to agree looking at the argument from a standpoint of consistency, we know that all single payer systems are extremely expensive and consumers suffer the consequences.
I suppose it comes down to the questions of wither you want to essentially rob from the rich to give to the poor.

anhailla

kblair..one problem with that whole post is that people like their medicare.

find me one elderly person that wants to switch to a private plan.

greed does not work when it comes to illness. Trusting corporate insurance whores to do the right thing is laughable beyond belief. The whole industry is based on denying claims to those who need it most.


a single payer program should be offered to everyone from the federal government, they can pay a premium to the government instead of Mr legal extortion man.

Eliminate unneccessary profit and the system will pay for itself.


I like a good free market theory as much as the next guy, but the problem is when people don't truly understand it's limitations.

__________________
...either I go, or that wallpaper does.

Oscar Wilde

DRS112

Unnecessary profit....I don't know if you've looked at the figures...but it is a 2 trillion dollar industry...and the insurance and pharma profits combined are about 200 billion...so eliminate ALL profit and it's 1.8 trillion....still almost equal to our current federal budget....profit is what drives innovation and efficiency...eliminate profit and costs will go up, new technologies, will dissapear...people will be unemployed....

how is that better? How much money are the people saving total as opposed to what those costs add up to?

DRS112

I should also add...that insurance profits are due in large part to the fact that they invest the money you give them...Is the govt going to decide where to invest this money? Or are they going to borrow from it to pay for pork projects?

I'm just asking since they've done a wonderful job with Social Security....15% of what you earn goes in and you get what kind of return?

anhailla

I knew you would show up drs112...



before we debate numbers...explain one thing

why are the other industrialized free countries not wrought with the supposed horrors of a government supported plan?

__________________
...either I go, or that wallpaper does.

Oscar Wilde

anhailla

remember..I said PURCHASE a good plan from the government, hell I would even advocate mandating the purchase of a good, affordable plan to create revenue. We do need the healthy to support the revenue.


also..I said eliminate UNECCESSARY profit
not all incentives

__________________
...either I go, or that wallpaper does.

Oscar Wilde

DRS112

What is unecessary?

anhailla

massive administrative salaries...bonuses, kick backs and on and on


I know medical sales reps that make 5 times the money of an excellent family physician.

(who at times sell crap products)


why is that ok?

why does mr insurance executive have 4 homes when my doc has one?

even a middleman insurance administrator makes 4 times what a nurse does

why?

__________________
...either I go, or that wallpaper does.

Oscar Wilde

kblair7

Your anti-private industry stance is so sunken in myth about the motivation of government. You can tell people over and over the real history of corporate liberalism, and the role of big business in setting the agendas, and they'll just go right back to repeating their historical mythology without missing a beat. It's so much more comfortable to believe that large, powerful corporations arose out of “evil and greed,” and that government intervention is the remedy rather than the cause of the crisis in healthcare. I completely and vehemently disagree with this viewpoint, that taxes and attempts to redistribute the wealth will ultimately not benefit Americans, as a matter of fact it will hit small businesses and investors hard. Since entrepreneurship and investment is the main source for economic growth in modern countries, your view of the situation is not in line with objective reality.

The limitations lie in egalitarian thought. I could go on and explain it but it won’t matter.

kblair7

I suppose you don't have any sort of proof of this...