Single-Payer: Is Nationalized Health Coverage the Way to Go?
(Photos by Robin Holland)
This week, the JOURNAL examined the political and logistical feasibility of single-payer universal health insurance, which has broad public support but has been conspicuously absent from the health care debate in Washington and the mainstream media.
“It’s what we used to call national health insurance, so government collects the money for health care from taxes. You don’t pay premiums – instead, you pay taxes, [which] pays all the bills. Hospitals remain privately owned and operated. Doctors remain mostly in private practice. But their bills go to the government insurance program, just as they do today with Medicare, but we’d be able to streamline the payment system if we had only one payer instead of Medicare being one among many. So a hospital would get paid like a fire department does today: you have one check a month that pays for the entire operation, and that means you can eliminate the huge billing apparatus of the hospitals and the doctors’ offices where we’re employing many people to do our billing.”
Advocate Donna Smith told Moyers why she supports single-payer universal health insurance over the present system or the public-private hybrid model proposed by the Obama administration:
“It’s a great idea from the left, which is public financing, combined with a great idea from the right, which is private delivery. And you put it together in one system that takes out the waste and the abuse that’s really happening, which is where all the money really goes in health insurance. Up to 30 percent of the costs have nothing to do with healthcare at all and everything to do with fueling the health insurance needs... We've got to have a national health program, we just have to do it. It's the only way we fix this mess. It's spun out of control, it's gonna bury us financially, it's gonna mortgage our children, and it kills people.”
Some are skeptical that the federal government is capable of responsibly running a national health insurance program. In the WALL STREET JOURNAL, columnist John Steele Gordon wrote:
“It might be a good idea to look at the government’s track record in running economic enterprises. It is terrible... Other than the source of its premiums, Medicare is no different, economically, than a regular health insurance company. But unlike, say, UnitedHealthcare, it is a bureaucracy-beclotted nightmare, riven with waste and fraud... Because of the need to be re-elected, politicians are always likely to have a short-term bias. What looks good now is more important to politicians than long-term consequences even when those consequences can be easily foreseen... And politicians tend to favor parochial interests over sound economic sense... The inescapable fact is that only the profit motive and competition keep enterprises lean, efficient, innovative and customer-oriented.”
What do you think?