Response to Joel Miller's "A Perfect Storm"
Robert LeBow, M.D., a former president of Physicians for a National Health Program:
Joel Miller's essay is great. It gives much useful data and well thought-out projections. Its conclusions supporting universal coverage are succinct and right on. But its shortcoming, like that of the organization he works for, the National Coalition on Health Care, is that he states the obvious ("We need universal coverage for all the right reasons") but stops there. It's as if they all know what has to be done, but they're afraid to come out and say it.
When he says, "We must move towards a health system in which every American has health insurance coverage," is he endorsing "incremental" change? He must know, and we know, that unless we have universal coverage -- and not just tweaking this group or that group to increase the number of insured Americans -- none of what he's advocating for will happen. Risk avoidance will not go away. Profit-seeking and high administrative costs will continue. The most vulnerable will continue to be the most vulnerable. Costs will not be controlled.
So why doesn't he...and the organization he represents...finally come out and say it? We need one risk pool with everybody in and nobody out. The euphemistic way of saying single payer or its equivalent. Maybe we need to find some way of getting people to accept single payer for what it is by giving it an appearance of some private sector involvement so it's more marketable to people and groups that make up the kinds of organizations that Joel Miller represents. They're good people, but I get the feeling their hands are tied. It would be wonderful if the National Coalition on Health Care could come out and say what they know has to happen to solve the dilemma of health care in America.
Bob LeBow
Professor Theodore Marmor responds to Professor James Robinson (Nov. 20 quote - the end of managed care and the introduction of consumerism, which "consumers will hate"):
I agree with your reaction, Don. This commentary is in most ways a comment of nihilism.
TED