A vote for single-payer health
Dr. Ann Troy
Marin Independent Journal
Article Launched: 01/12/2007
LAST YEAR, Gov. Arnold Schwarzenegger vetoed a bill that would have established a single-payer system to provide health care for all Californians.
Under SB840, patients would choose their own doctors; doctors would remain private, able to practice the way they want and be paid fairly and simply on a fee for service basis; and California would save billions of dollars.
Instead, the governor has come up with a plan that would keep the insurance industry in health care - to the detriment of us all.
The United States is the only developed nation without a national health program. We spend double per capita what any other nation spends on health care, yet we have 50 million people, including 11 million children, without health insurance and the worst health-care statistics in the developed world.
How can this be? About 50 percent of every health-care dollar is spent on something other than health care. Insurance companies admit they spend about 30 percent of the money we pay in premiums on something other than health care - multimillion dollar salaries for their top executives, profits for their shareholders, advertising and sales, screening applicants and claims, and generating mountains of paperwork and endless hassles for doctors and patients alike. There also is the money we have to spend dealing with them - in the creation of intermediary bodies and in hiring staff to do our billing and to deal with authorizations.
In the 1960s, Canada and the United States spent about the same amount per capita on health care and had similar health-care statistics. By 1971, all of Canada had single-payer. Thirty-five years later, Canada spends less than half of what we spend per capita, and provides health care for all its citizens. On almost every measure, their health-care statistics are better than ours. Our infant mortality rate is 50 percent higher than theirs and our overall mortality rate is 30 percent higher. The World Health Organization ranks the U.S. 37th, at the bottom of the developed world.
If we get the insurance industry out of health care, we will have more than enough money to provide health care for all and to pay doctors and hospitals fairly for their services.
No longer will people have to change doctors every time they change jobs or their employer finds a cheaper health plan. Nor will they have to worry about losing their access to health care if they lose their job or develop a chronic condition. No longer will families struggle to pay astronomical insurance premiums nor worry about paying for prescription drugs. No longer will 50 percent of bankruptcies be due to medical debt.
All patients will have a medical “home.” Continuity of care will be improved and problems will be treated earlier (when easier to treat) or prevented altogether. Rates for vaccinations and health screening will go up. Public health and productivity will improve and social problems associated with untreated mental health problems and addictions will decrease.
If doctors are reimbursed fairly for their services, fewer of them will feel the need to practice at a frenzied pace and will spend more time with patients, providing better quality care.
Smaller companies and small businesses can’t afford to provide health-care benefits and can’t compete for the best workers. A single-payer system would improve all of this and decrease absenteeism and increase productivity. All of these advantages would attract businesses to California, generating more jobs and more tax revenue.
SB840, which was passed by the Legislature last year, will be reintroduced. We have an opportunity to have the best health-care system in the world, to enable all Californians to have access to care that citizens of every other developed nation take for granted, and to lead the country in much needed health-care reform. Let’s be courageous and make it happen.
Dr. Ann Troy is a pediatrician in private practice in San Rafael.