Single payer health care: the right diagnosis for us
By EUGENE FARLEY and LINDA FARLEY
GUEST COLUMN
Coulee News
Published - Monday, June 11, 2007
What if a doctor knowingly rejected a proven cure despite years of successful tests among diverse nations, a cost that is just half of the existing treatment, and is hugely popular among patients who have experienced it? Wouldn’t that be a shameful lapse in medical ethics?
If so, how will we label those state legislators who appear afraid to seriously consider the Health Security Plan model of “an expanded and improved Medicare for all?” If legislators won’t thoroughly debate a proven answer for our health crisis, wouldn’t that be a cowardly case of “legislative malpractice?”
We already know that selfish interests from the insurance and hospital industries are going to wage all-out war against any reform. So we might as well design a program to create the best possible health system, and let the defenders of the shameful status quo take their best shot.
The Wisconsin proposal will make three key differences in our system:
1) A publicly-accountable body will replace the rapacious “middleman” insurers in collecting revenues and paying benefits, thereby shrinking the enormous costs of insurance bureaucracy.
2) Every citizen — not their HMO — will have the right to choose their doctor and their hospital. Both doctors’ practices and hospitals will remain in private hands.
3) Every citizen of Wisconsin will have health care coverage.
These changes are not far-out dreams: Canada, for example, has delivered on these promises for nearly 50 years. And despite insurers’ propaganda about Canada’s “Medicare” single-payer type health plan, support among the general American public for a single-payer system is remarkably strong.
Business Week in 2005 reported that “67 percent of Americans think it’s a good idea to guarantee health care for all U.S. citizens, as Canada and Britain, do, with just 27 percent dissenting.”
Looking at U.S. polls, there should be little wonder why the impulse for fundamental change in our health system is so powerful:
- COST: Per-person costs in Canada were 92 percent lower than the U.S. in 2004, just $3,165 in Canada compared with $6,102 in our nation (by 2006, the U.S. figure had climbed to over $7,000). Meanwhile, U.S. premiums continue to soar and more costs are shifted by employers to their workers.
- HEALTH RESULTS: By virtually every major health measure — infant mortality, life expectancy, or length of time a patient is allowed to recover in a hospital — Canada and other nations with universal health care rank far ahead of the U.S.
- COVERAGE: Some 47 million Americans lack health insurance (including an estimated 500,000 in Wisconsin who lack insurance at any given time), up from 40 million in 2000.
- BUREAUCRACY: Insurers rely on a massive bureaucracy to fight both doctors and patients. Not surprisingly, bureaucratic overhead accounts for 31 percent of U.S. health-care spending.
- COMPETITIVENESS: Wisconsin premiums are the third highest in the nation, according to Expansion Management magazine. They rank 26 percent above the national average, in part because Wisconsin requires insurers operating within the state to provide broader based coverage and reject fewer people for that coverage.
Wisconsin has suffered long enough under the present profit-obsessed health-care system. We deserve to hear a full and fair debate on all the alternatives to the status quo. We must not allow either timidity (“the insurers will never allow it”) or ideological rigidity (“It’s socialized medicine”) to block thoughtful consideration of the most proven and sensible approach to our health crisis.
We can and must fundamentally reform our health-care system so that no Wisconsin parents need to worry about how to receive and pay for the quality medical care that that they and their children need.
Both Dr. Eugene Farley and Dr. Linda Farley are emeritus faculty of the UW-Madison Medical School, where Gene served as chair of the Department of Family Medicine. Linda is the Wisconsin coordinator for Physicians for a National Health Program.