By ALWIN STEINMANN
Albany Times Union
Thursday, September 4, 2008
There have been a number of recent items on the opinion pages regarding the important and timely topic of health care, in particular, the issue of a single-payer system. Both Dr. John Bennett (Aug. 22) and Joel Margolis (Aug. 21) are critical of this potential solution for the problems that plague our nation’s medical system. Mr. Margolis implies that the nation can’t afford a Medicare-like system that would cover all Americans, yet the facts would argue otherwise. If one were to add up all the public monies currently spent on health care in the U.S. and applied it across our entire population, on a per capita basis, we already spend more than many industrialized countries do to cover all their citizens.
Dr. Bennett cites the shortfalls of the current Medicare system, but a “Medicare-for-all” product would look very different from the Medicare that we have been dealing with for four decades. A single-payer system based on Medicare would utilize its financial and administrative infrastructure to provide benefits that are better suited to a wider spectrum of patients and reward preventive care and chronic disease management. He closes by concluding that not-for-profit health insurers are the most qualified entities to tackle our broken health care system by virtue of their “proven track record of keeping costs down and managing the delivery of medical services.”
Given the fact that the U.S. spends nearly twice as much per capita on health care as any other industrialized nation and ranks well below those nations in the overall quality of care delivered, I am wondering what record he is referring to. The “proven track record” of our current system is the best argument for a major overhaul.
A number of medical professional societies, have called for health care reforms to provide universal coverage including the possibility of a single-payer system. An article published in the Annals of Internal Medicine showed that the majority of polled physicians (59 percent) supported the notion of a single-payer system. Given that 15 percent of our population lacks health insurance, and our overall expenditures on health care is in excess of $2.1 trillion, a single-payer system is no longer a fringe idea to be thought of as a dream. It’s instead a realistic solution to a health care system that rewards excessive care and administrative infrastructure while ignoring the real needs of its patients and providers.
Alwin Steinmann is a doctor. He lives in Slingerlands.