Robert Wood Johnson Foundation
News Digest
Dec 14, 2008
The rising numbers of unemployed and uninsured mean that “affordable health care has never been more urgently needed,” and “at this critical juncture, a single-payer plan is the only medically, morally and fiscally responsible path to take,” writes Oliver Fein, M.D., associate dean and professor of clinical medicine and public health at Weill Cornell Medical College and president of Physicians for a National Health Program, in an Atlanta Journal-Constitution guest commentary.
The health care reform proposals offered by President-elect Barack Obama, Sen. Edward Kennedy (D-Mass.) and Sen. Max Baucus (D-Mont.) all “share a fatal flaw: they preserve a central role for the private health insurance industry.” Fein points to the mandates in some of the proposed plans as problematic because they require people to purchase “the private health insurance that is failing us today.” And, while some offer a public option modeled on Medicare, private plans continue to “refuse to compete on a level playing field” and instead “cherry-pick healthier patients and insist on more than their share of payment.” Fein argues that private health insurance companies have high overhead costs and “force doctors and hospitals to spend heavily on billing and paperwork.”
Fein proposes getting rid of the private insurance industry, which would save $400 billion a year in administrative costs–“enough to ensure that everyone is covered and to eliminate all co-pays and deductibles.” In its place he suggests implementing a single-payer system that works like Medicare, which “has been a leader in keeping costs down, at least until Washington politicians decided to pay private insurance plans to enroll seniors at a cost 12- to 19-percent higher than traditional Medicare.” A single-payer system would allow patients to choose their preferred doctor and hospital; make it easier for doctors to get paid and allow them to concentrate on providing care; “enhance cost containment through global budgeting”; and emphasize primary care and prevention.
According to Fein, 59 percent of physicians and 62 percent of Americans support the idea of national health insurance. Even opponents of a single-payer plan “often admit it’s the best, most efficient and equitable way to provide quality care” but fear it is not “politically feasible” so prefer to keep it off the table. He concludes, “Medicare for All is within reach, but only if we are prepared to take on the private health insurance industry.” (Fein, Atlanta Journal-Constitution, 12/14/08)