A single-payer response to the health care crisis
By Ross C. Anderson (mayor of Salt Lake City)
A health care crisis in this country is having a profound impact on the lives of millions of people. We live in one of the wealthiest nations in the world, yet more than 44 million of our citizens are without access to health care coverage, including 8.5 million children.
Those who are covered, and employers who provide health care benefits to employees, are experiencing skyrocketing increases in the costs of medical insurance. Those higher costs are due largely to the huge profits of the middle-man insurance companies and the exorbitant compensation paid to insurance company executives.
The reasons for lack of health care coverage are varied. Many people are self-employed and unable to afford the cost of health insurance. Millions of people work for employers who don’t provide health insurance. Others are unemployed but not poor enough to qualify for Medicaid.
The consequences of living without health insurance are often devastating. The cost of basic preventive health services such as prenatal care, well-child check-ups and cancer screenings can be prohibitive. Many of the uninsured go without preventive care, waiting until a health disaster strikes before seeking assistance, and then often facing bills that bankrupt them. Or, worse yet, they may be unable to obtain medical services because of their inability to pay.
The Institute of Medicine has estimated that 18,000 adults in America die every year because they are uninsured. Women with breast cancer who don’t have health insurance are twice as likely to die as those who are covered. Uninsured men are nearly twice as likely to be diagnosed at a late stage of colon cancer as those who are covered. A lack of health insurance and the high cost of medical care can have a disastrous effect on individual lives and on our entire community.
The rising cost of health care is negatively impacting all sectors of our economy. City government has been hit hard. The cost to Salt Lake City Corporation of providing employee benefits has risen 59.5 percent since 1998, primarily due to the increase in health care costs. The increase in health insurance costs has caused significant budget challenges, leading to a loss of jobs and a decrease in city services. Likewise, in 2003, employers across the nation faced average one-year premium increases of 13.9 percent for private health insurance.
There is a solution to this crisis. As a nation we can do more to provide all of our citizens access to basic, quality health care services. But to accomplish this will require the political courage to stand up to those in the health care industry resistant to change.
Creation of a system that provides access to health care for all Americans could best be accomplished by developing a single-payer system under which a government-sponsored entity serves as the insurer for all Americans. Under this system, physicians, hospitals and drug companies would remain privately owned. Only insurance coverage would be centralized.
A single-payer system is better for patients and better for doctors. Canada, which has a single-payer system, spends $1,000 less per capita on health care than does the United States, but delivers more care and greater choice for patients. Combining the single-payer efficiency of Canada’s system with the much higher funding of ours would yield better care than Canada’s or ours at present.
Under a single-payer system, the General Accounting Office projects an administrative savings on health care costs of 10 percent — which in 2002 amounted to $150 billion dollars. This savings alone would cover the cost of providing medical care to those currently without health care coverage.
The Congressional Budget Office projects that a single-payer system would reduce health care costs overall by $225 billion, while providing comprehensive care to all Americans. No other plan provides this kind of savings.
We can no longer afford our current health care delivery system. A single-payer system would provide health care coverage for all Americans, create greater efficiency in our health care system and result in a healthier population. It would benefit the vast majority of patients, employers, governmental entities and taxpayers.
We can stand up to those who continue to gain from the inefficiency of our current system — the insurance companies, enormous hospital chains and pharmaceutical companies that comprise the health care oligarchy — and create a fair, efficient, single-payer health care system for all Americans.