Ann Troy, M.D., FAAP
San Rafael, Calif.
AAP News
March 2007
In his State of the Union address, President Bush acknowledged that we have a health care crisis in the United States. His plan for fixing it 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 more than double per capita what any other nation spends on health care, yet we have almost 50 million people, including 9 million children, without health insurance, millions more with grossly inadequate coverage, and the worst health care statistics in the developed world.
How can this be? Approximately 50% of every health care dollar is spent on something other than health care. Insurance companies themselves admit that they spend about 30% of the money we pay in premiums on something other than health care — multimillion dollar salaries for their CEOs, profit for their shareholders, advertising and sales, screening applicants and claims, and generating mountains of paperwork and endless hassles for doctors and patients, alike. Then there is the money we have to spend dealing with them — in the creation of intermediary bodies and in hiring staff to do 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 a single-payer system. Thirty-five years later, it spends less than half of what we spend per capita, yet is able to provide health care for all of its citizens. Fur ther more, on almost every measure its health care statistics, like those of other developed nations, are better than ours. Our infant mortality rate is 50% higher than Canada’s, and our overall mortality rate is 30% higher.
The World Health Organization ranks the United States 37th, at the bottom of the developed world! If we get the insurance industry out of health care and establish a single-payer system, we would have more than enough money to provide health care for all and to pay doctors and hospitals fairly for their services. Under a single-payer system, patients would be able to choose their own doctors; doctors would remain private, able to practice the way they want, paid fairly and simply on a fee-for-service basis; and we would save billions of dollars.
No longer would 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 would families struggle to pay astronomical health insurance premiums, or worry about paying for prescription drugs. No longer will 50% of bankruptcies be due to medical debt. All patients would 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.
Single payer will be good for the economy. American companies are at a huge disadvantage when competing with companies in other developed nations, which are not burdened with the high cost of providing health care for their employees. Smaller companies and small businesses can’t afford to provide health care benefits and, thus, can’t compete for the best workers. Un happiness over health care benefits is the leading cause of labor unrest in the United States. A single-payer system would improve all of this and also decrease absenteeism and increase productivity (workers with access to health care are healthier and more pro ductive). Furthermore, worker’s comp would be reduced or even eliminated. All of these advantages would create more jobs and generate more tax revenue.
A single-payer bill, HR676, authored by Reps. Conyers (D-Mich.) and Kucinich (D-Ohio), will be introduced soon. With this bill, we have an opportunity to have the best health care system in the world and to enable all Americans to have access to health care that citizens of every other developed nation take for granted. Let’s be courageous and make it happen!
Editor’s note: At press time, the Academy had not taken a position on the single-payer bill.
