By David L. Rabin, M.D., M.P.H.
Washington Post, Letters, Feb. 24, 2019
Universal health-care coverage is an essential social goal, as David Kendall and Jim Kessler noted. Their plan is politically pragmatic but denies the limitations of the Affordable Care Act upon which their plan is based.
As a physician, I can attest that the ACA does not resolve our system’s failures. The distinguishing features of U.S. health care are its high cost and poor performance compared with systems in other developed nations. Universal health care, to be cost-effective and sustainable, must pay for care in a rational manner, be administratively efficient and balance health promotion, disease treatment and health investments. Health-insurance money must be spent on health, not overhead and profit.
Only a single-payer system responsible for the health of the population, with budgetary constraints and payments for care based on defined costs rather than negotiated prices, can address our health – system failures and be sustainable.