The New York Times
December 2, 2003
A Conversation with Steffie Woolhandler
Heal Health Care System? Start Anew
By Judy Foreman
Dr. Steffie Woolhandler… an associate professor at Harvard Medical School and an internist at Cambridge Hospital, wants to change the health care system. Soon, and not in the way Congress just did.
Her plan is simple. Get rid of the private health insurance industry and abolish Medicaid, the government’s health insurance program for the poor. In their stead, set up a national health insurance system that would cover all Americans by expanding Medicare, the old-style Medicare, to include everyone from birth to death.
Dr. Woolhandler’s plan would add prescription drug benefits to Medicare, as the newly passed bill does. But in her plan, drugs would be paid 100 percent by the government, not administered through private insurance plans. She would also abolish co-pays and deductibles for both drugs and medical visits.
Patients would still choose their doctors, who would be paid on a fee-for-service basis. Hospitals would be privately run and would be paid a fixed monthly budget. By getting rid of the high administrative costs of private insurance, the money that people now pay out in premiums would be collected as a new tax.
Q. Is it too late to move ahead on your plan for national health insurance now that Congress has passed the new Medicare bill?
A. Actually, no. The reasons for moving ahead are even larger. We are going
to see more money spent on administrative costs than before. The bill doesn’t even benefit seniors, much less extend benefits to everyone else.
Q. … What, if anything, is going to get a vast majority of doctors on your side?
A. We want to get a real debate going, so the American people can choose. If
no one discusses it, we have deprived the American people of their right to
choose.
Comment: Steffie’s message to us is that our colleagues and the public must understand our model of social insurance and how that contrasts with the current system and with the other options for reform.
There is no question that the vast majority of Americans would choose the single-payer social insurance model if only they really understood it. It’s our job to make sure that they do.