By Samuel Metz, M.D.
Portland (Ore.) Alliance, March 2011
Here are two facts to disturb your coffee break.
1. Oregonians already pay enough in health insurance premiums to provide every Oregonian with comprehensive, no deductible, no co-pay, all medications included health care.
2. We aren’t getting it.
Where’s the disconnect?
It’s not the usual suspects: undocumented immigrants, medical malpractice, insurance fraud, government waste, or fee-for-service reimbursement. The answer is that private health insurance is the most inefficient method of financing health care known to man.
Any health care financing agency must keep administrative costs low. Single-payer agencies like Medicare and the VA are under 4 percent. Private single-payer agencies like Taft-Hartley multiemployer heath plans are less than that.
The private health insurance industry, sacred cow of Democrats and Republicans alike, produces a 40 percent administrative loss. This is not a misprint. Private health insurance financing is 10 – repeat – 10 times more costly than all known single-payer agencies.
Grip your coffee cup for the obvious question. How on earth can this happen? First, private health insurance companies keep 20 percent for lobbying, marketing, and profit plus executive salaries and other overhead expenses.
Of the 80 percent passed on to health care providers, another 20 percent is spent by providers to collect money owed them by insurance companies in the first place. After all, this industry denies 30 percent of all claims, not because they are bad people, but because denying claims is good business.
This staggering 40 percent administrative loss totals $4 billion in Oregon. How much additional money do we need to pay for comprehensive care for every Oregonian? Less than that, $3.5 billion. Clearly if we finance this with private health insurance, Oregonians must cough up another $3.5 billion in premiums, taxes, and out of pocket expenses. If we use single payer financing, the money is already there.
So there you are, with your coffee cup frozen an inch from your lips, realizing the solution to our health care crisis is so simple: single payer health care. And it has arrived in Oregon. Yes, the Oregon House is considering health care legislation as we speak, HB 3510 submitted by Michael Dembrow, and Senate SB 888 submitted by Chip Shields.
You are not the only one who should know about this legislation; your legislators should as well. Write, call, e-mail, or corner your legislators. Tell them single-payer health care is important and they should learn why. Do not let this historic opportunity pass.
But finish your coffee first.