By Carol A. Paris, M.D.
Alaska Dispatch News (Anchorage), August 9, 2017
In his column regarding a single payer health care system (ADN, Aug. 2), Charles Wohlforth rightly points out Americans currently spend more per person for health care than any other developed country. What do we get for our yearly $3.2 trillion? Compared to other industrialized nations, we rank 25th in preventable deaths, we leave 28 million uninsured, and our businesses are losing their competitive edge due to the cost of employee health insurance.
Attempts at incremental, market-based reforms have failed to return our nation to its position as a global leader in health care. But it is not beyond our grasp. A single-payer solution would save $500 billion annually by eliminating the “middle men,” the private insurance companies and their third-party administrator subsidiaries that siphon profits out of the system, but contribute nothing toward patient care.
Wohlforth notes investor-owned health care entities such as for-profit hospitals, surgery centers and nursing homes would be required to reorganize as nonprofit entities under a single-payer plan. But he is wrong to equate removal of the profit motive with “massive nationalization of private assets and individuals’ careers.” To be clear, the delivery of care would remain as it has always been: a mix of public (VA and IHS) and private care. Hospitals and doctors’ offices would be privately run. We simply need to eliminate the profit motive and conflicts of interest that drive up health care costs for everyone.
The Senate’s failure to repeal the Affordable Care Act has opened up a new national dialogue on the future of health care. While some may argue for more market-based tweaks to our health system, Wohlforth correctly points out in a previous column that “increased competition” can never work in rural states like Alaska because of its small population and isolation from larger markets.
We can either act boldly to achieve universal, high-quality health care at lower costs, or we can bow to Wohlforth’s assessment that it can’t be done. As for me, I’ll put my faith in American ingenuity and determination any day.
Dr. Carol Paris is a psychiatrist and president of Physicians for a National Health Program. She resides in Nashville.