By Marc H. Lavietes, M.D.
Asbury Park (N.J.) Press, August 14, 2017
I agree with recent letter writers: health care decisions should be between doctor and patient only. However, given the high cost of our pharmacopoeia and modern medical technology, the day of the altruistic physician accepting token payment from less affluent patients is gone. Bandaids such as those mentioned in the letters will not work. Yes, tort reform will help (a little). Purchasing insurance across state lines courts disaster; inadequate but inexpensive plans will siphon off young healthy persons from the general pool, making insurance more expensive for others.
By contrast, a single payer system administered by a non – profit entity will preserve the sanctity of the doctor – patient relationship. In such systems the administrator serves only as the bank. Single payer reimburses treatment, i.e., heart failure, asthma, etc., rather than fee – for – service, i.e., CAT scan, catheterization. Thus, the economics of single payer encourages medical decisions based upon patients’ need rather than physicians’ income. Yes, physicians will at times negotiate with the payer regarding complex, costly medical decisions as well as their own salaries. But the non – profit payer, unlike the private insurance company, will have no profit motive. Unlike the corporate CEO or shareholders, the government administrator will not earn millions of dollars yearly.
What works well in France and Canada will work for us! Our experience with the ACA tells us that lesser incremental change, i.e., bandaids, will not.