Single Payer Follies

Jolting the health policy debate out of the August doldrums, nearly 8,000 physicians recently announced that they are supporting a taxpayer-funded, single-payer health care system based on “an expanded and improved version of traditional Medicare.”

In their utopian plan, the federal government would pay for all physician and hospital care, and patients would not be required to pay co-payments or deductibles. The government health plan also would cover prescription drugs, medical equipment, long-term care, rehabilitation services, and dental care.

The authors claim that their plan, described in detail in the current Journal of the American Medical Association, would SAVE $200 billion a year by eliminating profits by private health insurance companies and curtailing burdensome paperwork. The savings would be used to cover 41 million Americans without health insurance.

It sounds too good to be true. And it is.

For starters, the group is using the current Medicare program, which covers 40 million seniors and disabled Americans, as its model.

But Medicare covers only about half the health care expenses of beneficiaries, with 90 percent of them obtaining supplementary coverage through Medigap polices, retiree coverage, or Medicaid to fill the gaps.

The new universal version of Medicare would have to be very much “improved” — and much more expensive — to even match the average private health plans that the great majority of working Americans have today, plans that are much more comprehensive than current Medicare.

Further, Medicare is hardly a model of paperwork reduction. It is governed by 110,000 pages of rules and regulations that give doctors and hospitals nightmares.

The Socialized health care systems in Europe are nearly collapsing under the weight of citizens’ expectations for free care and shortages of personnel and medical resources.

An article in The New York Times recently shows where this all-you-can-eat health care buffet can lead. It describes the experience of the residents of Wales in the United Kingdom seeking dental care from their National Health Service after the government provided a supplementary grant to meet demand for added dental treatment.

More than 600 people lined up this summer outside a small dental office called Brynteg Dental Surgery, desperate to get one of the 300 advertised appointments to see a National Health Service dentist.

Some people pitched tents on the sidewalk and slept there overnight in hopes they would get a slot.

One of the unfortunate ones was Steve Acworth, 56, who arrived too late. He could not have been more in need of dental care.

“My crowns all fell off,” he told the Times. “I got some really bad dentistry and it ruined all my root work. I have no front teeth and one pair of molars, which meet on the right side of my mouth. I can’t bite anything.”

The office manager, Heather Davies, who handed out the numbers, was cajoled and threatened by those who lost their shot at the dental care until she had to call the police. The office, in fact, installed a direct hot line to police headquarters.

“Because they are paying national insurance, people feel they are entitled to service,” Ms. Davies said.

Perish the thought!

So this is where it leads: Angry patients paying high taxes for universal access to health and dental care, only to be turned away after sleeping on sidewalks all night, with dental offices calling the police to protect themselves from desperate patients.

Donald Palmisano, president of the American Medical Association, made it clear that the AMA does not support a government health insurance system that leads to “long waits for health care services?and a decline in the authority of patients and their physicians over clinical decision-making.”

Dr. Palmisano’s — and the AMA’s — prescription is the right one: “The solution to the health care question is a mix of private and public sector financing, with coverage and care remaining in the private sector.

“The AMA’s health insurance proposal advocates refundable tax credits inversely related to income, individually selected and owned health insurance, and other reforms.”

The battles continue between advocates of government-run health care and those who are trying to build a consumer-driven system organized through competitive, free markets.

Americans are rightly frustrated with their health care system — millions of uninsured, high costs, and bureaucratic intrusion.

But more bureaucracy and centralized control in an era of dramatic new medical treatments and technologies simply can’t prevail. The United States has an obligation to lead the world to a better system, not move backward to the failed systems of the last century.

Grace–Marie Turner is president of the Galen Institute, a not–for–profit research organization that focuses on health reform. She can be reached at P.O. Box 19080, Alexandria, VA 22320 or at galen@galen.org

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Jolting the health policy debate out of the August doldrums, nearly 8,000 physicians recently announced that they are supporting a taxpayer-funded, single-payer health care system based on “an expanded and improved version of traditional Medicare.”

In their utopian plan, the federal government would pay for all physician and hospital care, and patients would not be required to pay co-payments or deductibles. The government health plan also would cover prescription drugs, medical equipment, long-term care, rehabilitation services, and dental care.

The authors claim that their plan, described in detail in the current Journal of the American Medical Association, would SAVE $200 billion a year by eliminating profits by private health insurance companies and curtailing burdensome paperwork. The savings would be used to cover 41 million Americans without health insurance.

It sounds too good to be true. And it is.

For starters, the group is using the current Medicare program, which covers 40 million seniors and disabled Americans, as its model.

But Medicare covers only about half the health care expenses of beneficiaries, with 90 percent of them obtaining supplementary coverage through Medigap polices, retiree coverage, or Medicaid to fill the gaps.

The new universal version of Medicare would have to be very much “improved” — and much more expensive — to even match the average private health plans that the great majority of working Americans have today, plans that are much more comprehensive than current Medicare.

Further, Medicare is hardly a model of paperwork reduction. It is governed by 110,000 pages of rules and regulations that give doctors and hospitals nightmares.

The Socialized health care systems in Europe are nearly collapsing under the weight of citizens’ expectations for free care and shortages of personnel and medical resources.

An article in The New York Times recently shows where this all-you-can-eat health care buffet can lead. It describes the experience of the residents of Wales in the United Kingdom seeking dental care from their National Health Service after the government provided a supplementary grant to meet demand for added dental treatment.

More than 600 people lined up this summer outside a small dental office called Brynteg Dental Surgery, desperate to get one of the 300 advertised appointments to see a National Health Service dentist.

Some people pitched tents on the sidewalk and slept there overnight in hopes they would get a slot.

One of the unfortunate ones was Steve Acworth, 56, who arrived too late. He could not have been more in need of dental care.

“My crowns all fell off,” he told the Times. “I got some really bad dentistry and it ruined all my root work. I have no front teeth and one pair of molars, which meet on the right side of my mouth. I can’t bite anything.”

The office manager, Heather Davies, who handed out the numbers, was cajoled and threatened by those who lost their shot at the dental care until she had to call the police. The office, in fact, installed a direct hot line to police headquarters.

“Because they are paying national insurance, people feel they are entitled to service,” Ms. Davies said.

Perish the thought!

So this is where it leads: Angry patients paying high taxes for universal access to health and dental care, only to be turned away after sleeping on sidewalks all night, with dental offices calling the police to protect themselves from desperate patients.

Donald Palmisano, president of the American Medical Association, made it clear that the AMA does not support a government health insurance system that leads to “long waits for health care services?and a decline in the authority of patients and their physicians over clinical decision-making.”

Dr. Palmisano’s — and the AMA’s — prescription is the right one: “The solution to the health care question is a mix of private and public sector financing, with coverage and care remaining in the private sector.

“The AMA’s health insurance proposal advocates refundable tax credits inversely related to income, individually selected and owned health insurance, and other reforms.”

The battles continue between advocates of government-run health care and those who are trying to build a consumer-driven system organized through competitive, free markets.

Americans are rightly frustrated with their health care system — millions of uninsured, high costs, and bureaucratic intrusion.

But more bureaucracy and centralized control in an era of dramatic new medical treatments and technologies simply can’t prevail. The United States has an obligation to lead the world to a better system, not move backward to the failed systems of the last century.

Grace–Marie Turner is president of the Galen Institute, a not–for–profit research organization that focuses on health reform. She can be reached at P.O. Box 19080, Alexandria, VA 22320 or at galen@galen.org

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About the author