Tuesday, April 18, 2006

The Efficiency of a Single Payer System

Typically doctors come out against calls for a single payer system for health care. The American Medical Association is one of the main organizations that tanked the idea back in the 1930s and 1940s. And ever since they have been fighting it tooth and nail.

But that might be starting to change.

Wall Street Journal (that liberal rag) columnist Dr. Benjamin Brewer--who also runs a private medical practice in Illinois--has an op-ed today that strongly advocates for a single-payer system. In it he writes:

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It took me a while to conclude that a single-payer health system was the best approach. My fear had been that government would screw up medicine to the detriment of my patients and my practice. If done poorly, the result might be worse than what I'm dealing with now.

But increasingly I've come to believe that if done right, health care in America could be dramatically better with true single-payer coverage; not just another layer -- a part D on top of a part B on top of a part A, but a simplified, single payer that would cover all Americans, including those who could afford the best right now.

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Brewer's conversion is based on the fact that administratively, a single-payer system would be far more cost effective for docs than the multiple-payer system we currently employ.

In a recent count done by Brewer and his staff, they concluded that the patients they see come from a total of over 300 different insurance plans. This complexity requires Brewer to employ four administrative staff members--two for billing and two to collect insurance information.

Under a single-payer system, Brewer thinks he could get down to one administrative employee without a problem.

He notes: "It would be simpler and better for the patient, and for me, if the patient could choose a doctor, bring their ID card with them, swipe it in a card reader at the time of service and have the doctor get paid on the spot with electronic funds transfer."

It's only a matter of time before more and more doctors start to come to the same conclusion. With administrative costs gobbling up around 1/3 of our total health care costs, they won't be able to afford not to concur.

2 Comments:

Anonymous Nate said...

I agree 101%. Programs like the Mass. plan do nothing at all to address the real crisis. It may to varying degrees insure a large percentage of the population but keep all the inefficiencies in place.

We need a needs based system with no co-payments, deductibles and the like. While fitting the conservative ideology of individualism, it rises costs considerably.

I would also add that if you're a small business the time is now to get on the single payer bandwagon. A conservative-liberal compromise such as the Mass. plan will make you pay dearly.

April 18, 2006  
Blogger Seth Zlotocha said...

Thanks for your comment, Nate.

It's amazing how many people can simply reject a single-payer system based upon free market ideology alone when in fact there are so many reasons to support it--reasons that benefit liberals and conservatives alike.

To me, health care is the preeminent issue in the US right now--certainly on the domestic front, at least. It'll be a big determinant of who I support in 2008--I can only hope that others feel the same.

April 18, 2006  

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