Ideal Health Care Reform: Single-payer

Health care reform is something we have needed for far too long. Those of us who have clamored for such reform for years remember our disappointment when ambitious plans to repair health care fizzled out under the Clinton administration. We are confounded that in one of the most prosperous nations in the world we have so many people without access to such a basic need.

This is why I'm glad to see that, with all of the issues that are on his plate, President Obama is determined to move forward on health care reform. In his most recent weekly internet address he outlined his ambitious goal of extending coverage to the 45 million uninsured, improving the quality of health care, and keeping consumer options intact. He pointed to the Mayo Clinic as an example of one institution that has succeeded in providing high quality health care at a lower cost.

It looks more and more like we will see some form of bipartisan reform bill come down the pipes in the next few years. Whatever is negotiated is bound to be an improvement over what we have now. The question remains, though, whether President Obama will be able to win the debate over whether to include a public insurance plan as a choice among private sector plans. One proposition that will definitely not be on the table is the option of converting to a single-payer system. Obama has already made it clear that this will not be a consideration and asserted his preference for rebuilding what is currently in place by continuing procedures that work while weeding out those that do not. Even if his administration did favor a single-payer system, the idea is so repugnant to most Republicans in congress that it would be blocked.

I applaud the pragmatism of President Obama's plans, but I think it's a shame that a single-payer health system will not be considered. It would clearly be the simplest, most efficient way to ensure that every person in the country has coverage. It makes little sense to me that we have public systems in place to ensure access to emergency services and education. We look at these as basic needs, but what is more basic than keeping people from getting sick or dying?

Let's leave compassion out of the picture for a moment and consider cost alone. The U.S. spends almost double that of most other industrialized countries on health care in spite of the fact that our private sector pays a greater portion of costs. We also have a lower life-expectancy and higher infant mortality rate. We spend more out of our pockets for fewer services. If you look at it from a pure economic standpoint, privatized health care has not been very cost effective.

Maybe you are insured and you care only about yourself. You don't see any reason to pay taxes that will finance the health care of others. If you don't think you are already paying for them, think again. Doctors have taken something called the Hippocratic oath. This means that, in an emergency, they are obligated to save the life of an uninsured person. This results in higher premiums for the insured. If your employer pays for your insurance, your employer incurs the cost of these higher premiums. At some point this will trickle down to you in the form of reduced services or higher out-of-pocket expenses.

Those who oppose a single-payer system worry that choice will be eliminated. I believe that this is a fallacy. The most important choice when it comes to an individual's health care is which caregiver or facility works best for you. There is nothing that would prevent an individual from having a free choice of doctors and hospitals just because the service was publicly funded. I also personally think that choice is overrated. Receiving quality medical care without spending the rest of my days paying expensive medical bills is all that really matters to me. If I am receiving this, what other choice do I need?

One of the biggest fears associated with a single-payer system is that the U.S. will suddenly become "socialist." There is certainly nothing inherently evil or repressive about socialism. Socialism and democracy are not mutually exclusive, but this is beside the point. The idea that single-payer health care would turn the U.S. into a socialist empire is hogwash. If having certain basic needs publicly funded is what will make us a socialist country, then we are already socialist. Fireman, police, public schools, medicare, and social security are all services we pay for with taxes. Amazingly, we still have a free market!

It is true that single-payer systems are not without their problems. Critics have pointed out that Swedish and British citizens often endure longer waiting periods for non-emergency or elective surgery. However, any American who has dealt with the red tape or HMO's knows that we have similar problems with private insurance. It is difficult to iron out what procedures are covered, and you might spend months going from one specialist to another trying to get approval for a given procedure.

Single-payer systems are, on the whole, more efficient, less expensive, and deliver higher quality care. Our best hope for now is that we are offered the choice of a publicly funded insurance plan. If this happens, perhaps some of the people who once feared it will see the benefits and feel a sense of relief that the country has not fallen into ruin. Then we can dispense with all of the nonsense and move on towards something even better.