Why I Am For Single Payer Health Care

One of the big issues in this election is the recent health care legislation,  which the Republicans are calling Obamacare.  For completely different reasons, I am no fan of the new rules, which I would hardly call reform.  In fact, I feel let down that he didn’t just “rip the scab off” the system and go for a single payer system.

First, I lived under a single payer system in the UK.  I had to travel a lot in those days, creating a number of opportunities for me, my family members or coworkers to sample the medical systems around the world.  There is no doubt that the US has the best overall quality of care.  We also spend the most  – $2.25 trillion annually and rising – so there is enough money in the system.  The problem is how we connect the money to the provision of the service.  Basically, we have a billing problem.

This is my first issue with the Obama health care plan.  It leaves insurance companies entrenched in the system.  While most people think of insurance as something that kicks in when a catastrophe happens, it is actually a “fixed” return investment, the kind of thing you put at the foundation of a portfolio of stocks.  There is no good reason to insert a financial product in the middle of this system.  The profits that are skimmed off by the insurance industry should be in the system.  Take a look at the profits declared and the bonuses paid by MetLife, AFLAC and others and then picture how much more health care those sums could buy.

Another reason that I am for a single payer system is that the current method of providing health insurance saddles employers with costs not borne by their foreign competitors.  I used to help make decisions on where to locate plants and where to manufacture new product lines.  I can tell you from experience that a big “$0″ or two in the employee benefits columns of a spreadsheet can go a long way toward making one location more attractive than another.  We can’t keep saddling our businesses with the full cost of our health care system if we want to produce products competitive in the global marketplace.

From the workers standpoint, we would actually enjoy more personal freedom if basic health care was a societal benefit, rather than an employment benefit.  Under the current arrangement, we are somewhat indentured to our jobs.  The provision of benefits gives the company a little more control over our lives and it makes it just a little bit harder to leave.   It places too much power in the hands of the employer as “lord and master,” with the ability to completely pull the rug out from underneath your life.

A good single payer system would leave the providers – doctors, hospitals,etc – in the private sector, competing in a free market against each other.  The vast majority of the UK’s NHS is paid for in gasoline, “sin” and modest payroll taxes.  If we take a fee hands out of the cookie jar, we should have more than enough money in the system to pay for care.

One other thing we could adopt from the systems in place in the UK and Germany is delegating the work a little differently.  Pharmacists can do more, as can physicians assistants, nurse practioners and RN’s.  Many medical services can be handled quickly and inexpensively by professionals who work under the guidance of a doctor.  With everyone in a more coordinated system, we will be able to reduce the cost person as compared to the current fragmented system.

The last reason I would give for a single payer system is that it is simply the right thing to do.  It is a hallmark of a modern society.  The US is the only major industrial country without a national health care plan.  We have far too many resources to leave such a large portion of our population “uninsured.”  You get insurance on a motorcycle or on a house.  Things you buy with cash and can replace with cash.  You basic health doesn’t seem to be the same sort of asset.  It’s a lot more fundamental to your general welfare, which was promised to be protected in the preamble of the Constitution.  That ought to be enough to set our course all by itself.