Single Payer Health Care

So many of you are concerned about health care and wonder if single payer is possible.  I wrote a commentary about it.  Not sure if the paper will print it anytime soon, so I'll share it here:

As a Democrat with a progressive bent, universal access to quality health care and the single payer model always made sense to me.  That turned to fervor when my son was hit by a truck.

He was 23 and teaching English in Thailand.  Thanks to Obamacare, the Affordable Care Act, he was still on my health insurance. 

My son suffered broken bones, destroyed joints, a skull fracture and a traumatic brain injury.  But he received the best of care during that critical window when the brain can recover.  Now he’s 26, and has just earned a master’s degree.  We were lucky.

There it is.  Luck.  My son has a bright future as a teacher and tax payer because we were lucky enough to have great health insurance.  Hmmm.  So, the kid who doesn’t have great health insurance is less likely to recover?  More likely to be condemned to the margins?  Maybe need publicly funded support for the rest of their life? 

I believe that quality health care is a human right.  Like public education and police departments and decent highways, I believe it’s government’s role to ensure there’s a health care system that helps us get and stay healthy, and heals us when we’re not. 

A radical idea?  Too expensive?  You may be surprised to know that every wealthy country on earth has universal healthcare, except for the United States.  Providing health care to every resident is not some utopian dream.  It’s normal in much of the world.

Let’s look at the data from a recent study in the Journal of the American Medical Association:

  • We spend twice as much per person on medical care as the ten other high-income countries (the United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland and Denmark)

  • This is despite having similar care utilization rates and lower rates of smoking

  • But our health is worse!  We have the lowest life expectancy, highest infant mortality, and highest birthing mother mortality of all those countries

  • Administrative costs in the U.S. account for 8% of health care costs; in the other countries it’s between 1% and 3% 

  • Per capita annual pharmaceutical costs in the U.S. were $1,443 compared to a range of $466 - $939 in the other high-income countries.  We’re not taking more medications; we’re paying more for each pill.

  • 90% of people in the U.S. have health insurance compared to 99% - 100% of those in the other countries

We’re paying more money but getting worse outcomes.  What are those other countries doing differently? 

Single payer healthcare.  A public agency handles all health care financing.  How does that save money?  Money isn’t spent on advertising and billing different insurance companies.  And the agency bargains for better pharmaceutical prices.

But didn’t Vermont already try this?  Didn’t we give up because we thought it would actually cost more?

The New York Times gives an analogy.  Our towns maintain our local roads.  Much of our municipal property tax bills go toward that.  Let’s say the State made us an offer.  They can maintain local roads for only 70% of what we’re paying now.  They have all the equipment anyway, and it’s a more efficient use of resources.  It would make our state taxes go up, but our municipal taxes would go down by even more.

If the government took over the cost of all health care, our taxes would go way up.  But compare that to our savings. 

  • A single payer system would save as much as 20% in marketing, administration and billing costs

  • Employers would no longer provide health insurance, and could pass those considerable savings onto customers, hire more employees, pay them more, and invest in their business

  • Individuals and families would no longer be paying part of those insurance premiums out of their pay checks

  • Single payer means no deductibles and can also eliminate co-pays and co-insurance costs

The savings would be much greater than the costs. 

Then there are the benefits to society.  No more staying with a job for the sake of health insurance.  That would encourage the start of new small businesses – a real boon to a state like Vermont where most of us are employed by small businesses.  And everyone would be covered, regardless of employment status, including the adventurous 23-year-old.