Single Payer System is Not the Answer

From the July 2007 Issue of Surgery News:

Single Payer System Is Not the Answer

The thoughtful letter by Dr. Basil Meyerowitz supporting a Single-Payer System (May 2007) illustrates some of the difficulties making sense of the current inefficient, expensive healthcare delivery system.

Although Dr. Meyerowitz cites a figure of 3% for Medicare administrative overhead, the Center for Medicare and Medicaid Services itself contradicts this. Their 2003 self-reported figure is 11.41%, a figure that omits the cost of collecting taxes that fund the system¹. The assertion that for private insurance companies this number is “closer to 30%” is also not borne out by CMS’s own data, which cites 9.03% in the same report. Most disturbing are the administrative costs associated with the Medicaid program, an astonishing 32.38%. More recent figures reinforce this, with 2005 numbers at 31%^{2, 3}.

I agree wholeheartedly with Dr. Meyerowitz that eliminating the middlemen is a step in the direction of restoring the doctor-patient relationship and returning choice to the individual. But the conclusion that a “government-sponsored, single-payer system is the only viable” way to do this is mistaken.

I respectfully suggest that what is needed is not more government regulation or a repeat of the failures of socialized medicine (rationed care), but to instead reject the mammoth system of administrative interference that makes health care delivery less affordable. Consumer-driven health care in the form of portable, affordable Health Reimbursement and Health Savings Accounts coupled with low-cost individual High Deductible Health Plans give the patient the freedom to make choices that would be made by the federal government under a Single-Payer System.

Dr. Meyerowitz is right to address the issue of managing risk. Rather than penalizing healthy individuals, this would be better addressed by a nationwide risk pool that protects sick patients without driving the average person out of a lower-cost pool.

Expanding bureaucracy has contributed to the current problems faced by patients and their doctors in this country. Whether the mammoth system bears a private insurance logo or the Seal of the United States makes no difference. The power of healthcare decision-making must be returned to the individual.

To see or download July 2007 issue: click here (large file). Letter is on page 6.

The letter submitted by Dr. Meyerowitz titled "Say Yes To A Single Payer System" referenced above was published in the May 2007 issue, page 17, of Surgery News. To see or download the May 2007 issue: click here (large file).