Single Payer System is a Good Idea

[Wooducke]

If you work in the Health Insurance industry like me, then as you read this, try to think of that Upton Sinclair quote ("It is difficult to get a man to understand something when his salary depends upon his not understanding it") and fight the power to act in your own selfish interest.

Even though it's politically impossible with congress right now. I've outlined some reasons why I think we should have a Medicare-like single payer health system in the United States:
• Everyone would have health coverage (including People with pre-existing conditions, un-employed people, people with crappy jobs, and people who just graduated college who have now been dumped from their parents coverage)
• Everyone would be paying into the system, including the people who are currently uninsured. (i.e. Healthcare would no longer be subsidized by the insurance premiums of a few; it would be subsidized by taxes, which everyone has to pay or go to jail)
• Employers would no longer be burdened by having to provide coverage and they could compete better in our global economy.
• More people would seek preventative care instead of waiting for expensive acute illnesses to take affect, as underinsured people do now.
• Hospitals wouldn’t have to charge as much because they wouldn’t have all these losses from uninsured people coming into their ERs.
• Government monopolistic pressure would drive down some of the ridiculous healthcare inflation we’ve been seeing, because they could pretty much set the rates as long as they paid providers enough to cover their costs.
• The government could further control costs by saying “no” to paying for ridiculous high priced drugs and organ transplants for 95 year olds, and CT scans for everything.
• There would be less overhead costs and complications. Think of all the contract negotiations that currently go on between each of the different insurers and providers in this country. Think about all the different re-imbursement rates that providers have to think about when providing coverage to someone. What a waste of resources!
• Insurance overhead cost would be consolidated; pretty much everyone would be getting their insurance through some body like the Center for Medicare and Medicaid Services. Right now the Medicare benefit expense ratio is 97% compared to 81-82% at my company. If Medicare was expanded to more people you could see that benefit expense ratio climbing even higher. Right now all this insurance administrative work is duplicated by scores of private Health Insurers around the country.
• If rich people didn’t like their coverage; they could afford to pay for their own private care, as people do now with plastic surgery.
• A single payer system would be cheaper overall
• A single payer system would be fairer than the current system we have in place where lots of people die or go bankrupt.
• We already have the Medicare system in place, so the idea of single payer health insurance is not really that radically new. We already know how to do it. We could expand Medicare slowly to give time for the economy to adjust. First, raise taxes. Second, expand Medicare coverage to different ages of people over a course of several years. Maybe first expand Medicare to people age 18-29 since this demographic makes up a large portion of the un-insured and then expand it again several years later. The federal government/States already pay for the oldest and sickest and poorest people in this country, expanding Medicare coverage to a bunch of healthy 18-29 year olds would be a nice easy way to start off.
• One of the cons would be that me and most of the other people who work in the health insurance industry would lose our jobs (but hey, at least we would have health coverage when I do!). Maybe I could get a job in P&C?
• Another con would be that doctors would probaby be paid less from the government. However, we would still have the Fee-For-Service system that we have now, so Doctors could still exploit the system like they do now and up utilization to be paid more, so it’s hard to say if doctors would really lose that much.
• Supposedly there would be less incentive for people to become doctors because they wouldn’t get paid as much. If this became too much of a problem though, the government could just increase the fee-schedules that it pays doctors. The government could also pay for smart people to go to medical school as some incentive as well.
• Less Medical technology and crazy drugs would be developed than now, because the re-imbursement rates would probably be lower, and the government wouldn’t pay for frivolous or extremely expensive things like cancer drugs that cost $100,000. This might be a good thing considering how much all these new technologies and drugs have contributed to healthcare inflation. The pendulum needs to swing the other way for a while. (On the other hand, the government already subsidizes a lot of medical research so we would probably still see some innovation.)
• With one giant health insurance provider like Medicare that would cover all sorts of demographics; it would be a great source for data and studies on the health of the American public.


Maybe you disagree or think I have idealized the single payer system. I'm sure it wouldn't be perfect, but the current hybrid system that we have in the US is pretty horrible and I really do think single payer would be a better model.

If you disagree, then I honestly want to hear what you think a ideal system would be. For instance, do you think a purely capitalistic system would be the most ideal situation? How do we resolve the problems with our current employer based health care coverage? (45 million uninsured, crazy healthcare inflation, burden to employers of having to provide health insurance in the US, etc.)