Friday, January 23, 2009

Another argument in support of a single payer health care system

There is a great piece in the New York Times, today, by Uwe Reinhardt, supports, nicely, the argument for a single payer health care system. In his piece, Dr. Reinhardt summarizes the "“Chaos Behind a Veil of Secrecy” (I love that line) of how hospitals determine pricing of medical acts. The details are, at the same time, fascinating and nauseating, like any good, blood-soaked medical mystery.
"Over all, then, annually establishing the prices that a given insurer will pay a particular hospital and the prices charged the uninsured is an enormously cumbersome and highly labor-intensive process not used by any other health system in the industrialized world. It adds a significant component to the high administrative cost that is unique to the American health system."
In is interesting to note, once we come to a national consensus in favor of universal coverage, how quickly the culture and practices that developed to stratify the haves from the have-nots become ridiculous. With everyone in the same risk pool and a single payer, there is no need for a health insurance industry. Buggy whip manufacturers, all of them. A whole host of healthcare dollars sucked from the system for no healthcare related benefit could be returned to or eliminated from the pie.
Also note that a single payer system does not mean that the government controls your health care options (any more so than it does now). Nor does it mean that health care providers won't need to compete and evolve under market forces. In fact market forces could be more easily directed at quality, efficiency and outcomes. A single payer would provide a level, open-to-scrutiny-and-regulation playing field upon which society could make its decisions about the allocation of health care resources to clinical care, research, education and community service.