Say yes to national health care
By Michael Hochman and David Himmelstein
October 29, 2007
Michael Moore's film Sicko gave a big boost to the movement for single-payer national health insurance this year. But even those turned off by Mr. Moore's less-than-subtle style will find many reasons to support a single-payer system. As the number of uninsured and underinsured Americans continues to rise and medical costs spiral out of control, these reasons are increasingly compelling.
As doctors at an urban hospital, we see uninsured patients in the emergency room with serious illnesses that easily could have been prevented with appropriate preventive care. We waste countless hours filling out unnecessary insurance forms. And we listen to patients complain about the complexities and hassles of navigating the health care system.
This is why an increasing number of us on the front lines have started calling for meaningful change in the form of a single-payer system in which the government funds health care.
Next weekend, proponents of single payer will gather in Washington for the annual convention of Physicians for a National Health Program. Our group has proposed giving every U.S. resident a health care card entitling him or her to all medically necessary services. The new program would be funded by an increase in taxes, but that would be fully offset by savings from abolishing insurance premiums and many out-of-pocket health care costs. Those wanting cosmetic and other medically unnecessary services could still pay out of pocket.
Opponents of a single-payer system argue that single payer could be even more inefficient and bureaucratic than the current system. They point to other countries, such as Canada, that have national health insurance and yet have long wait times to see doctors.
But research supports the opposite conclusion. For example, a 2003 study published in The New England Journal of Medicine found that the average overhead of U.S. insurance companies is 11.7 percent, compared with 3.6 percent for Medicare and 1.3 percent for Canada's national health insurance program. And the waits in Canada are a result of Canada's low level of health spending - on a per capita basis, about half that in the United States. The efficiency of Canada's national health insurance program coupled with our current high level of health funding would yield the world's best health care system.
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