Single-Payer System Would Give US the World's Best Care

By Dr. John Daley

May 7, 2007

Major newspaper editorials in the US rail regularly against health care reform. But more often than not, such railings represent yet another attempt by members of the health insurance industry, or someone with very good insurance, to torpedo the best choice for health care reform - a single-payer system, or Medicare for all - by using scare words like rationing or socialized medicine.

As a family physician on the front lines of medicine, I see daily the difficulties patients face due to lack of insurance or underinsurance. Generally, these patients ration their own care, disappearing for a year or two when they lose their job and insurance, only to return with sky-high blood pressures or out-of-control diabetes, effectively taking years off their lives.

In New Hampshire, approximately 135,000 citizens lack health insurance, and, for those who have it, many can't get all they need. The MRI wait may not be long, but many people can't see their doctor, much less get an MRI. Now, with health savings accounts and high-deductible plans, I have insured patients refusing their MRIs due to the cost.

It is estimated that 18,000 Americans die annually due to lack of insurance - a rather harsh effect of our present method of rationing. Shouldn't the elimination of these deaths be a national priority?

The editorial mentions Canadians coming to the United States for surgery because of better and more readily available care. These numbers are rather small, and the editorial fails to mention Americans going to Canada to get affordable drugs, or the ever-increasing phenomenon of medical tourism, where Americans travel abroad to get surgeries that are more affordable.

The bottom line is that Canadians enjoy longer, healthier lives than Americans, despite spending far less than we do, while covering every citizen. In a recent survey, only 3.5 percent of Canadians reported feeling that they waited too long for care - a much smaller number than our 15 percent uninsured, who wait quite a bit. Long waits are a misleading myth.

Furthermore, a recent Harris Interactive poll of patients in the leading industrial societies found that Canada ranked first and the United States last in patient satisfaction with health care. You can't just poll those with good insurance, after all!

Remember the term "single-payer" as the best solution to our health care system's problems. If one believes that health care is a human right and not a privilege, and if one wants to avoid having a health insurance company - which profits by denying care - choosing which tests you can have and which drugs you can take, it is the best answer.

The government pays for more than 50 percent of health care costs already through Medicare, Medicaid, federal employees, the military and the Veterans Administration, so it is not a radical stretch to extend Medicare to all Americans to cover the uninsured.

HR 676 has been introduced in the US House of Representatives by (along with others) Democratic presidential candidate Dennis Kucinich. In my home state of New Hampshire, the House has shown great wisdom in introducing a resolution to study single-payer care for the state.

When discussing health care reform, don't be scared by words like "rationed" or "socialized." Be informed, be wise and be empathic - choose what's best for America and all its citizens, not just those with good insurance.

If we took the money, structure and ingenuity in the current health care arena and applied it to the whole population via a single-payer system that eliminated the unfairness, complexities and waste, we truly would have the world's best health care for our citizens.

Dr. John Daley of Londonderry, New Hampshire, is a physician in Derry and a member of Physicians for a National Health Program.

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