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Medscape J Med. 2008;10(9):208. ©2008 MedscapePosted 09/05/2008When the ethics and the economics of major public policy agree, we ought to pay attention. House Resolution 676 promises to create a single-payer health insurance system to provide expanded and improved Medicare for all Americans.[1] It will insure everyone, and unlike many competing proposals, it could actually work.
In a single-payer system, the government will fund health insurance, but private providers will continue to deliver care. Economies of scale will save the money to make this possible. Many Americans, including Democratic presidential nominee Barack Obama, concede that single-payer insurance is probably our most efficient option.[2] But they worry that it lacks the spirit of the American market. Nothing could be further from the truth.
A single-payer system will harness the market's strengths while addressing its limitations. The private health insurance market is inefficient, bloated by advertising, duplicated bureaucracies, dividends, and executive compensation. What's worse, insurance policies are so complex and individuals' future needs so unpredictable that consumers cannot make the informed selections that induce competition between insurers.
However, consumers can create competition among healthcare providers. This is paramount because patients need the best healthcare, not the best middlemen to pay for it. Currently, providers are insulated from competition because private insurers often restrict coverage to select physicians. In addition, the 47 million uninsured Americans[3] have little impact on the market. A single-payer system will give all consumers the power of choice and open all healthcare providers to the effects of consumer decisions.
Single-payer works because of the efficiency of specialization. The government will manage the paperwork and private entities will provide the care. Adam Smith would be proud.
So if you believe in the market, ask your congressman to support HR 676. Together, we can restore common sense and common decency to American healthcare.
That's my opinion, I'm Prajwal Ciryam, a second-year MD/PhD student in the Medical Scientist Training Program at Northwestern University and a Co-Founding Member of Health Care for All Illinois.
Reader Comments on: A Market for Compassion: Single-Payer Health Insurance
See reader comments on this article and provide your own.Readers are encouraged to respond to the author at p-ciryam@md.northwestern.edu or to Peter Yellowlees, MD, Deputy Editor of The Medscape Journal of Medicine, for the editor's eyes only or for possible publication as an actual Letter in the Medscape Journal via email: peter.yellowlees@ucdmc.ucdavis.edu
References
- House Resolution 676: To provide for comprehensive health insurance coverage for all United States residents, and for other purposes. Available at: http://thomas.loc.gov/cgi-bin/bdquery/z?d109:h.r.00676 Accessed August 20, 2008.
- Macfarquhar L. The conciliator. New Yorker. May 7, 2007. Available at: http://www.newyorker.com/reporting/2007/05/07/070507fa_fact_macfarquhar?currentPage=1 Accessed August 20, 2008.
- US Census Bureau. Income climbs, poverty stabilizes, uninsured rate increases. US Census Bureau News. August 29, 2006. Available at: http://www.census.gov/Press-Release/www/releases/archives/income_wealth/007419.html Accessed August 20, 2008.
Prajwal Ciryam, MSII, second-year MD/PhD student, Medical Scientist Training Program, Northwestern University, Chicago, Illinois; Co-Founding Member, Health Care for All Illinois, Chicago, Illinois
Author's email: p-ciryam@md.northwestern.eduDisclosure: Prajwal Ciryam, MSII, has disclosed no relevant financial relationships.
