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US will eventually have to move toward single-payer system

Editor,

As much as my colleagues and I would like to join the celebration of the House’s passage of the health bill over the weekend, there is cause for serious reservation about the current course of health care reform.

Instead of eliminating the root of the problem — the profit-driven, private health insurance industry — this costly new legislation will enrich and further entrench these firms. The bill would require millions of Americans to buy private insurers; defective products, and turn over to them vast amounts of public money.

The hype surrounding the new health bill is belied by the facts:

About 23 million people will remain uninsured nine years out. That figure translates into an estimated 23,000 unnecessary deaths annually and an incalculable toll of suffering.

Millions of middle-income people will be pressured to buy commercial health insurance policies costing up to 9.5 percent of their income but covering an average of only 70 percent of their medical expenses, potentially leaving them vulnerable to financial ruin if they become seriously ill. Many will find such policies too expensive to afford or, if they do buy them, too expensive to use because of the high co-pays and deductibles.

Insurance firms will be handed at least $447 billion in taxpayer money to subsidize the purchase of their shoddy products. This money will enhance their financial and political power, and with it their ability to block future reform.

Health care costs will continue to skyrocket, as the experience with the Massachusetts plan (after which this bill is patterned) amply demonstrates.

This bill’s passage reflects political considerations, not sound health policy. A genuine remedy is in plain sight. Sooner rather than later, our nation will have to adopt a single-payer national health insurance program, an improved Medicare for all. Only a single-payer plan can assure truly universal, comprehensive and affordable care to all.

By replacing the private insurers with a streamlined system of public financing, our nation could save $400 billion annually in unnecessary, wasteful administrative costs. That’s enough to cover all the uninsured and to upgrade everyone else’s coverage without having to increase overall U.S. health spending by one penny.

Moreover, only a single-payer system offers effective tools for cost control like bulk purchasing, negotiated fees, global hospital budgeting and capital planning.

Polls show nearly 2/3 of the public supports such an approach, and a recent survey shows 59 percent of U.S. physicians support government action to establish national health insurance. All that is required to achieve it is the political will.

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The major provisions of the present bill do not go into effect until 2014. Although we will be counseled to “wait and see” how this reform plays out, we cannot wait, nor can our patients. The stakes are too high.

Work for the only equitable, financially responsible and humane remedy for our health care mess: single-payer national health insurance, an expanded and improved Medicare for all.

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