Sunday, April 29, 2012

Single Payer Is Not the Answer

We may want, even pray for, a quick, simple, painless answer to big, hard problems.  Our brains know that that will never happen.  Still, we let our emotions dictate our expectations.  So it was with Sarah van Gelder's panegyric for the single-payer solution to healthcare.
Her article was filled with errors, magical thinking, and one truth whose implications escaped the author. Van Gelder starts by saying healthcare has been in trouble ever since the Republicans convinced the Obama administration to drop the public option (for health insurance).  Recall that in 2008-09, Democrats controlled both Houses of Congress and the White House.  Had they wanted the public option in the Reform Bill, it would have been in.
Much more important is the egregious implication that healthcare wasn't in trouble until the Republicans (sic) stopped the magical answer: single-payer.  In reality, healthcare has been in deep trouble for over 45 years -- ever since Congress broke open the "lockbox" for our cash contributions to Medicare.  They took the money, spent it, and replaced it with IOUs.  Ever since then, Medicare has been a Ponzi scheme, one that will collapse by 2017.
One truth in van Gelder's article was the title of the graph: "We're Not Getting Our Money's Worth."  Worth is determined by the ratio of how much you expend compared to how much you get of something you want.
The U.S. is indeed spending much more than anyone else on the planet for healthcare (the system) and not getting the results we want from health care (the service).  This is true for overall longevity, infant mortality, and for preventable as well as chronic illnesses.  The question is, why?

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