Ginnie Vogts, RESULTS activist of Columbus, OH, recommended an article posted on the PNHP (Physicians for a National Health Program) website that compares President Bush’s proposal for health care reform, Consumer Directed Health Care, with single payer, which PNHP supports. The article concludes that an incremental approach to health care reform will not work.
An excerpt:
We advocate a fundamental change in health care financing—national health insurance (NHI)—because we are convinced that lesser measures will fail. Indeed, the alternative to NHI advocated by the Bush administration, so-called Consumer Directed Healthcare (CDH), would actually make matters worse. As discussed in detail below, CDH would financially penalize older and sicker patients, deter millions from seeking needed care, shift additional medical resources to those who are already well served, further inflate bureaucracy, and do little or nothing to contain costs.
Our Health Care System at the Crossroads: Single Payer or Market Reform? (David U. Himmelstein, MD, and Steffie Woolhandler, MD, MPH, The Annals of Thoracic Surgery, 2007; 84: 1435 – 1446; posted to PHNP Resources May 2, 2008)
Tags: single payer, U.S. health care costs, U.S. health care policy, Universal health insurance
May 9, 2008 at 12:17 pm |
The fundamental point being missed in much of the debate over “single-payer” versus “market reform” is that the largest dysfunction in our health care system is the profit motive. If we can successfully remove the profit motive in health care financing, it matters less exactly how we design the framework of care and service delivery.
With not-for-profit health care financing in the U.S., we will still need an administration system. But, since taxes will be collected nationally and costs will be disbursed widespread for doctors, health workers, equipment, hospital costs, etc., the administration of financing (not health care services) might as well be centralized.
The red herring that competition brings innovation is really only true for research and development. A not-for-profit system actually breeds greater competition among physicians and health care workers since they would be vying for patients more equally and based more on merit. Currently, in our HMO-dominated health care system, competition among HMO physicians is nearly non-existent, as they are typically guaranteed to see a set number of patients registered with their particular HMO.
Because of the resources of the insurance industry (not physician groups), the federal government is pressured to maintain the status quo, or at most offer slight changes to the for-profit system. As a result, the information provided to most U.S. citizens via the media is heavily skewed to downplay the benefits to tens of millions of people that a not-for-profit system would bring.
For these reasons, we must get better at speaking about the fundamental difference between all of the proposals for systematic health care change in the U.S.: Profit versus not-for-profit health care financing.
It’s not just that every industrialized country in the world has universal health care (with the exception of the U.S. and south Africa), it’s that they all have a not-for-profit health care financing system. It is not enough to call a plan “universal;” more accurately, it’s because of the not-for-profit financing that these systems can function effectively.