Recently Congresswoman Nancy Pelosi’s adviser, Wendell Primus, spoke to health insurance executives from Blue Cross, Blue Shield. One of the topics was single payer health care, National Improved Medicare for All. He listed five concerns about it. Here are responses to those concerns in case you hear them.
1. Cost – Single payer health care is proven to cost less than the current healthcare system and to slow the rate of increase in healthcare spending. There have been numerous studies of single payer systems and each has found that the savings from lower administrative costs, negotiated prices for goods and services and using global budgets offsets the increased cost of covering everyone and still produces a savings in total healthcare expenditures.
2. Creates winners and losers – A single payer healthcare system in the United States would be a big win for the people and health professionals. People would be able to receive the care they need regardless of income and without fear of financial ruin. Health professionals would be able to spend more time with patients and focus on their patient’s needs. The system would be simpler to use with one set of rules and everyone in it. The losers would be the private health insurance companies because they could not sell policies that duplicate what the system covers.
3. Stakeholders are against – This depends on who are considered to be the stakeholders. A majority of the public supports single payer, especially among Democratic and independent voters but more Republicans are supporting it too. A majority of nurses, physicians and hospital administrators support single payer too. See this recent poll by Medscape.
4. Monies are needed for other priorities – Healthcare is a fundamental need. The United States has poor health outcomes and a declining life expectancy. Health care is the number one concern of voters. This should be a high priority. That said, a single payer healthcare system costs less than the current healthcare system and it will stimulate the economy from the bottom up as people save money on health care, no longer experience bankruptcy or become homeless due to medical illness and are freed to start their own business without fear of losing healthcare coverage.
5. Implementation challenges – A single payer healthcare system will be easier to implement than the Affordable Care Act was. We already have a national payment structure through Medicare. Everyone is enrolled automatically. The benefits will be universal and there will be one billing system. Other countries have made the switch and we did it in the United States in 1965 for the elderly by creating Medicare from scratch without computers.
