Monday, May 18, 2009

The on-going confusion over "single-payer" health care

Single-payer isn't a synonym for "universal health insurance coverage." The two are separate issues - although many who support one support the other, as well.

Single-payer is only about who administers the payment. It could be the government, it might not be. In either case single-payer doesn't solve the question of "universal" coverage. The President has expressed his belief that while single-payer is an ideal, it is not a practical short-term goal due to the well-established (some would say entrenched) model already in force.

Universal health insurance coverage is one way to insure coverage for those who can't/don't get it through their employer - the unemployed, the self-employed, those who have been denied coverage for any number of reasons, etc.

A "public option" isn't either of those; a public option would mean setting up the government as one possible insurance plan provider among many, each responsible for their own paperwork. It is touted as a possible path to a single-payer system, but given the pragmatic attitude of the President dealing with wealthy companies buying influence in the Congress, it's not even that - and single payer is not going to happen anytime soon despite its obvious cost savings.

By the way: none of these is socialized medicine, either.

As long as what's being discussed is an option, as long as private plans remain available, the public option concept is simply about trying to get everybody covered. Are you with me? "Public option" isn't a synonym for either single-payer or universal health insurance.

Why, you may well ask, do the special interests oppose such changes, particularly that public option, and muddy the waters in the media while lobbying in Congress? Because insurance industry surveys show that a public option wouldn't attract merely the 50 million uninsured Americans, but actually more than double that number. Insurance companies don't want to compete with a plan system that operates efficiently on such low overhead - it threatens their profits, and the salaries and bonuses of the CEOs who, in some cases, earn tens of millions of dollars per year under the current system.

“…what we’ve seen is that the private healthcare insurers do not know how to deliver an efficient way.”

World Bank Chief Economist, Joseph Stiglitz