Obamacare, single-payer beat traditional health care

A comparison among 10 nations comparing medical care revealed that the traditional U.S. system (alone in lacking universal health care) is both the most expensive and most underperforming.

In the list, including Australia, New Zealand, the United Kingdom, Germany and Canada, we came last: life expectancy, infant mortality and mortality from treatable medical conditions. Enjoying the lowest percentage of health costs paid by the government, paradoxically, we were also the highest in per capita cost and both proportion of GDP and percentage of government revenue expended on health care.

When discussing health care, let's remember that the top 1 percent will always afford high quality health care whatever the system; the question is how best to provide health care for the remaining 99 percent, millions of whom are uninsured and many of whom die or suffer for lack of treatment. Though Obamacare (officially the Affordable Care Act) is a fine start, single-payer is better.

There remain many questions about how Obamacare and single-payer work. Early discussion regarding Obamacare included a subsequently though unfortunately eliminated single-payer system. While Obamacare certainly offers a substantial improvement over the traditional system because it would both enhance the quality of care available to Americans and reduce costs, it is not a single-payer system. Because many commentators falsely characterized single-payer as socialism, it was doomed. Since it maintains private health care, insurance and drug systems, Obamacare clearly is not a socialist system where health care providers are employed by the government. Nevertheless we should understand what a single-payer system might look like, since its many variations successfully operate around the world.

Under single-payer care everyone receives necessary medical care with payments coming from a single pool funded by taxpayer contributions (local, state, or national), by employees, by employers or some combination. Health care providers may then be employees of the state, which is the socialized system practiced in the U.K and by our Department of Veteran's Affairs. Alternatively, as in Canada, Australia and Taiwan, services may be provided by independent entities reimbursed on a fee-for-service basis. This is not socialized medicine; it is also how our remarkably successful Medicare system operates.

Economic analysis reveals that compared with our traditional system, both Obamacare and universal single-payer health care offer huge overall savings in costs and enjoy support from many medical organizations. Some polls indicate a majority of Americans favor some form of universal health care, but responses depend on wording, with 'like Medicare' in the question eliciting a favorable response and 'socialized' eliciting a negative result.

Many vested interests promote myths about a single-payer, universal health care system:

One frequent assertion about both Obamacare and single-payer is that they require rationing of treatment by the government. Let's remember that traditional health care is rationed, but by corporations who profit from minimizing spending on our treatment. Furthermore, the millions of Americans who lack health insurance and are left to their own devices often get health care belatedly by visiting emergency rooms (vastly more expensive than preventive physician visits). This is ultimately funded by taxpayers or by insured individuals who end up subsidizing care through higher rates.

Claims that long lines and waiting lists would occur under Obamacare and a single-payer system are bogus. Additionally, while 120 Americans die every day from a lack of health insurance, no one dies from this cause in single-payer systems.

By eliminating the health insurance industry, we could save billions per year, funds that would be used to insure those who lack insurance or are underinsured. Furthermore, when patients are not financially discouraged from seeking preventive medical care, later treatment is averted and more money saved.

Those claiming less medical research and development would occur don't mention that much is currently funded by the National Institutes of Health, an allocation that could grow under a single-payer system. Also, when all patients are under one system, their influence increases. Like both other countries where drug costs are lower than here and our VA, which gets a 40 percent discount on drugs, the price of drugs could be reduced.

Single-payer should fund all medically necessary care from doctor visits, hospital care, mental health care, nursing home care, home care, eye and dental care. Instead of paying health insurance and co-payments to providers, we would pay a similar or smaller amount to fund the pool. Indeed, most would pay less than currently, and still be able to visit any physician, specialist,or hospital in the nation with no bills, no deductible and no co-payments.

There remains much misinformation about both Obamacare and single-payer medical systems (promoted by insurance and drug corporations) yet both can improve health care substantially and reduce costs considerably. Not only does Obamacare deserve support from the 99 percent, but additionally a single payer option deserves consideration.

Dr. Alan Journet of Ashland, professor emeritus of biology from Southeast Missouri State University, has lived under single-payer systems in three countries. He can be reached at alanjournet@gmail.com.

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