To The Daily Sun,
I should like to respond to two recent letters in The Sun: Ms. Linda Riley's letter of March 31 and Mr. Robert Joseph, Jr.'s letter of April 8. Mr. Joseph wants to see Medicare expanded to cover everyone, which would be a single-payer approach. Ms. Riley has taken two ideas that many others support and juxtaposed them into a single paragraph that truly surprised me: "A single-payer system is not the answer. If people had to check different places for prices, the free market would bring down prices. Let's get the government out of patient care."
As a liberal who sympathizes with Mr. Joseph, I have to agree with Ms. Riley, for she is correct about the power of up-front pricing and free choice in bringing about efficiency and low costs.
How many people in the U.S.? About 318 million. How many visit doctors? Physician office visits — 922.6 million — plus hospital outpatient visits — 125.7 million — come to more than a billion without counting hospital stays or prescriptions
purchased. 1. That is a powerful customer base. How many medical service payers are there? Let's see: Medicaid and Medicare, that's two, plus a few more in the government plus about 35 private health insurance companies. 1. That's, say 50, versus the one billion plus visits of ordinary people.
We have, in effect, a single-payer system, for these 50 payers have the same motivation, and it is not your motivation. It is to save money for the government or to reduce costs for the insurance company, but not necessarily to confront
the medical service provider prices. In addition, both sides meddle in your health care decisions.
Let's widen our perspective from this "single-payer" concept as either a panacea or an anathema to a "single-collector-multipayer" concept. A medical security tax (remember the money is there, it is just not spent wisely) collects the
funds which get allocated to individual medical-budget-accounts for each and every person. These accounts could then be drawn upon by each and every person individually and administrated with the same efficiency as the debit/credit
card companies employ. Nobody, but nobody, not the insurance companies, not the government, would have any say in what you use your account for other that it be for the services of a medical professional or to fill a prescription.
We are back to personal responsibility, for better or worse, but isn't that the American way? Remember, it is a budget, with a cap.
I would recommend that a certain amount be set aside for truly one-of-a-kind catastrophic events, either personal or public. Of course, such a medical "rainy day" fund could be misused, but that should not invalidate the "single-collector-multipayer" concept.
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