Clearly, the U.S. health care system has its share of problems. Costs are rising rapidly, some 45 million Americans are without health insurance, and both doctors and patients decry their loss of options and control. But, would a government-run health care system be any better?
Single-payer health care systems have been proposed in a handful of states as the solution to the problem of access for the uninsured. While single-payer plans can offer all citizens some type of health insurance policy, they cannot guarantee access to medical care-much less prompt delivery of quality care. In the United States the issue is access to affordable health care. In a single-payer system the issue is not having timely access to quality care at all.
We only have to look to Canada to see that government-run health care doesn't work. Single-payer plans inevitably control costs by rationing care. Canadians often wait months to see a specialist or to receive much-needed medical treatment. Ninety percent of Canadians live within 100 miles of the United States, and many are crossing the border to receive private medical care. In fact, Canada is now in the process of offering a private health insurance option to its citizens.
Another way single-payer plans hold down costs is by having one centralized government bureaucracy make all health care policy and price decisions. Imagine being allowed to buy a car from only one manufacturer. Single-payer means limited choices for consumers, which discourages creativity, efficiency and quality. Medicare is scheduled to go bankrupt long before the Social Security system does, so turning the entire health care system over to a government bureaucracy makes little financial or quality-of-care sense.
Health care spending represents 15 percent of the U.S. gross domestic product (GDP). While Social Security is a political football, it would be dwarfed by the economic scope of a government-run health care system. Health care policy and decisions will be made on purely partisan political agendas.
While there is no question that our health care system is in trouble, a better solution is to implement market-driven initiatives to restore competition, such as refundable health insurance tax credits. Health tax credits represent a realistic way to extend private health insurance coverage to those who are most in need of assistance. It is an important component of an overall program to increase health care access and will provide a real solution to the problem of affordability-the most basic component of access to health care.
Indianapolis Association of Health Underwriters
Director of marketing
Indiana Health Network
I was pleased to serve as a panelist at the recent IBJ Power Breakfast on Health Care and Insurance (Focus-Oct. 3). IBJ should be commended for bringing local health leaders together to discuss the critical issues of health care access and affordability.
During the forum, some fundamental philosophical differences emerged regarding the future of health care in our country, with some on the panel advocating a single-payer, government-run approach. This is not the answer to what ails the health care system. A singlepayer system would eliminate the competition that is necessary to increase efficiency, improve quality and stimulate innovation. Experience has shown that this approach leads to rationing of medical services and delays in receiving care. For example, in 2003, patients in Canada waited an average of 18 weeks to receive treatment after being referred by a general practitioner.
No one is satisfied with the status quo. When it comes to addressing the challenges facing our health care financing system, physicians, hospitals, employers and insurers must work collaboratively. At Anthem Blue Cross and Blue Shield in Indiana, we've established a consortium-made up of two dozen area health care leaders-that meets regularly to discuss these challenges. The formation of this group is an acknowledgement that, despite our inevitable disagreements, there is much common ground.
More important, there is a common goal: to make real progress toward reducing the number of uninsured and underserved in our communities, while strengthening our choice-based, private health care system.
Dr. David Lee
Anthem Blue Cross and Blue Shield in Indiana
Vice president of health care management