Monday, April 17, 2006

Universal Health Care

Opponents of universal health care have objected to it for a number of reasons and it is incumbent upon those of us who support such a system to answer these objections and propose solutions which answer them.

The first is that a public system would be more efficient. What ever terms you want to use the numbers are obvious. For profit companies spend 20 to 25 percent on administrative costs versus 3 percent for Medicare, which by the way takes care of much sicker and older patients. Removing profit as a motive for managing the company improves efficiency by at least 17 percent by this reasonable measure.

Second is the argument that other types of insurance are offered by the free market so why not health insurance. Surely if it works for life or automobile insurance it would work for health insurance. Unfortunately, this argument ignores the cold fact that health insurance for most people is tied to an employer and employer-based health insurance does not operate on a free-market model. Consumers, assuming their lucky enough to even have a plan offered, do not choose their insurance companies to begin with and they cannot switch to another if dissatisfied with the product.

Third, public universal insurance would result in the government rationing the care covered by this plan. Such as argument ignores the fact that rationing already exists: It is done by the various mechanisms for profit companies use to subvert good science by co-pays, deductibles, pre-authorizations, diagnostic exclusions and many other barriers to discourage treatment. States have had to create laws to force private insurers to cover even simple preventive screening procedures such as mammograms and colonoscopies. If overt rationing were deemed necessary, at least theses decisions would be made more openly honestly by panels of caregivers and with appropriate public input; not by owners and investors seeking to maximize their profit on the back of the sick and injured.

We are the only industrial nation without national health care. We spend almost twice as much per capita as the next country, Switzerland. And, by any measure we are no where near the top in the quality of health care provided. We have at least 45 million people in the US who are uninsured and health care is no less essential than education or transportation which is provided by public funding.

Poll after poll shows that the public supports a national health system. Since 1945, when Harry Truman first proposed a national health system, public support was then and remains at about 75 percent. Why don’t our legislators support what three quarters of their constituents want? Perhaps it has something to do with campaign financing, but that’s the subject for another blog.

Physicians for a National Health Plan ( has worked since 1987 for universal health care and have an affordable model that works for all. It is time we made our elected officials implement it.

David M Goldberg