Thursday, February 19, 2009
Why Single Payer?
Jonathan Cohn wrote about single payer and The Great Orange Stan quoted a simply marvelous argument for it.
Advocates of single-payer systems complain frequently that the mainstream political debate doesn't give their idea the attention it deserves. They are right. Public insurance programs enjoy huge economies of scale; they don't fritter away money on profits or efforts to skim healthier patients from the population. When it comes to billing, they tend to be a lot simpler than, say, a system with dozens of competing insurance plans. All insurance systems require providers to file a lot of paperwork; single-payer systems, though, require just one set. The centralized power of single-payer systems also gives them unparalleled sway over not just the amount of money they pay but how they dole it out; with that kind of leverage, they can push the medical system toward making key improvements in quality.I work for a large corporation that has sought to contain its medical benefit costs every year. This year they went for a single payer plan and eliminated all the competing plans, where possible. I won't say my bosses are great business people, but they know cost. And I am willing to bet that most corporations would love the opportunity to shed the support costs of medical plans while having covered workers at the same time.
Conservative critics of single-payer raise the perfectly respectable question of whether a government program could really wield such power judiciously. But it's telling that, when Taiwan set out to create a universal coverage system for its newly prosperous society a few years ago, it carefully studied schemes from around the world--and settled on a single-payer system, because it seemed to deliver the best, most equitable medical care at the lowest price. Today, experts say Taiwan has one of the world's most efficient, convenient, and effective health care systems.
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