Single Payer Health Care System

Single Payer Health Care System

According to a poll by CBS News and the New York Times, Americans ranked health care third in the list of issues that were most important and that should be resolved in the next presidency (CBS News, 2008, para. 1). The problem with health care is its incredibly high and rising cost. The United States has the most advanced medical technology and pays more per capita for health care than any other country in the world, yet leaves 47 million Americans uninsured (Center on Budget and Policy Priorities, 2008, para. 1). According to Tandon, Murrray, Lauer, and Evans (2000) in a study of the World Health Organization, the United States overall health care system performance ranks at the 37th position below the underdeveloped country Costa Rica (p.18). The health care system in the United States is so inefficient because it is based in a fragmented multi payer system, rather than in a single payer system. Experts agree that our health care system is riddled with inefficiencies, excessive administrative expenses, inflated prices, poor management, inappropriate care, waste and fraud (National Coalition on Health Care, 2007, para. 5). In the Unites States, multiple investor owned profit driven health insurance companies seek to inhumanely make money out of people's health rather than to offer appropriate health care coverage to those in need. Private insurers make huge profits by pricing people out of health care. Insurers selectively insure healthy people, and charge extremely high fees for less healthy people or for people with a history of heavy health care utilization. On top of that, billions of health care dollars are wasted in the administration of each company's paperwork for their individual procedures and regulations. If the US had a single payer health care system, the billions of dollars spent in administration and executive salaries would go instead to the actual purpose of health care: curing people.

Single payer refers to a way of financing health care that includes both the collection of money and the reimbursement of providers for health care costs. In a single payer system, both the collection of funds and the reimbursement of providers are the responsibility of one entity: the government (Chao, K. Casoy, F., n.d., p.1). As Graham Walker MD (2004) presented in his animation, single payer health care is like prom. You pay upfront for a ticket and the money goes to the prom committee which is in charge of paying for the DJ, catering, decorations etc. Prom is different from other dining and dancing experiences because you do not see a bill. The prom committee pays the caterer and the DJ so that they do not have to worry about bringing individuals bills to tables or about processing credit cards or other payment methods, which would take time and more work from the caterers and the DJ. Therefore, this would drive them to charge more for their services. Since the DJ and the caterers do not have to worry about billing everyone in the party, they can have more time to concentrate in doing their job, enabling the DJ to pick the best music and the caterers to serve better food. In prom you give your money to the prom committee which pays for everything and you get to enjoy the night. In a single payer health care system the government would be like the prom committee. In a single payer system Americans would give their health care money to the government who would be in charge of paying for everything health care related. This would reduce the cost of health care and save more than enough money to make health care available for every American while improving health care outcomes.

Improving Cost

A single payer health insurance would be financed through a global budget founded by new taxes. Hospitals would receive an amount of money from the global budget that would cover all the operating expenses. Physicians would be reimbursed from the global budget by one of three methods: fee for service, salary at health care facility, or salary within a capitated group (Chao, K. Casoy, F., n.d., p.2). Global budgeting simplifies the health care administration by eliminating billing. By having one organization handle both the bureaucracy and the administration of the health care system, paper-pushing would greatly decrease (Walker, 2007, para.3)and more of the health care dollars would go into curing patients, instead of covering for administrative overhead. Currently private insurers and HMO's consume 12% of premiums for administrative overhead, while single payer insurers like Medicare and the Canadian National Health Insurance have overhead costs below the 3.2% (Woolhandler, Himmelstein, Angell, Young, 2003, p.799) According to a study in the New England Journal of Medicine the cost of health insurance administration in the US is 294.3 billion dollars (Campbell, Woolhandler, Himmelstein,(2003). 2003 p.772)

While taxes will increase for Americans with a single payer system, the increase will be offset by the reductions in premiums of out-of-pocket spending. Having the uninsured visit the ER when they have pneumonia, rather than having them visit a primary care doctor when they have a cold is worse for the insured, because insurance companies end up charging higher premiums to the insured since they have to cover for the expensive acute treatment of the uninsured. Also businesses will be able to offer higher wages to their employees, because they will no longer have to pay for health care benefits as part of employee compensation.

According to the National Coalition on Health Care (2008) health care spending reached 2.3 trillion dollars in 2007 (para. 1), and since the population of the United States is 305,673,364 with 47 million uninsured (U.S. Census Bureau, 2008) the average health care spending for every American per year is around 8,891.52 dollars. In a study in the New England Journal of Medicine Campbell, et. al. (2003) found that the cost of health insurance administration was 294.3 billion dollars (p. 772). The Insurance Information Institute reported that in 2006 the health insurance companies gained 73 billion dollars in profits. If one were to subtract this 294.3 billion and add the 73 billion dollars in profit of the insurance companies from the 2.3 trillion dollar cost of health care, the overall cost of health care would come down to 2.0 trillion dollars. This brings the health care per capita spending down to 7,471.6 dollars. With a single payer health care system, Americans would be saving 1,420 dollars per person, which adds up to a total of 367.3 billion dollars. This money could be put towards curing people, rather than paying for administration and executive salaries.

A single payer system would make all necessary prescription medication and medical supplies available