NYT: Single-Payer Health Care Is The Wrong Choice For The Country
Democrats are lining up to support Bernie Sanders’ single-payer health care plan.
So desperate for something to call their own, they’ve neglected to see the plan is fundamentally flawed.
Not only would single-payer bankrupt the country, but would not result in lower costs or better care for Americans.
Via The New York Times:
Last week, Senator Bernie Sanders introduced “Medicare for all” legislation, which would enroll all Americans into the nation’s Medicare program within four years. Senator Sanders, the Vermont independent, argues that his proposal would create a system that “works not just for millionaires and billionaires, but for all of us.”
Though we have widely divergent views on health policy — one of us preferring a German-style system (Dr. Weinberg), the other a more consumer-directed one (Dr. Chen) — we both believe that single-payer health care, including the proposal advanced by Senator Sanders, is the wrong choice for the country.
As Democrats and other policy makers debate the merits of Senator Sanders’s proposal, here are a few important observations about international systems that they ought to consider.
First, a vanishingly small number of countries actually have single-payer systems. In fact, almost all feature some role for private-sector insurance companies and providers. Britain, which employs providers in its National Health Services, has a parallel private payment system. In countries like Canada — the system most similar to the one that Mr. Sanders seeks to create — private corporations provide insurance for services that fall outside of government guarantees. And these guaranteed benefits are substantially more limited than those in the Sanders proposal. Canada, for example, has no national prescription drug benefit but instead a patchwork of provincial systems.
Some of the highest-rated international systems rely on private health insurers for most health care coverage — Germany’s, for example, is something like Obamacare exchanges for everyone, but significantly simpler and truly universal. The Netherlands and Switzerland have both moved recently to add more competition and flexibility to systems that were already built on the use of private insurers.
Second, single-payer countries have also failed to control rising health care costs. This is important, given that Mr. Sanders’s proposal was released without a cost estimate or financing plan. For historical reasons, many other countries started with lower levels of health care spending than we did. Several analyses have shown that this has almost nothing to do with higher administrative costs or corporate profits in the United States and almost everything to do with the higher cost of health care services and the higher salaries of providers here.
Third, it is simply untrue that single-payer systems produce a better quality of care across the board. Most health-policy lectures in American universities start with a slide showing that we rank poorly on a broad number of public health measures and outcomes. Yet the United States scores much more highly on different measures, including innovation, patient-centered care and preventive health.
But just as trade-offs must be made to improve health care, so are other countries struggling with balancing the cost and quality of care and universal access. All Americans should bear one important precept in mind: If the Sanders plan sounds too good to be true, it probably is.