Commonweal pro-single-payer

Commonweal, the smart and progressive Catholic journal has a thoughtful and persuasive editorial in favor of single-payer in its most recent issue. You can read it online.

Beginning with the news that some companies are paying for all their employees meds — preventive medicine saves money and lives — the writer moves on to the fact that by 2010 only half of adult workers will be covered by insurance through their employers and that insurance is becoming unaffordable.

Americans now spend roughly $2 trillion annually for health care, about twice as much per person as other developed countries, and with less to show for it....

John Edwards has outlined a mandatory federal system to cover all Americans, based on higher taxes for the wealthy and “Health Markets” to control costs. Such insurance pools, modeled after Medicare but separate from it, would allow negotiators to bargain with providers for lower prices and improved services. Edwards says his model might eventually evolve into a single-payer system, once the public saw the advantages such an option offers.

Under the present system, private insurers spend up to half their revenue on administration, advertising, and stockholder reimbursement, rather than on actual medical services. Health markets would deliver greater bargaining power in dealing with hospitals and drug companies, just as the Veterans Affairs Administration and the Canadian health-care system do today.

The writer describes Americans' changing attitudes well — our attitudes are "maturing." Latest poll numbers show that 64 percent of Americans are in favor of universal coverage, and would be willing to pay more in taxes to get it.

A single-payer system would not prevent individuals from buying added insurance. But the larger insurance pools would spread out the liability risk and allow the system to cover those who are now excluded. It would also facilitate preventive care.

In the past, Americans have said no to a national health system out of fear that it would lead to long lines and restrict choice in services. An evolving single-payer system like the one proposed by Edwards could allay those fears by providing greater efficiency, lower costs, and ample choice. The challenge will be to convince enough voters that the higher taxes required for such a program really would lead to better-and cheaper-health care.