Tuesday, November 07, 2006

Bad News for Single Payer

To the extent that Single Payer means Medicare for all or its equivalent, recent economic reports are bad news for its advocates.

Government involvement in the financing of social services is almost always motivated by the need to relieve somebody’s financial distress.

In the private sector of health services, the parties involved are providers, employers, insurance companies, and patients.

Hospitals complain of underpayment, but according to the October 20, 2006 of Modern Healthcare, their profits have been steadily rising, reaching the national level of 5.3% of revenue in 2005, or nearly $29 billion.

Concerns have been expressed about high health care costs harming the competitiveness of U.S. companies, but stock prices are climbing, with the Dow Jones Industrial Average reaching recent record levels above 12,000.

I don’t have figures at hand for health insurance companies, but I believe they are earning healthy profits, as well.

That leaves patients – particularly the uninsured and those who are being asked by their employers to bear a larger portion of their health insurance premiums. That is undoubtedly of concern to them, but apparently not enough to cause them to express themselves politically about it. The big push for the Massachusetts initiative for covering the uninsured came from the already flush providers and insurance companies, not from patients feeling a financial pinch.

It all goes to support my long-held view that any expansion of government involvement in the financing of health services will be incremental (such as the Medicare prescription drug benefit) and that financing care for the employed population will be a private sector responsibility for as far into the future as can be foreseen.

So instead of spending energy arguing about something that isn’t going to happen; i.e., single payer, we ought to be working on things we can do something about, like improving the performance of our inefficient health care delivery system.

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