You can’t help but love the Physicians for a National Health Program… they’re at least honest enough to make it clear in their name what they want for us: A Single Payer system. That’s their bottom line, and they work hard to find any justification for that end.
But that doesn’t mean they’re wrong about everything.
In their latest missive they point out that Massachusetts has “wasted” billions on administrative costs. I debate the “wasted” term, but I endorse the desire for a standardized system.
The reason I debate “wasted” is that I know from firsthand experience as a benefits consultant that the private carriers do a good job of medical managment. That’s the process whereby they involve themselves with people who have significant or cronic conditions and make sure that those patients get attention, direction, assistance and the best care possible.
I can almost see some of you raising your eyebrows at my suggestion that a for-profit organization can possibly give a hoot about people’s health and wellbeing.
Well, they do. Maybe not for altruistic reasons. Maybe for profit-centric reasons… but they do care. To the degree that they can get me or you well faster and better and help us make the best of a bad situation, they spend less.
If they spend less, they’ll have better pricing than their competitors, get more business, keep you happier so you’re less likely to mover to anotherh carrier, and thus make more money. They do well by doing good.
Where the Single Payer People Have It Wrong
Now let’s look at a single payer system like those dorks folks at the Physicans for a National Health Program want. Ask yourself a first question:
Does a single payer perform well because they’re worried about your leaving for another carrier?
The answer is obvious: WHAT OTHER CARRIER? It’s a single payer system. A monopoly. An exclusive. You CAN’T LEAVE. So tell me why they’d care about you.
Because they’re inherently more compassionate? Picture the IRS agent as you try to picture a compassionate government employee.
Now ask yourself another question:
Is a single payer system inherently more cost-effective?
That’s a bit harder to answer. They will have the advantage of a single administrative system (in theory — look at the state of Massachusetts where there are seven different technology platforms, most of which can’t talk to each other).
But efficient? Picture the post office as you try to imagine a cost effective government employee.
Where the Single Payer People Have It Right
There is a point of validity in the argument for standardized systems… simpler administration. I mentioned a study recently about the fact that dealing with different carriers’ paperwork costs the average physician’s office almost $70,000 per year.
How much would that come down with standardized forms? Which, by the way, we can move towards without having to destroy the competitve nature that has made our health system the best in the world.
I don’t know what the reduction would be, but it would be significant. Most of the savings would happen at the provider (doctor, hospital) level, not at the carrier/payer level. But they’d be real (leading to higher unemployment in the medical sector, but efficiencies always lead to dumping the buggy whip employee).
Can we achieve standardization? They’ve done it in the dentistry, where every procedure has a standard code all across the spectrum.
So yes, let’s go all out toward standardization of forms — but let’s not chop down the entire tree in our attempts to prune back some overgrown branches.
