My commentary does not advocate socialized medicine; it advocates a single-payor health care system. Mr Grambor, like many Americans, including myself, “does not want socialized medicine.” This is a phrase that is frequently used glibly to dismiss the single-payor concept. Socialized medicine is a system in which government owns the facilities, and the providers of care are government employees. In sharp contrast, a single-payor health care system uses the existing private and public sector health delivery system, preserving private ownership and employment.

The unique feature of a single-payor system is that all health care risks are placed in a universal risk pool, covering everyone. The pool is funded in a fair and equitable manner such that everyone pays their fair share, unlike our current system in which some pay far too much, and others are not paying for their share. The funds are allocated through a publicly administered program resulting in optimum use of our health care dollars. A single-payor health system has no more in common with socialized medicine than does our Medicare program.

Our Medicare program, a publicly administered program, operates on an administrative cost of less than 2%. The managed care intermediaries consume 9% to 30% of health care dollars. The difference is due to tremendous duplication of administrative efforts between companies and other intermediaries, and marketing expenses that would be superfluous in a public program. A single-payor health system has as its mission optimizing resources for better patient care. Funds are not wasted on corporate administrative excesses.

Single-payor insurance would provide coverage for the 44 million who are uninsured. It would eliminate the financial threat and impaired access to care for the tens of millions who do have coverage but are unable to afford out-of-pocket expenses because of deficiencies in their insurance plans. It would return to the patient free choice of physicians, hospitals, and all health care providers, not just choice of restrictive health care plans. It would relieve businesses of administrative hassles and expenses of maintaining a health benefits program. It would remove from the health care equation the middleman—the insurance/managed care industry—that has wreaked havoc on the traditional patient-physician relationship, while diverting outrageous amounts of patient-care dollars to their own coffers. It would control health care inflation through constructive mechanisms of cost containment that improve allocation of our health care resources, rather than controlling costs through an impersonal business ethic that strips patients of care to improve the bottom line. It would free businesses from scrambling to find health coverage for their workers. It would free Americans from the fear of losing health care when they lose their jobs. Taxes would have to be raised to pay for universal health coverage, but wages also could be increased because employers no longer would have to pay for health care.

In summary, a single-payor national health insurance system would provide access to high-quality care for everyone at an affordable price. Making available to everyone preventative and public health services would significantly improve the level of health of our entire nation. Healthy individuals make for a healthier work force. Quite simply, we would pay less and get more. On balance, universal and equitable health care is actually a competitive advantage.

—Mark A. Chmielinski, RRT
Vice President of Clinical Services
HomeCare of Michigan Inc
Allen Park, Mich