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My recollection is that Consumers Reports used to be sympathetic to single-payer health care because it's the simplest, non-profit, economical way to provide universal health care. They used to try to be informative. In the August 2009 issue, however, they helped obfuscate by saying the left wants to “nationalize health care as the British and Canadians have done” (page 12 -- slightly clarified on page 18) and create a huge new federal bureaucracy. The only similarity between the British and Canadian systems is the assumption that health care is a public responsibility. The two systems couldn’t be more different. In the UK (and also Sweden), the government owns the hospitals and pays the doctors salaries. Canada’s system is similar to Medicare. The government pays the bills, while private practitioners and private non-profit hospitals provide care. The bureaucracy is minuscule compared to the wasteful bureaucracies of our multitude of private insurance companies that concentrate on marketing, enforcing irrational rules, and denying benefits, requiring doctors and hospitals to hire armies of billing clerks to shuffle papers. All industrialized countries spend a lower proportion of their per capita gross domestic product on health care, covering everyone, so spending a little more would eliminate those waiting time that our opponents harp on. They parroted the absurd proposition that we need something American, based on the assumption that we can't learn from anyone else's experience. So I asked them what isn’t 100% American about Medicare? In providing Medicare for All, many of the constructive reforms Consumer Reports recommends can be implemented simply, without complex regulation of insurance companies. Medicare can be improved by offering adequate pay to primary care doctors -- internists, family practitioners, and pediatricians -- so they can coordinate private care, paid for episodes of illness, not procedures, reducing co-payments and deductibles (which bankrupt people who can’t afford Medigap policies that are just a bonanza for insurance companies). Medicare meets the criteria they laid out: freedom, fairness and choice. But I pointed out that we want choice of a doctor, not choice of an insurance company in a confusing Insurance Exchange. Everyone would be covered – young and old, rich and poor, sick and healthy -- with no ambiguity or worry about losing or changing jobs. In my opinion, linking insurance to employment made sense when people worked for the same company for life. Accommodating today’s frequent job changes and hiatuses is costly, confusing, and often disastrous, while private health insurance is unaffordable for small business. As for quality, it’s notable that all comparative effectiveness research has been conducted on Medicare data. Medicare for All would be the simplest avenue for providing everyone with data on what works and what doesn’t. The idea that people can choose the insurance plan that’s best for them is absurd because no one can predict what affliction may hit a family member next week or next year, or never. How can a person decide if it’s best to have a low-premium policy with minimum benefits or a high-premium policy with comprehensive benefits? In fact, no one can know. Have a look at the article and perhaps you, too, and give Consumer Reports the benefit of your comments. Comments
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