April 01, 2013

Letter to the Editor

To the Editor:

Your latest issue of Experience magazine (Vol. 22, No.3, 2013) is the most honest and extensive explication I have yet read about health care, in general, and the Affordable Care Act in particular. It gets past the political debates and “spin” to what the law actually says, how various portions of it are to be implemented, perceived inadequacies and omissions yet to be addressed, and a realistic presentation of costs.

I was disappointed that there was no discussion of what a single payer system, or a public option, might look like and cost. Perhaps this was due the fact that any such discussion would likely replicate all the different subjects contained in the existing article and require a complete, comparative presentation. And, it is true that there can be more than one kind of single payer system. One common feature is that in every nation that has single payer, the people approve it. 

I hope that a future edition will be devoted to adoption of single payer health insurance—something like Medicare for all: everybody covered from conception to burial; a single payment system; a single set of defined benefits, understandable by all; and everything (within reason) provided. Coverage for all medical, surgical, psychiatric, and pharmaceutical needs, plus vision, dental, hearing, and long-term care benefits, which are presently excluded. No deductibles, no co-payments, no exclusions, no lifetime limits. Maybe even no premiums, i.e., government-provided health care.

The most obvious cost containment factor in plain sight right now is the excessive administrative cost of continuing to provide health care through the insurance industry. This was a “sellout” to get anything enacted; the insurance industry wants to continue the multibillion-dollar government cash steam as long as it can. This involves 20 percent of premiums collected by insurance companies that go to “overhead,” including stockholder dividends, excessive executive salaries and bonuses, advertising, political contributions to keep the public trough flowing, and on and on. That amount does not provide any health care. Because Medicare operates at five percent administrative cost, going to single payer could result in an immediate savings equal to 15 percent of all the healthcare premiums collected by insurance companies.
 
Yours truly,
Norman S. Thaye

Norman S. Thayer (nst@sutinfirm.com), a senior member of the law firm of Sutin, Thayer & Browne in Albuquerque, New Mexico, specializes in complex litigation.