A Utopian view

The Oklahoman - - OPINION -

Pryce Mich­ener (Point of View, Oct. 7) paints a Utopian view of the sin­gle-payer so­lu­tion to health care, with­out re­gard to its short­com­ings. Cur­rent tax­payer­fi­nanced med­i­cal pro­grams make up $1.5 tril­lion of an an­nual $4 tril­lion bud­get, and cover 70 mil­lion peo­ple. Th­ese pro­grams gen­er­ally cover 80 per­cent of the cost to the pa­tient, so we would have to in­crease that amount to $1.8 tril­lion to make the cur­rent pro­grams “free.” To cover all Amer­i­cans in a pop­u­la­tion of 325 mil­lion, the to­tal cost of sin­gle-payer would be over $8 tril­lion an­nu­ally, re­quir­ing a tripling of an al­ready un­der­funded fed­eral bud­get. The re­quired tax bur­den would put most Amer­i­cans in poverty.

The next prob­lem is ei­ther to re­duce the per­cent­age that the pro­gram pays (like Medi­care), or limit what the pro­gram cov­ers to at­tempt to make it af­ford­able. The Bri­tish and Cana­dian health care both put re­stric­tions on spe­cial­ist treat­ment and elec­tive surgery, with pa­tients wait­ing months or years for knee re­place­ment as one ex­am­ple. Lim­its on the cost of med­i­ca­tions mean some health problems are re­stricted to med­i­ca­tions less than ideal. Nei­ther of th­ese types of re­stric­tions meets Mich­ener’s idyl­lic view of sin­gle-payer.

A real so­lu­tion would be to cut the govern­ment and the in­sur­ers out of the pic­ture by al­low­ing the med­i­cal com­mu­nity to of­fer sub­scriber con­tracts that cover all care. Elim­i­nat­ing the mid­dle man would lower the cost of care and re­store the doc­tor-pa­tient re­la­tion­ship.

Charles P. (Pat) Kelley, Ok­la­homa City

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