Single-payer health care: Why not?

180px-Roma_-_FatebenefratelliI’ve been fortunate to have traveled many places, and to have lived for extended periods in China, Australia, France, and Ireland. During those travels, my family has received health care on many occasions, including for our small children in China and Asutralia, my wife in Scotland, and my 87-year-old mother in Ireland.

This health care has come in a variety of forms, including treatment for my ten-year-old daughter’s eyes at the Hospitaller Order of St. John of God or Fatebenefratelli (see left), located on San Bartolomeo, the only island in the Tiber River in Rome. That hospital was built in 1584 on the site of the Aesculapius temple.

clontarfWe also faced emergency surgery for my mother’s hip at Beaumont Hospital in Dublin, Ireland and subsequent rehab at the Orthopaedic Hospital of Ireland in Clontarf (right). In China, we were served in medical facilities with separate queues for Western medicine (our choice) and traditional Chinese medicine (below left). I donated blood many times at the Hôtel-Dieu de Paris, founded in 651 on the Ile de la Cité (below right). I’ve also observed, though not had to depend upon, health care in Russia and even in economically oppressed places such as Haiti.

beida_hospitalOn the whole, I’ve received excellent care in a variety of conditions. Individual health providers have been courteous, knowledgeable, and dedicated to their professions. For myself and my family, the experience of care did not depend on the setting or language, but rather on the ailment or the specific people providing care.

And yet, one thing stands out: Among the industrialized nations, the United States is the only one without universal health care. All of the others provide health care for all. They also do it primarily through single-payer systems.

The United States operates instead through a complex bureaucracy of insurance policies, doughnut hole prescription drug coverage, forms and regulations galore, massive administration, unnecessary and excessive procedures, complex and confusing tax codes, leading to escalating costs and unfair coverage. The inequity of care actually costs all of us more in the end, because of lack of preventative care, inefficient delivery (e.g., emergency rooms), and lost productivity. Our system costs much more, even double that found in other countries.

hotel_dieuIf we were to find that spending a few dollars more gave us better care, there might be little room for argument. But in comparable economies, people spend much less, yet have longer, healthier lives (American Health Care: A System to Die For: Health Care for All). Why then, is the system that works in Canada, Japan, Europe, Australia, etc., not even under consideration here?

The answer is unfortunately all too obvious: Americans, unlike citizens in other countries, have ceded control of their own health care to profit-making insurance companies, hospitals, clinics, laboratories, pharmaceutical companies, and other entities. The best we can do is an occasional feeble cheer when someone asks why our government can’t even consider a single-payer system. Then we listen to an answer that mostly obfuscates and lays the blame for it back on our own timidity:

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