Single Payer Insurance Beats Current Options

By MICHELE SWENSON

The governor’s blue ribbon panel has been looking at ways to address the health care crisis in Colorado. Only one of five Colorado health care reform proposals evaluated by the Lewin Group has demonstrated any cost savings — $1.4 billion. The Colorado Health Services Single Payer Insurance proposal is also the only one shown capable of providing comprehensive health care for all.

Single payer — or single-risk-pool — insurance would eliminate wasteful administrative spending.

Currently more than 30 percent of U.S. health care dollars go to inefficient administration costs, CEO salaries and profits of more than 1,200 U.S.commercial insurances. Providers and hospitals are forced to hire extra staff just to deal with administrative costs of multiple insurance authorization procedures and drug formularies, and requirements for claims, billing and provider re-credentialing – - excess costs ultimately passed on to taxpayers and consumers.

U.S.commercial health insurance no longer performs the function for which it was developed in the 1930s and ’40s: to spread health care risk and cost.

Assertions that the “free market” will lower health costs are belied by the fact that commercial health premiums have risen 78 percent since 2001, and that increasingly we pay more for less coverage. U.S. health insurance is best described as a monopoly market, now dominated by three behemoths: UnitedHealth, Wellpoint and Aetna. Annual premium increases continue to exceed both the rate of inflation and increases in workers’ earnings.

In response to rising premium costs, more and more employers move employees into catastrophic insurance policies with high out-of- pocket costs that place individuals and families at greater health and financial risk.

Individual out-of-pocket health costs rose 59 percent over the decade preceding 2005; simultaneously, unpaid medical bills increased 60 percent, according to the American Hospital Association. Not coincidentally, large medical bills contribute to more than 50 percent of U.S. personal bankruptcies.

Commercial health insurances game the system to increase profits by covering the healthy and rejecting as a “preexisting condition” anyone who might require health care.

Gaming the system also takes the form of “denial management” — insurance middlemen scan claims for excuses to delay, deny or renig on reimbursements, at an additional cost of $20 billion annually, The Wall Street Journal reported on Feb. 14.

Privatizing public programs is also very costly. Medicare prescription drug reform of 2003 was exploited as an opportunity to move more seniors into higher-cost, heavily subsidized private insurance plans. Insurance and pharmaceutical lobbies co-wrote reform to enhance their bottom lines with billions of dollars of subsidies and inflated profits.

Because commercial health insurances shift more risks and costs to individuals, many hesitate to share personal information with their physicians for fear it will be used as an excuse to deny them coverage. In no other industrialized nation do people fear loss of health care benefits with change of jobs; nor do families agonize about losing everything due to huge medical bills, as U.S. families do.

Single Payer Insurance saves money by cutting high administrative costs of multiple private insurances; and by permitting negotiation of bulk rates for pharmaceuticals and durable medical goods. Additional administrative savings are realized by hospitals and providers and passed on to patients. No longer would cancer be a twin battle — one with disease and another to retain insurance coverage. Single Payer would eliminate U.S.commercial insurance premiums that average more than $1,000 a month.

Every other industrialized nation has some form of single payer insurance. All average half as much health care costs and better overall health outcomes than the U.S. Questions for our time: Can we muster the will to stand up to powerful lobbies and eliminate the wasteful spending on health insurance middlemen? Do we insure their bottom line or health care access for all?

Read summaries of the Lewin Group evaluation of Colorado health care reform proposals, and 19 federal and state studies of Single Payer proposals: www.healthcareforallcolorado.org

Swenson is a former nurse, a member of Health Care for All Colorado, and co-author of the Colorado Health

Services Single Payer proposal.

(c) 2007 Gazette, The; Colorado Springs, Colo.. Provided by ProQuest Information and Learning. All rights Reserved.