Single-payer best for health care

By Judith Gordon

We almost had a catastrophe in our health care system.

A mandated 10 percent reduction in Medicare reimbursements was averted Tuesday when Congress overrode President Bush’s veto of a bill that would protect doctors from the cut.

But the reduction was instigated by a flawed calculation designed to reduce Medicare spending that Congress has refused to fix and still must address by the next scheduled cut in January 2010.

Any drastic reduction in Medicare reimbursements will limit people’s access to physicians, which would cause a disaster in our health care system.

The proposed reduced reimbursements would have barely covered rising expenses in staff, utilities and malpractice insurance.

Since Medicare fees are the basis for all other insurance carriers, many physicians would have opted out of the Medicare system by either going to a fee-for-service structure (pay when you are seen and get reimbursed by your insurance company) or by getting out of medicine altogether.

If there are fewer doctors available to see patients, the doctors who remain will end up with bigger patient workloads, causing longer wait times and greater travel distances to see a doctor.

More than 50 percent of our nation’s doctors work in small practices of one to five physicians, which has created a sense of having community health-care providers.

This community access to physicians to address our health care needs is what was threatened by the proposed Medicare cuts.

The immediate crisis has been resolved, but the overall problem of future access to physicians has not.

In today’s environment, doctors have no input into fee reimbursements, insurance authorizations for care, or quality-care measures.

These are all dictated by non-medically trained, bottom-line entities that have frustrated physicians and kept them from providing the type of health care to patients that they swore to provide under the Hippocratic Oath: First, do no harm.

We must address the financing of our entire health care system, which is the root of political debate nationally on this issue.

A possible solution here in Pennsylvania could be the proposed Family and Business Health Security Act (HB 1660 and SB 300), which endorses a publicly funded, privately provided health care system.

This comprehensive (everything) universal (everyone) single-payer proposal calls for higher quality, comprehensive health care for patients with a 25 percent savings on administrative insurance costs.

Currently, non-Medicare carriers have a 30-percent overhead in administering their health care plans. Medicare’s overhead is 3 percent.

The bill would also end the need for nightmare negotiations between insurance carriers and health care providers and businesses because there would only be one payer for all health care costs.

This reform would be funded through an annual fair tax that replaces an unfair premium/co-pay/deductible system that far outstrips inflation. Businesses and patients would be able to budget their predictable and stable health care costs.

Adopting a single-payer health care system can be done. Our elected representatives must be forced to act by all of us – patients , physicians, and employers.

We need a system that will strengthen the doctor-patient relationship and encourages well-being and trust.

In 1776, there was a revolution spearheaded by events right here in Pennsylvania. Now, we in this state have the opportunity to lead a revolution in health care for the entire country.

We must all implore our legislators to be the leaders they were elected to be and take morally responsible action to provide health care for all Pennsylvanians.

Judith Gordon is state co-chair of E-mail her at

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