Yes, Williams is all wet.
Myths & Facts About Single-Payer Universal Health Care
Copyright ©2004 American Medical Student Association
(800) 767-2266
[email protected]
MYTH: It would cost too much money.
FACT: A single-payer universal system would cost no more than we're already spending on health care, according to studies by the Congressional Budget Office, the General Accounting Office (GAO), the Lewin Group, and the Boston University School of Public Health. The GAO estimates if the United States changed to a universal single-payer system, it would save in the short run: $34 billion in insurance overhead and $33 billion in hospital and physician administrative costs. This savings would come from providing timely care to those who would otherwise delay care, thereby becoming sicker and more expensive to treat.
The cost of serving the newly insured would be about $18 billion. The cost of providing additional services to the currently insured-due to elimination of co-pays and deductibles-would be about $46 billion.
MYTH: It is socialized medicine.
FACT: A single-payer universal health plan is not socialized medicine. Under socialized medicine, the government owns the hospitals and clinics. Doctors and nurses are government employees. A single-payer universal health plan preserves private ownership and employment. It has no more in common with socialized medicine than does Medicare. What's unique about a single-payer universal health plan is that all health-care risks are placed in a universal risk pool covering everyone.
MYTH: Americans would pay more.
FACT: Several studies show costs for middle-class Americans would not increase. All but the poorest Americans would pay more income tax, but in most cases the tax would be equal to or less than what they currently pay for health insurance premiums, co-pays and deductibles, which would largely be eliminated. Money to take care of the currently uninsured would come from money saved by eliminating private insurance overhead costs and by spending less on high-tech equipment that duplicates or exceeds what's needed in any geographic region.
MYTH: It would create a huge bureaucracy.
FACT: Experts say the employer-based managed-care system is already a huge bureaucracy. It consumes 9 to 15 cents of every health-care dollar. Medicare, a single-payer plan for seniors, spends only 2 to 3 cents of every dollar on bureaucracy.
MYTH: It would cost employers more, make them less competitive and force them to fire employees.
FACT: Experts say the employer tax would equal but not exceed what employers currently pay for health-care premiums and paperwork/billing overhead created by the current multipayer system.
MYTH: Medicine would be rationed.
FACT: Managed care already rations medicine. A single-payer universal health plan would ration services based on medical necessity. Managed care rations services based on profit. Under single-payer universal health care, no one would be denied care due to pre-existing conditions.
MYTH: Americans would have trouble getting in to see a doctor.
FACT: Canadians, who live in a single-payer system, see their primary care physicians more often than Americans do now. There are more doctors per capita in Canada than there are in the United States. Yet the cost of physician services in Canada is one-third less than it is in the United States. About half the cost savings in Canada comes not from offering less care but by reducing insurance overhead and paperwork. The rest of the savings comes from allocating money to pay for expensive equipment so there is less excess capacity and duplication. Ninety-six percent of Canadians prefer their health-care system to the U.S. model.
MYTH: Patients wouldn't be able to choose their own physician.
FACT: According to experts, a single-payer plan would give patients more choice than they currently have in most cases. The United States is the only developed country heading in the direction of less choice. Other countries are building more choice into their systems.
MYTH: The United States has the best health care in the world.
FACT: The United States has higher infant mortality, higher surgical mortality and lower life expectancy than Canada. The United States has a much lower rate of access to primary care doctors than Canada. Canada has the same acute care bed-to-population ratio as the United States. Patient satisfaction, quality of care and outcome of care in Canada equal or exceed that in the United States, according to the U.S. General Accounting Office. For this lower quality, Americans pay 40 percent per capita more than Canadians do on health care.
MYTH: There would be waiting lists for surgeries and high-tech procedures, which is why Canadians come to the United States to get health services.
FACT: The United States has waiting lists for specialty care, too. Canadians rarely come to the United States for health care. Less than 1 percent of Canada's health budget goes to paying for care Canadians get in the United States. Canada's waiting-list problem stems largely from underfunding, which is being corrected now. Waiting times would likely be no longer in the United States than they are now, because we would still spend much more than other countries do on health care and still have many more specialists and capacity.
MYTH: Physician salaries would be lowered, as would standards for physician training. It would discourage the best and brightest from going into medicine.
FACT: Primary care doctors would see little or no change in their salaries. Some specialists would see a decline. All physicians would be paid more if they work in remote or underserved areas. Education, training and licensing policies are so similar for U.S. and Canadian physicians that their credentials are virtually interchangeable.
MYTH: Canadian physicians are unhappy with their system.
FACT: Nearly two-thirds are either "satisfied" or "very satisfied." About 500 Canadian doctors emigrate to the United States each year-representing about 1 percent of all Canadian doctors. Some return to Canada.
MYTH: U.S. physicians don't want a single-payer universal health plan.
FACT: Despite pervasive negative spin, 57.1 percent of U.S. physicians believe a single-payer system with universal coverage would be the best option for the United States, according to a 1999 New England Journal of Medicine survey.
