Single-payer Legislation Is the Real Health Care Reform

Small businesses are a mainstay of the Berkshires — restaurants, stores, garages, contracting and landscaping businesses, and many more, including doctors’ offices. Small business owners are suffering under the weight of the costs of providing and administering health care insurance for themselves and their employees.

Recently, I was talking about health care with the chef of one of my favorite restaurants in the Berkshires. He is unhappy about the new health care law passed last month in Massachusetts. He recognizes that the bill will do nothing to reduce his health care costs, but will add millions to the profits of the private insurance companies who helped to craft the bill. He asked about single-payer health care, which would remove the responsibility from businesses to provide health insurance for their employees.

Single-payer health care means that the government (a single payer) would administer the health care funds, rather than the numerous private insurance companies that now administer the funds and keep a significant percentage of the health care dollar for their profits.

In 2005, health plans in Massachusetts posted increased profits from the previous year. United Health Group CEO William McGuire grabbed attention last month with his $1.6 billion (yes, billion) in unexercised stock options. Profit for the company in 2005 was $3.3 billion; United Health had retained 21.4{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of premiums paid for its own use.

There is no accountability or oversight for the health insurance industry. A recent report from the American Medical Association (AMA) states that while health insurers “are posting record profits, premiums for consumers have increased without any increase in benefits. Instead, consumers are paying more out-of-pocket for their health care, through increased deductibles, co-payments and co-insurance.” The AMA conducted a study that showed that because of mergers and the consolidation of health insurance markets, the health insurance industry is not a competitive industry. In 95{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the markets they surveyed, one insurer accounted for at least one-third of the market. This is not a free market.

If we had a single-payer health care system, small business owners would be off the hook. Health care funds would come from a modest payroll tax, and would be administered by the government, at either a state or a national level. It would be like improved Medicare for all. Medicare’s administrative costs are 3{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5}: the current system of health insurance consumes 30{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the health care dollar.

There would be much more choice in such a system. Patients could chose their own doctors. Patients and doctors would make health care decisions, rather than non-clinical employees of the health insurance industry. And small business owners would be relieved of the financial and administrative burden of trying to provide health insurance for themselves and their employees.

Just imagine such a single-payer system. You go to the doctor, and the office secretary swipes your card — no deductibles or co-payments. For the doctor, there would be no paperwork or three-month wait for reimbursement or denial of payment from the insurance company: with electronic funds, payment could be immediate. Instead of the headaches and frustrations of dealing with insurance companies, doctors could get back to the job they do best, taking care of their patients.

Small businesses could remain competitive, because they would not have to worry about the financial drain of providing health care insurance for their employees and themselves. And everyone would have much more comprehensive health care insurance, including medical, mental health, dental, prescription drug, and long term care coverage.

Single-payer legislation is the real health care reform that the Massachusetts Legislature should enact, to save the small and struggling businesses that make up the fabric of the communities in our state.

Dr. Susanne King is a practicing physician residing in Lenox.