Day: June 21, 2009

Friday, Geezer asked a very good question that I didn’t have time to get to in the Frank Luntz thread. His question: Why should we be for a non-single-payer “reform” plan?

Before I get to that and ask you guys to weigh in, I want to put up some resources to look at and to think about. These are mostly comparisons of health care systems from industrial countries (and none will take much time to review):

• International comparison of health care plans from NPR.  This is about a year old and very good.
• Another comparison, from Frontline, as part of their Sick Around the World program.
• From the same Frontline Program, a summary of the four basic models of health care coverage systems.
• Also from NPR — they did a major series about a year ago looking at heath care coverage systems from major industrial countries:  Germany, France,  Netherlands, UK, Switzerland, Taiwan, Japan.  Their Health Care page includes more stories from these countries re: care and not all of them (esp. UK) are stories pointing towards a better solution.
• Another chart comparing industrial nations’ health care systems.  This is a pdf.

I include all of this (and these are worthy descriptions and comparisons — no system is perfect and I remind everyone that anecdotes are not data) to broaden abit the scope of the conversation.

Part of the problem in listening to either advocates or critics of single-payer is figuring out what they are talking about.  Are we talking about recreating the entire system as single payer or just the portions that will cover the uninsured or underinsured?  Does that leave for profit insurance companies in place or does if make all of them move to not-for-profit status?  Critics of single payer frequently invoke the UK system as the single payer that advocates want, while spinning out their scary tales of the day.  Advocates almost never make clear the scope of their thinking — especially (as you can see from the resources above) single payer can take multiple forms.

The Public Option that was proposed by the House on Friday is essentially a Medicare for All program.  It would be paid for by premiums from its users, with the government subsidizing premiums for poorer people and families.  This part of the proposal is basically single payer, paid for by premiums.  It will offer insurance to those who don’t have it now and will provide a competitive choice for the rest of us.