Saturday, April 29th, 2017

Single-Payer System Will Leave Us Hungry


What does a single-payer system mean to me?  Fewer choices, less freedom.

The very people who object to having large insurance companies control a majority of the health care dollars are requesting an even larger entity to control all of the health care dollars.  For some reason, a for-profit organization that lavishly rewards the upper management causes a stomach churning reaction among many consumers while a mega-bureaucracy with no incentive program causes calm.  It has the opposite reaction for me.


I love grocery shopping.  I have choices and freedom.  In a county of 300,000 residents, I have more choices than could be orchestrated by a central organization. 

  • Grocery Store- Safeway, QFC, etc.  with standard “American food” choices.
  • Mom & Pop – Sprinkled about are tiny stores with higher prices, but convenient locations that can save a gallon of gas.
  • Niche Groceries- Asian market for Chinese/Japanese/Filipino ingredients, Health Food store with more varieties of produce than imaginable.
  • Coop – Collectives of like minded individuals who make bulk purchases from wholesalers.
  • Farmers’ Market- I know of at least two organized markets in addition to occasional roadside vendors.
  • 24Hour Convenience – That would include gas station stores.
  • Membership Store - Costco offers few items in bulk.

Every single household has direct control of their grocery dollars and we get choices.

Health Care

In the same county, we have a couple of hospitals, some large doctor’s groups, a few doctors in lone or small private practices, and a variety of “alternative” health care providers.  Health care is not as accessible as groceries, yet everybody needs some health care at points in their lives, just as we all need groceries. 

The limited variety of options is a direct result of the fact that the majority of the health care dollars are not controlled directly by the consumer, they are controlled by either insurance companies or government insurance (Medicare/Medicaid).  Additionally, compliance burdens put on all levels of the health care industry directly cause increases in overhead that translate into less for the consumer.

As an example, the author experienced this firsthand when a simple medical item, a catheter used by my paraplegic daughter for bladder management, was moved behind the counter.  The item cost went from $0.10 (ten cents) each to requiring a urologist to write a prescription and having a highly trained pharmacist dispense the item that now cost $1.00 (one dollar) each. 

First Class Mail

Just this week I experienced the efficiency of the US Postal Service.  A vendor used Priority Mail to send business envelopes from Kentucky to both Washington State and Southern California on Monday, July 20, 2009.   The USPS website estimated a 2 day delivery.  The Washington letter arrived three days later on July 23, 2009 and the California letter arrived four days later on July 24, 2009.  There was no delivery tracking, no return receipt, just simple, expedited letters.  No competition, no hurry.

Single-payer and Single-provider

Our country is filled with people and businesses who are willing to compete for your dollars.  When they have to compete for a large number of individual customers (like those selling groceries) they must work hard to satisfy the niche they have chosen.  When the number of customers dwindles to a few major private insurers and Medicare/Medicaid then there is a natural decline in choices.  Similarly, when an entity is a single-provider (like the USPS) they have little incentive to exceed its customers’ expectations.

Keep the debate open

Let’s keep the debate open on how to improve our imperfect health care system.  Let’s find ways to restore individual control of health care dollars and allow more provider options so we need not hunger for health freedom.

by Martha de Forest, Executive Director

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