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05/05/2017

Single Payer Healthcare

So what is single payer health care?  According to Merriam Webster’s dictionary single payer healthcare is defined as “of, relating to, or being a system in which healthcare-providers are paid for their services by the government rather than by private insurers”. Is this an accurate statement?  I will now explain what a single-payer is, the strengths that it creates, and the limitations towards fixing healthcare that come from it.

To begin with, is the definition of single payer healthcare, as given by Merriam Webster’s dictionary, correct?  The answer is complex, but best summarized as, not exactly.  Single-payer healthcare is generally simplified to having the government pay for everything.  For this reason, single payer healthcare can be said to be a subset or even a step towards socialized medicine wherein the government owns healthcare facilities and pays the medical personnel.   It is, however, possible to have a single-payer system that is run by the government.  The reason why anyone talking about healthcare system models needs to know this is that, many healthcare systems espoused by the left as perfect examples of nationalized single-payer healthcare are more accurately stated as universal government-guided healthcare systems (UGGHS).  The difference between these systems is that single payer healthcare has its strengths in reducing administrative costs and thus creating a more efficient system.  Universal government-guided healthcare, on the other hand, is any system where the government works to set prices for medical expenditures in a nation.  In this model, the government has far more control and thus can achieve more cost saving measures than simple administrative costs.  It should be noted that while UGGHS and single-payer can go together, they do not have to.

As stated previously, the greatest strength of single-payer healthcare is savings on administrative costs.  Right now, the U.S. healthcare system is a series of many different insurance companies that pay what they want and have their own set of paperwork associated with it.  This leads to tremendous problems as currently doctors are spending around half of their time on paperwork.  Considering that this time spent on paperwork excludes time spent examining patients, it is not too much of an exaggeration to say that paperwork is literally affecting patient’s health.  With this in mind, reducing administrative costs is a strength that single-payer healthcare can fix.  More importantly, it could even lead to overall better healthcare by giving medical doctors more time for individual patients and more time to take patients overall.  If such is the case, single-payer healthcare could revolutionize medicine for the better.

So then what are the limitations of this new system?  Firstly, the most important benefit of changing to a single-payer system, better healthcare overall, is not a guarantee but a hypothesis.  In reality, it is not uncommon for single-payer healthcare to begin leading to increased wait times in nations that have made their healthcare more socialistic in this manner.  Second, the biggest benefits of single-payer healthcare tend to run more in line with the UGGHS model stated earlier.  This means that even as healthcare costs would be changed, they would not be made cheaper since a single-payer healthcare system without an UGGHS will not necessarily control costs.  In the long-run, the worst case scenario is that healthcare becomes more expensive, and less capable of ensuring health benefits to people who most need them.

Ultimately the American healthcare system is a complex web of priorities, incentives and duties that ultimately lead to an individual receiving treatment.  Many different entities can play a part to helping an individual receive healthcare.  My opinion is that some sort of nationalized government-guided healthcare system is necessary in some way shape or form for cost control purposes.  This stems from the fact that countries like Germany and Finland use UGGHS, in addition to other factors, to help make healthcare simpler and more affordable.  At the same time, one cannot deny that having the federal government intrude too much in areas of healthcare has the potential for more harm than good.  So while I personally have been convinced that single-payer models have strengths that need to be examined more closely, I also think that the government’s role in healthcare needs to be better established.  Not for what it should do, but for what it should not.

Kunle Adejare, PharmD '19

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