Single Payer Is Not The Solution To The Problem Of Uninsured Americans

For years, some Democrats have proposed a “single payer” or “Medicare for all” health system as the solution to the problem of millions of Americans going without health insurance coverage. Lack of coverage is a serious problem that must be corrected by government action, but “political control” single payer (as opposed to market control) is not the answer. If single payer means that all health care providers should be paid by the same government entity, this would probably mean a continuation of the current and all-too-pervasive open-ended uncoordinated fee-for-service system, with resource allocation and prices controlled by political forces. But the fundamental failures of traditional fee-for-service are becoming increasingly apparent, and this route would not lead us to improved quality or lower cost. The incentives are wrong and would continue to be so under a single-payer system. Medical groups working under per capita prepayment arrangements would also be forced to switch to fee-for-service, which inappropriately rewards providers for the volume of services they provide, not the value or health status they improve. There are a number of reasons that fee-for-service does not improve the provision of care. First, medicine is a team endeavor. Quality and economy are produced and improved by teams of professionals working closely together in a well-coordinated effort. By not capitating payment, fee-for-service is a centrifugal force that acts as an incentive fo...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Insurance and Coverage Affordable Care Act Medicare repeal and replace single-payer health system Source Type: blogs