Benjamin Brewer is a doctor. He writes a regular column in the
Wall Street Journal called
The Doctor's Office.
Today, in the mighty, conservative, Bush-supporting pages of that newspaper, he called for single payer health care.
Granted, Dr. Brewer's column is not quite the editorial page--but it's progress. It's breathtaking progress. It's The Wall Street Journal.
Anyone care to guess how long he'll keep his writing gig?
Let's take a look at what he has to say.
First the title. Says it all.
Government-Funded Care
Is the Best Health Solution
Multiple Insurers, Multiple Plans
Create Expensive, Draining Hassle
Everyone knows this. Ask any doctor how much time he spends fighting and pleading with insurance companies to authorize routine medical procedures.
In fact Dr. Brewer explains that the Massachusetts plan doesn't go far enough and is still a jumble of confusion.
A recently approved Massachusetts plan designed to force all residents to get health insurance was a step in the right direction, but it doesn't go far enough.
Under the Massachusetts approach, there will still be a maze of plans provided by any number of insurers. That multiplicity is the problem. Multiple insurers and multiple plans create layers of unneeded expense and bureaucracy related to billing, collections and the entire assembly line of middlemen between the service rendered and the payment.
Does the above remind you of Medicare D? And here's the first money quote, in the third paragraph.
The solution that would really put health-care dollars, and providers, to their best use would be a single-payer system -- namely, government-funded health coverage for all.
It get's better. Much better. On the pages of the Wall Street Journal, Dr. Brewer says, our representatives should be forced to use the same system we use.
But increasingly I've come to believe that if done right, health care in America could be dramatically better with true single-payer coverage; not just another layer -- a part D on top of a part B on top of a part A, but a simplified, single payer that would cover all Americans, including those who could afford the best right now. Representatives and senators in Washington should have to use the same system my patients and I do were they to vote it in.
Some of you may remember the diary I wrote about the Rolls Royce coverage our elected officials give themselves. If they had the shit we had, we'd have health care reform overnight.
You can read that diary here. SHOCKING: Deluxe health care benefits for politicians.
http://www.dailykos.com/...
And he describes the sad reality facing just about every doctor in America. Do you want your doctor, calling insurance companies or spending his precious time becoming acquainted with the latest medical advances?
The amount of time, staff costs and IT overhead associated with keeping track of all those plans eats up most of the money we make above Medicare rates. As it is now, I see patients and wait between 30 and 90 days to get paid. My practice requires two full-time staff members for billing. My two secretaries spend about half their time collecting insurance information. Plus, there's $9,000 in computer expenses yearly to handle the insurance information and billing follow up. I suspect I could go from four people in the paper chase to one with a single-payer system.
Imagine. Close your eyes and just imagine a system like the one this good doctor describes.
It would be simpler and better for the patient, and for me, if the patient could choose a doctor, bring their ID card with them, swipe it in a card reader at the time of service and have the doctor get paid on the spot with electronic funds transfer.
Instead, patients have to negotiate a maze of deductibles, provider networks, out-of-network costs, exclusions, policy riders, ER surcharges, etc. Wouldn't a card swipe be simpler? No preexisting conditions to worry about. No indecipherable hospital bills. One formulary to deal with and one set of administrative rules to learn instead of 300.
Let's get real about waiting lists. Here's a diary I wrote (Ladies dig this, 1 year wait for a mammogram) about trying to get an appointment for a mammogram. In New York, America's largest city, the wait at one center is one year. So the next time someone tells you that single payer will result in waiting lists, ask them if they've tried to get a mammogram in Manhattan.
http://www.dailykos.com/...
With a single-payer system, there are concerns about waiting times for procedures and not getting access to the "best doctors." These are real issues, but not unsolvable ones. We have these disparities now. Fact is, they are mostly a matter of geography, insurance status and personal wealth.
Then Dr. Brewer bravely tackles the forces of evil lined up against the American people. This is why he will likely not be writing much longer for the Wall Street Journal.
There are powerful forces that oppose a single-payer system -- the health insurance industry for one. The insurance industry got its share of the Medicare drug benefit pie, as did the pharma industry. It would have been better and simpler for the government to design one plan with a standard drug fee schedule that everyone could understand, as the government does with care that doctors provide to Medicare patients. But that's not the way it happened.
You can read the rest of this extraordinary article/plea here:
http://online.wsj.com/...
Inch by inch. People like Benjamin Brewer will force change, upon this miserable, unfair and broken system.