How single payer will work

January 27, 2014

By: Ann Raynolds, Pomfret

In response to Kelly O’Hara’s letter (Jan. 24), my experience and that of many others is that the ACA (Affordable Care Act) is already not working for the many people who choose the high-deductible plans. Perhaps they couldn’t afford the non-high-deductible Silver plan or the Gold or Platinum plans. And there are the people, many of them young and healthy, who simply will not buy any plan and the ACA will fall of its own weight. However, there are several misunderstandings of how a good single-payer plan will work in this letter.

First of all, many of our own elected officials did not tell us the ACA would work, even our Congresspeople voted for it begrudgingly when the Public Option was removed. Locally, our elected officials voted for Act 48 which has set in motion the move toward a universal (everyone in, everyone pays) system in Vermont. Why not be the first state to try this? Many small and large western democracies (and at least one small Caribbean country I know of personally) have health systems which are set up to provide health care, not profits for insurance companies and their investors.

Not to worry about employees; those very people working in insurance companies in the state today will have marketable skills to be employed in a publicly run health system. It is probably true that my Massachusetts billing person will not be needed to keep track of my bills to multiple insurance companies, keep track of all their different rules and regulations, track down unpaid bills over small new regulation errors, but I am certain she will not be unemployed. I, as a health provider, will bill everyone straight to one entity, thereby saving overhead. Better yet may be to put more health providers on salaries as is the case in some countries.

And finally, let us not jump the gun on what the mix of taxes would be with a single payer system, certainly not all corporate or business taxes (some confusion has been caused on this by Sen. Galbraith’s premature bill). And everyone always needs to keep in mind that these taxes are in place of the premiums we now pay for whatever we get with health insurance from for-profit insurance companies with their multimillion dollar salaried CEOs. Many opposed to the single payer system always drop out this point. So, we will proceed as our elected officials have voted in Act 48, toward a publicly funded health care system.