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Be Careful What you Wish For

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A single-payer plan might not look like you think

As we get closer to election day, there are growing discussions among Americans regarding what’s generally referred to as the “health care crisis.” Despite the fact that public opinion surveys show the American public is happy with the health care they are personally getting, those same Americans are still unhappy about cost increases in the healthcare system, and just plain frustrated with the whole process.

In response, during the last year an unprecedented number of universal coverage initiatives were debated in state legislatures and in the city councils of several major municipalities—many of those were actually passed. Most were universal access initiatives, not true single-payer plans, where the government would be the only provider of health benefits.

As a person who sells insurance, it might not surprise you to learn I have concerns about various forms of single-payer systems, and I would warn you to be careful what you wish for.

Advocates of a single-payer system will tell you that one of the great things about this type of delivery system is that everyone has access to care all of the time—“the health care that’s always there.” But in a single-payer system, everyone has an EQUAL access to insurance coverage—not necessarily all the care a person wants, or even believes they need.

In America, everyone already has full access to all the healthcare services they want. The question is who will pay for it—the government, an insurance carrier, or the individual themselves.

In some countries with what is called “universal care,” residents don’t have the level of specialist care we have here. In addition, many of those single-payer systems are giant Health Maintenance Organizations without competitive options for people to switch to when they are dissatisfied with their care or outcomes. In some countries, you don’t even have the right to a second opinion, or a right to see what’s written in your medical record.

Since users of the system don’t pay for care directly, the only way to control costs outside of the existence of the system itself is to limit utilization and access to medical technology. A single-payer system’s economic success is dependent on rationing the access to services, particularly access to the most sophisticated and expensive types of medical treatment and services.

Next month I’ll talk more about the health outcomes with single-payer systems, and associated costs, but let me finish with this belief – Americans value freedom too much to accept a single-payer plan.

In other countries, these systems can work because people have more willingness to follow what their governments and bureaucracies tell them. Americans value the freedom to choose and I don’t believe they would flourish under a system with no options.

I feel that most people who support a single-payer system do so under a false set of beliefs as to what it would be like, and that they would be surprised by the reality. Just as with real medicine, it’s rare to find a miracle cure to our health care problems.  Health care is one area where we should feel good about promoting consumerism and the necessity to be informed.


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Angela Oakes Angela Oakes Angela Potts-Bopp is the owner of Summit Insurance Resource Group in Sandpoint, Idaho. A former professional ice skater, her passions are providing insurance for the uninsured, creating bike paths throughout town, and running marathons.

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