Single payer health plan saves moneyI am usually in accord...

the Forum

October 12, 1993

Single payer health plan saves money

I am usually in accord with columnist Robert Kuttner, but I must take issue with his Other Voices column of Sept. 28. I agree with him completely that a "single-payer" plan would reap savings in administrative costs. That said, I disagree with his belief that a single-payer system would require a massive tax hike.

The excessive administrative costs in the Clinton plan, as well as some other proposed plans, are the result of fragmentation.

It is dealing with perhaps millions of businesses, over 1,500 health insurance companies, uncounted "managed care" groupings, MO's, PPO's, etc., and the 50 states, plus D.C. and the possessions. What an administrative, bureaucratic and expensive nightmare.

It belies the fact that the U.S. has a highly mobile population. A single-payer plan could conceivably eliminate enough paper-shuffling administrative costs to negate a need for any tax increase.

Of course, the ideal plan would be to completely eliminate any and all, and I do mean all, public, private, employer-paid, employer-employee-paid, self-pay and any other plans, including Medicare and Medicaid.

Then an all-encompassing cradle-to-grave national health care system would be completely supported by a surtax, painlessly collected from most people by withholding, which would probably not exceed the combination premium and deductible and co-pay amounts now spent by most people for only partial coverage.

The simplest way is for everyone to have a health care card (resembling a credit card), good everywhere, which can be shown to any doctor, or run through a credit-card-like slot at any medical facility or pharmacy.

Using code numbers for each procedure or prescription, the health care provided would submit a claim by mail, fax, or computer to one central federal government computer center.

Personnel there, with great aid from computers, would determine the cost allowed for that procedure or treatment (much as insurance companies do now), or prescriptions, (a pricing standard having been agreed upon by medical/government conference) and reimburse the provider by check in the mail through direct deposit. Doctors would use a simple one-page form, while facilities and large pharmacies might have direct linkup to the central computer.

The whole thing would be backed by the insurance companies forming one huge consortium, which would sell its services to the single federal government agency. No fragmented groupings.

Mr. Kuttner further contradicts himself when, in speaking of cost control, he says of the present system ". . . the rich get better care than the poor . . ."

But he praises the Clinton plan: "People would still be free to spend their own money for enhanced coverage." In other words, just like now, ". . . the rich get better care than the poor . . ." Just like now, the rich live and the poor die.

A true national health care system would fully cover all possible medical procedures, so there would be nothing that the rich could get extra, just for being rich.

Harry E. Bennett Jr.

Baltimore

Coward Clinton?

Well, here we go again. America's finest are sent overseas as peacemakers and are murdered and dragged through the streets as raw beef. What initially was a peace mission to feed and aid turned out to be a total act of war.

What disturbs me the most is that our soldiers are sent to these areas by a commander-in-chief who dodged his obligations to his country by not entering the service. He decided to walk around with long hair, indicating he did not believe in mortal combat.

I do not feel that he or anyone else who was a known coward has the right to send any of America's finest overseas to fight unless they also were placed in this situation.

Edmund W. Huppman Sr.

Baltimore

Help Sudan

The analysis by your reporter in the Oct. 7 Evening Sun indicates that Operation Restore Hope has been an unqualified success, although the Sudanese counterparts have yet to receive any of this hope which has for 10 months been at the top of the United States' agenda.

While we are the hosting nation, the U.S. is not the United Nations. So, instead of telling us what our ambassador told Secretary General Boutros Boutros-Ghali in his executive suite at U.N. Plaza or perhaps in his office in a Swiss castle in the high Alps, where is Mr. Boutros-Ghali in the paper?

The one and only leader on this planet with a nonpolitical army at his command, Mr. Boutros-Ghali has been absent from the drama unfolding in the Sudanese nation, as he has been consistently absent before. What real hope exists for the Sudanese refugees other than that represented by this man?

Either Mr. Boutros-Ghali should save the refugees who are wandering in and out of this largely geographically imprisoned country, or nations with the authority behind human rights credentials must exclude the U.N. from an effective response to the atrocities in Sudan.

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