Single-payer health would cover all

Margaret mairead at
Thu Apr 29 17:35:25 PDT 1999

Jim Westrich <westrich at>) wrote:

>Afterall, I can think of a dozen reform schemes (including direct state
>provision of care or unregulated cut-rate HMO's running wild) that would
>get us lower costs. Focusing on costs is arguably a bad strategy, but
>focusing on costs independent of the many and varied distributional issues
>involved is even worse.

I'm not sure I follow. It seems to me that, if we control for ability to pay, distribution is reasonably good--apart from there being a lot of chronically underprovided geographic areas right now. So you must mean something else?

>This may be too fine a point politically. I don't know. I don't make this
>point because I think support of single payer--by those that do support
>it--is wrong.

Again I'm not sure I follow. Did you leave out a negation in there somewhere?

>I just think it's wrongheaded to let the Mass. Medical
>Society lead the charge. Physician support for single-payer is in part
>reactionary. Physicians can maintain higher incomes and greater autonomy
>under single-payer than they can in an increasingly "managed" care system.
>Physicians can also maintain greater power over others in the health care
>delivery system under single-payer ("managing" care has increased the power
>and responsibilities of other health care providers--but not necessarily
>their incomes).

Are we better off letting the money go into the pockets of the physicians or the administrators?

>(I take it "G" stands for "1000 Million" because many readers would need to
>see the "B" for "Billion").

Yes: G=giga, M=mega, K=kilo I don't use B for precisely the reason (i think) you suggest--it's not uniquely-defined.

>One could reduce health care spending by lowering interest rates, improving
>equity in education, increasing interpersonal skills, and making sure
>everyone had a good job as well.

And how wonderful THAT would be!

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