January 9, 2007

To The Editor:

Last year Governor Schwarzenegger vetoed SB 840, a bill that would have established a single payer system to provide health care for all Californians. Under SB840, patients would be able to choose their own doctors; doctors would remain private, able to practice the way they want, paid fairly and simply on a fee for service basis; and California would save billions of dollars.

Instead, the Governor has come up with a plan that would keep the insurance industry in health care—to the detriment of us all.

The U.S. is the only developed nation without a national health program. We spend more than double per capita what any other nation spends on health care yet we have 50,000,000 people, including 11,000,000 children without health insurance, millions more with grossly inadequate coverage, and the worst health care statistics in the developed world.

How can this be? Approximately 50% of every health care dollar is spent on something other than health care. Insurance companies, themselves, admit that they spend about 30% of the money we pay in premiums on something other than health care—multimillion dollar salaries for their CEOs, profit for their shareholders, advertising and sales, screening applicants and claims, and generating mountains of paperwork and endless hassles for doctors and patients, alike. Then, there is the money we have to spend dealing with them—in the creation of intermediary bodies and in hiring staff to do billing and to deal with authorizations.

In the 1960’s Canada and the U.S. spent about the same amount per capita on health care and had similar health care statistics. By 1971 all of Canada had single payer. Thirty-five years later, they spend less than half of what we spend per capita, yet, are able to provide health care for all of their citizens. Furthermore, on almost every measure, their health care statistics, like those of other developed nations, are better than ours. Our infant mortality rate is 50% higher than theirs and our overall mortality rate is 30% higher. The World Health Organization ranks the U.S. 37th, at the bottom of the developed world!

If we get the insurance industry out of health care we will have more than enough money to provide health care for all and to pay doctors and hospitals fairly for their services.

No longer will people have to change doctors every time they change jobs or their employer finds a cheaper health plan. Nor will they have to worry about losing their access to health care if they lose their job or develop a chronic condition. No longer will families struggle to pay astronomical health insurance premiums nor worry about paying for prescription drugs. No longer will 50% of bankruptcies be due to medical
debt.

All patients will have a medical “home”. Continuity of care will be improved and problems will be treated earlier (when easier to treat) or prevented altogether. Rates for vaccinations and health screening will go up. Public health and productivity will improve and social problems associated with untreated mental health problems and addictions will decrease.

Single payer will be good for the economy. American companies are at a huge disadvantage when competing with companies in other developed nations, which are not burdened with the high cost of providing health care for their employees. The auto industry spends more on health care than they do on steel and Starbucks spends more on health care than they do on coffee! Smaller companies and small businesses can’t afford to provide health care benefits and, thus, can’t compete for the best workers. Unhappiness over health care benefits is the leading case of labor unrest in the U.S. A single payer system would improve all of this and, also, decrease absenteeism and increase productivity (workers with access to health care are healthier and more productive). Furthermore, worker’s comp would be reduced or, even, eliminated. All of these advantages would create more jobs and generate more tax revenue.

SB840, which was passed by both houses of the legislature last year, will be re-introduced soon. With this bill, we have an opportunity to have the best health care system in the world, to enable all Californians to have access to health care that citizens of every other developed nation take for granted, and to lead the country in much needed health care reform.

Sincerely,

Ann Troy, M.D.
San Rafael, CA