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A single-payer system is best Rx in a bad economy

Yale Medicine Magazine, 2009 - Winter


A single-payer system may be the best way to provide health care coverage in the United States, especially when a faltering economy threatens to increase the ranks of the uninsured, an expert said at the Medical Student Council Perspectives on Medicine series in October.

“The employment-based approach is increasingly unworkable,” said Gordon D. Schiff, M.D., associate director of the Center for Patient Safety Research and Practice at Harvard’s Brigham and Women’s Hospital and past president of Physicians for a National Health Program. Roughly 47 million Americans were uninsured in 2007, a figure that will surely rise due to the credit crunch, Schiff said. Half of the nation’s 2 million personal bankruptcies were due to medical expenses, even though 76 percent of those filers had health insurance.

It’s time “people got over this bogeyman” of government’s inefficiency at managing health care, Schiff said. Whereas up to 40 percent of premiums in private plans are spent on nonmedical, largely administrative purposes, Medicare and Medicaid spend only about 2 percent, he said.

While a single-payer plan “isn’t perfect,” Schiff said, “it is the only approach that ensures universal health insurance for everyone.”