Jonathan Gruber gave testimony to Congress today regarding his role in the development of the Affordable Care Act (ACA). http://www.c-span.org/video/?323115-1/hearing-jonathan-gruber-marilyn-tavenner-health-care-enrollment
Representative Blake Farenthold R-Texas, 27th District asked Mr. Gruber the following question: “Would you consider the ultimate solution to rising health care costs to be a single payer or government run system, completely government run system?”
The question is off the mark, way off the mark, and it demonstrates politicians’ inability or unwillingness to understand what health care is. If a central payer system were structured properly in America, health care costs could actually increase. They might not, but they could because a properly structured central payer would free the doctor patient relationship from undermining control and interference from the payer. The major goal of a central payer structure is to make sure that anyone, when he/she feels the need, can get up and go to the doctor or emergency room without obstruction from the fear of huge medical bills. If there is some lowering of national health care expenditure because of the efficiencies of a central payer compared to private health insurance, then that would be fine. But this is NOT a goal to be sought after. Doctors and hospitals welcoming everyone in their community to enjoy unobstructed access to first class health care is the goal, and that is not happening at present. A properly structured central payer could easily make that happen.
The government can’t run health care. For goodness’ sake, look at the Veterans Health Care debacle! There is nothing wrong with a central payer structured to perform one clerical function: the collection and disbursement of the people’s money for payment of their health care bills. Money in and money out. There is everything wrong with the government trying to run health care!
The doctor patient relationship is health care; politicians, insurance companies, public payers, drug companies etc. are not. Only when the politicians create a structure, which separates the business of medicine from the medicine of medicine and makes the former subordinate to the latter, will we have a health care system which serves all of us. And this can be accomplished while maintaining very good profitability for necessary health care businesses. However, the politicians seem unwilling to think this through. I wonder why.
R. Garth Kirkwood, MD email@example.com