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Experts Support Single-Payer Health Care But Would It Work?

Experts at an Oregon Health Forum event said a single-payer system would improve access to care, lower costs and ease enrollment, but would not be easy to implement.
September 27, 2018

The need for the U.S. to fix its broken health system by providing universal care is a topic that has come up again this election cycle, with many politicians and constituents calling for health care reform.

One such system, the so-called single-payer option, would replace private insurers by having a public entity fund care through taxes.

But would that system be right for the United States? And if so, when could it be implemented?

That was essentially the topic discussed by a panel hosted by the Oregon Health Forum, a nonprofit affiliated with The Lund Report, on Thursday at the Multnomah Athletic Club in Portland. The panel of medical professionals discussed this premise: “If single-payer is the answer, what is the question?”

The four-person panel agreed that a single-payer system could be beneficial in the long term for increasing patient coverage and lowering costs, but all said it’s uncertain how feasible it would be.

Moderator Dr. Jeanene Smith, a principal at Health Management Associates and former chief medical officer for the Oregon Health Authority, said there’s interest in Oregon in comprehensive health care reform. She said between interest, early ballot measures and continued studies, questions remain on what, if any, kind of single-payer system would best suit the United States. Would it include Medicare and/or Medicaid?; who would it serve?; and what would be the impact on providers?

Dr. Samuel Metz, a local anesthesiologist and member of Physicians for a National Health Program, said adopting a single-payer system would not be the best option in some instances. For example, he said if the goal were to have health care reform encourage people to take charge of their health rather than having a government be responsible, or if the goal were to have speedier medical diagnoses, a single-payer system wouldn’t be the way to go. But if the goal were to improve access to care and lower costs, single-payer would be the best answer.

“The question we’re trying to answer is how can the U.S. get better care for more people for less money,” Metz said.

John McConnell, a health economist at Oregon Health & Science University, said a single-payer system would not necessarily ensure better health care. He added that it could be difficult for hospitals and providers to initially make the transition. But the system would lower costs, he said, make enrollment easier and allow patients to choose their own physicians.

Dr. Jennifer DeVoe, a physician and chair of Family Medicine at OHSU, said her primary concern is that patients get the care they need.

“The current answer isn’t working, and it’s gut-wrenching to sit in rooms with people and understand the basic and cheap options aren’t available to them,” DeVoe said. “Certainly I think single-payer could make a lot of things better.”

All agreed the current system is rife with problems.

The U.S.  health care system is the most expensive in the industrialized world, costing 18 percent of gross domestic product, and is inefficient and lacks standardization seen in other developed countries, said Peter Bernardo, former president of the Oregon Medical Authority. “That’s what we’re trying to fix, we want our patients to be healthy to do better,” he said. “We want easier access.”

Reach Colin Ellis at  [email protected].