Paul is Professor of Internal Medicine and Pediatrics at Albany Medical College. His partners and he have a primary care practice for children and adults in Latham. He teaches evidence-based medicine and does research and writing on judgment and decision making, health psychology, and the French health care system. In his first career he was Assistant Professor of modern European history at the University of North Carolina at Chapel Hill. He is co-chair of the Capital District chapter of Physicians for a National Health Program.
We've been engaged in some hallway debate for some time now. I'll share some of it shortly, but here's his argument for state-level single-payer system.
And here are some of the highlights:
A single-payer system in New York would be like Medicare for all on the state level. A single board, composed of representatives of the various stake holders, would administer the system. The board would decide what goods and services would be covered, would negotiate with providers and would contract with private companies to process claims and monitor quality.
The money used by the board to pay providers would come from a variety of sources: the federal Medicare and Medicaid funds currently spent on New York residents and a combination of payroll levies and state income taxes voted by the state Legislature. Medicaid would disappear as a separate program and would no longer burden county property taxpayers.
The key is that a single-payer system eliminates most of our huge, rapidly growing and enormously expensive health care bureaucracy. You -- or your employers -- wouldn't need multiple insurance companies and multiple plans to choose from. Your needs and wants are, fundamentally, the same as everyone else's: You want to be able to receive appropriate and effective care when you are sick and to receive the preventive care shown to keep people like you from getting sick.
By eliminating all these health insurance companies, everyone (except them) wins.
My staff and I win because we don't have to deal with myriad insurance companies and their regulations and regulators. I can spend my time taking care of you, rather than taking care of your insurance company.
Your employers win because they can get out of the business of providing -- or not providing -- you with health insurance, and because they no longer have to foot the bill for all these superfluous administrators.
You win because you are equal to everyone else in your access to care. You can receive care from the doctor and other provider of your choice. You can choose based on quality, not cost. You do not have to fear losing your health coverage or your doctor if you change jobs, are laid off or don't have a job.
Society wins because the huge savings in administrative costs allows us to provide universal access to health care -- allows us to become a more just society -- while not increasing overall health care costs.
Then come on over here and weigh in ...