Zealous supporters of a single payer system, such as PNHP, can be as inflexible and intolerant of alternative approaches to health reform as some socially conservative groups on the right are of abortion and gay marriage.
It will be interesting to see if they will budge in their narrow views on health reform. The ACP’s Bob Doherty quotes health policy heavyweight Jacob Hacker in emphasizing that the success of any major reform passing depends on whether single payer advocates are willing to compromise:
A successful effort this time “will require updated strategies including a greater willingness to compromise on means, yet greater clarity on ends” and “serious efforts to bring on board … reformers who support a universal Medicare plan, to provide them with the guarantees and arguments they need to embrace a less inspiring but more politically palatable approach.”
Over at Health Beat, a blog with moderate, rational left-of-center views, Niko Karvounis points out that most nationalized health systems – including the UK, Germany and the Netherlands – incorporate some degree of private insurance presence:
This might not be enough for some single-payer folks who have an ideological objection to seeing health care coverage offered by anyone but the federal government. But these people need to realize this: the international health care systems that they so often cite as models for change all incorporate a role for private and non-governmental insurance.
It would be tragically ironic if the intolerance of the single payer advocates were to blame for the downfall of major health care reform in the Obama era.
topics: single payer, health reform
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- Single-payer supporters, be careful what you wish for
- Gawande on health reform: "It is not single-payer"
- Single-payer: Forcing health care down people’s throats?
- Single-payer: Read the fine print
- The make-believe savings of single-payer
- Taking on the single-payer zealots
- Administrative costs and single-payer
{ 6 comments }
I agree that zealots do not help the situation.
However, for every “single payor” zealot, there are many more anti-single payor zealots. How come you do not object to them?
When I was in med school in the early 90’s, I had to endure many a blowhard attending bloviating aganist “socialized medicine” and “Billarycare”, all of whom at the same time had their hands in the medicare cookie jar. They were all zealots in their belief, blind to any compromise and deaf to any discourse. Well, here we are, almost 20 years later: are we better off? From a primary care viewpoint, the answer is clearly no.
Am I for single payor? I honestly don’t know. I know that things are pretty bleak for primary care at the present time. My income has not budged in 6 years, despite working harder. Because of inflation, I am making less money.
Let’s stop the bloviating and the labelling, and at long last, have a dialogue.
A concerned family practitioner
Not all who support PNHP are as narrowly focused as you assert. This is the USA and people can buy a Chevy (for a while, yet) or a Mercedes. Similarly, they might get a Chevy health plan from a central source (Federal government, other government, government owned corporation, other) paid for through a tax scheme and choose to spend disposable income for additional private insurance to get additional coverage/services. And that’s just one of many approaches that could be embraced. Some will offer these suggestions when approached by PNHP.
Meanwhile, what do you say to the greedy doctors who give every external appearance of being in it only for the money and who won’t listen to a presentation that raises questions and offers ideas and other choices for reform? /sjdmd
Proud to say. I have been banned from this site.
http://www.pnhp.org/blog/
Of course there are more anti-single payor zealots. This is America founded on liberty by men who sacrificed their lives and fortunes for that higher value. Concerned family practitioner seems to think that his falling income is a reason to surrender that. Single payor can only be achieved by tyranny. “Extremism in defense of liberty is no vice”. You may not agree with those words, but as long as America tends the graves of the men who gave their lives for freedom, a great many will.
Only 3 nations outlaw private purchase of medical care outside of the government: North Korea, Cuba, and Canada–and in the latter 90% of Canadians live within 30 miles of the US where they are permitted to freely travel and purchase care of their choosing.
Well, the Canadian system doesn’t allow non government insurance. And by all measures, Canadians have better population health than Americans.
A single payor system is intolerant of any parallel payment systems–so by definition it’s advocates are advocating an intolerant totalitarian system. Of course they are intolerant.
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