A Single-payer Healthcare System Would Create Choices, Not Limit Them
In the U.S. healthcare debate, the main reason insurers give for keeping our current system is choice. People want to keep their doctors. People don’t want to lose their existing plans. Insurers point to a wide range of plans for different needs, while a single-payer system would offer only a one-size-fits-all plan. The insurance companies have found an argument that resonates, and they’ll continue using it, as will their supporters. They create fear around losing access to quality care and losing choices. People are understandably fearful, but the “choice” and “quality care” that the insurance companies offer is an illusion.
Health insurance, by its nature, is designed to limit choices. While you may have a wide range of choices when it comes to your insurance plan and carrier, every plan limits your health care choices at each step of treatment. The limits placed on care by insurance companies do nothing to lower health care costs or improve treatment. Insurance company policies are designed to divert costs away from the insurance company and to direct customers to facilities owned by those companies, if possible. Their function is to increase profits.
While a single payer system would likely be one-size-fits-all (or close to it), that one size allows for far greater choice than anything offered by private health insurance. A properly designed single-payer system would give you more choice in when to see a doctor, which doctor to see, which procedures to get and which medications to take. Beyond that, it gives the doctor the freedom to design their treatment based around your needs, rather than profits.
Implicit in the argument made by insurance companies is that some entity will be tightly controlling your choice of doctors and procedures. This has been so central to our current system that most people just take it as a matter of course. But why should that be the case? Does limiting your choice of doctors (based on networks) in any way lower costs or improve care? If the profit motive is removed, why do this? The same is true for every step of the healthcare system.
Does limiting your access to health care, based on a set number of visits per year, lower costs or improve results? There’s nothing to suggest that it improves results (quite the opposite). As for costs, there is a reduction in unnecessary trips to the doctor. Those saving are offset by several factors though. The additional administrative costs in proving that a trip is medically necessary is one. The cost of treating serious conditions that arose from lack of treatment earlier is another. As these costs are generally not paid by insurance companies (most people who delay care are uninsured or underinsured), they are of little concern to them. The net effect of these policies is to add costs, divert those costs to taxpayers, and reduce quality of health care.
Does limiting your choices of available procedures help lower costs or improve results? Again, those goals are secondary to insurance companies. The greater goal is to maximize profits. Preventative medicine generally reduces costs and improves results in the long-term, yet some of the most effective of these procedures aren’t covered. Why? Because if you switch to a competitor, the insurance company has just increased that competitor’s profits by keeping you healthy.
In the midst of an opioid epidemic, many of the pain treatments recommended by the American College of Physicians aren’t covered by insurance. The ACP recommends evidence-based, non-invasive treatments as the first step in treating chronic pain. These include massage, acupuncture, spinal manipulation, yoga, tai chi, and mindfulness-based stress relief techniques. Few plans cover any of these techniques. Does this help lower costs or improve care? The cost of the opioid epidemic is hard to quantify, but the insurance companies pay only for the cost of medications. The rest is left to taxpayers. As for the quality of care, are we to believe that health insurance companies are more suited to creating protocols than doctors?
Does limiting your choice in pharmaceuticals help lower costs or improve results? We can safely say that what we’re doing here in the U.S. is not working when it comes to the cost of pharmaceuticals. As for treatment results, wouldn’t it be better to allow those best trained in their use make the recommendations? That means pharmacists and doctors, not health insurance companies.
The “choice” that the health insurance companies tout is an illusion. At best, your insurance plan limits your choices less than other plans. This may feel like it creates choices, based on your past experience, but don’t be fooled. The plans are designed around profits. The only “choice” that you’re offered is how many options you’re willing to sacrifice for a lower premium.
