From the surgeon-blogger:

Let me say it up front: I favor some form of a single-payer system.* It’s my view that the many problems with such a system can be overcome: it’s not single payer per se, as I see it, to which people seem to object. It’s some of the accouterments. Before getting to that, I’ll state what I think is the obvious: having countless health insurance companies — many of them for-profit — sucks gazillions of dollars out of the health care realm, in form of profits to shareholders, salaries of executives, and tens of thousands of workers in cubicles. Both in the bowels of the insurers’ buildings, and in hospitals and clinics and medical offices around the country, people input data, make calls, argue for and against payments, follow differing contractual rules within and between companies; in short, money that could be spent on care of the sick is diverted into pockets of those who provide no actual service to those in need of it.

The biggest problems with Medicare are that it treats providers like shit, has stupid rules, and responds little, if at all, to input from those who know what’s going on. It not only doesn’t recognize, but actually deincentivizes excellence. No small things; but there’s no reason a single payer has to be that way. What I’m saying, basically, is this: let’s have a single payer, and let’s make it smart and responsive. I think it’s not categorically impossible.

I know I’m basically quoting his entire post, but he gives a good, fair perspective and raises his concerns with Medicare and single-payer without saying it’s hopeless, and admitting that having such administrative duplication has to waste huge amounts of money that could be going toward patient care.

(Just one critique, Dr. Schwab–Canada is single-payer: doctors are private, clinics are privately owned, and hospitals aren’t run by the government. They’re just paid for by the government.)

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