Published in the Portland Press Herald, 12/12/18
I would like to add another perspective to Martin Jones’ response in the December 2 Maine Sunday Telegram regarding the effectiveness of a single payer heathcare system. Mr. Jones states that a single payer system would “discourage competition and removes incentives for consumers to seek value or for providers to create it.”
Mr. Jones appears to be drawing a comparison between shopping around for the best MRI price and buying bananas. If only we all did it, the price of both would be lower.
As someone who has a high-deductible health care plan, and because of this pays for most of my health care costs directly each year, I have a strong incentive to “seek value” for my health care, as well as other purchases in my life.
And while our retail system may work well for many of these purchases, i.e. cars, mattresses, televisions and bananas, it doesn’t work with health care, at least for me.
I have tried many times to research and compare the cost of a particular procedure or test. To “shop” this as I would any other expensive purchase. Every time I have met with failure. Asking my doctor is pointless, he or she doesn’t know the cost (and really, I don’t want to them to be concerned with that). I am usually directed to the billing office to seek that information. But unless I know the specific billing code for the procedure, AND I know every entity that will be involved in that test (the technican who performs the test, the location where the test is performed, the doctor who will interpret the test results, etc.) I cannot know how much that test will actually cost me because everyone submits their own bill.
Now try repeating that process with multiple providers (remember, you’re comparison shopping), some of who may accept your insurance plan (if you have one) and some who won’t.
This is not the kind of work that ordinary people can or should do. Especially not people who are ill to begin with and may not be up to shopping for bananas, much less a surgical procedure.
This a job for trained professionals. It is an enormous waste of time and energy for most people to try and do this kind of research. The hours I’ve spent trying to cost compare health procedures would have been better spent building my business, volunteering, or doing just about anything else productive.
Mr. Jones notes that health care provided by a single-payer system will cost the government. That is correct. And paying that will undoubtedly require tax revenues. But keep in mind, health care is not free now. Think about what you pay in premiums, copays, deductibles. Think about what your employer pays, if you have health insurance through them. And think about the time you may spend actually trying to find the best procedure at the best price. That is all money and time that could be going towards a more steamlined system that covers everyone, more efficiently.
Maine All Care (www.maineallcare.org) is working towards a universal care system that would cover all Mainers, fairly and efficiently. I’d enourage anyone interested to take a look at their site and think about the real costs of our current system. Decent health care and coverage for that in an advanced society such as ours is a basic right. It does not belong just to those who can afford it.
I agree that health care costs are out of control. There are many reasons, which are beyond the scope of this letter, but which should be addressed. However, the failure of consumers (patients) to shop hard for the best price is not one of them.
To think that is simply bananas.