Opinion | How Much Will Americans Sacrifice for Good Health Care? – The New York Times

Sadly, this New York Times Editorial op-ed is factually wrong in a material way that I had to write a letter. I also ripped into Dan Gorenstein on twitter(1) for linking to the article and “guessing” he didn’t think Americans would tolerate #MedicareForAll.

Here is the text I sent to the Times, who knows if they will publish it. My track record of getting corrections to editorial op-eds published is close to zero. It’s like they don’t want to be wrong.

The editorial board seems both confused, and factually inaccurate when it comes to how insurance works in government funded, single payer healthcare systems. It is common place in such systems to have an option of top-up insurance. I was lucky to have had such insurance when I needed serious surgery in the UK, in 1992. It was employer provided insurance.

One of the constraints in the many government single payer systems is the supply of buildings and doctors to treat a patient “on demand”. Urgent cases are as always seen as soon as they can be. Non-urgent cases, not so much. But then, medically, they are non-urgent. Top-up insurance allows patients to schedule both dates and locations, specialists for non-urgent treatment. The single payer system, pays an agreed amount for the treatment or surgery, much like Americas current insurance based system.

The difference is, that in America today there is massive over supply of both facilities and staff, specialists etc. That over supply is costing every one, both the insured and the uninsured, money for nothing. Yes, it’s great if you can walk into your local Dr’s today and get a referral to a specialist this afternoon for that annoying toe bunion that has bothered you for the past 6-months. Should our healthcare system be based on the costs of carrying that burden? Absolutely not.

While single payer systems are not perfect, nor is the current US Insurance based model. Almost everyone of the people that are involved in charging, finance, billing, negotiating, handling disputes, etc. is overhead. That overhead has to get paid for. So called “death panels” are more common in the US based insurance system than they are in single payer systems. In a single payer system there is no out of network, drug prices are controlled, and there is much more transparency. For everything else there is top-up insurance.

The editorial board overlooking this important fact, does a major dis-service to it’s readers and to Americans who continue to pay too much for healthcare.

Source: Opinion | How Much Will Americans Sacrifice for Good Health Care? – The New York Times

Author: Mark Cathcart

Formerly an Executive Director of Systems Engineering and a Senior Distinguished Engineer at Dell. Prior to that, an IBM Distinguished Engineer working for the Systems Group in NY and Austin. I'm currently "retired until further notice".