Health care call in

February 12 is the National Call-in Day for HR 676, which is the House resolution implementing a national single-payer health care system. Please call the Congressional switchboard: 202-224-3121 and ask for your representative's office. You can also call (202-456-1414) or fax (202-456-2461) the White House.

Single payer health care is different from "universal health care" because it eliminates the need for private health insurance plans. This helps realize a few important effects:

• Eliminate the inefficiencies of private plans. The 25% - 30% of our premiums which go toward profit and marketing can be used instead to provide care to more individuals.
• Remove the mis-alignment between profit and health. Insurance companies, to make a profit, routinely deny care to their customers, in what often seem like arbitrary decisions. A governmental single payer plan will need to determine what procedures and items to pay for, but it will at least be nationally consistent, a single set of rules for everyone. Yes, there will be a public organization or committee responsible for those decisions - but such deliberations should take place transparently, with the potential for oversight from all of us who are affected. Compare that to the decisions now made by your insurer - who makes them? Are they in your best interests? Do you feel they are concerned to make sure you're healthy, or do they deliver just enough care so you don't leave, and they can maximize their profit?
• Improve doctor choice. Current insurance plans exclude doctors and hospitals, forcing you to choose providers "in the plan". With a single payer, everyone is in the plan.
• Improve the competitiveness of American firms. Firms employing American workers have to pay inflated premiums (see the inefficiencies point above) for health care for their workers. Firms in almost every other developed country have their workers covered under some state-organized plan. Sure, health care has to be paid for somehow; payroll or per-worker taxes are the most likely tool to use. But when everyone's covered, and inefficiencies are squeezed out of the system, it should end up that the cost per worker, for the same level of care, is less under a single-payer plan than in our current environment.
• Potentially mitigate billing errors and issues. I'm on thin ice here because I have no experience dealing with Medicare or Medicaid. Do they pay on time, and in full? Dealing with a single payer may make it unnecessary for a practice or hospital to have a large staff dedicated to collecting payment from insurers. The process may be streamlined, saving time and money for everyone involved.
• Implement a single formulary for prescription drugs, allowing the negotiation of reasonable prices for such a huge market commitment. Yes, this would set a single price for each drug; it would have to be reasonable enough for drug makers to be able to fund research into new drugs. It may end up that the market shifts a bit; drug research and drug manufacture may be split up under some compulsory licensing scheme. A drug researcher would take on the costs of developing new drugs, typically with access to federal funds; once a drug (or device) is developed and tested, the organization would recoup the costs from licensing the resulting patents to manufacturers. A robust market in manufacture could help drive the cost to the consumer down.

A health care market under HR 676 would potentially look dramatically different from what we have now; some companies and segments will be unnecessary and disappear, and others will change dramatically. That's fine with me, because it seems the system we have now is fundamentally broken, and is not delivering the care we deserve for the dollars we're pouring in.