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Single-Payer System Guarantees Health Care for Less

EVERYONE agrees that our health-care system needs reform. Health-care costs are spiraling while more Americans are being priced out of the system. We spend more on health than any other nation in the world, yet our health statistics are poorer than most other industrialized countries.We need reforms which guarantee universal health care while cutting billions in wasteful administrative costs. A single-payer health insurance system does both. The General Accounting Office (GAO) and the Congressional Budget Office (CBO) have testified that a single-payer system can guarantee comprehensive health care to all Americans for less than we spend now. This year I introduced H.R. 1300, the Universal Health-Care Act of 1991, which would strengthen every American's ability to select the doctor of his or her choice. It replaces our nation's 1,500-plus insurance companies with a single, publicly administered and accountable program and uses the substantial savings to provide universal care and eliminate copayments and deductibles. The bill would cover all Americans for a wide range of benefits including hospital and physician care, long-term care, prescrip tion drugs, mental health services, dental care, and preventive care. Consumers would still be free to choose their own doctors, hospital, or health-care provider. My proposal incorporates many of the strengths of the health-care system that's been so successful in Canada. But it is not a Canadian system; it's an American one. It's about the things Americans have come to expect: freedom of choice, quality care, and the efficient and fair use of their hard-earned dollars. It's about giving Americans the peace of mind they deserve so that when their children are ill they can take them to a doctor without having to pay a high deductible; or when they change jobs, they won't lose their health insurance; or when their parents need long-term care, they will not have to mortgage their home. Ninety-five percent of Americans would save money under the bill and skyrocketing health-care costs would finally be capped. Rapidly escalating health-insurance premiums, copayments, and deductibles would be replaced with modest increases in payroll taxes, personal and corporate income taxes, and state and federal contributions. Under the plan, a family of four with $54,000 in income would save $1,750 a year. A single-payer system would dramatically reduce costs because all Americans would be covered under a single comprehensive program. Money would no longer be wasted on weeding out unprofitable groups and individuals, or on advertising, marketing, and commissions, or on billing millions of consumers. Doctors, nurses, and hospitals would no longer have to keep track of the eligibility requirements or complicated definitions of services in insurance plans. According to a recent report by the GAO, shifting to a single-payer system would save the US $67 billion in administrative costs alone. These savings would not only finance high-quality care for the uninsured, but would benefit middle-income Americans by eliminating all copayments and deductibles. The bill would hold down costs by establishing national and state health-care budgets. Fee schedules would be established so that physicians would know in advance how much they would receive for a specified service. Hospitals would be paid monthly, based on a global budget established at the beginning of the year. All of these measures have been cited by the GAO and the CBO as the most effective ways to contain costs. We can't afford to do anything less than single-payer. Partial solutions like insurance reform or mandated benefits won't work. Quality would continue to decline as insurers increased their role in medical decision-making and costs would continue to rise. I'm tired of hearing that a single-payer is the best system but could never happen in the US. For the amount of money we now spend, Americans should be living two years longer than Canadians, not the other way around. H.R. 1300 doesn't answer every deta il. But it does offer the framework for how health reform should be structured to guarantee that America has the best health-care system in the world - not just the most expensive.

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