Single Payer Healthcare
Community Radio by Miles Eddy
In this six part series of short interviews, rural doctor Rocky White, hospital CEO Russ Johnson, and emergency room doctor Beth Kinney speak out from three different perspectives why the current healthcare system is broken, why it is the problem of everyone including those with good insurance, and why a single-payer healthcare system would fix a lot of the problems.
PHOTO: Dr. Rocky White
Copyright 2005, Midi Age Productions.
- Listen to half hour show of series "Single Payer Healthcare" (28:50)
Half hour from series interviewing Dr. White, CEO Russ Johnson, and ER Doctor Beth Kinney.
- Transcripts of Series (ALL).
- Broadcast licensable version "Single Payer Healthcare"
Series on the Public Radio Exchange.
- Listen to Part 1: "Why Single Payer" (6:18)
Doctor Rocky White is a proponent of a single-payer healthcare system believing that it will help businesses remain competitive in a world market. In this six part series, Dr. White, hospital CEO Russ Johnson, and emergency room doctor Beth Kinney speak out from three different perspectives why the current healthcare system is broken, why it is the problem of everyone including those with good insurance, and why a single-payer healthcare system would fix a lot of the problems.
- Listen to Part 2: "A big slice of the healthcare pie - Insurance and Pharmaceutical Companies." (4:45)
Historically, people have received health insurance through employee benefits. But as the cost of insurance continues to grow, businesses are dropping this benefit in order to remain completive in a world market. Additionally, hospitals and clinics rely on patients with health insurance to offset there cost from other loses. In part two of this six part series, we continue the conversation with Dr. Rocky White, who spoke with business owners at the Alamosa, Colorado, Rotary Club; Russ Johnson, CEO of the Alamosa Hospital; and Dr. Beth Kinney, an Emergency Room doctor.
- Listen to Part 3: "Cash Flow in the Healthcare Industry" (4:41)
Many physician services and hospitals are going broke! With Medicaid, they loss money with every patient that walks through the door, with Medicare they barely break even, and with the uninsured they basically write it off.
Dr. Rocky White says, "We have to tap into the insurance industry in order to make enough money to keep our doors open, and you guys are the ones that are shouldering that bill. Because basically the insurance company has this army of bureaucrats trying to spend money to keep from paying us, and we have to hire an army of bureaucrats to try and get the money out of them. Twenty-six percent of our overhead was spent just on bureaucrats, people in the business office trying to deal with the insurance company. Not with Medicaid and Medicare, with the insurance companies."
It's businesses and employees with health insurance that pays enough to offset hospital losses from Medicaid and self-pay. But with fewer companies offering health insurance to their employees, the number of people with no insurance continues to rise, directly affecting the quality and availability of healthcare for everyone!
- Listen to Part 4: ": Emergency Rooms and Prevention" (6:48)
Access to healthcare is becoming increasingly difficult, even for those with good insurance. As wait times to see doctors increases, and as the number of people with no insurance increases, hospital emergency rooms are becoming the primary health service for a lot of people. Itís not uncommon for people who do have true medical emergencies to have to wait up to 12 hours just to be seen.
With the financing of our healthcare system being centered on acute medicine, often patients who go to the hospital for an out patient procedure thatís not emergent are not taken care of. So problems that could have easily been remedied if treated early become so severe that now they need a hospital admission at many, many times the cost. The system is so inefficient that that happens all the time.
As we look at a more broad universal coverage program, we must refocus on the preventative and primary care aspects of our population and make some decisions about whatís covered and not covered.
- Listen to Part 5: "The Flow of Medical Information, the legal system, and medical school." (5:35)
In the last five years thereís been a strong push towards regulating the type of healthcare information and the format of information between parties. But federal regulations designed to protect personal healthcare information has also prevented emergency rooms from having access. Hospitals can access old charts, if they can find them. But access to a patients primary doctors records are not accessible, even if private physicians keep records on the computer. Often, doctors have to rely on the patient for their medical history, which can lead to miscommunication about important information.
The legal system has also contributed to the cost of healthcare, but not for the reason most people think. Less than one percent of our total healthcare spending goes towards malpractice. However, what it doesnít take into account is what doctors call C.Y.A. medicine, or Cover Your Ass medicine. A doctor has to order many tests even when they know theyíre going to come back negative, but if the test isnít done and there is a problem, the doctor can be sued. Medical school doesnít teach how to deal with being sued, and doctors go to great lengths to try and avoid it.
The debt load for the cost of a medical education also creates problems. Physicians can come out of school with almost $200,000 of debt, and what thatís done is kept physicians from being able to set up private practice. A single payer system might help in that it will make it more realistic for a physician to practice medicine regardless of where he or she wants to live, and they can be independent because they wonít have to eliminate Medicaid and indigent people from their practice in order to be competitive and pay off their loans.
- Listen to Part 6: "The Single Payer System" (7:45)
The problems in healthcare have gone beyond just tweaking the current system to a point where we really have to look at infrastructure issues, and along that dialog goes an all payer system. This could help lessen serious acute care problems where people have simply let a health condition go far too long because they don't have access to care and they come in only when they are truly in a crisis.
We need to create a new single payer federal system. As a country, we already spend almost twice as much as every other country per person on healthcare, so there's money in the system. Doctors appreciate the free market system, but the problem is that we are racking profits off of a social industry that is medicine, scooping profits off the top, and people are dying or suffering as a result. Single-payer is not socialized medicine. Under the system being proposed, everything stays as a fee for service, provide competition, but hospitals and doctors no longer have to compete with one another to try and keep the poorly insured out of their practice. The whole emphasis now in competition will be competing for quality of care and outcomes, which is really where the competition in medicine has to occur.
FULL PRESENTATION DR. ROCKY WHITE
- Listen to full presentation Dr. Rocky White on Single Payer Healthcare (28:50)
Dr. Rocky White, MD and medical director of a local HMO in Alamosa, presents to business owners why they are paying the bulk of the price for the current healthcare crises and what they can do about it. Beginning with an outline of the current system, he explains why the proposed expansion of this system by the current administration, like lowering the eligible age of Medicare to 55 and creating cost shifting plans like high deductibles and health savings accounts, wonít work and why it puts an ever increasing burden on businesses. Over the course of his half-hour presentation, he outlines why a single-payer healthcare system is the only practical solution.
In earlier 2005, Dr. White gave his presentation to the Denver Chamber of Commerce. He jokes about how they probably expected a "long hair left over from the 60's teaching social justice" but instead got a "diehard cowboy Republican." The Denver Chamber was in the process of putting together recommendations for the Governors office about changes to healthcare, and after this meeting, Dr. White reports, the general reaction was "Folks, we need to go back to the drawing board." In less than an hour, this group of conservative, influential business owners went from thinking "single-payer healthcare" was a bad word from the liberal left, to being something that needed serious consideration. It can limit the crippling costs business owners pay to insure their employees as well as the cost to subsidize, through higher premiums, the uninsured, profit-taking by insurance and pharmaceutical companies, and the high overhead of a bureaucratic system. Recently, Dr. White was asked by Rep. Mark Larson of Durango, Colorado to write a Bill to introduce it to the Colorado Legislature detailing a single-payer healthcare plan. The intended use of this draft is to continue the conversation, between both conservatives and liberals, and to detail a plan. Several states are currently working on some version of a single-payer healthcare plan, and it is hoped that this type of plan will eventually be implemented nation wide in order to maximize the benefits.