USA TODAY
Transparency or fig leaf?
Posted 8/29/2006 8:45 PM ET
By Steffie Woolhandler and David Himmelstein
Nearly 47 million Americans are uninsured, and millions more have coverage so skimpy that a major illness would bankrupt them. Yet President Bush apparently thinks Americans are too well-insured.
He's pushing health savings accounts — a plan to make the sick pay thousands from their own pockets before insurance kicks in. And the fig leaf for his soak-the-sick scheme is "transparency." Just make hospitals and doctors post their prices, he says, and the market will magically cut health costs. The president's scheme will drive millions more into medical poverty, but it won't hold down costs.
Insured Americans already pay bigger co-payments and deductibles than do people in any other nation. Yet our health costs are far higher than anywhere else. Steep out-of-pocket costs have little impact on overall spending. They discourage preventive care such as immunizations but don't affect the real cost driver — expensive illnesses that afflict only 20% of Americans each year but account for 80% of spending.
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Transparency won't cut costs, but national health insurance would. A single-payer system could save $300 billion annually on health bureaucracy by eliminating paperwork and exorbitant CEO incomes. It could avoid the duplication of transplant facilities that raises costs and worsens quality. It would also reduce unnecessary surgery and other harmful procedures. Most important, national health insurance would guarantee comprehensive coverage and close the health gap with Canada and other nations where people live longer than we do.
Drs. Steffie Woolhandler and David Himmelstein teach at Harvard Medical School and co-founded Physicians for a National Health Program.
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