Comment on: "Single Payer or Bust"

Single Payer or Bust?

By MICHAEL TOMASKY      AUG. 14, 2017

https://www.nytimes.com/2017/08/14/opinion/single-payer-or-bust.html?comments#permid=23714009

I agree that "single payer" is not the only, and not necessarily the best system. As the author states, there are many models in the rest of the world to choose from. But the one thing ALL of these other systems have in common is, that EVERYONE MUST BE COVERED for a baseline of health care services. Only by spreading the risk over the entire population can the cost be brought down. The next most expensive per capita healthcare costs are in Switzerland, and that per capita cost is HALF of that in the US. The Swiss allow private, for profit insurance companies to provide the coverage, but under strict rules by the government. Because private, for profit insurance is involved in providing BASIC coverage is the reason they have the second highest per-capita cost, after the US - after all these companies are allowed to make a PROFIT.

In Germany, on the other hand, basic coverage is provided ONLY by non-profit companies, who get reimbursed from the "National Healthcare Fund", which is collected, based on income, half from employer, half from employee. Their reimbursements also take account of the differing risk pools, which is determined by analyzing their claim histories annually. The required contributions are reset (I think every other year), again based on claim histories. Rates have been fairly stable, indeed in some years actually go down. Private insurance companies can sell policies for coverage above and beyond the defined base line. Bottom line -- UNIVERSAL is the key!!