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Roger M. Battistella, "Health Care Turning Point: Why Single Payer Won't Work"

The battle over health care reform has reached a turning point. We can try to fashion new policies based on old ideas—or we can acknowledge today's demographic and economic realities. In Health Care Turning Point, health policy expert Roger Battistella argues that the conventional wisdom that dominates health policy debates is out of date. Battistella takes on popular misconceptions about the advantages of single-payer plans, the role of the market, and other health policy issues and outlines a pragmatic new approach.

Few would disagree that the current system is broken. Employer-supplied health insurance no longer works; it imposes a heavy burden on American companies when they compete against international firms and creates insecurity and instability for American workers. But, Battistella asserts provocatively, a government takeover of health insurance patterned after Medicare and Medicaid won't work either. With a battered economy and an aging population, the country simply can't afford it. Battistella argues that contrary to popular belief, single-payer coverage will not lower health spending but would encourage overconsumption and drive costs up. The most efficient and affordable way to reform health care, Battistella contends, is for consumers to take ownership of it. If consumers were responsible for buying their own health insurance (as they are for buying their own car and home insurance), he argues, they'd look for value and demand greater price and quality transparency from providers. Health insurance would be more like other forms of insurance and focus on major expenses, with routine care paid for out of pocket.

The economic shibboleth that the principles of market competition don’t apply to health care is nonsense, Battistella says. We won't achieve real health care reform until policy makers adjust to this reality and adopt a more pragmatic view.

HEALTH CARE TURNING POINT'S MYTHS ABOUT HEALTH CARE REFORM

•Health care is a social good that should be free to all.

•Single-payer coverage lowers health spending and eliminates social and economic health disparities.

•Prevention generates big savings.

•More health spending will stimulate the economy and have a positive effect on health status and longevity.

•Canada provides a desirable blueprint for U.S. health reform.

•The principles of market competition aren't applicable to health care.

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