Our failing system: A reasoned approach toward single payer

Abstract

The American health care system is in crisis. Per capita costs are roughly double those of any other modern nation, and the health of our nation is measurably worse than most of those nations. These problems are the direct result of the way we chose to organize our nation’s health care systems. We have built a business model that has driven many break-through innovations in high technology but provides little incentive for investments in changing the social determinants of our population’s health. Some of the problems Americans have accessing health care providers will be improved by the Affordable Care Act, but the fundamental challenges remain unchecked despite the ACA’s extensive reforms of the insurance industry. A strategic solution to our crisis has been well described in House Resolution 676, sponsored by US Congressperson John Conyers (D-MI). This bill would improve our existing Medicare program fill in the well-recognized gaps in benefit design and eliminate the financial barriers to care and expand this improved form of Medicare to all Americans. Health insurers would be barred from selling insurance products that duplicate the benefits covered under HR676. Including every American in this improved Medicare, including members of Congress, would ensure that the program remained strong. We could achieve this in a single leap by passing HR676, or we could adopt a series of incremental transitional steps. Regardless of how we get there, the sooner we start, the sooner we succeed.