Government’s Experience with Medicare Shows Single-Payer Health System Would Not Guarantee Access to Doctors, Columnist Writes

The United States' experience with the Medicare program demonstrates thtat a single-payer system would "succeed in destroying the private market" and would "guarantee everyone has the right to see a doctor" but not that "there will be a doctor to see," Merrill Matthews, director of the Council for Affordable Health Insurance, writes in an Investor's Business Daily opinion piece. Increased health insurance premiums and the rise in the number of uninsured U.S. residents in the past year have prompted lawmakers such as Sen. Edward Kennedy (D-Mass.) and former Vermont Gov. Howard Dean (D) to call for a universal health care system, but the proposals would likely result in budget deficits similar to those in Medicare, Matthews writes (Matthews, Investor's Business Daily, 1/21). According to a report released last March by Medicare trustees, under current federal law, Medicare Part A would become insolvent in 2030. Medicare Part A, the Federal Hospital Insurance Trust Fund, funds hospital, home health, skilled nursing facility and hospice care for Medicare beneficiaries. The report predicted that Medicare Part A would begin to run a deficit in 2016. In addition, the report predicted smaller expenditures for Medicare Part B -- the Supplementary Medical Insurance Trust Fund, which funds physician services, outpatient care and other medical services -- in the next few years, in part as a result of a 5.4% reduction in reimbursements for physicians that took effect on Jan. 1, 2002 (Kaiser Daily Health Policy Report, 3/27). The 5.4% reduction in Medicare reimbursements, in combination with a scheduled 4.4% reduction this year, has prompted many physicians to leave Medicare, "making it increasingly difficult for seniors to find treatment," Matthews writes. According to Matthews, Medicare has underpaid providers for years, and "the only reason the system hasn't imploded already is that providers have been able to shift costs to other patients," such as those in small-group and individual health insurance plans. He writes that a single-payer health care system would leave no place to shift costs, and "waiting lines and rationing will become part of the public debate just as they are in Canada." Matthews concludes, "We don't have to look at other countries to see how a single-payer health care system works. We have one right here that is collapsing before our very eyes" (Investor's Business Daily, 1/21).