Wyden-Ryan plan won't improve health care system

This piece appeared in the on-line version of the Statesman Journal

Author: Dr. Samuel Metz and Dr. Chris Goeser

Date: 01/24/2012


"Health care is a human right" is what the people of Vermont told their legislators and governor, a view shared by the majority of Americans according to the 2009 Kaiser Health Tracking Poll.
On May 26, 2011, Vermont Gov. Peter Shumlin signed our country's first statewide publicly financed health care law providing universal health care to all Vermonters. We should have a similar law in Oregon.

On Dec. 15, 2011, Sen. Ron Wyden, D-Ore., and Rep. Paul Ryan, R-Wis., co-authored "Guaranteed Choices to Strengthen Medicare and Health Security for All: Bipartisan Options for the Future." It seems Sen. Wyden wants to further entrench private health insurance for those employed, and to let private plans compete with Medicare.
This is not in the best interest of Oregonians. What they propose is the not so new idea of "defined contribution" health care plans. Simply put, these are vouchers. Employers provide a fixed sum to employees who then purchase whatever insurance they can afford. Because employer contributions stay fixed while health care costs increase, basic benefits quickly become unaffordable.

Without reform, American businesses can survive only by shifting escalating health care costs to someone else. A "defined contribution" plan allows just that it moves increasing costs away from businesses and onto employees. These plans do nothing, of course, for those without benefits or without a job.
No successful health care system uses "defined contribution" plans (or vouchers of any kind, for that matter). Nor do they discourage patients from seeking care with high co-pays and deductibles. In fact, we are the only industrialized country to do so.

Consequently, our health costs are double the amount of an average industrialized country, our public health is near the bottom of the industrialized world and the social consequences are devastating; no other industrialized country allows citizens to lose limbs, homes or lives if they get a treatable disease.

Health care financing in successful systems has three common properties:

1. Every citizen maintains health care access no matter how sick, poor, old or unemployed they become.

2. There are no financial impediments to receiving health care.

3. Financing is provided by publicly accountable, transparent, not-for-profit agencies.

"Defined contribution" plans have none of these properties. For the record, financing with all three properties but using one publicly accountable, transparent, not-for-profit agency is called "single-payer" health care. All of America's successful health care systems (e.g., Veterans Affairs medical centers and multi-employer health care plans) use single-payer financing.

The most significant bipartisan agreement that Sen. Wyden and Rep. Ryan could make is to recognize that health care is not a privilege but a human right. Instead, their plan continues employer-based private insurance to finance health care, which will accelerate the destruction of American's families, America's health and America's future as a civilized nation.

The Wyden-Ryan proposal is misleading and distracts from the best solution. Instead of "defined contribution" plans, let's define for Sen. Wyden what this country needs to save health care: single-payer, universal coverage. "Everybody in, nobody out."

Chris Goeser, D.C., M.D., is a radiologist practicing in Salem, Silverton, Woodburn and Albany, and a member of both Physicians for a National Health Program and Mad As Hell Doctors. He can be reached at Metz, M.D., is an anesthesiologist, member of Physicians for a National Health Program and founding member of Mad As Hell Doctors. He can be reached at


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