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
"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
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
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
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
"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
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
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
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 firstname.lastname@example.org.Samuel
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 email@example.com.