Dr. Tom: The business case for a single-payer system …

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Imagine that you run a U.S. small business. You have long-term employees to whom you are loyal and vice versa. You have an anniversary coming up, but it is not one you look forward to because it is that time of year when you renew the health insurance you purchase for your employees and yourself. Undoubtedly, the cost will go up; maybe you will be forced to shift more costs to your workers.

Not long ago, one of your long-term employees was diagnosed with breast cancer, thankfully caught early, but her surgery and chemotherapy were expensive. Another employee was severely injured in an auto crash.

You are, therefore, very worried that this year we might be going back to a time when premiums will take a huge jump because of your firm’s medical-loss ratio. Under the Affordable Care Act, you saw your premiums rise 3 percent in 2016, the average across the country, and you realize that, even though there aren’t very effective cost-control strategies in place, it still could get much worse.

You have been so concerned that you attended a town hall meeting with your U.S. representative and asked him why we don’t have a single-payer system. He replied that that would be government healthcare, which we don’t want in this country. If you want it, you should move to Canada. (This is what a representative actually said to one of his constituents).

Returning from your meeting, you imagine what healthcare in this country could be. It is estimated that everyone could be covered with a payroll tax of 3.3 percent, much less than the 7 to 12 percent of employee salaries businesses now pay for health insurance.

Also, you would no longer need to spend time being an insurance agent. Since all healthcare would be covered, your costs for workers compensation, automobile and liability insurance would also go down, and there would be no need to worry about retirement health benefits or employees switching jobs to get insurance or lower their costs.

Wow. Your administrative costs would decrease, your headaches would decrease, your profits would increase and you could give your employees long-awaited raises. And, you are pretty sure your friends who work at or own larger businesses would find labor negotiations a lot easier if they didn’t hinge so much on insurance costs.

But then you snap out of it. There are just too many people making too much money on healthcare for that to happen.

Although there is no rational basis for the continuing existence of health insurance companies, the $20 million the average CEO makes will pay for a lot of slick TV ads, a la Harry and Louise of the Clinton era, that distort the facts. Like the campaign to defeat Prop 61 in California: Be afraid; drug costs will increase for everyone. Which, of course, would increase drug-company profits, probably the reason they spent $109 million to defeat it.

Next, a few aphorisms, tidbits and comments on modern life.

Dr. Kluzak, an Idyllwild resident, is board certified in Anatomic Pathology, Obstetrics and Gynecology. He also is a freelance photographer for the Town Crier.

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  1. Concise and informative, thank you.

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