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The AMA Health Insurance Proposal—Reply
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In Reply: Dr Reis and Dr Thienhaus both suggest that single-payer national health insurance would be superior to the AMA's proposal in terms of cost. The idea that a single-payer system might offer cost savings is rooted in faulty and incomplete comparisons of administrative costs between the United States and Canada. It has long been recognized that public insurance imposes a variety of costs on patients—including excessive wait times, a proliferation of short visits, and lack of access to certain services and procedures. Proper accounting of such "hidden" costs shows that overhead costs in Canada are higher than in the United States.1
Another overlooked aspect of a single-payer system is its impact on the value of services delivered to consumers. Implementing a single-payer system in the United States would create a government monopoly in the health insurance market and a government monopsony in provider markets such as the physician services . . . [Full Text of this Article]
Donald J. Palmisano, MD, JD
American Medical Association
David W. Emmons, PhD
david_emmons@ama-assn.org
Center for Health Policy Research
American Medical Association
Chicago, Ill
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