Shaffer/Wellstone: Health Reform 1994

Ellen Shaffer and Senator Paul Wellstone described the value of the single payer approach, the pitfalls of the Clinton market based approach, and the political choices for health reform, in the chapter on “Health Reform” in State of the Union 1994:The Clinton Administration and the Nation in Profile, published by IPS:

Shaffer/Wellsone: Health Reform 1994

“Every other system in the world controls the amount that health-care providers are paid. Under Canada’s single-payer system, provinces negotiate with doctors to set rates and with hospitals to set global annual budgets. Multiple-payer systems like those of France and Germany also set fees, though heavily regulated workplace-based insurance companies play a role along with the government in negotiating and enforcing rates. Britain’s national health service pays hospitals and hires doctors and nurses directly.”

“Should we compromise for half a step now and keep fighting, as we did with Medicare and Medicaid in 1965, and risk that the other half step may be decades in coming? If the insurance industry remains in the picture, and a few large companies consolidate their grip, the other step may never be taken. Or should we hold out for something better, as in the late 1970s, and risk getting nothing at all?…If lost this time, the opportunity for meaningful reform could vanish for years.”

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