The One Payer System And The Unspoken Truth



by Julie Clark

The  Anthem/Cigna and Aetna/Humana mergers indicate  that the single payer system is not only unavoidable, but coming faster than we originally thought. In truth this has been coming for a very long time and may be over due. I do not think that this is entirely the fault of the Affordable Care Act or what others jokingly want to call  the Unaffordable Care Act. One has only to look at stock market graphs over the last thirty years to see that some of the best investment returns have been in the healthcare industry. 

Those market returns  reflect profits and  also reflect that the cost of health care has been rising at phenomenal rates...resulting in those profits. This has placed undue financial burdens on the working middle class population and in many ways penalizes middle class economic status.  (Editor's note: Most economists point out that rapid increases in medical costs were the driving force for Obama Care, because rising medical costs threatened to bankrupt the nation.  Even the American Medical Association recognized this challenge to the industry, and endorsed the Affordable Health Care Act.)


Now with the coming insurance industry mergers,  I hear frightening  rhetoric warning the general population of even higher insurance costs.  As a nurse who has spent years dealing with insurance and pharmaceutical companies I do not see a rise in the cost of insurance with this, but a stabilization of its costs. The  American people are unable to absorb any more increases in the price of medical care and the industry knows it.

The coming mergers will in essence shift the burden within the industry where cuts can and should be made and perhaps even bring the price of care down for many patient beneficiaries.

 Pharmaceutical companies are already clamoring for creative ways to off-set insurance industry refusals to pay exorbitant prices for medications sold at half the cost in other countries. Hospitals and medical providers are feeling the pinch as well and searching for ways to adapt.


The unspoken truth is that somewhere in the neighborhood of 60% of medical costs are not applied to patient care but to administrative expenses.

Perhaps insurance industry pressure will eventually force the majority of that 60%  from the pockets of administrators and divert them back to direct medical care where it belongs. A market correction is unavoidable and that is the unspoken truth. A philosophical correction, returning privately for profit medical institutions back to "Fiduciary Responsibility" and away from an emphasis of "Profits" vs quality of treatment and patient care. 


Editors Note:  Julie Clark is an author "Sword of the Valkyrie", and a regular contributor of articles to Global Perspectives. Our 300,000 readers have enjoyed her perspective and insight on medical issues.  This week celebrates her 30 year anniversary as a Pediatric Nurse.  She has been a devoted professional ever calling for quality patient care and high treatment standards in the medical industry. Julie has a number of doctors who call upon her to help unravel the complexities of  medical payment, insurance and "approved reimbursal" systems, to maximize insurance payments for patient treatments.