Single-payer would value what's important

April 13, 2011

  My fellow physician, Dr. C.W. Cobb, asserts in his recent letter that under a single-payer system physicians would be taken for granted ("Single-payer takes doctors for granted," March 30).

Yes, single-payer systems take doctors for granted. They take for granted our education, training and experience. They take for granted our dedication to our patients. They take for granted that we and our patients can decide between ourselves what care is most appropriate for each patient without needing to seek approval from some corporate bureaucrat.

What single-payer systems don't take for granted is the value of a doctor's work. Unlike the present system, in which insurance companies use market presence to herd physicians onto panels and then unilaterally dictate what we will be paid, in countries with single-payer systems doctors collectively negotiate with the health service, determining reimbursement by means of a two-way conversation.

When you take into account that physicians will no longer need to devote a large amount of time to "diagnosing" our patients' insurance coverage and will no longer need to devote a large amount of money to paying an army of office staff to do the billing, we will be able to realize a quite comfortable livelihood practicing medicine in a single-payer system. It won't make us as rich as Croesus -- but is that why we became doctors in the first place?


Dr. JONATHAN L. WEKER
Montpelier

Burlington Free Press