Who Is Kidding Whom?

In the mid 1980s, I suggested that in twenty years we would have six major health care systems in the United States, in addition to government systems. We are pretty close to that number now, and the insurance/HMO/health care industry has opted to consolidate which makes their operations virtually indistinguishable in principle from Medicare. There is one major difference: with the exception of Medicare and the Permanente health care system, the others soak up a lot of dollars that should be used to purchase health care and divert those dollars to administrative overhead. One research study demonstrated that about twenty five percent of the premium dollar wasn't buying physician services, hospital services, ancillary services, preventive health services or the other items we recognize as health care - the twenty five percent of the premium dollar was buying clerks and offices and administrative salaries and generous payments to top executives, while business and the individual purchaser of insurance products were struggling to manage their own health care costs. If Medicare and Permanente can provide the range of health services that their beneficiaries/members need for near 3 percent of the health care dollar, and since the insurers and their subsidiaries have become large impersonal, inefficient, unfriendly and difficult to deal with, why don't we exercise some common sense and move to a single or near-single payer system - so that we can use health care dollars for health care and maybe even have some money left over to provide for the 47 million uninsured in America?