To the editor: Guest contributor Kim-Lien Nguyen dusts off a tired and roundly disproven libertarian solution to our healthcare financing crisis, arguing that giving consumers money directly instead of to private insurers will somehow magically “empower” them to “make their own healthcare choices and leverage their self-interest” (“Subsidizing insurance just props up dysfunction. Empower consumers instead,” Nov. 20). This assumes that healthcare operates as an ideal free market and consumers and patients are all-knowing about the product they are purchasing when, in fact, the opposite is true.
Does a patient with chest pain that could be a heart attack really have time to study and decide on which ambulance service and emergency room they would like to go to from a cost standpoint? The same can be said for every major medical problem. And the amount of money that would be given directly to consumers will never cover the costs of care.
What is needed is what every other high-income country is doing, which is yielding better outcomes and lower costs than the U.S.: a universal unified system of public insurance, perhaps “Medicare for all.”
Nguyen also argues that “we don’t have to settle for a managed decline of our healthcare system.” But that is exactly what is needed for our financing of the system in order to ease the transition to a public nonprofit insurance system, very similar to a “managed decline” of our dependence on fossil fuels.
Steve Tarzynski, Santa Monica
This writer is the former president of the nonprofit advocacy group California Physicians Alliance.
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To the editor: The author suggests that giving the money directly to individuals would allow them to buy their own health insurance plan or pay for healthcare directly. The problem is, how much insurance can $2,000 (or however much is allotted) buy? Or, if paying for healthcare directly, what happens if you need surgery or other hospitalization? Neither of these solutions are really the answer.
What the insurance companies don’t want Americans to know is that the best (and only) solution is single-payer healthcare. Weirdly, 32 of the 33 industrialized nations have been able to make universal healthcare work (America is the only one that still relies on insurance companies).
So let’s explore the real answer. Get the middleman out of the way. See how Europe does it and make it better for Americans. We’ll save money too.
Ritch Barron, Cathedral City
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To the editor: Nguyen’s op-ed was intriguing and made me think. Unfortunately, there were no facts or studies to back up the opinion. The proposals sound like good ideas, but is there any evidence or experience of them working anywhere?
I’d also note that the entire idea depends on transparent pricing for medical services. That alone would be a huge improvement — one that providers would fight against tooth and nail. Let’s see that happen, and then we can talk about empowering citizens to make informed choices.
Michael Snare, San Diego
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To the editor: When one of Dr. Nguyen’s patients needs coronary bypass surgery and the patient tells her they have only $1,500 in their health savings account, is she going to say to them, “Come back and see me after you’ve gotten a bank loan to cover the rest of the cost”?
June Ailin Sewell, Marina del Rey