The single payer movement in the U.S. is built around the concept of an “improved Medicare for all”. The “improved” part of that message recognizes that our present Medicare system needs some revisions to make it a valid vehicle to provide universal health care. Some of the major areas of concern are the control over fraud and abuse, the contrary incentives of the fee for service system, the disappearance of the primary care workforce, and the uncontrolled costs of prescription medications and durable goods. Solution to many other aberrations in our delivery of health care will have to wait for single payer.
Tackling some of these problems now can help ready us for producing a winner out of the starting gate. This includes working to improve quality of medical care. But trying to move forward illuminates the same problem that prevented the Affordable Care Act from achieving quality and cost-saving while providing comprehensive insurance coverage, viz., the political power of the various stakeholders and lack of any immunity from micromanagement by congress and the administration.
We need to get our voices heard as we work on the triple goals to:
- Improve Medicare
- Improve the quality of medical care
- Create Single Payer Medicine
These goals provide a set of action points for realizing the “Triple Aim” of improving the individual experience of care; improving the health of populations; and reducing the per capita costs of care for populations. (http://content.healthaffairs.org/content/27/3/759.full)