Tuesday, July 30, 2013

Fwd: qotd: Montana government clinic: Maybe single payer is aiming too low

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-------- Original Message --------
Subject: qotd: Montana government clinic: Maybe single payer is aiming
too low
Date: Tue, 30 Jul 2013 09:34:18 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>

July 30,2013
Montana's State-Run Free Clinic Sees Early Success
By Dan Boyce

A year ago, Montana opened the nation's first clinic for free primary
healthcare services to its state government employees. The Helena,
Mont., clinic was pitched as a way to improve overall employee health.

A year later, the state says the clinic is already saving money.

(Government employees still have their) normal health insurance provided
by the state. But at the clinic, (there are) no co-pays, no deductibles.
It's free.

That's the case for the Helena area's 11,000 state workers and their
dependents. With an appointment, patients wait just a couple minutes to
see a doctor.

"For goodness sakes, of course the employees and the retirees like it,
it's free," says Republican State Sen. Dave Lewis.

He and others faulted then-Gov. Brian Schweitzer for moving ahead with
the clinic last year without approval of the state legislature, although
it was not needed.

Now, Lewis is a retired state employee himself. He says, personally, he
does like going there, too.

The state contracts with a private company to run the facility and pays
for everything — wages of the staff, total costs of all the visits.
Those are all new expenses, and they all come from the budget for state
employee healthcare.

Even so, division manager Russ Hill says it's actually costing the state
$1,500,000 less for healthcare than before the clinic opened.

"Because there's no markup, our cost per visit is lower than in a
private fee-for-service environment," Hill says.

Physicians are paid by the hour, not by the number of procedures they
prescribe like many in the private sector. The state is able to buy
supplies at lower prices.

Bottom line: a patient's visit to the employee health clinic costs the
state about half what it would cost if that patient went to a private
doctor. And because it's free to patients, hundreds of people have come
in who had not seen a doctor for at least two years.

Montana recently opened a second state employee health clinic in
Billings, the state's largest city. Others are in the works.


Comment: Let's see. This Montana state-run free clinic is government
owned, the physicians are salaried, there are no deductibles or co-pays,
employees and retirees including Republicans like it, and it costs the
state "about half what it would cost if that patient went to a private
doctor." Wow!

The single payer model of social insurance usually calls for a
government-run insurance program that pays for our largely private
health care delivery system, with all of its inefficiencies and
inequities. But what if it paid for a government owned and financed
health care delivery system similar to this Montana clinic, but with
government ownership expanded throughout the entire delivery system.

Instead of just aiming for the goal of a single payer social insurance
program, we could have a program of socialized medicine - government
ownership of the delivery system. Considering that it is a much lower
cost system with which everyone is happy, is that such a bad idea?

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