Friday, November 25, 2005

Why Have a Single-Payer System?

Like our medicare system.

One justification I could see is that the single payer forces some rationalization of the payments and the tracking system; a minimum would seem to me that all transactions with the system are recorded through some sort of central tracking.

And yet. And yet.

Today I went to yet another hospital (where my cataract surgery will be done) and found myself answering all the same questions I have answered several times before. They had NO record of any past encounter I have had with our medical system (largely through my local family medical clinic, but even through my ophthalmologist, and, even wilder, the cataract surgeon who will be fixing my eye at this same hospital).

Incentives matter. And there are none here.

At one level this seems nuts. But then one must ask the question - why should they link these systems, and make all this information shareable? Only to increase efficiency. Well, there is NO reason at all to do that in our current system. So I don't see anything changing soon.


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