Bernie Sanders’s single-payer plan isn’t a plan at all

[JDPriestly]

36. Yet European plans are cheaper than ours and far more generous.

When I lived in Austria, they introduced a co-pay for medications. It was almost too small to even count. They introduced it at that time to discourage people from overusing the system.

Right now, in our system, Americans tend to underuse the system, that is seek medical help only after their problem has reached a critical stage. That's because of the cost of the care in spite of insurance.

It's been a long time, but I recall having a cesarean and a two-week hospital stay -- yes two weeks back then -- and virtually no charges.

Single payer really does save a lot of money. I was a horrible patient. I was very American about going to the doctor too late and too rarely. I didn't realize how American that was until I came back to the US and had to fight with our healthcare system.

Single payer really does save a lot of money and makes preventive care more likely to occur.

When I was having a September baby, the local pediatrician in the small town in which I lived called all of her patients who were having babies in late summer and early fall in to her office and advised us on parenting. She told us to watch and make sure our children were really ready for school before the September when they turned six, the age at which Austrian children start school. She explained that children who are not mature enough to start school even though they are six in September have a big disadvantage later in school.

I will never forget that she told us to never say "no" to her children. (I tried, but that system did not work well for me. I soon realized that what she really meant was that we should not over-discipline or hit or yell at a small child. Because of the culture of child-rearing in Austria, she went to a bit of an extreme in her advice. As an American, I tended to be a bit too lax so I had to say "no" gently but say it and it worked well. She told us that if our babies wanted to tear up books or something, we should just give them newspaper to tear up. This sounds odd to Americans, but it was great in the social context of Austria. It's things like that, extras, that you get under single payer that actually save money in the end. It's hard to explain to you why advice from a pediatrician on child psychology and gentle discipline might save healthcare problems later on. It's a cultural thing. In a culture in which maybe corporal punishment was at one time condoned, in a single payer system having a pediatrician discuss communication with children with expecting mothers is a good thing.

Here, we might want the pediatrician to warn mothers about guns in the home or about alcohol abuse during pregnancy, smoking during pregnancy, watching for signs of maturity in a child about to begin school. We might want a pediatrician to warn about the signs and activities that constitute child abuse -- like whipping or beating a child. Our juvenile dependency courts deal with parents who are amazingly ignorant when it comes to how to treat young children.

Single payer offers opportunities for preventing medical problems that our for-profit insurance system simply does not offer. We need not only universal, but also comprehensive health care. Doctors and nurses should be teaching us how to take care of ourselves and others and not just healing us after we have hurt ourselves. There is little incentive to do that in a pay for procedure for-profit healthcare insurance system.

I must say that Kaiser is a healthcare insurance plan that does a lot more of this kind of preventive care than some other insurance companies.

So the savings in single payer plans is there and if you enjoy such a plan you can see it but it is hard to quantify on a spread sheet.

One less child with whip marks and a skull fracture is the kind of thing that single payer can be better for than is for-profit insurance.

I am writing this based on my experience living in four European countries and enjoying their single payer plans when my children were born and were young.