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The AFL-CIO’s illogical position - single-payer for the elderly but not for the rest - has contributed to labor’s feeble influence on the national health care debate.
THE CASE FOR SINGLE-PAYER
Two features are essential to an ideal single-payer system. First, one payer (or insurer), rather than hundreds of insurers, reimburses providers (doctors and hospitals) and drug manufacturers. This cuts administrative costs for insurers because a public insurer devotes a much lower proportion of revenues to overhead (marketing, supervising doctors, underwriting, lobbying, obscene salaries for management, and profits) than private-sector insurers do. It also cuts administrative costs for providers because providers have to bill only one payer, not hundreds.
This feature, by itself, would cut the U.S. health care bill by 10-15 percent if it were extended to all Americans. Second, the one payer in a single-payer system must have the authority to set
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