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News of the Day ... In Perspective10/22/2005Health insurance imploding; will �single payer� or �consumer-directed health care� prevail? Led by General Motors, �the demolition derby that is the U.S. health care system shifts into high gear,� writes David Lazarus (San Francisco Chronicle 10/19/05). GM, the world�s biggest private-sector purchaser of health insurance, will be slashing its $5.6 billion spending for medical benefits to workers and retirees by $1 billion next year. The United Auto Workers is apparently prepared to accept the reduction in benefits to forestall additional job cuts. Ford and DaimlerChrysler are already negotiating similar concessions. Lazarus claims that �single-payer� systems are �the norm in virtually all other developed democracies� and that such a system could �provide universal coverage for all Americans at a long-term cost to taxpayers well below what�s now paid annually by employers and workers.� While some big companies will no doubt try to unload their medical benefits costs onto taxpayers, greater consumer choice is an idea that is beginning to take off. Some 26% of U.S. companies with 500 or more employees say they are likely to offer higher deductibles, possibly coupled with tax-favored savings accounts. This is up from 14% who were planning to do so a year ago, according to a survey by Mercer Health & Benefits (Vanessa Fuhrmans, Wall St J 10/22/05). A 25-minute version of a planned full-length feature film on medical care in Canada and the United States is available on line at www.onthefencefilms.com/video/deadmeat/. The short version was presented at the Liberty Film Festival in West Hollywood, California, Oct 21-23. Additional information: �The Long Road to Freedom in Canadian Medicine� by Jacques Chaoulli, M.D., J Am Phys Surg, fall 2005 �Canadian Medicare: a Road to Serfdom� by William E. Goodman, M.D., J Am Phys Surg, fall 2005 �Tax-Advantaged Medical Coverage� by Madeleine Pelner Cosman, J.D., Ph.D.
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