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September 8, 2004

The AMA Health Insurance Proposal—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(10):1173. doi:10.1001/jama.292.10.1173-c

In Reply: Dr Reis and Dr Thienhaus both suggest that single-payer national health insurance would be superior to the AMA's proposal in terms of cost. The idea that a single-payer system might offer cost savings is rooted in faulty and incomplete comparisons of administrative costs between the United States and Canada. It has long been recognized that public insurance imposes a variety of costs on patients—including excessive wait times, a proliferation of short visits, and lack of access to certain services and procedures. Proper accounting of such "hidden" costs shows that overhead costs in Canada are higher than in the United States.1

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