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Article
October 12, 1994

Health System Reform: The Case for a Single-Payer Approach-Reply

Author Affiliations

House of Representatives Washington, DC

JAMA. 1994;272(14):1103. doi:10.1001/jama.1994.03520140031027
Abstract

In Reply.  —Since I submitted my article to THE JOURNAL, developments in the marketplace have underscored the necessity of moving to a single-payer system to preserve the patient-physician relationship. Notably, on March 22, 1994, the Travelers Insurance Company and Metropolitan Life announced their intention to merge their health care operations. Where are the physicians and the patients in this merger? US Health, a large national managed care corporation, is reported to take 28% of its premium dollar for "administrative overhead." That is 28 cents of every dollar as the measure of care denied to patients.The evidence is overwhelming that "the market" is responding to health care cost pressures and that that response is to consolidate the control of the for-profit insurance companies over the health care delivery system. We are on the verge of becoming the only country in the world to hand over its health care system to

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