By: Sarah Parker, UofL Medical Student

On Saturday, February 16^th, 2019, the American Medical Association Region 5 Medical Student Section held a conference at Indiana University School of Medicine in Indianapolis, Indiana. Among the many topics discussed, the anticipated highlights of the event included a healthcare systems debate of a single-payer vs. free market system.

 

In the near two-hour debate, panelists were asked to define problems with our current healthcare system and debate the effects their model would have on patient access, overall quality, and cost. Dr. Gramelspacher described the overwhelming sentiment of the panel and those in attendance in saying that “the U.S. is the best place in the world to get very sick, but it’s not a good place to stay healthy once you leave the hospital.” While both sides agreed that plethora of private and public 3^rd party providers overcrowds the system, the faith in who can effectively reign in the system—a unified government or a sea of independent physician entrepreneurs—is at the core of this issue.

Dr. Kummar and proponents of a single-payer system highlighted the appeal of the bargaining power a single government sponsored insurance entity would have in negotiating pharmaceutical costs. They pointed to studies showing that this effect combined with fact that single-payer would dramatically lower administrative overhead, leading to an estimated saving of 500 billion dollars. Dr. Sinha was outspoken in his firm belief that “healthcare is a right” and that without this commitment to insuring everyone, our poorest citizens will continue to die without care.

Proponents of the free market system highlighted the role of a direct primary care model as a solution. In this system, a clinic would forgo any insurance and charge patients monthly fees for their services. Mr. Habig, whose company helps physicians start their own direct primary care practice, argued that the U.S. is currently far closer to a single-payer system than a free market. He and family medicine resident Dr. Schmale agreed that the only way to solve our healthcare crisis is through deregulation and increased competition. Habig noted that the ideal regulation of the system would be similar to the way current automotive companies are regulated today.

Students were very concerned with the ability of a free market to be driven to provide for poorer populations. As first year UofL medical student Hayley Moss stated, “For people like me who depend on Medicaid, even the lowest market price would be too much.” A poll of the student audience taken at the end of the debate showed that 88% percent supported a single payer system, while 12% supported a free market approach.

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