In her Nov. 22 article, “Many on Medicaid in Kentucky Work for Low Pay,” Deborah Yetter once again makes the case for expanded Medicaid, reminding CJ readers and Gov.-elect Bevin that many of our hard-working neighbors will not be able to afford Indiana-style adjustments to Medicaid. Deductibles and co-pays will deter patients from getting needed care – for themselves, or for a child.

For Gov.-elect Bevin, private insurers, and many in the GOP, the solution to rising costs is “skin-in-the game,” a cruel concept that recalls Shakespeare’s “pound of flesh.” Obviously, the cost-cutters want patients to bear the pain – to absorb higher deductibles, co-pays and co-insurance for treatment and/or for medications. As is the case for many enrolled in private plans today, Medicaid patients will end up under-insured – with a policy they can’t afford to use.

Thinking that nothing else can be done to control costs, many well-meaning business people have bought into the “skin-in-the-game” fallacy. I suggest they (and Mr. Bevin) explore a solution that is not only more humane, but also makes sound economic sense.

Every entity in our health care system – our national economy, state and local governments, businesses, families, and individuals – would benefit by enacting a national, publicly-funded “single-payer” system. Other advanced democracies cover all their people, spend half what we do, and have better health outcomes. They do not waste money on profit-taking insurers who add no value to the enterprise.

For more information about single payer go to the web site of Physicians for a National Health Program (PNHP.org), or Kentuckians for Single Payer Healthcare (kyhealthcare.org). Read the bill that would solve our problems: HR 676 atcongress.gov.

Harriette Seiler
Louisville  40207