The Charlotte Observer Karen Garloch column

July 28--As a primary care physician, now retired and volunteering at free clinics, Dr. Ed Weisbart sees plenty of evidence that the U.S. health care system isn't working.

"I'm constantly seeing patients who can't pay for health care, and as a result they're desperately sick and they die," he said. "I think we can do better."

Weisbart, who chairs the Missouri chapter of Physicians for a National Health Program, will speak Thursday in Charlotte at a meeting of the North Carolina chapter of the same organization. The meeting is at 6 p.m. at Morrison Regional Library, 7015 Morrison Blvd. (To register, email: [email protected].)

Although millions more Americans now have insurance through the Affordable Care Act, Weisbart says the 2010 law doesn't provide enough incentives to keep the population healthy. "The reason Americans live shorter lives than anyone else in 50 countries in the modern world is that we don't have a business plan for improving public health and for long-term preventive medicine," he said.

The answer, he says, is a single-payer system, such as Medicare for everyone. That would relieve the fear among many Americans that "if they get one bad illness, they would have to sell their house."

Weisbart said insurance companies have little incentive to encourage preventive care because about 20 percent of their customers turn over each year. An insurer is financially penalized if its healthier consumers then switch to a competing company.

"That's perverse," Weisbart said. "You want to have all of the interests aligned, and the only way to do that is to put everyone in the same risk pool, including Congress and the president." That way, he said, improvements would benefit the whole system for years to come.

"Other countries spend half of what we spend on actual health care, but they spend significantly more on social services and public health," he said.

It wouldn't require a new system, Weisbart said. Just a change in the wording of the 1965 Medicare law to make it apply to all people, not just those 65 and over.

Reducing administrative costs alone would help. Today, 31 percent of health care expenditures are for administrative overhead in this country, compared with 2 to 12 percent in other countries, Weisbart said.

For most people, any tax increase under the new system would be less than increases in premiums, co-pays and deductibles under the current system, he said. "The vast majority of Americans would come out way ahead."

Despite political divisions over health care, Weisbart is confident a single-payer system will be adopted -- at some point.

"Most major social changes look impossible two years before they happen," he said. "I don't know if we're two years out or 40 year out. But every rational argument is aligned toward this, and the current path is completely unsustainable. The trick is to get people to understand it, and to get past misinformation out there."

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