By Marcia Angell  |  Boston Globe, December 31, 2006

IN SEPTEMBER, an ABC News/Kaiser Family Foundation/USA Today survey found that 56 percent of Americans preferred a government-run universal health system "like Medicare" to our current employment-based system run by private insurers. That is, they want a single-payer system. Among the causes of rising costs, respondents were most likely to name private insurance and drug company profits.

If this were a presidential election, it would be a landslide. Yet policy makers and the media dismiss single-payer by telling us the public doesn't want it. They falsely raise the specter of rationing and restricted choice of doctors. So we end up with schemes like Massachusetts's squeeze-blood-from-a-turnip health plan, which preserves the insurance industry while requiring individuals to pay most of the costs.

Why is this? The insurance lobby has succeeded not only in blocking single-payer health care, but in keeping it out of public discourse. We are the only advanced country with market-driven private health care. Other countries spend about half as much per person, cover everyone, and get better health results. Shouldn't this option be on the table?

Marcia Angell, MD, is senior lecturer in social medicine at Harvard Medical School.   

© Copyright 2006 Globe Newspaper Company.