In the heated objections to health-care reform in the United States, I never heard a recognition that in many places we already have a single-provider system. Almost unseen, the local hospital has bought up the physicians’ practices and much more – capped by high-paid executive officers and maybe interest dividends. Moreover, the hospital itself may be owned by an out-of-town corporation.

The national plan we came up, however, seems to have ignored this shift, even while keeping the insurance companies in the game.

With a single provider, though, I’m left wondering: Where’s the real difference for the individual compared to a single-payer approach?

Or even something along the lines of the Lakeside method of public services, where a municipality shops around for its providers from a variety of possible sources, rather than relying on just itself?


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