In her Feb. 24  letter, Valerie Dornan offers that the National Health Service in the U.K., despite chronic underfunding, often outperforms the U.S. system. A Commonwealth Fund study, comparing the two, showed that the U.K. comes out ahead by most measures.

The NHS is an example of socialized medicine. The facilities are owned and operated by the government and staffed by government employees. Most health care reform advocates in the U.S. (like me) do not advocate expansion of socialized medicine, but it is worth noting that we do have examples of it here and that it works well. A Rand Corporation study showed that quality of care under the Veterans Health Administration, for instance, compares favorably with care delivered by the private sector.

So, the government manages a complex health care system and does it well. However, health care reformers seek far more modest change. The goal is a simple, efficient, single-payer system, covering everyone, whereby the government collects the premiums and pays the bills. Delivery of services would remain in private hands.

The government has already demonstrated, with Medicare, that it pays providers more efficiently than private insurers do. In traditional Medicare (the largely public version), administrative costs account for only 1 to 2% of the budget. In Medicare Advantage, where public funds are routed through private insurance companies before providers are paid, overhead and profit consume between 15 and 20%. Costs per patient on traditional Medicare are less than on Medicare Advantage.

Thus, as the letter concludes, universal public funding of health care would provide better care for less.

Michael Bacon
Westbrook