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The Problem with Single-Payer Plans The fee-for-service delivery system needs reform, too.

Even in theory, single payer is not the best reform option. Here’s the problem: while it proposes the most radical reform of the health care financing system, it is conservative, even nostalgic, when it comes to the broken delivery system. It retains and solidifies the nineteenth century, fragmented, fee-for-service delivery system that provides profligate and bad quality care.
A commentary on “Single Payer Meets Managed Competition.”

Even in theory, single payer is not the best reform option. Here’s the problem: while it proposes the most radical reform of the health care financing system, it is conservative, even nostalgic, when it comes to the broken delivery system. It retains and solidifies the nineteenth century, fragmented, fee-for-service delivery system that provides profligate and bad quality care.
A commentary on “Single Payer Meets Managed Competition.”

Ezekiel J. Emanuel, Hastings Center Report 38, no. 1 (2008): 38-41.