Just why is it that we need health care reform? We all know one basic problem. There are just too many of our citizens without health insurance. Many eventually do get health care, but they get it in hospital emergency rooms, the venue most costly for the taxpayers and charities. But there is an even more important question about the cost of medical care. Are we the taxpayers and premium payers getting good value for our money? Or are we being ripped off?

Let us look at the facts. We Americans value excellent health care so we spend generously: to the tune of $5,271 per capital every year. For Canadians, the amount is just $1,939. But, you argue that you get what you pay for and we pay for the best medical services in the world. But do we? Life expectancy at birth in the United States is 78 years, perhaps a ripe old age. But our country is a shocking 47th among the nations of the world in life expectancy. Canadians live three years longer and rank No. 8. But we have excellent maternity hospitals so our infant mortality rate must be great. Nope. We are only 33rd among the nations. The Canadians beat us again: they stand as 23rd. But clearly we must excel when compared to less developed countries. How about the despised communist Cuba? No comfort there: Cuba beats us at number 28.

Perhaps we can console ourselves by the knowledge that our money at least makes sure we have multitudes of hospitals and doctors to help us when we do fall ill. Maybe, but we do not look very good in comparison. In terms of doctors per 1,000 population, we are way down the list at number 52. Hospital beds? We’re only number 27.

Oh, well, why worry? We’re a healthy group, constantly on our exercise machines, or jogging or working out at the gym. Oops, think again! We Americans are the fattest in the world. What percentage of our number are considered obese? 30.6 percent! Well, at least we are No. 1 on one list. It seems to me we are going to need those doctors and hospital beds that we do have have.

There is clearly something wrong with this picture. We are paying the most but getting mediocre results. To put it bluntly, yes, we are getting ripped off. Many other nations do much better at less cost. How can this be? I submit that the answer is obvious. We are buying our health care at retail cost, but other nations have cut out the middlemen. Most of the rest of the developed world uses some form of a single-payer system. I am convinced that it is time that we move to such a system, as it is clear that the way we do things today will just not do for tomorrow.

Yet, even the introduction of an alternative government insurance plan has only marginal chances of enactment. The Congressional Budget Office tells us that this is not the way to save money. Thus, it is time for bolder steps.

The only way we will decrease costs and improve the standards of our care is through a single payer system. It works elsewhere, so why not here? You and I will still have our choice of doctors and facilities, and as taxpayers and premium payers we will pay much less for better care. Does anyone have a better idea?

Robert W. Maule

Poulsbo