Dr. Caroline Poplin’s Letter to the NY Times Editor in response to David Goldhill’s Op Ed entitled “The Health Benefits That Cut Your Pay”

To the Editor:

With the best intentions, David Goldhill has described a free-market fantasy of health care. Market prices are based on power. In the United States today, hospitals and large doctor groups wield enormous market power, and they exercise it ruthlessly; consumers have none. Hospitals charge whatever the market will bear; uninsured patients pay the highest prices.

Large insurers bargain for “discounts” from prices set high enough so that hospitals still profit, and pass some of the “savings” on to large employers, who also have market power, but not to small businesses or individuals.

Whatever their faults, single-payer systems using government leverage, like the Canadians’ — or Medicare — deliver decent quality care to more people at lower cost. Mr. Goldhill makes the best the enemy of the good.

Bethesda, Md., Feb. 17, 2013

The writer is a primary care physician.