Re “Health Reform Realities” (column, Jan. 18):

I’m glad to see that Paul Krugman acknowledges that “if we could start from scratch, many, perhaps most, health economists would recommend single-payer, a Medicare-type program covering everyone.” His argument that we should not work for it now is unconvincing.

Just because private insurers are powerful doesn’t mean a concerted national campaign can’t overcome their well-funded opposition. Already a majority of the general public (58 percent in a recent Kaiser poll) supports single-payer. Cost will never be controlled until we do away with the bloated administrative expenses of our hopelessly complex financing arrangements and for-profit medicine.

And while the Affordable Care Act has indeed been a great help for many seeking health insurance, it has left over one-fourth of Americans ages 18 to 64 with problems paying their medical bills. As you have reported, that can be the case even for those with insurance (“Medical Debt Often Crushing Even for Insured,” The Upshot, Jan. 5).

We can do better, as every other developed nation has demonstrated.

ALAN MEYERS

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