I have been mulling this video, linked by Instapundit the other day, in which Glenn Reynolds interviews Margaret Flowers, M.D., co-chair of the Maryland branch of Physicians for a National Health Program.

Flowers seems, at first gloss, to make a pretty convincing argument. The gist of her case is that the current system is too complex and onerous. There are some 1300 different health insurance companies. Processing associated paperwork costs physicians’ practices $70,000 annually. Because insurers are trying to make a profit, they are inherently inclined to short patients on care.

A single-payer system would simplify the process for both doctors and patients, she says. She also says Medicare reimburses physicians at rates that are roughly on par with reimbursement rates of private insurers — the implication being that physicians would earn just as much if we extend Medicare to all Americans.

Since it would be a public system, you’d dispense with issues related to profit motives.

The flaws in her case are some of the same ones I’ve made here before.

A biggie: centralized systems are more vulnerable to corruption.

And while Flowers insists people will still have the right to choose their doctors, etc., what they won’t have is the right to opt out of health insurance  — and paying for it — altogether.

I do sympathize with her in one respect: doctors aren’t really in the driver’s seat when it comes to the patient/insurance/physician relationship. The insurers are.

That seems to me to be the fundamental issue.

If physicians had more power, they could “force” insurers to cover expenses based on the physicians’ evaluation of patients’ needs. They could force insurers to standardize their paperwork. Etc.

So here’s what’s interesting.

Physicians’ ability to band together and advocate for themselves is limited — by none other than the federal government.

Specifically, the National Labor Relations Board, as described by this 1998 article from Physician’s News Digest.

The critical issue for physicans is that only employees can unionize, and depending on the situation, the NLRB often classifies physicians as supervisors; if they are independent contractors they are also denied the right to organize.

So there you have it. Flowers, like everyone else, realizes there’s a problem. But she has failed to ask the right question. Therefore the solution she’s proposed is trapped in the deep dark confines of the proverbial box.

Perhaps physicians should look instead at the Labor Management Relations Act.

Maybe they should advocate that an 80-year old law be updated (repeal is probably too much to wish for!) so that it better serves the American people.

I mean, think about the last time the topic of insurance came up between you and your doctor. He/she feels completely helpless, right?

That isn’t right.

So why not upset the status quo by actually challenging it.

The exact opposite of handing even more control over to Washington.

Seems like a no-brainer to me.