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Editor's note: This article is a response to a recent guest opinion ("For health-care reform, use single-payer system," Sept. 7).

Before we jump on this centuries-old bandwagon, with its new banner, it's important to recognize that single payer is not a model medical system existing throughout the civilized world outside the United States.

In fact, only two countries — Cuba and North Korea — have a single payer, now that the Supreme Court of Canada ruled in 2005 that access to a waiting list did not constitute access to medical care.

Single payer means that nobody else is allowed to pay for "covered" medical services. If the government won't pay for it, neither can you — unless it's a cosmetic or experimental or other clearly noncovered procedure. Or unless you're a cat or a dog.

Now it appears that the Canadian government will no longer be able to fine doctors into penury, or even jail them, for the crime of accepting payment from (human) patients. And private clinics are opening at the rate of one a week.

Advocates of the old way are terrified that the coming "two-tiered system" will spell disaster for the pride of Canada: its egalitarian medical system. Imagine that! People will still have to pay for the public (tax-funded) system but will willingly pay a second time for medical treatment outside its deteriorating, overcrowded facilities. What an endorsement for the wonderful single payer.

Britain, of course, has always had a parallel private system, as do other European nations. In Germany, one-third of the population is eligible to opt out of the "sickness funds," of which there are many. Americans are less aware of the crises of cost and availability confronting public systems of France, Germany and Switzerland, because they can't read French or German. But they could at least look at British and Canadian newspapers before voting to force Americans over the same cliff.

Private insurance wastes more than enough money to pay for high-quality, comprehensive care for everyone, claim single-payer advocates. But what about the single payer that we already have in America: the one that runs Medicare and Medicaid? These supposedly efficient programs are bankrupting both federal and state governments. The many trillions of dollars in unfunded liabilities are promises that realistically can never be kept.

Medicare stopped paying bills during the last part of September to shift costs into the next fiscal year. In 2007, "wealthy" Medicare Part B recipients are going to have to start paying higher premiums. Medicare is slated to cut physicians' fees in January, and doctors are already cutting back on their Medicare practice.

How can throwing all Americans into the hands of this failing single payer be anything other than catastrophic?

Single payer is the gas-siphoning solution to the financing of medical care. If costs are too high, just force somebody else to pay them. Commandeer all the resources into the centrally planned system and pump subsidies around, with leaks at every stage. Slap on price controls, so that costs are infinitely high to those without a government-provided ration ticket. Timely care will often be unavailable at any price, and all care will carry a largely unmeasured overhead cost of waiting and hassles.

Americans actually do pay much more than necessary for their medical care. The reason is that 85 percent of all medical payments are channeled through a third party, the government or an insurer. Single payer would make that 100 percent.

It's like the prescriptions of our physician forbears. If the fever doesn't abate after the first bloodletting, apply the leeches again. The fever will eventually come down to room temperature, and bleeding always stops.