Cupporters of single-payer health care march to the Capitol in Sacramento, Calif., on April 26. (Rich Pedroncelli/Associated Press)

The June 19 editorial “The high cost of single-payer health care ” may be a bit pessimistic. Recognizing that any single-payer model would require a significant financial investment by our nation, in particular the Medicare-for-all proposal the editorial highlighted, there are myriad ways in which taxpayer burden could be attenuated to make such a model viable in this country as it is now in certain other developed Western nations.

The taxpayer burden could be limited by adopting a broader array and targeting of financing mechanisms than exist in Medicare. Also, benefit costs could be managed through a range of mechanisms including provider payment adjustments, determining the appropriateness of and payment for treatments based on empirically determined costs and effectiveness, and creative cost-sharing and cost-savings measures that encourage prudent health-care choices and practices among beneficiaries. As the editorial acknowledged, adopting such measures would be politically challenging, but not insurmountable.

Indeed, Republicans may have “tarred the Affordable Care Act’s Medicare cuts as attacks” on Medicare; however, after seven years, they still have not yet repealed these payment adjustments, many of which contributed to the Centers for Medicare and Medicaid Services Office of the Actuary’s initial projection that the act would extend Medicare’s Hospital Insurance Trust Fund by 12 years.

Mark Vinkenes, Arlington

The writer is a former Medicare branch chief at the Office of Management and Budget.

Remember the two decades of fierce, fear-inducing, false attacks on Medicare? It would bankrupt the government, overwhelm hospitals and destroy our health-care system. Sound familiar?

Private health insurance has many times the administrative costs of Medicare. It also adds significantly to the operating costs of doctors’ offices and hospitals. Hospitals have more insurance billing and reimbursement clerks than beds. Universal, single-payer health care would dramatically reduce malpractice premiums (by eliminating the cost of future medical treatment). Focusing on costs without addressing all projected savings is irresponsible.

Why not admit that the political cost of moving to single-payer frightens too many interest groups?

Judith B. Esterquest, Manhasset, N.Y.