The spat between doctors and a health insurer over which anti-addiction drug patients can get raises again the fundamental health care question Americans answer one way, and the rest of the world answers another: Whom do you trust? While the rest of the industrialized world puts its faith in the single-payer system, and spends much less as a result, we spend 50 percent more while relying on insurers and not even insuring everyone. Not that disputes like the one over Independent Health's switch to a cheaper drug – which it says works just as well with fewer risks – would disappear under single-payer.