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"What this country needs is a single payer health care system "
The fed hs tried that with the VA. Look how good that is going.
If the fed can't handle the VA, what makes you think they can handle a program 10 times, probably more then that, larger?
Single payer as it should be would be more like Medicare for all, so not so major an expansion as you suggest. Medicare is centrally administered and paid for, but mostly delivered by the private sector. The VA is all centrally owned and operated.
We want to keep the delivery of HC mainly in the private sector. Of course I may be biased, being a private primary care doc!
And YES, I'm admitting our government is incompetent in handing money. I'd have to be blind - I need
an ophthalmologist not to see that. But remember, a detached retina is not going to be able to be market driven like lasik for astigmatism is, which is the argument often used to tout a private market health care system.
It is more difficult to free market a serious, acute and/or or complicated medical condition or encounter than some relatively simple, non-emergent, low risk procedure like refractive correction. Most HC plans don't even cover elective procedures like lasik.
It is more difficult to free market a serious, acute and/or or complicated medical condition or encounter than some relatively simple, non-emergent, low risk procedure like refractive correction. Most HC plans don't even cover elective procedures like lasik.
Why?
I say it is not. Besides, REAL insurance is for those rare emergencies, not for the daily grind. If we stopped using insurance for all those normal things and used it only for catastrophic things, while the rest was subject to the pressures of free market medicine... Both would be affordable.
Your right. Bad example. I guess the average person has 5000 - 6000 dollars cash
for that. You know, they can just save up for it, while they are steadily going blind
When we get to talking cancer surgeries, heart surgeries etc. you've just got to be a real penny pincher.
I say it is not. Besides, REAL insurance is for those rare emergencies, not for the daily grind. If we stopped using insurance for all those normal things and used it only for catastrophic things, while the rest was subject to the pressures of free market medicine... Both would be affordable.
The more serious, acute and/or complicated the medical encounter, the more uncertainty and risk, where 'real' insurance is needed. How does one free market chest pain? Or an acute abdominal crisis?
Lasik does not require insurance because there is much less risk and uncertainty. It is much more easily free marketed being more predictable from both sides, 'buyer' and 'seller', as far as 'product' and outcome.
But with chest pain, the outcome could be anywhere from a minimal chest wall injury to a heart attack. And the treatment, risks, end points and costs of a heart attack are very difficult to predict from day 1. Chest pain might cost anywhere from $100 - $100,000 and even more if cardiac.
We don't necessarily need insurance for the quick and easy, simple, cheap and low risk things. But IMO we should still be able to buy that coverage if desired in a free market.
It is much easier free market HC and HC insurance with low risk and predictable populations.
Our big bad bugger of a problem is how to take care of the HC needs of our growing senior population. Because far and away this is where the serious, acute, unpredictable and/or complicated medical encounters are bound to happen on a much more regular basis.
....so many single payer advocates who understand nothing about health care prices in this country. Administrative costs aren't the driver and you still need a claims system even under single-payer. The three big components of unit cost are:
- Doctors; who get paid much more than in other countries for the same work
- Hospitals; which have their biggest cost being salaries, over half of which are for nurses, who are paid much more than in other countries for the same work
- Drugs; where the US is basically carrying the development costs and industry profits for the whole world.
We need serious reform in pharmaceutical pricing, but you can do that just as easily with regulatory changes to the current system than with single payer. Single payer does not bring down doctor and hospital costs significantly unless you are going to use it to ram through huge pay and reimbursement costs for both doctors and nurses, which even if you personally thought would be good public policy [I'd be against it, but that doesn't really matter as] there is clearly no political consensus to do (see: the perennial SGR patches).
I guess single payer could conceivably bring down costs significantly without being used as a tool to slash caregiver salaries by tightly rationing care more than commercial insurance customers would find acceptable or is allowed by current medicare/medicaid law but then you'd need to make "death panels" a literal thing, not just an exaggerated political attack like they were on the ACA.
Nursing is set up differently in every country, though the EU is getting more standardized. In other words, the work is different in every country. But knocking nursing salaries? Are you out of your ever-lovin' mind? And PROVE that nurses are paid "much more than in other countries for the same work". Control for education and COL in the various countries.
Quote:
Originally Posted by mwruckman
The first question for any single payer system of health delivery is Who is the payer?
I think we all agree on a single payer system if the other guy is the payer and not ourselves!
I don't think most single-payer advocates are that stupid.
Quote:
Originally Posted by pnwmdk
Why?
I say it is not. Besides, REAL insurance is for those rare emergencies, not for the daily grind. If we stopped using insurance for all those normal things and used it only for catastrophic things, while the rest was subject to the pressures of free market medicine... Both would be affordable.
Hoonose explained this well. However, the problem is that so many advocating for the "free market" system think the above.
Actually what the fed (Congress) tried with the VA is a catchment clinic model.
Give Vets an ID card and allow them to go anywhere they want, and you won't
have a bottle necked system. They should be given that freedom.
I think the government can handle being a single payer for our health care system.
Obviously our private insurance companies are happy with getting paid subsidies from the federal
government now. Just get rid of that
"I think the government can handle being a single payer for our health care system." I don't.
Look at where we are today, 17 TRILLION in debt and growing by the BILLIONS every minute.
Name a program that is NOT in financial trouble. SS, Medicare, etc.
Name an agency that has stayed wit in its original "charter" and has NOT grown into huge uncontrollable bureaucracy's.
Social Security has been around since Roosevelt and it is darining the taxpayer because the gov't in it's infinite wisdom decided to take the surplus, which was supposed to pay for future years, and spent it,
NOW we have to cash in the T-bills just to pay out what is due because it is paying out more then it is taking in.
With all due respect the fed has a lousy track record of handling programs.
What makes you think they will do any better with a single payer system?
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