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As a side note about a single payer system, which probably implies a single health system...
If you average out the amount of care people receive, you'll likely run into the issue of decreasing benefits for those at the top of the food chain. People with excellent corporate coverage and/or government employees are going to throw a fit. The only way to keep them at all happy, and to have the same coverage for everyone, is to give everyone in the US the best coverage currently available.
That's a thing that I doubt is affordable, no matter how you slice it up.
A single payor model will require some rationing (the word that leaves a bad taste in everyone's mouth). The government cannot print money fast enough to pay for the medical care in the country that the entire population wants.
That means that we fund (with a tax) coverage that will meet the needs of most of the country and subsidize the cost for those who cannot pay. If people want coverage beyond what is in the basket of "needs", they can buy additional coverage. Of course, the sticking point will be what that basket contains. When this was discussed before, the accusations of "killing grandma" flew. I do not see it that way. We spend a great deal, often at the end of life, on treatments that are futile and often only delay death by a very short length of time. Someone should not be able to demand that all the stops be pulled out for grandma when there is no hope for a meaningful recovery - unless someone other than the tax supported system is going to pay. I say that as one who is a grandma herself. There should be an option for buying extra coverage (similar to Medicare supplements), paid for with your own money, to cover "wants" that are not in the needs basket: dental, vision, infertility treatment, elective surgery, a private hospital room.
It is not necessary to give everyone in the country "the best coverage currently available." It is necessary to provide everyone with adequate care.
There is waste in the current system that can be removed, too, starting with cutting out advertising by doctors and hospitals and the onerous pre-authorization procedures that waste physician time. Cutting out the inefficiencies in the current claims process would be a big help, too.
Its a fact, which you dont seem to want to discuss
Not in dispute,
I have no idea what you are talking about. I didnt cherry pick any specialty, its the same with EVERY SINGLE UCR/ICD procedure, its how it works..
You dont seem to understand billed vs paid differences..
I understand the difference between billed and paid just fine. I also understand that the PAID part is vastly higher in the US then elsewhere, while the billed is even worse.
And what dont I want to discuss that hasnt been refuted already?
A single payor model will require some rationing (the word that leaves a bad taste in everyone's mouth). The government cannot print money fast enough to pay for the medical care in the country that the entire population wants.
That means that we fund (with a tax) coverage that will meet the needs of most of the country and subsidize the cost for those who cannot pay. If people want coverage beyond what is in the basket of "needs", they can buy additional coverage. Of course, the sticking point will be what that basket contains. When this was discussed before, the accusations of "killing grandma" flew. I do not see it that way. We spend a great deal, often at the end of life, on treatments that are futile and often only delay death by a very short length of time. Someone should not be able to demand that all the stops be pulled out for grandma when there is no hope for a meaningful recovery - unless someone other than the tax supported system is going to pay. I say that as one who is a grandma herself. There should be an option for buying extra coverage (similar to Medicare supplements), paid for with your own money, to cover "wants" that are not in the needs basket: dental, vision, infertility treatment, elective surgery, a private hospital room.
It is not necessary to give everyone in the country "the best coverage currently available." It is necessary to provide everyone with adequate care.
There is waste in the current system that can be removed, too, starting with cutting out advertising by doctors and hospitals and the onerous pre-authorization procedures that waste physician time. Cutting out the inefficiencies in the current claims process would be a big help, too.
The point I'm making isn't so much that we live in a world of limited resources, of course there's *always* rationing (except perhaps in a tiny percentage of cases), but that changing the system is politically impossible unless you don't reduce the benefit level for the highest group of recipients.
Government workers, union members, large company employees, and the like are powerful beyond their numbers, and any plan that is to their great disbenefit is probably a non-starter.
A single payor model will require some rationing (the word that leaves a bad taste in everyone's mouth). The government cannot print money fast enough to pay for the medical care in the country that the entire population wants.
That means that we fund (with a tax) coverage that will meet the needs of most of the country and subsidize the cost for those who cannot pay. If people want coverage beyond what is in the basket of "needs", they can buy additional coverage. Of course, the sticking point will be what that basket contains. When this was discussed before, the accusations of "killing grandma" flew. I do not see it that way. We spend a great deal, often at the end of life, on treatments that are futile and often only delay death by a very short length of time. Someone should not be able to demand that all the stops be pulled out for grandma when there is no hope for a meaningful recovery - unless someone other than the tax supported system is going to pay. I say that as one who is a grandma herself. There should be an option for buying extra coverage (similar to Medicare supplements), paid for with your own money, to cover "wants" that are not in the needs basket: dental, vision, infertility treatment, elective surgery, a private hospital room.
It is not necessary to give everyone in the country "the best coverage currently available." It is necessary to provide everyone with adequate care.
There is waste in the current system that can be removed, too, starting with cutting out advertising by doctors and hospitals and the onerous pre-authorization procedures that waste physician time. Cutting out the inefficiencies in the current claims process would be a big help, too.
Selling americans on "some care" towards end of life will never pass muster. Especially when seniors are the largest voting block.
A single payor model will require some rationing (the word that leaves a bad taste in everyone's mouth). The government cannot print money fast enough to pay for the medical care in the country that the entire population wants.
That means that we fund (with a tax) coverage that will meet the needs of most of the country and subsidize the cost for those who cannot pay. If people want coverage beyond what is in the basket of "needs", they can buy additional coverage. Of course, the sticking point will be what that basket contains. When this was discussed before, the accusations of "killing grandma" flew. I do not see it that way. We spend a great deal, often at the end of life, on treatments that are futile and often only delay death by a very short length of time. Someone should not be able to demand that all the stops be pulled out for grandma when there is no hope for a meaningful recovery - unless someone other than the tax supported system is going to pay. I say that as one who is a grandma herself. There should be an option for buying extra coverage (similar to Medicare supplements), paid for with your own money, to cover "wants" that are not in the needs basket: dental, vision, infertility treatment, elective surgery, a private hospital room.
It is not necessary to give everyone in the country "the best coverage currently available." It is necessary to provide everyone with adequate care.
There is waste in the current system that can be removed, too, starting with cutting out advertising by doctors and hospitals and the onerous pre-authorization procedures that waste physician time. Cutting out the inefficiencies in the current claims process would be a big help, too.
just as government schools are dumbed down so everyone can get the same education, so will health care be bastardized to give everyone " adequate care" ( whatever that highly flexible term implies)
We currently have a single-payer system for the elderly: I believe all people aged 65 and older are eligible. I believe Medicare/Medicaid spends around $900 billion a year, if I am not mistaken, for 45 million people (elderly and disabled). Curious how much the number balloons when 300 million people are thrown on it.
Consider the current health insurance companies: Blue Cross & Blue Shield, Harvard Pilgrim, United Health Care, etc. All of these companies have huge overhead, and executives that make millions. If all these fees, salaries, and bonuses are eliminated, of course it would be better. These companies are nothing but the middle man earning a considerable profit. If all these companies are cut out, and everyone is on the same page, with the same benefit options it would improve the costs, and probably the quality of health care as well, along with less confusion. Forget the idea that having numerous companies create competition; these companies all work in collusion, with benefits that get worse and worse for the consumer each year.
As a long time participant in the health care "industry" (what an odd word for a business that doesn't make anything!) I do not see doctors dropping out of traditional health care as something that is going to happen.
MDs, on average, do well in the rest of the developed world with universal healthcare.
The serious differences are hospitalization and medications including Cancer treatment.
Most U.S. hospitals in the US are not for profits. Many have $ hundreds of millions in profit each year. A lot of it is used to build the brand, advertise, acquire medical practices and either acquire or destroy the competition.
You don't see this sort of thing, to this extent, in the rest of the developed world. Hospitals are lean when in comes to non medical staff. You would likely find senior non- medical administrators making $ 7 figures.
The rest of the developed world relies on MD comprised ComRiative- Effective panels to determine the most efficient treatment protocols. This was a part of the original ACA. Republican's called them death panels and eventually it was struck from legislation. The price of medications are negotiated. No one pays $350 for a simple Walker from a medical supply house when one can buy the same thing for $35 from a Walmart like store. In the U.S. Big Pharm, American Hospital Association and medical equiptment manufacturers/ distributors own Congress. Their interests come before the masses.
Then there's the whole personal responsibility thing. 70% of US adults are overweight/ obese and substantially more vulnerable to otherwise preventable disease, Diabetes, heart Disease and certain Cancers. One- third of US children are overweight/ obese. The rest of the developed world is not dealing with a public that declines personal responsibility to the extent common on the US.
The overwhelming majority of this video is a Hillary bashing and has nothing to do with healthcare or this thread.
The two main points that relate to the former healthcare legislation is the individual mandate for healthcare insurance ( the backbone of any universal healthcare system regardless if it's public, private or a mix) and mandatory cuts to hospital spending ( another backbone of universal healthcare)
Let's take a look at how many other countries manage childbirth and do so with equal or better outcomes. Most births are delivered in independent birthing centers by mid wives, not MDs, unless medically warranted or if the mother is willing and able to pay out of pocket for hospitalization. Again, outcomes are equal to or better than in the US at significantly less cost.
The Americal Hospital Association, a huge US lobby and campaign financier, does not appreciate anything that could cut into their revenue streams.
BTW, Betsy is a PHD, not an MD. For crying out loud, she worked in Wall Street and eventually found the Conservative speakers circuit more lucrative.
By definition, single-payer is a monopsony and is all about price controls.
Determining the value of a thing isn't a bad approximation to controlling it. You can argue that federalizing the medical providers might work as well as a single-payer system.
Other countries with universal healthcare, not necessarily single- payer, have government controls over pricing. The state negotiates the price of prescription medications. They are not popping $100,000+!for a single round of Cancer Treatment as is common in the US. Hospitals trend true non profit. Making $ hundreds of millions a year in profit in unheard of. Having bloated non medical admin staffs is unheard of.
The Swiss have universial healthcare and requires everyone to maintain private healthcare insurance. The government subsidizes 40% of premiums. The premiums for all adults are the same and more affordable. The Swiss government owns and operates most hospitals and manages costs.
People are not dying in the streets.
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