How can the US afford a single-payer system? (solution, compared, financial)
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And the "secret" to making a single-payer system work is...drumroll...price controls!
That's what Canada does to make their system work, and to make our system work, even for Medicare in the years ahead when more people than ever are using it, is to control the actual cost of medical care. In Canada, they maintain these enormous lists of every medical procedure known to man and how much they should cost, based on a reasonable formula of how much it actually cost to deliver said service, plus enough profit so doctors can make a decent living.
Why is this not being discussed as a valid option in our health care debate? It's common knowledge that the US spends far more per capita than other nations, for care that's really no better. In the rest of the economy, people are allowed to pick and choose products and services based on price and quality, but this is unworkable when it comes to medical care, since there is only one standard of medicare care, and shopping around really isn't practical.
So, we just need to keep the standard of medical care where they are and put down some iron-clad price controls. If a hospital in St Louis can perform a surgery for $10,000, and another in Miami charges $45,000, we know that the $10,000 is probably a reasonable price to pay, and the hospital charging $45,000 is taking people to the cleaners.
Until we have a way of enforcing price controls, all other discussion of universal care is moot, since we'll never be able to afford it otherwise.
And the "secret" to making a single-payer system work is...drumroll...price controls!
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.
See venezuala and toilet paper or california and water, for recent examples.
acetaminophen tablet charged at $500. Thats what HAS occured to people. Think about that. Price controls are damaging like in Venezuela only when set to unreasonable amounts. Thats not the suggestion here.
Heck the ACA has a huge price control built in that applies to profit margins on health insurance!
I'm not going to argue that, but people will get in heartfelt debates pushing the benefits of systems in foreign countries that they know absolutely nothing about. It's very peculiar.
If it helps I have received medical care overseas. So I do have some clue.
acetaminophen tablet charged at $500. Thats what HAS occured to people. Think about that. Price controls are damaging like in Venezuela only when set to unreasonable amounts. Thats not the suggestion here.
Heck the ACA has a huge price control built in that applies to profit margins on health insurance!
any bills of $500 doesnt get paid at $500, the charged amounts are meaningless.
How much is PAID, because THATS what affects the cost.
To quote billed amount and then claim its relevant is silly.
Actually its not. Many without insurance do pay the billed amount.
Many without insurance dont pay, or did you forget the justification for ACA?
Quote:
Originally Posted by greywar
Even better...why should your insurance even try and reduce it....if its under your co-pay, or under the deductable near the end of the year?
They have no need to try to reduce it, the reimbursement rates are set by zip code, which even the government follows.
If you dont think the insurance company should pay less than the billed amount, then the government shouldnt either. One could argue them not paying "their fair share", is what causes the cash payers to get the $500 bills for a pill.
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