What’s Wrong With a Single-Payer System? - The Conversation Blog - NYTimes.com »
Posted By deathray 5 months ago in Political OpinionWhy Congress needs to start over and get serious about health care costs.
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deathray
Hm...summarizing a life...Investment banker, sailor, unintentional gourmet cook. Ex US Naval officer, also Foreign Service. Split my time between NYC and Miami Beach ...
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deathray5 months ago
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deathray5 months ago
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i'm going to go ahead and jump right in - i don't believe that there' a thing wrong with a single payer system.
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we have one right now - it's called medicare and it serves 40 million people, to the extent that many don't want their benefits to be touched at all.
and just to set things straight, the va is socialized medicine, medicare is not. -
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Candida5 months ago
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deathray: "gail collins and david brooks discuss the pro and cons of a single payer health care system."
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Except they don't really discuss it. Gail Collins raises it, and then it just gets shuffled to the side. They discuss cost containment, how the single-payer system is politically unacceptable, but they don't really discuss the pros and cons.
For example Brooks mentions that the US health care is as big as the whole UK economy and it would be unmanageable from Washington. So what would stop Washington to set down some basic rules (like universal coverage and relatively equal access) that all states have to fulfill and then let each state decide how to deliver its health care within that framework?
A lot of people are raising problems, but I don't see many suggestions for solving them.
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deathray5 months ago
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please elaborate.
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if price controls are also being addressed, why do you think we'll see the same price issues we saw from defense contractors during the reagan administration? remember it was the medicare part d program that did not allow group leverage to negotiate for lower medicine prices. -
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Amabaie5 months ago
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Think tiny hole in the roof that people put off fixing because they don't have the cash. Fast forward a year when tiny hole is big and now requires replacing the entuire roof. So many people suffering needlessly now...and it actually costs more to keep them suffering. Jsut look at Canada where everyone is covered, wait time for all but the very rich are shorter and conditions get treated usually earlier, when they a) cost less to treat, b) have a better chance of being treated effectively and c) cause less suffering.
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The Canadian medical system has no $600 hammer. If it did, doctors and nurses and technicians would be flocking north across the border. Ha! That'll be the day! -
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kobzikov5 months ago
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Klarissa, didn't you prop an article claiming Private Health Clinics Booming In Canada? How can you say that there is no competition under single-payer systems after that?
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rimbaud4 months, 4 weeks ago
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Medicare is most insurers' most profitable line of business: they get to collect a premium and the government does most of the paying, and is involved in controlling costs on their behalf. Insurance companies are financial institutions not Medical ones. They understand such things as "underwriting" and "actuaries," which are basically concerned with maintaining a healthy bottom line. Their role is simply getting money into the health care system. If there were no insurance, providers would be able to serve only those wealthy enough to be "self-insured". Take a look at how costs of dental care increased as Dental insurance became widespread, and what is happening to the costs of veterinary care as veterinary insurance becomes more widespread. Insurance is just the private sector's way of spreading the costs of care around the insured population. Single payer simply spreads the costs of care across the whole population, while introducing cost control measures.
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Amabaie5 months ago
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With single payer, most people don't hesitate to seek medical attention when they should (at least not for financial reasons). Opponents of single payer claim it would cost more for this reason. However, it costs much less when people seek medical attention in a timely fashion, rather than waiting until diseases and injuries have become so bad that they can no longer aboid seeking treatment and the cost of treating skyrockets ten-fold or a hundred-fold.
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StevieGee5 months ago
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Imagine a world where major American car companies can build their cars here in the US as cheaply as they can elsewhere. Imagine a world where small business isn't strapped with the cost of not just one but two insurance policies for their employees. I'm talking about their regular health insurance and workers compensation. Imagine a world where when you go to the doctor, the first half hour isn't filling out forms so they can get paid. This is the world of single payer health care.
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Natureboy4 months, 4 weeks ago
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True. W. Edwards Demming listed our healthcare system years ago as one of the "Seven Deadly Sins" that prevented the US from competing effectively with other industrialized nations. Single payor would take care of that.
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The downside from the employers' point of view is it would also bring an end to the unique American practice of continuing to work at a crappy, distasteful, low paying job in order to keep your medical insurance. -
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rimbaud4 months, 4 weeks ago
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Health Plans, like Kaiser-Permanente's, provide some of the advantages you site, but even they are now marketing high-deductible/high-copay, low cost plans, in an attempt to attract healthy subscribers, and to compete with insurance companies. The difference is they are intimately involved with the provision of health care, where the insurance companies are removed.
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Spadecaller5 months ago
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Not only do I support a single payer health care system, I do not see an alternative that will treat all Americans fairly. The ongoing conflict that this issue brings will only add to handicapping our nation economically. Our labor market cannot become competitive in the world with a system that divides Americans into fragments.
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Georgia504 months, 4 weeks ago
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Americans are 3% of the world's population. America generates 25% of global GDP. Name the country that is more productive on so massive a scale.
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How exactly do you stare into the face of the most dynamic engine of productivity the world has ever known and say it doesn't exist? Does this elective blindness go with being liberal?
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moxxxxxxxxxx5 months ago
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The single payor system is the best option however it will never pass because insurance corps are not going to give up the profit game in healthcare, and there will always be people who believe they deserve something better than everyone else. They are not interested in the common good. It's how they maintain their level of self importance.
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Georgia504 months, 4 weeks ago
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Yeah right. And Senator Dodd would die under single payer rather than have his cancer screened early enough to treat.
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Oh wait. Senator Dodd will NEVER be on the single payer system he wants for the rest of us. It seems there are some "who believe they deserve something better than everyone else."
No xit. We call those people "Congress."
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engineer5 months ago
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deathray5 months ago
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i found this white paper on a site referred to by david brooks in the blog; it's bone dry, but hey, what's a submission from deathray without a wonky white paper. see what you think.
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Funding Health Care For All Americans: An Economic Perspective
By Victor Fuchs and John Shoven
http://www.fresh-thinking.org/publications/Funding... -
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jovial5 months ago
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I could care less what it costs. It's the humane and right thing to do. Letting people die in this country is so wrong on so many levels. Letting people profit off of people's health is equally as wrong. The CBO is our worst enemy right now, because it's shifting the argument to cost instead of life. What the hell is money when lives are at stake?
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Georgia504 months, 4 weeks ago
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Actually, your lack of concern for cost is full of irony. For starters, liberals never care about cost because it's never about THEIR money. It's about their power to confiscate the money of others.
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How is it humane to support a health care system stacked in favor of minorities by statute, literally racism by fiat? How is it humane to force the elderly, who are remaining productive longer with each generation, to attend end-of-life re-education camps? How is it humane for a patient's health care to be meted out to him/her by a bureaucrat as opposed to him/her deciding on the best course of action with his/her health care provider? One-size-fits-all may work for tube socks. It cannot work in an environment heavily dependent on differential diagnosis with layered facts and circumstances. How is it humane to invade the medical privacy of every American (except Congress of course)? How is it humane to know beforehand that the rationing of health care will kill more people than the current system?
Answer: it is only "humane" in the sense that liberals will distort any term and wreak havoc on the English language without the first pang of conscience on their way to wreaking havoc on the American people. The liberal creed is "coverage for all" regardless of the outcome of that coverage. They rail against profits as if they have a clue as to the effort and insight that attend the making of a profit in a highly competitive market environment, a clue about the millions employed by in health care that will be put out of a job, a clue about the tax base that will be eviscerated along with the destruction of this industry, or even a clue about the millions of Democrat liberals who will be jobless as a result of this monstrosity of stupidity.
IOW, we find that supporting Obamacare is the only direction Jovial is capable of. His DNA will not allow him to critique the creed or question the cool aid. Liberals never question the cool aid. All good and well....but they never stop there. They want to force their cool aid on the rest of us.
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pokydoke4 months, 4 weeks ago
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Reading this article it was stated that the Government would not be able to handle single payer health care system. I disagree with this. Look at our military, the most advanced military in the world by far, run by the Government. Look at NASA, a government run operation. How many other countries have put men on the moon? Granted the US government has it's problems but the ability to handle large projects is there.
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Natureboy4 months, 4 weeks ago
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Lets go all the way. What's wrong with a British-type healthcare plan, in which the doctors are salaried government employees? Most people would LOVE to get a government job, they pay well and have better benefits than the private sector. It would be simpler and more direct than single payor medical reimbursement.
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And why don't we just regulate the living crap out of Big Pharma? They richly deserve it!-
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fjgalt4 months, 4 weeks ago
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A British parliament member warns us:
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Americans! Don't copy the British healthcare system!
http://blogs.telegraph.co.uk/news/danielhannan/940...
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greenmac4 months, 4 weeks ago
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This is from an aricle I have posted
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""If there's a blue pill and a red pill and the blue pill is half the price of the red pill and works just as well, why not pay half price for the thing that's going to make you well?" he asked, before providing part of the answer. "The system right now doesn't incentivise that."
American doctors tend to prescribe the expensive pill because they are paid more to do so. They may also be over-inclined to remove tonsils, as the President highlighted, because "the doctor may look at the reimbursement system and say to himself, 'You know what, I make a lot more money if I take this kid's tonsils out'."
As a consequence, costs have soared into the realms of fantasy: a sixth of the US economy, $2.4 trillion (£1.45 trillion), was spent on health last year. -
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