Don't you dread single payer?

[MagickMan]

I don't really want a doctor motivated by profit, do you?

Ah yes, altruism. They should all work because they love smelly feet and (literally) looking at assholes all day. While most do like helping people, they also like making hefty paychecks, and given what they have to go through for their education and training, not to mention the interminable hours as residents, they deserve it.

 

[Timorous]

Surely a relatively simple solution would be to allow the health insurance companies to cover anybody in the USA. Change it slightly so you do not have to go to an in coverage hospital and such.

I would expect after a few years there would be a small group of large companies and as long as the regulators are making sure they are not price fixing the fact that these companies can A) spread the risk more and B) buy in larger numbers to get bigger discounts should mean that premiums come down in price.

Doing that avoids a single payer system a lot of Americans do not want and it also reduces the amount you pay for your healthcare (provided regulators do their jobs and stop price fixing).

 

[AViking]

it will be retrograde. it will be institutionalized medical mediocrity. It's failing in Canada / the UK / Europe. It's evaluated against fantasy rather then reality.

You can't just make up your own reality.

It's doing just fine. It's doing better than the US. If you want to look at the figures such as cost, life expectancy, infant mortality, household bankruptcy, emergency room waiting times, etc then the US is doing rather poorly.

I think there is room for improvement but it's definitely better than the US. Not in every situation but overall. When it comes to emergency care it absolutely dominates the US which I think is pretty important. Where I am not sure is when it comes to experimental drugs and treatment for something like a cancer patient. I know it's pretty amazing in the US but I have no experience with it in Europe so I am curious.

 

[AViking]

Might be worth the time for everyone here to look up the profits for your insurance company. Pay special attention to the salaries and % change of their top executives and their bottom line.

 

[Anarchist420]

Might be worth the time for everyone here to look up the profits for your insurance company. Pay special attention to the salaries and % change of their top executives and their bottom line.

Insurance has always been super-regulated and would not be what it is without the State.

Ah yes, altruism. They should all work because they love smelly feet and (literally) looking at assholes all day. While most do like helping people, they also like making hefty paychecks, and given what they have to go through for their education and training, not to mention the interminable hours as residents, they deserve it.

I agree plus the fact that there is no choice and no incentive to do better under a single payer system.

If I don't like having to see a psychiatrist every time i need a prescription now then i think that even more monopolization would absolutely destroy real productivity and the quality of life. I realize that i can't be productive overall but what the hell am i going to do?

if single payer comes here then the govt needs to legalize physician assisted suicide for whoever wants it because the civilian gun use will also be banned and no one will enjoy life.

 

[WhipperSnapper]

And, you don't think for a moment that the $300k in student loans is a result of knowing that these schools can extract that kind of money from people who want to be doctors? Huge supply of people wanting to become doctors - limited number of openings in the school (as set by the AMA); supply & demand?

We're gonna have to change the way that we train doctors in this country. Allow people to get undergraduate-MD's. Let the first year be a study of basic science and then let the next 4 years be the regular medical school--boom--3 years of unneeded general education removed from the equation.

As with everything else, we should probably study how other nations with successful health care systems train their doctors.

 

[WhipperSnapper]

it will be retrograde. it will be institutionalized medical mediocrity. It's failing in Canada / the UK / Europe. It's evaluated against fantasy rather then reality.

...and if those nations spent 17.6% of their GDP like the U.S. does instead of 12% and under, would their systems still be "failing"?

 

[WhipperSnapper]

However, for Liberals/progressives single payer does have the attraction of killing off billions in market cap value (HI companies disappear etc) and converting even more people to govt workers (former HI employees who'll then work for the govt processing payments etc) thus making our govt even larger etc. Yeah, single payer is freakin awesome.

The goal is not to convert health insurance company employees into government employees. The goal is to reduce the number of non-doctors and non-nurses that are needed to make the health care system function.

Say what you will, but the numbers and facts speak for themselves.

U.S. System:

• 17.6% of GDP
• Tens of millions of Americans uninsured/underinsured
• Hundreds of thousands of medical cost-induced bankruptcies
• Terrified populace (lose your job, lose your health care)
• Economy and business environment burdened by health insurance concerns.

Other First World Nations:

• Much less than 17.6% of GDP spent on health care.
• 100% coverage
• Zero medical cost-induced bankruptcies
• A more contented populace
• Economy and business environment not burdened by health insurance concerns

Is it possible that nations with single payer systems waste fewer resources on advertising and paper pushers that don't actually provide any health care?

 

[WhipperSnapper]

Ah yes, altruism. They should all work because they love smelly feet and (literally) looking at assholes all day. While most do like helping people, they also like making hefty paychecks, and given what they have to go through for their education and training, not to mention the interminable hours as residents, they deserve it.

...But note that the job market for MD's is protected by limits placed on MD production. About 50% of everyone who would like to become an MD (and who is more or less qualified to become one) does not gain access to medical school. Thus, MD's are currently paid above what they would get in a real free market.

Also, keep in mind that while they are paid well they also receive other forms of compensation--job security, career security, social status.

Don't put these doctors on such a high pedestal; they're not amazing human beings. They're not ubermenschen. To hear some free market dogmatists tell it, the only yucky jobs are MD jobs. Do you think that other jobs don't have yucky, miserable elements equivalent to smelly feet and examining assholes?

I once toured a sugar processing plant where burning lime dust caked the floors and the air and those employees were getting $15/hour. I also saw a facility where people wrapped thermal cloth around exhaust pipes that were so hot they glowed orange. Do you really believe that the only jobs with miserable and unpleasant elements are MD jobs? Have you ever worked a real job before?

Another common myth in these types of discussions is that MD's deserve huge incomes because they have tons of education. However, a great many people have tons of education and end up unemployed or under-employed-out-of-field, including those with PhD's in the hard sciences.

 

[Anarchist420]

...and if those nations spent 17.6% of their GDP like the U.S. does instead of 12% and under, would their systems still be "failing"?

50 or so years ago, Milton Friedman said something like 90% of all hospitals were govt funded which means they have regs on them so i dont find it to be an apples-apples comparison.

 

[yllus]

Why wouldn't there be improved access to care? The only people who struggle getting health care in Canada are the homeless that can't manage to keep a health card on their person. If they literally have that one card and nothing else, they can get treatment as fine as what I can get.

We do however have a significant number of doctors leave Canada for the U.S. (read: higher wages) and I wonder what the effect of this would be. Of course, you could also arguably interpret that as U.S. overpaying for medicine at all levels...

 

[dank69]

Ah yes, altruism. They should all work because they love smelly feet and (literally) looking at assholes all day. While most do like helping people, they also like making hefty paychecks, and given what they have to go through for their education and training, not to mention the interminable hours as residents, they deserve it.

I guess, if altruism means I expect a doctor to want to do what's best for me instead of rushing through my appointment in order to make his tee time at the country club when I had to wait months for the appointment in the first place.

See, I'm not looking for doctors to work for free here. I just prefer doctors who hold the oath they take in higher regard than their paycheck. That doesn't mean the paycheck isn't a concern, it just shouldn't be the top concern.

 

[Londo_Jowo]

I expect in the near future it will take months rather than the current week or two to see a doctor/specialist in the US.

 

[AViking]

I expect in the near future it will take months rather than the current week or two to see a doctor/specialist in the US.

What are you basing this on?

 

[Londo_Jowo]

What are you basing this on?

Go look at the wait times in Canada for hip or knee replacement surgery, approximately 6 months. I've had coworkers get either procedure done within 2-3 weeks of the doctor determining that the procedures were necessary.

 

[Juddog]

I expect in the near future it will take months rather than the current week or two to see a doctor/specialist in the US.

If this means families not going bankrupt because of healthcare, and millions of dollars being drained in taxpayer revenue from the uninsured showing up in emergency rooms, then so be it.

 

[Juddog]

Go look at the wait times in Canada for hip or knee replacement surgery, approximately 6 months. I've had coworkers get either procedure done within 2-3 weeks of the doctor determining that the procedures were necessary.

How often do you need a hip or knee replacement again?

 

[Londo_Jowo]

If this means families not going bankrupt because of healthcare, and millions of dollars being drained in taxpayer revenue from the uninsured showing up in emergency rooms, then so be it.

Why would a family go bankrupt paying the same exact copay to see a doctor in two week vs two month?

 

[Londo_Jowo]

How often do you need a hip or knee replacement again?

When it gets to the point one is required you damn sure don't want to wait 6 months. Well, unless you want to eat hydrocodone by the handfulls while waiting.

 

[AViking]

This used to be one of my complaints with the Swedish system. At one point you might have had to wait 6 months to get a hearing aid if you were over 65. They had a priority system and since a 65 year old was retired they were not a priority. It's not like that anymore.

Now I can't speak on behalf of Canada but I have a friend who has had a number of hip replacements in Sweden and it doesn't take forever to get done.

I think you can easily pick a moment in time and find things like this. I could do the same thing with the US system. I had one of my crowns fall off and with an exposed nerve the soonest I could get a dentist to see me was 15 days later. What an outrage. Trust me it hurt but I don't think it's a very valid argument.

 

[Juddog]

When it gets to the point one is required you damn sure don't want to wait 6 months. Well, unless you want to eat hydrocodone by the handfulls while waiting.

Usually you know in advance if your knee is going bad. It's not like you just wake up one day and decide to replace your knee. I've waited 25 years to have more surgery done on my knee, because I know it's slowly going bad, but my health insurance doesn't cover it until it gets really bad and I can't afford to just have the surgery done regardless.

 

[Juddog]

Why would a family go bankrupt paying the same exact copay to see a doctor in two week vs two month?

If the family doesn't have insurance and gets stuck with a $50k medical bill, they will go bankrupt, versus waiting 6 months for the treatment and not having to go bankrupt - it's an easy decision to make.

Canada healthcare > USA
Sweden Healthcare > USA
.... etc

I can't believe people continue to defend the utterly crappy system we have in place.

 

[Genx87]

If it is done right it doesnt have to suck. And by that I mean a catastrophic system that makes sure if you have a catastrophic illness it wont wipe you out. But if we enact a system where co-pays are 15 bucks well then that will suck. Because it wont address any of the demand issues we have within the system because a 3rd party pays for our health care.

 

[dank69]

If it is done right it doesnt have to suck. And by that I mean a catastrophic system that makes sure if you have a catastrophic illness it wont wipe you out. But if we enact a system where co-pays are 15 bucks well then that will suck. Because it wont address any of the demand issues we have within the system because a 3rd party pays for our health care.

WTF is wrong with you characterizing the problem as a demand issue? Are you fucking serious with this shit? Do you have stats showing that reducing the amount of people going to the doctor unnecessarily will make any significant change to our current demand? If you don't, you have nothing supporting your position and we are free to characterize your position as "people just need to stop getting sick or hurt."

 

[nickbits]

If the family doesn't have insurance and gets stuck with a $50k medical bill, they will go bankrupt, versus waiting 6 months for the treatment and not having to go bankrupt - it's an easy decision to make.

Canada healthcare > USA
Sweden Healthcare > USA
.... etc

I can't believe people continue to defend the utterly crappy system we have in place.

FTFW:

"Poor/uninsured"
Canada healthcare > USA
Sweden Healthcare > USA

"Money/Insured"
USA > *