Single payer in California: can doctors still charge more?

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Grooveriding

Diamond Member
Dec 25, 2008
9,107
1,260
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I work in health care under a single payer system. You do not wait for care if you are presenting with an emergent case. I understand that is a common talking point used to scare monger about single payer and finding cases where there have been issues. I would simply point you to the studies done that show many nations with single payer care are delivering better care on a per capita basis while spending less money per person than the care provided in the US.

When you hear of one case here or there it's important to remember you are hearing about searched out instances of issues to push a narrative. No system is perfect. But looking at single cases is zooming in on one bad tree out of the entire forest. Zoom out to the forest at large and there are less bad trees in the single payer system than the for profit system. If you trust the data provided by the W.H.O. assessing health care systems around the world in 2000.

There are weaknesses, primarily in access to diagnostics, particularly MR, and less so CT. Still if a diagnostic is needed immediately, you'll get one. What you won't get is an MR done quickly on your forearm after possibly tearing a muscle playing tennis. Efficiency becomes more important and sensibly allocating diagnostic time. If you want a diagnostic rapidly for something that doesn't necessarily warrant it, you can pay out of pocket or with employer insurance at outpatient clinics.
 

boomerang

Lifer
Jun 19, 2000
18,890
642
126
The question posed by the OP resides in the 'cart before the horse' category. Legislators in CA know that tax revenue would have to be doubled to cover the cost of this program. They also know that it is going to be virtually impossible to juggle priorities around to make this happen.

Therefore, this is all political posturing. It falls into the wishing it was so category. When it becomes widely known that it is impossible to implement this it will be turned against the political enemies of the vocal supporters as fodder. In the meantime the chronically naive will believe it's actually going to happen.
 

boomerang

Lifer
Jun 19, 2000
18,890
642
126
There are weaknesses, primarily in access to diagnostics, particularly MR, and less so CT. Still if a diagnostic is needed immediately, you'll get one. What you won't get is an MR done quickly on your forearm after possibly tearing a muscle playing tennis. Efficiency becomes more important and sensibly allocating diagnostic time. If you want a diagnostic rapidly for something that doesn't necessarily warrant it, you can pay out of pocket or with employer insurance at outpatient clinics.
Proof that the left can rationalize anything.

It sucks, but it has to suck for... reasons.

Sign me up!!
 

brycejones

Lifer
Oct 18, 2005
25,992
23,792
136
Proof that the left can rationalize anything.

It sucks, but it has to suck for... reasons.

Sign me up!!

It sucks so bad that overall outcomes are better in those other countries.

Conservatives ignoring reality at any cost for decades now.
 

boomerang

Lifer
Jun 19, 2000
18,890
642
126
It sucks so bad that overall outcomes are better in those other countries.

Conservatives ignoring reality at any cost for decades now.
Move there if it's that important to you. Why keep bashing your head against the wall here when what you desire is so easily attainable. I'll give you a bit of advice before you buy the plane ticket. Research the real statistics instead of the bullshit you're fed by the media you so blindly follow. In other words make an informed decision. It may be arduous but the payoff could be huge.

Why are those that consider themselves to be the brightest of the bright so easily manipulated?

That's a rhetorical question. No need to answer.
 

brycejones

Lifer
Oct 18, 2005
25,992
23,792
136
Move there if it's that important to you. Why keep bashing your head against the wall here when what you desire is so easily attainable. I'll give you a bit of advice before you buy the plane ticket. Research the real statistics instead of the bullshit you're fed by the media you so blindly follow. In other words make an informed decision. It may be arduous but the payoff could be huge.

Why are those that consider themselves to be the brightest of the bright so easily manipulated?

That's a rhetorical question. No need to answer.

Oh boomer as if you have researched anything except vomiting up bs from right wing sites.
 
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JSt0rm

Lifer
Sep 5, 2000
27,399
3,947
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It was a long time ago, years, so it must have been a visually similar avatar.


tQDul0C.gif
 

Grooveriding

Diamond Member
Dec 25, 2008
9,107
1,260
126
@Grooveriding Is your system filled with lawyers and lawsuits?

We carry malpractice of course and there are certainly lawsuits. Not on the scale you see in the US though. My impression is that is a problem separate from medicine and endemic to a culture of lawsuits existing in all areas of life. I know from friends in medicine in the US that lawsuits are a significant concern.

Proof that the left can rationalize anything.

It sucks, but it has to suck for... reasons.

Sign me up!!

I never said it 'sucks', I said it's not perfect. But it's been measured objectively better than US healthcare. Which is not to say it's best in class omgamazingsquce, as most developed nations are the same in that they are under some degree of single payer and also provide a better standard of care per capita than Americans receive.

This is in no way a commentary on the quality of physicians in the US, as it is one on the underlying system and it's implementation being mediocre and inefficient. See: for profit, inflated costs, unnecessary care and lack of cost controls.
 

cfenton

Senior member
Jul 27, 2015
277
99
101
When shopping around for a service I'm always looking for a more expensive option.

Exactly. Why would you want to pay for a more expensive doctor? I could see paying for a nicer hospital room, or something like that, but most doctors know what they're doing. It's not like the 'cheap' doctors got their medical licenses from a cereal box.

Is it wrong for me to hope that those states that move towards single payer universal coverage also includes language that bars outsiders from other states from participating? Is wrong of me to not want to cover people who have no interest in covering those who have actively prohibited this nation from progressing who have voted for politicians who want government out of health care? Yes I know there are people in those states that are held hostage to the policies of others but my hope is that because they are barred from progress they will become more politically active and rid their state of the cancer that impedes them from progress.

Blue states already subsidize red states which I'm ok with except for the fact that they use their influence at the federal level to impede progress.

If California were the only state to implement single-payer, then it would have to work like this. Otherwise people from other states could just come to California for all of their medical care. Single-payer requires a tax base to fund it. I think it's a great trade-off, but everyone who can theoretically use the system has to pay for it through taxes. I imagine, if this were implemented, people from out of state would be sent a bill, just as they would be now. It would be up to them to make arrangements with their insurance company. opefully vote for a candidate that supports universal healthcare in the next election.

If other states implement single-payer, then it's just a matter of having a reciprocal agreement, like the provinces in Canada. Healthcare would be a state matter, but each state that had single-payer would agree to pay for their residents if they are injured in other single-payer states.

What happens if you are a resident of CA and travel/vacation to another state and need health/hospital services? Will the other states have to accept this insurance

My guess is that residents of California would have to get travel insurance if they want to be covered when they leave the state. Just like they would if they went to Mexico or Canada. It would suck for people who travel frequently, but they could get insurance policies like they have now.
 

echo4747

Golden Member
Jun 22, 2005
1,975
153
106
Health insurance always pays less then asking. Do you have health insurance?

Yes I do... I am pretty sure that the " less than asking has been negotiated and agreed upon fee schedule with the insurer and doctor,hospital,other health care provider
 
Nov 8, 2012
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So California's senate wants to go single payer where all healthcare would be free and state funded. Not sure I like that. What if you're working and earning well for yourself and can afford a more expensive doctor. Won't that doctor be allowed to charge extra anymore? Is California gonna pay for his higher fee?

Read this for context: http://www.motherjones.com/politics/2017/06/single-payer-california-brown-trump/

Pass laws first, ask questions on how to expense things later says the California voters.