Why single payer would work despite protest claims

[Carmen813]

the USPS doesnt get tax money does it?

Both Fedex and UPS received money to help purchase their aircraft. Check out this article on the Civil Reserve Air Fleet.

 

[Hayabusa Rider]

To answer Hayabusa's question about my friend. I'm not sure of all the details. It was awhile ago and I didn't exactly grill the guy. I do know he had a son that had a lot of mental problems so I am guessing that the insurance company decided that he and his family had "costed them enough" if I was to wager a guess. There is another person I know in a similar circumstance. Friend in OK with MS who is having problems and fighting to retain his insurance in court right now. At least he is living long enough to do so.

There is a general misconception among people here, and it is that anyone who opposes this particular bill opposes reform. I refuse to be thrust into anyone's ideological pigeon hole and no apologies to them.

Let me state what I believe to be the facts as both a provider and recipient of health care.

First, the problem is that people come to the table with notions of "evil" this or that. From that position they then construct arguments to back their position ignoring the consequences thereof. Take IronWing. His support for a single payer system is unquestioned. It's his religion. "Single payer will fix it, I believe it, and that settles it."

There is way to rationally deal with someone with "health care religion". My overall perception of you is that you are more concerned with how people are treated than being a Democrat.

With that allowance I'm going to suggest that neither the government nor private industry is good for health care. They are institutions which have their own agenda. The first is the acquisition and retention of political power, and the second maximizing profits.

Does that make them evil? Well that depends on how you define it. Is the wolf evil for eating the sheep? I think not. It is what it is.

Therefore one must have an understanding of where we want to be as a society, and how to use those institutions rather than being used by them.

There is this belief that insurance companies should not make a profit. Would you like to go to work every day and not make enough money to cover your expenses and be unable to buy equipment and pay staff? You'd get out of that in a hurry and you should. No matter what you do, no one should ask you to be their servant when they themselves wouldn't tolerate it. Now we get to a moral argument about the execs should get paid. Frankly I think that most executives are overpaid, however let's look at how that practically affects the cost of things. Health care costs about 2.2 trillion dollars a year. The amount that the profit (no matter how it's distributed. Disconnect distaste of compensation from what actually costs what) isn't enough to significantly impact that amount if it were entirely eliminated.

Just what does the operating costs buy you, the consumer? It allows me to get your medications to you in a matter of minutes to hours instead of a day or more compared to Medicaid. When you have 2 people doing the work of 10, quality suffers. Quality costs money. The reason that there are so many people isn't because some big wig wants them. Labor is one of the few controllable costs, but because there is a freedom of choice people will move from one plan to another if they have to wait forever. It is also not that great an amount compared to the total amount that flows through the health care system.

The down side is that insurance companies do have to survive. They cannot force taxes on you so they have to earn their keep financially. That means that some people aren't going to get covered and that's ugly. Again, I doubt you would want to have to surrender your belongings because someone said you weren't entitled to them.

So we have an inherent problems with the system. We have what we think is due everyone, but we have to provide it in a real world way.

That leads to the supposition that government is the way to go. It can't fail because it can get whatever it needs by force of law. It can operate at a loss because no one can seize it's assets. It's in effect invulnerable. That's a strength that is also it's weakness. It can do anything it likes, and the more control it gets the less it needs you. Supposing that insurance company really sucks. Most people have options. Now what happens if there is one insurance company? Suppose that not only does it have all the control internally, but it can force others to do it's will?

That is government. It's a useful tool which was created in the case of the US to serve it's citizens, but I submit it has come to serve the parties that control it. That being the case, it doesn't need to deliver, but merely promise to do so. It typically chooses a top down approach to most everything, creating a reality which everyone else must conform. We serve it.

What ought to happen is that people should be business AND government neutral and have a clear understanding of what constitutes health care, how it functions, what can be done to enhance the provider/patient relationship and so on.

We need people who can say. "Hey, this looks good, but I've seen X happen when this is tried. Is there a potentially better solution?". "Hey, I see what you are getting at, but what happens to prevent Y as an adverse consequence?"

In other words we need people who know how to ask the right questions, and then go about finding viable solutions, with the goal of providing quality care. In that way we have better patient outcomes, a streamlining of unnecessary bureaucracy, and the best utilization of resources both private and public.

The need dictates the means. How we have gone about this is that the powers that be define the need as they wish and then make rules about how their need is met. Never mind that they really don't understand enough to formulate good policy. They define their policy as good, and that's it.

In other words, the goal may be good, but goals aren't results. GM executives certainly didn't want to lose their jobs, but they knew what was best, and what was best was what was right. In truth, a bunch of line workers who make and drive their cars and talk to others would have made better decisions, but power leads to hubris.

Instead of asking "How can we do things better" we have effectively declared "This is how you will make things work" without knowing what "things" are except in the broadest concepts.

I oppose this whole process for that reason. Not that I don't want more people covered, but I want the job done right. If you wonder why I don't automatically believe that government writing regs will do that I submit I've seen the bad from both government and private.

Forget WHO does it, concentrate on what is being done.

 

[nonlnear]

There is a general misconception among people here, and it is that anyone who opposes this particular bill opposes reform. I refuse to be thrust into anyone's ideological pigeon hole and no apologies to them.

That was part of the marketing ploy by the Democrats when they repeatedly called the bill "reform", instead of "our reform". The omission of a specific article was a very deliberate ploy to make people think that the bill(s) being pushed were the only reform options, and that anybody who opposed their ideas was in favor of the status quo.

It's a classic tactic used by both sides of the pig trough. I'm sure you know this, but it's important to point it out in public so that others can wake up to how political rhetoric is molded to shape our thinking. Once you see it it loses its power, so I try to point it out to as many people as I can.

 

[jstern01]

I
You do realize that Medicare has higher admin cots when viewed form the per even, per person basis? Medicare only looks better because it's handling elderly with very expensive procedures. Spreading out the admin cost for a $100K procedure vs one for $500 is what favors medicare - I.e., it's biased way to prevent the info.

Medicare also has a higher claim rejection rate. yet private HI companies are demonized.

BTW: Their CEO's, while making a lot money, aren't at the top of the scale. That gets exaggerated too.

Our real problem is the underlying costs of HC. We lack standards that other countries have, and our tort system (which they don't have) combines to create a pot-load of redundand and otherwise unnecessary procedures.

We also need to stop subsidizing those countries drug costs. I see no reason we should pay 100% and they get discounts.

Fern

Your do realize, that elderly cost more, thus the cost per event is higher, so you would have to normalize that, and you would see that in many areas Medicare is cheaper that Private HI.

I have yet to see any solid numbers on Medicare rejection rate higher than private HI. Everytime Congress has asked for the numbers from private HI, they balk at it.

As to tort reform. Last year malpractice resulted in $30B in lawsuits. US Total HI cost was an average of $8190/citizen or $2.45T dollars in 2009, so malpractice lawsuits make up about 1.2% of the cost of healthcare. Not much savings there.

 

[Hayabusa Rider]

As to tort reform. Last year malpractice resulted in $30B in lawsuits. US Total HI cost was an average of $8190/citizen or $2.45T dollars in 2009, so malpractice lawsuits make up about 1.2% of the cost of healthcare. Not much savings there.

Few have made the claim that lawsuits per se have been the issue, but to protect itself medicine has adopted a defensive posture in order to cover their ass, resulting in higher overall costs. To prevent Dewey, Cheatem and Howe from saying "But you could have ordered one more test" before a judge or jury, they'll order that one more test.

 

[HumblePie]

There is a general misconception among people here, and it is that anyone who opposes this particular bill opposes reform. I refuse to be thrust into anyone's ideological pigeon hole and no apologies to them.

Nope. Never claimed that of you. I was just using anecdote back as you used your anecdote to make your point. Your point being that government run healthcare = bad. My point that private run healthcare = bad.

Here's the thing. There will ALWAYS be bad. People will make stupid, fucked up decisions. People will be seriously harmed or die from those decisions. It will happen until the end of time. The best we can do is minimize this. It is of my opinion, and many others, that letting the private insurance industry make all the decisions up until now has not been very good for minimizing these "mistakes." While government run isn't perfect either, it so far has a better track record overall. That is the point I was trying to make. Sure there is room for improvement, but the difference is how changes can be done. There is only so much regulation that can be done for the previous system. It was failing.

I'm not going to say a government run one won't fail either. It can just as well as private. The difference is the people can force improvements into government run where they can't against corporate monopolies.