Universal Health Care in the US. Yea or Nea?

[applecorped]

Would you be for a Universal Health Care system in the U.S.?

One Opinion:

http://www.news-sentinel.com/apps/pbcs.dll/article?AID=/20090126/EDITORIAL/901260336

"The solution is a complete paradigm shift away from a profit- driven model in the health care sector to a single-payer system. The trail leading us to this solution has already been blazed, and America is ready to take the first step. Public opinion polls show upward of 68 percent of citizens support such a shift, while 51 percent of American physicians are in favor of implementation of a single-payer system."


Another opinion:

http://www.cato.org/pub_display.php?pub_id=8852

"A bad idea to improve quality is a government-run "pay for performance" system. In theory, it is an excellent idea. The government would figure out what sorts of processes and treatments are most effective, and it would pay bonuses to providers who use such best practices. In practice, as the United Kingdom has found, "P4P" is a system that is ripe for gaming, because it is political. Doctors in the UK were able to build in an "exception" system, where they could designate certain patients as requiring exceptions from best practices."

 

[Segnosaur]

Just out of curiosity, why are those the only 2 options? After all, there is a middle ground between an entirely privatized and a single-payer system. And why is your single-payer system considered 'non-profit'?

A couple of mid-way options are:

- Guaranteed coverage for all citizens (the 'universality') for basic services, but individuals would have the ability to purchase additional insurance (e.g. for certain specialized procedures, certain types of access, etc.)

- Continue with the 'single payer' system, but allow doctors, hospitals, clinics, etc. to be privately run (i.e. for profit). While it might possibly result in slightly higher fees (to pay for the profit), it will give the system more flexibility (i.e. no reliance on government to make decisions which are not in the best interests of the patient)

I also have to question the statement that "Public opinion polls show upward of 68 percent of citizens support such a shift (to a single-payer system)". Now, I don't necessarily doubt the results... I'm sure there are opinion polls that show a lot of people want government-run health care. But its quite easy to say you support some government program when you aren't told of the cost. I'd be curious about how the numbers would change if people were asked "Do you want a single-payer system, but to fund it we will rais your taxes".

 

[balrog666]

I essentially ask this every time this subject comes up ... there are 60,000 hospitals, specialty and general medical clinics and 3.3 million doctors, nurses, and technicians in the USA providing medical services, mostly at a profit to someone.

So, which hospitals, clinics, and laboratories will you close and which workers will you fire to reduce current costs? And which corporations will you stomp into the ground for providing these services at market rates?

And how do you think this will *IMPROVE* the delivery of medical services?
!

 

[ServiceSoon]

Just out of curiosity, why are those the only 2 options? After all, there is a middle ground between an entirely privatized and a single-payer system. And why is your single-payer system considered 'non-profit'?

A couple of mid-way options are:

- Guaranteed coverage for all citizens (the 'universality') for basic services, but individuals would have the ability to purchase additional insurance (e.g. for certain specialized procedures, certain types of access, etc.)

I think this will work about as well as "kind of being pregnant." If government health care exists, then everybody will flock to it because I assume it would be less expensive than the other options.

I essentially ask this every time this subject comes up ... there are 60,000 hospitals, specialty and general medical clinics and 3.3 million doctors, nurses, and technicians in the USA providing medical services, mostly at a profit to someone.

So, which hospitals, clinics, and laboratories will you close and which workers will you fire to reduce current costs? And which corporations will you stomp into the ground for providing these services at market rates?

And how do you think this will *IMPROVE* the delivery of medical services?
!

Don't be afraid of change. To answer your question, the decision will be based on which hospital, clinic, etc gives the most campaign contributions to the party that is currently in-power, duh!

 

[Blue Mountain]

Another model is used in parts of Europe: everyone is required by law to have health insurance. The government plan is simply one of many that people can choose to go with,

 

[kallsop]

Obamamamma is going to pass a law that makes it mandatory for you to have health insurance. Problem solved, double quick.

Hope 'n Change and Tax Cheat for Treasury Secretary.

 

[DC]

Another model is used in parts of Europe: everyone is required by law to have health insurance. The government plan is simply one of many that people can choose to go with,

In Switzerland, you are required to have health insurance.
in case you dont have enough money to pay it. you can ask for government to help. and they will in case you have indeed not enough money.

 

[Francesca R]

I essentially ask this every time this subject comes up ... there are 60,000 hospitals, specialty and general medical clinics and 3.3 million doctors, nurses, and technicians in the USA providing medical services, mostly at a profit to someone.

So, which hospitals, clinics, and laboratories will you close and which workers will you fire to reduce current costs? And which corporations will you stomp into the ground for providing these services at market rates?

And how do you think this will *IMPROVE* the delivery of medical services?

When you ask directions for the best way to get to <someplace> and you get the smart response "The best way is not to start from where you are", do you stay put?

 

[Rolfe]

I think I might start by firing the insurance companies. And firing everybody who is employed to work out to the last penny the exact bill for everyone who receives treatment.

This would no doubt be deeply unpopular with the insurance industry, and the health-care bean-counters. But it would free up a substantial chunk of money.

Rolfe.

 

[Segnosaur]

Guaranteed coverage for all citizens (the 'universality') for basic services, but individuals would have the ability to purchase additional insurance (e.g. for certain specialized procedures, certain types of access, etc.)

I think this will work about as well as "kind of being pregnant." If government health care exists, then everybody will flock to it because I assume it would be less expensive than the other options.

It might be less expensive to use the 'government' plan, but you might also have longer wait times for certain services, or certain procedures might not be covered. (It all depends on the details of whatever health care plan is worked out.)

For example, here in Canada, we have 'public' health care... supposedly, all services are taxpayer supported. However, one or 2 of the provinces (Quebec being one of them) had been allowing private MRI clinics to provide services to paying customers. Some people might want to wait for the 'public' services, others may be happy to pay extra to get their tests sooner. While it might be seen as 'queue-jumping' to allow people to pay at the private clinics, it does help bring extra money into the health care system, reduces the burden on the public system, and gives a certain amount of flexibility that would otherwise be lacking.

 

[kedo1981]

I’d like to see stats on Uni Health care and it's correlation to the current world wide financial crises

 

[ServiceSoon]

I’d like to see stats on Uni Health care and it's correlation to the current world wide financial crises

I think I like where you are going with this. Medicare/Medcaid is 21% of the Federal governments budget in 2007 and growing in 2008.

 

[ZirconBlue]

I've completely reversed my opinion on this topic over the last ~5 years. Being of a somewhat libertarian bent, I am opposed to the idea in principle. But while single-payer systems have their own set of problems, what I've learned about the systems in Canada and several European countries has lead me to conclude that their systems are, if not perfect, much better overall than the mess we have here in the US.

 

[Ivor the Engineer]

From a consumer point of view it would be nice to have a healthcare system where physicians' interests are aligned with their patients' interests.

In any healthcare system where physicians have a personal financial incentive to instigate medical treatment this is not achievable.

 

[Francesca R]

From a consumer point of view it would be nice to have a healthcare system where physicians' interests are aligned with their patients' interests.

In any healthcare system where physicians have a personal financial incentive to instigate medical treatment this is not achievable.

How is it achieveable in any system? I don't see how interests can ever be totally aligned unless the physician and patient are close blood relatives which arguably violates medical ethics.

 

[ponderingturtle]

Another model is used in parts of Europe: everyone is required by law to have health insurance. The government plan is simply one of many that people can choose to go with,

Well there are actualy many systems. One part of some systems is that private companies can not make a proffit on their basic level of insurance, the one that is mandated for people to have.

 

[Ivor the Engineer]

How is it achieveable in any system? I don't see how interests can ever be totally aligned unless the physician and patient are close blood relatives which arguably violates medical ethics.

I agree. I would suggest anyone who wants to try though to not throw a spanner in the works at the very start by giving physicians a personal financial incentive to provide treatment to any particular individual.

 

[Francesca R]

What is so special about medicine? And if you give them no financial incentive then they have an incentive to provide as little treatment as they can get away with (this is not to say what their response to this incentive will be, but it will be there)

A lawyer has a personal financial incentive to give unnecessary legal services to a client (that would invite future legal services perhaps)

A used car salesman has a personal financial incentive to sell "lemon" used cars to customers (and given this, the only cars for sale will be lemons)

An individual has a personal financial incentive to lie about their health to get cheaper insurance (and given this, voluntary health insurance schemes will be priced so high that they only attract unhealthy people)

Assymmetric information and adverse selection can't be done away with.

 

[Ivor the Engineer]

What is so special about medicine?

Most people cannot debate with a physician about the pros and cons of one treatment vs. another vs. no treatment.

And if you give them no financial incentive then they have an incentive to provide as little treatment as they can get away with (this is not to say what their response to this incentive will be, but it will be there)

Financial incentives can still be used, they just have to be related to health outcomes, not treatment of individuals.

 

[Francesca R]

Most people cannot debate with a physician about the pros and cons of one treatment vs. another vs. no treatment.

It can be the same with your lawyer, plumber, fund manager, insurance salesperson, [ . . . ] Bad advice and service can be ruinous in all of these.

Financial incentives can still be used, they just have to be related to health outcomes, not treatment of individuals.

Do you have any idea why this isn't used? Anywhere?

(*Imagines "No Cure? No Fee!" billboards*)