single-payer system ... singled out

[Oliver]

So apparently the single-payer healthcare system doesn't get any attention in high level talks about the future of healthcare in the US. Obama [despite being for single-payer for years] said something along the line that it wouldn't work because of the mixed and historical system in the US.

Moyers recently reported that single-payer is willlingly ignored due to the powerful insurance lobbies and all the money they spend on Politicians. So is there still a chance that the issue will gain some momentum before a Bill will be ready till August?

 

[balrog666]

How would you coerce all doctors, nurses, technicians, administrators, clinics, hospitals, et al to go to work for the government? At Medicare pay rates?

 

[Random]

Single-payer is not socialized medicine like they have in the UK, single-payer is basically just the government acting as a single giant insurance company like in Canada. Doctors, nurses, etc, are still private employees, just the payments they receive are through a government-run insurance program.

A lot of doctors like it because they only have to deal with one insurance provider with predictable behavior and one set of paperwork, as opposed to the tens of thousands of private insurance companies we have now.

Single-payer systems are also able to provide identical services to private insurance companies, but much more efficiently as they do not have to worry about making a profit and can offer their services at cost.

HMOs in the US want to stay in business so they fight against single-payer tooth and nail. There is also talk of a “public option” in the current debate, which would basically be an opt-in government run insurance program. HMOs know that this program will be much better than what they can provide and will drive them out of business within ten years, so they are pulling out all the stops to make sure it is crushed.

All you have to remember to understand the debate is three things.

1- HMOs are a bad deal
2- The people who run HMOs know this
3- The people who run HMOs have lots of money and lobbyists

 

[Ziggurat]

Oliver, why are you so obsessed with US domestic issues? Seriously, isn't there anything going on in Germany right now?

 

[Ziggurat]

Single-payer is not socialized medicine like they have in the UK, single-payer is basically just the government acting as a single giant insurance company like in Canada.

So it's a different flavor of socialized medicine.

All you have to remember to understand the debate is three things.

1- HMOs are a bad deal
2- The people who run HMOs know this
3- The people who run HMOs have lots of money and lobbyists

Never mind that plenty of Canadian citizens are extremely unsatisfied with their system. Nope, that isn't part of the debate at all. Just ignore it. I said, stop looking at what Canada's system actually produces! It's not part of the debate, damnit!

 

[Robster FCD]

Never mind that plenty of Canadian citizens are extremely unsatisfied with their system. Nope, that isn't part of the debate at all. Just ignore it. I said, stop looking at what Canada's system actually produces! It's not part of the debate, damnit!

Canada still is rated as having better health care than the US. But why focus on Canada when we can look at lots of other nations with socialized medicine and are rated better than both the US and Canada?

 

[Ziggurat]

Canada still is rated as having better health care than the US.

That depends upon the metric one uses. Which there isn't universal agreement about. In fact, even with a given metric it's not a simple matter to compare. I know, for example, that the way the US counts infant mortality is different from many other nations (many very early premies who die shortly after birth get categorized as miscarriages elsewhere), which inflates our numbers relative to nations which count them differently. So even if one agreed to a metric, if the methods of measurement aren't the same (and they often aren't) then results aren't really comparable.

But why focus on Canada

Ask Random.

 

[Cleon]

Never mind that plenty of Canadian citizens are extremely unsatisfied with their system. Nope, that isn't part of the debate at all. Just ignore it. I said, stop looking at what Canada's system actually produces! It's not part of the debate, damnit!

This is such a non-argument. Every health care system has horror stories and leaves some people unsatisfied and pissed off. Every single one. Public, private, single-payer, multi-payer.

 

[Ziggurat]

This is such a non-argument.

You are correct, it is not an argument. It is a reference to an argument. Funny thing, though: Random's post didn't seem to elicit any criticism from you for its shortcomings. Not only is there a paucity of actual argument in Random's post, but it is in fact an attempt to deny any argument on the topic. Which, really, was the point of my post.

 

[Random]

Never mind that plenty of Canadian citizens are extremely unsatisfied with their system. Nope, that isn't part of the debate at all. Just ignore it. I said, stop looking at what Canada's system actually produces! It's not part of the debate, damnit!

You want to have that debate? Terrific! I would love to see our politicians have a discussion where the Canadian and American healthcare systems are put side by side and make a comparison of both. That would be fantastic!

The HMO industry is strangely reluctant to have this discussion however. I wonder why?

Single-payer has its problems, but the American system is appalling and will not improve on its own. Is the US, we have a layer of individuals and companies that actually benefit from you not getting needed medical care. The HMOs will deny claims, pick and chose customers, cancel policies, etc. Whatever will make them money. That is built into the very foundation of the US system and cannot be taken out piecemeal.

Americans are getting mediocre medical care and are paying through the nose it.

 

[Cleon]

You are correct, it is not an argument. It is a reference to an argument.

Apparently it's a reference to an argument nobody has made. I fail to see anyone claim that Canada's system is devoid of fault, or an appeal to its popularity in Canada.

Funny thing, though: Random's post didn't seem to elicit any criticism from you for its shortcomings.

The only "shortcoming" I saw was the focus on HMOs, rather than the health insurance industry in general. Other than that, it seemed fairly accurate.

Not only is there a paucity of actual argument in Random's post, but it is in fact an attempt to deny any argument on the topic.

Doesn't really seem that way to me. At all.

Which, really, was the point of my post.

In that case, Fail.

 

[Ziggurat]

Apparently it's a reference to an argument nobody has made. I fail to see anyone claim that Canada's system is devoid of fault, or an appeal to its popularity in Canada.

Let me quote from Random again:

"All you have to remember to understand the debate is three things.

1- HMOs are a bad deal
2- The people who run HMOs know this
3- The people who run HMOs have lots of money and lobbyists"

In other words, anything else is irrelevant. Whether or not a Canadian system (which he advocates) has problems is off the table entirely, according to Random. I am not claiming that Random said Canada's system is faultless. I'm saying the faults that it has are relevant to the debate, and should be understood, even though they are not on his list of things that should be understood. Random is trying to close the debate off from any other topic. You either don't understand that this is what he's doing, or you don't object to doing so.

In that case, Fail.

Yes, you did indeed fail to understand my point.

 

[Cleon]

Let me quote from Random again:

"All you have to remember to understand the debate is three things.

1- HMOs are a bad deal
2- The people who run HMOs know this
3- The people who run HMOs have lots of money and lobbyists"

In other words, anything else is irrelevant. Whether or not a Canadian system (which he advocates) has problems is off the table entirely, according to Random. I am not claiming that Random said Canada's system is faultless. I'm saying the faults that it has are relevant to the debate, and should be understood, even though they are not on his list of things that should be understood. Random is trying to close the debate off from any other topic. You either don't understand that this is what he's doing, or you don't object to doing so.

Your assessment appears to be incorrect, based on the following:

You want to have that debate? Terrific!

You're overreaching. Big time.

Yes, you did indeed fail to understand my point.

The failure lies in the fact that you don't really have one.

 

[Ziggurat]

The HMO industry is strangely reluctant to have this discussion however. I wonder why?

How do you define and measure the reluctance of such a broad group to discussing a particular topic, and how do you judge whether any resulting reluctance is strange? This is far too vague a claim to be even moderately useful. So why did you make it when there's no way you can actually support it? Perhaps because for the same reason that it is unsupportable, it is also unrefutable. It is, essentially, an appeal to emotion (those big bad evil plotting HMO's! How could anyone side with them?).

Single-payer has its problems, but the American system is appalling and will not improve on its own.

Many Canadians say the same thing about their own system.

Is the US, we have a layer of individuals and companies that actually benefit from you not getting needed medical care.

That happens in Canada too. It's just bureaucrats and politicians who benefit.

The HMOs will deny claims, pick and chose customers, cancel policies, etc. Whatever will make them money. That is built into the very foundation of the US system and cannot be taken out piecemeal.

They also compete for customers, meaning they have pressures to extend coverage, provide services, and respond to demands. And those pressures are excluded from the Canadian system, and cannot be inserted piecemeal.

Americans are getting mediocre medical care and are paying through the nose it.

And Canadians are getting lousy coverage, and paying moderately for it. Why we should necessarily prefer the Canadian system to our own is not actually obvious.

 

[Ziggurat]

This appears to be incorrect.

Random's response was, rather predictably, entirely centered around HMO's. So no, I don't think my initial assessment was incorrect.

 

[Random]

And Canadians are getting lousy coverage, and paying moderately for it. Why we should necessarily prefer the Canadian system to our own is not actually obvious.

You know something, you’re right. Maybe I am focusing too much on rhetoric and not enough on actual facts. How about this?

We take some countries with relatively similar standards of living that handle healthcare differently, say Canada, Germany, The UK and the US. You can pick any objective standard or standards of medical care that you like (life expectancy, doctor visits, average wait times, whatever) and then we will look up the numbers for each country, and look at cost per capita and see where the best deal is.

 

[Rolfe]

It so happened that a lady from Canada was sharing my office for a week last month, while she was on work experience. There was another thread about this at the time, so I asked her for her opinion of the Canadian health system.

She launched into very eloquent praise. She insisted that the standard of service was very good, but pointed out that priority was given to clinical urgency, not to ability to pay extra, so people with minor, non-urgent conditions might well wait for a while. Urgent cases, though, would be treated urgently. She volunteered that if ever she was in the USA and fell ill, she'd want to get back to Canada ASAP, and indeed said that the healthcare system in the USA was one of the reasons she'd chosen to study in Scotland rather than the USA when she decided to go abroad. She backed up her opinion with many personal anecdotes.

I remember at the same time reference was made here to a couple of video presentations which attempted to rubbish both the NHS and the Canadian systems, apparently for US-related political reasons. On examining the details of those presentations, I immediately knew that what was being said about the NHS was untrue, and I could tell that what was being claimed about the Canadian system was not actually substantiated by the material presented (for example, a woman with a very very chronic and slowly-progressing hormonal condition was presented as having a "brain tumour" which had to be operated on immediately to save her life - anyone with any medical knowledge would realise in an instant this was a pack of lies, but then most viewers don't have such knowledge).

So forgive me, but I'm not entirely buying it as fact when I hear Americans who oppose universal healthcare declare that the Canadian system is poor. It's quite true, you can find individual horror stories from absolutely any healthcare system you care to mention. What surprised me about the video presentations was that the makers had apparently not found any while they were searching for material, and had had to resort to fabrications instead. Nevertheless, there are always individuals who have been badly served by any healthcare system, and they often go to the press, so they're not hard to find. Argument by individual horror story makes a poor case.

I have, however, noticed a systematic difference between the horror stories coming out of the USA and those coming out of countries with universal healthcare. The latter almost invariably deal with people who for some reason have not received what they should have received - what they were entitled to. The former almost invariably deal with people who were not entitled to any healthcare, even though they needed it.

I know which country I'd rather be in.

Rolfe.

 

[KoihimeNakamura]

Ah, healthcare in the USA. The joys of having to put off care due to not being able to pay the doctor, yes siree, our system works well.

 

[Doc Daneeka]

Anecdotal, I admit:

I've lived in both Canada and the USA, and have experience as a patient in both countries. I'll take the Canadian system any day. It's very far from perfect, but at least I won't have to worry about being forced into bankruptcy after a car accident.

It's all well and good to point out that many Canadians are worried about our healthcare system. Which nation's citizens don't take issue with their system? Please consider this: public support is strong enough that no political party here would dare to openly advocate switching to the US model. That would be suicidal in a general election.

 

[Robster FCD]

HMOs and insurance as a whole is a casino system.

I bet the house $$$ every month that I'll get sick this month. If I do, I win some of my money back. Based on my age, sex, a few metrics, they run the odds and determine how much money I need to pay them before they will take the bet. They know the odds, and across the population, they will win. They also can add max payouts for certain parts of the insurance game, including lifetime caps.

The house always wins.

Lets add in another detail. Where will the insurance industry save its money? Stocks. So when the stock market drops, they up their rates, but always more than they need to to break even. They are, after all, a business, and businesses need to make a profit, even if its just on paper. So we are making a bet with the insurance industry that we will get sick, and there is a vig (cost of buying in) that goes into their pockets.

Cut out the cost of buying the insurance industry's stocks, and cut out the need to make a profit, and health care becomes much more affordable for us all.

Many EU nations have a policy that insurance agencies cannot make a profit on basic health care plans (that are fairly comprehensive), which everybody has to buy (with subsidization offered for financial hardship), but can sell and make a profit on other plans that have lots of bells and whistles, including paying for a wide variety of sCAM therapies.

I like that system because it eliminates some of the big problems (profiteering, everyone is covered, caps), and if you are ignorant enough to want sCAM, I don't have to help you pay for it.