What is single payer healthcare? (Page 2)

right, but a great part of the cost of care is the convoluted system we have right now.  in THEORY, single payor is motivated to get best rates, and costs of managing the system is significantly lower for the healthcare providers.  the whole system is a mess.  have you every tried to price an MRI?  they (medical imaging offices) can't do it.  it's a joke.  even with a school loan i can shop around for a competitive price!

Originally posted by purestone I was too lazy to read this whole thread but do you mean like what we have (or you think we have) in Canada? I must say that without "having a dog in the fight" as they say our house has talked about the American system and we really don't get it. We have come to the conclusion for us it is just a completely different mind set. I was raised in NZ and Canada both and we (meaning me and my friends and family) just have a core fundamental believe that everyone in our country should be treated equally in the system and it is a right not a privilege to get adequate health care. You can argue that "some" will milk the system because of bad health choices. But I can also say that all my family both sides have lived healthy, active, productive lives. I still spent 2 years as a teenager almost dying from something unpreventable, my husband lost is first wife to cancer, my husband has a hereditary heart problem. If you had to pay for even my time in the hospital 30 years ago we will still be paying if we didn't have insurance. That scares me. Whew there is my 1 cents worth

The fundamental difference is between a "right" and a "service". Health care is a service. Speech is a right, religion, bearing arms, equal protection... those are fundamental rights. Health insurance, and health care are services provided by a entity. You can't "force" a entity to provide it.

In the US, you would not still be paying for your treatment, it would have been written off long ago. That's what it is here. Nothing "cost" a figure, and people are charged. Non pays, indigent, and uninsured are all rolled into those that do pay. Yes, we are all already paying for that with the premiums we already pay.

The problem that we have today is not enough government, it is too much. Government coupled health care with employment, government took us away from simple customer/provider system and gave us a insurance company/doctor system. They have been "breaking" the system for 40 years with "single payer" being the only logical conclusion. The fact remains, the government is a very very poor cost effective service provider. Way to bloated, too much waste and too much abuse.

The only two thing we need in this country is a law decoupling work and insurance, and a law saying you can't be denied for preexisting. People should be able to shop for health care insurance and care like auto insurance or any other service. Those that provide the best service at the best cost will win. Health care providers could easily startup their own system of free health care clinics... because it would be cheaper than full ER rooms... yes it would have to be a cost rolled into service born by the consumer... but every cost in this country ultimately is born by the consumer. And every cost in this country is ultimately born my the tax payer. Given the choice, I would much rather pay a cost over a tax, and fund a bloated inefficient wasteful system. The Federal government has time and time again proven they can not provide a service as good, as cheap, and as efficiently as private sector. Period.

Unfortunately even those who don't have insurance don't really know the cost.  Except for a few communities (like the Amish) who self-insure, most uninsured people use care anyway at public hospitals who can't deny them care, and then ignore the bills.  Hospitals and physicians write off millions of bad debt each year. 

OK, I'm going to have a little fun with this, but I'm trying to point out the flaw with this argument.  You can make the exact same argument with any service that anybody provides.

Chances are as a lawyer your expertise were not only gained by your own ambition and talents but also through a public schooling system that uses tax money. Tax money that I paid in to help your government backed student loans. Tax money that went to the University to help build the learning facilities. Tax money that went to do the research so that you can understand and defend my case. So since I helped pay for your education and knowledge to a certain degree then yes your expertise and investment made to yourself is owed to me. It's part of a society; we ask some people to be lawyers so they can take care of us when we are in trouble. Some people make cars, some people clean toilets. So yes, legal defense is a right and not a privilege.

Chances are as a plumber your expertise were not only gained by your own ambition and talents but also through a public schooling system that uses tax money. Tax money that I paid in to help your government backed student loans. Tax money that went to the University to help build the learning facilities. Tax money that went to do the research so that you can understand and fix my toilet. So since I helped pay for your education and knowledge to a certain degree then yes your expertise and investment made to yourself is owed to me. It's part of a society; we ask some people to be plumbers so they can take care of our house when it has trouble. Some people make cars, some people treat patients. So yes, legal defense is a right and not a privilege.

**edit

ok, on second thought the lawyer is probably a bad example because you do have a right to an attorney, lol.  But I think you get the idea.  

Then you will be very happy when you move to Russia. That is not an insult or a dig. If you want to live under a communist form of government, then move to a country that has one. This isn't one of them. This is a representitive republic, where the individual has rights. And owning your work is one of them. As for all the great stuff taxes pay for... that doctor is going to pay much much more than most of his clients. It all works out.

Ah, yes.  "You didn't build that."   I know this argument.  :^)   ( I keed, I keed!)

I couldn't disagree more with your point.  

The lawyer example wasn't a good example because we have a right to an attorney as part of our right to a fair trial.  The Supreme court ruled that everyone has this right and in the event that an individual cannot afford an attorney the state must provide an attorney. (public defender)

In the case of a defense attorney you do have a constitutional right to have one and the government provides one, but the government pays the attorney to represent you.  This has nothing to do with the government educating the attorney so therefore you have the right to use his services.

Do you really want this though?  Often when people describe equal coverage they think of everyone having access to the excellent care they are currently receiving.  However, equal care doesn't equate into giving everyone excellent care it means giving everyone "equal" care so your care will not be at the same level you're accustomed to today.

Don't get me wrong, I am all for everyone having access to healthcare and I'm the first to say that our old system was jacked up.  However, there are much better solutions out there to fix the problem vs. just throwing our hands up and accepting a base "equal" healthcare for all with a single payer system.

lol, I'd say we're pretty close.  

To look at the "fix" for the old healthcare issue you first have to look at what the problem is.  The problem is that healthcare costs were increasing at a rate far greater than the cost of living.  Insurance rates as a result were increasing at a rapid rate to keep up.  There are many drivers to the increase in healthcare costs, but the primary one IMHO was similar to what we were discussing above about demand control.  With HMO's and low copay type insurance programs provided by employers the actual users of healthcare weren't feeling the appropriate level of pain when it came to paying the costs.  So the demand for the service has remained very high.  The Medical facilities continue to raise their rates higher and higher to reduce the demand.  However, the consumer doesn't really see these increases because their insurance maybe went up $50/mo. or their copay increased by $5.  Their company may even absorb the increase in premium, so there's just no real reduction in demand so the prices keep shooting through the roof.

The net result is the individuals who aren't fortunate enough to have a job that provides insurance cannot afford to just go to a doctor due to the inflated prices.  They also cannot afford to buy insurance by themselves because the rates are very high due to the overall cost of healthcare services.

So the ACA only looked at two things.  They saw people without insurance so the solution is obviously to create something that just gives people insurance. So, they created a law that's intent was to do just that, but unfortunately that's it only addresses a symptom of the problem and not the actual source.  The addition of millions of new people with insurance will do nothing more than drive healthcare costs even higher because the supply is still the same.  When these costs go up and up the insurance will go up and up and even with all of the subsidies and exchanges the insurance will be even less affordable for everyone.  So, billions (or trillions) of dollars down the tubes and the exact same problem of tens of millions of people without healthcare coverage.

I agree with you that the Republicans haven't come up with a compelling alternative to the ACA and the approach of just bashing the ACA is not a winning strategy.  I personally feel we need to address the source of the problem and stop trying to fix the symptoms.

1) Get healthcare out of businesses and remove the tax credit for employers.  The actual consumers of healthcare need to write the check every month for healthcare so they feel the true costs.

2) get rid of PPO and HMO type plans so that individuals have to pay a certain amount of their coverage out of pocket every year.  If I'm cutting a check for $200 to go to the doctor I'm more likely to go when I need to vs. a $20 copay where I go for every sniffle.

3) mandate everyone have a base level of coverage such as a catastrophic insurance plan with a $25k deductible or something like that.  This will at the least prevent people who are otherwise healthy from running up $500k in medical debt if they are unfortunate enough to contract something.  This type of insurance should be very cheap and if you're at a certain income level it can be subsidized by the govt.

4) remove stupid state wide boundary's for insurance companies.  Let people shop around for insurance.  If I only have 2 options in my state then prices are naturally going to be higher.

I like to compare the tuwood plan to automobile insurance.  We mandate that everyone who drives has to have liability insurance on their car.  Everyone has the option to buy fancy plans with full coverage and zero deductibles, but they don't have to if they don't want to.  I can go to probably 100 companies nationwide and shop around for car insurance and when I get a chip in my windshield I make the decision to just pay to have it replaced because I don't want it to effect my rates.  I also drive carefully because I don't want my insurance to go up.  I feel the pain on the demand side, so I keep my demand for car insurance VERY low.

As for poor people, there are currently programs that offer healthcare insurance for them (prior to ACA) but I'm not horribly opposed to doing a hybrid type approach like you mentioned with government provided clinics in high need areas.  If you show you're on welfare or whatever, then you can get free healthcare.  It sounds kind of silly, but I would almost bet it would have been a ton cheaper than ACA to put free single payer clinics in every major city and leave everything else alone.

Either way, we need a balanced approach that addresses the cause of the high healthcare costs.  There are other things affecting the costs as well that can be addressed through tort reform and sensible regulations, but I'm just starting with what I see as the heavy hitter.

tuwood for president.

I like the majority of what you are saying, I think your 25k deductible thing is a bit crazy though. If you are making 30k a year......

What about an amendment to the tuwood plan where certain procedures, lets say thing like chemo, or open heart surgery etc. are covered, with no deductible. This kind of happen a bit anyways if someone who can't pay has a heart attack and gets taken to the hospital.

lol, my thought on the $25k type deductible wasn't about the ability of people to pay for it because even somebody making $100k would likely have a tough time paying a $25k deductible.  I was more thinking about mandating a low cost catastrophic insurance that caps the amount of debt people would go into in the event of a catastrophic medical event.  No matter how much or little anyone makes, a $25k debt to work on is a lot easier to deal with than a $500k debt.

I think there's plenty of room for alternative plans though as well.  The marketplace would likely offer plans such as you mentioned, so the minimum required would be something like I mentioned, for say $50/mo and then offer a catastrophic cancer plan with 0 deductible for cancer treatment for $75/mo or something like that.

Because we are people, and people deserve to have their ailments treated.

A rainy day fund is good for a broken arm or a cavity. It doesn't cover cancer treatments, MRI's, Catscans, major surgeries. As mentioned before, healthcare costs have surpassed an individual's ability to pay for them.

Would you say that because we all deserve to have our ailments treated that we should ALL pitch in and help pay for it?  

Currently we have 50% of the country paying 100% of the Federal taxes, so if we went to a full single payer system and maintained the same tax structure we'd have 50% of the country paying for 100% of the healthcare.

I know i've said it several times, but the countries that have single payer systems tax all of their citizens, so if we do decide to move forward with a single payer system as a nation we will have to drastically alter how we tax our poor at the Federal level.

congratulations to ALL...we made it waaaay past x5 responses.

AND, have one of the best exchanges of ideas EVER on COJP.

I 'heart' you people. 

You also have the right not to use the attorney and to represent yourself.

But not with Obamacare... you will be fined for doing so.