As a healthcare finance professional I see a single gov’t payor system being a disaster. Issues as I see them.
– Medicare pays way under cost to providers and Hospitals. Medicaid is worse. Medicaid is by far the most difficult payor to deal with as far as billing and payment. If these two payors were to become 90% of the business then the US system as we know it will end.
- Private Insurance companies will slowly be put out of business. People are always going to choose the cheaper option which will be the gov’t program. The gov’t program does not need a profit to survive. If they need capital they will print money. Slowly it will become a complete socialized system.
- There will be no more growth or advances in technology. With a single payor system their will be no money for new capital. Technology such as PET tumor scanning will not be affordable to hospitals which in turn means not available to patients.
- Less smart people will be willing to go to med school. If a single payor system happens the MD pay scale will flatten. There is no way the system will survive unless Doc’s are willing to take a reduction in pay.
– There will be more push and pull between MD’s and cost control. One of the reasons Doc’s order so many tests(many which studies find unnecessary) is because they do not want to miss something and have a malpractice lawsuit. The malpractice system will also have to be overhauled.
- Many hospital jobs will be lost. Only the absolute necessary overhead will be able to be afforded by hospitals.
I do not know what the exact solution should be – but I know a gov’t run system is not the answer. I am proud that the US is the leader in technology and advance in healthcare. I do not want to see that come to an end.
I’ll put it this way, we have issues that need to be addressed but none of them call for single payer to be the solution. Single payer activists just twist the issues in order to garner support. We need to look at a number of things from the cost of malpractice insurance, the cost shift to private insurance caused by underpayment of medicare and medicaid, ability to get insured with pre existing conditions and a few others but lets address them rather than trying to put the government in control of more and more aspects of our lives
February 18th, 2010 at 6:38 am
Yes, everyone who hasn’t been brainwashed by the reich-wing noise machine knows so. And payer is spelled with an e in America. Except by shysters.
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You act like putting the private insurance racket out of business is a bad thing. Next you’ll be defending loan sharks too.
February 18th, 2010 at 7:11 am
I’ll put it this way, we have issues that need to be addressed but none of them call for single payer to be the solution. Single payer activists just twist the issues in order to garner support. We need to look at a number of things from the cost of malpractice insurance, the cost shift to private insurance caused by underpayment of medicare and medicaid, ability to get insured with pre existing conditions and a few others but lets address them rather than trying to put the government in control of more and more aspects of our lives
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February 18th, 2010 at 8:01 am
The jacked up price for services and health care are compounded by lawyers, insurance fraud, and the multitude of poor who never pay for anything…not to mention the fact that someone like you has to be hired in the first place just to handle the ever growing pile of paper work. It can only get worse, under the circumstances.
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February 18th, 2010 at 8:48 am
All of your facts are perfectly rational, but they just muddy up the water.
One simple fact rises above all of the stats and intellectual reasons you bring up against it and that is it stifles competition. With no competition, whomever is providing the money will set the prices.
I would never let my neighbor set the price on my home while attempting to buy it from me. Vise versa, he would never allow me to set the price of the home if he were the only one that could buy it from me.
Both scenarios are equally faulty.
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February 18th, 2010 at 8:57 am
1) I’m european, and live in a country with socialized medicine. While the lines are long for trivial procedures (that you can get privately done anyway), urgent or important care is immediate and never denied. Cost-control does not mean you deny care, just that you bully the pharmaceutical companies into submission, or restrict medical patents for fewer years and buy generics.
2) You can’t deny more care than the private health companies, so your point is moot.
3) It does not need a profit, right. But it is provided as a public service, and ideally run at zero-cost by a PAYGO scheme.
4) There is growth and technology advances. The State is a nice customer. It’s like saying there will be no technology advance if the military is state-run. Logical fallacy, companies court government contracts like flies court excrement.
5) The MD pay scale will flatten, yup. They won’t make seven figures. There will still be complementary private systems and cash-paid doctors to gain some extra-income for doctors and for people to get quicker care.
4) Private companies will be down-sized, yup. That’s a good thing, then they’ll have to focus on fast, efficient care to attract highest-quality minded customers, and not overcost basic care-minded patients.
5) So blatantly unneccessary procedures are used to avoid malpractice suits? Good riddance!
6) Not a single job will be lost. The neccessary overhead is much more than there is with full coverage to all people
.
7) Sorry for not answering your points in order.
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Proud social-democrat.
February 18th, 2010 at 9:31 am
Instead of single payer, what we are looking at in Universal Health care. The white house has said that single payer is dead, but there must be a public option.
I don’t buy your argument that technology will be stopped and a socialized system will be installed.
The opposite has happened in many countries with the single payer system.
In england you can purchase heath care insurance which gives care above the level that the government supplies.
It gives you access to Dr.s and hospitals at any time with no wait, and its half the price of US insurance. Why because it is added to the government system.
You have alot more reading to do, try the links below.
Below is a partial list of countries which have Universal health care,
China
India
Israel
Singapore
Taiwan
Thailand
Brazil
Canada
Colombia
Mexico
Peru
Germany
The Netherlands
England
Northern Ireland
Scotland
Wales
Australia
New Zealand
References :
http://en.wikipedia.org/wiki/Universal_health_care
http://en.wikipedia.org/wiki/Healthcare_in_the_United_Kingdom
http://www.factcheck.org/politics/pushing_for_a_public_plan.html
February 18th, 2010 at 9:58 am
Private insurance companies will not be put out of business. They will simply no longer be making a 40 percent gross profit margin. Keep in mind these same private insurance companies process Medicare and medicaid claims for less than 5 percent of the premium dollars. That includes their profit!! Of course the government contracting process forces these companies to ‘compete’ for the business (capitalism)
As for the charge that Medicare and Medicaid are slow paying. That is not the government being inefficient. That is an intentional move on the part of these same private insurance companies processing the claims. these companies get the float on the claims money so they delay payments to the extent they can get away with it.
Most of the complaints about ‘government’ involvement in medicine seem to be based on abuses by private industry!!!
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February 18th, 2010 at 10:41 am
No i don’t . My daughter in law was in the hospital for 8 days and the bill came to $ 138,000,00 . Someone sure the hell is living high on the hog it seems . Im not against doctors making money but everyone is screaming about the price of a new car, home ,food ,lights, gas you name it even the doctors feel they pay to much for things they buy . So what makes the doctors nurses hospitals think they are the only ones to keep the high price wile all others should drop there wages ? Im not trying to say there services aren’t worth it or that a new car isn’t worth it but how can we compete with the world if everything we do cost so much here in the states but so cheap in another country . See when i retire if i stay here i have to be a penny pincher and do without . On the other hand if i go to the Philippians with my retirement money i could live like a king or upper class anyway with servants that and a chauffeur
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February 18th, 2010 at 10:57 am
So a system so out of control fewer and fewer can afford it – but hey – that’s O.K. because they get all this neat technology for themselves!!!!!
In your mindset only the wealthy and well to do can or should have Health Care…….
– Sound like your more concerned your job category will no longer be needed.
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February 18th, 2010 at 11:29 am
Comparing single payer health care with the US system of HMO’s is like comparing true love with love for money.
I have received socialized health care in Norway, Denmark and Canada. I have received HMO care from Kaiser, Scott & White, NHP, Etna etc.
The service I received from HMO’s as well as the quality of care is far inferior; not because of the Doctors but because of the providers of the care. My waiting was also far worse under the HMO care, for example I had a hernia operation in Canada in 1972, and it took a week of waiting before the operation. I had a hernia operation in the US in 2002; I had to wait five weeks.
The money saved by not having the HMO’s bribe Senators is in the billions. I am covered through my employer but miss the quality of health care provided in countries with socialized medicine.
All those people who have Medical Care through their employer would get a pay increase for the employer would no longer make the payment. If your employer pays $800.00 – $1000.00 a month you would receive that money and in return your taxes would increase by about $100.00 a month.
The only people that would suffer would be crooked Senators and Insurance companies/salesmen but since they are a part of the problem rather than the solution it is nothing to worry about.
The lies fed the American public through TV and other ads are so outrageous that the proper punishment for those people would be that they go bankrupt.
No medical person would loose their job with socialized medicine; there would however for a while be a run on doctors by the poor people who have not been able to get proper care.
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February 18th, 2010 at 12:17 pm
First of all, Obama is not going to bring in universal healthcare, a fact that many people (including those who voted for him) seem not to realise. He wants to make insurance more available to all.
Second, of course universal health-cover sucks. That is why we in Western Europe have it. We think, hmm, our healthcare system sucks. I know, lets keep it. I guess that is the same with Japan and Canada as well.
FACT – the USA spends more on healthcare PER PERSON than any other nation on the planet.
FACT – the US has higher death rates for kids aged under five than western European countries with universal health coverage.
That means that a dead American four year old would have had a better chance of life if they were born in Canada, France, Cuba, Germany, Japan etc, all of which have universal health coverage.
References :
http://en.wikipedia.org/wiki/Health_care_in_the_United_States
http://www.guardian.co.uk/world/2007/sep/13/usa.health
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html
http://www.guardian.co.uk/world/table/2008/oct/01/uselections.healthcare
http://news.bbc.co.uk/1/hi/programmes/from_our_own_correspondent/7833290.stm