NationStates Jolt Archive

The Single Payer System. (http://www.pnhp.org/facts/what_is_single_payer.php) What some, including myself, would have as the nation's healthcare system. Relevant points include:
The system would cover everyone.
It would cost significantly less than our current system
It would not make hospitals Government owned.

Obama is on record for supporting it. What do you think about it?

i think a single centralised system would get quickly choked by beuraucracy. as an alternative to the current system in the US it is certainly attractive if you won't go for socialised medicine, but i think it would be far better implemented if organised on a more local level by government organisations operating according to nationally determined standards and proceedures.

If you're going to a single-payer system, forcing the government to provide the services in addition to paying for them is the biggest possible error, so it's good that Obama isn't doing that.

The second biggest possible error is prohibiting other payers. I don't know if he's doing that. Will private citizens still be permitted to pay for their own care? Will private insurance still be permitted for this purpose?

Canada, for example, prohibits private health insurance. This effectively eliminates anyone trying to buy major health services outside the single-payer system. Obama hasn't stated a position on that one.

I worry about turning fifteen percent of our national economy over to the government. The government does very little well and there's no reason to expect that they will do a good job managing health care.

The Single Payer System. (http://www.pnhp.org/facts/what_is_single_payer.php) What some, including myself, would have as the nation's healthcare system. Relevant points include:
The system would cover everyone.
It would cost significantly less than our current system
It would not make hospitals Government owned.

Obama is on record for supporting it. What do you think about it?

huge improvement over what you have now...expect a huge battle from all those benefiting from the current mess, it will take enormous test of will to stand up to the Insurance corporations...

I worry about turning fifteen percent of our national economy over to the government. The government does very little well and there's no reason to expect that they will do a good job managing health care.
And that's a good reason why they shouldn't ever provide the care.

But it also creates opportunities for abuse. Now that going to see your friendly doctor costs you nothing, why not pop in for an exam every time you feel even the slightest bit ill?

That sort of behaviour will dramatically increase US healthcare costs.

And that's a good reason why they shouldn't ever provide the care.

But it also creates opportunities for abuse. Now that going to see your friendly doctor costs you nothing, why not pop in for an exam every time you feel even the slightest bit ill?

That sort of behaviour will dramatically increase US healthcare costs.

a fallacy...truth is that many serious illnesses could be avoided and money saved if people went to the doctor sooner...the trend is for people (men in particular) not to go to the doctor until it is too late...if you had paid attention you might have noticed all the government adds encouraging people to see their doctors regularly and avoid serious illnesses....so even when it costs nothing people do not take advantage of it...

Getting govern out of healthcare would do a lot more for people.

Restrictive regulations, massive paperwork costs, a wide variety of localized rules, wildly divergent insurance costs caused by government interference, being unable to import pharmaceuticals, highly distorting messes of subsidies and tax breaks, etc all drive up the cost of healthcare.

The government is not a paragon of efficiency. It is a triumph of political compromise making sure nothing works. If something has a problem, they talk about it to make sure they all get good sound bites for the reelection campaign, then compromise on every issue to make sure nobody has an objection to anything (which makes the regulations onerous in terms of compliance yet utterly worthless).

A much better system would simply be to eliminate the morass of government subsidies and tax breaks that distort the costs of healthcare. Most specifically get rid of the subsidizing employer provided benefits. Being given health insurance should be taxed just like getting cash – this levels the field between those who get great benefits and those who do not get benefits. This would also drive costs down substantially as everyone becomes more cost conscious about what insurance actually costs.

Health insurance not being tied to an employer, but rather by the individual’s choice, means there is no more worries about not being covered when switching jobs and whatnot. This would generate a lot of competition among the insurance companies and you would see much the same outcome as with car insurance – better products, lower prices, and companies actually caring about keeping customers.

Corporate insurance means they only have to keep the executives happy, the common worker can get screwed over six ways from Sunday and they don’t care – it won’t cost them any business if the company executives are brown nosed. Individual plans allow one to switch companies if they are not satisfied or keep the same insurance while changing jobs. It would provide better flexibility, better pricing, better service, better products, etc. etc. etc. Have you people still not figured out that government monopolies are not a good thing? It doesn’t matter if it is a telephone company, an airline, or even the mail – a government monopoly will never be better than a competitive market.

Throwing more regulations and more government bureaucracy on top of failing bureaucracy is not going to fix the problem. It just makes more problems.

Health insurance not being tied to an employer, but rather by the individual’s choice, means there is no more worries about not being covered when switching jobs and whatnot. This would generate a lot of competition among the insurance companies and you would see much the same outcome as with car insurance – better products, lower prices, and companies actually caring about keeping customers.


Actually eliminating the employer is a boon to the insurance industry. The employers had the ability to negotiate since they brought numbers of customers.

How would there be competition for one person? That person doesn't have much to bargain.

An employer bringing a block of people will get more deals then a single person.

I'm not sure how much a fan I am of the single payer system. I'm sure there are probably much better ways to ensure universal healthcare. I read a paper about reforming UK healthcare (from a Tory think tank - yuck!) that provided a model for universal healthcare that was possibly quite feasible and interesting.

Entropic Creation

Health insurance not being tied to an employer, but rather by the individual’s choice, means there is no more worries about not being covered when switching jobs and whatnot. This would generate a lot of competition among the insurance companies and you would see much the same outcome as with car insurance – better products, lower prices, and companies actually caring about keeping customers.


had many car accidents?...auto insurance company's are sneaky bastards...the basics of insurance-they know the odds of your having an accident and are betting that you won't have one, they don't care about you, only their profit(private insurance health care is no different)...

you may think that by being able to shop around for the lowest price is a great idea but be realistic...if you get low rates you're not getting many benefits and be prepared to fight tooth and nail to get anything, Insurance company's make money by not paying and will look for any loophole to avoid it, in fact the loopholes are built in to their policies...government insurance has no profit motive and no reason to deny you benefits that you have paid for...

I've had dealings with both public and private health and auto insurance...I'd choose government run agencies any day...

No, no, no, no, and no.

As always, I'm against free healthcare. I don't think the government should should centralize a huge part of America's economy.

(Now that I glance over the thread again, someone else said the same thing:)
I worry about turning fifteen percent of our national economy over to the government. The government does very little well and there's no reason to expect that they will do a good job managing health care.

Actually eliminating the employer is a boon to the insurance industry. The employers had the ability to negotiate since they brought numbers of customers.

How would there be competition for one person? That person doesn't have much to bargain.

An employer bringing a block of people will get more deals then a single person.

True, but it also means that the self employed, and small businesses, get fucked.

a fallacy...truth is that many serious illnesses could be avoided and money saved if people went to the doctor sooner...the trend is for people (men in particular) not to go to the doctor until it is too late...if you had paid attention you might have noticed all the government adds encouraging people to see their doctors regularly and avoid serious illnesses....so even when it costs nothing people do not take advantage of it...

Yes, but it's possible to go too far the other way. Perhaps a low-cost triage system could sort that out.

If I take my kid to the doctor every time he scrapes his knee or gets a runny nose, I'm abusing the system. But similarly, if I never seek medical attention because I don't want to shoulder the cost, I'm abusing my kids. What we need is a middle ground.

So what I said was not a fallacy. You simply interpreted it overly broadly.

Yes, but it's possible to go too far the other way. Perhaps a low-cost triage system could sort that out.

If I take my kid to the doctor every time he scrapes his knee or gets a runny nose, I'm abusing the system. But similarly, if I never seek medical attention because I don't want to shoulder the cost, I'm abusing my kids. What we need is a middle ground.

So what I said was not a fallacy. You simply interpreted it overly broadly.

True that would be abusing the system, but except for hypochondriacs, would it actually happen in significant amounts? I doubt it. Most people don't have the time to see the doctor unless they at least think it's serious.

True, but it also means that the self employed, and small businesses, get fucked.

Not if they can form co-operatives and look for insurance that way. Let's be clear about whether we're talking about insurance or care. The most appropriate kind of insurance is certainly a major medical type program that pays for catastrophic illness, not the nickel and dime office visits that are asked for in a health care scheme.

I don't think I'd mind universal catastrophic health insurance, but I'm sure as hell opposed to "free" health care.

Not if they can form co-operatives and look for insurance that way. Let's be clear about whether we're talking about insurance or care. The most appropriate kind of insurance is certainly a major medical type program that pays for catastrophic illness, not the nickel and dime office visits that are asked for in a health care scheme.

I don't think I'd mind universal catastrophic health insurance, but I'm sure as hell opposed to "free" health care.

Except that if you don't supply some amount of "doctor checkups" then catastrophic health problems will be far more common. An ounce of prevention and all that...

Except that if you don't supply some amount of "doctor checkups" then catastrophic health problems will be far more common. An ounce of prevention and all that...

That's the point of distinguishing between whether a health care plan or a health insurance plan is desired. Going back to the auto insurance example, can you imagine how much more expensive auto insurance would be if it covered oil changes and tire rotation? That's what you're asking for! Just call it health care, not health insurance and at least we'll have the semantics right.

Yes, but it's possible to go too far the other way. Perhaps a low-cost triage system could sort that out.

If I take my kid to the doctor every time he scrapes his knee or gets a runny nose, I'm abusing the system. But similarly, if I never seek medical attention because I don't want to shoulder the cost, I'm abusing my kids. What we need is a middle ground.

So what I said was not a fallacy. You simply interpreted it overly broadly.

maybe I interpreted to broadly...but it is a fallacy that is widely used, "user fees will discourage abuse of the system" the fact is that the system is not being abused. Sure there are some people who run to the Doc for any minor ailment but they are small in number, for the vast majority the opposite is true, people generally do not go to the doctor until needed and most men until they are on deaths doorstep...User fees will discourage the poor from using the system, it's a Sick Tax that will hurt those who can least afford it, wealthy hypochondriacs won't be discouraged by a user fee....

...a low cost Triage system that fills a spot between a Clinic and the ER has merit...I haven't found need of one since I moved to Alberta so I don't know if any exist here... in Saskatchewan local clinics would stitch you up if need be, anything too serious and they would send you to the Hospital ER...

Not if they can form co-operatives and look for insurance that way. Let's be clear about whether we're talking about insurance or care. The most appropriate kind of insurance is certainly a major medical type program that pays for catastrophic illness, not the nickel and dime office visits that are asked for in a health care scheme.

I don't think I'd mind universal catastrophic health insurance, but I'm sure as hell opposed to "free" health care.

health care is never "free", public health care is paid for through taxes, taxes which amount to less than what an individual or corporate employee would pay for private plans for the same level of care...

That's the point of distinguishing between whether a health care plan or a health insurance plan is desired. Going back to the auto insurance example, can you imagine how much more expensive auto insurance would be if it covered oil changes and tire rotation? That's what you're asking for! Just call it health care, not health insurance and at least we'll have the semantics right.

I've always called it "health care", and I would definitely prefer a health care system to a health insurance system.

I don't think I'd mind universal catastrophic health insurance, but I'm sure as hell opposed to "free" health care.

A type of care should be free.

Free Neo-Natal care would save an ungodly amount of money for the medical system as issues could be caught early.

I am a little concerned that the business model has already infected medicine.

I can't name the company but it controlled around 120 hospitals. In the last year it was purchased due to it dying. Their main bitch was the fact that doctors were catching things early and using cheaper less invasive methods rather the invasive surgery.

I would think free preventative care would take a great deal of strain of the costs.

Then again, are insurance companies loosing money?

True, but it also means that the self employed, and small businesses, get fucked.

Oh I am not saying it's right.

Some people chose companies for health plans. Other chose to do their own thing. They don't have access to "decent" insurence.

Making the corporate people pay for their own is.....well robbing Peter to pay Paul?

My Cynicism says if the shrub gets his way, corporations will get a nice new bonus source from the savings (does anybody really believe the savings will get passed on?) and we will be paying more for weaker coverage.

health care is never "free", public health care is paid for through taxes, taxes which amount to less than what an individual or corporate employee would pay for private plans for the same level of care...
Thanks for the lesson, there, pal. Have you seen how mismanaged the nearly bankrupt Social Security system is? How about the nearly bankrupt Medicare/Medicaid systems? Not to mention the many state-sponsored health care plans that are running out of money -- have you noticed them? And then there are the innumerable entitlement programs that aren't bankrupt, yet, but only mismanaged. Our government cannot start an entitlement program and fund it at a sustainable level.

Now, what in that track record makes you think that this will be an affordable way of providing universal health care?