I have had it with this "single payer" nonsense...

[TreasonousBastard]

To begin with, nobody seems to have any good idea just what it means, although it's somehow the best damn plan out there. According to Wiki, the National Library of Medicine says:

"An approach to health care financing with only one source of money for paying health care providers. The scope may be national (the Canadian System), state-wide, or community-based. The payer may be a governmental unit or other entity such as an insurance company. The proposed advantages include administrative simplicity for patients and providers, and resulting significant savings in overhead costs."

Gee, that clears it up. Still doesn't manage to deal with the fundamental problem-- HEALTHCARE IN THE US COSTS TOO DAMN MUCH AND IS TOO INEFFICIENT. See, it's not the overhead insurance companies charge, it's what the hospitals charge. And the hosrpitals complain they're going broke.

I spent about half of my working life as an underwriter in other insurance lines. I know how rates are calculated, that was my job. I know how risk is assessed, that was my job, too. Claims wasn't my job, but I was close enough to the claims department to know how it worked.

Insurance premiums are based on underlying claims costs, called loss ratios, and historically companies could work with around 100% of premiums being paid out in losses in some lines, with the expenses and profit coming from investment income and reinsurance commissions. That's not entirely true any more, but the fundamentals of premiums being driven by claims is still there. Reduce the claims-- reduce the premiums. (Don't even THINK about arguing with me on that one-- not only did I know the numbers, I MADE the numbers.)

In health insurance, the old pay-for-service insurance went out of fashion, largely because it was so difficult to verify the claims. Managed care, HMOs and other schemes became the order of ther day, although they haven't proven to cut costs as much as hoped. In two years, I was in two managed care plans that went belly up because costs went higher than the old fee-for-service.

Several things can be done to improve the current system, like regulating health insurance companies the way utilities and auto insurance companies are regulated, and coming up with simplified and unified claims forms so doctors don't get so frazzled putting in the claims. and the tough choices, too, like requiring everyone be insured to avoid adverse selection and higher rates and subsidizing those who can't afford even the lower premiums.

Even if Medicare were expanded to be a universal coverage, there would still be administrative costs, and the bureaucracy would be enormous. In the past, Medicare had contracted with private healthcare insurers to handle claims, and might still be doing that. One company I worked for was self-insured but hired another company to handle its healthcare claims to avoid internal conflicts-- this sort of thing works, and can work very well.

But after the basics of hangnails, childbirth, and appendectomies, we have to make some real choices in just where we want to spend the trillions we're spending on healthcare. End of life expenses are just now hitting us hard and will hit harder in the future-- the medical and ethical concerns of keeping octogenarians alive on tubes and surgeries have to be addressed. Transplants, dialysis, and so many other things are incredibly expensive and whether you get them or not is often a matter of luck and location. So many other questions about healthcare costs and delivery that I am not qualified to address, but must be addressed....

But, hey, bitch on about them nasty, thieving insurance companies. Close 'em down, put a few hundred thousand more people out of work, and all the problems will be solved.

[leftstreet]

1. It'd be cheaper if people would just die sooner n/t

[The_Casual_Observer]

2. Mandatory death at age 65 and life termination above some upper

medical cost limit. It would pretty much take care of the financial aspect of the issue.

[vaberella]

42. I always wanted to live during the time of Logan's Run. n/t

[avaistheone1]

122. Wow. We have out new stimulus plan.

It's called "let's whack off the old folks".:sarcasm:

[eridani]

3. Horseshit. Canada runs its entire medical system with fewer bureaucrats--

--than are employed by Blue Cross in Massachussetts alone.

The thing that would change with enhanced Medicare is that global budgeting would be used for cost control. Currently, Medicare uses the same stupid individual case review that private insurers use. Compare controlling the movements of a herd of cattle by building a fence around them instead of hiring a bunch of cowboys with individual reins attached to each cow. Also, rates would not be set in a one-sided manner by government, but would be negotiated with providers.

The only kind of regulation that would be acceptable would be like that imposed on utility companies. A regulatory commission would set rates and dictate that no profit taking would be allowed from the insurance end. And if you think that would be more acceptable to insurance companies than single payer, you are delusional.

[TreasonousBastard]

6. Speaking of horseshit-- Canada has...

a population of 33 million. And, only Canada, the UK and maybe Australia have government healthcare-- every other industrial country thinks it's a dumb idea, and most of them have better healthcare than the UK, Canada, or us. Much more common is a hybrid mix of workplace insurance, safety nets and subsidies.

Global budgeting? You mean nobody watches the little cracks money slides into? Don't we already have enough problems with Medicare fraud?

Sure, just throw a bag of cash at a region and watch them use it as they see fit with no oversight. Or some oversight. Or maybe a little more oversight... What could possibly go wrong? (When you wreck you car, does the company just send you a check without looking at it?)

And, btw, utilities are allowed profit when rates are set, it's just limited.

On edit...

Scroll down a bit and see what a Canadian has to say about Canadian health care. Ain't what it's cracked up to be, is it?

[Oregone]

16. "When you wreck you car, does the company just send you a check without looking at it?"

The problem in the US though is that when you wreck your body, the companies will look at it every which way so they don't have to send you a check, period.

Id much rather be in Canada, knowing if my child is running a massive fever, I can run them to the emergency without having to work months of overtime to pay it off (maybe I need to, and maybe its just nothing but a venture into peace of mind). Ive been in both situations, and I don't prefer being out there on my own with a company that may or may not pay out.

Do you know what it is like to hold a sweaty infant while balancing risk management with fiscal management? Those are two schools of thought that should never have to conflict when it comes to children, and we can only pretend as parents we would never let them. But the truth is, despite how much one may resist, in a moment of contemplation, you cannot help but wonder if your attempt to help your child be safe in the short term will jepordize the child's long term financial security.

[asteroid2003QQ47]

20. "Workplace insurance" is a form of slavery! You support that!? n/t

[DailyGrind51]

36. I was hospitalized in a foreign country for three days...

and my total "out-of-pocket" was less than $600, that is good for about one blood test under America's present system.

[reggie the dog]

58. Here in France your total out of pocket for a hospital stay

would have likely been ZERO! perhaps 2 euros a day maximum. Yes 2.

[eridani]

37. You don't have to watch the cracks. Under global budgeting--

--cheaters take money out of the pockets of their colleagues, who are going to notice and object. This is all managed on a smaller scale regional level.

The notion that anyone ought to profit from risk spreading is disgusting, not to mention too expensive. The only people who deserve profit are those who add value, namely providers.

[TreasonousBastard]

127. That sounds a lot like the free market self-regulation the...

wingnuts are all a-twitter about. The self-regulation that has never managed to work.

This hatred of profit is somewhat irrational-- like it or not, it's pretty much what makes the world run. Every piece of equipment, every lab test, every floor washed and waxed in a doctor's office or hospital is done by someone who has profit in mind. Have any of you who see profit as the enemy decided just where to draw the line between profit and non-profit enterprise in health care?

[TheBigotBasher]

49. I would however point out that the UK has

an excellent system, with advanced preventative care and it covers, under some circumstances some of the more extremes of surgeries not covered by US medical insurance, such as weight reduction surgery, sex changes and some plastic surgery.

Waiting times are very low, with a maximum wait of around 2 months for non emergency services. While you do find a story about a bad hospital every now and again those are rare occurrences.

There is debate over how he NHS could be better managed - but there is no serious debate about scrapping it or even reducing funding to it.

[Bluenorthwest]

55. Sadly for you

Many of us know dozens of Canadians, in many cities, and have known them for decades.
But the point is, there is no need to hear a random opinion from a DU 'Canadian' when one knows so many Canadians, when one has worked there, etc. Canada is not Mars.
If 'a Canadian' saying a thing makes that thing valid, please note that Joe the Plumber is 'an American' as are Hannity and Rush. Do they reflect an honest assesment of American politics? Because the are 'an American'? Hilarious logic.

[TreasonousBastard]

112. This particular Candaian...

(who seems to be really a displaced USian) merely explained a few things about the system that I was not aware of, and that I doubt many who espouse it here are aware of.

So, ask the dozens of Canadians you know if Oregone's description of the system was correct or not.

Then get back to us.

[reggie the dog]

57. France has government health care

Our hospitals are public and our health insurance is run by the government.

[JerseygirlCT]

71. I've read that France's system is better than that in the UK

and Canada, and might provide the best model for us.

But I don't know much more detail about it.

[reggie the dog]

92. I think it is better than the system in England

I think Scotland has its own health system which is also excellent as they reversed the budget cuts that had happened in the rest of the UK. England cares for its people too. It costs us less out of pocket in France than in the UK but the UK is NOTHING like the USA.

[question everything]

99. Yes, I've heard that Germany and France have a better system

that either Canada or the U.S.

[TheBigotBasher]

137. There are effectively no out of pocket costs in the UK

not for operations or essential medicines. There are prescription charges but they make up a very small percentage of the NHS budget.

[TreasonousBastard]

114. My understanding is that it is another mix of ...

public and private financing, as this Business Week article describes:

http://www.businessweek.com/magazine/content/07_28/b4042070.htm

Michael Moore's documentary Sicko trumpets France as one of the most effective providers of universal health care. His conclusions and fist-in-your-gut approach may drive some Americans up the wall. But whatever you think of Moore, the French system—a complex mix of private and public financing—offers valuable lessons for would-be health-care reformers in the U.S.

n Sicko, Moore lumps France in with the socialized systems of Britain, Canada, and Cuba. In fact, the French system is similar enough to the U.S. model that reforms based on France's experience might work in America. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self- employed, are free to prescribe any care they deem medically necessary. "The French approach suggests it is possible to solve the problem of financing universal coverage... reorganizing the entire system," says Victor G. Rodwin, professor of health policy and management at New York University.

France also demonstrates that you can deliver stellar results with this mix of public and private financing. In a recent World Health Organization health-care ranking, France came in first, while the U.S. scored 37th, slightly better than Cuba and one notch above Slovenia. France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.

<...>

[Spider Jerusalem]

65. You might want to learn what you're talking about

hardly 'only Canada, the UK and Australia', for a start; Italy and Spain also have publicly funded health insurance (and in the UK private treatment is an option if you're willing to pay or have private insurance, which many do, for that matter).

[TreasonousBastard]

128. Actually, I was apparently wrong about Canada...

as private insurance is needed for more substantial care.

However, my point is that purely "single payer" or government funded systems are a rarity anywhere in the world. A point you have emphasized by mentioning the UK's private insurance.

[lumberjack_jeff]

87. Whaa? Where to start?

Neither Canada nor Australia have government healthcare, and the UK competes pretty well with the other countries that DO have government healthcare like France, Spain and Germany.

NO ONE uses the "hybrid mix of workplace insurance and subsidies" that we do, because it has been an abject failure.

[Hutzpa]

117. I see two things at play here

1) Gross ignorance and lacking of understanding

2) Misleading and distortion

These where the same tactics used against Bill Clinton and it looks like you're trying to
pull that same ol BS here, its not going to work, before coming and asking stupid questions
and innuendos you should first do a research, find materials pertaining to single payer
and then come back a little more wiser.

For starters, It's not only UK, Canada and Australia, Germany, Cuba, France all have single payer
and yes these countries all take care of its citizens.

Now, get off your high horse and do some researching.

[TreasonousBastard]

129. Research yourself-- none of them have single payer...

except Cuba.

[Lydia Leftcoast]

119. Canada, the UK, and Australia all have very different systems

Canada: single payer to private doctors

The UK: health care workers are government employees

Australia: mixed system

[Doremus]

125. Medicare fraud? Did you miss a turn on the free(p)way?

Medicare fraud is a favorite meme of the RW. Too bad the facts don't live up to their hyperbole.

[TreasonousBastard]

130. Funny, just last week I was reading about another doctor...

on his way to the slam for a few million in fraudulent billings.

Now, could you address a more significant point htat I may have made?

[Doremus]

138. Regurgitated wingnut hyperbole is not significant.

It's merely regurgitated wingnut hyperbole.

Oh, and by the way, the classic "cheating doctor" has grown trite from overuse. Surely your employers can provide you with better material than that.

FAIL.

[alarimer]

134. Canada does not have government health care.

The government pays for it but the care itself is private.

You are completely ignorant on this topic. Rent Sicko to see just how fucking wonderful our system is.

The vast majority of Canadians like their system. They certainly see it as much better than ours.

Educate yourself on the subject. You are simply repeated tired old right-wing talking points, none of which have any basis in reality.

[Enthusiast]

31. +1, eridani! nt

[Egnever]

4. For profit health care is not working

and the insurance companies are taking larger and larger shares of every health dollar.

Taking the profit motive from the insurance provider is just one step in fixing our health care but it is not an unimportant one.

http://www.fiercehealthcare.com/story/aetna-profits-member-premium-increases/2008-07-31
Aetna profits up on member, premium increases
July 31, 2008 — 12:26pm ET | By Anne Zieger

Aetna
Aetna has announced that its second-quarter profits have gone up 6.4 percent for its second quarter, courtesy of both rising membership numbers and a raise in premiums. The company earned $480.5 million during its second quarter, compared with profit of $451.3 million during the same period the previous year. The profit increase was fueled by a growth in revenue, which rose 15 percent to $7.83 billion from $6.79 billion.

Thats nearly 2 billion in profit per year that is not going to pay for any treatments, and that is just one company.

[TreasonousBastard]

9. That's a 6% profit, which might be a...

lot of cash, but not a windfall with those gross revenues. I don't know what their expenses were, but it looks like they paid close to 7 billion in claims- not too shabby for a quarter.

The anti-corporatist mantra often played here is fun sometimes, but "profit" isn't really a dirty word. Like it or not, one year's profits are a buffer for the next year's losses-- and there will be losing years. Capitalism has a lot of faults, but it's useful at times.

[Egnever]

11. Sorry but its a dirty word in health care

I dont care the percent of profit it is , it is lost dollars that could be paying for cancer treatments for someone that did not get them. 2 billion for one company. how many companies profit would it take to completely pay for a single payer system? acording to some studies 6% about gets us there.

National Studies
June, 1991 General Accounting Office
“If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs <10 percent of health spending> would be more than enough to offset the expense of universal coverage” (“Canadian Health Insurance: Lessons for the United States,” 10 pgs, ref no: T-HRD-91-35. Full text available online at http://archive.gao.gov/d20t9/144039.pdf).

December, 1991 Congressional Budget Office
“If the nation adopted… single-payer system that paid providers at Medicare’s rates, the population that is currently uninsured could be covered without dramatically increasing national spending on health. In fact, all US residents might be covered by health insurance for roughly the current level of spending or even somewhat less, because of savings in administrative costs and lower payment rates for services used by the privately insured. The prospects for con-trolling health care expenditure in future years would also be improved.” (“Universal Health Insurance Coverage Using Medicare’s Payment Rates”)

[TreasonousBastard]

13. Very old studies, and if...

you read down a bit you'll see that the Canadian system isn't all it's cracked up to be according to a Canadian. It's a nice system, but still requires private insurance to fix all your broken parts.

Paying providers at Medicare rates? Even that old study should have acknowledged that no one wants to work for Medicare rates, and it's even worse now. Try getting a new doctor and mentioning "By the way, I'm on Medicare." ("We're not taking any new patients")

I haven't mentioned mutual insurance pools, which would also work, but none of the "experts" here seem to know about them so why complicate the matter...

[Egnever]

15. I am not saying its utopia

but it beats the snot out of our current system especialy if you are one of the people that doesnt have or cant get health insurance.Ask that canadian if he would rather live under our system. I think the perspective you get back will not be enamored of ours.

Sure there are other ways to skin the cat, and yes doctors are refusing medicare, but that doesnt take away at all from the fact that 2 billion in profit from one company alone would go a long way to helping pay the costs.

Every dollar of profit any insurance company makes in health care is wasted health care dollars.

[Egnever]

17. OH and theres plenty of more recent studies at the link I got those from

http://www.pnhp.org/facts/single_payer_system_cost.php?page=1

Oddly enough its a site called physicians for a national health care program. Doesn't sound like at least these docs are scared of it all, despite the scared of medicare argument.

[Oregone]

19. Hey, Im not Canadian...

Im just not so fired up about the tea-bagging mobs in the streets down there anymore. Just insane. :)

My next kid will be a Canadian though (all paid-for with MSP). :)

I do want to mention, although I said that you do need private supplemental insurance to cover everything (including dental/vision), this only costs like $150 or less for your family from a good company. So, in the long run, you get the whole package for $250 a month (plus what you pay in taxes, which are comparable but not going to make bullets). So while government insurance isn't the cure-all as I mentioned, it may cure the market forces a bit by assuming risk and reducing demand, and thus, lowering the overall price of private supplemental coverage.

[TreasonousBastard]

131. Coupla small points about that...

since the initial, and perhaps major, costs are born by the provincial plans, the private insurance would normally be cheaper, like an excess policy. And, I suspect the actual costs of care delivery up there are lower than they are here, also lowering premuims.

Eventually, though, we're all coming up against the problem of an aging population needing vastly more expensive care, and that's going to kick us all in the teeth.

(and I guessed you weren't a natural-born Canuckistanian from your username, but who knows for sure...)

[Enthusiast]

34. The old tired insurance company line

"I know a Canadian, she thinks their system is awful." Hey, there are millions of American healthcare horror stories, I know, I have one. Do Canadians go bankrupt if they get seriously ill?

[Enthusiast]

33. Useful, but not in the case of insurance. nt

[urgk]

47. There is a difference between turning an honest profit and being greedy.

Insurers often deny the first submission of a claim in the hopes that there won't be a second. They also fish back through medical records to try to fabricate fore-knowledge of pre-existing conditions. If that kind of underhanded garbage is what it takes to keep insurers operating with a profit, then they have no business being in the business.

If no insurer can operate at a profit because of what they claim are the high costs of health care, then fine, they can go make money elsewhere, step aside and let the government take over. Which is fine by me, because when the government is responsible for health care coverage it is also more likely to make and enforce laws that protect the public and thereby reduce its own costs.

[Raineyb]

80. Every penny of profit taken is money not used to pay for actual health care

And there's no reason why any insurance company should be making a profit by withholding care from the people they're supposed to be covering.

It's only gotten worse since the insurance companies were allowed to become for profit companies.

[lumberjack_jeff]

88. Pharma companies have an average net profit of 20%+ n/t

[Orsino]

140. If profit drove innovation and better care, it wouldn't be a dirty word.

In the context of current US health care, though, it's just parasitic. The profit of the executives and major shareholders comes at the expense of our health.

Now, suggest a reform that would turn this aspect around, and I'd listen.

[Enthusiast]

32. And they are spending millions

on advertising/propaganda.

[Hippo_Tron]

5. In my experience, people don't want to talk about the costs of health care

I was at a Campus Progress a few years ago and in the audience during a health care panel (Tom Daschle was on the panel). The panel (Daschle aside I think) was talking about how single payer is wonderful with all of the repeated talking points that we've heard before.

When it came time to ask questions I raised my hands and asked "I've noticed you guys talk a lot about single payer but not a lot about cost cutting. Is it possible that people don't take single-payer seriously because its advocates generally don't also have a comprehensive plan to reduce the cost of health care?" They didn't really have much to say other than to look at some plan Governor Rendell came up with in Pennsylvania.

[eridani]

39. Jeezus H Kerist! Of course we don't talk about costs. That's because

--health care financing is the only serious problem we have that can be solved without spending any more money than we are now spending. That is twice as much as all countries that provide health care for everybody. We are ALREADY PAYING for univeral health care! We just aren't GETTING it.]\

If we are already spending it, why this horseshit about the money not being there?

[JayMusgrove]

59. That's the point! Exactly!

We are wasting a large percentage of the dollars we pay for "insurance" in order for several companies to provide no actual "care", and to siphon off tens of billions in order to pay insurance company employees and executives.

[ecstatic]

148. Exactly! I've asked several times how people reconcile

unlimited weed smoking etc. with a single payer plan. Will anything go and damn the costs of it all? How will all of it work without us making concessions with regard to lifestyle choices?

[napi21]

7. Everyone tries to compare US HC with European national HC, but

no one will say that doctors in europe arent viewed as Gods like they are here. My grand daughter & her fiance are both in med school. He's got one year to go & she has 3 years to go. When they graduate, their probable salary will be about $40,000/yr. Even much later in their career, they will not earn the big bucks that the US speciailists get. As my son said, doctors here aren't thought of as gods like they are in the US.

[Egnever]

12. Thats because of college costs no?

education is generally much cheaper there is it not?

[Bluenorthwest]

56. Doctors think of themselves as gods

as do many Americans. I tell you this, I've known physicians in the US and in Germany, and the Germans were doing just fine financially. They were also the first doctors I ever met who seemed to love their work, and themselves.

[reggie the dog]

60. Here in France tuition for med school

is between 5 and 250 euros per year. One does not go into debt to become a doctor.

[Oregone]

8. This probably won't be entirely popular to mention...

But not only do you control costs with single-payer by eliminating profit, you also control is by limiting what procedures and services you actually cover.

My single-payer service (Canadian) will provide unquestioned coverage to everyone covered (no denial of claims, no pre-existing conditions), but it only covers half the picture. This makes a huge difference.

The purpose of it is for to ensure, primarily, people don't die (or lose their savings and home). People also don't become slaves of their jobs to simply live.

Thereafter, they let the private market cover the rest. Offhand, its odd how my insurance would partially cover a sex change, but will not cover the ambulance ride to the hospital. But in a single-payer system, there must be a debate on what the state is minimally obligated to provide its people.

Anyway, the main point is, first and foremost, cure the people, and do it on the cheap.

Single-payer insurance saves money by bringing administrative costs down, eliminating profit, and by limiting the amount of services it offers in the first place. If you pair a government's ability to offer single-payer insurance with its urgency to negotiate with drug companies and set ceilings on what people can be charged for certain services (by private and public health care providers), then it can reduce the percent of GDP spent on health care significantly (while covering everyone). Those who want more coverage are able to purchase it.

Anyway, thats how my system is setup. It makes a lot of sense and works well. Its not paradise, but its something on the road to it. Once you make sure at least *everyone* isn't going to die, the "extra" supplemental private coverage has far less demand (and is priced accordingly). The state coverage eliminates a lot of the risk the private insurer would normally carry too.

[TreasonousBastard]

10. Oregon tried that years ago...

listed diagnostics and procedures that state would pay for and anything beyond that you were on your own.

Seemed like a good idea at hteh time, but the first Bush forced them to stop it, allegedly because of some conflict with the Americans With Disabilities Act, but everyone knew that was a load of crap. We didn't know exactly what the real reason was, but at the time no one was going to let a state lead the way in healthcare and force everyone else to follow their lead.

I don't know enough about the Canadian system to comment, but I suspected it wasn't the paradise some here seem to think it is. I have noticed that every time someone mentions any imperfections in your system, immediately the chorus is raised that it's some rightwing nutjob in the pocket of our insurance companies.

(Amazing how more people down here seem to love and defend your system than up there)

[Oregone]

18. A lot more people up here would defend this system if...

1) They knew people who lost their homes or lives due to medical costs (one mention of that, and the argument stops).

2) They realize how long you have to wait for certain services in the states as well. It seems like the big joke, at the hospital, how long people have to wait among the Canadians. In my experience, its reasonable in comparison. I have less trouble in Canada actually getting into clinics (immediate service walking-in). Scheduling specialists seems to take just as long as the states. Thats all anecdotal though.

3) They noticed how quality some of the equipment and clinics they have are. Ive seen Canadian offices jam packed with cutting edge gear, especially compared to what Ive seen elsewhere. On the other-hand, I wasn't impressed with the public hospital, which was streamlined for costs (though they are nice as hell, get you out of the lobby quick, and don't bill you).


I take a step back and see the Canadian system as practical, efficient, and pragmatic (not perfect). I think it helps a ton of people and improves general health and social mobility. It ensures everyone can at least be happy and well to some point. And if it isn't enough, pick up full coverage for another $100 or so on the private market. If you can have it all under $250 a month, who could complain?

I wish more people in the states understood how this insurance system worked. It would help them advocate it (to conservatives AND liberals). Its incredibly streamlined and practical. It isn't about the government pouring out a ton of money to help poor people. Pretty much every person pays less because of its effects. But you can't just say "Single-payer" and expect a miracle. Nor can you just say it without understanding how it works in various places. That doesn't get anyone anywhere.

To be honest, I didn't understand how it worked here either until I lived here a bit. Its just an insurance system. The company is owned by the provincial government. They offer limited coverage on necessary procedures to keep you alive and healthy (or change your sex). Its not about making a profit. They collect premiums monthly. You can write them off if your employer doesn't pay them (mine are $108 for my entire family, no matter how big). If you can't afford them, its subsidized. You are not checked for pre-existing conditions (you should have this from time of birth unless you immigrate, where you pass a medical test). Your covered services will not be denied. You will never get a bill in the mail from a public or private clinic. Health facilities can be owned publicly and privately (regardless, your insurance is billed). There are private plans for the extra goodies this doesn't cover. Simple enough?

I think this is a great "step" (if not a final one). Be careful of asking for the moon and stars. Isn't it enough to ask that no child be left to die, and no man be forced into foreclosure for basic procedures?

[Enthusiast]

35. Funny, I have never heard an advocate

of a Canadian style system claim it is "paradise". If you use Reich Wing talking points around here you should refine your technique for disguising them.

[reggie the dog]

63. The French system is paradise

Out of pocket cost for the peditrician is 20 euros. Out of pocket for most any specialist is 20 euros. Co op complementary insurance is not even 40 euros a month for my whole family. Hospital stays are FREE or cost 1 euro. Pre natal care, child birth care, and the first few months of care for the baby are all FREE, then you have to pay 20 again for the specialists. My wife and daughter spent four days in the hosptial when my wife gave birth. Our total out of pocket cost NOTHING! Our taxes, progressive income tax at that, pay for our health care, which is a right enjoyed by all here.

[PufPuf23]

123. Profits of insurance companies = direct reduction of health care

I am all for more doctors and nurses and low or no cost medical schools and government provided health care as a human right.

I like what you describe Reggie and I am 1/8 French == my geat great grandparents came to Blue Lake in Humboldt county in 1860.

Goverment provided health care with private health insurance and drs and facilities over and above for the narcissists.

Free med school for a commitment and after some years the option to go private.

Doctors are not gods. Health insurance companies are unnecessary and counter productive to health and humanity. But peo-le should still have the choice and medical professionals as well.

[Lydia Leftcoast]

120. The Oregon plan was not for the general public!

It was a Medicaid plan.

[eridani]

40. Nobody is objecting to people buying extra bells and whistles

I could care less that Bill Gates probably has a very expensive fire alarm and sprinkler system that I can't afford. All I care about is that we get the same fire engines if we need them.

[reggie the dog]

61. Here we have insurance co ops to cover stuff like ambulence rides

I pay all of 39 euros a month for my co op complementary insurance for my wife, my child and myself.

[Oregone]

96. Yeah, its that cheap here in BC too...

unless you want vision/dental.

Its odd. I can get a vagina put on me, but I can't get my teeth fixed.

[jeanpalmer]

83. How much per capita does the Canadian system cost

I've seen differing statistics but the US spends 50% more on healthcare than does Canada, according to canadaian-healthcare.org. So if we adopted the Canadian system and spent the 50% extra to upgrade it, seems like we might solve any problems inherent in their system (alleged wait times) and end up with a gold-plated system. The US spends anywhere from $5400 - $7000 per capita, while Canada spends $3800.

[Oregone]

93. Yeah, this is a good point.

If people are willing to adopt the model, but merely spend a bit more, then the can get the best of all worlds.

Here is a problem though...to do this you will have to increase the premiums collected. Hence, even a bigger part of the population than Canada's will need their premiums subsidized. Hence, this makes fewer people paying full into it, and thereby, creating maybe even higher premiums (its creates an upward cycle). The reality is that you want as many people as possible to pay premiums, and it thereby makes it more affordable by splitting the costs among more people (and requiring less subsidization). Of course, you could just fund it entirely with taxes, but, eh, either you'd have to raise taxes $7K per capita or cut defense....thats just fantasy land again.

Maybe there is strength in the streamlined Canadian version, eh? You need a gold plated gurney or something?

[uponit7771]

14. Wouldn't it make sense to say to the biggest cost factors that we're not paying what they want

....any longer and watch them go out of business?

They fold and the government takes the business?

Yes, I do think it has to be to that extreme now.

Thx in advance for your input

[depakid]

21. Let me be blunt

Health insurers are parasites on the system.

Monies thrown their way do almost nothing to "produce health care." Instead, it's wasted on marketing and administrative costs- much of which is designed to DENY OR AVOID health care costs through adverse selection, denials or stonewalling valid claims (protected by ERISA preemption and other legal barriers) preexisting conditions, coverage gaps and arbitrary limits, deductibles and coinsurance requirements that create huge disincentives for primary care or bankrupt folks who have the misfortune to fall ill or be injured.

All that while costing providers tons of money- and creating headaches and reimbursement problems that they don't need any more than bogus preapprovals.

The most efficient solution is to remove them entirely from the basic benefits equation- as Canada has done. Barring that, create a two tiered system similar to Australia's where evryone's got guaranteed coverage anxd those who want a few more amenities can purchase them- or get them as perks from their employers.

[Oregone]

22. Just an FYI...

Canada also has their basic coverage and you purchase supplemental private health coverage for the other "amenities". Its cheap, but I just wanted to point that out. You cannot purchase private instead of public to cover those basics though, as far as I know. Private is only supplemental.

[depakid]

25. Yep- that's one difference between Canada and Australia

Australians can purchase private insurance for basic benefits (relatively speaking it's CHEAP compared to the states and rates are regulated). Unlike Canadan they also have a system of both public and private hospitals- so in some respects, they're a bit closer to the British NHS than what you've got in BC.

[Oregone]

27. So they can "opt out"?

And thus, bankrupt the system by paying premiums to a private company instead?

[depakid]

28. Not opt out-

Aussies still pay through various taxes for basic benefits- but wealthier people or people whose employers want to provide insurance can go to different facilities (which in some cases afford better care- though not always. Sometimes the public teaching hospitals are the best places to be treated.

The private hospitals usually do have better amenities and often (but not always) waiting times for various elective or non-vital procedures are longer than in the public system. Surprisingly though- scheduling some things in America takes damn near as long, once you've jumped through all the hoops.

The results of allowing the private system in have been mixed; there's been some deterioration of public care for all- and costs have risen (reflecting inefficiencies).

[urgk]

45. There is a direct link between every valid, yet unpaid, claim...

...and the car in the CEO's driveway. And the vacation he spends in the Caribbean. And the work his wife has done on her face. Every dollar that shines his shoes could have been spent on insulin.

The corporate model in this country has evolved from delivering a valuable product to trying at every turn to cheat the customer out of his money. It is a system that favors the greedy and the morally bankrupt.

[SoCalDem]

23. Eliminate the insurance comapnies & HMOs

pay the doctors & nurses WELL...make hospitals not-for-profit, and all of a sudden, costs go down DRAMATICALLY..

The folks running this mess we have now, have made plenty of money for a very long time, and it's time for them to GO!!

Every US citizen gets a "health card", and they are good to go.. If other countries can figure this out, we surely can..

If you are a non-citizen, your homeland-country gets the bill or has it deducted from any foreign aid they would get..

[Oregone]

24. "make hospitals not-for-profit"

How do you do this? Do you purchase the hospital from the private shareholders if it isn't public? Who sets the price?

What about doctor's clinics and small private practitioners?

[SoCalDem]

29. You say.. enough already..and nationalize them

and the doctors at clinics still do their work..they just become govt employees...well paid ones...

[Oregone]

66. So just seize wealth from private stock holders?

1. Why stop at hospitals? Why not seize any business that will generate profit for the state that can be used for the people? Since any profit generating industry can be used socialisticly, where do you draw the line?

2. Why would a private practitioner who has ran his own business for years want to become a "well paid" govt employee after you seize his clinic from him?

3. Why would a government desire to become a bloated entity and seize every health care facility in a region, despite their saturation level? Do you understand what type of inefficiency, overhead and pointlessness that may cause if you have as many redundant government clinics in a town as McDonald's?



Look, I'm all for the government establishing local government owned facilities (many places already have city owned facilities). But sometimes a mixed market can leave the current socio-economic structure in tact and still accomplish the overall goals: health care for all. Why not just start at the insurance level, and then aim to create public facilities to compete against private ones? Set legal caps for billable services, and watch private facilities wither if they cannot operate under that criteria. But outright seizing all that property is not only out of character for the US, but it will never happen. Thats like advocating Superman come save everyone from accidents.

Personally, thats one reason I enjoy the system here in BC. Its much more grounded in reality and mixed-market principles, and still it ensures people are taken care of. It creates a solution that fosters affordable health for the population without attempting to establish a fantasy land.

[babylonsister]

115. I'm listening to you, and thanks for sharing. nt

[eridani]

41. Turning non-profit into for profit was massive theft of public resources in the first place

Taking it back isn't stealing.

[Oregone]

70. right

Keep telling yourself that. You can justify taking anything with that philosophy. Once you set a precedent. I mean, you might as well just be arguing for straight communism and be honest about it. Its not like I have a problem with that at all, but you know, its like advocating a fantasy in the free-market states.

[eridani]

109. Sociopaths and thives are currently managing our health care system

Time for patients and practitioners to take it back. And yes indeend--conversion of non-profit to for-profit is theft on a massive scale.

[eridani]

110. Sociopaths and thives are currently managing our health care system

Time for patients and practitioners to take it back. And yes indeend--conversion of non-profit to for-profit is theft on a massive scale.

[reggie the dog]

64. You wait for a hospital to go out of business then buy it

and run it by the state. Or the state simply builds hospitals with tax money and the hospitals are there to care for people, not make money. After all the state pays the health insurance so what is the point of the state hospital charging a lot to the state insurance just to say that the hospital made a profit for the state, which would then be used to offset the cost the state paid in its health insurance program.

Doctors clinics are private here in France.

[Oregone]

68. Yeah, I understand that approach

Its just tough to figure out what to do with for-profit hospitals that don't go out of business. I say if they are operating under caps for billable services (set by the government), and still running a profit, let them be.

I think this person wants to seize everything from clinics to hospitals with no compensation at all. Considering the context of the US, well, thats a bit off kilter.

Yeah, clinics are mostly private here in BC too.

[reggie the dog]

95. let them compete against government hospitals

that will keep pressure on the government hospitals to keep their care top quality and let rich people be free to spend their money on private health care if they think they need too. President Chirac had an operation in a public hospital while he was in office. Here in France there are private "clinics" that perform surgeries. A few people go there, most people go to the public hospitals.

[Oregone]

97. I totally agree!

Im not sure why people don't have more faith in mixed market economic systems. Why can't the government compete against private industry and profit for the people? ITs gotta be one way or another with people...the US is very polarized and extreme in that fashion.

Off topic, I buy all my beer at government liquor stores. They are way nicer, cheaper, and have more stuff than the other liquor stores around here. They set a standard that everyone has to live up to (and make over half a billion a year doing it).

[TreasonousBastard]

116. Around here we have the NYC Health and Hospitals...

Corporation with lots of city-owned hospitals. Most of the rest are run by churches or universities and non-profit, with some federal ones thrown into the mix. And a few private for-profits, but most of them have been owned by doctors.

Not that anyone can see the gummint-owned or non-profits have helped reduce health care costs one penny.

(And medical staff around here gets paid VERY well, even if they think they should make more)

[Lasher]

26. Potential savings are not limited to the overhead that insurance companies charge.

A baisc idea behind single payer universal healthcare is that substantial savings can be achieved by major reduction of insurance company involvement as we now know it - and this does not apply just to overhead costs like profit and advertising.

[Enthusiast]

30. Health insurance does not contribute to care

They remove resources from the system. Insurance serves no purpose, end of story. And, there is no reason to make a healthcare system hugely bureaucratic. This is the same old propaganda paid for by the insurance industry. The insurance industry apologists always say "Look at the VA system, is that the kind of government healthcare system you want?" It's a bullshit argument. If the status quo was the answer, prices would not be skyrocketing. If the status quo was the answer we would not be paying more than other countries yet receiving poorer care.

[Vinca]

38. Health insurance is only a payment mechanism and since their

profit is based on nonpayment, they have been instrumental in causing healthcare costs to rise. Say the hospital charges $100 for a procedure. The insurance company agrees to pay 40% of that amount, take it or leave it. So the hospital, rather than living with $40 for a $100 procedure, raises the cost of the procedure to $165 so they'll still get the original fee. Next time around, the insurance company, that is still only willing to pay $40, tells the hospital they will only pay 25% and the hospital proceeds to raise their rates again. And so it goes. Like rats on a treadmill. If private insurance is going to operate in addition to a government program, the government needs to step in with a mandated fee schedule - no more wheeling and dealing and no more putting profit ahead of health. Personally, I don't see how it can be done . . . we are so far from the day when Blue Cross/Blue Shield was a nonprofit.

[urgk]

43. Just because somebody else kicks me in the shins...

..doesn't mean I lose my right to complain about the person punching me in the face.

Sure, medical costs are too high. Ridiculous in fact. I paid $600 a couple of years ago for 5 minutes of time from an ER doc. That doesn't include the room fees or any other incidentals, just to have the doctor look at me for 5 minutes. That's, what, $7,200/hour? Of course the costs are too high.

But insurance companies are determining medical coverage. And their interests are profit-driven. Which means, inevitably, there will be a conflict between the executives' and investors' need for personal wealth and the patients' need for health care.

Single-payer health care may or may not be the whole answer. It may or may not be a part of the answer. But I'll be damned if I feel sorry for the insurers.

[PA Democrat]

44. I will bitch about those THIEVING insurance companies, because I have been a victim of their

corruption. Yes, I said CORRUPTION.

They spent 6 months harassing and screwing my doctors, and a local hospital out of payment. They PAID a claims processor a fat little bonus to fabricate a "preexisting condition". I had to involve insurance commissioners from two different states to get the filthy THIEVES to pay what was a 100% legitimate claim. Thank God my cancer required no further treatment, or we would have had to go into big time debt to pay while the THIEVES played with my life in order to try to maximize their profits.

It wouldn't be so bad if I had been the only person this company had cheated or attempted to cheat of health care. But it is apparently more profitable to lose the occasional lawsuit and get a slight slap on the wrist from the states' insurance commissioners than to fulfill their contractual obligations to pay for health care.

So I am supposed to be concerned about the jobs of people who are paid to find reasons to deny health care?

[urgk]

46. I'm with you.

I've watched my parents evolve from getting angry about health care to just automatically re-submitting all of their denied claims. They operate with the knowledge that the insurer will deny payable claims the first time they are submitted. Their insurer saves money by hoping people are too unaware or sick to fight. And not just people...customers who have honestly held up their end of the bargain.

What kind of sick bullsh** is that?

[PA Democrat]

51. I hear you.

In the process of fighting this insurance company, I learned some pretty sickening facts. In many states the person in charge of actually policing the insurance industry is often in bed with the insurance industry. So while they will investigate if people go through the hassle of filing a complaint, they do nothing more than make the company pay the claims they wrongly deny. There is no fine, no loss of license for egregious patterns of abuse, and so it remains profitable to cheat people out of health care. It is reprehensible.

[urgk]

53. My mom also worked as a pre-cert nurse for an insurer.

Which is probably the only reason she figured out how the system worked. I wish I could remember examples of some of the ridiculous rules she complained about, but she got into fights with her supervisor all the time for saying "look, from a nursing perspective, this doesn't make any sense at all." It seems there were things, like biopsies, that they'd pre-cert only if the growth were cancerous, but you'd have to do the biopsy to determine the malignancy in the first place.

I keep thinking that the first step of any and all of this is to cut off campaign contributions from lobbyists or health care companies. But the laws that regulate the contributions need to have open-ended clauses that prohibit any attempt to use money or favors to influence policy. Of course, the laws would have to regulate jobs and favors after the lawmakers head out into the private sector as well.

[Honeycombe8]

48. Maybe you're not old enuf to remember "before insurance"? If you were, then you'd know....

health care provider and pharma rates started skyrocketing when insurance entered the picture.

I'm not SO old that I remember before there was insurance. But I do remember the 60's and 70's, and know a bit about the '50's (when I was born). That was when there was insurance, but INSURANCE THEN DID NOT COVER ALL THAT IT COVERS NOW, AND A LOT MORE PEOPLE THAN NOW DIDN'T EVEN HAVE IT.

Do you expect insurance to pay for your hormones? Your viagra? Your annual checkup? Insurance regularly pays for these things now. In the old days, insurance wasn't used for everyday, ordinary medical expenses. Insurance was intended for unusual, extraordinary expenses, emergencies, surgeries, etc.

Do you run to the dr. when your sinuses are infected? You think you have IBS? You have a pain in your leg (or your sacroiliac or your arm or your shoulder), even though it isn't THAT bad, yet? In the old days, people didn't run to the dr. for every little thing. They had checkups, and then they went to drs. when things were REALLY wrong (the kid stuffed rocks up her nose, the sinus infection has been going on a long time and getting worse, etc.).

My company offers two plans: For no fee, you get the "lower" plan (high deductible, pays 80% of a hospitalization, higher co-pays, etc.). For a monthly fee, you can buy up to the "higher" plan (low deductible, pays 90%, etc.). Would you get the lower plan, since that is what insurance is for: to prevent you from becoming broke if you get hit with a big medical expense? Or would you buy the higher plan, since you want insurance to pay for as much as possible, in as high a percentage as possible?

So partly it's that people expect insurance companies to pay for things that we once did not expect them to pay for. And...once so many people started getting insurance, the health care providers started raising rates, since insurance was paying and not patients. THEY FOUND THAT WHEN INS. COS. PAID, THE PATIENTS QUIT PRICE-SHOPPING AND DIDN'T CARE WHAT THE COST WAS.

The health care providers rates got so outrageous that ins. cos. started the HMO/PPO thing. Remember when that started? That's an effort to control provider costs. And it has helped somewhat. But the providers STILL overcharge patients who don't have HMO/PPO plans, even more, so they can recoup the profits they lose by ins. cos. paying them lower because of HMO/PPO plans.

Pharmaceutical costs skyrocketed, after insurance started paying for drugs more.

So it's BOTH the fact that insurance entered the picture (providers raised rates to cash in on the fact that ins. cos. were stuck paying, and patients didn't care what the fees were when someone else paid them), AND the fact that patients started expecting EVERYTHING to be covered by insurance (viagra? I mean, come on!). AND the fact that people started relying on dr. visits and drugs for everything, instead of taking care of their health (no fast food, 1/2 hour exercise daily, etc.) and accepting an ache and pain as part of life instead of running to the dr. for a pill to fix it. AND the greed of health care providers.

So everyone, incl. the patients, are a bit to blame, IMO. Not to care about costs because an ins. co. is paying instead of yourself? That qualifies as greed as much as a provider charging several hundred doctors for an annual checkup.

But don't act like ins. cos. are innocent. They are mega-wealth profit centers. They don't pay providers and pass on the cost to the consumer. They are in the business of making money. They pay providers a cut rate (HMO/PPO), and turn around and charge outrageous premiums - as much as the market will bear and ins. commissioners will allow - over and above the amount they pay out. Result: They make enormous profits. And even though it's against the law, don't try to say that the ins. cos. don't get together and collude to keep rates at a certain level, so there isn't a rate price war.

If you take ins. cos. out of the picture, provider rates would probably quit going up at as rapid a pace, since whoever the payer is (patient or government) would be watching the rates and haggling over them. And it would cost us less because the ins. co. profit would be taken out of the picture.

[urgk]

54. "So everyone, incl. the patients, are a bit to blame, IMO. "

But, in defense of the general public, we are carefully trained to panic. Because somebody out there stands to make money from it. For every headache, for every sore joint, for every small ache or pain, there is a corporation ready to sell us medicine to cure it. And a media outlets to sell ad space while we watch stories about how we're going to die from it.

Let's not pretend that the average person has come to his own conclusion that he can spend his way out of pain or even mortality.

(edited to make a noun agree with a verb :))

[Honeycombe8]

124. I DO think that the avg person is primarily responsible for his/her health, and has a duty

to read up on health and symptoms.

We have an obesity epidemic. This is caused by the people themselves, and leads to a record number of cases of diabetes and other obesity-related ailments.

We have a diabetes II epidemic. This is caused by lifestyle. Period. So people eat at Popeye's Fried Chicken, then go to the dr. to get insilin. Their business, except they expect their employer's insurance to pay for it. Which means MY ins. premiums at my job go up.

The citizens are not solely to blame. Not even close. But they are part of the problem. The diabetes patient? She/he knows (if he read up on it), that he wouldn't need insilin if he changed his lifestyle. He won't get the information from a doctor. DOCTOR'S ARE IN THE BUSINESS (YES...THEY ARE A FOR-PROFIT BUSINESS) OF TREATING ILLNESSES WITH DRUGS. Doctors are NOT in the business of preventing illnesses, or giving common sense non-drug advice in lieu of drugs. Sometimes they do, but those are few.

I don't fall for the TV ads about nervous leg syndrome and such. In fact, I find them funny. I also find it very weird that drug cos. are advertising.

I'm not perfect. I'm 55 years old and a bit overweight. I struggle with my weight. But I TRY to get some exercise several times a week, and walk my dogs several times a week. I TRY to eat raw fruits and veggies every day. I take vitamins and minerals (they may not help...but they MAY, so why not take them?). I do yoga occasionally for stress (and the walking helps). I make it my business to read about nutrition and health on a regular basis.

Diabetes and heart trouble runs in my family, but because I work on trying to stay healthy, so far I've beat the odds. Result: Every decade my cholesterol goes down (it's about 133 now....used to be over 190 in my early 30's). My blood pressure stays pretty low. My LDL cholesterol is half of what it used to be. All my other bloodwork has always been normal. I take no medication whatsoever....unless you count my hormones. I didn't want to take hormones. I fought it and tried alternatives. Finally, I succumbed after experiencing the embarrassing hot flashes and having a temper tantrum so bad that I quit my job after working there for 17 years! I'm feeling much better now. (My employer let me take back my "quitting.") I find that the more people stay away from doctors, the healthier they are. Realize that: EVERY medication has a side effect. There are no exceptions. The symptom you're trying to treat with a medication? That is, in effect, a side effect of the mediation, as well. So they can have repercussions.

[TreasonousBastard]

133. Actually, I do remember those days, and the punditry about...

how every little hangnail was going to be a two week hospital "vacation" because insurance would pay for it.

At the same time, diagnostic and treatment technology was exploding, with medical cost "inflation" not being so much price inflation, but all of the new treatments and procedures available-- at a price.

That last part hasn't changed, and many health insurance companies are negotiating price with providers-- something not mentioned by many with the kneejerk insurance company hatreds. The evil profits they make can easily be counterbalanced by lower prices negotiated.

But you'll never get anyone to believe that.

[harun]

50. Just look at Canada and Europe asshole. No one is claiming

single payer solves all problems. It does take care of the biggest problem and that is for-profit insurers, which do NOTHING to improve care, are taken out of the equation.

[redqueen]

69. The problem is there are people saying "END PRIVATE INSURANCE!!!!111elevens!"

It's ridiculous. Both sides of this nonsense.

[harun]

72. Think about what you are saying. What good is Private Insurance?

How does it make your care better? How does it make your coverage better?

We don't need to end private insurance now, even though we should. We just need a gov't option, like Deen is suggesting. We get the gov't option and we are on the way to real reform. Without it we get nothing.

[redqueen]

73. Exactly. It doesn't matter what good I personally think it is or is not.

What matters is improving the situation... and that means using a solution that is possible... not pie-in-the-sky, foot-stomping, unrealistic nonsense.

[harun]

75. It is only unrealistic if people think it is, I don't. Without the threat of going

full on H.R. 676 the current system will not change. You hold H.R. 676 over the heads of the for-profit insurance lobby and you have a better chance at getting a gov't option included like Deen suggests. You need to threaten the for-profit insurers with annihilation to get their attention. If not, there will be no reform, their lobby is too good and too well funded.

[redqueen]

77. But even HR 676 doesn't eliminate private insurance. (nt)

[harun]

107. Yes it does. It makes it unlawful for anyone to offer the same services

as the gov't plan.

SEC. 104. PROHIBITION AGAINST DUPLICATING COVERAGE.

(a) In General- It is unlawful for a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act.

(b) Construction- Nothing in this Act shall be construed as prohibiting the sale of health insurance coverage for any additional benefits not covered by this Act, such as for cosmetic surgery or other services and items that are not medically necessary.

Which is why the bill is flat out awesome!

[Laelth]

126. Thanks for this information. I didn't know that. n/t

:dem:

-Laelth

[Stinky The Clown]

52. Well that settles it for me. I'll just go over there in the corner and die

You'll get to run your numbers with one less.

[Bluenorthwest]

62. Is there anyone who has not profited from the Insurance biz

that thinks they should continue to profit? Every poster who dislikes the idea of not for profit health care seems to have spent years working for the Insurance Companies. Now, I've not been active in my profession for a few years now, but I still advocate for that profession like mad, at every turn. My people, to whom I shall return, always get my voice. I'm sure the Insurance Profit crowd is the same way.

[redqueen]

67. Why are so many people here so dedicated to black and white thinking?

We cannot and will not just eliminate private insurance companies.

However, we need a single-payer system set up alongside the private system.

Seriously... it's not rocket science.

[Chan790]

74. Because...

the continued existence of private insurance is yet another factor that drains $ out of the system after the implementation of a nationalized single-payer healthcare system. Single-payer is important but the end of the private insurer while making sure that people have access to healthcare is more important. The goal should be to bankrupt the vampires in order to rein-in the exploding cost of healthcare, not to implement another bureaucracy on top of or in supplement to the current boondoggle. I'd gladly forgo single-payer if I could get the insurance companies forced to go non-profit or defunct and refused the ability to deny coverage to applicants. They'd no longer have a motivation to operate in the current fashion. At that point, you mandate coverage and you take health insurance out of the workplace.

It's one of those cart/horse things.

[redqueen]

76. Is there any country where private insurance was abolished

before single-payer was implemented?

Not sure what you maen by cart/horse... are you saying that we have to get rid of private insurance before we can have single-payer? That's not how it was done in Canada.

[Chan790]

79. I'm saying given a choice between...

the current system with single payer being added the way it's advocated by supporters of HR676 or simply not actively pursuing single-payer and banning for-profit insurance providers...I'd choose the latter because single-payer is a simple logical outcome of that whereas passing single-payer then trying to eliminate the private industry will only result in failure and permanently saddle us with a now-institutionally-entrenched private health insurance industry. The problem in healthcare is the middlemen expense of that private industry...not who's paying the bills in the end.

Yes, everybody has chosen the path of least resistance...but that path of least resistance is the cause of all the criticisms that are leveled against single-payer. The absence of single payer is not the problem, the existence of for-profit health insurance providers is.

Cart/horse. Implementing single-payer does nothing to control costs as long as private options of supplements exist. Thus the first step is to strangle the for-profit health insurance industry, not the implementation of single-payer.

[redqueen]

81. So... *is* there any country where that's been the process?

And also, do you think that eliminating private insurance and then implementing single-payer is possible in this country?

[Chan790]

82. That's never been the process anywhere...

and the inefficiencies that result are the "proof" pointed to by opponents of nationalized healthcare as for why nationalized or single-payer healthcare doesn't work. So why hasn't it been tried? Likely because those same opponents have argued everywhere every time for the necessity of the private option.

I absolutely think that elimination of the private health insurance industry will fulminate a resulting comprehensive healthcare system, whether that system is federally-run and funded by tax dollars or a highly-regulated choice-based compulsory model between non-profits with regulated premiums. It's the organic conclusion. Eliminating the middleman of the private insurance company in and of itself lowers the cost of services and bring price controls back into the system...however people will not stand, after so long, to live in a system with no health insurance. A proposal (or multiple proposals (Conservatives will certainly propose to reinstate the current model.)) to provide some sort of safety net would necessarily follow.

I'd be wary to call either of the possibilities I outlined above "single payer" as I don't know that the first would resemble anybody's current idea of a single-payer system (i.e. those that exist elsewhere. I'm pretty sure it would not as it would be both more efficient and demand different payment models and price-control, fraud-control and oversight methodologies.) and the second is more of your choice between "health administration systems" (based around any number of differences or treatment theories which are not fiscal in nature. Someone assuredly will propose one that is "family values" centric...others might emphasize homeopathic medicine or naturopathy or vegan diet or emphasis on diet and exercise or Chinese medicine, etc. ) although there is only one payer, whether that payer is the individual or the state. I personally favor the second model as it allows more choices to the consumer for the philosophy of treatment.

[redqueen]

84. But I didn't ask if single payer would be the result

of absolishing private insurance... I asked if you thought such a thing was possible in this country, at this time.

[Chan790]

104. If enough people are willing to fight for it, then yes. N/t

[redqueen]

105. That's a condition I don't see beeing the case anytime soon. (nt)

[TreasonousBastard]

135. Near as I can tell, private insurance hasn't been...

abolished anywhere, except in Cuba.

36 countries rate higher than us in healthcare on the WHO chart, and most, if not all, have some sort of private plans in addition to any public ones. (And we haven't started to look at Japanese and Taiwanese health care yet...)

But, hey, it's easier to say they all are "single payer" (whatever that is) and point to insurance companies as the villians.

Saying it must make it true.

[lumberjack_jeff]

89. I think you're using "single-payer" as synonymous with "public"

By definition, single payer can't be "set up alongside the private system"

If what you're saying is that everyone should be able to buy into medicare, then I agree. It will outcompete private insurers and eventually become single payer.

[redqueen]

94. Is hr 676 not a single-payer plan?

I thought it was...

If not, then maybe I don't support single-payer.

[lumberjack_jeff]

111. hr 676 is single payer.

It replaces private insurance.

From Conyer's website;

Private health insurance companies will be prohibited from selling coverage that duplicates any benefits included in the universal national health care program. The private companies will, however, still be able to sell coverage for services that are not deemed medically necessary, such as many cosmetic surgery procedures.

http://johnconyers.com/hr676faq

[Jakes Progress]

78. Kinda free with the insurance lobby info.

There are many problems in health care. If you are part of the health care insurance industry, you are part of one of those problems.

[biopowertoday]

90. Its a major problem. Did you see this?..........

Deep and strict insurance regulation is the key for its success


http://economix.blogs.nytimes.com/2009/04/17/health-reform-without-a-public-plan-the-german-model/



April 17, 2009, 7:02 am
Health Reform Without a Public Plan: The German Model
By Uwe E. Reinhardt



............In Europe, as in Canada, that social ethic is based on the principle of social solidarity. It means that health care should be financed by individuals on the basis of their ability to pay, but should be available to all who need it on roughly equal terms. The regulations imposed on health care in these countries are rooted in this overarching principle.

First, these countries all mandate the individual to be insured for a basic package of health care benefits.

Many Americans oppose such a mandate as an infringement of their personal rights, all the while believing that they have a perfect right to highly expensive, critically needed health care, even when they cannot pay for it. This immature, asocial mentality is rare in the rest of the world. An insurance sector that must insure all comers at premiums that are not contingent on the insured’s health status — a feature President Obama has promised — cannot function for long if people can go without insurance when they are healthy, but are entitled to premiums unrelated to their health status when they fall ill. ....................

[Jakes Progress]

101. Why Germany won't work here.

It's in your first sentence. The German plan requires "social ethic" and "social solidarity". I could see a strictly regulated industry that had, at its core, a desire to make things work. But the US is a unbridled capitalist country. We don't successfully regulate industry. We have almost no examples to rely on. When corporations get so bad that their excesses piss everyone off, we regulate them lightly. Even those light regulations fall within a decade as our bought and paid for congress writes new rules and new laws to let their benefactors run unfettered again.

Witness what we have done with the banking laws that we passed after the last depression.

Any corporate portion of the equation will be corrupted. We have a crappy and unequal medical system because of big insurance. We can point to how Germany does it, and we can say that Canada doesn't work, but the single-payer system is still the only one that has a chance in our corporate dominated country.

[TreasonousBastard]

136. I'm not part of it, as you would know if you read my post, but...

just what is your expertise in healthcare or insurance that lets you make such a weeepiong statement?

[Jakes Progress]

139. Read your post. Read mine?

I didn't say you were a part of the health insurance system. I said if you were, then you are a part of the problem.

You suggest that I have no business commenting on the industry because I am not a part of it. But you say you are not a part of it, although you rant at length about it. Kind of inconsistent thinking, don't you think?

I would suggest that I have a better view of how the system works than one who works inside it. I am on the receiving end of the system rather than the profit side. I get to see how it works rather than just how profitable it can be made. From out here, (the receiving end) the system sucks. From inside, you may see methodologies for maximizing profit and eliminating waste. (Would that be sick people?). But a purely corporate view of healthcare is the problem. You see it as a business. I see it as a service.

Hence our disagreement stems from two different points of view. You have a right prefer view the world through corporate-colored glasses, but you do not have any right to claim that your viewpoint is more valid than mine.

(Also. I know I'm kinda out of it, being an old fart and all. So I am not up on all the blog speak. I tried several alternative dictionaries and still couldn't find anything that explained your last adjective. I assumed the three e's were a typo, but even with only two e's, the only thing I can find is a link to an audio sound effect file. A little help with the new slang please.)

[TreasonousBastard]

144. And there was no reason for you to ask if...

you had bothered to read what I said. And you were not simply asking, you were implying with your question.

I do suggest that many of your comments, and those of others like you, are irrelevant as they are anecdotal, missing the larger picture, and generally born of ignorance.

When I was an underwriter, I had people outside the industry constantly telling what my job was and how I should do it. Just for fun, I would sometimes ask them how to calulate IBNR and relate that to inflation on future claims and the effect on my reinsurers-- and ultimately how that would affect their premium costs in two years. That's when they just said something about bullshit and ran off.

When I owned a driving school, I had people who had just flunked a driving test explain to me what went wrong, and completely ignoring anything I said. Even after I quit that business, I never could get in a word edgewise when the subject of troad tests came up, and that I got over 90% of my students through the test the first time made no difference.

Just two small examples of how the First Corollary to Parkinson's Law of Triviality manages to overwhelm any discussion of a complex subject when just anyone is allowed to chime in.

Now, just to make it clear, I am not defending health insurance companies when they wrongly deny coverage and increase suffering. I am defending the concept of health insurance and insisting that health insurance companies alone are not the root cause of our healthcare deliver probelms here.


(and about that odd word-- it had something to do with chasing the cat off the keyboard. Yes, I should have checked for "sweeping" before posting, even if most people might have guessed what it should have been or at least not been so snotty about it.)

[Jakes Progress]

145. ??? What are you on about in your first sentence.

It really takes a lot effort to make meaning of your leaping logic lapses. Those first two sentences have no basis in anything that was discussed. Were you trying to say something or did the cat get to your keyboard again.

I can see where your are coming from from your rant about all the people in your life that don't understand what you mean or who are not nearly as brilliant as you. Of course they are always the dumb ones. They are always the ones who just don't measure up to someone as clever as you. Don't examine the reasons for this. It won't turn out well.

Your two small examples are proof of my comment that those on the receiving end of services have a pretty good idea about how well those services work. Your gobbledy-gook about underwriting only emphasizes what I found when I worked with two different state insurance boards. I was part of a group hired to help insurance companies write policies in clearer language - one was a state mandated change, the other was a matter of good intention. In both cases, the work was dropped when they found that if policies were written clearly and with a point of making them less purposely obtuse, fewer policies were sold. The state mandated program was scuttled when the insurance lobby spent several million dollars to have the law "augmented" with just the kind of loop holes and double speak that are used in policies.

Your example of how clever you are also underlines my point that you seem to deliberately miss parts of posts that you don't have any argument for. I don't care if you can do math. So can a lot of people. You still didn't address the central issue that the insurance industry adds nothing to the health care issue but a level of expenses for lobbying and profit. Whatever other problems with universal health care there may be, adding insurance costs into the equation doesn't solve one single one of them. Try that math.

Notice that there is no groundswell of support for your point here. Of course that would be because you are so much brighter than all the fools who spend time on DU. Could it be that some of them are the underwriters and driver's ed teachers who have the insight and you are the one who won't listen.

(I taught a little driver's ed once. Total of 174 students. 3 failed. You do the math.)

(My question about the word wasn't snotty but genuine. But snotty seems to be the tone that goes with this thread.)

[TreasonousBastard]

146. And the bottom line is...

in all of those words you have not bothered to come up with the slimmest of arguments just WHY the insurance industry adds nothing.

You have also failed to address the underlying costs, which drive the premiums.

BTW, I was once the liason for my line to a firm the company hired when NY required some policies to be plain language. Since I had already spoken and written publicly about the coverages, I wasn't worried about what the reaction would be to the new policies, but was very worried about the lawsuits-- some of the wording was well over a hundred years old and had been defined by the courts during that time and we weren't looking forward to starting the process over again. We did end up issuing the new policies, however, so perhaps something else was wrong with your efforts.

[Jakes Progress]

147. Nice try.

In all of those words you have not bothered to come up with the slimmest of arguments of just why (capitals for emphasis is just lame) the insurance industry adds to the quality and abundance of health care. Premiums are the cost of health care plus profit and expenses. Without those profits and expenses (lobbying being a major expense) health care would be more affordable for whatever level is achieved. X dollars for a gall bladder operation under single payer. X dollars plus y dollars plus z dollars for a gall bladder operation under corporate insurance health care.

You have again assumed something that I never said. I didn't say other parts of the health care system need reforming. They do. But nothing that includes insurance profits will help with those. They are a separate matter. The old saw that insurance companies help hold down costs is just wrong. Insurance corporations are driven by profit. They don't care how much the health care costs as long as their profits are written into the system. Controlling costs needs to be done, but insurance companies just take the costs, add their profits (courtesy of the underwriters) and pass it on.

We basically have a different view of how health care should work. Again, I see it as a right of all citizens. You see it as a business proposition. No amount of argument will convince you that people should have health care the same way we have national defense. Nothing you argue will convince me that an American's health care should be a source of profit for corporations. That is not because we won't listen. it is because we have different values.

By the way, I hope your work for NY wasn't done for the health care insurance industry. As late as last summer, the policies from NY were used as fodder for seminars about insurance obfuscation and trickery. True, the auto, health, and especially life insurance programs in the two states where our team worked had problems. It wasn't with the clear writing of the policies. It was that they were writing policies that were poor examples of serving clients. When clients could understand what was being sold, they decided not to buy. Both states had rates significantly higher than those available in neighboring states. (Insurance companies in both states were losing money, not because of pay out on policies, but because of lousy real estate deals that they had been using money that should be used to insure their policies. They were using policy profit margins to subsidize their bad investments.)

[lumberjack_jeff]

85. The last line was great.

Now just lose the nine paragraphs that preceded it.

The reason that single payer works (unlike the patchwork quilt of insurers) is because it can establish rational prices for services. In exchange, doctors and hospitals know that they'll be paid for each service they provide.

[Oregone]

103. hospitals don't always care if they are paid...

They mark up the prices to siphon as much as possible (probably working off some formula of payout vs cost to find the optimum charges).

Then, they write off the rest as a loss (a marked up one at that) and pay a fraction of the taxes they should. This is the current fiscal model in the health industry in the states.

When you mark things up enough, the tax advantages on the losses become quite valuable in themselves.

[Laelth]

86. "Nasty, thieving insurance companies."

I couldn't have said it better, myself.

:dem:

-Laelth

[ItNerd4life]

91. I hope Obama's proposal (when it comes)

does include basic coverage for everyone and then people can get higher end care if they so choose.

The basic coverage definition will be the sticking point for most Americans.

[Oregone]

102. (if it comes)......

And if it does, its probably going to be nothing like that. It seems everyone is moving towards mandating private insurance, and pretending you are fixing it by putting a few bandaid regulations on it to look good. It may be another 50 years before anyone gets the balls to do something real. Sorry.

[Puzzler]

98. Actually in Canada, the system is provincial...

... rather than "national". In other words, every province (and territory) administers its own system. But they are all single-payer. Incidentally, in Canada, you are quite free to not pay any provincial medical insurance... the doctors are quite happy to send you a bill, just like in the US. The only difference is that we have this one huge plan that everyone can get, that the doctors/clinics and hospitals can bill. All very simple, actually. And, oh yeah... you can go to any doctor you want,

[question everything]

100. About health care reform

1. Access to health care should not be tied to employment or jobs. This is what started us on this slippery slope - when, after WWII, when there was a wage freeze, employers went around it by offering "benefits."

2. It is a right of every citizen to have access to affordable, reliable health care. The whole idea that people could die for lack of insurance does not belong in any society, certainly not in ours.

3. Such access should be funded by our taxes. My personal premium has been around $400. I'd rather pay this in tax and know that I will never have to deal with "pre existing" conditions.

4. While everyone should be taxed and be eligible for health care, this should not be the only system. If anyone wishes to go to a physician or a hospital and pay for it from his pocket - fine let him do this. We should compare such a system to the public school one: we support it with our taxes, every one can attend public school regardless of the family income or employment, yet anyone is free to send their kids to private schools.

5. We should accept the fact that none of us will leave this world alive. There were studies showing that for many of us, 90% of our medical expenses occur in the last year of our life. We need to be able to let go. There is no need to perform a triple by pass operation on a 90 year old person. And there is no need to perform "heroics" on someone who has lapsed into a coma who has been battling a terminal illness for a long time. I've heard that in many cases even a "Do not resuscitate" notes get ignored. And we have to many expensive tests because physicians and hospitals are cover their asses.

[Skwmom]

106. What's NONSENSE is having an unnecessary middleman.

If we got rid of the insurance companies, all of the money paid for insurance premiums could be used to pay for GOOD QUALITY health-care.

And yeah they are nasty, thieving insurance companies. Let's close them down and all of those people can be rehired do the necessary administrative paperwork.

Your post is pure hogwash.

[biopowertoday]

108. Obama and congress will never go far enough to really regulate

the companies as you suggest. Ideal but there is no political will to regulate those who donate to their campaigns.

[kath]

118. "no political will to regulate those who donate to their campaigns"

Yeppers, there's the rub.

Government of the corporation, by the corporation, and for the corporation.

[babylonsister]

113. Thanks. Bookmarked and recommended. nt

[avaistheone1]

121. THE ONLY NONSENSE IS THE EXISTING HEALTH INSURANCE SYSTEM -

Yes, I am screaming. The existing health insurance system in this country is ridiculous and a total rip off. :grr:

In the U.S. we are paying twice as much as other leading industrial countries for health care and having very poor results in our mortality and morbidity rates.

The existing system doesn't need to be tweaked. We need single-payer universal coverage. It has very low overhead, and will provide for good care. Last but not least it will provide over $2.6 million new jobs. Woohoo!

[alarimer]

132. Watch Sicko and it will all become much clearer.

And very obvious why we need single-payer health care.

The insurance companies are the reason why health care is so expensive. They charge ridiculous rates for premiums and then spend a lot of time denying coverage. It's all explained very well in that movie.

Plus we spend a larger percentage of GDP on health care and we have millions uninsured. Canada or England or France all spend a lot less on health care and every single person is covered.

Now Germany has a different system. It is private insurance but it is all very tightly regulated. Even that would be an improvement. But I think a Canadian style system works best. We already have the system in place. Medicare. Simply extend it to everyone. We would all pay premiums or we would pay higher taxes. And everything necessary would be covered but at much lower costs than we have now, simply because of the buying power of 300 million. I could give a rat's ass about the insurance companies. They are evil incarnate. But they could simply switch to selling life insurance or something.

[GreenTea]

141. Bullshit!

In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is "single-payer insurance." In talking to Americans about it, the better phrase is "Medicare for all."

Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don't have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid -- quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren't interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor's debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family's major expenses, expectations tend to run very high. A doctor's mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it's no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they're not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don't have to include coverage for future medical costs, which reduces the insurance company's liabilit

Most insurance companies are for profit corporations and as such have a CEO, CFO, president, board of directors, salespersons, other employees, and shareholders to which dividends must be paid. Therefore the total amount of money any insurance company can payout is the total amount of insurance premiums collected, plus any income or loss made on the investment of those premiums, minus the salary of the CEO, minus the salary of the CFO, minus the salary of the President, minus the salary of board of directors, minus the salaries and bonuses of salespersons, minus the salaries of other employees, minus the dividends paid to shareholder.

This scenario works well for insuring just about everything except health care. In order to cover those large non-healthcare expenses, insurance companies must attempt to insure only healthy people thus denying many with preexisting conditions any coverage. They must deny as many surgeries and procedures they can get away with and they must deny many medications.

We have tried PPOs, HMOs, and everything in between and they have all failed to reduce cost, increase service, or insure everyone.

A for profit market based system for creating medicines, medical procedures, and medical devices is likely the best way to ensure that we will realize innovations in medicine. That said, as a country we must decide if delivery of these health care services is more efficient with for profit insurance as opposed to a single payer nonprofit based insurance system. After careful analysis, the only solution to our healthcare problem must begin with a single payer insurance that does not restrict which doctor or hospital you use. With a single payer system:

* Duplicate staffing at doctor's offices working with multiple insurance companies and medical plans no longer exist thus reducing the doctors cost to deliver healthcare
* Exorbitant salaries to multiple managements vis-à-vis multiple CEOs, CFOs, presidents, and the like no longer exist and as such more monies to deliver healthcare
* Stock holder dividend payments no longer exist yet again more monies for healthcare
1. Canada's health care system is "socialized medicine."
False. In socialized medical systems, the doctors work directly for the state. In Canada (and many other countries with universal care), doctors run their own private practices, just like they do in the US. The only difference is that every doctor deals with one insurer, instead of 150. And that insurer is the provincial government, which is accountable to the legislature and the voters if the quality of coverage is allowed to slide.

The proper term for this is "single-payer insurance." In talking to Americans about it, the better phrase is "Medicare for all."

2. Doctors are hurt financially by single-payer health care.
True and False. Doctors in Canada do make less than their US counterparts. But they also have lower overhead, and usually much better working conditions. A few reasons for this:

First, as noted, they don't have to charge higher fees to cover the salary of a full-time staffer to deal with over a hundred different insurers, all of whom are bent on denying care whenever possible. In fact, most Canadian doctors get by quite nicely with just one assistant, who cheerfully handles the phones, mail, scheduling, patient reception, stocking, filing, and billing all by herself in the course of a standard workday.

Second, they don't have to spend several hours every day on the phone cajoling insurance company bean counters into doing the right thing by their patients. My doctor in California worked a 70-hour week: 35 hours seeing patients, and another 35 hours on the phone arguing with insurance companies. My Canadian doctor, on the other hand, works a 35-hour week, period. She files her invoices online, and the vast majority are simply paid -- quietly, quickly, and without hassle. There is no runaround. There are no fights. Appointments aren't interrupted by vexing phone calls. Care is seldom denied (because everybody knows the rules). She gets her checks on time, sees her patients on schedule, takes Thursdays off, and gets home in time for dinner.

One unsurprising side effect of all this is that the doctors I see here are, to a person, more focused, more relaxed, more generous with their time, more up-to-date in their specialties, and overall much less distracted from the real work of doctoring. You don't realize how much stress the American doctor-insurer fights put on the day-to-day quality of care until you see doctors who don't operate under that stress, because they never have to fight those battles at all. Amazingly: they seem to enjoy their jobs.

Third: The average American medical student graduates $140,000 in hock. The average Canadian doctor's debt is roughly half that.

Finally, Canadian doctors pay lower malpractice insurance fees. When paying for health care constitutes a one of a family's major expenses, expectations tend to run very high. A doctor's mistake not only damages the body; it may very well throw a middle-class family permanently into the ranks of the working poor, and render the victim uninsurable for life. With so much at stake, it's no wonder people are quick to rush to court for redress.

Canadians are far less likely to sue in the first place, since they're not having to absorb devastating financial losses in addition to any physical losses when something goes awry. The cost of the damaging treatment will be covered. So will the cost of fixing it. And, no matter what happens, the victim will remain insured for life. When lawsuits do occur, the awards don't have to include coverage for future medical costs, which reduces the insurance company's liabilit

* Health Insurance salesmen's' bonuses and salaries no longer exist yet again more monies for health care
Given that every American at some time gets sick or gets into an accident that ultimately we all pay for directly or indirectly, every working American should contribute to the single payer pool. The unemployed must be covered as well

Many argue that a single payer system would be restrictive. It is untrue. HMOs and PPOs are very restrictive. They select the pool of doctors you may choose from. They select what procedures and surgeries are allowed. They select what medicines can be prescribed. Why; because of their bloated cost structure.

Many argue falsely that it would be too expensive to include the uninsured. Every person paying for health care insurance directly or indirectly is paying for the uninsured given that they are not denied medical coverage anyway. They simply get more expensive coverage in emergency rooms.

Over the last 25 years we have allowed a very destructive thought to metastasize in our brains. We have allowed politicians and private enterprise to convince us that all government is bad, though when private enterprise has failed, they have constantly begged the government for rescue. The reality is that we must have a balance between both. Our health care system needs a competently run government. Government and competency are not mutually exclusive. We are the government and we can make it as competent as we want it to be first by electing competence instead of ideology.

We are at an impasse with health care. It is imperative that we open our minds and look at the problem objectively, factually, and by the numbers. A single payer system is ultimately our most efficient choice.

http://singlepayerhealthcarenow.com/
http://tpmcafe.talkingpointsmemo.com/talk/blogs/politicaltruths/2009/04/a-single-payer-healthcare-syst.phphttp://singlepayerhealthcarenow.com/

[grantcart]

142. I spent 18 years overseas and half of that time worked with doctors

from industrialized countries who took off a year or two to work with us (refugee related).


Every single doctor was from a country that had single payer systems and every single one of them (out of 50) preferred their system to the American system, which they were very familiar with.

I also am now involved in insurance benefits. When it comes to providing health care, once you have established that it is a right and not a rare commodity, insurance companies simply provide another profit center and don't actually add to providing any service. Once all of the efficiencies have been achieved and the industry matures they can only compete by denying care.

Tremendous efficiencies could be achieved if there was universal care and more emphasis was made on preventative measures, but there is no incentive for 'for profit' companies to do so, just as there is no incentive for drug companies to research how existing or inexpensive medicine could provide effective cures.

In Germany, for example, the government guarantees the revenue source but the actual administration of the system is done by 'not for profit' insurance companies that compete. Actual health providers continue to be private practices and compete for consumers by enhancing the quality of care.

No other country in the world wants to duplicate our system. No health providers anywhere in the world think that our system is an effective answer to public health and an efficient administration of medical care. No where.

[Sparkly]

143. "Single Payer" means eliminating the need for private insurance.

Insurance could still be purchased, but health care would be provided with or without it.

To an extent, health care is already provided without it -- but inefficiently and at enormous costs to everyone.

The key is the evil word, "mandatory." Everybody pays (to the extent they are able), everybody is provided for.

As for concern about loss of jobs in the insurance industry -- that would be more than made up for in the economic boost from businesses being out from under the burden of having to provide health insurance.