Alright, here we are. On the verge of "change" in health care. Some - mainly conservatives - are upset because they think Obama's plan will inevitably lead the way to some sort of arduous socialized health system under the guise of single-payer. And then some such as I are upset because I know single-payer health care is not in the works.
There are many other aspects that completely upset me about the health care reform issue. However, today I am only going to address the payment side of things, mainly the single-payer obfuscations that persist in the public debate.
Issue numero uno: the name. The term single-payer in itself has become somewhat enigmatic, and is meant to be that way. Single-payer health care has been replaced with such titles as "Socialized Health Care" and "Public Options". The stigmas that are attached to these terms are not fitting in the least bit. Socialized health care is a system whereby the government runs and controls the financing as well as the delivery of health care. And yes that is complete government control.
On the other hand, single-payer health care is a system whereby all medical treatments are paid for entirely by one entity (ie. the government). In other words, an individual has complete freedom of choice to which doctor they would like to visit, which hospital to be admitted to and so on. The difference being that the payment would come from just one payer instead of the hundreds of private (mostly for-profit) insurance companies we have in place today.
So that's that. Same system of health care delivery we have today. Same hospitals, same doctors, same procedures. Single-payer would just take advantage of being a non-profit, consolidated and more efficient means of paying those doctors and hospitals. I find that the Physician's for a National Health Program sum the situation up quite eloquently:
"Private insurers necessarily waste health dollars on things that have nothing to do with care: overhead, underwriting, billing, sales and marketing departments as well as huge profits and exorbitant executive pay. Doctors and hospitals must maintain costly administrative staffs to deal with the bureaucracy. Combined, this needless administration consumes one-third (31 percent) of Americans’ health dollars.
Single-payer financing is the only way to recapture this wasted money. The potential savings on paperwork, more than $350 billion per year, are enough to provide comprehensive coverage to everyone without paying any more than we already do."
Over the next three or four posts, I will continue analyzing the single-payer debate from different angles. I will touch on topics of physicians autonomy, health care as a right v. a privilege, wait times and lessons from Canada, and other topics.
- m.tsang
2 Comments:
I don't know how you can say, “government run” is synonymous with “more efficient.” I suppose if you think Medicare is a great system, that might be true. I don’t know if you have ever tried to get something out of the ordinary covered under Medicare, but I have. No thank you! Talk about lack of choice. Maybe the post office seems more efficient to you than UPS or Fed-Ex? And you would rather have over paid government employees, which has never innovated anything which are paid off of taxes on private industry than highly paid private industry that create new jobs, and innovation. But maybe you think Al Gore invented the internet?
You say we will have the same doctors choice, same hospitals, same everything we will have now. Let me ask you this, if a doctor decides not to accept obama-care reimbursement rates, and decides to accept cash only, or only accept private insurance from a private company, then what do you have? You have a two tier system. One socialized system for the poor, and one private system for the rich. I thought in America we were supposed to be against class based systems? But I suppose if having poor people vote democratic keeps the democrats in power, then we can see the real motivation of the party. It was a Republican who freed the slaves. You might of heard of him, Lincoln? After all, the democrats supported slavery in the south, and Jim Crow laws until the 1950-60’s. But since our liberal public schools don’t teach history, and try to ban the pledge of allegiance (..to the Republic for which it stands…ring a bell?) they are perpetuating the poverty and classism that keeps them in power.
Dear Anonymous,
I appreciate your overtly condescending tone an patronizing attitude. (Wait, Lincoln was the first Republican to be President right? Like OMG thank you so much for enlightening me. You mind explaining the differences between the Republican party of 150 years ago and the current party today?) Because after all you being able to take jabs at my intelligence is the heart of the matter. Where as you would like to shift the focus onto unconstructive disparaging I would rather focus on the subject at hand.
You do bring up a good point regarding reimbursement rates and/or how doctors would be paid in such a system. It is true that the paradigm under which at least half of all practicing physicians view their practice would have to change. (I say half because polls show that more than half of all practicing physicians now support some type of universal health care in the U.S. - See previous blogs) Taking a lower salary is a probable outcome. But there is no reason to think that this could not be a salary worth practicing for. There are plenty of other countries with health systems that demonstrate that scenario. But maybe the only way to avoid this is to exclude private insurers from the system altogether. And no, you can't compare this to how one ships their mail! There are many good essays on why free-market forces fail to effectively lower prices and improve efficiency. Health care is not a real "commodity" like other products you purchase for yourself. If you can find it online or in a library, read Kenneth Arrow's Article on the Economics of Health Insurance from the American Economic Review of 1963. He makes four solid points as to why this is:
1) The demand for health services is no regular or predictable
2) The supply of services does not simply respond to the desires of the buyer but is truly determined by a physician
3) There are limitation on who can enter the provider side of the market due to high start up costs and education, licensing and so on
4) There is significant insensitivity of prices and a near absence of price competition.
- m.tsang
p.s.) I do prefer the post office to UPS, and reciting an allegiance doesn't mean you are any more patriotic or devoted to improving the country in which you live. I am sorry you see this wholly as a Democrat v. Republican issue whereby you lie on the correct side. You are part of a united R&D faction as I lie separate by being independent. When you want to stick to focusing on the facts instead of trying to belittle what political party I may or may not be apart of, I would love to continue this discourse.
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