[mikemike]

ALL methods to date (except universal in a sense) have failures.. quantify to what degree of failure and you may have an argument. Failure should be compared to current failures, NOT left in a vacuum........

Mike, the whole idea should be to get away from insurance entirely and just have universal health care with a single payer (a government department).

I am seeing a lot of arguments saying that single payer would be good and is what we need but no argument that the ACA as passed or as the president wishes that it be amended will make headway in improving things.

[jolepp]

A related article: It’s The Prices, Stupid: Why The United States Is So Different From Other Countries ? Health Aff

[stevewig]

I am seeing a lot of arguments saying that single payer would be good and is what we need but no argument that the ACA as passed or as the president wishes that it be amended will make headway in improving things.

The single payer health care system is so foreign to the whole philosophical way of life in the USA that it is not surprising that it appears to be impossible to accomplish it. The almighty power of the Drug Companies, the Insurance Companies, their lobbyists and the accompanying propaganda machine (some of it repeated in this forum) is such, that even the small steps taken by the Democrats (so called “Obamacare”) - after much political fighting – has resulted in changes that are still far from the intended goal.

This makes things so much easier for the propaganda machine to continue its tireless work.

The power of the total propaganda machine, still in use, is able to make people whose lives would be vastly improved by single payer system really believe that this is the worst thing that could ever be done for them.

The propaganda machine successfully relies on the lack of interest in complexities and of knowledge in the masses.

[BigDave]

Whether people want it admit it or not, one of the reasons you can get good care in this country is because it is a profit based system. Drug companies can pursue any disease they want to develop a treatment/cure for. Surgical procedures can advance because people have a vested interest in the system. Yes, they want the monetary reward for their labors. Yes, it can be expensive. I pay over 1K a month for me and my family, mostly out of pocket.

However, if you put everyone in the health care industry under a government program, then the GOVERNMENT decides what to spend the money on. This includes both treatment and research. Yes, there is government money going for research now, but there is also drug company money, medical devices money, etc. that also gets used for research. Put the government in charge of it all and it will just be government money. And all of it will be dolled out in committee, congressional committees decide who gets what. Talking about a bloated and overbearing bureaucracy! And the potential for corruption! WOW!

When it comes down to it, do you want some board saying you cannot have treatment because you are "too sick", "too old" or they "tried too many times"? At least with insurance companies making these decisions, there is an appeal process. And even if they still say no, you can use your own funds to pay for it if you want. Under the one payer system, you cannot! Pay your own way health care goes away also. If you appeal, with the government run program, then you are dealing with a government, the appeals will be harder to get and harder to overturn. Remember, you can't fight city hall (or congress, etc.).

Have you ever known a government program that made things simpler and easier??? And PLEASE don't argue that is what their current program is trying to do. Again, I ask the question, Have you ever known a government program that made things simpler and easier??? They just can't help themselves it seems!

[Nesster]

Question: what makes you assume there's not an appeals process, whoever makes the funding decisions? Insurance company or single payor, same thing. Only the private company keeps their other eye on profit.

As for laws being imperfect when passed - most are, and those that are not would tend to be trivial ones. Everything is subject to the test of efficacy, practicability, and cost/benefit. We may not like the process, especially when it goes against our political convictions, but there is a process and over time it works.

An example of a good government program is/was the farm extension system. This came into law as an hodgepodge of programs and local customizations... what worked we did more of, replicated best practices in modern parlance, and we eliminated what did not work. One of the ideas behind this large health care bill is similar: see what works and replicate that, eliminate or modify what doesn't.

Consider how that paragon of virtue does it: a corporation in the private sector. Much business - much start up business in fact - is the story of finding a process, a product that works in the market, and replicating that as often as possible. Things that don't work get re-vamped or dropped. Case in point - McDonalds. Or, Indian outsourcing.

We really have to get away from the idea that government is some sort of a parent - or authority - who must be right all the time, and if not we sulk and turn against everything.

[redrockcoulee]

Whether people want it admit it or not, one of the reasons you can get good care in this country is because it is a profit based system. Drug companies can pursue any disease they want to develop a treatment/cure for. Surgical procedures can advance because people have a vested interest in the system. Yes, they want the monetary reward for their labors. Yes, it can be expensive. I pay over 1K a month for me and my family, mostly out of pocket.

However, if you put everyone in the health care industry under a government program, then the GOVERNMENT decides what to spend the money on. This includes both treatment and research. Yes, there is government money going for research now, but there is also drug company money, medical devices money, etc. that also gets used for research. Put the government in charge of it all and it will just be government money. And all of it will be dolled out in committee, congressional committees decide who gets what. Talking about a bloated and overbearing bureaucracy! And the potential for corruption! WOW!

When it comes down to it, do you want some board saying you cannot have treatment because you are "too sick", "too old" or they "tried too many times"? At least with insurance companies making these decisions, there is an appeal process. And even if they still say no, you can use your own funds to pay for it if you want. Under the one payer system, you cannot! Pay your own way health care goes away also. If you appeal, with the government run program, then you are dealing with a government, the appeals will be harder to get and harder to overturn. Remember, you can't fight city hall (or congress, etc.).

Have you ever known a government program that made things simpler and easier??? And PLEASE don't argue that is what their current program is trying to do. Again, I ask the question, Have you ever known a government program that made things simpler and easier??? They just can't help themselves it seems!

Yes the government paid health care system. The doctor has maybe three forms to fill out, one for health care, one for Worker's Compensation and a third one if the patient needs a note from the doctor to take to his boss for whatever reason. Doctor fills out one form and sends it to the govt and gets paid a pre arranged amount per visit. The patient needs one card or number to access any health care unit in the entire country whether it be a doctor in his home town or a hosptital the other side of the country. Once a year the federal govt sends the provinces a cheque to help cover the cost. Once a year or so the federal govt negotiates a price for drugs.

Doctors are self employed, the drug companies are privately owned as are the manufacturers of hospital equipment and even the company that makes the brooms to sweep the floors is most likely privately owned. 16% instead of 34% admin cost is a savings. It is cheaper for my health care provider the Alberta govt to have me transported home even if it means chartering a flight than to stay in a US hospital. Must be some cost savings there if they can afford to do that.

Surgical procedures advance due to surgeons wanting to do better and publishing their results. You are not still flying world war one fighter planes because the who but the govt buys fighter planes. And there are advances done by NASA, parks, NOAA, and scores of other people who are actually govt employees. Much of our research has been done by reseach councils or dept of the various govts. To think that if you work for a govt you are either stupid or lazy or both is insulting and to think that because the govt pays for it that it will not be advancing ignores what actually happens in the rest of the world

[jeffkrol]

Whether people want it admit it or not, one of the reasons you can get good care in this country is because it is a profit based system. Drug companies can pursue any disease they want to develop a treatment/cure for.

IF it's profitable, no sense wasting money on non-profitable diseases........
THAT alone should be worrisome for the "greater good".......

[Nesster]

...not to mention, creating new 'syndromes' to fit the marketing needs of a new drug

[stevewig]

IF it's profitable, no sense wasting money on non-profitable diseases........
THAT alone should be worrisome for the "greater good".......

...... and on the millions that cannot afford your services or drugs.

[jeffkrol]

And covering up any unfortunate side effects (like DEATH) until ROI has been covered........... then just folding up the US market and selling to the 3rd world...

[Nesster]

...but don't look down on Viagra, a true miracle cure produced by our efficient profit machine

[shooz]

Who's really watering it down?
Read and weep.

N.C. Consumer Advocates Seeing Red Over Bait and Switch by One of the Blues

[GeneV]

A related article: It’s The Prices, Stupid: Why The United States Is So Different From Other Countries ? Health Aff

Very informative article. I found this interesting:

Using PPP-adjusted U.S. dollars as the
common yardstick, the McKinsey researchers found that in the study year of 1990
Americans spent about $1,000 (66 percent) more per capita on health care than
Germans did. The researchers estimated that Americans paid 40 percent more per
capita than Germans did but received 15 percent fewer real health care resources.
A similar comparison revealed that theU.S. system used about 30 percent more inputs
per capita than was used in the British system and spent about 75 percent
more per capita on higher prices.32

We pay too much for health care. Factors mentioned in that article include our limited supply of providers and hospitals compared to other industrialized countries.

I would go a bit further and say that our health care is often based on systems which are centrered around hospitals. Hospitals are very expensive to build, equip and staff. One can't afford to have too many of them around empty in a profit driven system. They end up being something like public utilities. The barriers to entry are high, and that keeps the competition down and the cost high. Add to that the fact that consumers have no real choice about whether they use the service, and you have something that is more like the power company than , say, an auto dealer in the way the market functions.

[skyredoubt]

The barriers to entry are high, and that keeps the competition down and the cost high. Add to that the fact that consumers have no real choice about whether they use the service, and you have something that is more like the power company than , say, an auto dealer in the way the market functions.

That's a great insight, Gene. Supporters of the current system misleadingly think it functions like a free market while in reality it is closer to a monopoly. And as such, better make it a public monopoly - you'll get the benefit of democratic control.

[Nesster]

...not quite a monopoly, but a very complex negotiating set up between hospitals and insurance companies, where location and client erm patient profiles, prestige, and so on play a big role. There are several articles around on hospital finances...

for instance this: Why St. Vincent’s Is the Lehman Brothers of Hospitals -- New York Magazine