Does anyone believe the US should NOT have universal health care?

Polo423

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So I'm a believer in universal health care and that the US SHOULD implement a non-profit, national health care system, but I wanted to see if anyone was opposed to such a thing? And if so, could you please state your argument? This is just for my curiosity, but if a discussion is started so be it.


Oh and please if your argument against happens to involve Nazism or anything of the sort, please leave those out. I'm looking for intelligent arguments.
 

DrBowtie

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I'd say > 50% of the nation's population disagrees with you. Even most democrats don't want single payer system.

PS. As a Californian you should know how much government spends given your states current budget situation.
 
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Polo423

Polo423

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Well just because it's national doesn't mean it has to be single-payer (as evident by other countries, such as Germany, who have multiple payers who are regulated by the government).

But yeah in general though I want to know WHY we don't want a single-payer when people use it elsewhere. What are people's arguments against it? >50% disagree, but on what grounds?

And yup CA spends and the gov spends a lot, but not in the right places, and more often on things that are unneeded (bureaucracy and administrative costs). In terms of health care, for example, eliminating insurance billing would cut out tons of administrative cost.
 

docB

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Why don't you do a search? This has been covered here extensively.
 

JackADeli

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...But yeah in general though I want to know WHY we don't want a single-payer when people use it elsewhere. What are people's arguments against it? >50% disagree, but on what grounds?...
Yep, is used elsewhere... so why don't you check and see why >50% do NOT want what is used elsewhere i.e. ?Canada, UK, Germany. Maybe the grounds are exactly that it has and is done elsewhere and >50% do not like what they see? Also, I suggest you consider the difference in population sizes and services when trying to extrapolate a system from Canada, Uk, or Germany to the USA.
...And yup CA spends and the gov spends a lot, but not in the right places, and more often on things that are unneeded (bureaucracy and administrative costs). In terms of health care, for example, eliminating insurance billing would cut out tons of administrative cost.
Some how you are under the impression that moving the government further into healthcare will decrease beauracracy and administrative costs.... We have examples of problems domestically just with medicare/medicaid/social security, etc.... As said by docB:
Why don't you do a search? This has been covered here extensively.
Agreed. And, don't just search SDN forums, look at the numerous other sources...
 
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A single-payer, universal system would be much more efficient and less byzantine than our current system, but it would also inhibit our freedom. Unless it could be done without compulsory participation of any sort, I am against it.

Just about anything government can do, individuals or collections of individuals can do if they choose to do it. There is an old adage "Bad news makes for bad laws" it could also be said that bad choices make for bad laws.
 

JaggerPlate

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Uhhh ... raises hand ... I'm opposed to it. Why would you assume that 'no one' would be opposed to a single payer system where the government (who else can finance a NPO like this) is in charge of your medical care. Call it a non sequitur, but I've seen the way they handle the post office, DMV, etc, and I'm 100% vehemently opposed to allowing that much of a monopoly over care.

Would I be off in saying you're from the Northern part of California? I had a roommate freshman year of college from 'Nor-Cal' and he used to crack me up because he'd claim to be the most accepting, open-minded, fair person in existence, until you disagreed SLIGHTLY with his arrogant POV; at which point you were a Nazi, bafoon, racist and he hated you. Truly accepting and open minded (not trying to label you as anything here, this situation just reminded me of that).
 

MOHS_01

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So I'm a believer in universal health care and that the US SHOULD implement a non-profit, national health care system, but I wanted to see if anyone was opposed to such a thing? And if so, could you please state your argument? This is just for my curiosity, but if a discussion is started so be it.


Oh and please if your argument against happens to involve Nazism or anything of the sort, please leave those out. I'm looking for intelligent arguments.
:uhno:

How do you propose enacting such an endeavor in a way that does not involve theft, surrogate decision making, or compulsory labor? Solve that little riddle and you'll find many, many supporters.
 
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The national gov't has gotten involved with healthcare twice, Medicare and Medicaid. After seeing the success (or lack thereof) of these programs, it makes me weary to give it another try. There are various other options, such as HSA's, of fixing the health care system before we move to this last resort of the single payer system (because that's what it would be).

Oh yeah, and Nazism
 

JackADeli

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What I never understand and probably never will is the extreme irrational idealism the very question posed represents.

1. no government anywhere, including the USA, has ever to my knowledge demonstrated an ability to take over any industry of significant magnitude, run it efficiently, produce a good product, and decrease costs.....

2. In the USA, even on smaller numbers, we have continued failure of government to run things and the solution always seems to be the same, i.e. don't fix it, don't get government out, just increase government and tax more.

3. Despite our track record of failure in other federal programs, individuals keep citing foreign nations as examples of success. yet, has anyone looked at "austerity"? It is all the rage abroad. Also, have you looked at knowledgeable people in those countries, they are laughing at why we seem so enamored with their systems while they are trying to formulate an exit strategy to get out of their system!

4. Latest data shows government employees are paid upwards of 20% more then their private sector counterparts. yet, the private sector employees almost universally work more efficiently and are more productive.

5. Despite 1, 2, 3, & 4 above, folks seem to consider foreign systems... But have you considered the fact that you are talking about a population in the range of ~300 million in the USA? Please consider the magnitude of difference as compared to your foreign models. The foreign models are crushed under the government systems in place for their substantially smaller populations.

6. Always amazed at folks from California. By any and all financial standards that state is fully bankrupt and just has not declared it. They can not pay the 100s billions on the books let alone the over 1 trillion off the books. Still, everybody wants their cherry and will keep isnsisting in Cali-Gov expansion and increased benefits.

It would be nice if everything was roses and puppy dogs. It would be nice if everyone had an easy life. It would be nice if world hunger no longer existed. It would be nice if nobody got sick. But, it would also be nice to get back to some reality and ask the hard question of if and how does someone accomplish all this stuff. You don't just dream a fantasy, make it law and then assume it will all be ok and sort itself out later, i.e. "Let's pass the law first and I'm sure we'll magically figure out how to pay for it later....".
 

JaggerPlate

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What I never understand and probably never will is the extreme irrational idealism the very question posed represents.

1. no government anywhere, including the USA, has ever to my knowledge demonstrated an ability to take over any industry of significant magnitude, run it efficiently, produce a good product, and decrease costs.....

2. In the USA, even on smaller numbers, we have continued failure of government to run things and the solution always seems to be the same, i.e. don't fix it, don't get government out, just increase government and tax more.

3. Despite our track record of failure in other federal programs, individuals keep citing foreign nations as examples of success. yet, has anyone looked at "austerity"? It is all the rage abroad. Also, have you looked at knowledgeable people in those countries, they are laughing at why we seem so enamored with their systems while they are trying to formulate an exit strategy to get out of their system!

4. Latest data shows government employees are paid upwards of 20% more then their private sector counterparts. yet, the private sector employees almost universally work more efficiently and are more productive.

5. Despite 1, 2, 3, & 4 above, folks seem to consider foreign systems... But have you considered the fact that you are talking about a population in the range of ~300 million in the USA? Please consider the magnitude of difference as compared to your foreign models. The foreign models are crushed under the government systems in place for their substantially smaller populations.

6. Always amazed at folks from California. By any and all financial standards that state is fully bankrupt and just has not declared it. They can not pay the 100s billions on the books let alone the over 1 trillion off the books. Still, everybody wants their cherry and will keep isnsisting in Cali-Gov expansion and increased benefits.

It would be nice if everything was roses and puppy dogs. It would be nice if everyone had an easy life. It would be nice if world hunger no longer existed. It would be nice if nobody got sick. But, it would also be nice to get back to some reality and ask the hard question of if and how does someone accomplish all this stuff. You don't just dream a fantasy, make it law and then assume it will all be ok and sort itself out later, i.e. "Let's pass the law first and I'm sure we'll magically figure out how to pay for it later....".
:thumbup:
 

Pharmavixen

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1. no government anywhere, including the USA, has ever to my knowledge demonstrated an ability to take over any industry of significant magnitude, run it efficiently, produce a good product, and decrease costs.....
Where I live, a privatized correctional facility was vastly more expensive than those run in the public system, and the government returned it to the public system as the failed experiment that it was. I wrote two papers for the Minister of Correctional Services explaining how drug purchases were cheaper for our ministry if kept in the public system rather than privatized, and he kept saying, "But I don't understand...the private sector has efficiencies that the public sector does not. It doesn't make any sense." Such are the dangers of relying on the ideology of other people instead of your own personal brain power.

2. In the USA, even on smaller numbers, we have continued failure of government to run things and the solution always seems to be the same, i.e. don't fix it, don't get government out, just increase government and tax more.
Obviously I can't speak with any authority on the American experience. However, I have observed that when you have people in government who hate government at the same time as they run it, they will construct government programs to fail, underfunding or understaffing them, and when they fail, they can then point to the "inefficiency" of the public sector. And then privatize some more, giving their buddies in the big corporations more sweet government contracts. And when the citizens get tired of this and turf them out, they get golden parachutes in terms of sitting on boards of corporations they gave contracts to when they were in power.

But that's my experience with Canadian conservative politicians. To be fair, perhaps your American conservative politicians are more ethical.

3. Despite our track record of failure in other federal programs, individuals keep citing foreign nations as examples of success. yet, has anyone looked at "austerity"? It is all the rage abroad. Also, have you looked at knowledgeable people in those countries, they are laughing at why we seem so enamored with their systems while they are trying to formulate an exit strategy to get out of their system!
This is total bull****.

4. Latest data shows government employees are paid upwards of 20% more then their private sector counterparts. yet, the private sector employees almost universally work more efficiently and are more productive.
More bull****.

5. Despite 1, 2, 3, & 4 above, folks seem to consider foreign systems... But have you considered the fact that you are talking about a population in the range of ~300 million in the USA? Please consider the magnitude of difference as compared to your foreign models. The foreign models are crushed under the government systems in place for their substantially smaller populations.
You divide it up. For instance, we don't have one single-payor health care system; we have twelve.

6. Always amazed at folks from California. By any and all financial standards that state is fully bankrupt and just has not declared it. They can not pay the 100s billions on the books let alone the over 1 trillion off the books. Still, everybody wants their cherry and will keep isnsisting in Cali-Gov expansion and increased benefits.
Cutting taxes bankrupts governments.

It would be nice if everything was roses and puppy dogs. It would be nice if everyone had an easy life. It would be nice if world hunger no longer existed. It would be nice if nobody got sick. But, it would also be nice to get back to some reality and ask the hard question of if and how does someone accomplish all this stuff. You don't just dream a fantasy, make it law and then assume it will all be ok and sort itself out later, i.e. "Let's pass the law first and I'm sure we'll magically figure out how to pay for it later....".
Fair enough. Ultimately, Americans deserve the health care system desired by the majority - maybe a referendum?
 

JackADeli

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I am not going to argue with Canadians about how they might think our system should be run...in relationship to theirs. Or, more specifically, I'm not going to try an argue how Canadians should run their system. If you like your system, great, it's your system!
...Obviously I can't speak with any authority on the American experience...
So then don't.
...3. Despite our track record of failure in other federal programs, individuals keep citing foreign nations as examples of success. yet, has anyone looked at "austerity"? It is all the rage abroad. Also, have you looked at knowledgeable people in those countries, they are laughing at why we seem so enamored with their systems while they are trying to formulate an exit strategy to get out of their system!...
...This is total bull****...
No, that's actually fairly acurate in the USA. But, your free to your opinion. I will just watch the tele as riots in Greece, UK, ?Portugal, then maybe some other nation.... Plenty of austerity spreading and plenty of attempts to cut back and one of the biggest reasons cited are government benefits to include healthcare. Again, your free to your opinion.
...4. Latest data shows government employees are paid upwards of 20% more then their private sector counterparts. yet, the private sector employees almost universally work more efficiently and are more productive...
...More bull****...
No, that is actually true in the USA. You should stick to your early statement, i.e. "Obviously I can't speak with any authority on the American ...". Again, I am not speaking to what Canadian private vs government employees may or may not earn.
...5. Despite 1, 2, 3, & 4 above, folks seem to consider foreign systems... But have you considered the fact that you are talking about a population in the range of ~300 million in the USA? Please consider the magnitude of difference as compared to your foreign models. The foreign models are crushed under the government systems in place for their substantially smaller populations...
...You divide it up. For instance, we don't have one single-payor health care system; we have twelve...
What, the Canadian population is something like 30 million as compared to USA population in the range of 300+ million... I stand by my earlier points.
...6. Always amazed at folks from California. By any and all financial standards that state is fully bankrupt and just has not declared it. They can not pay the 100s billions on the books let alone the over 1 trillion off the books. Still, everybody wants their cherry and will keep isnsisting in Cali-Gov expansion and increased benefits...
...Cutting taxes bankrupts governments...
Actually, that isn't the track record. Cutting taxes has in the USA almost always raised treasury collections and allowed economic growth. It is raising taxes that hurts economic growth and raising government spending that has bankrupted governments. California's problem is not one of under taxation it is of expansion of government and social benefits. They have continued to propose taxes in California. On the other hand, the demonized "Bush Tax cuts" actually raised treasury collections. The problem was the spending rate of government rose faster. Thus, austerity abroad to decrease government spending.
...It would be nice if everything was roses and puppy dogs. It would be nice if everyone had an easy life. It would be nice if world hunger no longer existed. It would be nice if nobody got sick. But, it would also be nice to get back to some reality and ask the hard question of if and how does someone accomplish all this stuff. You don't just dream a fantasy, make it law and then assume it will all be ok and sort itself out later, i.e. "Let's pass the law first and I'm sure we'll magically figure out how to pay for it later....".
...Fair enough. Ultimately, Americans deserve the health care system desired by the majority - maybe a referendum?
Not even sure why you are commenting on the USA system. We have been referenduming this very long. The majority (~80%) were happy with the healthcare coverage they had before the current administration even attempted so called "reform". This has never been an effort or push by the "majority".

The USA does not have a track record to remotely suggest a government/socialized healthcare system for 300+ million could even be funded. I believe California has a bigger population (~36million) then Canada (~34million) and they (Cali) are bankrupt! Those are USA realities.
Interesting Essay said:
Why Universal Health Care Keeps Failing

Posted on January 30, 2008 by Jay Reding
The Wall Street Journal has an interesting piece on the failure of California's attempt at universal health care and what it means for the rest of the nation. It is interesting to see how many of these plans have failed to pass or ended up being scrapped due to cost overruns. If universal health care was such a great thing and so economically compelling, it's hard to see why so many states would be having such a hard time making it work. The reason why is simple: universal health care doesn't actually work in the real world:
Like collapses in Illinois, Wisconsin and Pennsylvania, this one crumpled because of the costs, which are always much higher than anticipated. The truth teller was state Senate President Pro Tem Don Perata, who thought to ask about the price tag of a major new entitlement amid what's already a $14.5 billion budget shortfall.
An independent analysis confirmed the plan would be far more expensive than proponents admitted. Even under the most favorable assumptions, spending would outpace revenue by $354 million after two years, and likely $3.9 billion or more. "A situation that I thought was bad," Mr. Perata noted, "in fact was worse."
This reveals that liberal health-care politics is increasingly the art of the impossible: You can't make coverage "universal" while at the same time keeping costs in check — at least without prohibitive tax increases. Lowering cost and increasing access, in other words, are separate and irreconcilable issues.
Universal health care has a basic and fatal flaw, you can't simultaneously reduce the cost of a service and increase access to it. If you have universal access, you have to find a way of paying for people to get that access, which raises costs. If you want to keep costs down you can only economize so far before you have to restrict access. Universal health care is a bit like a perpetual motion machine—it would be wonderful in theory, but it can't actually exist in reality.
What inevitably ends up happening is that governments cut costs first—which requires them to cut off access. This is how Britain's NHS and the Canadian system work. You end up either waiting in line or having a government bureaucrat deny your request for treatment. That's why the healthcare systems in those countries are having such trouble managing costs without drastically cutting back on services—and why both are more and more turning to private agencies to provide services they cannot.
The failure of the California plan isn't a shock—people support universal health care in theory, but when confronted with the fact that there's no such thing as "free" health care most people balk at the price. A further sign that the support for universal care is theoretical comes from evidence that most Americans are satisfied with their current health care coverage. When confronted with a plan that forces people to change their coverage—and not necessarily for the better—it's not surprising that the theoretical support for universal coverage ends up losing to the desire not to lose what people already have.
Universal health care is not the only solution, and already there are better solutions out there. In fact, of all the possible solutions, universal health care is almost certainly the least advantageous. Corporations love it because it passes on the costs to the federal government—turning it into a corporate welfare transfer payment. Bureaucrats love it because it gives them more power, as it would with politicians. However, it's hard to see where the groundswell of demand for universal health care really is. If there was such a groundswell, a liberal state like California wouldn't be balking at the price.
The failure of California's initiative demonstrates why universal health care simply doesn't work. The laws of economics and human behavior go against it, and those factors can't be legislated away. You can't square the circle of trying to simultaneously lower costs and increase access without throwing a ton of money at the problem and continuing to throw more and more money at it until the system collapses. If even California legislators can learn that principle, hopefully Congress can as well.

Posted in Economics...
Another interesting little read:
http://www.mapleleafweb.com/features/canada-s-health-care-system-overview-public-and-private-participation
http://www.cbc.ca/canada/story/2010/04/15/f-vp-newman.html
should we multiply the costs by 10x if to extrapolat to the USA population... that's rhetorical.
 
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Stitch

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So I'm a believer in universal health care and that the US SHOULD implement a non-profit, national health care system, but I wanted to see if anyone was opposed to such a thing? And if so, could you please state your argument? This is just for my curiosity, but if a discussion is started so be it.


Oh and please if your argument against happens to involve Nazism or anything of the sort, please leave those out. I'm looking for intelligent arguments.
I think the very question is misleading. There is no such thing as universal healthcare. It's a spin developed to make people feel warm and fuzzy. Let's get down to it: what do you mean by universal? Universal access? Universal coverage? Universal treatment? Which treatments? This word salad is the problem. No one knows exactly what their terms mean, so we can't get anywhere when we discuss it.

Someone, somewhere has to ration. Money and resources are not infinate. In America we leave rationing to the private insurance payors. England has the NICE. Either way, patients don't have much skin in the game so they don't care about costs and won't ration themselves. But again, someone has to be denied some test or procedure that they think they need. The question is how and who should make that decision. So here are the problems.

1. No American politician, Republican or Democrat has the balls to ration care in any way. Period. And I think it's unlikely for Americans to accept an (government) institution who makes those decisions.

2. Every other country protects their physicians from ridiculous malpractice suits. Many even pay for the malpractice insurance, so suing a doc takes cash out of the public pocket. Physicians there are more free to make clinical judgements and order fewer tests. No one here is willing to do that.

3. Every country with 'universal' health care has higher taxes than the U.S. Some more than others, but England and France are especially high. Like 18% sales tax, or a 70% income tax for high earners. For whatever reason, whether you agree or disagree with it, Americans are against taxes. They are culturally unwilling to fund such an institution through taxes, and no politician will do it. But someone has to pay. So where should the money come from?
 

lee9786

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how far can I raise my hand. See my post on the use of microchips for healthcare records. If a class II microchip is a requirement for participation, it won't be universal because I won't be participating. Anyone else that think it's a good idea is out of their minds let alone not being a good idea.

[YOUTUBE]http://www.youtube.com/watch?v=nkZM-9hP2uQ[/YOUTUBE]

For a less propagandized version.
[YOUTUBE]http://www.youtube.com/watch?v=O0z9J5E9lto[/YOUTUBE]
 

Pharmavixen

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I think the very question is misleading. There is no such thing as universal healthcare. It's a spin developed to make people feel warm and fuzzy. Let's get down to it: what do you mean by universal? Universal access? Universal coverage? Universal treatment? Which treatments?
True, this. The term, "single payor" is more precise because there's no such thing as universal health care, really.

1. No American politician, Republican or Democrat has the balls to ration care in any way. Period. And I think it's unlikely for Americans to accept an (government) institution who makes those decisions.
I've been thinking the whole discussion around rationing is a bit of a red herring. Just as there is no such thing as universal health care, there is no such thing as limitless health care in any jurisdiction under any system.

2. Every other country protects their physicians from ridiculous malpractice suits. Many even pay for the malpractice insurance, so suing a doc takes cash out of the public pocket. Physicians there are more free to make clinical judgements and order fewer tests. No one here is willing to do that.
An argument for single-payor health care is that those who have been injured by a medical mistake have less of a requirement to sue because their medical bills are covered by the system.

3. Every country with 'universal' health care has higher taxes than the U.S. Some more than others, but England and France are especially high. Like 18% sales tax, or a 70% income tax for high earners. For whatever reason, whether you agree or disagree with it, Americans are against taxes. They are culturally unwilling to fund such an institution through taxes, and no politician will do it. But someone has to pay. So where should the money come from?
I'm not sure how much you can attribute health care as the sole reason for higher taxes in some countries. These countries also have more social services in addition to health care, especially in Europe. In Canada, we're relatively stingy compared with England or France, though we do have, for instance, one year of maternity leave paid for by the government, which I don't think you have stateside.
 

JackADeli

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...An argument for single-payor health care is that those who have been injured by a medical mistake have less of a requirement to sue because their medical bills are covered by the system...
This ignores the fact that the issue of malpractice is far less to do with the costs associated with medical care and more to do with compensation over and above the medical bills.
...I'm not sure how much you can attribute health care as the sole reason for higher taxes in some countries. These countries also have more social services in addition to health care, especially in Europe. In Canada, we're relatively stingy compared with England or France, though we do have, for instance, one year of maternity leave paid for by the government, which I don't think you have stateside.
You might want to look into that so you are sure.

Yes, they do have more social programs. However, one needs to consider what percent of these countries government employees are directed/employed towards the healthcare systems and what percent of these countries budgets go towards the healthcare systems. If I am not mistaken, I believe the largest employer of UK citizens in the UK actually is the UK NHS! Yes, I welcome correction and more information if you have some.
http://www.timesonline.co.uk/tol/news/uk/health/article1050197.ece

We do not have a single payor system in the USA. However, the fastest growing employment sector has been government employees. As I noted previously, government employees are generally paid ~20% more then their private sector counterparts. Our current government healthcare programs (medicare/medicaid) that provides coverage for only a segment of our population are already financially unsustainable. Yet, it is difficult if not impossible for us to cut back on these two programs. So, we do have a track record that shows that expansion to all 300+million in the USA is just not rational. To look at our past and current track record and see our failures on the "smaller" programs and assume we can expand and extend to the entire population is not just insanity but respresents grave ignorance of reality.

The problem with this discussion is the deception inherent. People that say they want such systems often mean they want the same or more of their current healthcare for "free" and/or believe government will decrease costs. They are under the mistaken belief that their current pay checks will increase since their insurance deductions will no longer be there. At the same time, Unions want salvation by off-loading their currently unsustainable "legacy" costs through transfer of healthcare coverage costs to the national tax payers.

As noted previously, too many people do not see the costs of their care and simply demand more, all the while employers pay insurance companies more and/or tax payers pay more. A universal or single payer plans, in the USA, will NOT result in cheaper care, "free" care, or more care. All you need to do is watch a American TV program and see the numerous "free" electric scooter advertisements... these are under our current, limited scope programs (aka medicare/medicaid).
 
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docB

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An argument for single-payor health care is that those who have been injured by a medical mistake have less of a requirement to sue because their medical bills are covered by the system.
That is a point that is often brought up. I think it really points to how bad the med mal crisis is here in the US. Plaintiffs invoke the specter of ongoing medical costs but that is actually bogus. If a patient is disabled they become eligible for diasbility and Medicare.

The most telling thing that shows that the lawyers just want to keep the gravy train rolling is their resistence to tort reform laws like the MICRA law in CA. These laws cap punative damages (e.g. in CA the cap is $250k in NV it's $300k). A plaintiff can still sue for any amount for real damages like medical costs or lost wages. That's why John Ritter's wife was able to sue for $88 mil in CA. She wasn't seeking punative damages. She was seeking lost wages. The fact that lawyers fight these laws shows that they just want to keep these astronomical awards going so they can reap their 40%.
 

MOHS_01

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This is factually wrong. Google the polls.
...and the majority's opinion is categorically irrelevant in matters that require the use of force to enact economic exploitation. Two wolves and a sheep deciding what's for dinner and all....
 

StevenRF

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Given EMTALA, its effectively universal already, but the state foots the bill. Like most pre meds, I was for universal coverage. However, after finishing med school, I don't think it is sustainable given American culture and the pervasive moral hazards in our system.

The basic costs just don't add up. In the past when the major treatment for everything was antibiotics, and people dropped dead from major illnesses, it worked. Now with current practices in preventive medicine, treatment options for lifestyle induced chronic diseases, and demands for end of life care, it is not sustainable. The proportion of patients needing healthcare expenditures greater than their lifetime of income accrued continues to grow. It can't function without some sort of significant rationing.

The other issue is the moral hazards from our current system. Humans just don't do well at balancing short term and long term costs. Without any direct financial impact, or at least some immediate effect, a majority of patients will not alter their lifestyles to improve their health. The same goes for end of life care and unreasonable treatment demands. It becomes easy to demand things of low value and high cost when someone else is footing the bill.

I guess if I had my way:
-Universal coverage for preventive medicine and significant communicable diseases
-End for profit insurance and switch to catastrophic plans, decouple them from employment
-Laws forcing pricing transparency among doctors and hospitals
-Make public and searchable all data on each physician's and hospital's outcomes
-End EMTALA but have a national database to access for insurance coverage for the ED's
-Some level of safety net for coverage of children, mentally/physically disabled, others who have no reasonable expectation of self sufficiency
-Whatever's left over is picked up by charity work or SOL

The other thing I've always wondered is if you could argue it from a GDP perspective. What would be the optimum level of coverage for the population to ensure maximum productivity and growth of the nation, since the government has more of a vested interest in that endpoint, rather than individual outcomes?
 
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...and the majority's opinion is categorically irrelevant in matters that require the use of force to enact economic exploitation. Two wolves and a sheep deciding what's for dinner and all....
I was imply saying he was factually wrong, not making a comment on whether that opinion is good policy.

There are many policy positions that I hold where I disagree with the majority opinion, and I'm sure you do the same.
 

docB

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Given EMTALA, its effectively universal already, but the state foots the bill.
When I first read this comment I was all ready to unleash a vitriolic post 'o flame. But the rest of your post was really reasonable so I see where you're coming from. I do want to correct that sentence though.

The state does NOT pay for EMTALA mandated care delivered to the uninsured. It is a totally unfunded mandate. It requires any facility that takes Medicare and Medicaid to provide "without regard to ability to pay, any stabilizing treatments necessary for any patient who presents to an ED with an emergent condition."

So the hospitals and the doctors eat the costs of providing that care.

This is just one of the aspects of EMTALA which make it so horrible. In this case it punishes doctors and hospitals that try to exist in areas with poor payer mixes.
 

callsux

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docb is correct in his/her interpretation of emtala being an unfunded mandate. it is also correct to say this is a financial burden for doctors and hospitals in areas with large medicare/medicaid/selfpay populations.
it should also be noted however that hospitals can receive millions of dollars per year in what is called "dsh" money--a federal subsidy to provide care in poorer areas. this is in addition to whatever the hospital does get from mc/ma. no such program exists for physicians, so they are really the ones being shafted by emtala. my hospital reportedly receives millions per year under this program and has proven very unwilling to share it with the physicians here.
 

lee9786

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Well for all of the supporters of it, you'll get what you're looking for. Everything is getting more and more consolidated everyday. Just look at the mergers over the past decade and government trends. You'll have your single-payer system. I haven't heard a good argument yet that supports otherwise. Whether its good or not is a moot point now. Brace for impact.