Originally posted by republicandr
...don't they need to control immigration first? ... someone mentioned Sweden as a panacea of universal health care, and said they would move there if they could get in... Well, we have a huge problem of illegals who don't pay at all for their health care as is, and will not later because they don't pay taxes, and even if they did their marginal rate would be so low that they wouldn't pay taxes.
We do have huge problems in health care now. But rather than rush into something, I think it should be tested first. And also someone mentioned that under universal health care a docotor's salary may decrease to about 40K a year!
But then again, I can see the sentiments of capitalism is evil all over this thread, and so I guess that in the ideal country, everyone's salaries would be controlled by a guru in the government, and then we wouldn't have to worry about anyone being obsenely wealthy.
there are serious problems with it because whenever the government gets involved the paperwork increases and administrators are the ones who end up getting the "big bucks".
1) I don't know much about immigration effects, but my first reaction would be this: if, as you say, we're already paying for immigrants' care with emergency visits, it'd be much cheaper to pay for primary care visits, *and* it would improve their health. One ER visit can easily be $1,500; one outpatient visit is what, $100-$200?
2) Single-payer has been tested. Canada, Denmark, Norway, Sweden... they've all had NHI programs since the mid 1960s. Single-payer is effective at controlling costs, insuring the entire population, but keeps the system private. (Not sure if those are your major reservations against it.) Canada's health costs were beginning to spiral out of control just the US's, up until they passed their medicare program in 1963 (I think?). After that, their cost increases declined sharply, while the US's continued to rise.
3) Do you have any data, evidence, or, uh, anything showing a doctor's salary at $40,000 per year? I've never seen anything remotely near that estimate; there's lots of misinformation out there. In fact, in Canada, when medicare was passed, physicians' salaries went UP by 35%. (Universal Health Care, by Pat and Hugh Armstrong.) Most estimates state that general pratice/IM/FP doc salaries would stay mostly the same, but specialists salaries would decrease. And plus, doctors would have it easier: fewer billing clerks, no hassle from HMOs about getting procedures covered, etc.
4) I don't think capitalism is evil. It works great in some situations, but not all of them. When people are making money off of people's health, denying treatments, performing unnecessary treatments, however, yeah, I've got a big problem with that. All of that $400 million Tenet has paid its CEO over the past 15 years could have gone toward patient care, could have saved lived, and eased suffering. I don't think that's right.
5) I'm not sure if you've read single-payer proposals--it really doesn't seem like you have, republicandr.
http://www.physiciansproposal.org. There are three major ways doctors can work in a single-payer system. They can work in a private practice. They can be employed for salary. They can be part of a collective health maintenance oragnization. If you work for a government-run hospital, then, yes, your salary is set by the government. Otherwise, it's not. Physician groups collectively bargain with the government for reimbursement rates. The government doesn't just set them. Negotiation is involved, and doctors are represented by doctors.
6) In a random survey of academic doctors, when asked if they'd support a single-payer national health insurance program, 57% said yes. When a randomized sample of Massachusetts doctors (including surgeons!) were asked if they'd support single-payer, 63% said yes. Hell, when small business owners, possibly the most conservative group of people in the US were asked 5 years ago, "Would you support a national health program financed by tax payers covering all Americans in a single government plan,? 40% supported, 9% were unsure, 50% were against it. And that was 5 years ago.
7) There is paperwork in every system. You have to accept that. But I don't care if you think it's a lot of paperwork in the military--it's all relative. HMOs spend 15%-30% of their health care dollars on administrators and paperpushers. Medicare spends 3%. Private insurers do worse than Medicare, and are just as unable to control medical costs as Medicare is.
8) Why would there be less paperwork? BECAUSE THERE'S ONE PAYER. Case in point: in a mental health study in Seattle, done for other reasons than health insurance, over 750 different health insurance plans were found among the study's 2700 participants. Imagine the sheer volume of paperwork, phone calls, billing software, forms, faxes, database managers, and confusion go into just one doctor's office in Seattle, even if they had a FRACTION of that number of health insurance plans in their office. It's a mess. With one payer, everyone has the same forms, the same database, the same contacts. It saves time and money--over $150 billion--from cutting administrative waste alone.
9) This isn't just a Democrat/Republican Liberal/Conservative idea. As I've posted before, Canada's Auto Association (that would be Ford, Chrysler, among others--big business, and therefore, usually pretty conservative) supports their health care system--their SINGLE-PAYER system--because it saves so much money.
Employer's costs of health insurance in the US on average: 8% of an employee's salary. In Canada: .6%. Again, you do the math, and please, read a *little* bit on single-payer before you make assumptions about it. I'm happy to answer questions and to try to explain it, but rash generalizations about what you heard someone say aren't gonna cut it if we're going to have a true, informed discussion.