Single Payer Healthcare?

[xnfs93hy]

Should the US adopt a single payer health care system? What are your thoughts on this?

I know that Canada has one and I have heard that it has failed miserably. I don't even know what Universal health care but it sounds similar to single payer health care, or maybe it isn't. Can someone go more in depth with this please?

 

[tennisball80]

The Japanese universal health care system is awesome !
http://www.pbs.org/wgbh/pages/frontline/video/share.html?s=frol02n71dq101

People always talk how awesome it is and I barely heard any negative comment about health care when I lived there.

It also covers: Density and Vision

We have high % of private hispitals as well. Socializing medicine does not mean hostpitals must be owned by the government.

 

[tennisball80]

Should the US adopt a single payer health care system? What are your thoughts on this?

I know that Canada has one and I have heard that it has failed miserably. I don't even know what Universal health care but it sounds similar to single payer health care, or maybe it isn't. Can someone go more in depth with this please?

One thing I can say is that the waiting time in Canada is ridiculously long.

 

[glowworm]

One thing I can say is that the waiting time in Canada is ridiculously long.

Oooh yeah, I have a Canadian relative with lots of health problems and she has almost died several times from long waits for stuff. (She has lupus and several other things).
I agree that the US has health care problems, but I somehow don't think the government is going to help much. (the government is the single payer in that system right? Correct me if i'm wrong) The government can't win a war in Iraq, give (most) kids a decent education, or protect us from terrorists, so I really don't want them responsibe for my health. ( I am biased against the government though, so take that for what its worth.)
If anyone could talk me into liking gov't run healthcare, I'd appreciate it, 'cause right now I'm kinda scared of them.

 

[glowworm]

Should the US adopt a single payer health care system? What are your thoughts on this?

I know that Canada has one and I have heard that it has failed miserably.

One dentist I talked to said that Canada and some European countries were having so many problems with their healthcare that they were incorporating more free market ideas. I hope the US learns form their mistakes and designs a better system (if we have to have one) and not another disaster like social security.

 

[WellWornLad]

Single-payer health care is basically socialized insurance - the government pays for everyone's health insurance. Socialized medicine (a la Cuba, China) is when the government directly controls hospitals.

Universal health care is a broad term - it just means that everyone has access to health care somehow, either because they're forced to buy insurance, the government pays everyone's insurance, or because the government runs the hospitals and doesn't charge anyone for care.

A single payer system makes sense, at least on paper. A lot of people cry about the injustice of their tax dollars going towards someone else's health insurance. They're right that it's not fair, but whether it comes from taxes or increased health care costs, we all pay for the health care of uninsured people. The costs just get absorbed by the hospital and distributed to you and I (well, your parents) in the form of higher insurance premiums. If you just take that money and use it to buy health insurance for the uninsured, and consequently give them access to routine and preventative care, maybe their conditions could be treated before they become acute and expensive.

That's the idea, anyway. There are obviously a lot of picky details to work out.

 

[kdburton]

Should the US adopt a single payer health care system? What are your thoughts on this?

I know that Canada has one and I have heard that it has failed miserably. I don't even know what Universal health care but it sounds similar to single payer health care, or maybe it isn't. Can someone go more in depth with this please?

I live about 5 minutes from Canada. Last summer I was working in the ER at the county hospital and this guy comes in on an ambulance, from Canada, with a broken femur. That is a pretty serious injury. He came to the US and decided to pay out of pocket because the wait time for him to see an orthopod in Canada was ridiculous. Femoral neck fractures carry a 20-35% one year mortality rate and this guy was 6 days post-fracture without even being seen by somoeone who can help him. Basically what it comes down to is that Canada sucks (whether or not the idea of a one-payer system does or not)

 

[Terpskins99]

I live about 5 minutes from Canada. Last summer I was working in the ER at the county hospital and this guy comes in on an ambulance, from Canada, with a broken femur. That is a pretty serious injury. He came to the US and decided to pay out of pocket because the wait time for him to see an orthopod in Canada was ridiculous. Femoral neck fractures carry a 20-35% one year mortality rate and this guy was 6 days post-fracture without even being seen by somoeone who can help him. Basically what it comes down to is that Canada sucks (whether or not the idea of a one-payer system does or not)

 

[tennisball80]

Many Canadians in Canada think their health care system is very good unlike in the U.S. When we hear U.S standards, everything scares us a lot in Canada.

Funny thing is Canadians think American System is horrible and Americans think Canadian system is horrible.

 

[Terpskins99]

Many Canadians in Canada think their health care system is very good unlike in the U.S. When we hear U.S standards, everything scares us a lot in Canada.

Funny thing is Canadians think American System is horrible and Americans think Canadian system is horrible.

Let me put it this way... when you're nice and healthy, you think your country's healthcare system is the best and the other one stinks.

When you are sick, your wallet decides which system is better.

 

[kdburton]

Let me put it this way... when you're nice and healthy, you think your country's healthcare system is the best and the other one stinks.

When you are sick, your wallet decides which system is better.

Agreed. If I was livingin Canada right now then I would like their system (had I not heard any news stories about how ****ty it is) because I've been healthy my whole life for the most part. If I had some chronic illness that caused me to need to see doctors quite a few times per year then I would hate it. In the US you don't need to wait around forever to be seen, and when you're seen the treatments are usually the best in the world. WHen you go to the doctor, however, it may cost you an arm and a leg. In canada you have to wait around forever and chances are they have some protocol for the treatment of each disease that doesn't unclude the best (most expensive, usually) treatments available to US citizens. The thing that Americans need to realize is that our healthcare is the most expensive in the world because we've demanded to have tons of research and cutting edge technology to tackle the diseases that plague us. As long as you're on the higher end of the innovation curve then all of your products are going to sell at a higher price. The more expensive it is the harder it is for companies/individuals to afford healthcare, so the tradeoff is that we have a lot of people who don't have insurance. Also If you look at Michael Moore's video Sicko (if you can stand to see his fat face) you'll see that he tries to compare the US to some 3rd world countries whose entire GDP is less than the cost of a Divinci robot. They may have great preventative care, but thats because their people can't afford to be as unhealthy as most Americals. The population needs to actually be concerned about their own health and want to take the initialtive to prevent disease before any sort of socialized medicine program will be useful and not more expensive than our current system.

 

[ou_jay]

Agreed. If I was livingin Canada right now then I would like their system (had I not heard any news stories about how ****ty it is) because I've been healthy my whole life for the most part. If I had some chronic illness that caused me to need to see doctors quite a few times per year then I would hate it. In the US you don't need to wait around forever to be seen, and when you're seen the treatments are usually the best in the world. WHen you go to the doctor, however, it may cost you an arm and a leg. In canada you have to wait around forever and chances are they have some protocol for the treatment of each disease that doesn't unclude the best (most expensive, usually) treatments available to US citizens. The thing that Americans need to realize is that our healthcare is the most expensive in the world because we've demanded to have tons of research and cutting edge technology to tackle the diseases that plague us. As long as you're on the higher end of the innovation curve then all of your products are going to sell at a higher price. The more expensive it is the harder it is for companies/individuals to afford healthcare, so the tradeoff is that we have a lot of people who don't have insurance. Also If you look at Michael Moore's video Sicko (if you can stand to see his fat face) you'll see that he tries to compare the US to some 3rd world countries whose entire GDP is less than the cost of a Divinci robot. They may have great preventative care, but thats because their people can't afford to be as unhealthy as most Americals. The population needs to actually be concerned about their own health and want to take the initialtive to prevent disease before any sort of socialized medicine program will be useful and not more expensive than our current system.

Amen. If people don't take responsibility for their own health, then throwing money at their health problems will only give them license to live a more unhealthy lifestyle.

We need a single payer: the patient. If healthcare has to be free for people to utilize it then by definition it has no value to them. People need to accept responsibility for their own health. The best way for that to happen is for them to have to pay for it.

As a dental student, I see a whole lot of the world's most prevalent chronic, infectious disease (tooth decay). BTW it is about 99.9% preventable. Almost all of the risk factors are modifiable. Unfortunately for 95% of patients it takes a freakin' miracle to get them to floss their teeth, and they would never even consider discontinuing their habit of sucking down sugary beverages all day long.

Then when a tooth rots out and the pulp finally gets infected, it hurts a lot. All of a sudden they need a root canal and a crown. These procedures are technically difficult and expensive. A lot of patients act like it's some great injustice that you are asking them to pay a couple thousand dollars to fix it, or even better they say "doc I don't have insurance; so I can't afford to get it fixed." Well they could afford three sodas a day for the last 10 years. Without those they would have a lot more money and a healthy tooth.

The situation is similar for a lot of chronic disease with modifiable risk factors (e.g. type II diabetes, hypertension, etc). The individual not the government should take responsibility for the person's health and health care.

There should be (and already is) affordable, high deductible, private insurance that simply insures against major medical expenses due to unforeseen circumstances (injury, cancer, etc). It's not a payment plan to cover all your medical expenses. Patients should be responsible for routine care and chronic disease care.

 

[glowworm]

Amen. If people don't take responsibility for their own health, then throwing money at their health problems will only give them license to live a more unhealthy lifestyle.

We need a single payer: the patient. If healthcare has to be free for be to utilize it then by definition it has no value to them. People need to accept responsibility for their own health. The best way for that to happen is for them to have to pay for it.

As a dental student, I see a whole lot of the world's most prevalent chronic, infectious disease (tooth decay). BTW it is about 99.9% preventable. Almost all of the risk factors are modifiable. Unfortunately for 95% of patients it takes a freakin' miracle to get them to floss their teeth, and they would never even consider discontinuing their habit of sucking down sugary beverages all day long.

Then when a tooth rots out and the pulp finally gets infected, it hurts a lot. All of a sudden they need a root canal and a crown. These procedures are technically difficult and expensive. A lot of patients act like it's some great injustice that you are asking them to pay a couple thousand dollars to fix it, or even better they say "doc I don't have insurance; so I can't afford to get it fixed." Well they could afford three sodas a day for the last 10 years. Without those they would have a lot more money and a healthy tooth.

The situation is similar for a lot of chronic disease with modifiable risk factors (e.g. type II diabetes, hypertension, etc). The individual not the government should take responsibility for the person's health and health care.

There should be (and already is) affordable, high deductible, private insurance that simply insures against major medical expenses due to unforeseen circumstances (injury, cancer, etc). It's not a payment plan to cover all your medical expenses. Patients should be responsible for routine care and chronic disease care.

PERFECT! I finally have somebody who agrees with me!

 

[kdburton]

Amen. If people don't take responsibility for their own health, then throwing money at their health problems will only give them license to live a more unhealthy lifestyle.

We need a single payer: the patient. If healthcare has to be free for be to utilize it then by definition it has no value to them. People need to accept responsibility for their own health. The best way for that to happen is for them to have to pay for it.

As a dental student, I see a whole lot of the world's most prevalent chronic, infectious disease (tooth decay). BTW it is about 99.9% preventable. Almost all of the risk factors are modifiable. Unfortunately for 95% of patients it takes a freakin' miracle to get them to floss their teeth, and they would never even consider discontinuing their habit of sucking down sugary beverages all day long.

Then when a tooth rots out and the pulp finally gets infected, it hurts a lot. All of a sudden they need a root canal and a crown. These procedures are technically difficult and expensive. A lot of patients act like it's some great injustice that you are asking them to pay a couple thousand dollars to fix it, or even better they say "doc I don't have insurance; so I can't afford to get it fixed." Well they could afford three sodas a day for the last 10 years. Without those they would have a lot more money and a healthy tooth.

The situation is similar for a lot of chronic disease with modifiable risk factors (e.g. type II diabetes, hypertension, etc). The individual not the government should take responsibility for the person's health and health care.

There should be (and already is) affordable, high deductible, private insurance that simply insures against major medical expenses due to unforeseen circumstances (injury, cancer, etc). It's not a payment plan to cover all your medical expenses. Patients should be responsible for routine care and chronic disease care.

I couldn't agree more. Unfortunately, as you've pointed out, its too much to ask to have people care about prevative medicine for their own health until its too late - at which point the patients want the best care for whatever situation they've gotten themselves into (which is always more expensive). If I ever became a primary care doc - which I probably won't - I'd seriously make my diabetes and hypertension patient sign contracts saying they'll take steps X, Y and Z to improve their glucose, blood pressure, etc. If they don't comply with the treatment then they've breached the contract that we agreed on and they can go find themselves a new doc. As bad as that sounds I think thats teh only way to practice medicine today if you want to keep the costs of healthcare to a minimum. Things like high blood pressure and chronic gingivitis don't "hurt enough" to take care of properly until you have an MI

 

[tennisball80]

I believe there is no such a "perfect" system that works for every country in the world. Every country has to figure out their own health system.

 

[Anthony Hartsoc]

The general level of ignorance on this thread is discouraging. Let us first dispell some easy misconceptions.

Single-Payer vs. Socialized Medicine

Single-Payer refers to a funding mechanism that will financially provide funding for universal healthcare coverage. This is collected from employees, employers, and governmental entities. Socialized medicine can include a single-payer system but does not necessarily need to. The biggest difference between socialized medicine and single-payer is that under socialized medicine hospitals are owned by the government and physicians, nurses, etc are employees of the govenment. With a single-payer system hospitals and health care workers retain the same autonomy that they do now.

In any case, all industrialized countries place higher than us on all health indicators. We are last in maternal mortality, HIV/Aids prevalence, infant mortality, U5MR, preventable death, etc. All of the remaining industrialized countries either have socialized medicine or a single-payer system; all have universal health care coverage for their citizens.

We spend 2.2 tril on healthcare through our current corrupt privatized/public system. The world, as a whole, spends 4.1 tril. Yes, we spend more than the rest of the world and comparatively recieve the results of third-world medicine.

Do I blame this on undereducated doctors, nurses, and subsequent inadequate care? No. This is because the hands of health care professionals are tied by health insurance companies and their managed care system. You would like to think that as a person who has been through medical school, residency, and beyond that you might be in a position to make a decision related to the well-being of your patients; your opinions are great but they are subject to insurance company oversight which supercedes your obviously worthless stance.

1 in 7 hospital claims are denied. Insurance companies give bonuses for canceling policies. Policies are canceled when limits on stays, medication and procedure costs are considered too much. Meanwhile companies see 300% profit increases when American wages have remained virtually stagnent.

Oh, and about us not needing to cover the lazy people, drunks, druggies etc. They aren't the ones who are the largest victims of this; studies show that title belongs to women and children. Furthermore, it's been known for years that in the US the main indicators of being able to obtain health insurance lies directly along the lines of race and gender.

Don't feed Cold War mentalities, Fox, O'Reilly, and the other mantras into forums. Do some research, take your mind off of a potential paycheck, and wake up. If not, go into business or IT.

 

[Anthony Hartsoc]

P.S. Why is a dental student talking about prev med outside of the mouth? No, 99.9% of all disease is not preventable; read a book. As far as preventive medicine and UHC is concerned:

Studies show that under UHC systems there is a lower rate of disease. Why? Because preventive medicine is at the forefront of those physicians minds for several reasons. One of those reasons being (and you money-focused people will love this one) there are often preventive medicine bonuses. For instance, you lower your patient population's number of smokers...you get a bonus. You lower the BMI of your patient pop...ahhh bonus... and etc.

 

[docB]

Some of the difinitions put forth here so far are not correct. The issues of universal and socialized healthcare are very hotly debated and consequently there is a lot of emotion that goes along with that. Some people are defining terms based on how particular groups argue we as a country should proceed or what they think would be best. That does not make it the definition of the term.

Here are some definitions and discussion from a relavent thread.

Universal Healthcare ≡ A system that ensures that every individual is provided with access to healthcare whether they contribute to the system or not.

Single payor ≡ A system where there is only one entity that pays for all covered healthcare. Single payor by itself does not necessarily imply government or private control although it does imply that there will not be both.

Socialized Healthcare ≡ A system that uses public resources to pay for healthcare. Portions of the American healthcare system are socialized such as Medicare and Medicaid.

People are interchanging these terms and it makes it hard to figure out what they really mean.

Can't we have a universal system that is single payer?

Sure. Different systems have overlap and/or different combinations. The system Hillary envisioned in the early 90s was a socialized, single payer, universal system.

And for that matter, a "socialized" universal system??

Absolutely. The current favorite for what will happen in the future is a system that expands medicaid to cover everyone who can't or won't buy insurance on their own. That will be a socialized, universal system. It probably won't be a single payer system as people will likely be able to buy their own insurance outside the system (we'll see).

Docb... isn't the Emergency Medical System a socialized, universal system?

No. The unfunded mandate of EMTALA creates a universal right to emergency care but not to anything else. In general the concept of "universal coverage" is thought to mean access to primary, outpatient and non-emergent care as well. But that's a good point and is a weakness in my original definition.

It is also not socialized since the EMTALA mandate is unfunded. There is no public money allocated to pay the costs of EMTALA care to the uninsured. If the patient happens to have insurance or Medicaid, etc. we can get some reimbursement from that but if the patient is a no pay we (the docs, hosptials, lab, etc.) just eat the cost.

BTW, thanks for teaching me last month I had a great time in the ER

Glad to hear it. If you woked with me you know all about unreimbursed indigent care .

 

[JJMrK]

Do a search on this in the pre-allo forum. There are a million threads, most of which turned into flame wars.