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What to Say to Those Who Think Single Payer Advocates Are Wacko
What do we say to our more conservative friends, who genuinely think that the Single Payer solution to our health care crisis would be a disaster? Try what follows. In the end, you may simply agree to disagree. That's O.K., but what follows may give them pause to think.
Already, 60% of all our health care dollars come directly or indirectly (because employers insurance premiums are tax deductible) from the taxpayer. The care of our oldest neighbors are financed by Medicare, i.e. the taxpayers. The care of our disabled neighbors is financed by Medicaid. Ditto the care of our poorest neighbors who, because health follows wealth, are also at greater risk of high expense. Fourteen hundred insurance companies, at significant expense, stratify the rest of the population by "risk". Their top-secret formula results in them covering the employed people, small groups, and individuals who can prove that they are at low risk. What about the others? When those who can't afford the premiums get sick, go bankrupt, and can't pay their bills, "we" all pay for it in higher charges. Furthermore, employer-paid premiums are tax deductible which means insurance company profits are subsidized by the taxpayer.
As near as I can tell, this is a big taxpayer rip-off. Additionally, our non-system is fraught with numerous perverse incentives that result in more care, but not necessarily better care. Physicians must share a significant part of the blame here, but that's a different, though important, discussion. Addressing these perversities is problematic because we don't have a Health Care System we have For-Profit Sick Care Non-System that, to extent that it has any design at all, is designed to serve the for-profit insurance and the pharmaceutical industries. Perverse incentives work for those who profit from them. They don't work for patients or those who pay the bills, i.e., taxpayers.
Single payer means one risk pool. You've heard the slogan. Everyone in. Nobody out. We gather all the money that employers and individuals are currently paying for health care. It's not more money. It's the same money, already being spent on health care, but by pooling it, we can save 20% right off the top. Providers won't have negotiate fee schedules with all the different payers. Providers will only have to send bills, electronically, to one place. Furthermore, substantial savings accrue as the system matures. When an ER Doctor in Oregon sees a patient passing through town, he will access her electronic medical record in Iowa, resulting in, not just less expensive care, but better care. None of this is going to be accomplished until we have Public Health Authorities administering a health care system with the goal of health, financed publicly and delivered privately.
This isn't pie in the sky. Check out what the other developed countries are doing, but please don't respond with anecdotes. We have 45,000 new anecdotes every year that illuminate how real or perceived financial barriers to timely, appropriate care cause unnecessary death.
The real question is whose "system" produces the least number of unnecessary deaths and the least suffering for the dollars being spent? Yes, other countries are struggling because of limited resources, but they are dealing with the problems maturely, they are making difficult decisions, and, by recognizing that health is a human right, they are getting a healthier population for less cost.
Is access to appropriate health care a human right? If not, we can agree to disagree. If so, it is a legitimate function of our government to make sure that nobody falls through the cracks. Also, doesn't the government have a fiduciary responsibility to make sure the taxpayer is getting value for its health care dollars? Insurance company CEO's have a fiduciary responsibility to maximize profits even if it means investing large sums of money in manipulating public policy... and that's exactly what they've been doing. It's unfathomable to me that some people distrust "The United States" more than United Health Care. That may be where we end up agreeing to disagree.
In any case, the taxpayer is being ripped off, big time.
- Posted in
58 Comments so far
Show AllIt is unclear what Dr. Hochfeld means when he says that one should not respond with anecdotes regarding the success of developed countries that have universal health care. As he implies, European countries cannot say, as the U.S. does, that 45,000 of its citizens will die because they do not receive adequate health care. Hundreds of thousands of its citizens will not have to declare bankruptcy because their citizens cannot pay their medical bill which is the case in the United States. European countries cover everyone, regardless of whether they have a "pre-existing condition", something which happens all too frequently in this country.
Two aspects of single-payer that should have wide appeal are 1)the competitive boost enterpreneurs and small business owners get with single-payer, and 2) the number of additional jobs single-payer will open up for young Americans.
1) As far as providing employee medical benefits is concerned, enterpreneurs and small business owners will never be able to compete with foreign companies, large US corporations or the Federal Government as long as we have the current fragmented convoluted mess. Adopting Obamacare or any of the nebulous schemes Republicans advocate will make enterpreneurs and small businesses even less competitive, and
2) Tens of millions of older Americans are delaying or forgoing retirement solely to keep their employer-sponsored medical insurance. Single-payer would allow them to retire immediately and open family-wage jobs up to young Americans who are currently experiencing extremely high rates of unemployment.
In 2008 health care spending in the United States amounted to $2.8 Trillion dollars, or $7681.00 per person. I believe that single-payer would cut this by at least a third. The savings on paperwork alone would amount to $25 Billion dollars a year.
I don't think arguments about efficiency, health care as a "human right", a healthier population, or even 45,000 unnecessary deaths a year are going to have any impact at all on American health care policy. Americans are just too selfish to care, sorry.
If there is any hope at all for an American health care policy it will be because of the truth expressed in the last statement of this article: "the taxpayer is being ripped off, big time." This fact, driven home persistantly, will erode the stranglehold that the Privateers have on America.
Give up trying to reason with the American public. They are too goddamn stupid. Wait till they feel the pain in the pocketbooks and {duh} connect the dots at last.
gladtobeincanada: I agree, per your second paragraph, that many of these "selfish" Americans can be appealed to with the "tax-payer rip off argument." These arguments will appeal to the taxpayer revolt Tea Party folk in our midst.
However, I'd argue I bit with whether the "pain in the pocketbook" to which you refer in your last pocketbook is a pain arising from the size of the "selfish" American's tax bill. The same arguments about the absurd cost of war have not elicited much of this kind of "pain" despite the best efforts of anti-war people to bring home the costs of war to every town and every person as a per capita expense. However we might disagree, to them the cost is "worth it" because they see it as the price of preserving our "freedom," which is priceless. The real challenge is to bring home to the self-centered citizen the pain that will arise if he/she is caught in the victim's web created by the vicious "perverse incentives" of insurance companies NOT to cover health costs. What if you (God forbid) or your spouse or your child got seriously sick and you found that your family wasn't covered by "free enterprise" insurance and you had to watch that person die from lack of medical coverage? That's a hard sell for "live for the moment" folks who say let tomorrow take care of itself, but a few "anecdotes" of "people just like you" you have had that experience can do a world of good for those with any capacity to imagine themselves in unfortunate situations.
phoenix20: I agree entirely. The "live in the moment" folks can't grasp a "what if you" situation. Empathy is a largely a lost skill. Think American baseline = The Simpsons.
gladtobeincanada: I'm glad we agree on the "empathy" bit, but I don't want to give up on what I call a "hard sell." Political campaigners as well as feature journalists have learned the fine art of the "revealing anecdote" by means of which people can relate their own self-absorbed experiences with those of others. I'm not saying you can't reach Americans through their "empathy" bones, only that you have to be smart to do it---and expect some resistance.
Not everyone in the US is stupid, but I will agree a large minority, to a small majority are. And among those there are some so stupid that they will never connect the dots even when they feel the pain in their own pocketbooks.
Between some personal experiences and watching the right wing in this country I have sadly found out, in the later part of my life, that a lot of my fellow man are simply dumber than a block of granite.
For those who think you are wacko (or "too radical"), these arguments may be heard, especially if you emphasize the cost ineffiency of the system and the "perverse incentives" of insurance companies NOT to provide coverage.
From those socialized in decades of "free enterprise" concepts propagandized by the corporations (insurance and medical providers) that benefit from the status quo, I'm afraid you're still going to get a "Yeah, but" response. Yeah, you make some good points but the system you're talking about is "socialized medicine" and that really isn't the "American way," now is it?
To counter this, I believe you are going to have to cite other areas of the common welfare, like education, police and courts, transportation infrastructure, that (so far) have been (mostly) "single payer" operations by government entities. You're not going to get around the libertarian sentiment that all "government" is bad. but hard core skeptics of anything done by "the people" as opposed the free "persons" are probably lost to any rational and compassionate discussion of public policy for the benefit of the public.
Phoenix20
I have been "cit[ing] other areas of common welfare", such as the areas that you mention, on this and other sites, until I have been practically blue in the face, so to speak. In particular, I have cited Steven Hill's most excellent book Europe's Promise: Why The European Way Is The Best Hope In An Insecure Age which goes into detail into such topics as not only universal health care [which is not quite the same thing as a single payer system] but also other areas such as the environment, energy, paid sick leave, paid parental leave, paid vacation days, elder care, child care, and also:
* flexicurity which, as Hill explains, "permits relatively easy hiring and firing of workers in exchange for job training and retraining, apprenticeships for new workers, and generous financial and other workfare supports for those who lose their jobs"
* codetermination which in European countries, as Hill points out, "generally gives workers a say in their workplace and work conditions far beyond what any workers in the United States can even imagine. It acts as a barrier against CEOs playing god by having the unchecked prerogative to fire everyone, or to reduce wages, health care coverage, and pensions, at a moment's notice."
As an American who is married to a Swede says in Hill's book, if Americans actually knew how many benefits the average European receives as a result of the taxes that the [alleged] overtaxed European pays in those countries, the end result would be rioting in the streets of these United States [which is probably long overdue in coming].
I think that it is also instructive to cite a passage in Europe's Promise which demonstrates just one of the many differences between how many of the European countries of Europe dealt with the economic crisis of 2008-2009 compared to the anemic effort put forth by the U.S.
* "In Germany, for example, instead of laying off some employees, many business began cutting back the hours of ALL their employees so that the pain was spread around to more workers. Then the German government made up roughly two-thirds of lost wages out of a special fund filled in good times through payroll deductions and company contributions, a program known as Kurzarbeit, which translates as 'short work.' Over a million workers, including nearly seventy thousand employees of the automaker Daimler, were placed on short-hour status. While that meant a lot of people with slightly lower incomes, on the positive side it meant those employees still had jobs and money in their pockets that would help maintain consumer spending at a sufficient pace. It also meant that the workforce would mostly remain intact, and employers would not lose their skilled workers whom they had spent so much to train."
* Contrast this with what happened in the United States, where, "instead of cutting back all workers' hours a bit and maintaining the workforce, businesses began laying off millions of employees. For many months in a row over six hundred thousand workers lost their jobs, at one point resulting in the biggest three-month drop since immediately after the end of World War II... Over three million jobs were lost in 2008 alone, with millions more workers getting their pink slips in 2009." And yet so many Americans still continue to think of Europe in disparaging terms with that dreaded word socialism rearing its ugly head [though Hill refers to the economies in Europe as examples of social capitalism]. The March 2010 issue of The American Prospect also does a nice job in talking about this in their article entitled Germany's Economic Engine: Why the German model has held up even as so many other economies have collapsed.
erroll: thanks for your inspiring posts reminding (informing) us that there are "other ways" of more social if not socialized living---even in the capitalism-corrupted countries of Western Europe. Where can we get ourselves some of that Kurzarbeit?
Socialism. I find myself bemused by the military in general which is one of the most rabid rightwing organizations in existence, yet the military is a perfect example of a socialist organization. EVERYTHING military is paid for by taxpayers. How much more socialist can you get?
No it isn't,it is corporatist or fascist.No majority of taxpayers voted for the four wars we are waging.No socialist mandate here .This is not legal war by mandate or referendum.The majority want health care and don't want war.
walk in healthy peace
Joe Sestak, liberal Democrat and primary challenger to Arlen specter says,"I believe that privately funded Health Insurance is the best mechanism to allocate our Health Care Resources." Joe is a smart guy and I don't even think he really believes it or could defend this position except as Dr. Hochfield says, "anecdotely." Why does he say this in front of Democratic partisans--because he believes that he can get votes by professing his faith in the free market. The least we as Democrats can do is disabuse him and those of his ilk of their notions about what we as Democrats want. And if the Democratic party will not listen to us, and I know that they will not listen in Pennsylvania's 4th Congressional District, it is time to leave them and go our own way. To stand for what we believe in. For me this means going Green. I will leave Jason Altmire and Joe Sestak to their vain attempts to win the conservative Democrats and "independent vote" with their free market rhetoric. Good luck with that. After the election I'll ask you guys how wel it is working out for you.. Just as Sarah Palin does.
I find it disconcerting that no one seems to recognize the further savings we will benefit from under a single payer system. For instance, you pay a medical charge on your car insurance. With single payer, that will no longer be necessary. It will be covered under single payer. What about your home owner's insurance? There is a medical charge there, too. If we had single payer, it would not be necessary, either. What about workman's comp? Also, if we have single payer, there will be NO NEED for paying AGAIN for that "coverage" as well. Right there, THREE sets of savings. I have no doubt that there are probably a dozen more places where we are being charged for the SAME thing again and again. It's a hell of a scam, and one that we are getting screwed by every day. No wonder they won't mention it. If the people knew how many times they are paying for the same thing, they would be up in arms with the pitchforks and torches.
That's why I bring it up every chance I get.
Don't forget about savings in medical law suits against hospitals and doctors. There would be no need to sue for medical expenses. Think of it as a form of "tort reform". You would think that all these savings would make Republicans happy but na, they are blinded by the dogma of everything has to be privatized.
Sioux Rose
Tom: I hadn't thought of that, either; but I'll bet the trial attorneys won't like it. The ambulance chasers are accustomed to making big bucks in major physical injury cases. Still, the savings would be grand... thanks for thinking OUT of the box here.
Sioux Rose
WJM: Thank you for pointing those savings areas out. I had never considered those benefits, atop the already sound ones! Adds more fuel to a just and economically prudent argument in favor of single payer.
Hochfeld convinced me, but then I was already convinced, and have been for 20 years or so! These arguments are preaching to the choir. What is needed is how to reach bubba and bubba does not use reason - he uses emotion, which the right so effectively uses, from Reagan on down. Check out Rush Limbaugh (but not too soon after eating). He and the other right wing buffoons are very effective at making the stump-broke lumpen like what they get. We need to attack their strength with scorn and ridicule and not worry about finesse.
The suggested posted in this thread are all excellent. But I wish Dr. Hochfeld had made of a list of SIMPLE talking points, his statements have a definite wonkish character. Good points but hard to get across to the public.
Gary
“Simplicity is the ultimate sophistication.”
-- Leonardo da Vinci
The lack of conciseness is a problem that many on the left seem to always have.
See this relevant clip from Manufacturing Consent:
http://www.youtube.com/watch?v=3cceC3DeFcY
It is tough to re-write the concept of Health Care in the USA in only a few words. There are decades of propaganda to overcome.
Not true! HR 676 is concise, comprehensive and eloquently written. If more Americans were made aware of the existence of this bill, and took the few minutes it takes to read through it, they would DEMAND that Congress pass it immediately! And it would surely go down in history as one of the finest pieces of legislation ever conceived.
Read it. It will bring tears to your eyes. I guarantee it.
http://www.govtrack.us/congress/billtext.xpd?bill=h111-676
Single payer will NEVER come about in this country because two rules apply:
1) The "golden rule"--them that as the gold makes the rules.
2) Follow the money
When single payer rears its ugly head, a lobbyist is dispatched to DC saying, "We want this law killed." The Congressman says, "okay, but it'll cost you a $250,000 'contribution' to my reelection campaign." The lobbyist pulls out a checkbook and asks, "Who do I make the check out to?" Repeat 535 times for each HR and senator and you have a recipe for no single payer bill never making it through both Houses.
That's reality at its ugliest, kiddies.
"What do we say to our more conservative friends, who genuinely think that the Single Payer solution to our health care crisis would be a disaster?"
- Many of whom are Democrat. I've tried making the arguments mentioned in the article to friends and family. They cover their ears, they rationalize it can't be done, or throw up their hands and say its all politics and their vote doesn't count. What a great country we live in thanks to our MSM propaganda network and declining education system in which we give up on students in failing schools.
I say single-payer efficaciously covers mental illness, too!
Excuse me, but seniors have been paying into the Medicare system their whole life. Don't make out like it's your dollar paying for the breathing machine or wheel chair.
There is a form you can turn in to the SS people if you want to be exempt, it's always been there. But good luck with that one. You might want to look at your W2 and see how much you pay in to your own ss and medicare and ask the gov't, where will mine be?
If we held doctors accountable for maintaining health and wellness instead of fixing the damages by the chemical/food/alcohol/tobacco/medical/pharm industries-who pay nothing for their travesties BTW-we might actually help people, new concept, and correct the direction of all of this.
One day we need to say as Australia Labor did in the 1972 election "It's time" and put through our equivalent of Medibank as Labor referred to its program which provided health care for all in that country after Labor won that election and pulls all its troops out of Vietnam along with a lot of other worthy things including provided for land rights for indigenous people.
That was 37 years ago, and it's time for us today.
1972 was the same year the USA reelected a GOP president over George McGovern by a huge landslide, and we've definitely paid for that error on our parts. We have a chance to to get it right in the future. We will need to build movements for health care for all, for reversing the militarization of our foreign policy, and for so many other things and synthesizing all this into a political program to push ahead for, It took Australian Labor quit some time to come up with the same in their case, but it was worth it. We have to be as determined.
AD
Let us not forget the rest of the story from 1972 Australia.
Gough Whitlam and his Labor Party was elected in 1972, but then sacked in 1975 by the Governor-General following a protracted constitutional crisis where every move by the Government was blocked by the then "Party of No", the Liberal-Country Party.
For those not used to Australian political party affiliations, the Labor Party was left of centrist, and the Liberal-Country Party was far-right of centrist (think GOP).
There are psychological studies that show how when people are shown conclusive evidence that their most cherished beliefs or opinions are inescapably WRONG, they cling even more tenaciously and fanatically to those false beliefs. Creationists are a case in point. Iraq invasion supporters are another, as are global warming deniers. The tea baggers who have organized against any semblance of single-payer won't listen to Hochfeld's wonkish arguments any more than creationists, Bush believers in WMD, or climate change deniers will listen to countervailing arguments that demolish their idiotic beliefs, which they will desperately cling to for pathetic psychological security, which trumps truth every time.
John Kenneth Galbraith once said the given the choice between changing one's mind and proving that it needn't be changed, most people sit down and work on the proof.
Anthem just sent me its annual Valentine: the like-clockwork arbitrary increase in my monthly premium.
The last 4 years, every year, my cost has gone up a little more than a $100./per month. That works out to about 30-35% increase; I dream to think that my income could increase by that margin every year. Fat chance.
Anthem's "greeting card" comes with not even a month's warning of the increase---in fact, they choose February to make these "announcements" because it's the shortest month, which leaves me with even less time to find an alternative. In short, it's the mafia playbook in action, complete with the proverbial gun held to my head, and an "offer I can't refuse."
Their "gift" to me this year tops all other previous increases: as of March 1st, my premium will go from $776 to $1,074 per month (that's right a whopping $298). They also include the following clause in their letter: "Anthem Blue Cross will usually adjust rates every 12 months; however, we may adjust more frequently..." That's what I call Cadillac balls!! But hey, welcome to the world of proto-fascist Supreme Court justices, unlimited greed, corruption, and sociopathic behavior.
Denial of health care or inacce$$ability to it = genocide.
The neocon agenda is merely a plan to deal with the planet's diminishing resources + overpopulation. They have decided that a certain strata of the population (about 25%) needs to be elliminated, starting with the elderly (55+), the working poor, the weak, and even a sliver of the struggling "middle class." In short, as in every junk-consuming culture, "disposability" and "obsolescence" eventually extends to human beings. Add to these designated disposables anyone who doesn't fall in line with the plan, anyone who questions, who resists, or who is merely too intelligent. (Remember Cambodia?)
Of course, the right wing slavemasters won't resort to using gas chambers; they have more subtle, invisible ways to carry out the program. Everything is already in place, including a legal system to justify its abuses.
I have a different experience with conservatives and single payer to what the author wrote. Single payer is supported by more conservatives when discussed as actually saving the taxpayers more money and it does that. The fight for single payer never got off to a good start and the politicians by their own nature refused to put it on the table. Someone once told me that single payer is a socialist idea and that came from a Green Party voter. I think that the reason single payer failed was that everyone agreed on the wrong premise that it's exclusively socialist whereas there could have been united support despite the differences. Liberals like it because it means health care for everyone. Conservatives like it because it saves the taxpayers money. If you are going to talk to a liberal about single payer, then give the advantages from a liberal point of view whereas if you are going to talk to a conservative about single payer, then give them the advantages from a conservative point of view.
Thanks for the tips but already been there done that. Some people never listen. 10 years from now, we'll be in the same hell hole on health care we're in today.
Why should we be trying to convince the ideological discredited conservatives in the first place?
At this point, shouldn't THEY be the ones trying to convince US they're not wacko?
If you ask me, progressives framing the issue or shaping the arguments to convince conservatives is part of the problem.
Convincing people of the validity of singlepayer is not the problem.
Power is the problem:
Conservatives and corporate "progressives" have it--people fighting for singlepayer don't.
So convincing people to ACT collectively to correct that huge inbalance of power is the problem.
Solve that and we won't have to worry about what the conservatives may or may not be thinking.
If only single payer sounded so good like being an NRA member. Let's amend the Constitution to declare the right to bear health care ?
-"Let's amend the Constitution to declare the right to bear health care ?"
Shawn, aren't you folks supposed to enjoy "LIFE, liberty, persuit of...", emphesis on life? ...oh right that is the declaration of independance isn't it. It doesn't have any legal force? It's dead on arrival (DOI)?
We don't have the DOI (the declaration), we don't need one, but we do have a good universal healthcare system. Not having to go bankrupt if I get sick, sounds way better to me than being an NRA member.
Changing your constitution, your constitution that hasn't been changed in a 'coons age, your constitution that your Democrat-confirmed supreme court judges will reinterpret anyway their corporate mentors want them to, anyway...
That would be tough. Baby steps Shawn, baby steps. Why not start by supporting people that have a history of working for the betterment of America's pathetic death-trap of a healthcare non-system?
Did you hear about that Dr. Flowers that Obama had arrested on his white house door-step? She was trying to answer the US president's (supposedly) sincere question, posed in the US "state of the union"...Obama asked: does anyone have any better ideas (better than the massive give-away to the insurance/drug companies) he has planned. She was trying to tell him about single-payer, one of the best systems, used successfully around the world.
I'm no NRA member but I come across them alot.
If only an amendment to the Constitution could pass, Flowers wouldn't have been pushed into trouble. 3/4 of the states could approve of it but I know it's getting harder to pressure 1/3 of Congress to approve of it. The required 2/3 looks tougher.
I still love my country man !
-"I still love my country man !"
Americans say that a lot, don't they? Not quite sure what they mean. I certainly don't love ALL the people in my country. I don't love the politicians. They either do what I want them to do, or I replace them...no love lost.
Never argue with a fool. There is no cure for stupidity, and the dummy you would like to convince thinks his only chance to appear wise is to demonstrate his consistency (a trait which Emerson called the hobgoblin of little minds).
You will discover the worst parts of yourself coming to the surface---not a pretty picture.
Third parties can't tell which of you is the fool.
"We have a For-Profit Sick Care Non-System"
The author is very clear that this system is rotten from top to bottom. He is wrong that the physicians' part is another discussion for another day. The physicians and the FDA are at the heart of this mess. Fix them first, the costs over time will plummet. Then the financial benefits of single payer can be realized, otherwise you will be sending the US taxpayer to the chop shop.
Dr Hochfeld is an ER doctor, almost the only part of the medical system that is effective and useful so he may have a different perspective on his colleagues.
I don't think single payer is wacko, I think it's putting the cart before the horse.
From the author...
The reason it is part of another discussion is because of its complexity. At the heart of it is the concept that we have unlimited demand for limited resources. It's about physicians being responsible ONLY for the well being of the patient in front of him or her, not the well being of the community. There's a difference between taking care of individual trees and taking care of the forest. It's about "the flat of the curve" medicine that yields diminishingly small improvements in outcome for increasingly large investments.
Physicians have morphed from being responsible for the health of the community to being technicians who get paid well to invoke technology to care for individuals. We are caring beings who are responding to perverse incentives in predictably human ways.
We need to systematically deal with the perverse incentives. It can only be done by, first, having a system, then bringing common sense into the reimbursement mechanism. Indeed, it's a very long conversation.
As for the FDA, it's absurd that "they" are mandated by Congress to approve new drugs that are more effective than placebo without first proving that they are more effective than existing, less expensive medication. Don't blame the FDA. Blame Congress and it's Puppetmasters (Big Pharma) who are making the rules.
Good sound logical talking points. The only problem is that no one will listen.
Not the Republicans, they just yell Socialism, at the behest of the Tea Party intellectuals.
Not the Democratic Senators, they just yell socialism, at the behest of their corporate owners.
Not the greedy, they just yell socialism at the insistence of their "financial advisers"
Someone has to teach them akll that socialism is good.
The best argument against single-payer (and it persuaded me, I was in favor of sp beforehand)is by Ezekiel Emanuel in his excellent book Healthcare Guaranteed. He sums up the case against single payer at Boston Review (http://www.bostonreview.net/BR30.6/emanuelfuchs.php):
Single-payer plans are not only bad politics; they are bad policy. First, a single-payer system, like Medicare and the Canadian provincial system, would institutionalize fee-for-service reimbursement for a substantial portion of the delivery system. Fee-for-service is terribly inefficient; even with single-payer, it leads to duplication of services and tremendous problems with the continuity and coordination of care. Fee-for-service also provides a huge financial incentive for doctors to order tests and procedures and no financial incentive to, say, refer terminally ill patients to hospice. Second, creating a public system that guarantees comprehensive benefits while cutting out the private market invites financial disaster.Single-payer systems that promise comprehensive benefits confront a dilemma: either provide every service at huge and growing costs or ration services by queuing.
This is absolute nonsense.
Single payer is merely a method of payment, along with the funding mechanism and does not necessarily entail fee-for-service. Agreed that the abuse of fee-for-service is behind much of the excess health care costs in this country but it is controllable, such as by relying mostly on salaried health care providers, such as the Mayo Clinic or Kaiser (with 7 million members already a single-care provider and an outstanding one at that).
Yeah such bad policy - I've really enjoyed watching news reports of all those single payer countries arguing over dumping their systems in favor of one like ours.
oh, wait.
Your argument is a false dilemma. The choice is not between either a single-payer plan or our current system. France, no.1 in the world per WHO rating, does not have a single payer system, nor does Germany or a number of countries with terrific systems. I would advise you to read T.R. Reid's book on health care.
As the brother of Rahm Emanuel, staunch opponent of Medicare for All, this doesn't surprise me. I haven't looked it up, but I would bet that both Emanuels are darlings of the Medical Industrial Complex. And, as others have said, not one country with health care for all -- and health care as a right -- is clamoring to get rid of their system. On the contrary, they are working for ways to make their systems better.